[Effect of gum chewing on bowel function recovery in patients after radical cystectomy with urinary diversion]

OBJECTIVE

To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function in patients after radical cystectomy with ileum urinary diversion.

METHODS

In the study, 60 patients who underwent radical cystectomy followed by ileum urinary diversions during Nov. 2014 and Nov. 2015 in Department of Urology of Peking University First Hospital were randomized into three groups: gum chewing group, placebo group treated with the abdomen physical therapy machine and control group treated with ordinary method. Time to flatus, time to bowel movement, incidence of postoperative distension of the abdomen and abdominal pain, and gut related complications (such as ileus, intestinal fistula, and volrulus) of all the patients were recorded and analysed.

RESULTS

In gum chewing group, the median time to flatus was 57 hours (49-72 hours), and the median time to bowel movement was 95 hours (88-109 hours), which were significantly shortened compared with the other two groups of patients (82 hours, 109 hours in placebo group and 81 hours, 108 hours in control group, respectively). No significant difference of the median time to flatus and to bowel movement was observed between placebo group and control group. There were no significant differences in the incidence of postoperative distension of the abdomen and abdominal pain, and gut related complications among the three groups.

CONCLUSION

Chewing gum had stimulatory effect on bowel function recovery after cystectomy followed by ileum urinary diversion. Chewing gum was safe and simple, and could be routinely used for postoperative treatment after cystectomy and ileum urinary diversion.

Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students

OBJECTIVE

The use of chewing-gum and piercing has become common among adolescents and might result in increased oral muscle activity and overloading. Aim To investigate the frequency of oral piercing and parafunctions in relation to symptoms of temporomandibular disorders (TMD) among adolescents.

MATERIALS AND METHODS

One hundred and twenty-four third level high school students, living either in a city or in a small town, enrolled in either science or media programmes, were included. The students completed a questionnaire regarding different parafunctions and symptoms of TMD. A clinical examination of the temporomandibular system and estimation of the tooth wear was performed in 116 students.

RESULTS

Chewing-gum was used by 86% of the students (25% with a daily use) and 14% had an oral piercing. The science students used more chewing gum than the media students (p = 0.008), while the media students had more piercings (p < 0.001). Symptoms once a week or more were reported with 39% for headache, 18% for clicking, 7% for facial pain and 6% for difficulty to open wide. Girls reported more headaches (p = 0.007) and more severe symptoms (p = 0.003), had more medical consultations and used more analgesics (both p < 0.05) and had more clinical signs (p = 0.01) than boys. Girls had more oral piercings and used more chewing gum than boys (both p < 0.05). The media students had more sick leave (p < 0.01) than the science students. Chewing-gum use was associated with headache (p < 0.01), with difficulty to open wide (p < 0.05) and with tenderness of the temporomandibular joints and muscles (both p < 0.05). Oral piercing was associated with headache and muscle tenderness (both p < 0.05) and daily nail biting with headache (p < 0.05) and tooth wear (p = 0.004).

CONCLUSIONS

There is an association between use of chewing gum, nail biting, oral piercing, and symptoms of TMD.

Best evidence topic reports. BET 2: Are patients who have used chewing gum at an increased risk of aspiration during sedation?

A short-cut review was carried out to establish whether patients who have chewed gum are at increased risk of aspiration during sedation. Twenty-nine papers were found, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. The clinical bottom line is that patients who have chewed gum in the past 6 h may theoretically be at increased risk of aspiration. This should be considered when making a balanced decision about the use of procedural sedation.

Oral ulceration due to chronic use of Nicorette gum: case report

Oral ulceration is a common presentation in a dental clinic. These ulcers may be acute or chronic, based on the duration of symptoms. The etiology of oral ulceration can range from trauma to squamous cell carcinoma. It is the responsibility of the dentist to differentiate the various etiologies of oral ulceration for proper management. This case report is presented to remind dentists that the long-term use of Nicorette gum should be considered in the differential diagnosis of chronic oral ulcers.

Intraoral contact mucositis induced by cinnamon-flavored chewing gum--a case report

Contact mucositis is an inflammatory mucosal reaction caused by many agents. A case of a 53-year-old man with contact-type allergy in oral mucosa due to cinnamon chewing gum is presented. This condition should be considered in the differential diagnosis of nonspecific oral lesions.

