Sugar-free Chewing Gum Research Articles

Preoperative chewing gum versus pericardial p6 point acupressure for attenuation of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy – A comparative evaluation

: Preoperative use of non-pharmacological agents like chewing gum and acupressure at Pericardial p6 point in prevention on postoperative nausea and vomiting in patients posted for laparascopic cholecystectomy under general anaesthesia. The primary objective of the study was to compare the efficacy of preoperative chewing gum and pericardial P6 acupressure point application in reduction of postoperative nausea and vomiting. Secondary objective was to assess the anxiety and satisfaction scores of the patients in the study. In this Quasi experimental study,3 groups of 62 patients each, with intact mental status in the age group of 18-60 years of either gender posted for laparoscopic cholecystectomy under general anaesthesia, after obtaining written informed consent were included in the study.Group 1 patients received standard treatment, group 2 patients received standard treatment plus Wrigley’s extra sugar free chewing gum, group 3 patients received standard treatment plus bilateral p6 point acupressure by pressure right drug free single use pressure sensitive wrist strip." Patients were assessed for anxiety in preoperative period, before and after the intervention. In postoperative period patients were assessed for nausea and vomiting, requirement of rescue antiemetic and patient satisfaction.The Chi-square test or Fischer’s exact test, as applicable was employed to compare the postoperative incidence of nausea and vomiting.Highly significant decrease in Amsterdam anxiety score in chewing gum group (p<0.001), followed by significant decrease in acupressure group (p=0.005). No significant change in nausea in all the groups, but in context of vomiting, both chewing gum and acupressure showed significant decrease in number of episodes in first 6 hrs (p=0.013). For rescue antiemetics in nausea, there was no significant variance in usage among the groups. However, for vomiting, a substantial decrease was found. Group 2 required significantly less (p=0.001) amount of antiemetics followed by group 3.The patients in the chewing gum group scored more in the satisfaction scoring index and this was found to be statistically significant (p = 0.010). Bothchewing gum and acupressure reduced nausea and vomiting and the need for rescue antiemetics. However, chewing gum proved to be better among the two.

Self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh

BackgroundBad breath (halitosis) is a common problem affecting psycho-social wellbeing of young people. We aimed to explore the extent of self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh.MethodsA cross-sectional study was conducted among university students from November 2021 to April 2022. Six private and two public universities were approached. A total of 318 participants were conveniently selected for the study. A self-administered questionnaire was used for data collection. Students unwilling to participate were excluded. Multivariable logistic regression analysis was used to examine factors associated with halitosis. Statistical analysis was conducted using Stata Version 17.ResultsA total of 55.97% of students had self-perceived halitosis, with females (74.53%) having a significantly higher proportion than males (36.94%) (p < 0.001). A significantly higher proportion of halitosis was found among participants who were overweight ( 61%), had obesity (60.77%), smoked cigarette (46.79%), consumed alcohol (71.43%), lacked exercise (66.29%), were on unhealthy diet (57.35%), consumed coffee/tea (61.35%), breathed through mouth (64.60%), brushed tooth infrequently (85.71%), changed toothbrush after 6 months (77.42%), did not use toothpaste (94.74%), did not use/ sometimes used fluoride toothpaste (75.76%), lacked dental floss use (60.85%), did not use toothpick (62.87%), did chew or sometimes chewed sugar-free chewing gum (75.82%), did not clear / cleaned tongue sometimes (76.14%), did use mouth freshener regularly or occasionally (64.97%), did not use or used mouthwash sometimes (58.87%) were also associated with higher self-perceived halitosis (p < 0.05 for all). Students with gum bleeding, swollen gums, dry mouth, dental caries, food accumulation, and tooth sensitivity had a significantly (p < 0.05 for all) higher proportion of self-perceived halitosis (76.85%, 81.82%, 72.50%, 67.78%, 64.13% and 67.40%, respectively) compared to those without this problem. Being female (OR = 5.04; 95% CI: 2.01–12.62; p < 0.001), alcohol consumers (OR 7.35; 95% CI: 1.77–30.50; p = 0.006); not using sugar free chewing gum (OR = 0.25; 95% CI: 0.10–0.58; p = 0.001), lack of tongue cleaning (OR 4.62; 95% CI: 2.16–9.84; p < 0.001), and gum bleeding (OR = 7.43; 95% CI: 3.00-18.35; p < 0.001) were independently associated with halitosis on multivariable regression.ConclusionThis study reveals a high proportion of self-perceived halitosis and relevant factors. There should be more public education on the causes of halitosis and potential management approaches.

