Dentists, Consumer Groups Debate ADA Seal on Gum

Sept. 26, 2007 — -- The American Dental Association's decision to bestow its seal of acceptance on Wrigley's sugar-free gum products is drawing fire from some consumer advocates who say the dental health benefits implied by the endorsement are still unclear.

Still, dentists say that attainment of the seal is no small matter and that sugar-free gum has been shown to live up to the distinction.

The seal, usually reserved for products such as toothpaste, dental floss and toothbrushes, will now be displayed on packages of Orbit, Extra and Eclipse, which have been clinically proven to help prevent cavities, reduce plaque acid and strengthen teeth. It will be the first time the seal will be used for such products.

"When you see the ADA seal on the package of a dental product, you can rest assured that an independent team of experts has evaluated scientific evidence and has concluded the product meets the ADA's criteria for safety and effectiveness and provides oral health benefits," said ADA executive director James Bramson in a press release issued Tuesday.

Some dentists agreed the seal carries weight. "The ADA seal is pretty rigorous to get," said Ronald Grothe, assistant clinical professor of pediatric dentistry at the University of Minnesota. "It is not given out lightly. Anything with the ADA seal, you can trust. You have the assurance that the product does what it claims."

Gum Studies a Stretch?

But, the fact that the company, at least partially, funded some of the studies — along with the large sums of money the company paid to the ADA to submit its products for approval — have some second-guessing the validity of the seal.

"What does the seal really mean?" asked Dr. Peter Lurie of the Health Research Group at Public Citizen, the nonprofit consumer advocacy group. "If it had been an FDA-style approval, we would know what studies had been done and we would be able to scrutinize them for ourselves. Because this study has been done privately, we have no way of knowing the clinical benefit."

Wrigley paid $12,000 to submit each gum brand — $36,000 total. Wrigley also regularly spends $35,000 to $45,000 in exhibit booth space at the ADA's annual meeting, advertising in its publications, and on other sponsorships, and the company also sponsors an ADA health screening program.

"Wrigley has an ongoing relationship in the tens of thousands of dollars with the ADA," said Lurie. "This, coupled with the fact that the clinical studies are not open to the public, means the meaning of the seal remains obscure."

Lurie also thinks the seal will give Wrigley a marketing advantage. "People will see the seal and be impressed by the apparent scientific review," he said. "It seems possible that other sugar-free gum companies will apply for the seal, as well. It will be interesting to see how the ADA treats their applications."

'Nine Out of 10 Dentists Agree … '

Still, to be considered for the ADA's seal of acceptance, each gum brand submitted by Wrigley underwent a battery of tough laboratory and clinical tests to show that it was, indeed, safe and effective at preventing cavities.

At the heart of its benefits is an increase in saliva production.

"Sugar-free gum capitalizes on saliva stimulation," said Paul Casamassimo, professor of pediatric dentistry at Ohio State University. "It dilutes any acids formed in the mouth, it helps wash away sugar and food substances and it contains antibodies and chemicals that reduce the likelihood of tooth decay."

But, dentists quickly pointed out that only sugar-free gum has been proven to have any kind of benefit in terms of oral health.

They also warn that gum lovers should chew with moderation, because chewing too much has its drawbacks.

"There will be some people who make an intense effort to chew lots of gum all the time, resulting in sore jaws and sore teeth," said Casamassimo.

And don't throw away your toothbrush just yet.

"Gum chewing is not a replacement to brushing or flossing — it's just a supplement," Grothe said. "The most important thing to prevent cavities is regular brushing and flossing, and avoiding sugary foods and drinks."

In short, those who expect gum chewing to become part of a recommended daily routine, along with brushing teeth or flossing, may be disappointed.

"I don't think dentists will start recommending that patients start chewing gum," said Casamassimo. "Dentists will ask if patients chew gum, and if they do chew gum, and have a lot of tooth decay, dentists will recommend a sugarless chewing gum approved by the ADA. Certain gums will become a substitute if a patient already has a gum-chewing habit."