Contact allergy to cinnamon: case report

Allergic contact stomatitis is a rare disorder that is unfamiliar to most clinicians. The vast majority of cases are associated with consumption of products containing cinnamaldehyde or cinnamon essential oil, which are used as flavourings because of their pleasant taste and sensation of freshness. We report here the case of a patient who was diagnosed with alllergic contact stomatitis due to cinnamon-flavoured chewing gum. The clinical features of allergic contact stomatitis, which may occur indiscriminately on any of the oral mucosa, include edema and erythroplakic, ulcerous or hyperkeratotic changes, generally accompanied by a burning sensation. The histopathologic aspect of allergic contact stomatitis is nonspecific but tends to support the clinical diagnosis. Treatment generally consists of eliminating the causal agent. To avoid unnecessary diagnostic procedures and treatments, it is important for clinicians to recognize this disorder to be able to diagnose it quickly and accurately.

Severe weight loss caused by chewing gum

Sorbitol intake should be considered in patients with bowel problems, chronic diarrhoea, and weight loss

Addiction to the nicotine gum in never smokers

Background

Addiction to nicotine gum has never been described in never smokers or in never users of tobacco.

Methods

Internet questionnaire in 2004–2006 in a self-selected sample of 434 daily users of nicotine gum. To assess dependence on nicotine gum, we used modified versions of the Nicotine Dependence Syndrome Scale (NDSS), the Fagerström Test for Nicotine Dependence and the Cigarette Dependence Scale.

Results

Five never smokers used the nicotine gum daily. They had been using the nicotine gum for longer than the 429 ever smokers (median = 6 years vs 0.8 years, p = 0.004), and they had higher NDSS-gum Tolerance scores (median = 0.73 vs = -1.0, p = 0.03), a difference of 1.5 standard deviation units. Two never smokers had never used smokeless tobacco, both answered "extremely true" to: "I use nicotine gums because I am addicted to them", both "fully agreed" with: "after a few hours without chewing a nicotine gum, I feel an irresistible urge to chew one" and: "I am a prisoner of nicotine gum".

Conclusion

This is to our knowledge the first report of addiction to nicotine gum in never users of tobacco. However, this phenomenon is rare, and although the long-term effect of nicotine gum is unknown, this product is significantly less harmful than tobacco.

Chewing gum and risk of oesophageal adenocarcinoma: A new hypothesis tested in a population-based study

The aim of this study was to test the hypothesis that chewing gum is associated with risk of oesophageal and cardia adenocarcinoma. A Swedish nationwide, population-based, case-control study was conducted in 1995-1997. All patients were prospectively and uniformly documented and classified shortly after diagnosis. In all, 189 and 262 patients with oesophageal and cardia adenocarcinoma, respectively, and 820 population-based control subjects were interviewed. These patients together constituted 85% of eligible cases occurring in Sweden. Odds ratios (OR) with 95% confidence intervals (CI) were calculated by multivariable logistic regression with adjustment for plausible confounders. Regular users of chewing gum (P3 times/week for P6 months) were not at increased risk of oesophageal adenocarcinoma (OR 1.0, 95% CI 0.6-2.2), and no duration-response relation was observed (P = 0.38). No association between regular gum chewing and cardia adenocarcinoma was found (OR 1.0, 95% CI 0.6-1.7), irrespective of duration of use (P = 0.56). In conclusion, with regard to risk of oesophageal or cardia adenocarcinoma, gum chewing seems harmless.

Clinical features of cinnamon-induced contact stomatitis

Cinnamon flavoring agents are known to act on the mucosa as irritants or sensitizers. The objective of this study was to report on clinical and histologic features important in the diagnosis of cinnamon-induced contact stomatitis. We examined 37 past cases of contact stomatitis and identified clinical signs and symptoms and possible causes. The most common cause in the 37 cases was toothpaste; other causes were chewing gum and foods. Although various clinical findings were observed, some characteristics were evident. The most commonly affected site was the gingiva, which showed diffuse or generalized erythema and epithelial sloughing. It is important to identify the causative agents of such a disorder by understanding characteristic signs and symptoms and conducting an appropriate inquiry.

