咀嚼无糖口香糖对成年人菌斑指数的影响

目的 评价麦芽糖醇口香糖对菌斑集聚水平的影响。方法 60名年龄于25~50岁之间,符合纳入标准的志愿者,按照性别、Qu igley-Hein(Turesky改良)菌斑指数(MPI)随机分为3组,每组20人,3组分别为麦芽糖醇口香糖组(MCG)、木糖醇口香糖组(XCG)、单纯胶基口香糖组(GB);指导志愿者咀嚼口香糖,每天5次,每次2粒(约1.4 g/粒),持续12周。通过记录MPI来评价菌斑集聚水平的变化,采用多因素重复测量方差分析的方法对处理因素,时间因素,以及处理与时间交互因素进行分析(P<0.05)。结果 与基线值相比,MCG组、XGG组、GB组受试者MPI分别下降了48.1%、52.4%、21.6%,MCG组与XCG组之间无显著性差异(P>0.05),MCG组、XCG组与GB组之间均有显著性差异(P<0.01)。结论 传统木糖醇口香糖与麦芽糖口香糖对菌斑抑制有着相似的功效。     

The effect of chewing sugar-free gum on plaque regrowth at smooth and occlusal surfaces

BACKGROUND AND AIM: Chewing gum has the potential to provide oral health benefits including plaque control. The aim of this study was to determine the effects of chewing sugar free gum on plaque regrowth at buccal, lingual and occlusal surfaces of teeth. METHOD AND MATERIALS: 11 healthy and dentally-fit dental hygiene students participated in this randomised, single-blind crossover 4-day plaque regrowth study. From a zero plaque score on day 1, subjects suspended oral hygiene measures and either chewed gum or did not chew gum over 4 days. Gum chewing was one piece chewed for 30 min 4 x per day. On day 4, subjects were scored for plaque after disclosing from buccal, lingual and unrestored occlusal surfaces. RESULTS: There was no significant difference in smooth surface plaque scores between the treatments but significantly less plaque accumulated (44%) at occlusal surfaces during gum chewing compared to no gum chewing. CONCLUSION: Chewing gum can reduce plaque accumulation at sites of predilection for caries but has little or no effect at sites of predilection for gingivitis.     

Prevention of plaque growth with chewing gum containing chlorhexidine acetate

The purpose of the study was to assess the anti-plaque effect of chlorhexidine (CHX) in chewing gum. The 0.80 g pieces of test gum contained 5 mg chlorhexidine acetate with or without a hydrogen peroxide releasing agent. The gum base with flavouring agents but containing neither CHX nor H2O2 was used as a control. 12 dental hygiene students volunteered to participate in the 3 x crossed-over double blind clinical trial. During the 4-day test periods, no other oral hygiene measures were allowed than chewing 2 pieces of gum at the time for approximately 10 min, 5 times daily. Between test periods, meticulous mechanical oral hygiene measures were practised for 3 days. At the beginning and at the end of each test period, the quantity of plaque was assessed using the plaque index, plaque wet weight, and the area of plaque on the tooth surface as criteria. The results indicated that both CHX gums completely inhibited the increase in plaque index and plaque weight. With regard to area of plaque, the difference between the 2 test gums and the control gum was less marked but still present. The test persons subjectively assessed the gum base to have a poor cleansing effect but also the least unpleasant taste. It was concluded that use of both the chlorhexidine gum and the gum-containing chlorhexidine in addition to the hydrogen peroxide releasing agent had an excellent plaque growth inhibiting effect during the 4-day test periods.     

Release of fluoride from fluoride-containing chewing gum

The release of fluoride from fluoride-containing chewing gum and the fluoride concentration in whole saliva was measured at different intervals after the start of the chewing procedures. The residual fluoride contents were 78, 32, and 6% of the initial 0.25 mg in the gum after chewing for 2, 5, and 10 min, respectively. When chewing for 10 min, the salivary fluoride increased from 0.05 to 11.7 and 15.3 parts/10(6) after 2 and 5 min, respectively, followed by a fall to 3.9 parts/10(6) after 10 min. Concentrations exceeding the preintake level were still recorded 60 min after the start of the chewing.     