Microencapsulated propolis powder: A promising ingredient of chewing gum

The incorporation of natural ingredients to food products as a source of bioactive compounds is currently an increasing trend for food companies. The purposes of this work were to study the physicochemical properties of microencapsulated propolis powder, and to research the potential beneficial effect of it on texture and sensory quality of sugar-free chewing gums. Propolis ethanolic extract was microencapsulated by spray-drying technology, using maltodextrin as carrier, protecting conceivable bioactivity. Morphology of propolis microparticles was evaluated using Scanning Electron Microscope (SEM) and showed homogeneous microparticles with different sizes and no cracks. Propolis powder showed low water activity, moisture and hygroscopicity, high amounts of Ca, P, and high values for antioxidant-related parameters. Propolis powder phenolics were analysed by HPLC-UV and HPLC-ESI-MS. Apigenin, gallic acid, CAPE, and galangin demonstrated the highest degree of encapsulation, providing antiradical activities. Propolis powder was incorporated in chewing gums at 5%, improving their texture and sensory properties.

Assessment of Oral Masticatory Muscle Activity With Different Chewing Gums: A Cross-Sectional Study Based on Electromyogram Analysis.

Facial muscles, particularly those involved in mastication, play a pivotal role in the chewing process. Despite their influence on chewing, these muscles undergo alterations during mastication. Examining the relationship between chewed substances and muscle activity can provide insights into various pathological processes and aid in the development of therapeutic chewing techniques. This study aimed to evaluate the impact of different commercially available chewing gums on the activity of key masticatory muscles. Twenty-two participants were recruited for the study. They were instructed to chew four commercially available gums: group 1 comprised sugar gum with a strong flavor; group 2 included gum containing sorbitol; group 3 consisted of gum containing xylitol; and group 4 provided sugar gum with a mild flavor. Electromyogram (EMG) recordings were utilized to assess muscle activity. Various aspects of muscle activity, including chewing time, maximum muscle potential, and coordination between different muscles, were evaluated. Data tabulation and analysis were performed using IBM SPSS software version 23.0 (IBM Corp., Armonk, NY). Analysis revealed that in terms of temporalis symmetry, group 2 exhibited the highest mean deviation, while for masseter symmetry, group 3 demonstrated the highest mean deviation. The total deviation for the temporalis and masseter muscles was 72.16% and 65.55%, respectively, indicating greater symmetry in the temporalis muscle. Additionally, group 3 displayed the highest mean deviation in both left and right-sided synergic activity of the muscles. The total deviation for the right and left sides was 64.34% and 65.67%, respectively. The findings suggest that sugar-free chewing gums elicit increased muscle activity compared to sugar-containing chewing gums. Furthermore, the utilization of calorie-free chewing gums with a firm texture was associated with better-coordinated muscle activity. These results provide valuable insights into the effects of different chewing gums on masticatory muscle function and coordination, which may have implications for therapeutic interventions and oral health management.

Investigating the effect of gum base components on chewing gum quality and aroma release mechanism: In-vitro kinetic modeling

In this study, the effects of main gum base components, namely butyl rubber, polyvinyl acetate and natural resin, on the aroma (menthol) release mechanism and quality of sugar-free chewing gums were investigated. According to the results, the sensory evaluation of aroma release was closely similar to the analysis performed with the GC–MS equipment. The Korsmeyer-Peppas model was the best model explaining the menthol release from chewing gum, and it was found that the release was mostly in the form of Fickian diffusion. The polyvinyl acetate had the greatest effect on the aroma release, and the aroma intensity increased in parallel with the ratio in the formulations. According to the optimization results, softening temperatures and instrumental hardness of the sample, which showed the highest aroma durability were found to be 80.00 °C and 22.45 N.

A concise review of chewing gum as an anti-cariogenic agent.

