The concept of oral hygiene is almost non-existent in India,” rues Ashok Dhoble, honorary secretary general of the Indian Dental Association (IDA). He adds that 98% of adults in India have periodontal disease, 60-70% of children are victims of tooth decay, and only 2% visit dentists for preventive check-ups.
Chew on this
Apart from brushing teeth twice a day, flossing daily, eating a balanced diet, and consulting a dentist regularly, the IDA also recommends chewing sugar-free gum to keep tooth decay at bay. Says Dr Dhoble, “Chewing sugar-free gum is a convenient way to maintain and improve oral health.”
“The concept of sugar-free chewing gum used as a tooth cleaner has been prevalent in the West for a while, but it is gaining popularity in India only now,” says Atul Mahajan, a dentist who practises in Mayur Vihar, New Delhi.
It’s only been about four years or so since government restrictions on selling sugar-free products in the confectionery category in India were done away with. Although several sugar-free chewing gum brands are currently available and prescribed informally by dentists as a tooth cleaner, it’s only now that the first brand has managed to obtain an IDA seal of acceptance for its health claim. Wrigley’s Orbit has just got IDA validation for its research claim that chewing the sugar-free gum for 20 minutes immediately after eating or drinking helps reduce incidence of tooth decay by 40%. Others with similar claims are waiting in the wings.
Of course, Dr Dhoble stresses that while chewing gum, undoubtedly, has a beneficial effect, it cannot substitute brushing and flossing—and is only to be used as an additional cleaning aid.
How it works
How the chewing gum (only sugar-free) works as a tooth cleaner is simple. The action of chewing stimulates saliva, which speeds up the removal of food debris and dietary carbohydrates from the mouth. It also helps neutralize harmful plaque acids in the mouth. As Payal Nayar, consultant dentist, Max Healthcare, Noida, explains: “Chewing gum has a cleansing action. Most people don’t rinse after snacking. As a result, food particles tend to stick to our molars. There the bacteria breed and produce an acidic environment. Chewing gum pulls out the debris.”
More than a cleanser
Chewing gum is said to be beneficial—not just for oral health, but also for a host of reasons ranging from stress relief to weight management. In fact, defence forces in several countries have been supplying their soldiers with chewing gum to improve their concentration and relieve stress. The US army has even developed a special formulation of caffeinated gum to keep soldiers awake.
Dentists also prescribe chewing gum for various oral conditions. For instance, Dr Nayar points out that for patients with lockjaw, she prescribes chewing gum as it is an effective exercise for opening their mouth. Medicinal gum may be prescribed for trauma or fracture of the teeth. Dr Mahajan says that often during dental operations, injecting anaesthesia causes soreness of the jaw, and chewing gum is an effective exercise to prevent spasms and relieve the soreness.
Chewing gum is also prescribed to those with oral sub-mucous fibrosis—a widely prevalent condition among Indians that leads to changes in the inner mucosal lining of the mouth. “Basically, the mucosal lining loses elasticity and becomes hard and rubbery, causing problems in opening the mouth,” says Dr Mahajan. Excessive consumption of tobacco, betel nut or gutka leads to this pre-cancerous condition.
Dr Dhoble points out that paan chewing is the leading cause of oral cancer in India. And so, he suggests, since most Indians have the habit of chewing anyway, why not chew gum instead of supari (betel nut)?
It remains a contentious issue whether sugar-free chewing gum can be recommended to children as some of these contain aspartame. In India, sugar-free chewing gum could not be marketed until 2004 due to health concerns. Even today, concerns about the artificial sweeteners used in chewing gum abound. Many dental health products—toothpastes and sugar-free gum included—contain bulk sweeteners such as sorbitol, xylitol, isomalt and maltitol. Some contain high-intensity sweeteners such as aspartame and acesulfame K. A report in the British Medical Journal early this year described how women who had consumed more than 20 chewing gum sticks a day lost weight due to diarrhoeal attacks. Sarath Gopalan, senior consultant, paediatric gastroenterology, Pushpawati Singhania Research Institute, New Delhi, explains, “Too much sorbitol has a potential effect of causing loose stools. That’s because sorbitol tends to draw water into the gut, thereby causing diarrhoea. It also leads to bloating.” However, Gopalan adds that it would take a large intake of sorbitol to cause this effect.
Asked whether the IDA had taken into consideration these issues while granting its seal of acceptance to Wrigley’s Orbit, Dr Dhoble clarified that it contains a very small quantity of aspartame, way below the India Regulatory Limit of 10,000ppm. Dr Nayar stresses that those who have had dental fillings should go easy on chewing gum. “One disadvantage is that it has a tensile action,” she says. “So, those with fillings should avoid chewing gum as it could pull out the fillings.”
10 tips for a better smile
Brush your teeth twice a day. While brushing, also include the gum line. Dr Nayar says it is also a good idea to give yourself a gentle gum massage with your finger.
Sleep well. Lack of adequate sleep can increase susceptibility to bacterial infections in the mouth.
Visit a dentist twice a year. IDA’s Dr Dhoble rues the fact that only 2% of Indians visit dentists for preventive
check- ups. Regular visits and early detection go a long way in keeping teeth healthy.
Flossing is important. Before brushing, one must floss to remove food particles stuck between teeth. It’s best to floss before brushing, as this will loosen debris and make brushing more effective.
Beware of quick fixes. Many of us use home remedies such as lemon and salt to whiten teeth. While this is effective in the short term, Dr Nayar warns against long-term damage to the tooth enamel from the acid in the lemon and abrasion caused by salt.
Limit colas, sugary foods and tooth-unfriendly food. This includes maida-based soft and sticky foods, overcooked vegetables, syrupy sweets. Eat plenty of carrots, pears, cucumbers and apples which are natural oral cleansers. “These contain antioxidants, have an astringent effect and massage the gums,” says Dr Mahajan.
Change your toothbrush regularly. Or do so as soon as the bristles start fraying. Dr Mahajan suggests using two toothbrushes alternately for morning and night, so that each brush has 24 hours to dry out completely—a damp brush could breed bacteria, he warns.
Cut out the cigarettes. Smoking stains the teeth badly. It also inhibits absorption of calcium, leading to tooth decay, besides adding to the risk of oral cancer.
Take calcium supplements. Women above 30 especially need increased calcium intake to offset the reduction in bone density.
Use mouthwash for fresh breath.While you sleep, there is a build-up of bacteria and stagnant saliva in the mouth. Dr Nayar suggests sugar-free, water-based mouthwashes rather than alcohol-or oil-based ones.
(Alcohol- based ones have a drying effect.) Regular saline water rinses are also a good idea. Dr Mahajan says bacteria build-up in the mouth is so rapid that within half an hour of brushing, it comes back to the same level as earlier!
Obviously, moderation is the key.
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