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Nutrition Today
April 2014 
Volume 49  Number 2
Pages 47 - 48
 
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ABSTRACT
Health Canada has concluded that scientific evidence exists to support a claim about sugar-free chewing gum and dental caries risk reduction. This claim is applicable to the general population of Canada because dental caries often begin to develop during childhood and continue into adulthood and the prevalence of dental caries is much higher in adults than in children. In addition, the process of caries development is the same in adults and children. The group that reviewed the evidence referenced 12 studies to support the claim. A search by the Canadian Food Directorate identified 3 additional studies, bringing the total number of relevant studies to 15 (with 31 relevant trial arms), all of which were conducted in generally healthy school children. Six studies reported on children from populations at higher risk for dental caries. The daily amount of gum tested ranged from 1 stick, 2 times per day, to 2 pellets, 5 times per day. Sugar alcohols used to sweeten the gum included xylitol (11 test arms), a combination of xylitol and sorbitol (9 test arms), sorbitol (7 test arms), or a combination of sorbitol and mannitol (3 test arms). Daily sugar alcohol loads ranged from 1.9 to 12.4 g. The gum was always given after snacks or meals. The duration of the studies ranged from 2 to 3 years. To assess the effect of sugar-free chewing gum on dental caries risk, the decayed, missing, or filled tooth surface index was used. The "preventive fraction" was calculated to identify the percentage of decayed, missing, or filled tooth surface that was prevented in the children given sugar-free chewing gum, relative to those who did not receive gum. Overall, the direction of the effect was highly consistent, with 91% of the test arms favoring sugar-free chewing gum over no gum. When only statistically significant associations were taken into account, the direction of the effect was favorable in 74% of the sugar-free chewing gum test arms, and findings did not change when only higher-quality

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