Controversia acerca del tiempo de ayuno preoperatorio de chicles y caramelos / Controversy on chewing gum and sweets during the preoperative fasting period

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Assessment of chewing sugar-free gums for oral debris reduction: a randomized controlled crossover clinical trial.

PURPOSE: To assess the oral debris removal efficacy of two commercial sugar-free chewing gums, based on a newly developed oral debris scoring system. METHODS: A randomized, examiner-blinded, three-arm crossover study was conducted, with a 1-week washout period between the crossover phases. 42 healthy adults were randomly assigned to sugar-free stick gum (Wrigley's Extra Freshmint), sugar-free pellet gum (Wrigley's Extra Fruit) or no-gum chewing groups. Subjects consumed a single chocolate cookie, and were examined at baseline, and at 2-, 5-, and 10-minute time points with or without gum-chewing treatment. Primary outcome measures were oral debris scores on the occlusal surface, interproximal and gingival margin areas. The entire test procedure was repeated on two subsequent visits. RESULTS: The baseline conditions in the three groups did not differ significantly. Chewing either stick gum or pellet gum resulted in significantly lower oral debris scores (P < 0.0001) compared to the control (no-gum) treatment for all intraoral sites, while no significant difference was observed between the two chewing gum groups. Intra-examiner repeatability of the new scoring criteria was high throughout the study (Kappa > 0.90).

The erosive effects of saliva following chewing gum on enamel and dentine: an ex vivo study.

OBJECTIVES: The primary objective was to determine the erosive effect of expectorated saliva, following chewing acidic gum, on enamel and dentine samples, using a non-acidic gum as a negative control. Secondary objectives were to determine the effect of brushing enamel and dentine samples and the effect of individual saliva pH and buffering. DESIGN: A single-centre, single-blind, placebo-controlled, two-way crossover study. SETTING: A clinical trial, involving healthy participants, undertaken at Bristol Dental School and Hospital. METHODS: Eight healthy participants expectorated saliva onto prepared enamel and dentine samples while chewing gum (strawberry flavoured acidic gum [active] or peppermint flavoured non-acidic gum [control]). Half of the enamel and dentine samples were brushed before measurement by contact profilometry. MAIN OUTCOME MEASURES: Mean enamel and dentine erosion, with and without brushing and the relationship to salivary buffering.Results At 10 days, mean depth of surface loss from dentine samples (95% CI), following chewing of acid-containing gum and subsequent brushing, was -11.34 µm (2.22 µm) and from un-brushed dentine samples was -11.02 µm (1.71 µm). No significant erosion was noted for other groups. CONCLUSIONS: Frequent chewers of acid-containing gums are susceptible to dentine erosion even in the presence of good salivary buffering. Enamel erosion was insignificant within the time constraints of the present study but warrants further investigation.

Preferences and saliva stimulation of eight different chewing gums.

OBJECTIVES: Chewing gums have been studied for clinical use to stimulate the salivary flow rate in healthy and diseased individuals. However, differences in preferences of chewing gums may influence patient compliance during long-term use. Therefore, we compared the effect of several chewing gums on the flow rate of whole saliva and pH, and investigated the preferences of these gums. METHODS: 83 healthy subjects participated in the first part of the study. Both parafilm-stimulated and chewing gum-stimulated whole saliva from 8 different chewing gums was collected and salivary flow rate and pH were determined. In another group of 112 healthy subjects, we investigated the preferences for the chewing gums with a 10-item questionnaire. RESULTS: All gums had comparable effects on salivary flow rate and pH. The average increase in flow rate was 187% during the first minute of chewing compared with parafilm stimulation. After 10 minutes of gum chewing, the amount of saliva was equal to parafilm stimulation. The questionnaire showed differences in preferences for the chewing gums, which were related to taste and gum shape. Gender interactions were observed for sparkling taste (p = 0.019), total judgement (p = 0.047) and the willingness to use the gum for several weeks (p = 0.037). CONCLUSIONS: Although all chewing gums stimulated the salivary flow rate equally, the observed differences in preferences may influence long-term compliance. Therefore, we recommend that chewing gums are tested before the start of clinical studies, to identify the most accepted chewing gum for specific groups of patients.

Chewing gum--facts and fiction: a review of gum-chewing and oral health.

The world market for chewing gum is estimated to be 560,000 tons per year, representing approximately US $5 billion. Some 374 billion pieces of chewing gum are sold worldwide every year, representing 187 billion hours of gum-chewing if each piece of gum is chewed for 30 minutes. Chewing gum can thus be expected to have an influence on oral health. The labeling of sugar-substituted chewing gum as "safe for teeth" or "tooth-friendly" has been proven beneficial to the informed consumer. Such claims are allowed for products having been shown in vivo not to depress plaque pH below 5.7, neither during nor for 30 minutes after the consumption. However, various chewing gum manufacturers have recently begun to make distinct health promotion claims, suggesting, e.g., reparative action or substitution for mechanical hygiene. The aim of this critical review--covering the effects of the physical properties of chewing gum and those of different ingredients both of conventional and of functional chewing gum--is to provide a set of guidelines for the interpretation of such claims and to assist oral health care professionals in counseling patients.

The use of low-tack chewing gum for individuals wearing orthodontic appliances.

A clinical study was carried out to determine the acceptability of a sugar-free, low-tack chewing gum by orthodontic patients undergoing fixed appliance treatment. Twenty-five orthodontic and 25 non-orthodontic control subjects were questioned on their preference between regular-tack and low-tack chewing gum. The orthodontic subjects showed a strong preference for the low-tack gum compared with the regular-tack gum. It was concluded that low-tack, sugar-free chewing gum can be used by orthodontic patients to increase saliva flow, with the potential to promote remineralization and help reduce white spot lesion formation related to fixed orthodontic appliances. This gum should also be of value in patients being treated for xerostomia who are wearing a partial denture.

In situ remineralization of subsurface enamel lesion after the use of a fluoride chewing gum.

In situ remineralization of early enamel lesions by a fluoride chewing gum was studied. Human enamel specimens with subsurface lesions were mounted in removable lower appliances for 6 adults. Subjects used a F-free dentifrice 3x/day and chewed five sticks/day for the F gum group (0.1 mg F/stick) or five sticks of sugarless gum. No gum was chewed for controls. Surface microhardness was performed on: (1) sound enamel; (2) lesions; (3) after intraoral exposure, and (4) after acid-resistance testing (ART). Separate specimens were etched and measured for F uptake and image analyses on microradiographs were performed for all regimens. delta Z values were calculated and converted to percent of mineralization. Values for F gum were significantly higher (p > 0.05) than non-F gum and controls for ART, percent remineralization, and F uptake up to 70 microns depth.