Chew on This

I inherited a bunch of stuff from my mother. Among them are a strong aversion to confrontation and amateur theatrical performances, comfortable relationships with sketching pencils and paint brushes, and a mouthful of dental caries. In fact, I have enough amalgam in my teeth to tune in National Public Radio if I open my mouth just enough and face northeast.

For years, I thought my plethora of dental cavities was because my mom was always generous with the chewing gum she habitually carried in her purse. Whenever my sister and I were out and about with my mom and seeming a bit bored or devilish, she would unwrap a couple of sticks to keep us amused.

Well, it turns out that although bathing my teeth with sugar-containing saliva wasn’t helping the situation, the suite of bacteria that my mother shared with me when I was a neonate was a coconspirator in rotting my teeth. Thriving on the nutrient-rich saliva, Streptococcus mutans gobbled away at my enamel.

While I was still processing this new assault on my mother’s reputation, I discovered that, had she lived into the 21st century, her free gifting of chewing gum would be considered on the cutting edge of oral health. I recently discovered that some dentists are encouraging their young patients to chew gum to help prevent dental caries. Of course, not just any gum, but gum that contains xylitol, a sweetener found in some fruits and vegetables.

It turns out that chewing gum increases saliva production, which is a good thing as long as the saliva is not sugar rich. When sugar is replaced with xylitol, the saliva is less acidic. The combination of more saliva and a higher pH seems to encourage remineralization of teeth, even those that have already begun to degrade. The effect is apparently most effective when xylitol-containing gum is chewed regularly before adult teeth have erupted.

If we accept the studies that support these findings, then it means that most communities should be making a fast 180 shift in their policies about chewing gum in school. Having spent most of one summer as school custodian laying on my back scraping petrified gum off the undersides of desks with a putty knife, I can understand why school administrators would be resistant to a change in policy.

However, there might be another reason to encourage gum chewing in school that might get the administrators’ attention. It turns out that a handful of researchers have observed that gum chewing can help cognition and improve attention. One explanation for this phenomenon is that for many of us, repetitive physical actions such as pencil tapping helps us concentrate. Bouncing my legs to the throbbing beat of the Rolling Stones helped me get through medical school. It may simply be that the music kept me awake, but for whatever reason, it worked.

But, to be fair, there is a study from the Netherlands that found that not only did chewing gum not help with attention, but that it was detrimental to task execution and vigilance in both healthy children and those with attention-deficit/hyperactivity disorder (Appetite 2010;55:679-84).

I hope that others will try to repeat this study and find that my mother was on the right track in keeping my sister and I focused with a stick of gum. If the detrimental effects on learning stand up, this information will present an interesting dilemma for pediatricians. Rotten teeth or distracted students?

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine.

I inherited a bunch of stuff from my mother. Among them are a strong aversion to confrontation and amateur theatrical performances, comfortable relationships with sketching pencils and paint brushes, and a mouthful of dental caries. In fact, I have enough amalgam in my teeth to tune in National Public Radio if I open my mouth just enough and face northeast.

For years, I thought my plethora of dental cavities was because my mom was always generous with the chewing gum she habitually carried in her purse. Whenever my sister and I were out and about with my mom and seeming a bit bored or devilish, she would unwrap a couple of sticks to keep us amused.

Well, it turns out that although bathing my teeth with sugar-containing saliva wasn’t helping the situation, the suite of bacteria that my mother shared with me when I was a neonate was a coconspirator in rotting my teeth. Thriving on the nutrient-rich saliva, Streptococcus mutans gobbled away at my enamel.

While I was still processing this new assault on my mother’s reputation, I discovered that, had she lived into the 21st century, her free gifting of chewing gum would be considered on the cutting edge of oral health. I recently discovered that some dentists are encouraging their young patients to chew gum to help prevent dental caries. Of course, not just any gum, but gum that contains xylitol, a sweetener found in some fruits and vegetables.

