The potential of xylitol chewing gum as a preventive strategy for plaque index and saliva pH in fixed orthodontic appliance users

Potensi permen karet xylitol sebagai strategi preventif indeks plak dan pH saliva pada pengguna peranti ortodonti cekat

Abstract

The use of fixed orthodontic appliances increases the risk of iatrogenic factors such as massive plaque accumulation and a decrease in saliva pH, which trig-gers enamel demineralisation. The main challenges in plaque control are behavioural factors and patient compliance due to complex and time-consuming cleaning procedures. This systematic review examines the potential of xylitol chewing gum as a low-barrier, intervention-based preventive strategy to con-trol plaque index and salivary pH in orthodontic patients. Biochemically, xylitol inhibits the growth of Streptococcus mutans via a ‘futile metabolic cycle’, re-ducing bacterial colonisation by up to 47.12%. Physiologically, the act of chewing stimulates saliva flow and increases bicarbonate concentration, thereby helping 78.1% of patients achieve a neutral saliva pH. From a health promotion perspective, xylitol chewing gum offers an enjoyable approach, making it ea-sier to integrate into daily life compared to rigid conventional hygiene instructions. It is concluded that xylitol chewing gum is effective as a mechanochemi-cal adjuvant capable of bridging clinical needs with patients’ psychological dynamics to improve the quality of life for orthodontic patients.