Chewing gum has been endorsed as a caries preventive agent by the FDI World Dental Federation, the American Dental Association, and the European Food Safety Authority. This review discusses the mechanism and provides an update of the use of chewing gum for caries prevention. Chewing gum typically consists of a water-insoluble gum base, water-soluble added ingredients, and active ingredients. It can be classified as sugar-containing or sugar-free, as well as nonmedicated or medicated. Chewing gum prevents dental caries through a range of mechanisms, including the clearance of the oral cavity, neutralization of oral acidity, inhibition of cariogenic bacterial growth, remineralization of enamel, and reduction of appetite. Recent clinical studies have evaluated the efficacy of sugar-free chewing gum for caries prevention, with most demonstrating positive results, although some studies have reported contradictory outcomes. To achieve optimal caries prevention, it is generally recommended that individuals chew sugar-free gum for five minutes after meals, three times daily.

Functional sugar-free chewing gum infused with spices bolsters antioxidant capacity and phenolic content of saliva

Oral and vascular diseases are seemingly disparate conditions, yet individuals with poor oral health are at increased risk for cardiovascular events. Spice-derived bioactive polyphenols with antioxidant functionality may attenuate mechanisms linking the diseases, namely oxidative stress and inflammation. Acknowledging that novel approaches to increase antioxidant intake are warranted, the purpose of this study was to evaluate the influence of two functional sugar-free gums infused with spices on antioxidant capacity and phenolic content of saliva using the oxygen radical absorbance capacity and Folin-Ciocalteu assays, respectively. Unstimulated followed by stimulated saliva was collected according to a validated method across a prescribed five minute chewing period. Both gums significantly increased hydrophilic, lipophilic, and total antioxidant capacity of saliva (p < 0.05) yet to varying extents. Phenolic content of saliva was significantly higher (p < 0.001) post-chew for both gums. Results suggest spices infused into sugar-free chewing gum bolster the antioxidant capacity of saliva, thereby promoting oral health. Research evaluating the sublingual absorption of spice-derived antioxidants in functional gums and their influence on systemic oxidative stress is warranted.

The “Immensity of Things”: Noah Baumbach’s White Noise and the Consumer Sublime

The “Immensity of Things”: Noah Baumbach’s White Noise and the Consumer Sublime Eileen G’Sell (bio) Thirty years before White Noise, Don DeLillo’s 1985 postmodern paean to the pleasures—and perils—of consumer culture, Allen Ginsberg raved about “shopping for images” in his prose poem “A Supermarket in California.” “What peaches and what penumbras!” he extols in its third paragraph. “Whole families shopping at night! Aisles full of husbands! Wives in the avocados, babies in the tomatoes!” Swap Berkeley, California, for the fictional “Blacksmith,” Ohio, the peaches for packages of sugar-free chewing gum, the avocados for honeydew melons, and you have the alimental abundance spilling across White Noise in double-bagged abandon. “[I]n the mass and variety of our purchases . . . the weight and size and number, the familiar package designs and vivid lettering,” reflects narrator Jack Gladney in the fifth chapter, “in the sense of replenishment we felt . . . the security and contentment these products brought to some snug home in our souls—it seemed we had achieved a fullness of being that is not known to people who need less, expect less, who plan their lives around lonely walks in the evening.” As is clear from his extensive filmography, Noah Baumbach knows a thing or two about loneliness, so his choice, however audacious, to adapt the canonical title for the screen is not all that surprising. From The Squid and the Whale (2005) to Greenberg (2010) to Marriage Story (2019), Baumbach has made his mark plumbing the (often pathetic) depths of a very male sort of alienation. If anything, DeLillo’s deliciously stylized, comically droll prose serves to temper the director’s penchant for autobiographical self-seriousness, a type of self-seriousness that can sometimes overshadow the seriousness of his films. DeLillo purists might be justifiably wary that a movie version could adequately translate the “noise” conjured on the novel’s page—both externally in the incessant, stilted yet rhythmic chatter between characters, and internally in the narrator’s rumbling existential panic, often punctuated by a triad of brand name products (“Clorets, Velamints, Freedent”), as though to varnish his dread with the dazzle of adspeak. But as the novel is divided into three parts—“Waves and Radiation,” “The Airborne Toxic Event,” and “Dylarama”—translating its plot to the three acts of a film has a kind of easy logic to which Baumbach mostly adheres. The characters and [End Page 114] events stay much the same, albeit with some creative, and mostly effective, casting. Middle-aged Jack Gladney, founder of “Nazi Studies” at a small, Midwestern liberal arts college, is played by a somewhat younger Adam Driver, if with plausible poor posture. His fourth wife, Babette, is played by Greta Gerwig, silly yet sympathetic in her jogging suit and wild perm. Murray Siskind, Jack’s best friend and academic colleague (and Jewish in the novel), is played by Don Cheadle with wry charm and pedantic hilarity. “Brilliant” neurochemist Winnie Richards is played a bit incongruously by Jodie Turner-Smith, a terrific actor (take After Yang), but not at all the jittery, awkward beanpole so poignant in the original. Jack’s doctor, originally of Indian descent as Sundar Chakravarty, is now a man of Chinese descent, Chester Lu (Francis Jue), a performance unfortunately verging on caricature. Wilder (Dean Moore) doesn’t stay a toddler, but remains sagaciously mute as the youngest of Jack and Babette’s voluble brood. Part of what Baumbach honors in the film is its very mid-80s context—rife with its most visually salient signifiers, from wood-paneled station wagons and plastic visors to pre-hipster mom jeans and Minnie Mouse sweats. And part of the film’s delightful appeal is how it channels our late-capitalist contemporary angst—whether about socioeconomic precarity, environmental degradation, the erosion of the nuclear family, or addiction to screens—into a time period in which all of these concerns were already present, if at a lower volume, presciently probed by DeLillo. In both the novel and the film, what characters swallow, breathe in, ingest, and consume—whether gustatory, audiovisual, or ideological—is both taken for granted and dangerous. The very things that distract us from death are...

