- Chewing sugar-free gum after eating increases saliva, which washes away food and helps neutralise acid. The American Dental Association suggests 20 minutes after meals.
- UK government guidance describes the evidence that gum reduces tooth decay as tentative. Gum does not replace brushing.
- Sweeteners used instead of sugar can help lower the risk of decay, but "sugar-free" does not mean acid-free: diet fizzy drinks can still wear enamel away.
- Xylitol may help, but a Cochrane review found too little good-quality evidence to judge most xylitol products.
- Cautions: some sweeteners have a laxative effect in large amounts, xylitol is dangerous for dogs, and gum is best avoided with jaw problems or fixed braces.
This article looks at what sugar-free gum and sugar substitutes can and cannot do for your teeth. For the bigger picture on diet, see eating for healthy teeth and sugar, acid and your teeth.
How does sugar-free gum help your teeth?
It works mainly through saliva. The American Dental Association (ADA) says chewing sugar-free gum increases the flow of saliva, which:
- washes away food and other debris
- cancels out acids made by bacteria in the mouth
- carries calcium and phosphate that help strengthen tooth enamel (the hard outer layer of the tooth)
The Better Health Channel (Victoria) adds that saliva helps wash sugar out of the mouth, fights bacteria and helps repair the early stages of decay. healthdirect Australia suggests it to increase saliva and dilute acid, as a way to limit dental erosion (enamel worn away by acid).
When and for how long?
The ADA says clinical studies have shown that chewing sugarless gum for 20 minutes after meals can help prevent tooth decay. The Australian Dental Association suggests keeping sugar-free gum with you to chew if you have a sugary or fizzy drink while out.
Gum with sugar is different. The ADA notes that it also increases saliva, but the sugar is used by plaque bacteria to make the acids that cause decay.
How strong is the evidence?
Bodies put this differently. The ADA's wording is confident. Delivering Better Oral Health, the UK government's evidence-based guidance for dental teams, is more cautious: it says a recent systematic review (a study that pools the results of trials) found tentative evidence that chewing sugar-free gum reduces decay compared with not chewing, but the effect varied a lot and the trials were generally of moderate quality. It notes that NICE guidance for care homes includes sugar-free gum as one option for frail older adults who have their own teeth.
The ADA is clear that gum is an extra, not a replacement. It still recommends brushing twice a day for two minutes with fluoride toothpaste, cleaning between your teeth daily, limiting sugary snacks, and regular dental visits. See how to brush your teeth.
Sugar-free gum is also one of the self-help steps for a dry mouth suggested by the US National Institute of Dental and Craniofacial Research (NIDCR) and the Australian Dental Association. See dry mouth.
Do sweeteners harm your teeth?
The NHS says all sweeteners approved in Great Britain go through a safety assessment and are considered a safe alternative to sugar. In Australia and New Zealand, Food Standards Australia New Zealand (FSANZ) assesses sweeteners as food additives before they are approved, and its recent review of intense sweeteners found no public health and safety issues.
On teeth, the NHS says that using no-calorie sweeteners, as long as the product does not contain any sugars, can help reduce the risk of tooth decay. The ADA describes aspartame, xylitol, sorbitol and mannitol as sweeteners that do not cause cavities.
Some sweeteners, such as sorbitol, xylitol and erythritol, are known as polyols (the US Food and Drug Administration calls xylitol a sugar alcohol). Delivering Better Oral Health says medicines sweetened with polyols such as maltitol, sorbitol or xylitol are listed as sugar-free because there is evidence they are non-cariogenic, meaning they do not cause decay.
What about xylitol?
Xylitol is a sweetener used in some sugar-free gums, sweets and toothpastes. Health bodies are positive but careful:
- NIDCR says sugarless gum and sweets containing xylitol may help prevent cavities.
- The Australian Dental Association says xylitol can help prevent tooth decay.
A 2015 Cochrane review, which searched for studies up to August 2014, is more cautious. It found low-quality evidence that fluoride toothpaste containing xylitol may reduce decay in children's adult teeth by about 13% over three years, compared with fluoride toothpaste alone. For the other products it looked at (lozenges, sucking tablets, sweets, syrups and wipes), the evidence was too weak to say whether they prevent decay in children or adults. None of the studies it included tested chewing gum.
Sugar-free does not mean acid-free
A sugar-free label tells you about sugar, not acid. The NHS says fizzy drinks are linked to dental erosion because of their acid content, whether they contain sugar or sweeteners. The Australian Dental Association says sugar-free soft drinks, energy drinks and sports drinks have a low pH (they are acidic) and can wear teeth away if drunk regularly. The Better Health Channel advises limiting soft drinks, including sugar-free and diet ones. See sugar, acid and your teeth for how to reduce the harm.
