Professor advises against the recommendation of sugarless gum

EU experts have recognized chewing gum with xylitol as a preventive against caries. But now, warns a professor from the School of Dentistry in Copenhagen against over-interpretation of the message that sugarless gum with xylitol reduces the risk of tooth decay in children.

A group of experts from the European Food Safety Authority has found that xylitol chewing gum reduces the risk of cariesudvikling in children. And thus there would be scientific evidence to say that sugar-free gum containing polyols (xylitol and sorbitol), reduces the risk of getting cavities.

But now, warns Professor Svante Twetman from the School of Dentistry in Copenhagen, which Tandlægebladet have asked for an interpretation of the message that sugarless gum with xylitol reduces the risk of tooth decay in children, and the professor does not believe that we should recommend the Danish children chewing gum to prevent tooth decay.

Industrial interests and inadequate documentation
Svante Twetman points out that the EU experts' conclusion is based on reports that in many cases have been initiated on the basis of industrial interests. And that the studies underlying this conclusion is of most varied quality scientifically. Among other things, the previous work and field studies from Latin America included, and it is studies of Twetman lacks validity for Danish conditions.

Professor Svante Twetman therefore believe that the evidence of xylitol's preventive effect against dental caries is inadequate. And he also lacks a health economic evaluation of chewing gum from holes. A careful calculation shows that prevention of even a single hole will require 4,000 to 5,000 pieces of gum. And since the risk of tooth decay among Danish children are already very low, there is a need to reduce this risk with xylitoltilskud.

No recommendations lack of knowledge
Svante Twetman will not rule out that sugar free gum with xylitol and sorbitol may have a beneficial effect on dental health. It stimulates saliva development and it can not be excluded that xylitol and sorbitol can affect the oral environment in a positive direction.

Svante Twetman suggest it as a possible adjunct to the treatment that you normally use to stop the development of a hole in a tooth in children and adolescents with high risk of tooth decay, such as fluoride treatment, and painting. But he also stresses that as long as there are gaps in our knowledge of such optimal dose can be given a general recommendation of chewing gum with xylitol and sorbitol.

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The full article can be read in Tandlægebladet No. 6 2009 or www.tandlaegebladet.dk

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