The Effect of Prolonged Sugar-Free Chewing Gum Mastication on Self-Reported Fatigue Levels and Changes of Static and Dynamic Surface Electromyography Parameters in Young Individuals With and Without Temporomandibular Joint Disorders.

Effect of Sugar-Free Chewing Gum Mastication on Fatigue of the Masticatory Muscles in Young Adults With and Without Temporomandibular Joint Disorders

This case-control study investigates fatigue induced by prolonged gum mastication in individuals with temporomandibular disorders (TMD). The study addresses two primary questions:

How does self-reported fatigue, measured with a visual analogue scale (VAS), change during sustained chewing? How do static and dynamic surface electromyographic (sEMG) parameters evolve over the same period? Participants with TMD will be compared with healthy controls to determine group differences in perceived fatigue and EMG responses.

All participants will undergo baseline EMG assessment, then chew sugar-free gum continuously for 3 minutes, alternating sides without rest. After each 3-minute interval, static and dynamic EMG recordings will be obtained and participants will rate their fatigue on the VAS. This cycle may be repeated up to six times (maximum 18 minutes). Participants are free to stop chewing at any time if fatigue becomes intolerable.

Study Overview

• Status: Recruiting
• Conditions: Temporomandibular Joint Disorder
• Intervention / Treatment: Other: Mastication of sugar-free chewing gum

• Study Type: Observational
• Enrollment (Estimated): 30

Contacts and Locations

• Study Contact: Name: Aesha Allam, DDS; Phone Number: +39 3276218958; Email: aesha.allam@unimi.it

Study Locations

• Italy
  • Milan
    • Milan, Milan, Italy, 20142
      • Recruiting
      • University of Milan
      • Contact: Aesha Allam DDS; Phone Number: +39 3276218958; Email: aesha.allam@unimi.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of volunteer participants recruited from the undergraduate dentistry program and postgraduate specialty training programs at the University of Milan.

Description

Inclusion criteria (both groups):

• Age 19-35 years
• Chewing-gum users, even occasional
• Good general health
• Good oral health

Inclusion criteria (Healthy controls):

- no diagnosed temporomandibular joint disorders

Inclusion criteria (study group)

- diagnosed temporomandibular joint disorders

Exclusion criteria (both groups):

• Non chewing gum users
• History of neurological disorders
• History of musculoskeletal diseases
• History of facial or cervical injuries
• Presence of cervical pain
• Two or more missing teeth
• Current treatment with fixed or removable orthodontic appliances
• Active periodontal disease
• Presence of cavitated carious lesions

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Case group (subjects with TMD); This group contains subjects with temporomandibular disorders	Other: Mastication of sugar-free chewing gum; The chewing task will last for a maximum of 18 minutes.
Control group (TMD-free subjects); This group contains healthy subjects without temporomandibular disorders	Other: Mastication of sugar-free chewing gum; The chewing task will last for a maximum of 18 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Self-reported (subjective) fatigue after prolonged sugar-free chewing gum mastication	The whole session has a maximum duration of 18 minutes, assessments are done every 3 minutes

Secondary Outcome Measures

Outcome Measure	Time Frame
Changes of static and dynamic surface electromyography (sEMG) parameters after prolonged mastication of sugar-free chewing gum	The whole session has a maximum duration of 18 minutes, assessments are done every 3 minutes

Collaborators and Investigators

• Sponsor: University of Milan

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2025
• Primary Completion (Estimated): July 30, 2026
• Study Completion (Estimated): July 30, 2026

Study Registration Dates

• First Submitted: November 26, 2025
• First Submitted That Met QC Criteria: November 26, 2025
• First Posted (Actual): December 9, 2025

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 27, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Stomatognathic Diseases; Muscular Diseases; Joint Diseases; Jaw Diseases; Mandibular Diseases; Craniomandibular Disorders; Temporomandibular Joint Disorders
• Other Study ID Numbers: 95 /25

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES