You have probably heard the commercials that tell you four out of five dentists surveyed recommend sugarless gum for their patients who chew gum. It seems to me that, number one, the statement is only for those individuals who already chew gum, and, number two, it says four out of five dentists recommend sugarless gum. I would think all dentists would tell you to avoid sugar! The wording of the statement is intentional. I believe the risks outweigh the benefits. The main advantage of chewing gum being a lower chance of decay if the gum is sugarless. This benefit only holds true if you are eating a cavity-causing diet. You can read more about the substances that lead to tooth decay here.

Typical reasons for chronic gum chewing include freshening the breath, the taste, satisfying hunger, and calming the nerves. Chewing gum is considered a parafunctional habit. A parafunctional habit is using a body part repeatedly in a way that is not the regular use. It is similar to clenching and grinding but is voluntary. The typical use of the mouth is for eating, drinking, and speech. Gum chewing resembles eating, but three factors make it different. One, the amount of gum commonly chewed, is much smaller than a typical bite of food. Two, chewing gum usually lasts much longer than a meal. Three, gum is not meant to provide nutrition.

The small amount of gum means that the teeth continually penetrate the gum and make contact with each other, which is contrary to what happens with food. The larger bolus of food prevents the teeth from contacting very much. The time spent chewing is also longer than when eating a meal. The result is tooth wear that can become quite severe and painful. Another lesion related to gum chewing is an abfraction, which is loss of enamel by the gum-line, which can also be painful and unsightly. You can read more about abfractions in a previous post I did here.

The amount of pressure placed on the teeth by different gum chewers varies. The heavier the load, the higher the potential to wear the teeth. Additionally, the constant pressure the teeth apply to each other can compress the ligaments that support the teeth. Frequent overloading of the ligaments leads to inflammation and pain. With enough inflammation of the ligament, the teeth can feel pain to any pressure, which means chewing a meal can become difficult.

The nerves in the teeth can also become inflamed with the repeated trauma of gum chewing, causing temperature sensitivity. Typically, the sensitivity is more noticeable with cold. The reason for this is that cold liquids can be close to freezing, which is seventy degrees Fahrenheit colder than body temperature; this is not so for hot liquids. Wear, sensitivity to pressure and cold sensitivity usually involve several teeth when gum chewing is involved.

Finally, the muscles responsible for moving the jaw can get fatigued. These muscles are collectively called the muscles of mastication, and they are situated on the sides of the face and the temple above and in front of the ears (see the diagram below). Repeated fatigue can lead to constant pain (myalgia) and spasm (myospasm), even when not eating.

Headaches and migraines are a common co-occurring problem. There are internal muscles that can be involved as well. When they spasm, it can feel as if your ear is clogged or that you have an earache. As I have stated in a previous post, the most common cause of an ear that hurts to touch, yawn, or swallow is musculoskeletal inflammation due to excessive grinding, clenching, or gum chewing.

Finally, clicking and popping noises in joint in the region of the ear, known as the temporomandibular joint, is typical in chronic gum chewers. The constant motion of the jaw can result in compression of the articular disk that acts as a buffer between the mandible bone and the temple bone. The continuous compression of the disc can lead to inflammation. The disc can eventually be squeezed out of place when the jaw moves, producing noise as the disk pops in and out of position. Ringing in the ears called tinnitus is another potential symptom.

Other indirect symptoms are dizziness, fatigue, and neck and back pain. In more extreme cases, depression, insomnia, irritability, anxiety, and lack of concentration can occur. Typically, these symptoms are secondary to chronic pain and muscle spasms. The stress and insomnia can cause more gum chewing, and a vicious cycle can ensue. Many times the anxiety and insomnia will be treated with pharmaceuticals and not connected to the original problem of too much gum chewing.

Most gum today is highly processed. You can visit this website to find out the specific ingredients that are known to cause problems. I want to say a word about cinnamon gum. In my career, I have had several emergency visits due to cinnamon gum, which is an irritant to the mucosa of the mouth.

I don’t want you to get the wrong idea. Occasional gum chewing is generally not a problem. Chewing gum is not a guarantee that you will develop any problems. It is considered a risk factor that can lead to some or all of the issues I have just described. If you are someone who chews gum regularly and you suspect you may have one or more of the matters I just described, call your dentist to have an evaluation.