Mastic Is Something to Chew on
Mastic Gum May Have Far-Reaching Effects
By attacking bacteria that cause tooth decay and gum disease,
it may help prevent other diseases as well
By Hyla Cass, M.D.
hat is it with the word gum? On the one hand, it means a sticky, chewy substance that’s exuded by certain trees and that can be made into a variety of useful products. On the other hand, it means the firm connective tissue that surrounds the base of our teeth. Was it accidental that the same word came to be used for both, or is there some connection between the two?
© iStockphoto.com/Ruslan Gilmanshin
The answer is yes: it was accidental, but there is a connection, namely, gum is good for your gums. Probably the best kind of chewing gum in terms of oral health benefits is mastic, a gum resin that comes from the bark of the mastic tree, Pistacia lentiscus. Mastic has been used as a chewing gum and a medicinal food in Mediterranean cultures for many centuries. (A synonym for chew, by the way, is masticate. Coincidence? Nope.)
We’ll get to mastic shortly, but for the word freaks among you, here’s the etymology of gum. The gum that comes from trees is derived from the Middle English gomme, which traces back to the Latin gummi, thence to the Greek kommi, and finally, perhaps, to the Egyptian kmj-t (the Egyptians were apparently not big on vowels). The gum tissue in your mouth is derived from the Middle English gome (one m, not two), from Old English goma, meaning palate or jaw. So the accident hinged on one letter.
The Good, the Bad, and the Gummy
Regardless of word origins, it’s true that gum is good for your gums (some kinds are better than others), in several ways. First, the rhythmic mechanical action of chewing stimulates blood circulation in the gums, and it stimulates the flow of saliva, which tends to wash away food debris and accumulated bacteria from the gum pockets, at least to some extent (the deeper the pockets, the less effective this will be). And the sticky gum wad itself provides a physical cleansing action. Since these benefits arise from purely physical effects, it doesn’t matter what kind of gum is chewed—all kinds are good.
The flip side of physical is chemical, and here it matters a lot what kind of gum is chewed. Some chemical compounds found in chewing gum can be bad for your teeth and gums (and, ultimately, the underlying bone), whereas other compounds can be good for them. Avoid the bad, go for the good.
When Is “Little” Not So Little?
The main culprit, of course, is sugar, because it promotes tooth decay. We all learned that in childhood, but we don’t always live according to what we’ve learned, do we? Besides, we like sugar, and life is too short to worry about every little thing that feels good but that might do us some harm in the distant future, right? Some people might say that that attitude is self-indulgent or even self-destructive, but let’s face it—it’s human nature. A vital part of living life, after all, is enjoying life, and that always entails tradeoffs between what feels good and what’s good for us. My job is not to preach doom and gloom, but to inform and educate so that you can make rational choices about your own health and well-being.
That said, there are some facts regarding tooth decay and gum disease that might alter your view that life is too short to worry about a “little” thing like eating (or chewing) too much sugar. Life is too short, period, and here’s the bottom line: gum disease can make it shorter still. That’s because gum disease is a risk factor for things you would surely worry about, such as heart disease and cancer. At first glance, it’s hard to see how gum disease could possibly lead down those particular paths, but it’s not really far-fetched at all. For an explanation, see the sidebar.
From the Gums to the Heart and Pancreas and . . . ?
To understand how gum disease can be a risk factor for diseases elsewhere in your body, recall that nothing in your body exists in isolation—connections are everywhere, and the “connector supreme” is your blood, which regularly visits every one of your cells. Blood delivers essential nutrients, but it can also deliver toxins, such as bacteria and their byproducts. These nasties can enter your circulation at many different sites, including your gums.
Not to be too graphic about it, but gum pockets can harbor stuff so disgusting that even Hollywood wouldn’t know what to do with it. The longer it resides there (and the deeper the pockets), the more of it will find its way into your circulation and go looking for trouble. The best opportunity for this is when your gums bleed, because then the door is wide open, so to speak. Blood comes out, and bacteria go in.
Your gums can act, in effect, like a permanent source of slow-dose poison for your body, spreading low-grade infections and systemic inflammation. The latter is believed to underlie or exacerbate many chronic degenerative diseases, such as cardiovascular and neurodegenerative diseases, cancer, and arthritis.
People with gum disease often bleed when they brush or floss. It would be foolish, however, not to brush or floss because of that—it would merely make things worse in the long run. Such people should, of course, see a dentist, but at the very least, they should keep their teeth and gums as clean as possible. That means regular oral hygiene with implements available at any drugstore, as well as using an antibacterial mouthwash. (Drinking green tea is also useful, because it has antibacterial properties along with its numerous other health benefits.)
