title: Crossover clinical investigation of a whitening chewing gum for inhibiting dental stain formation in conjunction with tooth brushing.
abstract: OBJECTIVE
  The purpose of this clinical investigation was to evaluate the effectiveness of a marketed whitening chewing gum compared to a no-gum control in preventing the formation of extrinsic stains on the teeth of stain-forming subjects when chewed over a 12-week period of regular unsupervised use in conjunction with daily tooth brushing.
  
  
  METHODS
  This was a single-center, examiner-blind, randomized, 12-week crossover clinical trial. Stain-forming (after smoking or drinking coffee or tea) adults, starting with a stain-free baseline, either chewed the test gum (Orbit White) unsupervised four times per day, 15 minutes/chew, or used no gum along with daily brushing with a commercially available toothbrush and dentifrice for 12 weeks. At the crossover, all procedures were repeated with subjects assigned the opposite treatment. Extrinsic stain was measured at six and 12 weeks by both the Lobene Stain Index (LSI) and the Modified Lobene Stain Index (MLSI) using separate experienced examiners.
  
  
  RESULTS
  After 12 weeks, LSI stain scores showed a significant 25% reduction (p = 0.0008) in new stain formation for subjects using the test chewing gum along with tooth brushing versus tooth brushing alone (no-gum control). The corresponding MLSI stain scores demonstrated a 36% reduction (p < 0.0001) in the formation of extrinsic stain on the teeth.
  
  
  CONCLUSIONS
  The overall findings of this clinical study demonstrated that regular use of Orbit White chewing gum, soon after smoking or drinking coffee or tea, will supplement daily tooth brushing in preventing unsightly stains from forming on the anterior teeth compared to brushing alone.
authors.forename: Jeffery L
authors.initials: JL
authors.lastname: Milleman
authors.forename: Kimberly R
authors.initials: KR
authors.lastname: Milleman
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Kleber
authors.forename: Howard M
authors.initials: HM
authors.lastname: Proskin
authors.forename: Michael
authors.initials: M
authors.lastname: Dodds
authors.forename: Michael
authors.initials: M
authors.lastname: Kelley
authors.forename: Lilian
authors.initials: L
authors.lastname: Ramirez
mesh_terms: D000328:Adult; D002638:Chewing Gum; D003069:Coffee / Q000009:adverse effects; D018592:Cross-Over Studies; D003802:Dentifrices / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D012907:Smoking / Q000009:adverse effects; D013662:Tea / Q000009:adverse effects; D014075:Tooth Discoloration / Q000209:etiology / Q000628:therapy*; D014099:Toothbrushing; D016896:Treatment Outcome
chemical_list: D002638:Chewing Gum; D003069:Coffee; D003802:Dentifrices; D013662:Tea