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.