无糖口香糖对口气相关值的影响

目的 研究咀嚼无糖口香糖对半胱氨酸激发性口臭的抑制作用。方法 将10名志愿者随机分为处理组和未处理组,每组5名,均接受半胱氨酸口气激发实验,激发实验后未处理组不进行任何处理,处理组咀嚼无糖口香糖1 min后吐出。在咀嚼口香糖后1、10、20 min测量两组的硫化氢（H2S）、甲基硫醇（CH3SH）、乙基硫化物[(CH3)2S]浓度。结果 处理组咀嚼口香糖后1、10、20 min,H2S浓度下降百分比分别为82.68%、92.27%、97.47%,CH3SH浓度下降百分比分别为65.49%、73.79%、82.89%,(CH3)2S浓度下降百分比分别为60.45%、73.82%、59.72%。处理组与未处理组在不同时间的H2S、CH3SH、(CH3)2S浓度下降百分比均有统计学差异（P<0.05）。结论 无糖口香糖对半胱氨酸激发性口臭具有一定的抑制作用。     

The efficacy of an anti-gingivitis chewing gum

Abstract Chlorhexidine is a well-established agent used for the control of supragingival plaque but is not without disadvantages, such as tooth staining, which limits its clinical applications to short-term use. This clinical trial studied the clinical effectiveness and stain-forming potential of chlorhexidine in a chewing gum base. Subjects (151) were screened for baseline plaque and gingival indices before receiving a dental prophylaxis and randomized into 3 treatment groups: group 1 chewed 2 pieces of chlorhexidine diacetate gum for 10 min 2× a day (total daily chlorhexidine=20 mg). group 2 chewed 2 pieces of placebo gum for 10 min 2× a day and group 3 rinsed with 10 ml of 0.2% chlorhexidine gluconate mouthwash for 1 min 2× per day (total daily chlorhexidine=40 mg). Plaque, gingivitis and stain evaluations were made at 4 and 8 weeks. Plaque and bleeding scores were significantly lower at 4 and 8 weeks in the chlorhexidine gum group compared to the placebo gum group and similar at 8 weeks to the rinse group. Stain intensity at week 8 was significantly less for the chlorhexidine gum than rinse. The staining measured by extent was also Jess with the chlorhexidine gum than the rinse, but the difference was not significant at week 4. At week 8, stain extent was significantly lower in the chlorhexidine gum group than chlorhexidine rinse. In conclusion, the results of this study demonstrate that this chlorhexidine chewing gum used with normal tooth cleaning provides similar adjunctive benefits to oral hygiene and gingival health as a 0.2% chlorhexidine rinse.     

Caries preventive effect of sugar-substituted chewing gum

OBJECTIVES: The aim of this 3-year community intervention trial was to determine the caries preventive effect of sugar-substituted chewing gum among Lithuanian school children, and to assess compliance with the instructions for gum use. METHODS: A total of 602 children, aged 9-14 years, from 28 school classes in five secondary schools in Kaunas, Lithuania, were given a baseline clinical and radiographic caries examination. The schools were randomly allocated to receive one of the following interventions: sorbitol/carbamide gum; sorbitol gum; xylitol gum; control gum; and no gum. Children in the four active intervention groups were asked to chew at least five pieces of gum per day, preferably after meals. The children were reexamined clinically after 1, 2 and 3 years, and radiographically after 3 years. Self-reported compliance was monitored anonymously four times during the study. RESULTS: A total of 432 children were available at the 3-year clinical follow-up examination. The crude mean 3-year caries increments (DMFS--all stages of lesion formation) were 11.8 for the sorbitol/carbamide gum group; 9.0 for the sorbitol gum group; 8.1 for the xylitol gum group; 8.3 for the control gum group; and 12.4 for the no gum group. The adjusted 3-year caries increments were statistically significantly lower in the sorbitol gum group, the xylitol gum group and the control gum group than in the no gum group, whereas no statistically significant difference was seen between the no gum group and the sorbitol/carbamide gum group. Adjusted 3-year caries increments in the xylitol gum group and the sorbitol gum group did not differ statistically significantly from the caries increments in the control gum group. Compliance with the study protocol was better in School C (xylitol gum) than in the other schools. In all schools, compliance decreased over time. CONCLUSION: The results indicate that the caries preventive effect of chewing sugar-free gum is related to the chewing process itself rather than being an effect of gum sweeteners or additives, such as polyols and carbamide.     