Effects of Sucking Acidic Candy on Whole-Mouth Saliva Composition

Limited information is available on the effects of sucking acidic candies on saliva composition and the protective role of saliva in this relation. Therefore the aim of this study was to determine salivary effects of sucking acidic candies in vivo in relation to individual variations in whole-saliva flow rate (WSFR) and buffer capacity (WSbeta). Ten healthy young males (24 +/- 2 years) sucked a rhubarb-flavoured acidic hard-boiled candy with tartaric acid available on the Danish market. The whole saliva was collected into a closed system, regarding CO2, at different times as follows: firstly, unstimulated saliva for 5 min (baseline), secondly stimulated saliva for 4 min upon sucking the candy, and finally post-stimulated saliva for 10 min. Saliva pH was determined on a blood gas analyser and WSbeta was estimated from the saliva bicarbonate concentration obtained by the analyser and by ionic balance calculation. The erosive potential of the candy in saliva was estimated from the saliva pH values and degree of saturation with respect to hydroxyapatite (DS(HAp)). The results showed that saliva pH dropped from 6.5 (baseline) down to 4.5 at the fourth minute of sucking the candy, and returned to pH 6.5 five minutes after stimulation (post-stimulated). DS(HAp) decreased upon sucking the candy and saliva from all subjects became undersaturated with respect to HAp. Significant positive correlations were obtained between pH and WSFR (r(s) = 0.47; p < 0.05) and between pH and WSbeta (r(s) = 0.65; p < 0.01). In relation to WSbeta we found that 70% of the buffer capacity originating from the bicarbonate buffer system upon sucking the candy was exerted as phase buffering. We conclude that sucking this type of acidic candies changes whole-mouth saliva composition so that it may have erosive potential and that high WSFR and WSbeta have protective effects against these salivary changes.

Safety and efficacy of the nicotine patch and gum for the treatment of adolescent tobacco addiction

OBJECTIVES

To determine the safety and efficacy of the nicotine patch and gum for adolescents who want to quit smoking.

DESIGN

Double-blind, double-dummy, randomized, 3-arm trial with a nicotine patch (21 mg), nicotine gum (2 and 4 mg), or a placebo patch and gum; all participants received cognitive-behavioral group therapy.

SETTING

Inner-city, outpatient clinic on the East Coast. Subjects. Thirteen- to 17-year-old adolescents who smoked > or =10 cigarettes per day (CPD), scored > or =5 on the Fagerstrom Test of Nicotine Dependence, and were motivated to quit smoking. Intervention. Twelve weeks of nicotine patch or gum therapy with cognitive-behavioral therapy, with a follow-up visit at 6 months (3 months after the end of treatment).

MAIN OUTCOME MEASURES

Safety assessed on the basis of adverse event reports for all 3 groups, prolonged abstinence, assessed through self-report and verified with exhaled carbon monoxide (CO) levels of < or =6 ppm, in intent-to-treat analyses, and smoking reduction (CPD and thiocyanate concentrations) among trial completers.

RESULTS

A total of 120 participants were randomized (72% white, 70% female; age: 15.2 +/- 1.33 years; smoking: 18.8 +/- 8.56 CPD; Fagerstrom Test of Nicotine Dependence score: 7.04 +/- 1.29) from 1999 to 2003. Participants started smoking at 11.2 +/- 1.98 years of age and had been smoking daily for 2.66 +/- 1.56 years; 75% had at least 1 current psychiatric diagnosis. Mean compliance across groups was higher for the patch (mean: 78.4-82.8%) than for the gum (mean: 38.5-50.7%). Both the patch and gum were well tolerated, and adverse events were similar to those reported in adult trials. Changes in mean saliva cotinine concentrations throughout treatment were not statistically significant. Intent-to-treat analyses of all randomized participants showed CO-confirmed prolonged abstinence rates of 18% for the active-patch group, 6.5% for the active-gum group, and 2.5% for the placebo group; the difference between the active-patch and placebo arms was statistically significant. There was no significant effect of patch versus gum or gum versus placebo on cessation outcomes. Abstinence rates at the 3-month follow-up assessment were sustained but were not significantly associated with treatment group. Mean smoking rates, but not CO or thiocyanate concentrations, decreased significantly in all 3 arms but not as a function of treatment group.

CONCLUSIONS

Nicotine patch therapy combined with cognitive-behavioral intervention was effective, compared with placebo, for treatment of tobacco dependence among adolescent smokers. Decreases in the numbers of cigarettes smoked appeared to be offset by compensatory smoking. Additional study of nicotine gum, with enhanced instructional support, is needed to assess its efficacy among adolescent smokers.

Adult sudden death caused by aspiration of chewing gum

A case of a fatal foreign material aspiration is presented in the following text. A 24-year-old white male died suddenly. A piece of chewing gum lodged in a pool of frothy fluid was revealed at autopsy. Microscopic examinations revealed atelectasia emphysema, eosinophilic exudate and empty spaces. Blood and urine samples were analyzed, for alcohol and drug use by fluorescence polarization immunoassay (FPIA) on an Abbott AXSYM system. No alcohol or other drugs were detected in blood or urine.

