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Relationship Between Intake of Green Tea and Periodontal Disease


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Green tea is a very popular beverage, and in vitro studies have shown that green tea polyphenols inhibit the growth and cellular adherence of periodontal pathogens and their production of virulence factors. We investigated the epidemiologic relationship between the intake of green tea and periodontal disease. We analyzed 940 Japanese men aged 49 to 59 years as part of a comprehensive health examination. Probing depth (PD), clinical attachment loss (AL), and bleeding on probing (BOP) were used as the periodontal parameters. We examined the relationship between the intake of green tea and periodontal parameters. The intake of green tea was defined as the number of cups per day in a self-administered questionnaire. The intake of green tea was inversely correlated with the mean PD, mean clinical AL, and BOP. In multivariate linear regression models, every one cup/day increment in green tea intake was associated with a 0.023-mm decrease in the mean PD (P <0.05), a 0.028-mm decrease in the mean clinical AL (P <0.05), and a 0.63% decrease in BOP (P <0.05), after adjusting for other confounding variables. There was a modest inverse association between the intake of green tea and periodontal disease.
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Relationship Between Intake of Green
Tea and Periodontal Disease
Mitoshi Kushiyama,* Yoshihiro Shimazaki,* Masatoshi Murakami,* and Yoshihisa Yamashita*
Background: Green tea is a very popular beverage, and in
vitro studies have shown that green tea polyphenols inhibit
the growth and cellular adherence of periodontal pathogens
and their production of virulence factors. We investigated the
epidemiologic relationship between the intake of green tea
and periodontal disease.
Methods: We analyzed 940 Japanese men aged 49 to
59 years as part of a comprehensive health examination.
Probing depth (PD), clinical attachment loss (AL), and bleed-
ing on probing (BOP) were used as the periodontal parameters.
We examined the relationship between the intake of green tea
and periodontal parameters. The intake of green tea was de-
fined as the number of cups per day in a self-administered
Results: The intake of green tea was inversely correlated
with the mean PD, mean clinical AL, and BOP. In multivariate
linear regression models, every one cup/day increment in
green tea intake was associated with a 0.023-mm decrease
in the mean PD (P<0.05), a 0.028-mm decrease in the
mean clinical AL (P<0.05), and a 0.63% decrease in BOP
(P<0.05), after adjusting for other confounding variables.
Conclusion: There was a modest inverse association be-
tween the intake of green tea and periodontal disease. J Peri-
odontol 2009;80:372-377.
Epidemiology; green tea; periodontal disease; periodontitis.
Periodontal disease is a chronic dis-
ease that is prevalent in adults.
The incidence and progression of
periodontal disease is related causally to
periodontal pathogens,
as well as to
various host and environmental fac-
Eating habits and nutritional
intake affect periodontal disease. Many
studies have reported that consumption
of vitamin C and calcium is linked to
periodontal disease
and that the con-
sumption of whole-grain and lactic acid
foods has a prophylactic effect on peri-
odontal disease.
Green tea is a popular drink, and the in-
take of greentea and its components,such
as catechin, had a preventive effect
against cancer development and cardio-
vascular disease in experimental and
epidemiologic studies.
Several in vi-
tro studies have suggested that green tea
catechins, such as (-)-epigallocatechin
gallate (EGCg), inhibit periodontal path-
and the destruction of peri-
odontal tissue.
A pilot clinical
showed that periodontal treatment
chin improved periodontal status. How-
ever, it is not clear whether the daily
intake of green tea has a beneficial effect
on periodontal health. Therefore, we exam-
ined the epidemiologic relationship be-
tween the daily intake of green tea and
periodontal disease through a compre-
hensive health examination in middle-
aged Japanese men.
* Department of Preventive Dentistry, Kyushu University Faculty of Dental Science,
Fukuoka, Japan.
doi: 10.1902/jop.2009.080510
Volume 80 Number 3
Study Population
More than 95% of the men enlisted in the Self-Defense
Force in Fukuoka, Japan, attended a comprehensive
health examination that included a 5-day admission
to the Self-Defense Force Fukuoka Hospital in the 5
years before retirement. The examination was con-
ducted for preretirement healthcare for the subjects.
We examined a total of 1,123 men aged 49 to 59 years
between January 2000 and March 2002. Of these, 940
subjects who had 20 teeth and all of the data required
for analysis were studied to ensure an adequate as-
sessment of periodontal condition. The subjects pro-
vided oral consent to participate in this study. The
study was conducted in accordance with the Helsinki
Declaration, and the design and procedures were ap-
proved by the Self-Defense Force, Fukuoka Hospital,
and the Ground Staff Office.
Oral examination was carried out by one dentist
trained to perform a clinical examination of oral health
status using a normal dental chair. Probing depth (PD)
and clinical attachment loss (AL) were measured
using a periodontal probe
at the mesio-buccal and
mid-buccal sites for all remaining teeth, except third
molars, following the method of the Third National
Health and Nutrition Examination Survey.
bleeding on probing (BOP) was evaluated by calculat-
ing the percentage of teeth exhibiting gingival bleed-
ing within a few seconds of probing the periodontal
pockets. The examiner reliability of the periodontal
examination was verified by an intraexaminer calibra-
tion of volunteers; the percentage agreement (within
1 mm) ranged from 91.0% to 100% for PD and from
89.0% to 100% for clinical AL. The kappa value
ranged from 0.86 to 1.00 for PD and from 0.84 to
1.00 for clinical AL. The examiner was masked to
the answers of the questionnaire while conducting
the periodontal examination.