The inhibitory effect of combining chlorhexidine and hydrogen peroxide on 3-day plaque accumulation

Abstract. In a blind, randomised, 4-cell, cross-over study, the effect of rinsing with a perborate solution (1.9 g sodiumperborate-monohydrate dissolved in 30 ml water bocasan. Oral-B$$) on the vivo plaque-inhibiting effect of 0.12$$ chlorhexidme (Oral-B$$) was examined. After a thorough professional prophylaxis including interdental cleaning. 12 subjects started to rinse according to 4 different regimens: regimen (C-P-C): chlorhexidine in the morning, perborate at noon and chlorhexidine in the evening: regimen (CP-CP): chlorhexidine immediately followed by perborate in the morning and in the evening: regimen (PC-PC): perborate immediately followed by chlorhexidine in the morning and in the evening: regimen (C-C): chlorhexidine in the morning and in the evening No further oral hygiene measures were allowed for the next 72 h. After 72 h. the subjects were scored for plaque, and a washout period of 4 days followed: cross-over was randomly assigned according to a Latin square design. Following this procedure, all subjects went through all 4 regimens. The regimens C-P-C and PC-PC resulted in significantly lower plaque-scores. 0.27 and 0.28 respectively, than regimen C-C (0.40). For the regimen CP-CP, the plaque-score was 0.28. which was not significantly different from the C-C regimen. The results suggest a positive interaction between chlorhexidine and hydrogen peroxide. Rinsing with a combination of 0.12% chlorhexidine (Oral-B$$) and a perborate solution (bocasan Oral-B$$) can result in more effective short-term plaque growth inhibition than rinsing with chlorhexidine alone.     

The development and validation of an occlusal site-specific plaque index to evaluate the effects of cleaning by tooth brushes and chewing gum

These studies sought to develop and validate an occlusal site-specific plaque index to be used to measure plaque removal by brushing or chewing gum. The index divides the occlusal surfaces into imaginary zones from which scores are apportioned on a 0-4 basis dependent on the perceived % plaque coverage of each zone. Examiner calibration was conducted over 2 studies assessing inter-examiner reproducibility and intra-examiner repeatibility, respectively. Study 1 involved 2 examiners who recorded scores from the same 3 groups of subjects who had suspended tooth cleaning for 4 days. Analyses for inter-examiner reproducibility showed no significant mean differences between examiners or no significant differences between variances of the 2 examiners scores. Study 2 involved the same 2 examiners individually scoring 3 groups of subjects 2 x (approximately 60 min apart) for occlusal plaque. Analysis for intra-examiner repeatability showed no significant mean differences between the 2 scorings of each examiner. Furthermore, there were no significant differences between the variances of each examiner's scores except for 1 examiner in the repeatability exercise for the 1st group of subjects. Study 3 involved groups of subjects at 2 separate clinical sites (Bristol, England and Berne, Switzerland) being scored for occlusal plaque before and after toothbrushing with water or after no toothbrushing. Data from individual examiners and examiners combined revealed a significant reduction in occlusal plaque with brushing compared to no brushing. Study 4 was the same as study 3 but occlusal plaque was scored before and after chewing gum or not chewing gum. The Bristol examiner recorded a significant reduction in plaque by chewing gum compared to not chewing gum but the Berne examiner did not. The latter may have resulted from a considerable disparity in the number of evaluable occlusal surfaces between the two study sites. The index could be employed as part of the overall assessment or oral hygiene or used in clinical trials to study mechanical and chemical plaque control agents.     

咀嚼无糖口香糖对牙龈炎的影响

目的探讨无糖口香糖对牙龈炎的临床疗效。方法选择患有牙龈炎的志愿者88例，根据基线探诊出血百分比和性别分为试验组和对照组，试验组要求每日使用益达草本精华木糖醇口香糖4次，每次20min，两组使用统一提供的不含任何抗菌斑药物成分的牙膏和牙刷，在试验的第6周、第12周检查全口牙探诊出血百分比。结果基线探诊出血百分比咀嚼口香糖组与对照组差异无统计学意义，在12周试验过程中，咀嚼口香糖组探诊出血百分比值呈逐渐下降趋势，第6周、第12周探诊出血百分比低于对照组（P〈0.05）。结论咀嚼无糖口香糖作为辅助手段对牙龈炎有一定疗效。     

