The potential of dental-protective chewing gum in oral health interventions.
BACKGROUND
The authors provide an overview of chewing gum as a delivery vehicle for dental-protective agents, highlighting xylitol and its potential application in caries-prevention programs for children.


METHODS
The authors reviewed selected clinical investigations and previous reviews associated with chewing gum containing substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol and their effects on reducing caries. They searched the MEDLINE database by using the key words "dental caries," "oral health," "calcium," "bicarbonate," "carbamide," "chlorhexidine," "fluoride" and "xylitol."


RESULTS
Chewing gum is being used as a delivery vehicle for substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol to improve oral health and reduce caries. These substances exhibit properties that are protective of the oral environment and mediate common oral diseases. The debate for advocating xylitol use in caries prevention is advancing; however, chewing gum use by young schoolchildren in the United States is hindered by choking hazard concerns and lack of specific xylitol dosing recommendations.


CONCLUSIONS
The use of chewing gum containing dental-protective substances, particularly xylitol, in caries-prevention programs can reduce the tooth decay epidemic. Chewing gum use by children in the school setting should be reconsidered.
Ly
Kiet A
KA
Department of Dental Public Health Sciences, Northwest/Alaska Center to Reduce Oral Health Disparities, University of Washington, Seatle, Washington 98195-7475, USA. kietaly@u.washington.edu
Milgrom
Peter
P
Rothen
Marilynn
M
D000468:Alkalies / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D002327:Cariostatic Agents / Q000008:administration & dosage*; D002364:Caseins / Q000008:administration & dosage; D002638:Chewing Gum / Q000032:analysis; D002648:Child; D002710:Chlorhexidine / Q000008:administration & dosage; D003731:Dental Caries / Q000517:prevention & control*; D003773:Dental Plaque / Q000628:therapy*; D004337:Drug Carriers; D005459:Fluorides / Q000008:administration & dosage; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D013295:Streptococcus mutans / Q000187:drug effects; D013402:Sugar Alcohols / Q000008:administration & dosage
D000468:Alkalies; D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D002364:Caseins; D002638:Chewing Gum; D004337:Drug Carriers; D013402:Sugar Alcohols; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D005459:Fluorides; D002710:Chlorhexidine