Sugar-free medicines
Some medicines contain sugar. NSW Health says cough syrups, cough lollies, antacids and some vitamins can, and that many liquid medicines made for children have sugar added for taste. It suggests rinsing with water afterwards and asking your GP or pharmacist about sugar-free alternatives. The NHS and the Better Health Channel both advise using sugar-free medicines where possible.
Delivering Better Oral Health says people on long-term liquid medicines, such as children with epilepsy, are at increased risk of decay, and advises parents to ask a pharmacist whether sugar-free versions of over-the-counter liquid medicines are available. Never stop or swap a prescribed medicine yourself: see medicines that affect your mouth.
Cautions
Stomach upsets
The NHS says polyols can have a laxative effect if eaten in large amounts, and that a product whose added polyols make up more than 10% of it must carry a label warning that excessive consumption may produce laxative effects. The Cochrane review notes that xylitol can cause bloating, wind and diarrhoea.
Phenylketonuria
The NHS says the sweetener aspartame is not suitable for people with phenylketonuria (PKU), a rare inherited condition, and products containing it carry a warning that they contain a source of phenylalanine. FSANZ says that in Australia and New Zealand, labelling must also alert people with PKU to aspartame.
Jaw problems
The ADA says chewing gum for long periods, especially dense gum, could lead to jaw pain and headaches and raise the risk of temporomandibular joint (TMJ) disorders, which affect the jaw joints and chewing muscles. It advises avoiding gum altogether if you have a TMJ disorder. The NHS advice for jaw joint problems also says not to chew gum, and the Australian Dental Association says gum may not be a good idea if you have jaw pain. See jaw pain.
Braces
The NHS says not to chew gum while wearing braces because it can get stuck in them. See caring for teeth with braces.
The US Food and Drug Administration (FDA) says xylitol can poison dogs. It can cause a rapid drop in blood sugar within 10 to 60 minutes, which can be life-threatening. Signs include vomiting, weakness, staggering, collapse and seizures. Xylitol (also known as birch sugar or wood sugar) can be found in sugar-free gum and mints, baked goods, toothpaste, some nut butters and some medicines. Keep these out of reach, never use human toothpaste on a dog, and call a vet straight away if your dog may have eaten some.
- You get jaw pain, clicking or locking. The ADA says to see your dentist for a proper diagnosis.
- You or your child take a sugary liquid medicine long term. In the UK, Delivering Better Oral Health advises dental teams to check for a sugar-free version and ask the GP about switching.
- Your mouth often feels dry. NIDCR says your doctor or dentist can review your medicines and history, and recommend treatment depending on the cause.
Frequently asked questions
Can chewing gum replace brushing?
No. The ADA says sugar-free gum is a helpful tool but not a substitute for brushing twice a day with fluoride toothpaste and cleaning between your teeth.
Is xylitol gum better than other sugar-free gum?
It is not clear. NIDCR says xylitol may help prevent cavities, but the Cochrane review found no trials of xylitol gum and too little good evidence for most xylitol products.
Are diet fizzy drinks fine for teeth?
They avoid the sugar but not the acid. The NHS and the Australian Dental Association both say they can still cause erosion.
Sources
- Chewing gum, American Dental Association (MouthHealthy), accessed September 2026
- Chapter 4: dental caries, Delivering better oral health: an evidence-based toolkit for prevention, Department of Health and Social Care, Welsh Government, Department of Health (Northern Ireland) and NHS England, accessed September 2026
- Xylitol-containing products for preventing dental caries in children and adults, Cochrane (Riley and others, 2015), accessed September 2026
- The truth about sweeteners, NHS, accessed September 2026
- Tooth decay, NHS, accessed September 2026
- Temporomandibular disorder (TMD), NHS, accessed September 2026
- Braces, NHS, accessed September 2026
- Intense sweeteners, Food Standards Australia New Zealand, accessed September 2026
- Paws off xylitol; it's dangerous for dogs, US Food and Drug Administration, accessed September 2026
- Dry mouth, NIH National Institute of Dental and Craniofacial Research, accessed September 2026
- Dry mouth, Australian Dental Association, accessed September 2026
- Sugary drinks, Australian Dental Association, accessed September 2026
- Dental erosion, healthdirect Australia, accessed September 2026
- Teeth and mouth care, Better Health Channel (Victoria), accessed September 2026
- Tooth decay: young children, Better Health Channel (Victoria), accessed September 2026
- Medications and your mouth: tip sheet (PDF), NSW Health, accessed September 2026
This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.