Sugar-free chewing gum versus conventional analgesic drugs for pain relief with fixed orthodontic appliances. A systematic review and meta-analysis.

To compare the effect of chewing sugar-free gum towards alleviating self-reported orthodontic treatment (OT) pain compared with conventional analgesic drugs (CADs). An unrestricted search of indexed databases and manual searching was performed up to September 2021. Randomised controlled trials (RCTs) comparing the impact of chewing gum and CADs on relieving self-reported orthodontic pain were included. Data screening, extraction and risk of bias (RoB) assessment were performed by two authors. Meta-analyses were performed using a random-effects model. The quality of available evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. Nine RCTs were included. Eight RCTs used the Visual Analogue Scale for self-reported pain assessment, while one RCT used the Numeric Rating Scale. Five RCTs had a high RoB and four RCTs had a moderate RoB. Power analysis for sample size estimation was performed in six RCTs. Separate meta-analyses were performed by pooling quantitative data from five RCTs that compared self-reported orthodontic pain between chewing gum and ibuprofen groups for the following timepoints: baseline; immediately; 2 hours; 6 hours; bedtime; 24 hours; 2 days; 3 days; 5 days; and 7 days after the placement of orthodontic appliances. None of the timepoints individually indicated a difference in self-reported pain scores between chewing sugar-free gum and ibuprofen groups. The overall level of evidence was very low. Chewing sugar-free gum is a potentially useful alternative to CADs towards pain alleviation during fixed OT.

Whitening Optical Effect of New Chewing Gums

Background: Today, many treatments are available to enhance the color of teeth, but they require a few days to weeks to deliver this effect. Objective: To evaluate the instantaneous optical whitening effect of two new sugar-free chewing gums and one dentifrice of proven efficacy versus one placebo chewing gum. Methods: This was a single-blind, parallel trial. 424 participants entered the study and were randomly allocated to four groups. They received a personal silicone mask with a calibrated hole at one upper incisor to apply a dental colorimeter. The tools tested were chewing-gum containing indigotine (E132-FD&amp;C Blue 2) and spirulina, chewing-gum containing only spirulina, chewing-gum placebo, and dentifrice containing Blue Covarine. Vita® Easyshade scored the tooth color, and the WIO and WID whiteness indexes were calculated. For chewing gums, the color of the teeth was scored before the assumption and after 2’30” of mastication. For dentifrice, participants brushed for 1’30”, then rinsed, and the color was scored before brushing and after 2’30”. Statistical analysis was performed by ANOVA and Tukey post-hoc. Results: The two experimental whitening chewing gums and the dentifrice significantly increased the WIO and the WID indexes from the baselines (p&lt;0.001). Moreover, their effects were statistically greater than those reported for the placebo chewing gum (p&lt;0.05) but not significatively different among them (p=NS). Conclusion: All the tested whitening tools showed an instant optical whitening perception. Further studies are required to assess the intensity of the effect over a prolonged time to meet the people's request for fast whitening tools. The clinical trial registration no. is PVM-2020-01.

