Elevating the use of sugar-free chewing gum in Germany: cost saving and caries prevention

Abstract Objective: To analyse the lifetime monetary and health related effects of the consumption of sugar-free chewing gum. Material and methods: Using a Markov model we assumed that the German consumption of sugar-free chewing gum (111 gums/year) could be elevated to the level of Finland (202 gums/year). The calculation was based on a model patient representing the development of oral health from the age of 12 to 74 years and clinical data on the effectiveness of chewing sugar-free gum. Lifetime and yearly costs for the ‘Finland-scenario’ were determined and compared with the actual German expenses of the statutory health insurance companies for dental health. Results: The actual total lifetime expenditures of the statutory health insurance companies are 17,199.96€ per capita and would be 12,188.94€ in the scenario with elevated consumption of sugar-free chewing gum in Germany. Thus, 5011.02€ per capita could be saved in a lifetime and 80.82€ per year. Conclusions: On a national scale, the elevation of the consumption of sugar-free chewing gum in Germany to the level of Finland would lead to a considerable benefit for cost saving and oral health for the statutory health insurance companies.

[1]  M. Taylor,et al.  Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK , 2016, BDJ.

[2]  M. O. Sharif,et al.  Xylitol-containing products for preventing dental caries in children and adults. , 2015, The Cochrane database of systematic reviews.

[3]  V. Welch,et al.  Water fluoridation for the prevention of dental caries. , 2013, The Cochrane database of systematic reviews.

[4]  G. Falony,et al.  Effect of Erythritol and Xylitol on Dental Caries Prevention in Children , 2014, Caries Research.

[5]  L. Miller,et al.  Effects of maltitol and xylitol chewing-gums on parameters involved in dental caries development. , 2013, European journal of paediatric dentistry.

[6]  T. Marthaler.  Salt fluoridation and oral health. , 2013, Acta medica academica.

[7]  M. Woodward,et al.  Milk fluoridation for the prevention of dental caries. , 2010, Acta medica academica.

[8]  S. Mickenautsch,et al.  Effect of xylitol versus sorbitol: a quantitative systematic review of clinical trials. , 2012, International dental journal.

[9]  S. Paris,et al.  Karies: Wissenschaft und Klinische Praxis , 2012 .

[10]  Eeva Widstrm,et al.  Caries Prevalence and Use of Dental Services in Finnish Children and Adolescents in 2009 , 2011 .

[11]  K. Rippe.  [Ethical aspects of the fluoridation of water, salt, and milk]. , 2009, Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz.

[12]  C. Splieth,et al.  Modelling lifelong costs of caries with and without fluoride use. , 2008, European journal of oral sciences.

[13]  C. van Loveren.  Sugar Alcohols: What Is the Evidence for Caries-Preventive and Caries-Therapeutic Effects? , 2004, Caries Research.

[14]  C. van Loveren,et al.  Sugar Alcohols: What Is the Evidence for Caries-Preventive and Caries-Therapeutic Effects? , 2004, Caries Research.

[15]  Z. Bian,et al.  Can school‐based oral health education and a sugar‐free chewing gum program improve oral health? Results from a two‐year study in PR China , 2004, Acta odontologica Scandinavica.

[16]  V. Baelum,et al.  Caries preventive effect of sugar-substituted chewing gum. , 2001, Community dentistry and oral epidemiology.

[17]  J. Bánóczy,et al.  Effect of After-meal Sucrose-free Gum-chewing on Clinical Caries , 2001, Journal of dental research.

[18]  L. Kannas,et al.  Use of xylitol chewing gum among Finnish schoolchildren. , 1999, Acta odontologica Scandinavica.

[19]  P. Petersen,et al.  Carbamide-containing polyol chewing gum and prevention of dental caries in schoolchildren in Madagascar. , 1999, International dental journal.

[20]  G. Stookey,et al.  The effect of chewing sugar-free gum after meals on clinical caries incidence. , 1998, Journal of the American Dental Association.

[21]  D. Bratthall,et al.  The caries decline: a review of reviews. , 1996, European journal of oral sciences.

[22]  K. Isotupa,et al.  Xylitol Chewing Gums and Caries Rates: A 40-month Cohort Study , 1995, Journal of dental research.

[23]  K. Isotupa,et al.  Stabilisation of rampant caries: polyol gums and arrest of dentine caries in two long-term cohort studies in young subjects. , 1995, International dental journal.

[24]  D. Kandelman,et al.  A 24-month Clinical Study of the Incidence and Progression of Dental Caries in Relation to Consumption of Chewing Gum Containing Xylitol in School Preventive Programs , 1990, Journal of dental research.

[25]  P. Alanen,et al.  Xylitol chewing gum in caries prevention: a field study in children. , 1988, Journal of the American Dental Association.

[26]  R. Glass.  A two-year clinical trial of sorbitol chewing gum. , 1983, Caries research.

[27]  E. Tammisalo,et al.  Turku sugar studies XVIII. Incidence of dental caries in relation to 1-year consumption of xylitol chewing gum. , 1975, Acta odontologica Scandinavica.

[28]  S. Poulsen,et al.  The effect of sorbitol-containing chewing gum on the incidence of dental caries; plaque and gingivits in Danish schoolchildren. , 1973, Community dentistry and oral epidemiology.