Salivary flow rate · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth
Across 19 studies the effect of gum chewing on stimulated and/or unstimulated salivary flow rate was mixed (9 positive, 10 no effect); this broad outcome was not meta-analyzed.
1 finding from 1 review
The effect of gum chewing on xerostomia and salivary flow rate in elderly and medically compromised subjects: a… 2023 All outcomesVarious (single session to 12 months) · Haemodialysis units, elderly / geriatric care, cancer and palliative care, and xerostomia / hyposalivation clinics (studies from multiple countries)
Narrative vote-count: of 19 studies measuring stimulated and/or unstimulated saliva flow rate, 9 found a positive effect of gum chewing [17,18,22,24,27,35,36,38,39] and 10 detected no effect…
19 studies
GRADE not reported
Oral mucosal moisture · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth
One small study found that chewing hard (but not soft) gum increased oral mucosal moisture.
1 finding from 1 review
Salivary flow rate (unstimulated) · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth
In elderly and medically compromised people with xerostomia, chewing sugar-free gum daily for two or more weeks produces a small but statistically significant increase in unstimulated whole salivary flow rate versus no gum (SMD 0.44, 95% CI 0.22 to 0.66); certainty of evidence was not formally graded.
1 finding from 1 review
Dry mouth (xerostomia) · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth
Gum chewing was linked with improved self-reported xerostomia / dry mouth in most studies (12 of 17 positive, 5 no effect); heterogeneous instruments precluded meta-analysis.
1 finding from 1 review
The effect of gum chewing on xerostomia and salivary flow rate in elderly and medically compromised subjects: a… 2023 All outcomesVarious (single session to 3 months) · Haemodialysis units, elderly / geriatric care, cancer and palliative care, and xerostomia / hyposalivation clinics (studies from multiple countries)
Narrative vote-count: of 17 studies measuring self-reported xerostomia / dry mouth, 12 found a positive effect of gum chewing [18,19,21,23,24,25,26,27,30,31,38,40] and 5 detected no effect [17,29,33,34,37]. No study…
17 studies
GRADE not reported
Dental erosion · Five-year-old preschool children in Sharjah
Sugary or carbonated beverage consumption was associated with lower odds of dental erosion.
1 finding from 1 review
Dental caries · Individuals in East Africa assessed for dental caries
Frequent carbohydrate intake was associated with significantly higher odds of dental caries (OR 1.575, 95% CI 1.13 to 3.051); certainty not graded.
1 finding from 1 review
Dental caries · Healthy children and adolescents in the United Arab Emirates
Higher snacking and soft-drink/sugar consumption were associated with more caries in most studies, though one study found no association with sweet-consumption frequency (narrative synthesis; not GRADE-rated).
1 finding from 1 review
Soft drink consumption (Khadri et al.: 0.31, 95% CI 0.14-0.47) and a high extent of snacking (Hashim et al.: high vs low snack level aRR 1.46, 95% CI 1.26-1.70; snacking >=3x vs once daily aRR 1.25, 1.00-1.57) were…
Studies not reported
GRADE not reported
Caries development in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)
Early-childhood oral hygiene and dietary habits show inconsistent associations with permanent-teeth caries, often losing significance after adjustment for past caries (2 studies; not pooled; not GRADE-rated).
1 finding from 1 review
dmfs index score (decayed, missing, filled primary surfaces; range 0-80) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
Advice about a healthy diet (including breastfeeding promotion and… showed no clear difference in dmfs index score (decayed, missing, filled primary surfaces; range… compared with standard care (low certainty).
1 finding from 1 review
Caries presence in primary teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
Advice about a healthy diet (including breastfeeding promotion and… probably leads to lower caries presence in primary teeth compared with standard care (moderate certainty).
1 finding from 1 review
Caries severity (d1 + mfs >= 5) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
Advice about a healthy diet (including breastfeeding promotion and… led to lower caries severity (d1 + mfs >= 5) compared with standard care; GRADE not reported.
1 finding from 1 review
Mother self-reported oral health behaviours and attitudes · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
1 finding from 1 review
Caries in primary teeth: dmft (3 years) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
It is very uncertain whether advice about a healthy diet (including breastfeeding promotion and… changes dmft index score (decayed, missing, filled primary teeth; range 0-20) compared with standard care (very low certainty).
1 finding from 1 review
Child oral health behaviours · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
1 finding from 1 review
Adverse events for mother or child · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
1 finding from 1 review
Enamel/dental hard-tissue changes and e-liquid cariogenic properties (demineralization, colour change, pH, sugar content, metals) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…
In vitro evidence suggests e-liquids are often acidic and sugar-containing and can alter enamel/dentin colour and properties, supporting a plausible cariogenic effect, but findings are heterogeneous and not pooled (ungraded, narrative).
1 finding from 1 review
Change in Mutans streptococci (MS) and Lactobacilli in saliva · Schoolchildren (6-9 years), high caries risk
The single stevia trial (Cocco 2019) reported a significant reduction in salivary Mutans streptococci and lactobacilli, but gave no effect size and was not GRADE-rated.
1 finding from 1 review
Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. 2024 All outcomes42 days · Schoolchildren in Italy, high caries risk; sweetener delivered as a daily snack · Single study (Cocco 2019); not pooled
Cocco 2019 (the only high-intensity sweetener trial): the stevia snack showed a significant decrease in MS (P < .01) and in lactobacilli (P = .03) versus baseline, whereas the white-sugar snack showed no significant…
1 study · 271 participants
GRADE not reported
Effects of non-stevia high-intensity sweeteners (aspartame, sucralose, saccharin) on cariogenic bacteria in dental plaque or saliva · healthy people
No eligible studies evaluated high-intensity sweeteners such as aspartame, sucralose, or saccharin for their effect on cariogenic bacteria.
1 finding from 1 review
Change in Mutans streptococci (MS) count in saliva · healthy people
Xylitol significantly reduced Mutans streptococci in saliva compared with no intervention (SMD -1.47, 95% CI -1.94 to -0.99; 3 trials), though heterogeneity was very high (I2=98%); not GRADE-rated.
1 finding from 1 review
Intervention not reported
Change in prevalence of salivary Streptococcus sobrinus
1 finding from 1 review