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EFSA health claim opinion

Sugar-free chewing gum reduces tooth decay, finds EFSA

By Jane Byrne , 04-Oct-2010
Last updated on 04-Oct-2010 at 15:40 GMT

The European Food Safety Authority (EFSA) has approved a health claim for xylitol, sorbitol and mannitol-based sugar-free chewing gum that it reduces the risk of tooth decay.

The application was submitted by leading gum manufacturer, Wrigley, under Article 14 of the health claims process, the category which refers to disease risk reduction.

EFSA’s Panel on Dietetic Products, Nutrition and Allergies found causality has been established between the chewing gum, which also contains high intensity sweeteners that are authorised for use in the EU, and reduction of tooth demineralisation and in incidence of caries.

This approval follows an earlier endorsement by EFSA in 2008 for a claim submitted by the Dutch and Finnish group Leaf Holland that xylitol-sweetened chewing gum was beneficial to dental health.

The de- and remineralisation equilibrium of teeth is mainly driven by saliva and the main contributors are flow rate and concentrations of calcium, phosphate, and bicarbonate.

At rest, low amounts of saliva are secreted, but stimulation by chewing may increase saliva flow more than 10-fold. When flow rate increases, saliva concentration of calcium, phosphate and bicarbonate also increases, and such increases favour remineralisation of tooth crystals.

The EFSA panel said that, in weighing the evidence, it took into account that almost all of the clinical trials of sugar-free chewing gum consumption submitted by Wrigley "showed reduced tooth demineralisation as indicated by a reduction in caries incidence, and that there was strong evidence supporting the biological plausibility for the effect."

The Parma-based scientists said that, in order to obtain the claimed effect, 2 to 3 grams of sugar-free chewing gum should be chewed for 20 minutes at least three times per day after meals. "This quantity and pattern of use of chewing gum can easily be included within a balanced diet," it added.

However, the Panel notes that there is a risk of osmotic diarrhoea at excessive intakes of polyols such as xylitol, sorbitol and mannitol. Furthermore, it cautions that the use of chewing gum should be avoided in children less than three years of age owing to a high choking hazard with the product in this age group.

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