Oral health plays a crucial part in everyday life. Different aids help us maintain good oral hygiene. One such aid is chewing gum. Chewing gum has been used in various ways since ancient times. The Greeks chewed the gum on the mastic tree, called mastiche. The ancient Maya preferred the sapodilla tree (tsicle.) Native Americans from New England chewed on the Spanish spruce. Today, the base used for most gum products is a combination of synthetic materials (elastomers, resins, and waxes in various proportions,) flavors, colors, and sweeteners that can help protect teeth. Oral Effects of Chewing Gum: Food that is consumed is broken down into acids by various bacteria (mainly S.mutans, L.bacillus.) These acids are the main source of enamel destruction which eventually leads to cavity formation. Enamel is the only substance that cannot be regenerated after birth. So, it is very crucial to take care of enamel. Chewing gum stimulates oral saliva, which helps wash off all the acids produced by bacteria. Washing off acids will greatly help in the prevention of enamel destruction. Different chewing gums are available in the market. The most often types we see are sugar-coated chewing gums and sugar-free chewing gums. Sugar-Coated Chewing Gums: Sucrose is mostly coated on these gums. These gums when chewed, lead to increased salivary production, almost 10 times more than normal salivary production, which helps wash away acids produced by bacteria. Hence, they gained huge popularity when released into the market. But the “sucrose” used on the coating of these gums can be easily fermentable by the bacteria and thereby produce acids. Moreover, chewing these gums for a prolonged time leads to exposure of teeth to this fermentable sugar for hours together, which leads to large acid production and fall in pH of the oral cavity below 5.5 (pH=5.5 is considered critical pH of the oral cavity, below which leads to caries.) This phenomenon ultimately leads to caries. Sugar-Free Chewing Gums: To avoid the above-mentioned problems, sugar-free chewing gums have been introduced into the market. Chewing gum can be termed sugar-free if it contains less than 0.5g of sugar per serving. Instead of sugar, artificial sweeteners such as acesulfame-K, aspartame, neotame, saccharin, sucralose, or stevia are used to make gum sweet. Gum can also be seasoned with sugar alcohols such as xylitol, erythritol, isomalt, maltitol, mannitol, and sorbitol. These sweeteners contain fewer calories than sugar, but the US Food and Drug Administration (FDA) considers aspartame and all of the sugar alcohols listed above as healthy sweeteners because they contain more than 2% of calories in equal amounts of sugar. These sugars are non-cariogenic as they are not easily fermentable by the bacteria in the oral cavity.

Advantages of Chewing Gum: *Increases salivary flow *Washes off unnecessary acids *Maintains oral pH *Prevents dental erosion caused by acids *Good oral hygiene aid *Flavored chewing gums helps get rid of bad breath How to Choose Chewing Gum: *Sugar-free chewing gums are best *Avoid chewing gums containing citric acid as they further lower mouth pH *Avoid chewing gums containing a “sucrose” coating Best Time to Chew a Piece of Gum Few sweet chewing gums have shown reduced pH of the oral cavity when consumed after food and increased pH when consumed before food. So choose the time of consumption of chewing gum based on this. Chewing gum is an aid to clear off food debris from the oral cavity when it is not possible to brush with toothpaste, especially between meals. Hence it is recommended to chew gum between meals. Chewing Gum as a Medical Aid: In conditions like xerostomia or dry mouth, chewing gum helps in increased salivary flow. Chewing gum helps clear the esophagus by increasing salivary flow and aids in alleviating symptoms in conditions like gastroesophageal reflux disease (GERD.) Mint flavored chewing gums are suggested as an adjuvant in conditions like halitosis. Nicotine addiction in smokers can be controlled by counseling and asking them to chew gum when they feel like smoking. Can Chewing Gum Replace Brushing? The answer is a big “NO!” Though chewing gum can increase the salivary flow by 10 times, it doesn’t help to completely get rid of the debris on teeth. Hence chewing gum can be used as an “adjuvant” to brushing and flossing, but it can never replace them.

When to Avoid Chewing Gum Though over the counter chewing gum is not harmful, there are a few conditions where there is a need to avoid chewing gum, such as: *Braces, during orthodontic treatment- it is better to avoid chewing gum. *Denture patients- patients wearing a complete denture might find it difficult to chew a piece of gum as it sticks to artificial teeth on the denture and destabilizes the denture. *Allergies- if a person is allergic to any of the synthetic components used in the gum base, it is better to avoid that gum, look out for the ingredients mentioned on the pack of gum before purchasing. *TMJ problem- many chewing gums come into the market. Some of them have teeth whitening agents and they are sold as “whitening/brightening” chewing gums. They may not show as good a result as professional bleaching, but one can give it a try as they are OTC and perfectly safe. But do not go overboard in chewing the gum as continuous chewing of gum may lead to TMJ problems and clicking sounds while opening and closing the mouth. If a patient is diagnosed with MPDS, a TMJ problem, it’s better to avoid chewing gums for a long time.  Bearing in mind the above exclusions, one can happily enjoy a piece of gum at any time of the day.