title: Potential benefits of chewing gum for the delivery of oral therapeutics and its possible role in oral healthcare.
abstract: BACKGROUND
  Over the years, chewing gum has developed from a candy towards an oral health-promoting nutraceutical. This review summarizes evidence for the oral health benefits of chewing gum, emphasizing identification of active ingredients in gum that facilitate prevention and removal of oral biofilm.
  
  
  METHODS
  Chewing of sugar-free gum yields oral health benefits that include clearance of food debris, reduction in oral dryness, increase of biofilm pH and remineralization of enamel. These basic effects of chewing gum are attributed to increased mastication and salivation. Active ingredients incorporated in chewing gums aim to expand these effects to inhibition of extrinsic tooth stain and calculus formation, enhanced enamel remineralization, reduction of the numbers of bacteria in saliva and amount of oral biofilm, neutralization of biofilm pH, and reduction of volatile sulfur compounds.
  
  
  CONCLUSIONS
  Evidence for oral-health benefits of chewing gum additives is hard to obtain due to their relatively low concentrations and rapid wash-out. Clinical effects of gum additives are overshadowed by effects of increased mastication and salivation due to the chewing of gum and require daily chewing of gum for prolonged periods of time. Future studies on active ingredients should focus on specifically targeting pathogenic bacteria, whilst leaving the healthy microbiome unaffected.
authors.affiliation: a Department of Biomedical Engineering , University of Groningen and University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Wessel
authors.affiliation: a Department of Biomedical Engineering , University of Groningen and University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Henny C
authors.initials: HC
authors.lastname: van der Mei
authors.affiliation: b William Wrigley, Jr. Company , Chicago , IL , USA.
authors.forename: Amarnath
authors.initials: A
authors.lastname: Maitra
authors.affiliation: b William Wrigley, Jr. Company , Chicago , IL , USA.
authors.forename: Michael W J
authors.initials: MW
authors.lastname: Dodds
authors.affiliation: a Department of Biomedical Engineering , University of Groningen and University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Busscher
mesh_terms: D001419:Bacteria / Q000187:drug effects; D002638:Chewing Gum; D016503:Drug Delivery Systems; D006801:Humans; D012463:Saliva / Q000378:metabolism; D012472:Salivation
chemical_list: D002638:Chewing Gum
keywords: Bacteria; chewing gum; oral biofilm; oral health; oral microbiology; saliva