Optimal dosage of chlorhexidine acetate in chewing gum

In a previous study, 800 mg pieces of sorbitol-flavored gum, each piece containing 5 mg chlorhexidine (CHX) acetate, when chewed 2 at the time 5 x daily, were found to have an excellent plaque growth inhibiting effect. The aim of Trial 1 of the present study was to assess whether chewing only 2 x daily, 2 pieces of the same concentration CHX gum for about 10 min would be as effective. 6 dental students participated in the 3 x randomly crossed over double-blind clinical trial. During the 5-day chewing periods, no other oral hygiene measures were allowed. The Hibitane Dental (HD) rinse was used as a positive and the gum base containing neither CHX nor the sweetening agent as a negative control. At the end of each test period, recordings were made for the plaque index (PII), the plaque wet weight (PWW) and the relative area of plaque covered tooth surface (plaque area %). Chewing of CHX gum twice daily inhibited plaque growth as effectively as the HD rinse. The aim of Trial 2 was to assess the antiplaque effect of lower concentration CHX gums with, hopefully, a less unpleasant taste. For this trial, 8 dental students were recruited to chew 2 x daily during 6-day periods two 800 mg pieces of sorbitol-flavored gum, each piece now containing either 5 mg, 4 mg or 3 mg CHX acetate. The effect of these dosages did not differ from the effect of the HD rinse.(ABSTRACT TRUNCATED AT 250 WORDS)     

Abrasives in foods and their effect on intra-oral processing: a two-colour chewing gum study

In this study we suggest that the presence of abrasives in food items lead to physiologic responses that reduce the amount of tooth loss because of abrasion. Subjects were presented with two pairs of two-colour chewing gum, one sample had 0.5 g of an abrasive powder added. Subjects were instructed to chew for 10 or 20 chewing strokes and then remove the gum. After removal the chewing gum was placed in a plastic bag and flattened. Each pair of gums was compared on the basis of the amount of mixing observed. In all cases the addition of the abrasive powder resulted in slower chewing and less mixing. Salivary flow rate increased from a resting value of 0.6 to 0.9 mL min(-1) when stimulated by the non-abrasive gum to 1.1 mL min(-1) with the abrasive gum. This difference was significant (P < 0.05). We conclude that when abrasive particles are detected in the mouth, less bolus manipulation is performed and more saliva is secreted. These responses would have the effect of reducing loss of tooth substance at the expense of reduced cominution of the food.     

The use of sorbitol- and xylitol-sweetened chewing gum in caries control

BACKGROUND: The author compared the caries-inhibitory action of sorbitol- and xylitol-sweetened chewing gum and assessed the role of these products in caries prevention. TYPES OF STUDIES REVIEWED: The author reviewed studies including randomized field trials with substantial numbers of participants and observational studies. He did not review case studies. He found studies through a MEDLINE search and by hand searching. RESULTS: When compared with sugar-sweetened gum, sorbitol-sweetened gum had low cariogenicity [corrected] when it was chewed no more than three times per day. Xylitol-sweetened gum was noncariogenic in all of the protocols tested. Some studies claimed that xylitol-sweetened gum had an anticariogenic effect, though these claims need further study. There also is good evidence that when mothers of infants and young children chew xylitol-sweetened gum, it will block transmission of mutans streptococci from mother to child. CLINICAL IMPLICATIONS: The evidence is strong enough to support the regular use of xylitol-sweetened gum as a way to prevent caries, and it can be promoted as a public-health preventive measure. Chewing xylitol-sweetened gum, especially for patients who like chewing gum, can be fitted readily into a regimen that includes frequent fluoride exposure, good oral hygiene and regular dental appointments.     

Salivary flow rate and pH during prolonged gum chewing in humans

Gum chewing for 20 min causes an increase in salivary flow rate and salivary pH. Most people chew gum for longer than 20 min, and our aim was to determine how whole mouth salivary flow rate and pH might adapt during prolonged gum chewing. Resting saliva was collected over 5 min; gum-stimulated saliva was collected at intervals during 90 min, chewing a single pellet (1.5 g) of mint-flavoured, sugar-free gum (n = 19). Subjects chewed at their own preferred rate and style. Both salivary flow rate and pH were increased above resting levels for the entire 90 min. The salivary flow was significantly greater (anovaP < 0.05) than resting flows up to 55-min chewing. The saliva pH remained significantly higher (P < 0.0001) than the resting pH even after 90-min chewing. When the experiment was repeated with the gum pellets replaced at 30 and 60 min (n = 9), similar increases in salivary flow rate and pH were found. In the latter experiment, there was no evidence of any cumulative effects on flow or pH. The persistent increase in salivary pH in particular could be beneficial to oral and dental health.     

