zaterdag, maart 12, 2011

Cranberry tegen tandbederf?

Bonifait L, Grenier D. Cranberry polyphenols: potential benefits for dental caries and periodontal disease. J Can Dent Assoc. October 2010;76:a130.
A growing body of evidence suggests that polyphenols from cranberry (Vaccinium macrocarpon) may help treat and/or prevent dental caries and periodontal disease. Cranberry juice is known to help prevent urinary infections in women because its high-molecular-weight polyphenols inhibit adhesion of Escherichia coli in the urinary tract. Similarly, by inhibiting adhesion of Helicobacter pylori to gastric mucosa, cranberry polyphenols or tannins can interrupt development of human gastric ulcers. They have been found to inhibit adhesion of seasonal influenza virus and proliferation of cancer cells in the mouth, colon, and prostate, and may be useful in cardiovascular diseases. Several studies have used a cranberry fraction called the nondialyzable material (NDM). The NDM contains about 65% proanthocyanidins and 0.35% anthocyanins. The oligomeric proanthocyanidins are unique in having a double linkage between epicatechin units (A type), while most oligomeric proanthocyanidins in other fruits have a single linkage (B type).

In humans, over 700 bacterial species live in the oral cavity. Dental biofilm on hard and soft surfaces of the mouth is made up of these bacteria, epithelial cells, proteins, enzymes, and food particles integrated into an extracellular polysaccharide matrix. Dental biofilm is the source of the two main bacterial conditions affecting the mouth: dental caries and periodontal diseases. Caries, or cavities, is a multifactorial condition characterized by demineralization of tooth enamel. Cariogenic bacteria, such as Streptococcus mutans and S. sobrinus, produce tooth-eroding organic acids when fermentation of sugars reduces the pH of the biofilm to less than 5.5. In vitro studies have found that cranberry constituents inhibit production of organic acids by cariogenic organisms, formation of biofilms by S. mutans and S. sobrinus, and adhesion and coaggregation by other oral Streptococcus species. Cranberry seems to block adhesion of bacteria to the dental biofilm at glucan binding sites.

Only one clinical study has so far investigated these potentially valuable in vitro results. Use of a mouthwash supplemented by the NDM fraction of cranberries significantly reduced total oral microflora, notably S. mutans, after six weeks.

It seems unlikely that drinking cranberry juice in itself significantly boosts oral health, due to the brief contact between mouth tissues and cranberry polyphenols. Added sugar in cranberry drinks, and their acidity, may even contribute to tooth decay. Oral hygiene products with bioactive cranberry compounds or local application of these substances to diseased periodontal sites are among the interesting possibilities for future research.

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