Each subject completed a self-administered ques-
tionnaire that assessed smoking history, alcohol in-
take, toothbrushing habits, and the daily intake of
green tea; an examiner checked the answers orally.
Smoking habit was quantified as the number of ciga-
rettes smoked per day multiplied by the number of
years smoked. The frequency of toothbrushing was
divided into five categories and coded as follows:
never =1; sometimes =2; once a day =3; twice a
day =4; and three or more times a day =5. We asked
about the habitual frequency of drinking green tea as
the number of cups per day and used it as a continu-
ous variable in the analysis.
Physicians examined each subject’s systemic con-
dition. A blood sample was collected from the antecu-
bital vein after an overnight fast to determine lipid and
glucose levels. The body mass index was defined as
the weight in kilograms divided by the square of the
height in meters. Body fat was defined using foot-to-
foot bioelectric impedance analysis using a body com-
position monitor.
Statistical Analysis
Weused the mean PD,mean clinicalAL, and BOP as de-
pendentvariablestoreflectperiodontaldisease.We cal-
culated the Spearman correlation coefficient among
each periodontal parameter, the intake of green tea,
andotherstudy variables.We used simple linear regres-
sion analysis to examine the relationship between the
intake of green tea and each periodontal parameter.
Stepwise multivariate linear regression analysis was
used to examinethe effect of each independent variable
on the periodontal parameters. The variables for which
the correlation coefficient was significant were entered
into the multivariate model. The statistical analyses
were performed using a software program.
The characteristics of the subjects were compared to
the data for men 50 to 59 years old from the National
Nutrition Survey of Japan, conducted in 2000 (Table
Most of the data were similar; however, the
subjects’ systolic blood pressure and triglycerides
were slightly lower and the high-density lipoprotein
(HDL) cholesterol was slightly higher compared to
the results of the National Nutrition Survey. The per-
centage of smokers (current and past) was 81.5% in
this study and 76.7% in the National Nutrition Survey.
Table 1 shows the Spearman correlation coefficient
of the study variables. The intake of green tea, smok-
ing habit, number of teeth, and HDL cholesterol were
significantly correlated with all of the periodontal pa-
rameters. The frequency of toothbrushing was associ-
ated with the mean PD and BOP, and the body fat and
triglycerides were associated with BOP. The intake of
green tea was correlated with the frequency of tooth-
brushing and number of teeth. There was no signifi-
cant seasonal variation in mean green tea intake.
The simple linear regression analysis identified a
significant relationship between the intake of green
tea and each periodontal parameter (Table 2). Table
3 shows the results of the stepwise multivariate linear
regression to evaluate each independent variable in
relation to the periodontal parameters. The intake of
green tea was significantly inversely correlated with
all of the periodontal parameters. Every one cup/
day increment in green tea intake was associated with
a 0.023-mm decrease in mean PD (P<0.05), a 0.028-
mm decrease in mean clinical AL (P<0.05), and a
† PCPUNC15, Hu-Friedy, Chicago, IL.
‡ TBF-401, Tanita, Tokyo, Japan.
§ SPSS version 15.0, SPSS Japan, Tokyo, Japan.
J Periodontol March 2009 Kushiyama, Shimazaki, Murakami, Yamashita
0.63% decrease in BOP (P<0.05), after adjusting for
other confounding variables.
We conducted a comprehensive health examination
of males in their fifties and examined the relationship
between the daily intake of green tea and periodontal
disease. Most of the subjects in the Self-Defense Force
were men, and men in their fifties have a relatively
large number of existing teeth and a high prevalence
of periodontal disease. The daily intake of green tea
was significantly associated with indices of peri-
odontal disease, including PD, clinical AL, and BOP,
such that the more frequently the subjects drank
green tea, the better was their periodontal condition.
Bacterial biofilm development in the marginal
gingiva and periodontal pockets is important in the
pathogenesis of periodontal disease. Previous in vitro
studies showed that green tea catechin inhibits the
growth of Porphyromonas gingivalis,Prevotella inter-
media, and Prevotella nigrescens
and the adher-
ence of P. gingivalis onto human buccal epithelial
In addition, green tea catechins with the steric
structures of 3-galloyl radial, EGCg, (-)-epicatechin
gallate (ECg), and (-)-gallocatechin gallate, which
are the major tea polyphenols, inhibit the production
of toxic end metabolites of P. gingivalis.
These re-
ports of the inhibitory effects of catechin contained
in green tea on periodontal pathogens may provide
the basis for the beneficial effect of the daily intake
of green tea on periodontal health.
Periodontal disease is an infectious disease involv-
ing gingival inflammation and the destruction of peri-
odontal tissue. Periodontal pathogens, such as P.
gingivalis and Aggregatibacter actinomycetemcomi-
tans (previously Actinobacillus actinomycetemcomi-
tans), produce matrix metalloproteinases (MMPs)
and exhibit collagenase activity.
MMPs, such as
Table 1.
