News

The Wrigley Oral Healthcare Program participated in the 2019 World Dental Congress in September. The Congress was co-hosted by the World Dental Federation (FDI) and the American Dental Association (ADA), and gathered over 30,000 dental professionals and industry leaders to advance the science and practice of oral health through a scientific program and trade exhibition.

At the congress, WOHP organized a scientific symposium on the benefits of chewing sugar-free gum on oral health, with presentations by Mike Dodds, Lead Oral Health Scientist at Mars Wrigley, and by two researchers from the Faculty of Dentistry, Oral & Craniofacial Sciences at Kings College London. With around 300 participants, this symposium was the first external discussion of the results of a systematic review carried out by KCL – and sponsored by WOHP – that confirms the efficacy of sugar-free gum in maintaining oral health.

World-first data published in the American Journal of Dentistry builds on evidence to support the benefits of sugar-free gum in oral care

Increasing consumption of sugar-free chewing gum by just one piece per day could save billions of dollars worldwide on dental expenditures from treating tooth decay, according to a new study published in the American Journal of Dentistry.¹ The data is significant given tooth decay and oral diseases rank fourth among the most expensive global health conditions to treat, according to the World Health Organization.² While tooth decay is largely preventable, it still affects 60-90% of schoolchildren and nearly all adults globally.²

The first-of-its-kind global study suggests that if current consumers of sugar-fee gum increase their consumption by just one extra piece per day as part of a complete oral hygiene routine, global dental expenditures from treating tooth decay could be reduced by US$4.1 billion a year.¹ The data provides new insights that build on the extensive body of evidence supporting the benefits of chewing sugar-free gum in oral care.

The study was funded by Wrigley and conducted by specialist health economics research group, the Institute of Empirical Health Economics (IfEG), with input from an international scientific steering committee comprised of thought-leaders in dental and public health and economics.

“The study represents a solid and substantial approach to the accurate calculation of cost savings in industrial countries that would arise from increasing sugar-free gum consumption,” said Professor Reinhard Rychlik, MA MD, PhD, PhD, Director of the IfEG and the study’s lead author. “Chewing sugar-free gum as a preventive measure for tooth decay has the potential to deliver significant dental care cost savings worldwide.”

Potential cost savings reach $2.07 billion a year in the U.S., representing nearly 3 percent of expenditures on treating tooth decay. Comparatively, potential cost savings could reach $1.1 billion a year in Europe and $149 million a year in China.¹

“In addition to the well-established clinical benefits, for the first time, this study models the reduction in the relative risk of tooth decay and subsequent cost savings for dental care as a result of increased consumption of sugar-free gum as part of a complete oral hygiene routine. While further studies are needed, these are exciting new insights which add to the extensive body of evidence on the benefits of sugar-free gum in oral care.” said Michael Dodds, BDS, PhD., Wrigley’s lead oral health scientist. 

Recognized Oral Health Benefits of Sugar-free Gum

Global rates of tooth decay continue to present a major public health concern – nearly all adults experience tooth decay² – suggesting that new preventive strategies may be required to supplement existing measures in reducing the risk of tooth decay and improving oral health. The oral care benefits of chewing sugar-free gum are widely recognized and supported by various regulatory and governmental authorities,^3,4 FDI World Dental Federation and nearly 20 national dental associations around the world. The growing body of evidence could support the inclusion of sugar-free gum in national oral healthcare advice, alongside other proven oral hygiene behaviours in future.

References

1. Rychlik R, Kreimendahl F, Blaich C et al (2017). A global approach to assess the economic benefits of increased consumption of sugar-free chewing gum. Am J Dent, in press.
2. World Health Organization. Oral Health Disease Burden. Last Accessed August 2016. Available at: www.who.int/oral_health/disease_burden/global/en/
3. EFSA (2010) Scientific Opinion on the substantiation of a health claim related to sugar-free chewing gum and reduction of tooth demineralization which reduces the risk of dental caries pursuant to Article 14 of Regulation (EC) No 1924/20061. Available at: http://www.efsa.europa.eu/sites/default/files/scientific_output/files/main_documents/1775.pdf. Last accessed: October 2015
4. Health Canada. Summary of Health Canada’s assessment of a health claim about sugar-free chewing gum and dental caries risk reduction. Available at: http://www.hc-sc.gc.ca/fn-an/label-etiquet/claims-reclam/assess-evalu/gum-gomme-dental-carie-dentaireeng.php Last accessed December 2016.

