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PubMed1980

Clinical use of nicotine chewing-gum.

Nicotine chewing-gum has recently become available to doctors in Britain for use as an aid to giving up smoking. It produces blood nicotine concentrations similar to tobacco smoking and so relieves symptoms of nicotine withdrawal. Owing partly to the slower rate of absorption of nicotine through the buccal mucosa, however, it does not reproduce the pleasure of cigarette smoking. Indeed, in the early stages it is usually slightly aversive. Optimal use in a skill requiring practice and careful instruction. Since it is an aid rather than easy cure, its use is limited to smokers who want to stop. Earlier trials showed modest advantages over placebo, but improvements in the gum and more experience in its use suggest that long-term success rates of 40% or more can be obtained. It required little time to administer and is therefore a feasible method for busy doctors.

Body Weight↗

PubMedDate not supplied

Effect of time and duration of sorbitol gum chewing on plaque acidogenicity.

Recent data indicate that salivary stimulation by chewing sugarless gum after snacks or meals can reduce the acidogenic potential of foods significantly. The purpose of this study was to determine the optimal initiation time and duration of post-snack salivary stimulation to obtain the maximum benefits of chewing sorbitol gum on reducing the acidogenic potential of starch-containing snacks. An indwelling plaque pH telemetry system was used on five adults in a randomized block design with four starch-containing snacks--pretzels, potato chips, granola bars, and corn chips. Results indicated that salivary stimulation caused by chewing sorbitol gum initiated after 5 min rather than waiting 15 min significantly reduced the acidogenic challenge induced by the snack foods. This study indicates that when the recommendation to chew sugarless gum following food ingestion is used as an adjunct in caries prevention, it should start within 5 min after food ingestion--the sooner the gum chewing is initiated the better--and should continue for at least 15 min to obtain the maximum benefits.

Adult↗

PubMed2006

Gum chewing reduces ileus after elective open sigmoid colectomy.

HYPOTHESIS: Gum chewing after elective open colon resection may stimulate bowel motility and decrease duration of postoperative ileus. DESIGN AND SETTING: Prospective, randomized study in a community-based teaching hospital. PATIENTS: Thirty-four patients undergoing elective open sigmoid resections for recurrent diverticulitis or cancer. MAIN OUTCOME MEASURES: First feelings of hunger, time to first flatus, time to first bowel movement, length of hospital stay, and complications. RESULTS: A total of 34 patients were randomized into 2 groups: a gum-chewing group (n = 17) or a control group (n = 17). The patients in the gum-chewing group chewed sugarless gum 3 times daily for 1 hour each time until discharge. Patient demographics, intraoperative, and postoperative care were equivalent between the 2 groups. All gum-chewing patients tolerated the gum. The first passage of flatus occurred on postoperative hour 65.4 in the gum-chewing group and on hour 80.2 in the control group (P = .05). The first bowel movement occurred on postoperative hour 63.2 in the gum-chewing group and on hour 89.4 in the control group (P = .04). The first feelings of hunger were felt on postoperative hour 63.5 in the gum-chewing group and on hour 72.8 in the control group (P = .27). There were no major complications in either group. The total length of hospital stay was shorter in the gum-chewing group (day 4.3) than in the control group (day 6.8), (P = .01). CONCLUSIONS: Gum chewing speeds recovery after elective open sigmoid resection by stimulating bowel motility. Gum chewing is an inexpensive and helpful adjunct to postoperative care after colectomy.

Chewing Gum↗

PubMed1999

The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention.