咀嚼木糖醇口香糖对牙面菌斑原位pH值的影响

目的通过对牙面菌斑原位pH值的动态检测，观察咀嚼木糖醇口香糖对牙菌斑pH值的影响。方法采用受试者自身对照的试验方法，选择9名健康成人志愿者为受试对象，用pH微电极在口内测定菌斑的原位pH值。在测定受试者牙面48小时成熟菌斑的基线pH值之后用10％的蔗糖溶液漱口，测定漱口后即刻、3、8、13、20、30、40分钟后菌斑的pH值，然后分别咀嚼蔗糖口香糖和木糖醇口香糖，测量相同时间点、相同位点牙菌斑的pH值。结果用10％的蔗糖溶液漱口后牙菌斑pH值迅速下降至5．5以下，咀嚼蔗糖口香糖后牙菌斑pH值也有下降。但下降幅度较小，在即刻、3、8分钟三个时点二者之间有显著性差异（P〈0．05）。咀嚼木糖醇口香糖后牙菌斑的pH值没有下降，在即刻、3、8、13、20分钟五个时点的pH值明显高于咀嚼蔗糖口香糖后的pH值（P〈0．05）。结论咀嚼木糖醇香糖不会导致口腔中牙菌斑pH值的下降，有助于釉质再矿化。     

An efficacy and safety analysis of a chlorhexidine chewing gum in young orthodontic patients

AIM: The objective of the present study was to investigate the impact of a chlorhexidine (CHX) chewing gum in teenage orthodontic patients on plaque levels, gingival bleeding tendency and tooth staining. MATERIALS AND METHODS: A randomized-controlled, double-blind, parallel study was conducted on 31 teenagers in fixed orthodontic therapy. Subjects of the CHX gum group were asked to continue their oral hygiene procedures in conjunction with chewing two pieces of a 5 mg CHX-containing chewing gum for 10 min. twice a day for 3 months. Subjects of the placebo gum group received the same instructions; however, using a CHX-free chewing gum. Plaque levels, gingival bleeding on probing and tooth staining were monitored at baseline and subsequently after 1-3 months. RESULTS: Plaque levels significantly decreased from baseline at lingual/palatal sites in the placebo gum group. In the CHX gum group, a similar, yet non-significant trend was observed. At buccal sites, plaque levels remained unaffected in both groups. Gingival bleeding tendency significantly decreased in both groups, predominantly at lingual/palatal sites. There were no significant between-group differences in any of the efficacy parameters at any time point. However, the increase in staining was nearly five times higher in the CHX gum group. CONCLUSIONS: There seems to be no indication for a CHX chewing gum in teenage orthodontic patients when used as an adjunct to normal oral hygiene practices.     

麦芽糖醇口香糖对青少年牙菌斑的抑制效果

目的评价麦芽糖醇口香糖控制青少年牙菌斑集聚水平的临床效果。方法将30名13～15岁龋易感受试者随机分为A、B、C组,根据分组分别每天咀嚼麦芽糖醇口香糖、木糖醇口香糖、胶母基口香糖5次,每次10 min。采用改良Quigley-Hein菌斑指数记录法分别于基线、4周时检查受试者的菌斑指数情况。应用SPSS 17.0软件对数据进行统计分析。结果咀嚼口香糖4周后,3组受试者的菌斑指数都有明显下降,与基线相比的差异有统计学意义（P=0.000、0.000、0.006）;3组菌斑指数变化间的差异也有统计学意义（P=0.015）,组间两两比较结果表明,A组与B组菌斑指数变化间的差异无统计学意义（P=0.687）,而A组与C组、B组与C组菌斑指数变化间的差异有统计学意义（P=0.019、0.007）。结论麦芽糖醇口香糖对青少年牙菌斑的抑制效果与木糖醇口香糖相似。