title: Remineralization of early caries by chewing sugar-free gum: a clinical study using quantitative light-induced fluorescence.
abstract: OBJECTIVE
  To determine whether sugar-free gum can provide remineralization and caries control of active enamel caries lesions compared to baseline (before gum chewing) and to a no-gum group, following daily chewing for 12 weeks by school children; to determine whether chewing frequency can affect the extent of remineralization.
  
  
  METHODS
  A pragmatic cluster-randomized controlled clinical trial with schools as the unit of randomization was employed. Three schools in Chengdu, PR China comprised the clusters. The study was approved by the Internal Review Board of Sichuan University. 177 school children, 8-13 years old, with at least one visible white-spot lesion were enrolled in the study. Each of the three clusters was randomly assigned to one of three groups: (1) no gum; (2) chew 2 pieces of sugar-free gum for 20 minutes, 3x per day; (3) chew 2 pieces of sugar-free gum for 12 minutes, 5x per day. White-spot lesions were examined by quantitative light-induced fluorescence (QLF) at baseline and after 4, 8, and 12 weeks of treatment.
  
  
  RESULTS
  155 subjects completed the study. Of them, the mean values of fluorescence loss at baseline were 9.52, 9.83 and 9.17 for no-gum group, 3x per day group and 5x per day group, respectively. For the area, the mean values at baseline were 2.52, 2.61 and 2.57 mm2 for no-gum group, 3x per day group and 5x per day group, respectively. For AQ, the mean values at baseline were -27.91, -28.29 and -29.67 for no-gum group, 3x per day group and 5x per day group, respectively. To adjust for differences in groups at baseline, ANCOVA was used. After 12-weeks, for all QLF metrics, the absolute values of 5x per day group were the lowest and the no gum group was the highest; the differences among three groups were statistically significant (P < 0.05). For AQ, which was accepted as the most useful metrics of QLF system, the adjusted mean values at 12 weeks were -26.35, -19.81 and -17.58 for no-gum group, 3x per day group and 5x per day group, respectively. There were significant differences between groups.
authors.forename: Ying
authors.initials: Y
authors.lastname: Dong
authors.forename: Wei
authors.initials: W
authors.lastname: Yin
authors.forename: Deyu
authors.initials: D
authors.lastname: Hu
authors.forename: Ximu
authors.initials: X
authors.lastname: Zhang
authors.forename: Lily
authors.initials: L
authors.lastname: Xu
authors.forename: W J
authors.initials: WJ
authors.lastname: Dodds
authors.forename: Minmin
authors.initials: M
authors.lastname: Tian
mesh_terms: D002638:Chewing Gum; D005260:Female; D005453:Fluorescence; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D064792:Pragmatic Clinical Trials as Topic; D014089:Tooth Remineralization
chemical_list: D002638:Chewing Gum