The Effect of Chewing Gum on Dizziness in Patients Diagnosed With Posterior Canal Benign Paroxysmal Positional Vertigo in the Emergency Department

August 4, 2026 updated by: Şeref Kerem Çorbacıoğlu, Ankara Ataturk Sanatorium Training and Research Hospital

The Effect of Chewing Gum in Addition to Standard Treatment on Dizziness in Patients Diagnosed With Posterior Canal Benign Paroxysmal Positional Vertigo in the Emergency Department: A Randomized Controlled Clinical Trial

Dizziness is a common reason for emergency department visits. Posterior canal benign paroxysmal positional vertigo (BPPV) is one of the most frequent causes of peripheral vertigo. Intravenous dimenhydrinate is among the standard treatments administered in the emergency setting; however, this and similar drug classes may cause sedation and delay central compensation.

This study tests the hypothesis that chewing gum may modulate the vestibular system via trigeminal and cervical neuromuscular pathways, thereby reducing dizziness and nausea symptoms. Patients diagnosed with posterior canal BPPV who are started on intravenous dimenhydrinate will be randomly assigned to two groups: the intervention group will chew sugar-free mint-flavored gum for 20 minutes in addition to standard treatment, while the control group will receive standard treatment only. Dizziness and nausea severity will be assessed using VAS at baseline, 20 minutes, and 60 minutes.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

88

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Aged 18-65 years
  • Duration of dizziness complaint less than 24 hours
  • Posterior canal BPPV diagnosis confirmed by the emergency physician via the Dix-Hallpike test
  • Intravenous administration of 50 mg dimenhydrinate in 100 cc 0.9% NaCl initiated by the responsible emergency physician
  • Symptomatic dizziness with VAS ≥ 4
  • Alert, cooperative, and able to chew gum
  • Willingness to participate and provision of written informed consent

Exclusion Criteria:

  • Findings suggestive of central vertigo (vertical nystagmus, diplopia, ataxia, hemiparesis, focal neurological deficit, etc.)
  • Pregnancy
  • Known gum intolerance, history of allergy to gum or its excipients, temporomandibular joint dysfunction, significant tooth loss, use of dentures or removable prosthetics that would prevent chewing
  • Altered level of consciousness
  • Central pathology detected on investigations performed during the visit
  • Hemodynamic and/or respiratory instability
  • Diagnosis other than posterior canal BPPV as the cause of vertigo
  • Treatment other than pharmacological therapy planned or already administered by the responsible emergency physician
  • Active vomiting at the time of enrollment
  • Severe dizziness with VAS ≥ 8 (excluded due to high likelihood of requiring additional treatment, risk of protocol deviation, and safety concerns regarding gum chewing)
  • Patients who initially consented but subsequently wish to withdraw from the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Control Group
Patients receive only the standard treatment initiated by the responsible emergency physician: 50 mg dimenhydrinate in 100 cc 0.9% NaCl administered intravenously
Drug: Dimenhydrinate
Dimenhydrinate 50 mg diluted in 100 mL of 0.9% sodium chloride administered intravenously as standard treatment for posterior canal benign paroxysmal positional vertigo in the emergency department.
Experimental: Intervention Group
In addition to standard treatment (50 mg dimenhydrinate in 100 cc 0.9% NaCl IV), patients receive sugar-free mint-flavored chewing gum simultaneously with the start of treatment and chew it under observation for 20 minutes.
Drug: Dimenhydrinate
Dimenhydrinate 50 mg diluted in 100 mL of 0.9% sodium chloride administered intravenously as standard treatment for posterior canal benign paroxysmal positional vertigo in the emergency department.
Behavioral: Sugar-Free Mint-Flavored Chewing Gum
Participants chew one piece of sugar-free mint-flavored chewing gum under observation for 20 minutes, starting simultaneously with standard intravenous treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in dizziness Visual Analog Scale score from baseline to 20 minutes
Time Frame: Baseline and 20 minutes after treatment initiation
The primary outcome is the change in dizziness severity measured using a 10-cm Visual Analog Scale, ranging from 0 (no dizziness) to 10 (worst imaginable dizziness), with higher scores indicating greater dizziness severity, between baseline and 20 minutes after treatment initiation.
Baseline and 20 minutes after treatment initiation

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Nausea Visual Analog Scale score at 20 minutes
Time Frame: 20 minutes after treatment initiation
Nausea severity will be assessed 20 minutes after treatment initiation using a 10-cm Visual Analog Scale, ranging from 0 (no nausea) to 10 (worst imaginable nausea), with higher scores indicating greater nausea severity.
20 minutes after treatment initiation

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara Ataturk Sanatorium Training and Research Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

July 23, 2026

First Submitted That Met QC Criteria

August 4, 2026

First Posted (Actual)

August 6, 2026

Study Record Updates

Last Update Posted (Actual)

August 6, 2026

Last Update Submitted That Met QC Criteria

August 4, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024-KAEK-24/43

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe