Does chewing gum have any medical effects?

Does Chewing Gum Have Medical Effects?

Yes, chewing gum has several established medical effects, particularly in gastrointestinal recovery after surgery and oral health, though evidence for other applications remains limited.

Postoperative Recovery

Chewing gum accelerates return of bowel function after abdominal surgery and is incorporated into Enhanced Recovery After Surgery (ERAS) protocols. 1 The mechanism involves stimulation of the cephalic-vagal reflex, promoting earlier return of gut function beyond standard bowel regimens and early feeding protocols. 1

• Patients should chew gum starting on postoperative day 0 as part of multimodal bowel recovery strategies 1
• This intervention complements (but does not replace) early mobilization, early feeding, and standing laxatives 1

Colonoscopy Preparation

For bowel preparation before colonoscopy, chewing gum improves patient satisfaction but does not enhance bowel preparation quality. 1

• One randomized trial showed patient satisfaction increased from 90.7% to 97.4% (P = 0.015) when gum was chewed after completing a 2L PEG regimen 1
• The 2023 ASA guidelines conditionally suggest not delaying elective procedures in healthy adults who are chewing gum, based on very low-quality evidence 1
• Critical caveat: Patients must remove gum from their mouths before the procedure begins 1

Oral Health Benefits

Sugar-free chewing gum provides proven anti-caries benefits through multiple mechanisms related to increased salivation and mastication. 2, 3

Primary Mechanisms:

• Stimulated saliva flow promotes rapid oral clearance of sugars 2
• High pH and buffering capacity of stimulated saliva neutralizes plaque pH after sugar challenges 2
• Enhanced remineralization of early caries-like lesions 2
• Prospective clinical trials demonstrate reduced caries incidence in children using sugar-free gum 2

Active Ingredients:

• Xylitol-containing gum shows specific caries-therapeutic effects 2, 4
• Other additives (fluoride, calcium phosphates, antimicrobials) aim to enhance inherent benefits, though evidence for their specific effects is limited due to low concentrations and rapid wash-out 3

Important Limitations:

• Recent observational data from NHANES 2013-2018 found no association between self-reported chewing gum use and oral health measures (gum disease, bone loss, root caries, or caries) in U.S. adults, except for increased odds of dental restoration 5
• Clinical effects of gum additives are overshadowed by basic mastication and salivation effects and require daily use for prolonged periods 3

Nicotine Delivery

Nicotine gum is an FDA-approved medication for smoking cessation with specific dosing requirements. 6

• Use 4 mg if first cigarette is within 30 minutes of waking; use 2 mg if more than 30 minutes after waking 6
• Proper technique: chew slowly until tingling, then park between cheek and gum; repeat for approximately 30 minutes 6
• Do not eat or drink for 15 minutes before or during use 6
• Use at least 9 pieces per day for first 6 weeks, maximum 24 pieces per day 6
• Common adverse effects include local reactions, nausea, sweating, mood alterations, and sleep disturbances 7

Dietary Quality Association

Chewing gum use is associated with improved diet quality (higher Healthy Eating Index scores) and decreased intake of snacks and added sugars, though causality cannot be established from observational data. 5

Clinical Recommendations

Use sugar-free chewing gum as an adjunct (not replacement) to traditional oral hygiene methods for caries prevention. 2, 8 Products labeled "safe for teeth" or "tooth-friendly" have been proven not to depress plaque pH below 5.7 during or for 30 minutes after consumption. 8

Incorporate gum chewing into postoperative care protocols for abdominal surgery patients to accelerate bowel recovery. 1

Consider gum chewing to improve patient experience during colonoscopy preparation, but do not expect improved bowel cleansing quality. 1

Important safety consideration: Choking hazard concerns limit chewing gum use by young schoolchildren in the United States, despite potential caries-prevention benefits. 4