Chewing gum stimulates salivary flow, neutralizes and raises pH, and serves as a medium
for administering therapeutic agents. However, global increases in sugar consumption have
led to the development of chewing gums containing sugar substitutes, including polyols or
non-fermentable sugars, of which the most commonly used are nutritive sweeteners such as
sorbitol and xylitol.The use of polyol-containing chewing gums could play a role in
preventing dental caries compared to not using gum or using sugared gum, most likely due
to increased salivary flow and pH, improving enamel lesion remineralization; however,
xylitol has anticariogenic properties influencing the reduction of dental plaque.
The study will conduct as a prospective randomized controlled trial. The population will
consist of all enrolled students (1275 students) in the Dentistry program at the Catholic
University aged 18 to 25 who voluntarily meet the inclusion criteria. The sample size
will be 21 participants in each group, but it will be adjusted for a 15% loss of
information or study dropout, thus requiring 25 participants in each group. Participants
who meet the selection criteria will be probabilistically assigned using simple random
sampling through a lottery system to four groups: the first group (G1) will consume
xylitol chewing gum, the second group (G2) will consume sugar-free gum, the third group
(G3) will consume sugared gum, and the fourth group (G4), the control, will chew
paraffin.
Saliva samples will be taken between 8 to 10 am, taking into account that subjects should
not have ingested food, smoked, or brushed their teeth at least 1 hour prior to sample
collection. They will be asked to rinse their mouth with pure water to remove any food
residue. Subsequently, they will be seated in a chair in an upright position with the
head slightly tilted forward and eyes open, and the basal saliva sample will be taken as
indicated by the established protocol of the collection method for unstimulated saliva by
Tomas Seif. Before starting the test, they will be asked to swallow saliva, keep their
mouth slightly open, and allow saliva to drain into the tube. The test lasts for five
minutes and the salivary pH will be evaluated and recorded, labeled as T1. For stimulated
saliva, the protocol dictated by the Faculty of Dentistry at the University of Southern
California will be used. Through the drainage method, stimulated saliva will be collected
in another pre-weighed test tube at three more time intervals: T2 from 5 to 10 minutes,
T3 from 15 to 20 minutes, and T4 from 25 to 30 minutes after starting chewing gum
consumption. The Measurement of saliva pH level will be evaluated immediately using a pH
meter (BT-675 meter, Boeco-Germany), while the salivary flow will be evaluated by the
difference in weight of the basal pH with the final pH.
Data will be entered into an Excel spreadsheet and data analysis will be performed. The
analysis will be conducted using SPSS v.25, with descriptive data analysis. Chi-square
test will be used for demographic data, Levene's test will determine data homogeneity,
and ANOVA will determine differences in means, followed by Tukey's post-hoc comparison to
find significant differences between group means, with a significance level of p<0.05.
The expected results, that the mean salivary pH and flow will differ among the different
chewing gums