Characteristics of Variables and Spearman Correlation Coefficients
Spearman Correlation Coefficient
Mean SD
National Nutrition
Mean PD
Clinical AL BOP
Intake of
Green Tea
Age (years) 52.4 0.9 (49 to 59) (50 to 59) -0.04 -0.01 -0.03 0.03
PD (mm) 2.5 0.8 (1.0 to 7.0) 0.77* 0.69* -0.11*
Clinical AL (mm) 3.0 1.0 (0.7 to 8.2) 0.77* 0.50* -0.11*
BOP (%) 17.7 19.0 (0 to 100) 0.69* 0.50* -0.08
Intake of green tea (cups/day) 3.5 2.2 (0 to 12) -0.11* -0.11* -0.08
Smoking habit (pack-years) 23.3 17.7 (0 to 87.5) 0.24* 0.30* 0.14* -0.06
Alcohol intake (times/week) 4.4 2.7 (0 to 7) -0.01 -0.03 0.004 -0.04
Toothbrushing frequency (times/day) 3.8 0.8 (1 to 5) -0.13* -0.02 -0.15* 0.09*
Teeth (n) 26.3 2.9 (20 to 32) -0.22* -0.35* -0.12* 0.07
BMI (kg/m
) 23.8 2.6 (16.6 to 32.8) 23.6 3.0 0.05 -0.03 0.03 -0.01
Body fat (%) 21.5 4.4 (10.1 to 35.5) 0.06 -0.004 0.07
Systolic blood pressure (mm Hg) 128.9 14.9 (90 to 220) 134.9 19.5 0.03 0.003 0.05 0.03
Diastolic blood pressure (mm Hg) 82.6 9.9 (46 to 126) 83.9 11.7 0.02 -0.05 0.04 -0.02
Total cholesterol (mg/dl) 205.5 33.1 (99 to 339) 204.0 36.6 0.01 -0.05 0.05 -0.02
HDL cholesterol (mg/dl) 57.5 15.9 (23 to 128) 54.1 15.6 -0.09* -0.11* -0.09
Triglycerides (mg/dl) 149.6 124.2 (31 to 1,753) 164.3 161.2 0.05 0.04 0.08
Fasting plasma glucose level (mg/dl) 102.1 19.2 (74 to 289) 101.7 29.9 0.04 0.04 0.05 -0.02
=not applicable.
Intake of Green Tea and Periodontal Disease Volume 80 Number 3
collagenases and gelatinases, break down the colla-
gen and gelatin that make up the extracellular matrix
of periodontal tissue, and MMP activity plays an im-
portant role in the pathogenesis and progression of
periodontal disease. When periodontal pathogens
live on local periodontal tissue, fibroblasts and mac-
rophages produce several cytokines, including inter-
leukin-1 and -6 and tumor necrosis factor-alpha, as
mediators of the inflammatory response and immune
These cytokines play a direct role in the
destruction of periodontal tissue and encourage
fibroblasts and macrophages in periodontal tissue
to enhance the production and activation of MMPs, re-
sulting in the progressive destruction of periodontal
showed that green tea catechin,
EGCg, and ECg inhibit the activity of P. gingivalis
derived collagenase. In addition, EGCg inhibited
osteoclast formation in a coculture of primary osteo-
blastic cells and bone marrow cells,
and it induced
the apoptotic cell death of osteoclast-like multinucle-
ated cells in a dose-dependent manner.
suggested that green tea catechin has a
preventive effect against the development of cancer
and cardiovascular disease, and the effect has been
ascribed to the antioxidative mechanisms of cate-
Oxidative stress plays an important role
in the pathogenesis of periodontal disease, as well
as many other disorders,
and it is believed that
antioxidants can defend against inflammatory dis-
Vitamin C is a well-known antioxidant,
and reports
have shown a significant relationship
between vitamin C deficiency and periodontal break-
down. In addition, a recent animal study
that the oral administration of vitamin C prevented
alveolar bone resorption by decreasing oxidative
damage to periodontal tissue. Therefore, similar
mechanisms might be involved in the effects of the in-
take of green tea.
Smoking habit and the frequency of toothbrushing,
which are important lifestyle factors for periodontal
Ta b l e 3 .
Parameter Estimates From Stepwise Multivariate Linear Regression Models Evaluating
Each Independent Variable in Relation to Periodontal Parameters
Dependent Variable
Mean PD (mm)
Dependent Variable
Mean Clinical AL (mm)
Dependent Variable
BOP (%)
Independent Variables Coefficient SE PValue Coefficient SE PValue Coefficient SE PValue
Intake of green tea
-0.023 0.011 0.037 -0.028 0.013 0.035 -0.63 0.27 0.021
Smoking habit
0.008 0.001 <0.001 0.013 0.002 <0.001 0.096 0.035 0.006
frequency (times/day)
-0.072 0.031 0.021 -3.04 0.79 <0.001
Teeth (n) -0.056 0.008 <0.001 -0.12 0.011 <0.001 -0.65 0.21 0.002
Intercept 4.19 0.26 <0.001 6.01 0.29 <0.001 46.24 6.52 <0.001
for mean PD =0.103, for mean clinical AL =0.193, and for BOP =0.048.
Ta b l e 2 .
