Scientific Opinion on the substantiation of health claims related to sugar-free chewing gum sweetened with xylitol and plaque acid neutralisation (ID 485), maintenance of tooth mineralisation (ID 486, 562, 1181), reduction of dental plaque (ID 485, 3085), and defence against pathogens in the middle ear (ID 561, 1180) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

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Article
Panel on Dietetic Products, Nutrition and Allergies
EFSA Journal
EFSA Journal 2011;9(6):2266 [20 pp.].
doi
10.2903/j.efsa.2011.2266
Panel members at the time of adoption
Carlo Agostoni, Jean-Louis Bresson, Susan Fairweather-Tait, Albert Flynn, Ines Golly, Hannu Korhonen, Pagona Lagiou, Martinus Løvik, Rosangela Marchelli, Ambroise Martin, Bevan Moseley, Monika Neuhäuser-Berthold, Hildegard Przyrembel, Seppo Salminen, Yolanda Sanz, Sean (J.J.) Strain, Stephan Strobel, Inge Tetens, Daniel Tomé, Hendrik van Loveren and Hans Verhagen
Acknowledgements

The Panel wishes to thank for the preparatory work on this scientific opinion: The members of the Working Group on Claims: Carlo Agostoni, Jean-Louis Bresson, Susan Fairweather-Tait, Albert Flynn, Ines Golly, Marina Heinonen, Hannu Korhonen, Martinus Løvik, Ambroise Martin, Hildegard Przyrembel, Seppo Salminen, Yolanda Sanz, Sean (J.J.) Strain, Inge Tetens, Hendrik van Loveren and Hans Verhagen The members of the Claims Sub-Working Group on Bone/Teeth/Connective Tissue: Rikke Andersen, Olivier Bruyère, Albert Flynn, Ingegerd Johansson, Jukka Meurman and Hildegard Przyrembel

Contact
Type
Opinion of the Scientific Committee/Scientific Panel
On request from
European Commission
Question Number
EFSA-Q-2008-1272
EFSA-Q-2008-1273
EFSA-Q-2008-1348
EFSA-Q-2008-1349
EFSA-Q-2008-1919
EFSA-Q-2008-1920
EFSA-Q-2008-3817
Adopted
25 March 2011
Published
30 June 2011
Affiliation
European Food Safety Authority (EFSA), Parma, Italy
Note
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Abstract

No abstract available

Summary

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to provide a scientific opinion on a list of health claims pursuant to Article 13 of Regulation (EC) No 1924/2006. This opinion addresses the scientific substantiation of health claims in relation to sugar-free chewing gum sweetened with xylitol and plaque acid neutralisation, maintenance of tooth mineralisation, reduction of dental plaque, and defence against pathogens in the middle ear. The scientific substantiation is based on the information provided by the Member States in the consolidated list of Article 13 health claims and references that EFSA has received from Member States or directly from stakeholders.

The food that is the subject of the health claims is sugar-free chewing gum sweetened with xylitol. The Panel considers that sugar-free chewing gum sweetened with xylitol is sufficiently characterised in relation to the claimed effects.

Plaque acid neutralisation

The claimed effect is “plaque reduction”. The target population is assumed to be the general population. In the context of the proposed wordings, the Panel assumes that the claimed effect refers to plaque acid neutralisation. The Panel considers that plaque acid neutralisation is a beneficial physiological effect.

A claim on sugar-free chewing gum and plaque acid neutralisation has already been assessed with a favourable outcome. The Panel considers that the scientific substantiation and proposed conditions of use also apply to sugar-free chewing gum sweetened with xylitol.

Maintenance of tooth mineralisation

The claimed effects are “mouth, teeth” and “tooth remineralisation”. The target population is assumed to be the general population. In the context of the proposed wordings, the Panel assumes that the claimed effects refer to the promotion of a beneficial balance between de- and remineralisation of tooth enamel and dentin. Maintenance of tooth mineralisation is a beneficial physiological effect.

A claim on sugar-free chewing gum and maintenance of tooth mineralisation has already been assessed with a favourable outcome. The Panel considers that the scientific substantiation and proposed conditions of use also apply to sugar-free chewing gum sweetened with xylitol.

Reduction of dental plaque

The claimed effects are “plaque reduction” and “plaque formation”. The target population is assumed to be the general population. Reduction of dental plaque may be a beneficial physiological effect.

A claim on sugar-free chewing gum and reduction of dental plaque has already been assessed with an unfavourable outcome. The Panel considers that the scientific substantiation of the claimed effect also applies to sugar-free chewing gum sweetened with xylitol. The references cited for this claim did not provide any additional scientific data which could be used to substantiate the claim.

Defence against pathogens in the middle ear

The claimed effect is “ears”. The target population is assumed to be the general population. In the context of the proposed wordings, clarifications from Member States and references provided, the Panel assumes that the claimed effect refers to defence against pathogens (i.e. Streptococcus pneumoniae) in the middle ear. The Panel considers that defence against pathogens (i.e. Streptococcus pneumoniae) in the middle ear is a beneficial physiological effect.

In weighing the evidence, the Panel took into account that two intervention studies in healthy children showed an effect of xylitol-sweetened chewing gum chewed five times a day on acute otitis media in healthy children, that two additional studies did not show an effect of xylitol-sweetened chewing gum on acute otitis media in children with acute respiratory infections, or when consumed three times daily, and that the evidence provided did not show an effect of xylitol-sweetened chewing gum on Streptococcus pneumoniae carrier rate. The Panel notes that the results from the intervention studies are inconsistent, and that no evidence of a mechanism by which xylitol-sweetened chewing gum could exert the claimed effect has been provided.

On the basis of the data presented, the Panel concludes that the evidence provided is insufficient to establish a cause and effect relationship between the use of sugar-free chewing gum sweetened with xylitol and defence against pathogens (i.e. Streptococcus pneumoniae) in the middle ear.

Keywords
Xylitol, chewing gum, plaque acid, tooth mineralisation, dental plaque, pathogens, ear, health claims
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Number of Pages
20