[Chewing gum Dirol effect upon the status of oral cavity and gastric acid secretion in patients with hypersecretion of hydrochloric acid]

The purpose of our research was to learn the efficacy of the Dirol chewing gum upon the condition of the oral cavity and the stomach acidity in patients with hyperchlorhydratic type of secretion. It has been estimated that correct usage of chewing gum by patients with hyperacidity of the stomach in a month after its administration decreases the level of gastric acidity to a normal one. Thus, it has been proved that the Dirol chewing gum favorably changes the condition of oral cavity both from hygienic point of view, acido-alkaline balance and saliva condition.

Hat Kaugummi eine Bedeutung f�r die An�sthesie?

Chewing gum is a common habit. Based on two cases of esophageal obstruction during induction of general anesthesia, the importance of chewing gum for anesthesiology is outlined. The dangers of chewing gum result from obstruction of the trachea and oesophagus but complications may also result from stimulated production of gastric juice with a risk of consecutive regurgitation and aspiration. In the case of an obstacle in the oesophagus when inserting a nasogastric tube, an obstruction by a mass of chewing gum should be considered. Although the literature provides differing statements concerning the volume and acidity of gastric juice after chewing gum, the use of chewing gum should be included in preanesthetic NPO rules.

Nicotine gum-induced atrial fibrillation

A 39-year-old man with no prior history of atrial fibrillation was hospitalized with atrial fibrillation and a rapid ventricular rate. For the 7 months before presentation, he had been chewing nicotine polacrilex gum on his own. The week he first developed palpitations, he was chewing more than 1 piece of nicotine Polacrilex gum per hour during work. His diagnostic work-up during hospitalization found no cause for atrial fibrillation. He was cardioverted to sinus rhythm. At 6-month follow-up, he had not renewed chewing nicotine polacrilex gum, was in sinus rhythm, and had no history of palpitations. The temporal relation between more frequent gum usage and the excessive consumption of nicotine polacrilex chewing gum with a probable high serum nicotine level at the time the patient developed his first episode of atrial fibrillation suggests a causal relationship.

Effects of prolonged gum chewing on pain and fatigue in human jaw muscles

Gum chewing has been accepted as an adjunct to oral hygiene, as salivary stimulant and vehicle for various agents, as well as for jaw muscle training. The aim of this study was to investigate the effects of prolonged gum chewing on pain, fatigue and pressure tenderness of the masticatory muscles. Fifteen women without temporomandibular disorders (TMD) were requested to perform one of the following chewing tasks in three separate sessions: chewing a very hard gum, chewing a soft gum, and empty-chewing with no bolus. Unilateral chewing of gum or empty chewing was performed for 40 min at a constant rate of 80 cycles/min. In each session, perceived muscle pain and masticatory fatigue were rated on visual analog scales (VAS) before, throughout, and after the chewing task. Pressure pain thresholds (PPTs) of masseter and anterior temporalis muscles were assessed before and immediately after the chewing tasks, and again after 24 h. The VAS scores for pain and fatigue significantly increased only during the hard gum chewing, and after 10 min of recovery VAS scores had decreased again, almost to their baseline values. No significant changes were found for PPTs either after hard or soft gum chewing. The findings indicate that the jaw muscles recover quickly from prolonged chewing activity in subjects without TMD.

The effect of hot beverages, cold beverages, and chewing gum on oral temperature

BACKGROUND

A prospective blood donor's oral temperature is affected by external stimuli such as drinking a hot or cold beverage or chewing gum. These stimuli can cause a deferral or an inappropriate acceptance for a certain unknown time.

STUDY DESIGN AND METHODS

Ten volunteer subjects were exposed to each of the three stimuli in separate studies. Oral and tympanic membrane temperatures were taken before exposure, immediately after exposure, and at various times until the subject's temperature returned to baseline.

RESULTS

The drinking of a hot beverage caused an immediate mean temperature elevation of 2.6 degrees F which would lead to deferral for 7 of 10 subjects. All subjects were acceptable for blood donation (temperature <99.6 degrees F) by 5 minutes. A cold beverage lowered the temperature; the temperature in 6 subjects returned to baseline by 10 minutes and that in 4 did so by 30 minutes. Gum chewing caused minimal temperature elevations; only 1 donor's temperature reached 99.6 degrees F, and it was at acceptable levels for blood donation by 5 minutes.

CONCLUSION

Drinking a hot beverage and, to a much lesser degree, gum chewing can lead to a deferral for elevated temperature, but subjects were acceptable by 5 minutes. Cold beverages are of more concern, because they suppress the temperature for a short time and could theoretically lead to acceptance of a febrile, possibly infectious donor.

Oral habits among adolescent girls and their association with symptoms of temporomandibular disorders

AIM

To evaluate the contribution of certain parafunctional activities to the presence of temporomandibular disorder (TMD) symptoms among teenage girls, with special emphasis to gum chewing and jaw play.

METHODS

A total of 323 girls, aged 15-16 years, were randomly selected from a religious junior high school. The girls responded to a questionnaire on oral habits and TMD symptoms.

RESULTS

Gum chewing was a very prevalent habit (62.4%), performed daily (mean chewing time 3.95 h day-1). Girls who chewed intensively (more than 4 h day-1) showed associations with pain in the ear area during function and at rest, as well as with joint noises. Jaw play, although reported by only 14.3%, was significantly associated with pain in the ear area during function and at rest, feeling of tiredness of the jaw while chewing, joint noises, catch and lock. All oral parafunctions, except chewing gum, were associated with jaw play and with each other.

CONCLUSIONS

Jaw play was the most detrimental habit in TMD; intensive gum chewing was a potentially contributing factor for joint noises and pain. Oral parafunctions (except chewing gum) were significantly associated between themselves and suggest a behavioural pattern of "jaw hyperactivity".

A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer

This was a prospective, randomized, open, crossover study comparing a mucin-based artificial saliva (Saliva Orthana) with a low-tack, sugar-free chewing gum (Freedent) in the management of xerostomia in patients with advanced cancer. The conclusions of this study were that both Saliva Orthana and Freedent are effective in the management of xerostomia in patients with advanced cancer, that both Saliva Orthana and Freedent cause some side-effects in this group of patients, and that patients with cancer think that chewing gum is an acceptable treatment. Sixty-nine per cent of the patients preferred the chewing gum to the artificial saliva. Furthermore, the chewing gum scored better than the artificial saliva on every measure of efficacy. However, none of these results reached statistical significance.

Effect of chewing gum on recovery after tonsillectomy

OBJECTIVE

Patients are traditionally advised to eat early and frequently in the initial post-tonsillectomy period to reduce the severity of pain and to facilitate early resumption to a normal diet. We investigated the action of mastication and therefore the promotion of saliva formation and deglutition on the post-operative recovery of tonsillectomy patients.

METHODS

We present a prospective randomised controlled trial set up to observe the effects of chewing gum on these patients. One hundred and two patients undergoing routine tonsillectomy for recurrent tonsillitis were randomised into cases (those given chewing-gum) and control groups (those not given chewing-gum). Eighty-four patients were reviewed on the seventh post-operative day. We measured the time taken in days for the subjects to resume to their normal diet after surgery and measured pain on a daily basis.

RESULTS

Our study demonstrated that chewing gum in the early post-operative period significantly delayed resumption of normal diet (Chi-squared test with Yates' correction, chi2= 4.6, P = 0.032). Chewing gum also increased the average amount of pain experienced by the cases over the controls and this became statistically significant on day 7 (mean difference = 14.8, t-test with two tailed probability, P = 0.041).

CONCLUSION

We conclude that chewing gum should not be routinely advised in the early period following tonsillectomy.

In situ de- and remineralisation of enamel in response to sucrose chewing gum with fluoride or non-fluoride dentifrices

OBJECTIVES

Enhancement of the remineralisation of artificial enamel lesions has been observed in an intraoral model whether subjects chewed gum sweetened with a non-cariogenic sweetener such as sorbitol [1-3] or sucrose [4] after meals or snacks, and with use of a conventional (1500 ppm F) fluoride dentifrice. Since most of the clinical surveys which have shown the potential cariogenicity of sucrose chewing gum [5] were conducted before use of fluoridated dentifrices became widespread, the effect of fluoride dentifrice on de- and remineralisation of artificial lesions in enamel in response to chewing sucrose-sweetened gum has been examined with the aim of attempting to resolve this apparent discrepancy.

METHODS

Subjects wore an intraoral device bearing an enamel lesion and chewed one piece of sucrose gum for 20 min after each of three meals and two snacks daily for two 3-week periods, during which they used a dentifrice containing either 0 or 1500 ppm F in a double-blind, cross-over design. Measurement of the mineral content of the lesions was determined by microradiography or polarised light microscopy.