Parameter Estimates From Simple Linear Regression Models Evaluating Intake of Green
Tea in Relation to Periodontal Parameters
Dependent Variable
Mean PD (mm)
Dependent Variable
Mean Clinical AL (mm)
Dependent Variable
BOP (%)
Independent Variable Coefficient SE PValue Coefficient SE PValue Coefficient SE PValue
Intake of green tea (cups/day) -0.034 0.011 0.002 -0.046 0.015 0.002 -0.84 0.28 0.002
Intercept 2.65 0.047 <0.001 3.21 0.062 <0.001 20.70 1.14 <0.001
for mean PD =0.010, for mean clinical AL =0.010, and for BOP =0.010.
J Periodontol March 2009 Kushiyama, Shimazaki, Murakami, Yamashita
disease, were significantly associated with periodon-
tal parameters and were associated with the intake
of green tea in the bivariate analyses. However, when
we entered the green tea intake and these factors si-
multaneously as independent variables into a multi-
variate regression model whose dependent variable
was an index of periodontal disease, the intake of
green tea was significantly associated with each peri-
odontal parameter, independent of other variables.
This shows that the relationship between the intake
of green tea and periodontal disease is independent
of other confounding factors.
The correlation coefficients in this study were gen-
erally small, suggesting that it is difficult to explain
periodontal disease using only a few variables, be-
cause periodontitis is a multifactorial disease. The
sample size in our study was sufficiently large to show
the statistical significance of the relationship between
the intake of green tea and periodontal disease,
but the factors considered in this study were not suffi-
cient to account for periodontal disease. Although a
number of previous studies suggested that the intake
of food and nutrients, such as dairy products,
and vitamin C,
may affect the preva-
lence of periodontal disease, we did not examine the
intake of foods and supplements other than green
tea. Further studies including a dietary survey are
necessary to identify other important confounders that
explain the relationship between periodontal disease
and the explanatory variables. Our periodontal exam-
ination at the mesio-buccal and mid-buccal sites of
each tooth may have led to bias because we did not
examine the periodontal condition at six sites per
tooth. In some studies
that have examined the
reproducibility and validity of dietary questionnaires,
reasonable levels of reproducibility and validity were
observed for the intake of tea. Nevertheless, because
we did not assess the validity and reliability of our
self-administered questionnaire, a bias derived from
measurement errors may have affected the study re-
sults. The study design was based on a cross-sectional
model, so the results cannot establish whether the
regular intake of green tea has a beneficial effect on
periodontal disease. Longitudinal studies of the rela-
tionship between the continued intake of green tea
and periodontal disease are required to strengthen
the interrelation. In addition, because our study sub-
jects were males in their fifties, studies of both genders
and a wide range of ages are needed to generalize
the relationship between the intake of green tea and
periodontal disease.
The present study suggests that there is a modest in-
verse association between the daily intake of green
tea and periodontal disease. Drinking green tea at
meals and breaks is a relatively easy habit to main-
tain, and drinking green tea as frequently as possible
may help to maintain a healthy periodontium. However,
because the observed relationship between the daily
intake of green tea and periodontal disease was
weak, the application of concentrated green tea com-
ponents, such as catechin, may be expected to have
a more beneficial effect on the periodontal condition.
This work was supported by Grants-in-Aid of Scientific
Research (19390541 and 20592458) from the Minis-
Tokyo, Japan, and by the department budget of
Kyushu University, Faculty of Dental Science. The au-
thors report no conflicts of interest related to this study.
1. Haffajee AD, Socransky SS, Taubman MA, Sioson J,
Smith DJ. Patterns of antibody response in subjects
with periodontitis. Oral Microbiol Immunol 1995;10:
2. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent
RL Jr. Microbial complexes in subgingival plaque.
J Clin Periodontol 1998;25:134-144.
3. Clarke NG, Hirsch RS. Personal risk factors for gener-
alized periodontitis. J Clin Periodontol 1995;22:136-
4. Papapanou PN. Periodontal diseases: Epidemiology.
Ann Periodontol 1996;1:1-36.
5. Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan
M, Genco RJ. Dietary vitamin C and the risk for peri-
odontal disease. J Periodontol 2000;71:1215-1223.
6. Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan
M, Genco RJ. Calcium and the risk for periodontal
disease. J Periodontol 2000;71:1057-1066.
7. Merchant AT, Pitiphat W, Franz M, Joshipura KJ.
Whole-grain and fiber intakes and periodontitis risk
in men. Am J Clin Nutr 2006;83:1395-1400.
8. Al-Zahrani MS. Increased intake of dairy products is
related to lower periodontitis prevalence. J Periodontol
9. Shimazaki Y, Shirota T, Uchida K, et al. Intake of dairy
products and periodontal disease: The Hisayama
Study. J Periodontol 2008;79:131-137.
10. Taniguchi S, Fujiki H, Kobayashi H, et al. Effect of
(-)-epigallocatechin gallate, the main constituent of
anoma cell lines. Cancer Lett 1992;65:51-54.
11. Wolfram S. Effects of green tea and EGCG on cardio-
vascular and metabolic health. J Am Coll Nutr 2007;
12. Hirasawa M, Takada K, Makimura M, Otake S. Im-
provement of periodontal status by green tea catechin
using a local delivery system: A clinical pilot study.
J Periodontal Res 2002;37:433-438.
13. Makimura M, Hirasawa M, Kobayashi K, et al. Inhib-
itory effect of tea catechins on collagenase activity.