Since 2013, the FDI World Dental Federation has celebrated and organized World Oral Health Day, held March 20, to raise awareness of the importance of good oral health and its significance in safeguarding general health and well-being. Once again, Wrigley is proud to support this international day of action.

As we think about Oral Health, it is not uncommon to focus on the converse of oral health – namely oral diseases. While it is relatively simple to quote statistics on untreated caries in children and adults, provide stark warnings on tobacco use, and point to the links between periodontal diseases and systemic health, why not focus instead on the positive benefits of a healthy mouth and dentition on overall health and wellbeing!

In September of last year, the FDI unveiled a universal definition of Oral Health stating it:

Is multi-faceted and includes, but is not limited to, the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and free from pain or discomfort, and disease of the craniofacial complex.

This holistic definition conveys a sense of wellbeing and quality of life that goes beyond the absence of caries or gingivitis. Conveying a range of emotions, of course, includes smiling. A study conducted by the University of Cambridge Psychometrics Centre, funded by Wrigley, assessed how people smile in photos and linked this to psychometric profiles and self-perceived oral health, based on a validated questionnaire[1]. More than 2,000 participants submitted photos and provided access to their social media profiles, from which more than 300,000 faces were identified and subjected to image analysis that determined a ‘smile score’. Smile scores and psychological traits were combined in a massive database to reveal interesting correlations. Based on a self-reported assessment of oral health:

People reporting to have better oral health responded as being significantly more satisfied with life than those reporting to have poor oral health.
Better self-reported oral health was positively correlated with frequency and intensity of smiling in photos.
With this growing recognition of the link between oral health and psychological traits, we are reminded of the central importance of better oral disease prevention.

While we tend to associate dental disease prevention with use of fluoride, oral hygiene, sealants and other traditional clinical and preventive modalities, evidence suggests that chewing sugar-free gum is a simple and enjoyable complementary behavior to reduce caries incidence. These benefits are widely recognized and supported by global regulatory authorities, dental professional associations and some governments. Building on these established benefits, a new study funded by Wrigley, to be published in the April issue of the American Journal of Dentistry[2] models a potential economic benefit of chewing sugar-free gum. Further studies are needed, but these data provide fresh insights showing that chewing sugar-free gum could positively affect global dental care expenditures at a country level.

Wrigley is committed to supporting oral health and helping people smile more. Join us in our simple mission this World Oral Health Day!

Disclosure:

Michael Dodds BDS, PhD is Oral Health Lead Scientist at the Wrigley Company. Wrigley is proud to support World Oral Health Day 2017.

“WRIGLEY, SMILE BACK, and all associated trademarks and designs are trademarks of the Wm. Wrigley Jr. Company or affiliates. Used with permission.”

[1] Smile Back Study, Cambridge University, 2015. Full study available upon request

[2] Rychlik R, Kreimendahl F, Blaich C et al: A global approach to assess the economic benefits of increased consumption of sugar-free chewing gum. Am J Dent 2017, in press.

Wrigley has become the latest partner to join Vision 2020, an FDI initiative to raise the political profile of oral health among public health officials and other decision-makers at national and international level.

“Wrigley has been a long-time keen supporter of FDI work and I’m delighted they have agreed to sign on to our ambitions in oral health advocacy by strengthening the activities and goals of Vision 2020,” said FDI President Dr Patrick Hescot. “This support will enable us to position oral health where it needs to be: high on the global health agenda.”

“Wrigley is very supportive of the Vision 2020 ambition, to drive awareness among governments and health authorities of the human and economic cost of oral disease, and to develop strategies to address this burden,” said Matthew Kent, Senior Corporate Affairs Manager, Global Oral Care. “Through Vision 2020 we have an opportunity to change behaviours at a grass-roots level, to focus more on prevention oriented oral health care.”

