Sugar-free gum for dental health: Innovations in science

We tackle one of the most topical areas in the field: tooth mineralization, better known as tooth decay prevention.

According to Dr. Doris Tancredi, director of health & wellness for global gum & candy at Mondelez International : “Chewing gum has more approved EFSA [European Food Safety Authority] claims than any other food product.”

Most of these claims are in dental health. In Europe for example, EFSA, considered one of the most stringent authorities globally, has authorized health claims for sugar-free gum, such as “helps to maintain tooth mineralization, neutralizes plaque acids and reduces oral dryness.”

Natural functionality of sugar-free gum

This means sugar-free gum is in itself functional.

“Saliva is nature’s mechanism to protect your teeth – it’s an incredible biological system Mother Nature has created,” said Tancredi.

Stimulated saliva is saturated with calcium, phosphate and buffers, which help balance pH levels to prevent tooth demineralization and promote remineralization. Tancredi said that gum should be chewed after every meal, snack or carbohydrate-containing beverage to stimulate saliva.

Enhanced mineralization – Recaldent

Other ingredients can also be added to gum to potentially enhance its dental health functional properties.

Xylitol has a claim for decreasing mineralization, but there is no EFSA claim to positively remineralize teeth through added ingredients. However, Tancredi believes it’s the next big thing.

“I think the next great area is enhanced mineralization and the primary ingredient with the most peer-reviewed publications to do that is Recaldent.”

Mondelez International has exclusive rights for Recaldent in gum and candy, which it uses for Trident Xtra Care in the US, Canada and Mexico, under the Trident Total brand in Colombia and Brazil, under Beldent in Argentina - and in Thailand and Japan under the brand name Recaldent.

Mondelez says this gum is performing well as the overall category suffers.

Recaldent is derived from cow milk protein and has the technical name casein phosphopeptides amorphous calcium phosphate, or CPP-ACP.

Mondelez is keeping the gum production process using Recaldent under wraps, but says the ingredient goes into the non-soluble gum base rather than the coating.

Tancredi said that the dose varied depending on the market – but was fully released after around 10 minutes of chewing.

“It’s very expensive to make,” she said, making it difficult to bring to emerging markets that command lower retail price points.

CPP-ACP doubters

A recent study by Colombian researchers questioned whether CPP-ACP gums and xylitol gums could prevent dental caries and gingivitis after conducting a clinical trial. However, Tancredi queried the study’s methods, including selection of sample size and length of the trial period. See HERE.

A New York consumer has also probed Mondelez’s claims that Recaldent rebuilds teeth by launching a class action lawsuit. However, this was dismissed by the New York Supreme Court in March 2011.

Xylitol decreases demineralization, says EFSA

Mondelez’s Recaldent gums compete with Wrigley Orbit Professional gum, which is sweetened with xylitol.

Xyltiol has been touted as the stand out ingredient for dental health in gums, according to a review by Wrigley.

EFSA has authorized a health claim for “decreasing tooth demineralization” for food and drinks containing intense sweeteners (polyols) such as xylitol, sorbitol, mannitol, maltitol and others, which includes xylitol gums.

Wrigley: More evidence needed for enhanced mineralization

However, Wrigley has itself doubted the positive tooth mineralization effect of multiple ingredients, including xylitol and CPP-ACP.

“Chewing sugar-free gum alone provides a proven remineralization and anti-caries benefit,” Wrigley scientists said in a review last year.

“However, against this background level of enhanced remineralization provided by the action of gum-stimulated saliva flow, it has proven challenging to provide unequivocal and consistent evidence for a statistically significant and clinically relevant superior effect for gum with specific active agents providing an anticaries effect.”

Tancredi said the review highlighted that longer term studies were needed.  She added that: “By far, the largest number of studies demonstrating a short term remineralization effect supports Recaldent’s efficacy, and there are published reviews to support this.”

Fluoride, peroxide and carbamide

Fluoride is another option which has been approved for use in some countries. In Europe, sugar-free gums with fluoride have an EFSA health claim for increasing resistance of enamel to acid attacks and increasing the rate of remineralization.

However, Wrigley said that despite this claim “published clinical studies have usually required that study participants use a fluoride-free dentifrice [toothpaste], limiting the real-world relevance of this effect”.

Mondelez is also looking at peroxide as a teeth whitening ingredient, which has never been used in gum before. Last year it filed a patent for a method using encapsulated solid peroxide within the gum base.

Carbamide is another ingredient that has an EFSA health claim in gum. The claim says that sugar-free gums containing carbamide neutralize plaque acids more effectively than sugar-free chewing gums without the ingredient.