Habitual xylitol gum-chewing may have a long-term preventive effect by reducing the caries risk for several years after the habitual chewing has ended. The goal of this report was (1) to determine if sorbitol and sorbitol/xylitol mixtures provide a long-term benefit, and (2) to determine which teeth benefit most from two-year habitual gum-chewing - those erupting before, during, or after habitual gum-chewing. Children, on average 6 years old, chewed gums sweetened with xylitol, sorbitol, or xylitol/sorbitol mixtures. There was a "no-gum" control group. Five years after the two-year program of habitual gum-chewing ended, 288 children were re-examined. Compared with the no-gum group, sorbitol gums had no significant long-term effect (relative risk [RR], 0.65; 95% confidence interval [c.i.], 0.39 to 1.07; p < 0.18). Xylitol gum and, to a lesser extent, xylitol/sorbitol gum had a long-term preventive effect. During the 5 years after habitual gum-chewing ended, xylitol gums reduced the caries risk 59% (RR, 0.41; 95% c.i., 0.23 to 0.75; p < 0.0034). Xylitol-sorbitol gums reduced the caries risk 44% (RR, 0.56; 95% c.i., 0.36 to 0.89; p < 0.02). The long-term caries risk reduction associated with xylitol strongly depended on when teeth erupted (p < 0.02). Teeth that erupted after 1 year of gum-chewing or after the two-year habitual gum use ended had long-term caries risk reductions of 93% (p < 0.0054) and 88% (p < 0.0004), respectively. Teeth that erupted before the gum-chewing started had no significant long-term prevention (p < 0.30). We concluded that for long-term caries-preventive effects to be maximized, habitual xylitol gum-chewing should be started at least one year before permanent teeth erupt.

Belize↗

PubMed1989

Clinical study to evaluate the effects of three marketed sugarless chewing gum products on plaque pH, pCa, and swallowing rates.

The purpose of this study was to determine the ability of three commercially available chewing gums (Extra, Trident, and CareFree) to stimulate saliva flow and reverse the plaque acid and ionized calcium levels induced by a glucose challenge. Electrodes to measure pH and pCa were situated in a Hawley appliance. When the Hawley appliance was in place, the electrodes were inserted into three day old plaque at maxillary interproximal sites. A pressure sensor, located in the posterior center of the Hawley appliance, was used to record swallowing rates. After baseline values were determined, the test procedure consisted of first administering a 5% glucose challenge solution followed by a 10 minute challenge effect period, a 5 minute gum chewing or product period, and finally a 10 minute product effect period after the test gum was discarded. An ANOVA was used to compare the ability of each chewing gum to stimulate saliva and cause a return of the plaque acid and/or ionized calcium to baseline levels following product discard. The three chewing gum products varied in both time and level of pH attained while neutralizing plaque acidity (p less than .05) induced by the glucose rinse. No significant differences were found between the chewing gums for the pCa data and swallowing rates. All chewing gum products stimulated swallowing and effectively reversed plaque pH and pCa changes caused by the glucose rinse.

Calcium↗

PubMed1985

Theoretical background and clinical use of nicotine chewing gum.

In our view, nicotine chewing gum is the most significant single advance achieved so far in the whole field of smoking cessation. It is the only treatment that has yet been shown to have a specific effect over and above that of attention-placebo factors, and this has been demonstrated repeatedly by several research groups in different countries. It is suitable for use as an adjunct both to intensive psychological methods of treatment and to minimal and largely self-help types of intervention. In either case, it approximately doubles the success rates achieved by intervention without the use of gum. It can be administered effectively by psychologists and family physicians and no doubt by other adequately trained health professionals too. The efficacy of nicotine chewing gum is not limited to the smokers who use it. Its incorporation into a treatment or intervention programme revitalises and maintains the morale of therapists. Until the advent of nicotine gum it has required either a research interest, financial reward, or a degree of masochism to remain for long at the sharp end of the business of helping people to give up smoking. Without a treatment capable of reducing withdrawal symptoms, therapists become drained by having constantly to give out encouragement and support to help their clients to tolerate withdrawal long enough for the difficulties gradually to wane. The rapid and tangible effect of the gum in relieving withdrawal symptoms is a boost to the morale and confidence of client and therapist alike. It is perceived as helpful even by those who fail. This encourages people who relapse to return for further therapy. A discouraging feature with other treatments has been the tendency for those who relapse to avoid contact with their therapists even to the extent of not responding to data collection at long-term follow up. In view of its efficacy, its potential for use in many settings, its minimal demands on therapists' time, and its synergistic effect in encouraging and boosting the confidence of clients and therapists alike, it is possible that over a period of years nicotine chewing gum could have a significant impact on national smoking prevalence. But to achieve this, it is essential that it be used correctly.

