The Impact of Chewing Gums on the Plaque Index in the Lack of Oral Hygiene Measures in Patients Referred to a Private Dental Clinic

Main Article Content

Nazanin Forghani


Introduction: Nowadays, Chewing Gum is one of the frequent habits among people. The purpose of this study was to compare the effect of two types of chewing gums (with and without sugar) on dental plaque accumulation in the lack of oral hygiene measures.

Materials and Methods: In this descriptive cross-sectional study, plaque accumulation during three 4-day periods (with two-week interval) was recorded (Sillness & LÖe Index) in a group of 20 patients in the absence of routine oral hygiene methods. The patients were asked to chew sugar-free Gum (Trident) during the first 4-day period and sugar-containing Gum (Dubble Bubble) during the second 4-day period and stop chewing during the third period. Participants were asked to chew five gum sticks daily after meals for about twenty minutes. The data were statistically analyzed using One Way ANOVA and LSD full form tests.

Results: The results showed that both sugar-free and sugar-containing gums reduced the amount of plaque (P<0.001). The comparison of the mean dental plaque accumulation between the two groups indicated that the effect of the sugar-free gum was more significant than that of the sugar-containing one (P<0.001). 

Conclusion: Although sugar-free gum is more effective than sugared gum on reducing dental plaque accumulation, chewing sugar-containing gum also decreases the level of dental plaque.

Dental plaque, chewing gum, oral hygiene.

Article Details

How to Cite
Forghani, N. (2020). The Impact of Chewing Gums on the Plaque Index in the Lack of Oral Hygiene Measures in Patients Referred to a Private Dental Clinic. Asian Journal of Dental Sciences, 3(2), 8-14. Retrieved from
Case Study


Slade GD. Epidemiology of dental pain and dental caries among children and adolescents. Community Dent Health. 2001;18(4):219-27.

Marthaler TM. Changes in dental caries 1953-2003. Caries Res. 2004;38(3):173-81.

Winter GB. Epidemiology of dental caries. Arch Oral Biol 1990;35(Suppl):1S-7S.

Karami Nogourani M, Safaian Ghasemi H, Ahmadi A, Poorsina F, Narimani T. The effects of four commercial chewing gums on pH, bacterial count and Streptococcus mutans of saliva. The journal of Islamic Dental Association of Iran. 2005;17(2):40-7.

Karami Nogourani M, Banihashemi M. The effect of chewing gum on dental plaque accumulation [Doctorate Thesis]. Iran. Islamic Azad University khorasgan Branch; 2007. (Persian)

Hanham A, Addy M. The effect of chewing sugar-free gum on plaque regrowth at smooth and occlusal surfaces. J Clin Periodontol. 2001;28(3):255-7.

Mäkinen KK, Isotupa KP, Mäkinen PL, Söderling E, Song KB, Nam SH, et al. Six-month polyol chewing-gum program in kindergarten-age children: A feasibility study focusing on mutans streptococci and dental plaque. Int Dent J. 2005;55(2):81- 8.

Autio JT, Courts FJ. Acceptance of xylitol chewing gum regimen by pre-school children and teachers in a head start program: A pilot study. Pediatr Dent. 2001;23(1):71-4. Dental plaque. Southeast Asian J Trop Med Public Health. 2004;35(4):1024-7.

Thaweboon S, Thaweboon B, Soo-Ampon S. The effect of xylitol chewing gum on mutans streptococci in saliva and dental plaque; 2004.

Edgar WM. Sugar substitutes, chewing gum, and dental caries-a review. Br Dent J. 1998;184(1):29-32.

Pizzo G, Licata ME, La Cara M, Pizzo I, Guiglia R, Melilli D. The effects of sugar-free chewing gums on dental plaque regrowth: A comparative study. J Dent. 2007;35(6):503-8.

Stookey GK. The impact of saliva on dental caries. J Am Dent Assoc. 2008;139: 11S-17S.

Van Loveren C. Sugar alcohols: What is the evidence for caries-preventive and caries-therapeutic effects? Caries Res. 2004;38(3):286-93.

Loesche WJ, Grossman NS, Earnest R, Corpron R. The effect of chewing xylitol gum on the plaque and saliva levels of Streptococcus mutans. J Am Dent Assoc. 1984;108(4):587-92.

Beiswanger BB, Boneta AE, Mau MS, Katz BP, Proskin HM, Stookey GK. The effect of chewing sugar-free gum after meals on clinical caries incidence. J Am Dent Assoc 1998;129(11):1623-6.

Cosyn J, Verelst K. An efficacy and safety analysis of chlorhexidine chewing gum in young orthodontic patients. J Clin Periodontol. 2006;33(12):894-9.

Burt BA, Eklund SA. Dentistry, dental practice and the community. 5th ed. Philadelphia: W.B. Saunders Co. 2004; 189.

Barnes VM, Santarpia P, Richter R, Curtis J, Xu T. Clinical evaluation of the anti-plaque effect of commercial chewing gum. J Clin Dent. 2005;16(1):1-5.

Wennerholm K, Arends J, Birkhead D, Ruben J, Emilson CG, Dijkman AG. Effect of xylitol and sorbitol in chewing-gums on mutans streptococci, plaque pH and mineral loss of enamel. Caries Res. 1994;28(1):48-54.

Isotupa KP, Gunn S, Chen CY, Lopatin D, Mäkinen KK. Effect of polyol gums on the dental plaque in orthodontic patients. Am J Orthod Dentofacial Orthop. 1995;107(5): 497-504.

Twetman S, Stecksén-Blicks C. Effect of xylitol-containing chewing gums on lactic acid production in dental plaque from caries active pre-school children. Oral Health Prev Dent. 2003;1(3):195-9.

Szöke J, Bánóczy J. Effect of after-meal sucrose-free gum-chewing on clinical caries. SADJ. 2005;60.

Dong YM, Pan YC, Wang DM, Cao CF. Effect of chewing sugar-free gum after sucrose challenge on dental plaque pH in situ. Zhonghua Kou Qiang Yi Xue Za Zhi. 2003;38(6):423-56, 248-51.

Hoerman KC, Gasior EJ, Zibell SE, Record D, Flowerdew G. Effect of gum chewing on plaque accumulation. J Clin Dent. 1990; 2(1):17-21.