The potential benefits of sugar-free chewing gum on the oral health and quality of life of older people living in the community: a randomized controlled trial

Objectives To determine the effects of prescribing sugar-free chewing gum on the oral health and quality of life of dentate older people living in the community and attending for routine dental care. Methods A randomized controlled trial was conducted on 186 older people who were not regular chewers of gum, (aged 60 years and over with = 6 teeth) recruited from primary care clinics. Participants were randomly allocated to a gum-chewing group (chewing xylitol-containing gum twice a day for 15 min; n = 95) or a control group (no gum; n = 91). Both groups were examined at baseline and at the end of the study (6 months later). The primary outcome measure for the study was increased in stimulated saliva flow rate. Secondary measures included improvements in Plaque and Gingival Indices, and self-perceived change in oral health. Results The retention rate for the study was 78.5% (n = 146 at follow-up); reported compliance with the protocol was 84% (ranged between 12% and 100%). There was no significant change in the saliva flow of the gum-chewing group (1.201.17 ml/min), while the control group experienced an increase in flow rate (1.061.32 ml/min; P = 0.001). The gum-chewing group, however, demonstrated significant improvement in Plaque and Gingival Index scores over the control group. For the Plaque Index, the mean scores (+/-SD) were 0.29 (+/-0.29) and 0.56 (+/-0.46) for the gum-chewing group and control groups, respectively (P < 0.001), at the second examination, which remained significant after controlling for age and saliva flow rate. For the Gingival Index, the scores were 0.73 (+/-0.30) and 0.92 (+/-0.32), respectively (P < 0.001), which persisted after controlling for age. A significantly higher proportion of participants in the gum-chewing group perceived that their oral health had improved during the study period in comparison with the control group (40% cf 21%; P = 0.016). Conclusions Prescription of sugar-free chewing gum to dentate older people living in the community and attending routine dental services was not associated with a significant increase in stimulated saliva flow. There were, however, significant improvements in Plaque and Gingival Index scores, and in self-perceived oral health.