Chewing Gum↗

PubMed2006

The effect of adding calcium lactate to xylitol chewing gum on remineralization of enamel lesions.

The purpose of the study was to determine whether adding calcium lactate to chewing gum containing xylitol enhances remineralization of enamel surfaces using an early caries lesion model. Enamel slabs were cut from human extracted sound teeth and artificial subsurface lesions created within each. Half the enamel slabs were used as controls and stored in a humidifier while half were mounted into oral appliances worn by 10 volunteers (22-27 years old, 2 males and 8 females) in a three-leg trial, during which they wore the appliance without chewing gum, chewed gum containing xylitol + calcium lactate or chewed gum containing only xylitol 4 times a day for 2 weeks. Calcium concentrations in the enamel surfaces of control and test slabs were measured by X-ray spectrometry and degrees of remineralization were calculated. The mean degree of remineralization was greater after chewing xylitol-Ca gum (0.46 +/- 0.10) than after no gum (0.16 +/- 0.14) or after chewing xylitol gum (0.33 +/- 0.10) (p < 0.01). In conclusion, chewing gum containing xylitol + calcium lactate could enhance remineralization of enamel surface compared to chewing gum containing only xylitol or no gum chewing.

Adult↗

PubMed2003

[Does chewing gum have consequences for anesthesia? A case report].

Chewing gum is a common habit. Based on two cases of esophageal obstruction during induction of general anesthesia, the importance of chewing gum for anesthesiology is outlined. The dangers of chewing gum result from obstruction of the trachea and oesophagus but complications may also result from stimulated production of gastric juice with a risk of consecutive regurgitation and aspiration. In the case of an obstacle in the oesophagus when inserting a nasogastric tube, an obstruction by a mass of chewing gum should be considered. Although the literature provides differing statements concerning the volume and acidity of gastric juice after chewing gum, the use of chewing gum should be included in preanesthetic NPO rules.

Adolescent↗

PubMed1997

Efficacy of chewing gum in preventing extrinsic tooth staining.

The purpose of this six-week clinical study was to determine the efficacy of sugar-free chewing gum versus no chewing on preventing Peridex (0.12% chlorhexidine)-associated stain. One-hundred and fifty healthy adult subjects, categorized by tea or coffee intake and smoking, were randomly assigned to a chewing or no chewing gum group. All subjects were given Peridex and an ADA-approved toothbrush and fluoride toothpaste to use twice a day. Gum was chewed for 20 minutes five times each day, after toothbrushing and Peridex rinse in the morning and evening, and after each meal. At baseline, all subjects received a professional cleaning to remove all supragingival deposits and extrinsic strain. At three and six weeks, safety and stain intensity and area were monitored on the anterior teeth and posterior Ramfjord teeth using the Lobene stain scoring method. Seventy-two subjects in each group completed the study. Attrition was unrelated to product use. No untoward reactions were reported or observed at any time in the study. At the six-week evaluations, the chewing gum group exhibited significantly lower (p < 0.05-0.001) total stain scores on both anterior and posterior areas evaluated compared to the no chewing group scores. In addition to the stain evaluations, a randomly selected subset of 60 subjects was evaluated for gingivitis at baseline prior to cleaning, and at three and six weeks, on the buccal and lingual surfaces of the Ramfjord teeth. Both the chewing gum and no chewing gum subset subjects had a significant decrease in gingivitis scores from baseline to three weeks (p < 0.001) and from baseline to six weeks (p < 0.05-0.001). There were no significant statistical differences between the two groups at anytime during the study on gingivitis levels. Chewing gum, after product use, did not reduce the efficacy of chlorhexidine on gingivitis scores.

Adolescent↗

PubMed1996

Gum chewing and jaw muscle fatigue and pains.