Chewing gum can help too, as long as it’s a good kind of gum, such as mastic, whose antibacterial action augments the physical benefits of masticating. By reducing the levels of oral bacteria, moreover, mastic may indirectly help prevent—or at least retard the progression of—atherosclerosis, which typically leads to cardiovascular disease, including heart attack and stroke. It may also reduce the risk for bacterial endocarditis, a serious infection caused by direct invasion of the heart by harmful bacteria, such as streptococci or staphylococci.
In a Swedish study of 129 healthy dental patients aged 80 or older, researchers found a link between root caries and cardiac arrhythmias (irregular heartbeats). Root caries is cavities of the root surface of a tooth; the condition is common in elderly people whose gums are receding because of poor oral hygiene. The study showed that, all else being equal, people with root caries had a 2.4-times (140%) greater risk for arrhythmias than their peers. Surprisingly, it showed no correlation between gum disease and arrhythmias, even though other research has shown a linkage between gum disease and various types of heart disease.
Gum disease can also contribute to the development of one of the deadliest of cancers, pancreatic cancer, which often goes undetected until it has spread to other organs. The 5-year survival rate is only about 5%. At Harvard Medical School, researchers examined 16 years’ worth of data on nearly 52,000 male doctors who had participated in a long-term health study that began in 1986. After correcting for many possible confounding factors, they found that men with a history of gum disease had a 63% higher risk for pancreatic cancer than those who did not—even if they were not smokers. The risk for smokers with gum disease was about 2 times (100%) greater.
The researchers speculated that the reason for these results is that gum disease results in chronic inflammation over the years and decades, and the blood of people with gum disease tends to have higher than normal levels of chemical compounds called nitrosamines, most of which are highly carcinogenic.
Note added in proof: A newly published study indicates that consumption of foods or beverages with high sugar content may increase the risk for pancreatic cancer, quite apart from the link with tooth decay and gum disease—one more reason to watch your sugar intake.
- Anon. Tooth decay linked to heart arrhythmia in very old. Reuters Health, Nov. 26, 2002.
- Rauscher M. Diseased gums raise risk of pancreatic cancer. Reuters Health, Nov. 13, 2006.
- Anon. Study links pancreatic cancer to high sugar intake. Reuters Health, Nov. 8, 2006.
Sugar—A Feast for Oral Bacteria
Sugar is bad for our teeth because it’s the principal food for various bacteria that colonize our mouths. It has been said that human bites are more dangerous than dog bites, because our mouths tend to be bacteriologically more potent than theirs. Be that as it may, the worst offender in terms of tooth decay is Streptococcus mutans, a destructive bacterium that thrives on sugar. Other prominent offenders are various species of the genus Lactobacillus, which are collectively called lactobacilli.
To feed these bugs, you don’t even have to eat sugar as such, because some sugar is produced by the fermentation of carbohydrates in your food, bits of which get stuck in the crevices of your teeth and in your gum pockets. As sugar is produced, S. mutans and other bacteria devour it, and their proliferation produces the sticky, mucous, acidic, bacteria-rich material called dental plaque, which coats your teeth and eats away at them. That can lead to dental caries, or cavities, as well as bad breath.
What Happens in Your Mouth May Not Stay in Your Mouth
The bacteria thriving in your gum pockets (periodontal pockets in dentist-speak) can also cause periodontitis, or inflammation of the connective tissue that surrounds the roots of your teeth and holds them in their bony sockets (periodontal means “around the teeth”). And the bacteria can cause gingivitis, or inflammation of the gingiva, the medical term for gum. In severe cases, the gingivae may develop small abscesses called gumboils.
All this is bad for your teeth, of course, but it’s also bad for your health in general, because, as we saw in the sidebar, the systemic inflammation to which it contributes is implicated in many chronic degenerative diseases. The process is facilitated when inflammatory agents circulate in the blood, as can occur when gingival or periodontal tissues become inflamed and are prone to bleeding. This condition poses an especially serious threat to people whose health is already compromised by chronic diseases of various kinds.
