Mastic for Improved Oral Health
Chewing the right kind of gum can help your teeth - and your stomach!
By Aaron W. Jensen, Ph.D.

ou probably think that you take pretty good care of your teeth. If you are like most people, you brush them every night before going to bed and again every morning when you wake up, floss occasionally, and have regular dental check-ups. And you go about your busy life taking for granted that your teeth - most of them, anyway - are going to be with you for the rest of life's journey. Chances are, most of them will be - but oh, what a pain it can be to lose some!

Your teeth, even though they are protected by a layer of enamel (the hardest substance in your body), are not immune to erosion by unseen forces, in the form of bacteria - your mouth's worst enemy. How do these tiny life forms wreak such havoc in your mouth? Certain types of bacteria form colonies in the crevices of your teeth and gums. Once they have set up house in these cozy spaces, they start to produce acidic secretions that erode the protective enamel of the teeth, causing a loss of mineral content and exposing them to further attack. The exposed area becomes a cavity and needs prompt attention by a dentist to prevent rapid further decay, or even loss, of teeth.

For bacteria to thrive in your mouth, they require a nutrient source. Their preferred nutrient is sugar, and they need just a little bit of it. Even though you swallow all your food when you eat, there is generally enough dissolved sugar left behind to keep bacteria alive and happy (see the sidebar "Bacteria, Bacteria Everywhere"). The sugar need not have started out as such, however; sugar is produced by the fermentation of some carbohydrates, so even a sugar-free meal can be a source of it. But don't despair - you can do something about this, and it's simple, fun, and delicious.

Bacteria, Bacteria Everywhere

Under favorable conditions, such as your mouth, which is moist, warm, and nutrient-rich, bacteria grow alarmingly fast - they can divide every 20 minutes, in fact. So, if you started with just one bacterium (which is extremely unlikely, but it makes the math easier), you would have two bacteria in 20 minutes, four in 40 minutes, and 8 in an hour. This exponential growth would continue until the food source was depleted, but it wouldn't take long before there were an awful lot of bacteria swarming around in your mouth. After 7 hours, for example, there would be over 2 million, if their growth were left unchecked and you didn't swallow your saliva. And remember, that's starting with only a single bacterium.

A couple of million bacteria may sound like a lot, but when oral hygiene is lacking, there can be many billions of bacteria residing in the mouth. Now that's a lot of bacteria. And the more of them there are to secrete acid, the greater the risk of dental problems.

How do you fight tooth decay? The best way is to limit the bacteria's food source. Frequent brushing and flossing remove not only bacteria but also residual sugar from the mouth. Longer brushings are better because they are more effective at eliminating bacteria throughout your entire mouth. Most people brush for only 30-45 seconds (although they may think they brush longer). Shorter brushings not only remove fewer bacteria, they also tend to cover less surface area of the teeth (and the back teeth are often neglected). And don't forget to brush your tongue, whose bacterial colonies are the main source of bad breath.

Limiting your sugar intake is another way to reduce bacterial growth, especially if you limit the length of time the sugar remains in your mouth. For example, sucking on candy or eating food that sticks to your teeth (such as caramel, licorice, or peanut butter) greatly increases the amount of bacterial growth. Avoiding these eating behaviors is a good way to reduce tooth decay - and it's good for your waistline, too!

Mastic Gum Reduces Bacterial Damage

Although we can't eliminate all bacteria in our mouths, we can limit the damage they do to our teeth and gums (as well as our breath). There are a couple of methods for improving oral hygiene. The best, of course, is to brush and floss right after every meal - but that is often impractical. Alternatively, we can rinse our mouth thoroughly with water or an antibacterial mouthwash after eating, or drink green tea, which has antibacterial properties, or chew gum for about ten minutes after each meal.

Gum? Yep, gum! But make sure it's the sugar-free variety. Dental researchers in Turkey, a country that suffers from a high incidence of tooth decay because dental services are in short supply, have demonstrated that chewing sugar-free gum after a meal reduces the acidity of dental plaque and may thus reduce the extent of damage to the enamel.1 And if the gum is derived from natural mastic, the benefits are even greater, because mastic is known for helping to prevent periodontitis and gingivitis. (See the sidebar "A Quick History of Mastic" to understand more about this ancient remedy.)

A Quick History of Mastic

The mastic tree (Pistacia lentiscus) is native to the Mediterranean regions of Greece, where it grows primarily on the island of Chios. The tree and its aromatic resin, mastic gum, have played an important role in health and commerce in this area through the millennia.

References to mastic (the word comes from the Greek mastikhan, meaning "to grind the teeth") can be found in the medical literature as far back as the first century, where it was reported to reduce abdominal pain and sooth digestive and urinary distress. It was also used as a whitening agent and toothpaste.

Although the lore of mastic passed from generation to generation in the region where it was grown, it failed to penetrate very far afield. It was not until Iraqi researchers published a study in 1984 that mastic received international attention. Their research demonstrated that chewing mastic gum was an effective means for reducing dental plaque.

Other researchers soon jumped on the bandwagon and proclaimed the benefit of mastic in eliminating bacteria, not only from the mouth but also from the digestive tract. Now there is growing scientific evidence to support the use of mastic for reducing the risk of tooth decay and improving gastric health.

Mastic Gum Reduces the Acidity of Dental Plaque


The gum-resin "tears"
of the mastic tree.
 
