Sugar-Free Gum and Xylitol: What the Evidence Says

Sugar-free gum is one of the few treats dentists actively suggest. Xylitol, a sweetener used in many sugar-free gums and mints, is often marketed as a cavity fighter. This guide separates what the evidence supports from what it doesn’t, using guidance from the American Dental Association (ADA), the American Academy of Pediatric Dentistry (AAPD) and the U.S. Food and Drug Administration (FDA). It also covers when gum can cause problems.

How sugar-free gum helps

The ADA says clinical studies show that chewing sugarless gum for 20 minutes after meals can help prevent tooth decay. The benefit comes mainly from saliva. Chewing increases saliva flow, and the ADA explains that saliva helps by:

• washing away food and debris
• neutralizing acids made by bacteria
• spreading disease-fighting substances through the mouth
• bringing extra calcium and phosphate to strengthen enamel

Gum with sugar also boosts saliva, but the ADA notes that plaque bacteria use the sugar to make decay-causing acids. So the gum must be sugarless to help.

The ADA also suggests sugarless gum to keep saliva flowing after acidic foods and drinks. See tooth erosion from acidic foods and drinks. The National Institute of Dental and Craniofacial Research (NIDCR) lists chewing sugarless gum among self-care steps for dry mouth. See dry mouth and your teeth.

Choosing a gum

The ADA recommends gum with its Seal of Acceptance. The ADA says the Seal means the gum is sugarless and met ADA guidelines for safety and effectiveness, and that companies must verify their packaging claims. All ADA-accepted gums use sweeteners that don’t cause cavities, such as aspartame, xylitol, sorbitol or mannitol.

What about xylitol specifically?

Xylitol is a sugar alcohol. The AAPD explains that sugar alcohols are not readily metabolized by mouth bacteria, so they are considered non-cavity-causing sugar substitutes. Beyond that, the picture is mixed.

What the AAPD says

In its policy on xylitol, the AAPD:

• supports xylitol and other sugar alcohols as non-cavity-causing sugar substitutes
• acknowledges the current lack of consistent evidence that xylitol is a primary way to prevent cavities, particularly in reducing cavity-causing bacteria in children
• recognizes that the large doses and frequent use in clinical trials may be unrealistic in everyday practice
• supports further research on dose, frequency and delivery method

The AAPD’s review notes that design flaws and bias in some studies limit how much weight their findings can bear.

The practical takeaway

Choosing xylitol gum over sugary gum is a sensible swap. Treating xylitol as a substitute for fluoride, brushing or dental visits is not supported. The ADA calls gum “a helpful tool,” not a substitute for other dental care.

Keep xylitol away from dogs

The FDA warns that xylitol can have devastating effects on dogs. It explains that xylitol does not trigger insulin release in people, but it does in dogs. The FDA lists sugarless gum, breath mints, toothpaste, mouthwash, chewable vitamins, some peanut and nut butters and baked goods among products that may contain it, sometimes labeled as birch sugar or wood sugar. If you think your dog ate something with xylitol, the FDA advises calling your vet, an emergency clinic or an animal poison control center right away. Store gum and dental products out of reach.

When gum can cause problems

The ADA notes that chewing gum works the jaw harder and more often than food does. Heavy, prolonged chewing, especially of dense or thick gum, could lead to jaw pain and headaches and raise the risk of temporomandibular joint (TMJ) disorders. The ADA advises:

• Skip gum if you have a TMJ disorder. It adds stress and can make the condition worse.
• Be wary of “jaw exercise” gum. The ADA says hard, tough-to-chew gums marketed to reshape the jaw are part of social media trends rarely backed by science, and they can cause additional issues for people with jaw pain.
• See a dentist for jaw symptoms such as clicking, locking or pain.

If you clench or grind as well, see teeth grinding and night guards.

People with braces should also check with their orthodontist. The ADA lists chewing gum among foods to avoid during treatment.

Gum is a bonus, not a routine

The ADA still recommends brushing twice a day for two minutes with fluoride toothpaste, cleaning between teeth daily, eating balanced meals with limited sugary snacks, and seeing your dentist regularly. Sugar-free gum after a meal is a useful extra on top of that. For more on cavities, see our tooth decay and cavities guide.

Frequently asked questions

How long should I chew sugar-free gum after eating?

The ADA cites clinical studies showing benefit from chewing sugarless gum for 20 minutes after meals.

Is xylitol gum better than other sugar-free gum?

All ADA-accepted gums use non-cavity-causing sweeteners. The AAPD says the evidence that xylitol itself prevents cavities is not consistent.

Can children chew xylitol gum?

The FDA notes some pediatric dentists recommend xylitol gum for children. Ask your child’s dentist, and consider whether your child can chew gum safely.

Sources

• ADA MouthHealthy: Chewing Gum
• American Academy of Pediatric Dentistry: Policy on Use of Xylitol in Pediatric Dentistry (PDF)
• FDA: Paws Off Xylitol; It’s Dangerous for Dogs
• ADA MouthHealthy: Dietary Acids and Your Teeth
• NIDCR: Dry Mouth

By the Dentist Review Editorial Team.

This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.

Featured image: “Chewing gum stick” by Lusheeta, via Wikimedia Commons, licensed CC BY-SA 3.0. Resized and compressed for the web.