Effect on Dental Stains by Potassium Tripolyphosphate Added Chewing Gum

Background: Today, people worldwide consider the discoloration of teeth the main concern, therefore, dental stains are an important problem for a lot of patients, especially for smokers, and tea and coffee consumers. Objective: This trial was planned to evaluate the effectiveness of a sugar-free chewing gum added with potassium tripolyphosphate, compared to a placebo chewing gum on the development or the removal of dental extrinsic stains preserving regular daily oral hygiene. Methods: This was a single-center, double-blind, randomized, 6-week parallel controlled clinical trial. Among those who were eligible for the trial, 162 adult participants were randomly allocated into two groups of 81 each and were instructed to maintain customary oral hygiene. All subjects started the trial period after an in-office dental visit to set the stain index baseline. They chewed one of the two chewing gums for six weeks, five pieces per day, preferably after meals and snacks, for 10 minutes. Both chewing gums were sugar-free, 2g of weight with the same size and shape. The test chewing gum contained potassium tripolyphosphate (24.4 mg per piece), the control chewing gum was identical without potassium tripolyphosphate, therefore, it did not contain any anti-stain agent. The dental extrinsic stain was measured at the first visit and at the end of six weeks by the Modified Lobene Stain Index (MLSI). Comparisons between the groups were performed using ANOVA after adjustment of the baselines, and comparisons between initial and final indexes inside the groups were performed using paired t-tests. Results: After the 6 weeks, 154 subjects completed the trial, 77 in each group. The mean difference in stain composite index for all sites after six weeks was 0.04±0.07 in the control group and -0.03±0.07 in the test group. This difference was statistically significant after baseline adjustment (p&lt;0.001). Moreover, the differences in stain indexes for both buccal or lingual-palatal sites showed a statistically significant difference (p&lt;0.001) for those using the test chewing gum versus the control chewing gum. Conclusion: The overall findings of this clinical study suggest that the use of chewing gum containing potassium tripolyphosphate can reduce dental stains versus placebo chewing gum on frontal teeth after six weeks of maintaining regular oral hygiene with normal tooth brushing.

Smart electrochemical sensing of xylitol using a combined machine learning and simulation approach

A novel sensor was proposed for the detection of xylitol in sugar free chewing gum using Au nanoparticles (NPs) derived from Callistemon viminalis leaf extract coupled with multiwalled carbon nanotubes (MWCNTs) doped onto glassy carbon electrode (GCE). In comparison to the bare GCE, the modified GCE/MWCNT/AuNPs sensor showed about 45-fold better electrochemical response to xylitol. Under the optimal conditions, the designed sensor achieved a detection limit of 9.8 × 10−6 pM for concentrations ranging from 9.9 × 10−6 to 2.9 × 10−5 pM. The practicability was tested on sugar-free sample yielding recoveries of 97–100% with RSDs of 2.83–3.33%. Machine learning (ML) was used to predict changes in voltammetric signal with changing potential over time demonstrating the fundamental knowledge of the electrochemical reaction. The performance of the Artificial Neural Network (ANN) provides good accuracy and precision in predicting the intensity (I) along with repeated ANN runs, with a mean square error (MSE) of 0.007 (± 0.002) and a determination coefficient (R2) of 0.9992 ± 0.0006. Additionally, the interaction of xylitol on the electrode surfaces were investigated using Monte Carlo adsorption studies and 1000 ps Molecular Dynamics simulations under NVT conditions. According to the frontier molecular orbitals obtained through Density Functional Theory calculations, the reactive sites of xylitol occur at the hydroxyl group on the second carbon. Using complementary measurement techniques, this new strategy exhibits a great potential for rapid detection of xylitol in food and dental products.

