咀嚼木糖醇口香糖對唾液之影響

背景和研究目的：咀嚼口香糖可刺激唾液分泌，然而不同口香糖對唾液影響可能有不同效果，故本研究將評估木糖醇含量分別為100％、58％、31％的口香糖和口香糖基對唾液的影響。研究方法：從28位健康者（20.07± 0.20歲）中先收集未刺激的整個唾液（Whole Saliva）後，再收集咀嚼口香糖20分鐘的刺激性唾液，並將唾液樣本分為八個時段收集，而四種口香糖分別隔週咀嚼收集。分析每個樣本的唾液流速、唾液pH值和唾液內容物濃度（氟離子、總蛋白質、磷酸根離子和總鈣）。結果：唾液流速於咀嚼初期（0-4分鐘）有顯著差異，以含1.2%水果酸的31%木糖醇口香糖流速最快，後期（4-20分鐘）四組口香糖刺激唾液效果相似。刺激初期唾液流速增加為未刺激唾液流速的4-14倍，隨後流速逐漸減緩，且最後時段仍高於未刺激唾液流速的2倍。咀嚼100%、58%木糖醇口香糖和口香糖基時，唾液pH值立即增加，而含1.2%水果酸的31％木糖醇口香糖，唾液pH值在0-1分鐘下降至5.79，但隨後快速上升，且四組口香糖的唾液pH值皆在8-10分鐘達高峰。在未投予氟化物的狀況下咀嚼口香糖後，唾液氟離子濃度以31%木糖醇口香糖最高，其次為口香糖基。而刺激性唾液總蛋白質濃度，只有初期（1-4分鐘），以31％木糖醇口香糖有顯著高於其他兩組，其餘時段無差異，且刺激性唾液總蛋白質濃度似乎會隨著唾液流速增加而增加，但分泌型態有延遲高峰現象。唾液磷酸離子濃度似乎隨著唾液流速增加而降低；唾液總鈣濃度似乎隨著唾液流速增加而增加。結論：咀嚼木糖醇口香糖可刺激唾液流速增加、提高唾液pH值、促進蛋白質和唾液總鈣分泌，有正面的影響。故建議嚼食木糖醇口香糖可作為輔助預防齲齒的措施。

關鍵字

木糖醇口香糖；唾液流速；唾液電解質

並列摘要

Background and study objective: Gum chewing can stimulate a protective salivary flow. However, different chewing gums may differ in saliva secretion rate and composition. Therefore, we compared the effect of 100%, 58% and 31% Xylitol gums and gum base on the flow rate and composition of whole saliva. Methods: We collected unstimulated whole saliva from 28 healthy subjects （20.07± 1.86 years）, who on different occasions, chewed one of three concentrations of Xylitol gum, or gum base, for 20 mins, during which time eight separate saliva samples were collected. Flow rates were calculated and the saliva was assayed for salivary pH, fluoride, total protein, inorganic phosphate and total calcium concentration. Results: All chewing gums stimulated the flow rate significantly during the initial stage（0-4 mins）of chewing, with 31% Xylitol gum containing 1.2% fruit acids being the most effective. By 4-20 mins, all chewing gums were equally effective salivary stimulants. These initial stimulated flow rates averaged 4-14 times more than the unstimulated rate, and then dropped progressively with time. The final stimulated flow rates were still about 2 times more than the unstimulated rate. When chewing 100% and 58% Xylitol gum and gum base, the salivary pH rose immediately on stimulation. With 31% Xylitol gum containing 1.2% fruit acid, the salivary pH fell at 0-1min to a mean of 5.79, but then recovered rapidly. Salivary pH of all groups reached a peak at 8-10 mins. Of the subjects who chewed gum, without additional fluoride supplements, the stimulated salivary fluoride levels of 31% Xylitol gum was the highest, followed by the gum base. Of the 1-4 mins of chewing, 31% Xylitol gum elicited a significantly higher salivary total protein than the other three compositions. Stimulated salivary protein concentration seemed to increase with the increasing flow rate induced by chewing gum and the secretion patterns had a delayed peak phenomena. Salivary inorganic phosphate concentration seemed to drop with the increasing flow rate; salivary total calcium concentration seemed to increase with the increasing flow rate. Conclusion: Chewing of Xylitol gums has the positive effects of increasing stimulated flow rate, evoking salivary pH, promoting protein and total calcium secretion. Hence, the suggestion that chewing of Xylitol gum can assist in the prevention of dental caries.