Professor advises against the recommendation of sugarless gum

14. may 2009  
Filed in News

The EU experts have recognized chewing gum with xylitol as a preventive against dental caries. But now, warns a professor of dentistry in Copenhagen against overfortolke the message that sugar-free gum with xylitol reduces risk of tooth decay in children.

A group of experts from the The European Food Safety Authority has determined that the xylitoltyggegummi reduces the risk of cariesudvikling in children. And thus, there should be scientific evidence to say that sugar-free chewing gum containing polyols (xylitol and sorbitol), decreases the risk of having gaps in the teeth.

But now warns professor Svante Twetman from the Dentistry in Copenhagen, as Tandlægebladet have asked, against an over-interpretation of the message that sugar-free gum with xylitol reduces risk of tooth decay in children, and the professor does not think that we should recommend to the Danish children to chew gum to avoid cavities in the teeth.

Industrial interests and insufficient documentation
Svante Twetman points out that the EU experts ' conclusion is based on the reports, which in many cases is initiated on the basis of industrial interests. And that the studies that underlie this conclusion are of highly varying quality, scientifically speaking. Bl.a. is previous work and field studies from Latin america included, and it is the study, which, according to Twetman lacks validity for Danish conditions.

Professor Svante Twetman believe, therefore, that the documentation for xylitols preventive effect in relation to the holes in the teeth is insufficient. And he misses in addition, a health economic evaluation of chewing gum against the holes. A careful calculation shows that the prevention of just a single hole will require 4.000 – 5.000 pieces of chewing gum. And since the risk of cavities in the teeth in Danish children is already very low, there is not a need to mitigate this risk with xylitoltilskud.

No recommendations with lack of knowledge
Svante Twetman will not, however, exclude the possibility that sugar-free chewing gum with xylitol and sorbitol can have a beneficial effect on tandsundheden. It stimulates the spytudviklingen, 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 complement to the treatment, one usually uses in order to stop the development of a hole in a tooth in children and young people with a high risk of tooth decay, for example fluorbehandling and varnishing. But he emphasizes at the same time, that as long as there are gaps in our knowledge of e.g. optimal dosage, there may not be a general recommendation of chewing gum with xylitol and sorbitol.

The entire article can be read in Tandlægebladet no. 6 2009 or on