Santé mentale et Santé bucco-dentaire : de l’intérêt de faire tomber le masque

The mouth is at the heart of our daily life. However, oral health is often overlooked, especially in people with mental illness. The objectives of this review were to identify the factors that can increase their vulnerability toward oral diseases, to describe the consequences in terms of health and quality of life, and to explore solutions for preventing and managing oral diseases in this population. Why are patients with mental illnesses more at risk of poor oral health?The mental illnesses themselves, which can alter one's self-image and perception of the body, may decrease motor skills or disorganize daily life, contribute to a decrease in the practice of daily oral hygiene or in seeking healthcare services. The presence of vomit or gastroesophageal reflux stimulates the demineralization of dental surfaces. Addictive substances, the consumption of which is frequent in this population, particularly tobacco, have a direct impact on the oral mucosa and contribute to poor oral health as well as to a reduction of the effects of pharmacological treatments used to treat psychiatric pathologies. By stimulating the appetite, they promote snacking. By inhibiting the production of saliva, they prevent it from playing its role as a natural oral lubricant. It has a negative effect on self-cleaning dental surfaces, the neutralization of oral acidity and defensive power but also on food pre-digestion, chewing, swallowing and speaking. Finally, by inducing abnormal movements of the lips, tongue or jaw, problems of lip incompetence, breathing through the mouth or bruxism may develop. Difficulties in accessing oral care can also contribute to patients’ poor oral health. They may be related to mental pathology: the failure to keep appointments, refusal of care, anxiety, to the lack of information and understanding of their rights for health insurance and transportation to a dental office. They can also be linked to a stigmatizing or critical attitude or a rush to provide care from some dentists that can discourage the patient from continuing his/her oral follow-up. What are the consequences?Xerostomia has several consequences: difficulty in chewing, swallowing, speaking, wearing removable dentures and altered taste, bad breath, cracked lips, and burning mouth. The patient will then modify his/her diet and increase their consumption of soft drinks and soft foods, which adhere more to dental surfaces. Patients have an increased risk of carious lesions, erosion of the teeth, and periodontal lesions accentuated by smoking. People with substance addiction are roughly three times more likely to have periodontal pockets than control groups. People with eating disorders are five times more likely to have dental erosion, responsible for sensitive teeth than control groups due to vomiting or gastroesophageal reflux. Finally, the problem of dental caries is more severe in people suffering from mental illness: People with schizophrenia seem to be the most affected with 7.7 more tooth decay, missing and filled teeth on average than do control participants. Oral afflictions are responsible for acute and chronic pain and infection. Patients with severe mental illness are 2.8 times more likely to lose all their teeth than those in control groups. Edentulism has many repercussions for the patient's health and quality of life, (eating disorders, speech impediments, and deformed smiles, all of which can lead to low self-esteem and social isolation). What are the solutions?A set of measures can be proposed against xerostomia: frequent intake of unsweetened, non-acidic drinks, chewing sugar-free chewing gum with xylitol, salivary substitutes or salivary stimulants. Support measures to encourage patients to quit smoking, when possible and compatible with the patient's clinical condition, should be offered during psychiatric follow-up. Patients could be encouraged, as soon as their mental pathology has stabilized, to select a dentist and to consult him/her at least once a year for dental care and preventative measures and to become accustomed to receiving dental care. The continuum between psychiatric care and oral care is important, as is the training of medical teams. The number of dental treatments and/or the mental pathology of some patients can cause them to be uncooperative and may necessitate the use of a general anaesthesia during oral care, but this procedure has many limitations. For long-term health improvement and to avoid the accumulation of comorbidities, therapeutic patient education seems to be an appropriate complementary approach. Integrating oral health with psychiatric care would make it possible to encourage patients to develop habits of healthy eating and good oral hygiene, to seek dental care, and to acquire improved social behaviours.

What are dentists seeing in older adults?

What are dentists seeing in older adults?

How is the quality of the available evidence on molar-incisor hypomineralization treatment? An overview of systematic reviews.

