Evaluation of the Antimicrobial Effectiveness and the Effect of Dosage and Frequency of Sugar-free Chewing Gums

Streptococcus mutans is strongly associated with caries in humans1 and its level in the mouth can be a good indicator of caries-risk. However, caries is a multifactorial disease and the presence of high levels of Streptococcus mutans at a particular site does not imply that such a site will inevitably develop a lesion. In addition, Streptococcus mutans is not found alone in association with caries. Human oral microorganisms, and specifically Streptococcus mutans, do not have enzymes to utilize xylitol as a source of energy for acid production or for synthesis of extracellular polysaccharides. In 1975, the first xylitol chewing gum was launched almost simultaneously in Finland and United States. The consumption of xylitol, a sugar alcohol of pentitol type, had been found in early 1970s to reduce the incidence of dental caries. In recent years, the use of chewing gums has increased. Human beings have been chewing gum-like substances since ancient time. The pleasure of chewing is to clean the mouth or freshen the breath. In 1991, Chewing gum was approved as a term for a pharmaceutical dosage form by the commission of European communities. Chewing gum2 is defined as a “solid preparation with a base consisting of gum which should be chewed and not swallowed, providing a slow steady release of medicine contained.”