Chewing gum is a favorite snack among millions of teenagers and young adults worldwide. It brings relaxation, improves focus and work performance. Also, it has some health benefits for the treatment and prevention of various diseases—medications added to the gums act as an alternative drug delivery system.
These therapeutic gums have been used for problems such as peptic ulcers, upper digestive tract cancer, and oral candidiasis. They also help to relieve the symptoms of dry mouth (xerostomia), Parkinsonism, tooth sensitivity after bleaching, cavity prevention, and oral malodor. Moreover, these gums maintain oral health, relieve stress, and aid in weight loss.
In this blog, I will explain the composition and types of chewing gum, how medicated or sugar-free chewing gums help prevent cavities, how to use them, their mechanism of action, and adverse effects.
So, lets get started:
Historical evidence of chewing gum from ancestors?
Many poeple believe that chewing gum is a contemporary habit but that’s seemingly not quite the case. The earliest evidence of humans chewing gum-like substances dates back to 10,000 years, where DNA of Swedish children and adults were found on the lumps of birch bark tar. Also, the ancient Greeks chewed on a gum-like substance called mastic, and Native American Indians and Inuit chewed gum from spruce trees. Later, Europeans from New England adopted the Native American Indian custom.
Composition of a chewing gum
Chewing gum contains three major components:
Water-insoluble gum base – it is non-nutritive and can’t be dissolved during chewing.
Water-soluble added ingredients – They enhance chewing gum’s physical and chemical properties. These include bulking agents, flavoring agents, antioxidants, sweeteners, colorants, opacifiers, softeners, emulsifiers, anti-tack agents, and anti-caking agents.
Active ingredients—These are added for medicinal purposes and include casein phosphopeptide–amorphous calcium nano complexes (CPP-ACP), fluoride, carbamide, or chlorhexidine.
Types of chewing gums
There are two types of gums: sugar-containing chewing gums and sugar-free chewing gums.
Sugar-containing chewing gums contain fermentable carbohydrates such as glucose, fructose and manose, which are readily metabolized by our oral bacteria as their energy source. The growing colonies of these bugs produce plaque and acid that play a role in the initation and progression of cavities and gum disease.
Sugar-free gums, on the other hand, contain less than 0.5 grams of sugar per serving. Artificial sweeteners such as aspartame, acesulfame-K, neotame, saccharin, sucralose, or stevia are added to the gum. Some chewing gums contain sugar alcohols such as xylitol, sorbitol, mannitol, or maltitol. Our oral microbiome (mouth bacteria) can’t metabolize these artificial sweeteners, and hence, they don’t contribute to the developing cavities and gum disease.
Does chewing gum help prevent cavities?
Some evidence suggests that regular use of sugar-free gum may reduce tooth decay. However, it can’t replace a regular oral hygiene routine consisting of once-daily flossing and twice-daily toothbrushing.
If used for tooth decay or caries prevention, only sugar-free chewing gums with an ADA Seal of Acceptance should be purchased.
Read more: Cavities: Causes, Symptoms, Prevention, and Treatment
Frequency and duration of chewing gum on cavity prevention
It is essential to know that for medicinal purposes, you have to chew gum for a shorter duration to get the maximum benefits. Otherwise, you’ll end up doing more harm than good.
It is recommended to chew it 3 times a day for 5 minutes after a meal. Chewing gum for longer than recommended may damage your gastric lining, especially if chewed on an empty stomach. When you chew, you send messages to the stomach to start producing gastric secretions to prepare the stomach for digestion. When food doesn’t reach the stomach, the strong hydrochloric acid may damage the lining, causing acid reflux or, in advanced cases, gastric ulcers. It may be a good idea to chew the gum for the recommended time after a meal.
A study was conducted in which one group of participants chewed gum 5 times daily for 12 minutes while the second group chewed gum 3 times a day for 20 minutes for 12 weeks. The total time duration in both the groups was same (60 minutes), but the former group, with a higher frequency and lower chewing time, showed better enamel remineralization. Therefore, it can be infered that increased salivation for 12 minutes after meals and snacks is enough for enamel remineralization and cavity prevention.
Some studies also document that cavity protection can be achieved with the gum chewing duration of 5 minutes after meals.
How does chewing gum help prevent cavities?