J Periodontol 1993;64:630-636.
14. Sakanaka S, Aizawa M, Kim M, Yamamoto T. Inhibitory
effects of green tea polyphenols on growth and cellular
adherence of an oral bacterium, Porphyromonas gingi-
valis.Biosci Biotechnol Biochem 1996;60:745-749.
Intake of Green Tea and Periodontal Disease Volume 80 Number 3
15. Yun JH, Pang EK, Kim CS, et al. Inhibitory effects of
green tea polyphenol (-)-epigallocatechin gallate on
the expression of matrix metalloproteinase-9 and on
the formation of osteoclasts. J Periodontal Res 2004;
16. Yun JH, Kim CS, Cho KS, Chai JK, Kim CK, Choi SH.
(-)-Epigallocatechin gallate induces apoptosis, via
caspase activation, in osteoclasts differentiated from
RAW 264.7 cells. J Periodontal Res 2007;42:212-
17. Brown LJ, Brunelle JA, Kingman A. Periodontal status
in the United States, 1988-1991: Prevalence, extent,
and demographic variation. J Dent Res 1996;75:672-
18. Status of National Nutrition. Result of National Nutrition
Survey, Japan in 2000 ( in Japanese). Tokyo: Dai-ichi
Shuppan Publishing; 2002:102-113.
19. Sakanaka S, Okada Y. Inhibitory effects of green tea
polyphenols on the production of a virulence factor of
the periodontal-disease-causing anaerobic bacterium
Porphyromonas gingivalis.J Agric Food Chem 2004;
20. Robertson PB, Lantz M, Marucha PT, Kornman KS,
Trummel CL, Holt SC. Collagenolytic activity associ-
ated with Bacteroides species and Actinobacillus
actinomycetemcomitans.J Periodontal Res 1982;17:
21. Schwartz Z, Goultschin J, Dean DD, Boyan BD.
Mechanisms of alveolar bone destruction in periodon-
titis. Periodontol 2000 1997;14:158-172.
22. Page RC, Offenbacher S, Schroeder HE, Seymour GJ,
Kornman KS. Advances in the pathogenesis of peri-
odontitis: Summary of developments, clinical implica-
tions and future directions. Periodontol 2000 1997;14:
23. Nakagawa H, Wachi M, Woo JT, et al. Fenton
reaction is primarily involved in a mechanism of
(-)-epigallocatechin-3-gallate to induce osteoclastic
cell death. Biochem Biophys Res Commun 2002;
24. Bors W, Heller W, Michel C, Saran M. Flavonoids as
antioxidants: Determination of radical-scavenging ef-
ficiencies. Methods Enzymol 1990;186:343-355.
25. Rizvi SI, Zaid MA, Anis R, Mishra N. Protective role
of tea catechins against oxidation-induced damage
of type 2 diabetic erythrocytes. Clin Exp Pharmacol
Physiol 2005;32:70-75.
26. Chapple IL. Reactive oxygen species and antioxidants
in inflammatory diseases. J Clin Periodontol 1997;
27. Nishimura F, Soga Y, Iwamoto Y, Kudo C, Murayama
Y. Periodontal disease as part of the insulin resistance
syndrome in diabetic patients. J Int Acad Periodontol
28. Halliwell B, Gutteridge JM. The antioxidants of human
extracellular fluids. Arch Biochem Biophys 1990;280:1-8.
29. Amaliya, Timmerman MF, Abbas F, et al. Java project
on periodontal diseases: The relationship between
vitamin C and the severity of periodontitis. J Clin
Periodontol 2007;34:299-304.
30. Sanbe T, Tomofuji T, Ekuni D, Azuma T, Tamaki N,
Yamamoto T. Oral administration of vitamin C pre-
vents alveolar bone resorption induced by high dietary
cholesterol in rats. J Periodontol 2007;78:2165-2170.
31. Colditz GA, Willett WC, Stampfer MJ, et al. The influ-
ence of age, relative weight, smoking, and alcohol
intake on the reproducibility of a dietary question-
naire. Int J Epidemiol 1987;16:392-398.
32. Feskanich D, Rimm EB, Giovannucci EL, et al. Re-
producibility and validity of food intake measurements
from a semiquantitative food frequency questionnaire.
J Am Diet Assoc 1993;93:790-796.
Correspondence: Dr. Yoshihiro Shimazaki, Department
of Preventive Dentistry, Kyushu University Faculty of
Dental Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka
812-8582, Japan. Fax: 81-92-642-6354; e-mail: shima@
Submitted October 8, 2008; accepted for publication No-
vember 19, 2008.
J Periodontol March 2009 Kushiyama, Shimazaki, Murakami, Yamashita
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... Turmeric has been shown to be effective as an adjuvant treatment for PD (Zhang et al., 2022a), reducing gingival indices and sulcus bleeding; however, the results of clinical studies are controversial, with findings ranging from those reporting great efficacy as an adjuvant treatment (Mohammad, 2020) to those considering it completely ineffective (Pérez-Pacheco et al., 2021). Green tea catechin has been shown in vitro, to be effective in the treatment of PD by suppressing specific periodontal infections (Kushiyama et al., 2009), and some clinical investigations have shown its efficiency as an adjuvant therapy for PD (Rezvani et al., 2022). There are few references to the usefulness of peppermint in the treatment of PD, and we only discovered one in vitro study that looked at its antibiofilm potential, in conjunction with a chitosan nanogel (Ashrafi et al., 2019). ...