In the Turkish study, 15 volunteers (aged 22–33) suspended their normal oral hygiene habits for two days (after a thorough cleaning) to accumulate dental plaque on their teeth, and the pH of the plaque was then measured in each volunteer.* They then rinsed their mouths thoroughly with a sugar solution for one full minute to provide a food source for the bacteria, and the pH of their dental plaque was measured repeatedly over the next 30 minutes. As predicted, the pH decreased (i.e., the acidity increased) significantly after the sugar rinse, with the lowest values (highest acidity) occurring within 5 to 10 minutes.


*The pH scale is a logarithmic measure of acidity in which the value 7 corresponds to neutral. Values above 7 are alkaline, while values below 7 are acidic. Thus, a decrease in pH corresponds to an increase in acidity.


The subjects then rinsed their mouths with tap water, and then again with a sugar solution for one minute, and the plaque pH was measured. They were then divided into three gum-chewing groups: (1) sugared gum, 3 grams; (2) sugar-free (but artificially sweetened) gum, 3 grams; and (3) natural mastic gum, 2 grams, with 1 gram of paraffin added to make it easier to chew.

The subjects chewed their gum for 10 minutes. The pH of their plaque was measured repeatedly during that interval and for the next 20 minutes. All three chewing gums decreased the acidity of the plaque, probably owing to the ability of any gum to stimulate salivation and to accelerate the removal of fermentable carbohydrates left over after the ingestion of food or drink. Not surprisingly, though, the sugared gum had only a slight effect in decreasing the acidity. The sugar-free gum and the mastic gum were more effective. The authors noted that, although statistical analysis of the data did not allow a ranking of the three gums according to their effect on plaque pH, the mastic gum produced the greatest decreases in acidity.

These results are consistent with those of a previous study in which researchers found that chewing sugar-free gum for 20 minutes after a sugar-rich meal or snack enhances remineralization of the teeth.2 In other words, the gum suppresses the loss of minerals in the enamel through acidic erosion caused by bacteria. Researchers caution that while chewing sugar-free gum does not replace the need for brushing and flossing, it is an effective tooth- and mouth-cleansing activity for the short term, until you can give your teeth more attention.

Mastic Alleviates Stomach Distress

Not all the species of bacteria that reside in the mouth lead to dental complications. One such "tooth-benign" species is Helicobacter pylori. Just because this particular microorganism doesn't lead to tooth decay, however, doesn't mean that it's harmless - quite the contrary. H. pylori is a pernicious bacterium associated with 60-80% of gastric (stomach) ulcers and 95-100% of duodenal ulcers (together, these are called peptic ulcers). It is a wily organism that not only survives, but thrives, in the highly acidic environment of the stomach. That can cause serious problems, such as gastritis and ulcers.

H. pylori burrows through the mucous lining of the stomach, exposing the sensitive cells beneath to stomach acid (ouch!). This can produce an open sore that becomes an ulcer. In addition, H. pylori infection can interfere with one's ability to recover from gastroesophageal reflux disease (GERD), also called heartburn.3 There is also some evidence that it can increase the risk of stomach cancer: its eradication decreases the risk of precancerous growths in the stomach.4

But how do you eradicate H. pylori? Well, you can take the pharmaceutical route and pump your body full of antibiotics, or you can try the gentle healing power of mastic. That's right, mastic! It is a potent killer of H. pylori not only in the mouth, but also in the stomach. In addition, it can kill a variety of other nasty bacteria, such as Escherichia coli, Staphylococcus aureus, and Sarcina lutea.5

Once H. pylori is eradicated from your stomach, however, you can become reinfected if it's still present in your mouth. In fact, eradicating H. pylori from the stomach is very difficult if there is an oral infection, as demonstrated in a recent Japanese study.6 The researchers showed that gastric eradication occurs in 91.6% of patients who have no oral infection, but in only 52.1% of patients who do have an oral infection. These results suggest that getting rid of H. pylori in your mouth dramatically increases the chances of doing the same in your stomach.

Since H. pylori infections are associated with a number of gastrointestinal ailments, it may be wise for you to employ the power of mastic to keep the bugs at bay.

References

  1. Koparal E, Ertugrul F, Sabah E. Effect of chewing gum on plaque acidogenicity. J Clin Pediatr Dent 2000;24(2):129-32.
  2. Manning RH, Edgar WM, Agalamanyi EA. Effect of chewing gums sweetened with sorbitol/xylitol mixture on the remineralization of human enamel lesions in situ. Caries Res 1992;26:104-9.
  3. Schwizer W, Thumshirn M, Dent J, et al. Helicobacter pylori and symptomatic relapse of gastro-oesophageal reflux disease: a randomised controlled trial. Lancet 2001;357:1738-42.
  4. Okhusa T, Fujiki K, Takashimizu I, et al. Improvement in atrophic gastritis and intestinal metaplasia in patients in whom Helicobacter pylori was eradicated. Ann Int Med 2001;134:380-6.
  5. Iauk L, Ragusa S, Rapisarda A, et al. In vitro antimicrobial activity of Pistacia lentiscus L. extracts: preliminary report. J Chemother 1996;8:207-9.
  6. Miyabayashi H, Furihata K, Shimizu T, et al. Influence of oral Helicobacter pylori on the success of eradication therapy against gastric Helicobacter pylori. Helicobacter 2000;5:30-7.


Dr. Jensen is a cell biologist who has conducted research in England, Germany, and the United States. He has taught college courses in biology and nutrition and has written extensively on medical and scientific topics.


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