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Chew sugar-free gum – The evidence shows it can be effective in helping to reduce dental cavities 

The pressures on our dental system are widely reported. With no clear end to the COVID-19 pandemic, many people are avoiding the dentist for routine check-ups and teeth cleaning. For their part, oral healthcare teams are having to deep-clean surgeries after each visit and leave up to 60 minutes between procedures.

All this means that dentists and oral health professionals can see fewer patients. According to the British Dental Association, 19 million fewer dental appointments were taken up this year (40 million in 2019, 21 million in 2020). During the first lockdown, many NHS dental services were forced to close under the government restrictions. For a while, NHS dental services ran at only 25% capacity, despite over 500 urgent dental care centres being opened around the country for access to emergency dental care.

So what can people do to prevent oral & dental problems emerging while we’re all cooped up at home? There are obvious and less obvious answers.

A rigorous teeth-cleaning regime

The first answer is to supervise a rigorous teeth-cleaning regime for all the family, especially for children.

Surveys undertaken by the Oral Health Foundation suggest we may have got worse at ‘home care’ (basic tooth brushing and flossing) during the pandemic. Rather than using the additional time at home to improve home care oral health regimes, people appear to be less focused on brushing and cleaning their teeth.

Younger children will be the worst affected by this. The protective enamel is thinner and the pulp (nerve tissue) proportionately larger, so problems occur and progress quicker in children.

Sugar-free gum

The second answer is perhaps less intuitive.

From a young age we are told that things that taste good must be bad for us. Fizzy drinks destroy teeth due to their acidity and sugar content, whilst also contributing to diabetes and obesity in poorly controlled diets. Sweets do the same. So, it’s counter-intuitive to think that chewing sugar-free gum periodically might actually be the right thing to do. But, for adults, it might just be.

As long as the gum is sugar-free, (an important qualification!), it can be an effective and simple way for adults to improve their basic dental health. I say ‘for adults’ because the advice does not extend to young children for whom chewing gum could be a choking hazard. Even older children don’t always understand they shouldn’t swallow chewing gum.

This advice is based upon a review of published research which I led at the Faculty of Dentistry, Oral & Craniofacial Sciences, at King’s College London, where I am Professor of Cariology & Operative Dentistry as well as an NHS Consultant in Restorative Dentistry. The data analysed indicated that people who regularly chew sugar-free gum develop 28% fewer cavities than those who do not. The equivalent figure for fluoride toothpastes and other supplements was 24%. 

This is because chewing sugar-free gum picks up food particles on the surfaces of teeth so helping to clean your mouth as you chew. It encourages an increased saliva flow, helps neutralise dental plaque acids and can discourage over-consumption of sugary snacks — all big positives for improved oral and general health. Studies show that saliva flow is boosted approximately 2.6 times while chewing sugar-free gum. The chemical constituents of saliva enable remineralisation / strengthening of the tooth enamel. For this reason, chewing sugar-free gum for twenty minutes after a meal can be an effective supplemental activity to help cut down on cavities developing.

The results of our review should serve as an important reminder to oral healthcare professionals and policymakers about the important role sugar-free gum can play in reducing the economic, societal and healthcare burden created by poor oral health. The major dental associations around the world, including the World Dental Federation, the American Dental Association, the Australian Dental Association and the European Food Safety Agency, are already in agreement on the benefits of sugar-free gum.

But, more importantly, the results should inform our own decay-prevention strategies while we stay at home during lockdown. Regular chewing after meals with a sugar-free gum for 20 minutes, together with careful tooth brushing with a fluoride-containing toothpaste and flossing, for at least two minutes, twice a day, all can help prevent tooth decay while we’re waiting for appointments with our dentists and oral healthcare teams and also in the long-term future.