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The effect of sugar-free chewing gum on plaque and clinical parameters of gingival inflammation: a systematic review

Authors

  • RS Keukenmeester,

    1. Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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  • DE Slot,

    Corresponding author
    • Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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  • MS Putt,

    1. Health Science Research Center, Indiana University-Purdue University, Fort Wayne, IN, USA
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  • GA Van der Weijden

    1. Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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  • ♦ = Studies selected for this systematic review.

D.E. (Dagmar Else) Slot

Department of Periodontology

Academic Centre for Dentistry Amsterdam (ACTA)

University of Amsterdam and VU University Amsterdam

Gustav Mahlerlaan 3004

1081 LA Amsterdam The Netherlands

Tel.: +31205980179/307

E-mail: d.slot@acta.nl

Abstract

Objective

The aim of this study was to systematically review the current literature on the clinical effects of sugar-free chewing gum on plaque indices and parameters of gingival inflammation.

Material and methods

The MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were searched up to 20 April 2012 to identify any appropriate studies. Plaque indices and parameters of gingival inflammation were selected as outcome variables.

Results

An independent screening of the 594 unique titles and abstracts identified six non-brushing and four brushing studies that met the eligibility criteria. In the non-brushing studies, the use of chewing gum did not significantly affect the parameters of interest. In the descriptive analysis of the brushing studies, four of five comparisons showed a statistically significant effect in favour of the sugar-free chewing gum with respect to plaque scores. The meta-analysis for the Quigley & Hein (J Am Dent Assoc 1962; 65: 26) plaque index scores in the brushing studies also showed a significant difference (DiffM −0.24, 95% CI [−0.41; −0.08]). For bleeding tendency, the descriptive analysis showed that one of the two comparisons identified a significant difference in favour of chewing gum. The meta-analysis, however, did not substantiate this difference.

Conclusion

Within the limitations of this systematic review, it may be concluded that the use of sugar-free chewing gum as an adjunct to toothbrushing provides a small but significant reduction in plaque scores. Chewing sugar-free gum showed no significant effect on gingivitis scores. In the absence of brushing, no effect on plaque and gingivitis scores could be established.

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