title: The effect of medicated chewing gums on oral health in frail older people: a 1-year clinical trial.
abstract: OBJECTIVE
  To determine the effects of a medicated chewing gum on the oral health of frail older people.
  
  
  METHODS
  A controlled, double-blind trial using three groups based on random allocation of residential homes.
  
  
  METHODS
  Sixteen residential homes in West Hertfordshire, England.
  
  
  METHODS
  One hundred eleven dentate subjects aged 60 and older who completed the 12-month study.
  
  
  METHODS
  Subjects were assigned to a chlorhexidine acetate/xylitol gum (ACHX) group, a xylitol gum (X) group, or a no-gum (N) group. Subjects in the gum groups chewed two pellets for 15 minutes twice daily for 12 months.
  
  
  METHODS
  Primary outcome measures were salivary flow rate, denture debris score, prevalence of angular cheilitis, and denture stomatitis; secondary outcome measures were salivary levels of caries-associated microorganisms. A single examiner, who was blinded to group allocation, made all measurements at baseline before gum usage and at subsequent examinations after 3, 6, 9, and 12 months. Separate analyses were performed for subjects with dentures.
  
  
  RESULTS
  Subjects in the three groups were similar in most of their baseline characteristics. The stimulated whole saliva flow rate +/- standard deviation increased significantly for the ACHX (1.4 +/- 0.7 mL/min) and X (1.6 +/- 0.9 mL/min) groups (P <.01) over baseline (ACHX = 0.9 +/- 0.6 mL/min, X = 0.8 +/- 0.6 mL/min) and N group levels (0.6 +/- 0.9 mL/min). The levels of mutans streptococci, lactobacilli, and yeasts significantly increased (P <.05) in the X and N groups. Denture debris status was significantly lower in the ACHX and X groups than at baseline or in the N group (P <.01). The reductions of 91% and 75% in denture stomatitis and angular cheilitis prevalence, respectively, that occurred in the ACHX group were significantly greater (P <.01) than the reductions in the X group (denture stomatitis 62%, angular cheilitis 43%). Prevalence of denture stomatitis and angular cheilitis were not significantly changed in the N group.
  
  
  CONCLUSIONS
  The use of a medicated chewing gum significantly improved oral health in older occupants of residential homes. Chewing gums should be considered as a potential adjunct to other oral hygiene procedures in older subjects.
authors.affiliation: Dental Caries Research Group, Guy's, King's and St Thomas's Dental Institute, London, United Kingdom.
authors.forename: Debra
authors.initials: D
authors.lastname: Simons
authors.forename: Susan R
authors.initials: SR
authors.lastname: Brailsford
authors.forename: Edwina A M
authors.initials: EA
authors.lastname: Kidd
authors.forename: David
authors.initials: D
authors.lastname: Beighton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002638:Chewing Gum; D002710:Chlorhexidine; D004311:Double-Blind Method; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D013997:Time Factors; D014993:Xylitol
chemical_list: D002638:Chewing Gum; D002710:Chlorhexidine; D014993:Xylitol