A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity

Melanie Nasseripour; Jonathon Timothy Newton; Fiona Warburton; Oluwatunmise Awojobi; Sonya Di Giorgio; Jennifer Elizabeth Gallagher; Avijit Banerjee

doi:10.3389/froh.2022.845921

A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity

Melanie Nasseripour^*, Jonathon Timothy Newton, Fiona Warburton, Oluwatunmise Awojobi, Sonya Di Giorgio, Jennifer Elizabeth Gallagher, Avijit Banerjee

^*Corresponding author for this work

King's College London

Research output: Contribution to journal › Review article › peer-review

6 Citations (Scopus)

Abstract

Background: The aim of this systematic review of published literature was to answer the research question, “What is the difference in the level of plaque quantity, in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG, who do not chew gum, or who use alternatives such as probiotics or fluoride varnish?”. Methods: The systematic review [registered on PROSPERO 2018 (CRD42018094676)] included studies on adults and children with chewing of SFG as the main intervention, where “sugar” referred to monosaccharides and disaccharides. Included studies were in English and corresponded to primary research published between 1946 and 2020. The search conducted spanned all relevant databases using both Medical Subject Headings (MESH) and free text with combinations of “chewing gum,” “sugar-free,” “caries,” “xerostomia,” “periodontal disease.” Results: Eight articles included plaque quantity as part of their outcomes. Meta-analysis showed that SFG significantly reduced plaque quantity (effect size-0.778; 95% CI-1.167 to-0.39). The correlation between the baseline and the end of study data was assumed to be 0.95 for the control and 0.65 for the SFG group. A sensitivity analysis was conducted with the pre- to post-test correlation, set at 0.95 for the SFG group. This gave an effect size of-1.098 (95% CI-1.539 to-0.656) with I2 = 89.73%. When looking more specifically at xylitol gum, the results of themeta-analysis showed that it significantly reduced plaque quantity (effect size-0.743; 95%CI-1.148 to-0.338). There was a high degree of heterogeneity between studies with I2 = 86.0%. Conclusion: There is some evidence that chewing sugar-free gum, in particular xylitol SFG, reduces the quantity of plaque in the oral cavity in comparison to non SFG chewing or no chewing controls. Further research with improved design, lengthier timeframes and higher number of participants should be considered.

Original language	English
Article number	845921
Journal	Frontiers in Oral health
Volume	3
DOIs	https://doi.org/10.3389/froh.2022.845921
Publication status	Published - 2022

Keywords

adults
children
clinical trials
plaque
polyols
prevention
sugar-free gum
xylitol

Access to Document

10.3389/froh.2022.845921

Cite this

@article{7e9716b1517d4004922bbcc8bd56c4d1,

title = "A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity",

abstract = "Background: The aim of this systematic review of published literature was to answer the research question, “What is the difference in the level of plaque quantity, in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG, who do not chew gum, or who use alternatives such as probiotics or fluoride varnish?”. Methods: The systematic review [registered on PROSPERO 2018 (CRD42018094676)] included studies on adults and children with chewing of SFG as the main intervention, where “sugar” referred to monosaccharides and disaccharides. Included studies were in English and corresponded to primary research published between 1946 and 2020. The search conducted spanned all relevant databases using both Medical Subject Headings (MESH) and free text with combinations of “chewing gum,” “sugar-free,” “caries,” “xerostomia,” “periodontal disease.” Results: Eight articles included plaque quantity as part of their outcomes. Meta-analysis showed that SFG significantly reduced plaque quantity (effect size-0.778; 95% CI-1.167 to-0.39). The correlation between the baseline and the end of study data was assumed to be 0.95 for the control and 0.65 for the SFG group. A sensitivity analysis was conducted with the pre- to post-test correlation, set at 0.95 for the SFG group. This gave an effect size of-1.098 (95% CI-1.539 to-0.656) with I2 = 89.73%. When looking more specifically at xylitol gum, the results of themeta-analysis showed that it significantly reduced plaque quantity (effect size-0.743; 95%CI-1.148 to-0.338). There was a high degree of heterogeneity between studies with I2 = 86.0%. Conclusion: There is some evidence that chewing sugar-free gum, in particular xylitol SFG, reduces the quantity of plaque in the oral cavity in comparison to non SFG chewing or no chewing controls. Further research with improved design, lengthier timeframes and higher number of participants should be considered.",

keywords = "adults, children, clinical trials, plaque, polyols, prevention, sugar-free gum, xylitol",

author = "Melanie Nasseripour and Newton, {Jonathon Timothy} and Fiona Warburton and Oluwatunmise Awojobi and Giorgio, {Sonya Di} and {Elizabeth Gallagher}, Jennifer and Avijit Banerjee",

note = "Funding Information: This investigator-led independent research financially sponsored by a grant from Mars Wrigley. Sources–The review was funded by Wrigley{\textquoteright}s. Sponsor–The review{\textquoteright}s sponsor was King{\textquoteright}s College London. The funder had no role in the development of this protocol, data analysis or interpretation of results. All members of the review team are employed by the sponsor, King{\textquoteright}s College London. Publisher Copyright: {\textcopyright} 2022, Frontiers Media SA. All rights reserved.",

