Chewed up

This may be worse for your teeth than you think.

A new study in the British Dental Journal has caused a stir by questioning one of the basic bits of oral health we all receive regularly: that chewing sugar-free gum is good for your teeth. The study, which is available online here, found there was an unrecognised risk from acidic flavouring in sugar-free candies and drinks which can erode tooth enamel.

A team from the universities of Boston, Helsinki and Southern Nevada, examined the role of sugar substitutes used in products to tackle tooth decay. They said a group of substitutes of sugar alcohols including xylitol and sorbitol can reduce the risk of cavities, but also increase mouth acidity which erodes dental enamel. This is especially true if they contain fruit flavourings.

Researcher Dr Sok-Ja from Boston University, said: “The term sugar-free may generate false security because many people may automatically believe that sugar-free products are safe on the teeth.”

Writing in the review, the researchers said: ‘As the use of sorbitol and xylitol containing products increases, the public should be educated on the hidden risk of dental erosion due to acidic additives, as well as the adverse effects of gastric disturbance and osmotic diarrhoea.

‘Especially in sugar-free products, these adverse effects may be more insidious because the public has blind confidence that they are oral health friendly.’

They concluded that further clinical trials were needed in the area.

In a commentary on the findings, Stephen Hancocks, editor in chief of the BDJ, said there was a “minefield of confusion for the patient who is trying his or her very best to comply with healthy choices and a complex labyrinth of communication for the professional in attempting to convey practical advice.”


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  1. The article quoted was a literature search and not in any way a study that tested the relationship between acidity and dental erosion. The conclusions are only assumptions which have not been tested in the model, gum , that delivers the sugar alcohols into the oral environment. There is no evidence the risk exists , however the questions surrounding and if this is to be considered then in vivo and in vitro studies may be warranted or changes by the manufacturer in the fruit flavouring agents.


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