Mastic Reduces Oral Bacteria and Plaque
Among chewing gums, sugarless gums are obviously better than ones that contain sugar, but mastic gum (which is sugarless) is best of all. Why? Because mastic contains compounds that are known to inhibit the growth of oral bacteria, including S. mutans. The tangible benefits of mastic in this regard have been demonstrated in placebo-controlled studies done with healthy young adults by researchers in Turkey and Japan.* Collectively, they showed that chewing mastic gum:
- Reduced the total bacteria count in saliva, to a degree comparable to that obtained with the antibacterial drug benzethonium chloride
- Reduced the incidence of gingival inflammation
- Reduced the rate of formation of dental plaque
- Reduced the acidity of dental plaque
Placebo gums were used in these studies so that the benefits due to the physical effects of chewing could be accounted for, thus revealing the benefits due to the chemical effects of mastic’s antibacterial components.
Mastic—A Valuable Component of Oral Hygiene
Recently one of the same Turkish research teams performed a similar study, this time with 25 children (average age 14) who had good dental hygiene and no periodontal disease but who were undergoing orthodontic treatment for severe malocclusion. The motivation for this study was that orthodontic appliances (braces) can damage the tooth enamel by providing multiple sites for plaque accumulation. Increased levels of oral bacteria are, in fact, observed after such devices are installed.
As in their prior adult study, the researchers had the kids chew mastic gum or a placebo (paraffin wax), following a strict regimen under controlled conditions. They then prepared cultures of the kids’ saliva and measured the levels of S. mutans, lactobacilli, and total oral bacteria. The results reflected those of all the previous studies: compared with placebo, mastic significantly reduced oral bacteria and plaque formation. The researchers concluded,
. . . we suggest that regular use of mastic gum may be useful in controlling dental caries because of its antibacterial effect and anti-plaque-formation activity. . . . the idea of adding an equally or more effective chewing gum product to a patient’s mechanical hygiene measures has significant appeal from a convenience and compliance perspective. Routine use of mastic gum may also include situations where mechanical hygiene measures or mouthwashes would be impractical but where a chewable antiplaque agent would be desirable.
The researchers neglected to mention that mastic gum is best sweetened with xylitol, a compound found in plants and in our own bodies. Unlike sugar, xylitol cannot be used as a food source by the bacteria that colonize our mouths, and it even inhibits the growth of the worst of the lot, S. mutans. In that, it goes artificial sweeteners such as aspartame one better.
Mastic Also Attacks Oral H. pylori
It would be irresponsible to conclude this article without at least some mention of another benefit that mastic can provide for our oral health: its ability to kill Helicobacter pylori, the bacterium primarily responsible for gastritis and peptic ulcers (it’s also strongly implicated in stomach cancer). Although H. pylori does its dirty work primarily in the stomach and duodenum, it also frequently colonizes the mouth, whence it can reinfect a stomach from which it had been eradicated. That’s a good reason for attacking H. pylori in the mouth as well as in the gastrointestinal tract—and mastic gum can do that.
Some studies have suggested, by the way, that H. pylori may also be implicated in the development of coronary heart disease, possibly by modifying serum lipid concentrations (see
“H. pylori May Be Linked with Heart Disease” in the May 2004 issue). If this turns out to be true, H. pylori will have the dubious distinction of being one more bacterium that can damage your heart via your gums.
Chew on This
So if you want to protect not just your teeth but also your heart, your pancreas, and other organs that may be susceptible to the effects of systemic inflammation caused by bacteria in your mouth, you would do well to devote yourself to good oral hygiene. In addition, you should consider adopting mastic gum (with xylitol) as an enjoyable health aid. And if you happen to be a teacher, the next time you catch a kid chewing gum in class, ask if it’s mastic. What if the kid says yes—then what?
- Koparal E, Ertugrul F, Sabah E. Effect of chewing gum on plaque acidogenicity. J Clin Pediatr Dent 2000;24(2):129-32.
- Takahashi K, Fukazawa M, Motohira H, et al. A pilot study on antiplaque effects of mastic chewing gum in the oral cavity. J Periodontol 2003;
- Aksoy A, Duran N, Koksal F. In vitro and in vivo antimicrobial effects of mastic chewing gum against Streptococcus mutans and mutans streptococci. Arch Oral Biol 2006;51(6):476-81.
- Aksoy A, Duran N, Toroglu S, Koksal F. Short-term effect of mastic gum on salivary concentrations of cariogenic bacteria in orthodontic patients. Angle Orthodont 2007;77:124-8.
Dr. Hyla Cass is a nationally recognized expert in integrative medicine, an assistant clinical professor of psychiatry at the UCLA School of Medicine, and the author or coauthor of several popular books, including Natural Highs: Supplements, Nutrition, and Mind-Body Techniques to Help You Feel Good All the Time and 8 Weeks to Vibrant Health: A Woman’s Take-Charge Program to Correct Imbalances, Reclaim Energy, and Restore Well-Being.