It turns out that chewing gum increases saliva production, which is a good thing as long as the saliva is not sugar rich. When sugar is replaced with xylitol, the saliva is less acidic. The combination of more saliva and a higher pH seems to encourage remineralization of teeth, even those that have already begun to degrade. The effect is apparently most effective when xylitol-containing gum is chewed regularly before adult teeth have erupted.

If we accept the studies that support these findings, then it means that most communities should be making a fast 180 shift in their policies about chewing gum in school. Having spent most of one summer as school custodian laying on my back scraping petrified gum off the undersides of desks with a putty knife, I can understand why school administrators would be resistant to a change in policy.

However, there might be another reason to encourage gum chewing in school that might get the administrators’ attention. It turns out that a handful of researchers have observed that gum chewing can help cognition and improve attention. One explanation for this phenomenon is that for many of us, repetitive physical actions such as pencil tapping helps us concentrate. Bouncing my legs to the throbbing beat of the Rolling Stones helped me get through medical school. It may simply be that the music kept me awake, but for whatever reason, it worked.

But, to be fair, there is a study from the Netherlands that found that not only did chewing gum not help with attention, but that it was detrimental to task execution and vigilance in both healthy children and those with attention-deficit/hyperactivity disorder (Appetite 2010;55:679-84).

I hope that others will try to repeat this study and find that my mother was on the right track in keeping my sister and I focused with a stick of gum. If the detrimental effects on learning stand up, this information will present an interesting dilemma for pediatricians. Rotten teeth or distracted students?

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine.

I inherited a bunch of stuff from my mother. Among them are a strong aversion to confrontation and amateur theatrical performances, comfortable relationships with sketching pencils and paint brushes, and a mouthful of dental caries. In fact, I have enough amalgam in my teeth to tune in National Public Radio if I open my mouth just enough and face northeast.

For years, I thought my plethora of dental cavities was because my mom was always generous with the chewing gum she habitually carried in her purse. Whenever my sister and I were out and about with my mom and seeming a bit bored or devilish, she would unwrap a couple of sticks to keep us amused.

Well, it turns out that although bathing my teeth with sugar-containing saliva wasn’t helping the situation, the suite of bacteria that my mother shared with me when I was a neonate was a coconspirator in rotting my teeth. Thriving on the nutrient-rich saliva, Streptococcus mutans gobbled away at my enamel.

While I was still processing this new assault on my mother’s reputation, I discovered that, had she lived into the 21st century, her free gifting of chewing gum would be considered on the cutting edge of oral health. I recently discovered that some dentists are encouraging their young patients to chew gum to help prevent dental caries. Of course, not just any gum, but gum that contains xylitol, a sweetener found in some fruits and vegetables.

It turns out that chewing gum increases saliva production, which is a good thing as long as the saliva is not sugar rich. When sugar is replaced with xylitol, the saliva is less acidic. The combination of more saliva and a higher pH seems to encourage remineralization of teeth, even those that have already begun to degrade. The effect is apparently most effective when xylitol-containing gum is chewed regularly before adult teeth have erupted.

If we accept the studies that support these findings, then it means that most communities should be making a fast 180 shift in their policies about chewing gum in school. Having spent most of one summer as school custodian laying on my back scraping petrified gum off the undersides of desks with a putty knife, I can understand why school administrators would be resistant to a change in policy.

However, there might be another reason to encourage gum chewing in school that might get the administrators’ attention. It turns out that a handful of researchers have observed that gum chewing can help cognition and improve attention. One explanation for this phenomenon is that for many of us, repetitive physical actions such as pencil tapping helps us concentrate. Bouncing my legs to the throbbing beat of the Rolling Stones helped me get through medical school. It may simply be that the music kept me awake, but for whatever reason, it worked.

But, to be fair, there is a study from the Netherlands that found that not only did chewing gum not help with attention, but that it was detrimental to task execution and vigilance in both healthy children and those with attention-deficit/hyperactivity disorder (Appetite 2010;55:679-84).

I hope that others will try to repeat this study and find that my mother was on the right track in keeping my sister and I focused with a stick of gum. If the detrimental effects on learning stand up, this information will present an interesting dilemma for pediatricians. Rotten teeth or distracted students?

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine.