Plaque · Adults and children (predominantly adults; one study in children), with natural dentition
Xylitol sugar-free gum significantly reduced plaque quantity versus no-gum/control (SMD -0.743, 95% CI -1.148 to -0.338), with high heterogeneity (I2 = 86.0%; ungraded).
1 finding from 1 review
Salivary flow rate (unstimulated) · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth
codex
1 finding from 1 review
Plaque · Adults and children (predominantly adults; one study in children), with natural dentition
Sugar-free chewing gum significantly reduced plaque quantity versus no-gum/control (SMD -0.778, 95% CI -1.167 to -0.390), with high heterogeneity (I2 = 86.6%) and no GRADE rating (ungraded).
2 findings from 1 review
Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)
Xylitol-only sugar-free gum significantly reduced Streptococcus mutans load versus pooled controls (SMD -0.46, 95% CI -0.64 to -0.28; 12 trials, I2 43%); certainty not formally graded.
1 finding from 1 review
Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)
In a sensitivity analysis assuming a 0.95 baseline-to-endpoint correlation for the sugar-free gum arm, the effect remained significant (SMD -0.55, 95% CI -0.80 to -0.30; 13 trials, I2 73%); certainty not formally graded.
2 findings 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
Self-reported thirst · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth
Gum chewing reduced self-reported thirst in most studies (6 of 7 positive, 1 no effect); not meta-analyzed.
1 finding from 1 review
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
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
Caries increment, surface index D(M)FS · Children and adolescents aged 16 years or less
1 finding from 1 review
Caries increment in deciduous (primary) teeth/surfaces (dmf index) · Children and adolescents aged 16 years or less
1 finding from 1 review
Fluorosis (adverse effect; % of children with fluorotic teeth) · Children and adolescents aged 16 years or less
The review found no eligible studies for this question.
1 finding from 1 review
Caries increment in permanent teeth · Children and adolescents aged 16 years or less
2 findings from 1 review
Caries increment in permanent teeth · Children and adolescents aged 16 years or less
3 findings from 1 review
Plaque and gingivitis scores · Children and adolescents aged 16 years or less
1 finding from 1 review
Fluorosis (adverse effect; % of children with fluorotic teeth, questionable to severe) · Children and adolescents aged 16 years or less
1 finding from 1 review
% of children with fluorotic teeth (questionable to severe), follow-up 55 months. Assumed risk 32/212 = 15%; corresponding risk 40/202 = 20% (APF once a day) and 43/197 = 22% (APF twice a day). Relative effect: Not…
1 study · 611 participants
Very low
Caries increment on permanent tooth surfaces (DMFS, approximal surfaces) · Children and adolescents aged 16 years or less
1 finding from 1 review
Caries increment in deciduous (primary) teeth/surfaces (dmf index) · Children and adolescents aged 16 years or less
1 finding from 1 review
Caries in deciduous teeth (change in dmft) · Children and adolescents aged 16 years or less
1 finding from 1 review