year = "2022",

doi = "10.3389/froh.2022.845921",

language = "English",

volume = "3",

journal = "Frontiers in Oral health",

issn = "2673-4842",

publisher = "Frontiers Media",

}

TY - JOUR

T1 - A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity

AU - Nasseripour, Melanie

AU - Newton, Jonathon Timothy

AU - Warburton, Fiona

AU - Awojobi, Oluwatunmise

AU - Giorgio, Sonya Di

AU - Elizabeth Gallagher, Jennifer

AU - Banerjee, Avijit

N1 - Funding Information: This investigator-led independent research financially sponsored by a grant from Mars Wrigley. Sources–The review was funded by Wrigley’s. Sponsor–The review’s sponsor was King’s College London. The funder had no role in the development of this protocol, data analysis or interpretation of results. All members of the review team are employed by the sponsor, King’s College London. Publisher Copyright: © 2022, Frontiers Media SA. All rights reserved.

PY - 2022

Y1 - 2022

N2 - Background: The aim of this systematic review of published literature was to answer the research question, “What is the difference in the level of plaque quantity, in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG, who do not chew gum, or who use alternatives such as probiotics or fluoride varnish?”. Methods: The systematic review [registered on PROSPERO 2018 (CRD42018094676)] included studies on adults and children with chewing of SFG as the main intervention, where “sugar” referred to monosaccharides and disaccharides. Included studies were in English and corresponded to primary research published between 1946 and 2020. The search conducted spanned all relevant databases using both Medical Subject Headings (MESH) and free text with combinations of “chewing gum,” “sugar-free,” “caries,” “xerostomia,” “periodontal disease.” Results: Eight articles included plaque quantity as part of their outcomes. Meta-analysis showed that SFG significantly reduced plaque quantity (effect size-0.778; 95% CI-1.167 to-0.39). The correlation between the baseline and the end of study data was assumed to be 0.95 for the control and 0.65 for the SFG group. A sensitivity analysis was conducted with the pre- to post-test correlation, set at 0.95 for the SFG group. This gave an effect size of-1.098 (95% CI-1.539 to-0.656) with I2 = 89.73%. When looking more specifically at xylitol gum, the results of themeta-analysis showed that it significantly reduced plaque quantity (effect size-0.743; 95%CI-1.148 to-0.338). There was a high degree of heterogeneity between studies with I2 = 86.0%. Conclusion: There is some evidence that chewing sugar-free gum, in particular xylitol SFG, reduces the quantity of plaque in the oral cavity in comparison to non SFG chewing or no chewing controls. Further research with improved design, lengthier timeframes and higher number of participants should be considered.

AB - Background: The aim of this systematic review of published literature was to answer the research question, “What is the difference in the level of plaque quantity, in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG, who do not chew gum, or who use alternatives such as probiotics or fluoride varnish?”. Methods: The systematic review [registered on PROSPERO 2018 (CRD42018094676)] included studies on adults and children with chewing of SFG as the main intervention, where “sugar” referred to monosaccharides and disaccharides. Included studies were in English and corresponded to primary research published between 1946 and 2020. The search conducted spanned all relevant databases using both Medical Subject Headings (MESH) and free text with combinations of “chewing gum,” “sugar-free,” “caries,” “xerostomia,” “periodontal disease.” Results: Eight articles included plaque quantity as part of their outcomes. Meta-analysis showed that SFG significantly reduced plaque quantity (effect size-0.778; 95% CI-1.167 to-0.39). The correlation between the baseline and the end of study data was assumed to be 0.95 for the control and 0.65 for the SFG group. A sensitivity analysis was conducted with the pre- to post-test correlation, set at 0.95 for the SFG group. This gave an effect size of-1.098 (95% CI-1.539 to-0.656) with I2 = 89.73%. When looking more specifically at xylitol gum, the results of themeta-analysis showed that it significantly reduced plaque quantity (effect size-0.743; 95%CI-1.148 to-0.338). There was a high degree of heterogeneity between studies with I2 = 86.0%. Conclusion: There is some evidence that chewing sugar-free gum, in particular xylitol SFG, reduces the quantity of plaque in the oral cavity in comparison to non SFG chewing or no chewing controls. Further research with improved design, lengthier timeframes and higher number of participants should be considered.

KW - adults

KW - children

KW - clinical trials

KW - plaque

KW - polyols

KW - prevention

KW - sugar-free gum

KW - xylitol

UR - http://www.scopus.com/inward/record.url?scp=85163651052&partnerID=8YFLogxK

U2 - 10.3389/froh.2022.845921

DO - 10.3389/froh.2022.845921

M3 - Review article

AN - SCOPUS:85163651052

SN - 2673-4842

VL - 3

JO - Frontiers in Oral health

JF - Frontiers in Oral health

M1 - 845921

ER -

A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this