An aim of this year’s World Oral Health Day was to empower people with the knowledge, insight, and confidence they need to secure a healthy mouth. This is a noble goal, and one that I share as both a practicing dentist and a trained yoga instructor. In both roles, my job is to give individuals the necessary tools to take effective charge of their health – whether oral or general.
In each case, lifestyle is key. According to the Oral Health Foundation, almost two in five (39%) UK adults don’t visit the dentist on a regular basis, whilst one in four (25%) don’t brush twice a day with fluoride toothpaste. Additionally, one in three (33%) confess they have never flossed or cleaned interdentally.
This shows a shocking lack of awareness about the habits necessary to secure good oral health and it is the job of clinicians to fill this gap with actionable and useful advice for patients. Some of this will be standard fare; spit don’t rinse after brushing, visit the dentist every 6-12 months, invest in an electric toothbrush, however there are less obvious areas too where light could be shed.
Take chewing, for example. Chewing is one of those activities which is so ubiquitous in daily life that we tend to overlook the enormous role it plays in supporting our overall health and wellbeing. This simple act aids digestion, supports immunity, improves nutrient uptake from food, and prevents oral disease by stimulating saliva flow – which rebalances the pH of the mouth and reduces plaque.
Indeed, the benefits of chewing to oral health are well-established, with much research in recent years focusing on the medical benefits of sugar-free chewing gum. One study from Kings College London finds that people who chew regularly have a 28% reduced risk of developing cavities than those who do not, revealing the importance of chewing as a prevention strategy.
Similarly, a systematic review, also from Kings, found that using sugar-free gum, in particular xylitol sugar-free gum, reduces the quantity of plaque in the oral cavity in comparison to non-chewing conditions.
Whilst more research is needed here, the results are certainly promising and they should be more widely known amongst dental patients. Furthermore, the benefits of chewing are not limited to oral health. Evidence suggests that chewing can benefit mental health by increasing feelings of calm, relaxation, and focus.
In one study, students in Japan were asked to chew gum over a period of 14 days and record their results. They reported a reduction in their levels of depression and fatigue, compared to a control group. Another study found that chewing two pieces of gum for 20 minutes a day has a positive impact on students’ reported level of stress symptoms, even under a heavy workload.
The reason for the calming effects of gum chewing is not fully understood, although we do know that chewing activates the parasympathetic nervous system, helping individuals to relax and to relieve stress.
It is possible to speculate on further mental health benefits in terms which resonate with my own experience as a yoga teacher; one explanation being that chewing may play a similar role to that experienced through meditation and mindfulness practices. By engaging the senses of scent, touch, and taste, chewing perhaps serves to re-focus our minds on the present moment. This is one of the goals of practices like meditation and yoga.
Indeed, similar explanations have already been endorsed by some mental health experts. In January, the US-based trauma consultant Alysha Tagert spoke on a panel at Davos to argue that chewing gum can be an effective tool for patients struggling with anxiety:
‘Noticing the smell, texture, colour, or flavour of chewing gum forces the mind to focus on the act of chewing. It turns the mind away from an intrusive memory, intense thought, stress, or fear and has a calming effect’.
She also advocated including gum as part of a ‘coping toolbox’, which patients can then carry around and access whenever they feel the onset of panic. Other items might include stress balls, fidget spinners, and other tactile objects designed to soothe the user by getting them out of their head.
Of course, the benefits of chewing to both oral health and general wellbeing should not be overstated. Whilst tools like sugar-free gum may offer patients a hand in nurturing their oral microbiome, it should not be seen as a substitute for other positive lifestyle practices, such as eating a nutritious diet, limiting alcohol and sugar consumption, and exercising regularly.
Nevertheless, the evidence is sufficiently compelling to suggest that chewing can play a small but important role in securing positive health outcomes. This is information that would be useful for people to know, and equally for clinicians to advocate.
Dr Maria Papavergos is a general dentist and practicing yoga instructor with over 10 years of clinical experience. She founded The Lifestyle Dentist to help spread her preventative philosophy and lifestyle-centered approach to oral health and wider, whole-body health