Prebiotic chewing gum could be helpful for gum disease

People with gum disease could soon benefit from chewing gum containing nitrate, a compound that reduces the growth of inflammatory bacteria.

Gum disease, known as gingivitis in its milder form, occurs when a thin film of bacteria, known as plaque, accumulates on teeth, causing inflammation and bleeding in the gums.

Brushing your teeth twice a day, cleaning between them with floss or interdental brushes and using antibacterial mouthwash can help to prevent or treat the condition, but this isn’t always easy to do consistently, says Shawn Green at the Harbor-UCLA Medical Center in West Carson, California.

Left untreated, the condition can progress to a more severe form, known as periodontitis, which can lead to mouth abscesses and tooth loss.

Prior studies suggest that eating nitrate-rich foods, such as leafy greens and beetroot, reduces gum inflammation by enhancing the growth of anti-inflammatory bacteria – but not everyone has access to, or enjoys eating, such foods, says Green.

To test an alternative way to harness nitrate’s benefits, Green and his colleagues recruited 30 adults with mild gum disease. They randomly assigned the participants to chew either a gum enriched with nitrate – developed by the team – or a gum without nitrate that tasted the same for at least 15 minutes, three times a day, for three weeks. The participants were asked to follow their usual oral hygiene routines and diets throughout the study.

Before and after this period, the team assessed how easily the participants’ gums bled by using a small metal stick to probe the gums around every tooth. In the group chewing nitrate gum, this revealed that 26 per cent of the probed regions bled, on average, at the start of the study, but this reduced to 15 per cent by the study end. In contrast, the gum without nitrate had no effect.

“That is a clinically meaningful reduction in bleeding,” says Praveen Sharma at the University of Birmingham, UK, who wasn’t involved in the study.

Further analysis of saliva samples revealed that the nitrate gum seemed to work by boosting levels of beneficial mouth bacteria that convert nitrate, a prebiotic, into nitric oxide. It also reduced the abundance of harmful plaque-forming bacteria, such as Porphyromonas gingivalis.

The findings suggest the approach, in combination with standard treatments, could offer a simple way to relieve symptoms of gum disease. “This is good as a proof of concept,” says Francesco D’Aiuto at Imperial College Healthcare NHS Trust, UK. But larger studies should explore how long the effects last and whether the approach can treat severe gum disease, he says.