Chewing gums prevents tooth decay through the following mechanisms:
Clears and restores the oral pH
Chewing gum prevents tooth decay by clearing the oral cavity. It mechanically flushes food debris and bacteria out of the mouth and restores the oral pH more efficiently after a sugary meal. Chewing gum causes 187% and 86% rise in saliva production (stimulated saliva) during the first two minutes, and takes 10 minutes to return to baseline. Besides, stimulated saliva has a higher buffering capacity than an unstimulated saliva.
It also contains higher protein levels, sodium, calcium, chloride, and bicarbonate. Salivary proteins form a protective layer on the tooth surface that protects it from acid erosion. Moreover, the saliva supersaturated with calcium and phosphate ions remineralizes the demineralized enamel surface.
Inhibits the replication of nasty decay-causing bacteria
Xylitol-containing gums impede the attachment of Streptococcus mutans, primary tooth decay-causing bacteria, to the tooth surface. Also, bacteria can’t metabolize it for their fuel. Instead, xylitol competes with polysaccharides in their metabolic pathways and inhibits the production of lactic acid, which causes demineralization of the teeth.
Reduction of appetite
Chewing gum after meals also reduces snack cravings and the desire for sweet and carbohydrate-rich foods.
Read more: Cavities Between Teeth: Why They Happen Even If You Brush Every Day
Choice of chewing gum
You can purchase xylitol, sorbitol, magnolia bark extract, or tea polyphenol-containing gums with an ADA Seal of Acceptance.
Potential Side effects of gum overuse
Despite various advantages of chewing gum, there may be some potential side effects related to excessive chewing and consuming ingredients in the gum. These include:
Choking
Chewing gum can cause choking, especially in young children. According to the Centre for Disease Control, 19% of cases of non-fatal candy/gum choking in children were reported in 2001. For the same reason, the U.S. Department of Agriculture prohibits giving chewing gum to children under 4.
In 2024, a 24-year-old white male suddenly died of aspiration of gum—the obstruction of the airway by a foreign object (chewing gum) resulted in death. So, proper caution should be taken while chewing the gum.
Jaw muscle pain
Prolonged chewing of gum for more than three hours daily can fatigue the jaw muscles, leading to pain in the temporomandibular joint. Also, avoid chewing gum for more than the recommended duration.
Chronic Headaches
Chronic headaches are often linked to excessive chewing gum in young adults. They may be triggered by fatigue of the temporomandibular joint or aspartame in the gum.
Increased mercury load on the system
If you have amalgam fillings in the mouth, friction from chewing gum can accelerate the release of mercury from the fillings. Chewing gums can increase upto 6 times the amount of mercury release from the silver fillings.
GI upset
Gastrointestinal symptoms are common in gum eaters. Chewing gum eaters commonly suffer from bloating, abdominal pain and discomfort due to excess swallowing of air in the stomach.
Although gums are safe, the Polyols in the gums may irritate the gut lining and can lead to irritable bowel disease (IBS) or worsen the symptoms of exsisting IBS.
Aspartame – a possible carcinogen
Aspartame, a common artificial sweetener used in sugar-free gums, metabolizes into wood alcohol and formaldehyde in the body. Both of these metabolites are toxic to the body. Also, our body is unable to eliminate them through kidneys and feces. Moreover, excess consumption of aspartame has been linked to cancers, congenital disabilities, and weight gain.
In 1974, the FDA approved aspartame as an artificial sweetener—an alternative to white sugar in gums, cereals, instant coffee, and other food items. In 2023, the World Health Organization’s International Research Agency on Cancer announced that aspartame is a possible carcinogen (cancer-causing agent). Moreover, a 2020 study found an increased incidence of lymphoma and leukemia in mice who consumed aspartame.
Barry Popkin, a professor of nutrition at the University of North Carolina Gillings School of Global Public Health, responded to WHO’s claim by saying, “Consume moderate levels of aspartame, and you’re OK.”
My expertise and opinion
In my opinion, if you’re healthy and just want to prevent cavities, there are several other ways to do so—oral hygiene maintenance, diet, and lifestyle changes. However, if you suffer from dry mouth and malodor, I would recommend using it as recommended above to stimulate saliva production. Also, avoid using aspartame containing gums.
How does chewing gum help prevent cavities? Chewing gum stimulates saliva and washes debris and odor-producing bacteria out of the mouth. You can achieve this with oral hygiene maintenance and a healthy fiber diet. Saliva is an ultrafiltrate of blood (plasma without cells), so the alkalinity and buffering capacity of saliva comes from the blood. Consumption of fiber, vitamins and minerals, healthy fats, and protein help build teeth, bones, and gums and maintain their integrity.
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