This overview analyzed the quality of the systematic reviews (SRs) available on treatments for molar-incisor hypomineralization (MIH). Six electronic databases were searched (PubMed/MEDLINE, Scopus, Web of Science, LILACS, Brazilian Bibliography of Dentistry and Cochrane Library) until March 2022. Two reviewers independently performed the selection, the quality assessment (Assessment of Multiple Systematic Reviews 2 - AMSTAR-2), and the risk of bias assessment of the SR (Risk of Bias in Systematic Reviews - ROBIS). Two hundred nine records were retrieved; after removing duplicates and applying the inclusion/exclusion criteria, 5 SRs remained. Three SRs were rated as showing critically low methodological quality and high risk of bias, and two were rated as moderate methodological quality and low risk of bias. The identified treatments that may be suitable for MIH were classified as (1) non-invasive - casein incorporated into toothpaste and sugar-free chewing gum, toothpaste containing arginine, 0.4% stannous fluoride gel; fluoride varnish; (2) micro-invasive - resin sealants for pits and fissures, microabrasion, dental whitening, resin infiltration; (3) invasive - ART restorations, indirect restorations (metal, composite, or ceramic); and (4) mixed intervention - stainless steel crowns. Despite the considerable number of published papers included in this set of systematic reviews, the evidence supporting the effectiveness of treatments for treating MIH is limited due to the methodological quality and risk of bias of the systematic reviews, as well as the quality of the primary studies (PROSPERO: CRD42020144831). Different treatments have been purposed for MIH treatment, but there is still not enough scientific evidence of good quality for the establishment of a definitive clinical protocol for the treatment of MIH.

Health promotion through structured oral hygiene and good tooth alignment.

Aim: Periodontal diseases and caries are two of the most common forms of chronic degenerative diseases, with consequences not only for the oral cavity manifesting as tooth loss, orofacial pain and xerostomia, but also with effects on the cardiovascular system and, in the elderly, on the pneumonia rate. This can be prevented or controlled by structured oral hygiene.Method: Based on a systematic literature search in PubMed, the possibilities for ensuring structured oral hygiene are analyzed.Results and conclusion: Limiting the consumption of sugary meals and beverages, regular removal of food debris – supplemented by sugar-free chewing gum if desired – and preventing plaque formation by brushing with fluoridated toothpastes, using dental floss and interdental brushes after meals, serve to prevent or control gingivitis, periodontitis and caries. In the long term, the development of periodontitis-associated cardiovascular diseases and, in the elderly, the risk of pneumonia can probably be reduced. Antiseptic rinsing of the oral cavity is an important supplement to prevent periodontitis, especially in cases of limited ability to perform mechanical biofilm removal, but also for the prevention of respiratory infections. Proper functional tooth alignment is important for optimal mechanical cleaning to prevent plaque accumulation. If correction of misaligned teeth is possible with the use of removable aligners instead of fixed orthodontic appliances, these are to be preferred because of the better accessibility for mechanical hygiene measures.

Antiplaque and antigingivitis efficacy of medicated and non-medicated sugar-free chewing gum as adjuncts to toothbrushing: systematic review and network meta-analysis.

This network meta-analysis (NMA) assessed the antiplaque and anti-inflammatory efficacy of different sugar-free chewing gums (SFCG) as adjuncts to toothbrushing. PubMed, Scopus, EMBASE, Web of Science, and CENTRAL databases were searched up to February 2021 to identify randomized controlled trials, involving adults, comparing antiplaque and anti-inflammatory effects of SFCG, with different active ingredients, as adjunctive to mechanical control of biofilm, with a minimum of 7-day of follow-up. Plaque and gingival indexes were assessed. The risk of bias assessment was performed with the RoB 2.0 tool. NMA, and pairwise meta-analyses were performed for both dental plaque and gingival indexes. Twelve studies were included, comprising 850 (antiplaque) and 1459 (gingival inflammation) subjects randomized into 9 interventions: (1) chlorhexidine; (2) chlorhexidine + xylitol (CHX+Xyl); (3) green tea + xylitol (GT+Xyl); (4) magnolia; (5) Lactobacillus reuteri; (6) vitamin C + xylitol; (7) vitamin + carbamide; (8) eucalyptus; and (9) negative control, sorbitol, gum base only, or no chewing gum. No statistically significant differences were detected among SFCG, with different active ingredients, for both antiplaque and anti-inflammatory efficacy (p > 0.05). However, SFCG with GT+XyL outperformed negative control gums regarding antiplaque efficacy (SMD, - 2.93; 95% CrI, - 0.45 to - 5.38). The SUCRA results showed that SFCG containing GT+Xyl was ranked first, for both antiplaque and anti-inflammatory outcomes. SFCG containing GT+Xyl showed better antiplaque effect over negative controls. However, cautious interpretation is required due to the low number of direct comparisons arms. These shortcomings underscore the need for RCTs with mostly head-to-head comparison that provide more conclusive evidence. There is no robust evidence for the clinical indications of sugar-free chewing gums as adjunct to toothbrushing for the control of biofilm or the treatment of gingivitis.

