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Research Looks At Chewing Gum Flavoring For Infection Prevention

Gumballs by Patrick Hoesly via Flickr and a Creative Commons license

A common flavoring of chewing gum was associated with a 25% reduction in acute otitis media (AOM) in a small meta-analysis of children in Finnish day care centers, researchers reported.

Chewing gum has long been touted by gum manufacturers for preventing tooth decay and by frequent flyers for keeping one’s ears from popping during take-offs and landings. It’s been looked at for heartburn from overeating, relief of stress and anxiety and in dieting (although sugar-free gum has no more effect, it’s been recently noted).

Now, one of gum’s common flavorings, xylitol (birch sugar) is being looked at for its antibitoic properties in an age of antibiotic overuse and potential drug resistence. Xylitol has been used for decades as a natural non-sugar sweetener in gum, toothpaste and medicines.

AOM is the most common bacterial infection among young children in the United States. By the age of one, approximately 62% of children have experienced at least one episode of AOM; and by the age of three, almost 83% of children have experienced at least one episode. In the United States, it accounted for almost 16 million office visits in 2000 and costs almost $3.8 billion annually in direct and indirect health care costs, researchers noted in their review.

Now, researchers are looking at it for prevention of Streptococcus pneumoniae and Haemophilus influenzae.

Researchers looked through randomized controlled trials (RCTs) or quasi-RCTs of children aged 12 years or younger where xylitol supplementation was compared to placebo or no treatment to prevent AOM. They found four studies (from the same research group). Results were published at The Cochrane Library. They concluded that 8.4 g of xylitol (two pieces of chewing gum, five times a day after meals for at least five minutes) can prevent AOM in children without acute upper respiratory infections.

In three RCTs with a total of 1,826 healthy Finnish children attending day care, there was a reduced risk of occurrence of AOM in the xylitol group (in any form) compared to the control group (relative risk [RR], 0.75; 95% confidence interval [CI], 0.65 to 0.88). The fourth RCT included 1,277 Finnish day care children with a respiratory infection and found no effect of xylitol on reducing the occurrence of AOM (RR 1.13; 95% CI 0.83 to 1.53).

Xylitol chewing gum was superior to xylitol syrup in preventing AOM among healthy children (RR 0.59; 95% CI 0.39 to 0.89) but not during respiratory infection (RR 0.68; 95% CI 0.43 to 1.07). There was no difference between xylitol lozenges and xylitol syrups in preventing AOM among healthy children (RR 0.77; 95% CI 0.53 to 1.11) or among children during respiratory infection (RR 0.74; 95% CI 0.47 to 1.14). Similarly, no difference was noted between xylitol chewing gum and xylitol lozenges in preventing AOM among healthy children (RR 0.73; 95% CI 0.47 to 1.13) or among children during respiratory infection (RR 0.92; 95% CI 0.59 to 1.46).

Researchers noted that while the effect was strong, the association was limited because the data arise from a small number of studies, mainly from the same research group.

For more general trivia about chewing gum, try these resources:
ChewingGumFacts.com
International Chewing Gum Association
Wrigley

*This blog post was originally published at ACP Internist*


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