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... 174,175 In 2009, an epidemiologic study showed a moderate reverse correlation between the routine supply of green tea and periodontal disease. 176 Many clinical studies have investigated the possibility of using green tea as an adjective treatment TherapeuTic advances in chronic disease against periodontitis. In a recent clinical trial, 30 patients were divided into two groups. ...
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Periodontitis is a persistent inflammation of the soft tissue around the teeth that affects 60% of the population in the globe. The self-maintenance of the inflammatory process can cause periodontal damage from the alveolar bone resorption to tooth loss in order to contrast the effects of periodontitis, the main therapy used is scaling and root planing (SRP). At the same time, studying the physiopathology of periodontitis has shown the possibility of using a local drug delivery system as an adjunctive therapy. Using local drug delivery devices in conjunction with SRP therapy for periodontitis is a potential tool since it increases drug efficacy and minimizes negative effects by managing drug release. This review emphasized how the use of local drug delivery agents and natural agents could be promising adjuvants for the treatment of periodontitis patients affected or not by cardiovascular disease, diabetes, and other system problems. Moreover, the review evidences the current issues and new ideas that can inspire potential later study for both basic research and clinical practice for a tailored approach.
... In a survey conducted in Japan, the periodontal health of 940 subjects was clinically evaluated. The authors found that subjects who were habitual green tea drinkers had better periodontal health than green tea nondrinker peers 56 . Moreover, the frequency of green tea consumption is an essential cofactor that influences the magnitude of its effects. ...
Matcha tea is a fine-powdered green tea with a unique "Umami” taste. It is a popular beverage prepared from the leaves of the Camellia sinensis plant, which is growing under the shade a few weeks before harvesting the leaves. Consequently, Matcha tea is a green tea possessing distinctive proportions of bioactive chemicals. The health-promoting effects of Matcha tea are well-documented. Matcha tea constituents have diverse beneficial biological activities such as anticarcinogenic, anti-stress, anti-inflammatory and antioxidant effects, and enhancing cognitive function. On the other hand, research regarding oral healthpromoting properties of Matcha tea has yet to be conducted. Oral health benefits of Matcha tea are always granted to green tea. This review highlights the healthpromoting properties of Matcha tea and its chemical composition. Also, it summarizes the oral health benefits of green tea as a representative of matcha tea. It is highly suggested to investigate the benefits of Matcha tea for enhancing oral health as it shares bioactive components with green tea but at different proportions. Keywords: Matcha tea, oral health, Camellia sinensis
... Epicatechin-3-gallate and epigallocatechin-3 gallate are the two significant catechins. Compared to black tea, green tea contains higher polyphenols (30-40% vs. 3-10%), with enhanced antioxidant capacity and strong anti-inflammation, antibacterial, antiviral, antimutagenic, and anti-aging activities [132][133][134]. Inflammation and periodontitis are positively affected by green tea. ...
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Periodontal diseases and dental caries are the most common infectious oral diseases impacting oral health globally. Oral cavity health is crucial for enhancing life quality since it serves as the entranceway to general health. The oral microbiome and oral infectious diseases are strongly correlated. Gram-negative anaerobic bacteria have been associated with periodontal diseases. Due to the shortcomings of several antimicrobial medications frequently applied in dentistry, the lack of resources in developing countries, the prevalence of oral inflammatory conditions, and the rise in bacterial antibiotic resistance, there is a need for reliable, efficient, and affordable alternative solutions for the prevention and treatment of periodontal diseases. Several accessible chemical agents can alter the oral microbiota, although these substances also have unfavorable symptoms such as vomiting, diarrhea, and tooth discoloration. Natural phytochemicals generated from plants that have historically been used as medicines are categorized as prospective alternatives due to the ongoing quest for substitute products. This review concentrated on phytochemicals or herbal extracts that impact periodontal diseases by decreasing the formation of dental biofilms and plaques, preventing the proliferation of oral pathogens, and inhibiting bacterial adhesion to surfaces. Investigations examining the effectiveness and safety of plant-based medicines have also been presented, including those conducted over the past decade.
... According to published research, green tea is proven to be antibacterial against a majority of oral microorganisms. Additionally, it has been demonstrated to enhance oral health by raising oral peroxidase activity, delaying the onset and progression of periodontitis, lowering dentin erosion and tooth loss, and thus contributing to the reduction of bad breath [72][73][74][75][76]. By interacting with the Pneumolysin and Sortase A of Streptococcus pneumoniae, epigallocatechin gallate (EGCG) was discovered to regulate antibiotic resistance [77]. ...
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After decades of research and development concerning cancer treatment, cancer is still at large and very much a threat to the global human population. Cancer remedies have been sought from all possible directions, including chemicals, irradiation, nanomaterials, natural compounds, and the like. In this current review, we surveyed the milestones achieved by green tea catechins and what has been accomplished in cancer therapy. Specifically, we have assessed the synergistic anticarcinogenic effects when green tea catechins (GTCs) are combined with other antioxidant-rich natural compounds. Living in an age of inadequacies, combinatorial approaches are gaining momentum, and GTCs have progressed much, yet there are insufficiencies that can be improvised when combined with natural antioxidant compounds. This review highlights that there are not many reports in this specific area and encourages and recommends research attention in this direction. The antioxidant/prooxidant mechanisms of GTCs have also been highlighted. The current scenario and the future of such combinatorial approaches have been addressed, and the lacunae in this aspect have been discussed.