To study possible associations between gum chewing and fatigue and pains in the jaw muscles, eight healthy adults performed prolonged idling, prolonged unilateral chewing of gum, and brief vigorous clenching of the teeth (MVC). Through surface electromyography (EMG), the authors monitored the cumulative (microV.s) as well as the average rates (microV.s-1) of contractile activities in the right and left masseter muscles. During 10 min of idling there was an absence of muscle fatigue and muscle pains when the EMG rates of the right and left masseter muscles were 2% and 3%, respectively, of those required to elicit isometric muscle pains through MVC. During 10 min of right-sided gum chewing at a rate of 1.2 Hz, the majority of subjects (75%) experienced weak jaw muscle fatigue-not jaw muscle pains-when the EMG rates of the right and left masseter muscles were 38% and 19%, respectively, of those required to elicit isometric pains through MVC. In comparison with 10 min of idling, the weak muscle fatigue of 10 min of unilateral gum chewing appeared when the total contractile activities of the right and left masseter muscles were increased by 1664% and 519%, respectively. It seemed as if prolonged unilateral gum chewing and previous pain-releasing MVC caused some sensitization of muscle nociceptors which, in turn, aggravated subsequent isometric jaw muscle pains elicited through MVC. Even though the right masseter muscle was the most frequent site of clinical fatigue and pains, the authors found no evidence supporting the theoretical foundation of the myofascial pain/dysfunction syndrome.

Adult↗

PubMed2001

Effects of prolonged gum chewing on pain and fatigue in human jaw muscles.

Gum chewing has been accepted as an adjunct to oral hygiene, as salivary stimulant and vehicle for various agents, as well as for jaw muscle training. The aim of this study was to investigate the effects of prolonged gum chewing on pain, fatigue and pressure tenderness of the masticatory muscles. Fifteen women without temporomandibular disorders (TMD) were requested to perform one of the following chewing tasks in three separate sessions: chewing a very hard gum, chewing a soft gum, and empty-chewing with no bolus. Unilateral chewing of gum or empty chewing was performed for 40 min at a constant rate of 80 cycles/min. In each session, perceived muscle pain and masticatory fatigue were rated on visual analog scales (VAS) before, throughout, and after the chewing task. Pressure pain thresholds (PPTs) of masseter and anterior temporalis muscles were assessed before and immediately after the chewing tasks, and again after 24 h. The VAS scores for pain and fatigue significantly increased only during the hard gum chewing, and after 10 min of recovery VAS scores had decreased again, almost to their baseline values. No significant changes were found for PPTs either after hard or soft gum chewing. The findings indicate that the jaw muscles recover quickly from prolonged chewing activity in subjects without TMD.

Adult↗

PubMed1993

Miconazole chewing gum for treatment of chronic oral candidosis.

A chewing gum containing the antifungal drug miconazole may be convenient for topical treatment of oral candidosis. Therefore a trial was performed to examine the effect and tolerance of miconazole chewing gum in comparison with miconazole gel in the treatment of oral candidosis. The study group consisted of 32 patients with oral candidosis harboring yeasts, predominantly Candida spp. Half of the patients chewed one piece of chewing gum (dose: 3.6 mg of miconazole) four times daily; the other half dispersed a 2% gel (dose: 50 mg of miconazole) in the oral cavity four times daily. After 6 wk of treatment, there was no clinical evidence of yeast infection in either of the two groups. No significant differences between the two groups were found in clinical, mycologic, and cytologic investigations conducted after 3 and 6 wk of treatment or at the follow-up examination 4 wk after termination of the treatment. The results indicate that miconazole released from chewing gum is as effective as miconazole gel. The chewing gum reduced the dosage of miconazole for treatment of oral candidosis, and the patients approved the chewing gum as a pleasant medicament.

AIDS-Related Opportunistic Infections↗

PubMed2001

Effect of after-meal sucrose-free gum-chewing on clinical caries.

Previous in situ and in vitro studies have demonstrated that the chewing of sucrose-free gum after eating reduces the development of dental caries. To investigate the extrapolation of these findings to the clinical setting, we conducted a two-year study on 547 schoolchildren in Budapest, Hungary. Subjects in the "Gum" group were instructed to chew one stick of a commercially available sorbitol-sweetened chewing gum for 20 minutes after meals, three times daily. The "Control" group was not provided with chewing gum. After two years, the "Gum" group exhibited a 38.7% reduction in incremental caries, excluding white spots, compared with the "Control" group. Including white spots, a corresponding 33.1% reduction was indicated. These results clearly suggest that even in a moderate caries population practicing normal oral hygiene, including the use of fluoride dentifrices, an after-meal gum-chewing regimen can significantly reduce the rate of caries development.