Effectiveness of Chewing Gum Containing CPP-ACP for Remineralisation of Demineralised Enamel around Orthodontic Brackets: An in Situ Study

Objective: To evaluate the effectiveness of chewing gums containing CPP-ACP in remineralisation of demineralised enamel around orthodontic brackets. Material and Methods: Enamel blocks from 120 bovine incisors were used. The blocks were flattened and polished, followed by the development of incipient subsurface caries. The blocks have been subjected to a baseline microhardness analysis. Orthodontic brackets were bonded to the exposed area of the blocks, reserving an area for hardness analysis. An in situ crossover (three-way crossover phases of 21 days with an interval of one week between them), controlled, randomised and blind experimental model was used, with the participation of 12 volunteers divided into groups: G1 – negative control group, without chewing gum; G2 – conventional sugar-free chewing gum, without CPP-ACP (placebo); and G3 – sugar-free chewing gum with CPP-ACP. The following parameters were analysed: superficial linear (Ra), volumetric roughness (Sa), and superficial structural loss, which was indicated by Gap measurement (difference between the healthy and treated area). Statistical tests used were the Friedman, Wilcoxon and Shapiro-Wilk, Kruskal Wallis' nonparametric tests and ANOVA. Results: There was a significant reduction in enamel microhardness after demineralisation in all the groups (p<0.05). This deleterious effect was attenuated in the three groups after the final evaluation, although there were no statistical differences (p<0.05); however, the final values did not return to the baseline values (p<0.05). Conclusion: Chewing gum containing CPP-ACP did not promote in situ remineralisation of demineralised enamel around orthodontic brackets.

An In Vivo Comparison of the Effect of Sugar-Free Chewing Gum on Salivary Flow Rate and pH in Children at High Risk and Low Risk for Dental Caries

Aim The purpose of the study was to compare the changes in salivary pH and salivary flow rate after chewing xylitol-containing chewing gum in children at high risk and low risk for dental caries.Method Forty school children aged 9 to 12 years were selected for the study according to the inclusion criteria and were divided into two groups - Group A 20 children at high caries risk for dental caries and Group B 20 children at low risk for dental caries. Initially baseline saliva samples were collected for both the groups and subjected to salivary pH and flow rate assessment. Following this the children were instructed to chew xylitol-containing sugar-free chewing gum for 10 minutes. Salivary pH assessment was done at different time intervals like 0 15 30 45 and 60 minutes. The salivary flow rates were measured once the froth settled.Results Data was analyzed statistically using repeated-measures ANOVA. After chewing sugar-free gum salivary flow rate showed no significant difference pgt0.05 between Group A and Group B whereas salivary pH showed a statistically significant difference plt0.001 between the two groups at different time intervals.Conclusion Xylitol-containing sugar-free chewing gum showed an elevated salivary pH in children at high risk for dental caries when compared to the low-risk group while it showed an equal effect on salivary flow rate in both the groups. Xylitol-containing chewing gums were more effective in children at high risk for dental caries than the low-risk group.

Marine Bioactive Compounds as Nutraceutical and Functional Food Ingredients for Potential Oral Health.

Oral diseases have received considerable attention worldwide as one of the major global public health problems. The development of oral diseases is influenced by socioeconomic, physiological, traumatic, biological, dietary and hygienic practices factors. Currently, the main prevention strategy for oral diseases is to inhibit the growth of biofilm-producing plaque bacteria. Tooth brushing is the most common method of cleaning plaque, aided by mouthwash and sugar-free chewing gum in the daily routine. As the global nutraceutical market grows, marine bioactive compounds are becoming increasingly popular among consumers for their antibacterial, anti-inflammatory and antitumor properties. However, to date, few systematic summaries and studies on the application of marine bioactive compounds in oral health exist. This review provides a comprehensive overview of different marine-sourced bioactive compounds and their health benefits in dental caries, gingivitis, periodontitis, halitosis, oral cancer, and their potential use as functional food ingredients for oral health. In addition, limitations and challenges of the application of these active ingredients are discussed and some observations on current work and future trends are presented in the conclusion section.