Launched in 2012, Vision 2020 provided a map of the challenges facing the oral health community, which were to:

• Meet the increasing need and demand for oral health care
• Expand the role of the health-care professional
• Shape a responsive educational model
• Mitigate the impacts of socio-economic dynamics
• Foster fundamental and translational research and technology

Today, FDI global advocacy and Vision 2020 have merged into common strategy with a twin focus: on the one hand, ensuring the oral health community is aligned and equipped to put pressure on national governments to address oral disease within national health action plans; on the other ensuring that FDI member national dental associations and the wider oral health community are represented in the international health policy debate.

Wrigley Oral Healthcare Program
The Wrigley Oral Healthcare Program (WOHP) partners with dental professionals worldwide, helping them improve their patients’ oral health through one additional simple and enjoyable step in their daily routine: chewing sugarfree gum after eating and drinking on-the-go. For more than 25 years, WOHP has supported independent clinical research into the benefits of chewing gum, including saliva stimulation, plaque acid neutralization and tooth strengthening to help dental professionals and their patients understand the role of sugarfree gum as a convenient tool for everyday oral care. WOHP is one example of how we make a difference to people and the planet through performance, and how we incorporate our principles based approach to business into all that we do.

By: Michael Dodds, BDS, PhD

A new review of the most up-to-date scientific research reinforces the positive effects of sugar-free gum (SFG) on oral health and emphasizes the identification of active ingredients in gum that could facilitate prevention and removal of oral biofilm.

The review confirmed the oral health benefits of chewing sugar-free gum, including the clearance of food debris, reduction in oral dryness, increase of biofilm pH, remineralization of enamel, freshening breath through the reduction of volatile sulfur compounds and inhibition of extrinsic tooth stain. These benefits are attributed to increased mastication and salivation. The authors say that with the addition of active ingredients in chewing gums, it may be possible to expand these benefits to also include:

• Enhanced inhibition of extrinsic tooth stain and calculus formation.
• Enhanced enamel remineralization.
• Reduction of the numbers of bacteria in saliva and amount of oral biofilm.
• Neutralization of biofilm pH.
• Enhanced reduction of halitosis.

The analysis, which was published in Expert Opinion on Drug Delivery in May 2016, looked at the evidence for oral health benefits of chewing SFG, citing 138 articles, and drawing findings from 69 papers. Its emphasis was on identifying active ingredients in gum that facilitate the prevention and removal of oral biofilm. The evidence shows that while chewing gum can allow active ingredients to be gradually released into the oral cavity, they have a low potency and are rapidly washed out from the oral cavity by increased salivation. Furthermore, the health benefits from increased salivation and mastication may easily overshadow the additional benefits of added active ingredients unless used for prolonged periods of time, making it hard to demonstrate their clinical benefits.

Oral diseases develop when the balance within the oral microbiome is lost and pathogenic bacteria start to dominate. This occurs, for instance, when cariogenic strains in a biofilm produce an excess of acids through fermentation of environmental sugars causing enamel demineralization or when peridontopathogens residing mostly in gingival pockets cause gingivitis or, in more advanced state, periodontitis.

The review confirms the well-documented benefits of chewing SFG associated with increased mastication and salivation, many of which are supported by the European Food Safety Authority (EFSA).

Chewing SFG results in a 10-fold increase in salivary flow rate, which enhances the ability of saliva to clear the mouth of food debris and sugars, neutralize acids and support remineralization, all of which can help to reduce the incidence of dental caries.

While data points to specific benefits for certain active ingredients, such as xylitol, carbamide and polyphosphates, the authors state longer term clinical trials are needed to confirm these benefits. Future studies on active ingredients should focus specifically on targeting pathogenic bacteria, whilst leaving the healthy microbiome unaffected. However, the authors of the review conclude that the basic benefits of the long-term chewing of SFG due to increased mastication and salivation are beyond dispute.

About the author

Michael Dodds, BDS, PhD is Oral Health Lead Scientist at the Wrigley Company, based in Chicago, with responsibility for developing scientific support for the oral health benefits of chewing sugar-free gum. He holds a dental degree from the University of Edinburgh and a PhD in Dental Science from the University of Liverpool. Prior to joining Wrigley in 2002, Dr. Dodds was Associate Professor of Community Dentistry, San Antonio, Texas, and is currently also adjunct Associate Professor of Pediatric Dentistry at the UIC College of Dentistry, Chicago.