... The researchers have also found that drinking six or more cups of black tea per day was associated with decreased serum cholesterol and triglyceride concentrations (GeleijnSe et al. 2002). The decrease in gum disease factors (kuShiYaMa et al. 2009). Tea may also contribute to oral health. ...
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Tea is one of the most popular beverages in the world, which, along with a number of beneficial health ingredients, such as trace elements, also contains undesired substances – as impurities. Among the impurities occur heavy metals, and their presence in tea leaves can pose serious problems to human health because they are not biodegradable, remain in the environment and can become part of the food chain. The total metal content of the tea leaves and infusions depends on the type of tea (green, black) and on the influence of other factors, including the properties of the soil. Despite the limited extent of metal migration from the dried tea to infusions, tea pollution with metals such as lead, cadmium or mercury is not indifferent to human health.
Oral cavity contains the second largest microbial community in the human body. Due to the highly vascularized feature of mouth, oral microbes could directly access the bloodstream and affect the host healthy systemically. The imbalance of oral microbiota is closely related to various oral and systemic diseases. Green tea extracts (GTE) mainly contain tea polyphenols, alkaloids, amino acid, flavones, and so on, which equipped with excellent anti‐inflammatory activities. Previous studies have demonstrated the beneficial effects of GTE on oral health. However, most researches used in vitro models or focused on limited microorganisms. In this study, the regulatory effect of GTE on oral microbiome and the alleviative effect on oral inflammation in vivo were evaluated. The results showed that GTE could efficiently alleviate the inflammations of the tongue, cheek pouch, as well as throat. GTE effectively inhibited the activation of NF‐κB through the upregulation of the anti‐inflammatory cytokine interleukin (IL)‐10, consequently leading to reduced expression of pro‐inflammatory cytokines IL‐6 and tumor necrosis factor‐α. The indexes of spleen and thymus were also elevated by GTE in stomatitis mice. Moreover, GTE promoted the growth of probiotics Lactobacillus and Bacillus , inhibited the reproduction of pathogens Achromobacter , reversing the microbiota disorders in oral cavity. This study not only presents a novel approach for enhancing oral microecology but also facilitates the wider adoption of tea consumption.
Abstract Periodontitis is generally considered to be a consequence of an unfavourable host-parasite interaction in which bacteria are the determinants of disease. An intense search continues for the bacteria, specific or non-specfic, that are responsible for periodontitis and various forms of the periodontal diseases have been associated with, and are widely believed to be caused by, specific bacterial groups. However, the distribution of periodontopathic bacteria is far wider than the distribution of periodontitis, indicating that the association between bacteria and periodontitis is weak. This paper proposes a paradigm for the etiology of generalized periodontitis in which ‘host’ factors are not only those triggered by bacteria (the agent) but are also those personal factors that influence the outcome of the host/parasite relationship. The personal factors that diminish the efficiency of host defence may include psycho-social stress from the social environment, factors from the lifestyle such as diet, smoking and alcoholism and systemic factors such as intercurrent disease or deficiencies within the immune inflammatory system. A model is described in which the interaction of personal factors with the social environment provides the potential for the initiation of periodontitis. Biological variation is significant and the combination of factors that cause generalized periodontitis or any other chronic disease in one individual may not result in dental or any other chronic disease in another.
(-)-Epigallocatechin gallate (EGCG), the main polyphenolic constituent of green tea, inhibits tumor promotion and chemical carcinogenesis in animal experimental systems. Here we report that the peroral administration of EGCG inhibited metastasis of B16 melanoma cell lines, such as B16-F10 and BL6, in both experimental and spontaneous systems.
The antioxidants in the aqueous phase of human plasma include ceruloplasmin, albumin (the protein itself and possibly also albumin-bound bilirubin), ascorbic acid, transferrin, haptoglobin, and hemopexin. Assays that attempt to answer the question "what is the most important antioxidant?" are compared, it being concluded that the answer is different depending on the nature of the prooxidant stress imposed in the assay.
To evaluate factors that affect the reproducibility of a semi-quantitative food frequency questionnaire used in a large prospective study we compared an extended 99-item questionnaire with a shorter, 61-item form completed by 1497 women with an interval of nine months between. Correlation coefficients for individual items assessed by the two questionnaires were highest for beverages (Spearman r = 0.70). For other foods, coefficients ranged from 0.60 to 0.70 for items eaten frequently (or habitually), to values between 0.34 and 0.45 for foods, such as sweet potatoes and ready made pie, that were eaten less frequently. For food items, the correlation between mean frequency of consumption and the reproducibility coefficient (Spearman r) was 0.51 (p less than 0.01), formally confirming that the reproducibility of measurements was positively associated with frequency of use. Pearson correlation coefficients for calorie-adjusted intakes of nutrients between the two questionnaires ranged from 0.40 for trans-fatty acids to 0.71 for vitamin E (including supplements). These correlation coefficients did not vary materially between subjects in different categories of smoking status or tertiles of age or relative weight. Moderate alcohol use had minimal effect on correlation coefficients, but reproducibility was slightly reduced among heavier drinkers. These data indicate that this self-administered dietary questionnaire can provide reproducible information about individual food and nutrient intakes which is not altered materially by age and a number of important health habits.