RESULTS

It was found that remineralisation tended to occur with 1500 ppm F dentifrice, but demineralisation with non-F dentifrice; the difference in enamel mineral content between the two periods was significant (P < 0.05).

CONCLUSIONS

The results indicate that the potential cariogenicity of sucrose-containing chewing gum may indeed be negated by the use of a conventional fluoride dentifrice.

Squamous cell carcinoma of the tongue associated with cinnamon gum use: a case report

BACKGROUND

Cinnamon aldehydes found in cinnamon-flavored gums can incite mucosal alterations at points of contact with the oral mucosa. These alterations may include inflammation and epithelial proliferation, but as a rule, the changes are reversible and promptly resolve when gum-chewing activity is discontinued.

METHODS

The authors report a case of a 24-year-old woman who developed a squamous cell carcinoma of the tongue following persistent and prolonged exposure to cinnamon-flavored gum.

RESULTS

Several social, clinical, and histopathologic features point to the cinnamon-flavored chewing gum as a possible causal factor in the development of the patient's oral carcinoma.

CONCLUSIONS

Prompt withdrawal of cinnamon products is encouraged in heavy gum chewers who develop cinnamon-related oral lesions. For those lesions which do not promptly resolve upon cinnamon withdrawal, diagnostic biopsy should be considered to exclude the possibility of a squamous cell carcinoma.

Modern life' in the epidemiology of inflammatory bowel disease: a case-control study with special emphasis on nutritional factors

OBJECTIVE

The rising incidence of inflammatory bowel disease (IBD) since the Second World War coincides with profound changes of the dietary pattern. The aim of the study was to investigate the possible pathogenic role of some characteristic 'modern life' dietary factors in IBD.

DESIGN

Case-control, studying risk factors in recently diagnosed cases, 290 with Crohn's disease and 398 with ulcerative colitis, compared with 616 population controls. Smoking, age, gender and education were taken into account by using logistic regression analysis.

SETTING

Hospital cases and population controls.

INTERVENTIONS

Questionnaires.

MAIN OUTCOME MEASURES

Logistic regression-derived odds ratios.

RESULTS

A positive association with cola drinks [OR: 2.2 (95% CI 1.5-3.1)], chewing gum [OR: 1.5 (95% CI: 1.1-2.1)] and chocolate consumption [OR: 2.5 (95% CI: 1.8-3.5)] and a negative association with citrus fruit consumption [OR: 0.5 (95% CI 0.3-0.7)] and the development of Crohn's disease were found. Consumption of cola drinks [OR: 1.6 (95% CI 1.1-2.3)] and chocolate consumption [OR: 2.5 (95% CI 1.8-3.5)] were positively associated with developing ulcerative colitis. There was a negative association between the intake of citrus fruits [OR: 0.5 (95% CI 0.4-0.8)] and 'having a stuffed pet' for a period longer than 5 years [OR: 0.6 (95% CI 0.4-0.9)] and developing the disorder. No association with the frequency of tooth brushing and developing IBD was found.

CONCLUSION

All the nutritional items mentioned may be true risk factors or they just might be the expression of a modern life-style also involving other risk factors for the development of IBD which at the present are still unknown.

Chewing gum headaches

Aspartame, a popular dietetic sweetener, may provoke headache in some susceptible individuals. Herein, we describe three cases of young women with migraine who reported their headaches could be provoked by chewing sugarless gum containing aspartame.

[Influence of chewing gum consumption and dental contact of amalgam fillings to different metal restorations on urine mercury content]

It had been shown previously by various authors that contact of amalgam fillings to metal fillings of different type can increase the electrochemically caused amalgam corrosion in vitro thus leading to an elevated release of mercury. So it was recommended to renounce of a dental contact of amalgam to metal fillings of other type. One aim of the present study was to evaluate possible influences of this contact in vivo on the urinary mercury contents in human volunteers. Neither approximal nor occlusal contacts had any influence on the urinary mercury excretion in comparison to a reference group with similar amalgam status. Furthermore, the influence of gum chewing on urinary mercury levels was taken into account. It could be shown that the consumption of chewing gum resulted in a significantly higher mean urinary mercury content in probands with amalgam fillings in comparison to people with similar amalgam status (gum chewers: 1.36 Hg/24 h vs. non-chewers 0.70 microgram Hg/24 h). Thus, gum chewing has to be considered as important parameter of influence on the urinary mercury levels of people with amalgam fillings.