Adolescent↗

PubMed2005

Effect of after-meal sucrose-free gum-chewing on clinical caries.

Adolescent↗

PubMed2001

The effect of hot beverages, cold beverages, and chewing gum on oral temperature.

BACKGROUND: A prospective blood donor's oral temperature is affected by external stimuli such as drinking a hot or cold beverage or chewing gum. These stimuli can cause a deferral or an inappropriate acceptance for a certain unknown time. STUDY DESIGN AND METHODS: Ten volunteer subjects were exposed to each of the three stimuli in separate studies. Oral and tympanic membrane temperatures were taken before exposure, immediately after exposure, and at various times until the subject's temperature returned to baseline. RESULTS: The drinking of a hot beverage caused an immediate mean temperature elevation of 2.6 degrees F which would lead to deferral for 7 of 10 subjects. All subjects were acceptable for blood donation (temperature <99.6 degrees F) by 5 minutes. A cold beverage lowered the temperature; the temperature in 6 subjects returned to baseline by 10 minutes and that in 4 did so by 30 minutes. Gum chewing caused minimal temperature elevations; only 1 donor's temperature reached 99.6 degrees F, and it was at acceptable levels for blood donation by 5 minutes. CONCLUSION: Drinking a hot beverage and, to a much lesser degree, gum chewing can lead to a deferral for elevated temperature, but subjects were acceptable by 5 minutes. Cold beverages are of more concern, because they suppress the temperature for a short time and could theoretically lead to acceptance of a febrile, possibly infectious donor.

Beverages↗

PubMed1990

Relative bioavailability of methadone hydrochloride administered in chewing gum and tablets.

Methadone administered in chewing gum in doses of 16.7-22.6 mg to seven patients in a study using an open balanced cross-over design, was compared with 20 mg of methadone given perorally as tablets. There was no significant difference in the AUC/D obtained after administration of chewing gum and tablets (p greater than 0.05). It is concluded that the chewing gum formulation should be considered for further testing with respect to suppression of abstinence syndrome in narcotic addicts.

Adult↗

PubMed1993

The distribution of saliva and sucrose around the mouth during the use of chewing gum and the implications for the site-specificity of caries and calculus deposition.

Over a 20-minute period, subjects expectorated 8 samples of whole saliva (EWS) while chewing gum. Flow rates were calculated, and sucrose was analyzed in these samples as well as in saliva collected on filter paper strips from different tooth surfaces. Salivary film velocity (SFV), based on a 0.1-mm-thick film, was estimated from the clearance half-times of KCl in agarose disks positioned in different regions of the mouth. Salivary flow rate peaked at 5.1 mL/min in the first min but fell to about 1.25 mL/min by the end of the 20 min of gum-chewing. In contrast, flow rate when subjects sucked sour lemon drops averaged about 5.3 mL/min throughout the 20-minute period. The mean salivary sucrose concentration during gum-chewing peaked in the second min at 384 mmol/L (13.1%) but had fallen to 14 mmol/L by the 15-20-minute time interval. The sucrose concentrations on the palatal surfaces of the upper incisors and the facial and lingual surfaces of the lower molars were not significantly different from that in EWS but were much lower on the facial surfaces of the upper incisors and molars, and on the lingual surfaces of the lower incisors. When flow was unstimulated, SFV was 0.8-1.0 mm/min on the facial surfaces of the upper incisors and lower molars but about 5-8 mm/min on the facial surfaces of the upper molars and on the lingual surfaces of the lower incisors and molars.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2006

Chlorhexidine-containing chewing gum. Clinical documentation.

A clinical documentation on chlorhexidine containing chewing gum is presented on the occasion of the launch of CHewX, a chewing gum containing 5 mg of chlorhexidine diacetate in Switzerland. Following an overview on functional chewing gum, the mechanism of action of chlorhexidine (CHX), its toxicity and safety are summarized and a review of clinical studies performed with CHX-containing chewing gum given. Indication, dosage, precautions and benefits of CHX chewing gum are described.

Adult↗