Collagenolytic activity was assessed in a variety of microorganisms with particular emphasis on members of the indigenous oral flora. Organisms were grown in complete and peptide depleted basal anaerobic broth. Cell sonicates and media preparations were assayed for collagenolytic activity using 14C-labelled collagen in solution and as fibrils. Assay reaction products were evaluated by acrylamide gel electrophoresis. All tested species of Bacteroides, including B. gingivalis, B, melaninogenicus ss. melaninogenicus and intermedius, B. capillus, B. oris, B. thetaiotaomicron, and B. fragilis produced collagenase which was primarily associated with the cell fraction. Collagenolytic activity was also observed in both media and cell sonicates of Actinobacillus actinomycetemcomitans, Strain 511. The Bacteroides and Actinobacillus enzymes were heat labile, inhibited by EDTA and human serum. Enzyme activity appeared to be enhanced when these organisms were grown in peptide depleted medium. Collagenase production by tested species of Bacteroides and A. actinomycetemcomitans (511) was unique among other members of the oral microflora including species of Fusobacterium, Actinomyces, Capnocylophaga, and Selenomonas, which did not demonstrate collagenolytic activity under the same cultural conditions.
Periodontal diseases comprise a heterogeneous group of infections that are difficult to distinguish on a clinical basis alone. The purpose of the present investigation was to group periodontitis subjects according to their elevated serum antibody levels to specific subgingival species. A total of 119 subjects (19-70 years) with evidence of prior periodontal destruction were monitored at 2-month intervals (maximum 8 visits), prior to therapy, using clinical parameters measured at 6 sites per tooth. The probing attachment level was measured twice at each visit, and an increase of > 2.5mm at a site was used to define subjects with progressing disease. Serum samples were obtained from each subject at each visit and the level of antibody determined by enzyme-linked immunosorbent assay to 12 subgingival species. Subgingival plaque samples were taken from the mesial aspect of all teeth in each subject at each visit, and the levels of 14 different subgingival species were determined using a colony-lift method and DNA probes. Subjects were grouped by cluster analysis of their elevated antibody levels using a simple matching coefficient. Ninety-two subjects fell into 9 clusters with 100% similarity; 29 subjects in one cluster group exhibited elevated antibody to none of the test species. Seven subjects in a second cluster group showed elevated antibody to Bacteroides forsythus. Subjects in the other 7 clusters showed elevated antibody to Actinobacillus actinomycetemcomitans serotype a only or in combination with B. forsythus, A. actinomycetemcomitans serotype b, Prevotella intermedia or Porphyromonas gingivalis.(ABSTRACT TRUNCATED AT 250 WORDS)
Few food frequency questionnaires have been evaluated for their ability to assess intakes of individual foods that may be related to disease independently of their nutrient content. The reproducibility and validity of food intake measurements by a 131-item semiquantitative food frequency questionnaire were evaluated in a sample of 127 men from the Health Professionals Follow-up Study, a large longitudinal study of diet and disease. Each subject completed two questionnaires 1 year apart and two 1-week diet records 6 months apart during the intervening year. Pearson correlations assessing reproducibility between food intakes from the two questionnaires ranged from .31 for pie to .92 for coffee (mean = .59). Validity was measured by comparing food intakes from the second questionnaire with those from the diet records. Pearson correlations corrected for within-person weekly variation in diet record data ranged from .17 for other nuts to .95 for bananas (mean = .63). Large within-person variation precluded the calculation of accurate validity correlations for 29 foods. As we previously observed in women, the foods most often overreported were fruits and vegetables, and meats and dairy products were most often underreported. With few exceptions, reasonable levels of reproducibility and validity were observed for intake of individual foods in this extensive food frequency questionnaire.
A major purpose of this study was to examine inhibitory effect of the catechin derivatives from Japanese green tea Camellia sinensis on collagenase activity. The crude tea catechins, which contain (+)-catechin (C), (-)-epicatechin (EC), (+)-gallocatechin (GC), (-)-epigallocatechin (EGC), (-)-epicatechin gallate (ECg), and (-)-epigallocatechin gallate (EGCg), were tested for their ability to inhibit the prokaryotic and eukaryotic cell derived collagenase activities. Among the tea catechins tested, ECg and EGCg showed the most potent inhibitory effect on collagenase activity when an optimal concentration of tea catechins (100 micrograms/ml) was added to reaction mixture containing collagenase and collagen. Preincubation of collagenase with tea catechins reduced the collagenase activity as well. In contrast to ECg and EGCg, the other four tea catechins (C, EC, EGC, and GC) did not show any collagenase inhibitory effect. Our results suggest that the steric structure of 3-galloyl radical is important for the inhibition of collagenase activity. The collagenase activity in the gingival crevicular fluid from highly progressive adult periodontitis was completely inhibited by the addition of tea catechins. These results demonstrated that tea catechins containing galloyl radical possess the ability to inhibit both eukaryotic and prokaryotic cell derived collagenase.