Wine polyphenols could fend off bacteria that cause cavities and gum disease

Sipping wine is good for your colon and heart, possibly because of the beverage's abundant and structurally diverse polyphenols. Now researchers report in ACS' Journal of Agricultural and Food Chemistry that wine polyphenols might also be good for your oral health.

Traditionally, some health benefits of polyphenols have been attributed to the fact that these compounds are antioxidants, meaning they likely protect the body from harm caused by free radicals. However, recent work indicates polyphenols might also promote health by actively interacting with bacteria in the gut. That makes sense because plants and fruits produce polyphenols to ward off infection by harmful bacteria and other pathogens. M. Victoria Moreno-Arribas and colleagues wanted to know whether wine and grape polyphenols would also protect teeth and gums, and how this could work on a molecular level.

The researchers checked out the effect of two red wine polyphenols, as well as commercially available grape seed and red wine extracts, on bacteria that stick to teeth and gums and cause dental plaque, cavities and periodontal disease. Working with cells that model gum tissue, they found that the two wine polyphenols in isolation -- caffeic and p-coumaric acids -- were generally better than the total wine extracts at cutting back on the bacteria's ability to stick to the cells. When combined with the Streptococcus dentisani, which is believed to be an oral probiotic, the polyphenols were even better at fending off the pathogenic bacteria. The researchers also showed that metabolites formed when digestion of the polyphenols begins in the mouth might be responsible for some of these effects.

Guidelines for fluoride intake -- Are they appropriate?

The appropriate use of fluoride has transformed oral health over the past 70 years, in part due to the guidelines created for fluoride intake. Recently, researchers are questioning these longstanding guidelines which served as advisory recommendations for decades. This issue of Advances in Dental Research, an e-Supplement to the Journal of Dental Research (JDR), presents the proceedings of a symposium at the 95th General Session of IADR in San Francisco, USA and includes reviews that critically examine the current guidelines for fluoride intake.

Since the benefits of fluoride in drinking water were first recognized, it has been accepted that fluoride is ingested and that remains the basis for automatic delivery. However, sources of ingested fluoride have changed and in parallel the prevalence and severity of dental caries and dental fluorosis have changed, leading to the idea that it is time to re-visit guidance on fluoride intake. Optimum fluoride intake should balance the prevention of dental caries with minimizing the occurrence of undesirable dental fluorosis.

"Guidelines for fluoride intake were first proposed when water was the only important source of fluoride. Now, there is a variety of ways of delivering fluoride and it was time to review these guidelines, considering current knowledge of the balance of benefit and risk," said guest editor Andrew Rugg-Gunn, Newcastle University, UK and the Borrow Foundation. "Experts from around the world gave reassurance that the current optimum range of fluoride intake is soundly based and that there is good evidence for raising the upper limit of fluoride intake. With the increase in the use of fluoride for preventing caries in adults, different guidance should be given for fluoride intake in adults compared with infants and young children."

"While changes to current guidance on adequate intake and upper limit of fluoride intake have not been settled, it was agreed that there are strong grounds for reconsidering current guidelines," said IADR President Angus William G. Walls, University of Edinburgh, who also contributed to this issue. "Further research and international discussion is needed to answer the question posed by the title of this symposium."

Importantly, the symposium prioritized the following research gaps:

What level of dental fluorosis is acceptable to populations globally given the benefit of caries reduction?
What is the best method for measuring total fluoride intake and exposure?
What is the best way to estimate total fluoride intake in children from birth to 3 to 4 y of age exposed to fluoridated or nonfluoridated water or fluoridated salt?
What is the best method to evaluate the patterns of fluid intake of children across different zones with different outdoor air temperatures?
Do we need periodical analyses of fluoride concentrations in infant formula, bottled water, and infant foods?
Do we need to validate biomarkers of exposure to fluoride?
What is the effect of different types of exercise on the metabolism of fluoride?
What is the relationship between gene polymorphisms and enamel fluorosis?
What is the relationship between malnutrition and enamel fluorosis?
Is supplementation with calcium helpful to reduce enamel fluorosis?
What are the pre-eruptive effects of fluoride on caries progression into dentin?
What is the efficacy of low-fluoride toothpastes whose formulations have been modified to increase the anticaries efficacy?
These reviews, as well as summary of the discussion during the symposium, are included in this issue of Advances in Dental Research, an e-supplement to the Journal of Dental Research.

Lack of guidance may delay a child's first trip to the dentist

IMAGE: What age kids should start dentist visits? view more 

Credit: C.S. Mott Children's Hospital National Poll on Children's Health.

Without a doctor or dentist's guidance, some parents don't follow national recommendations for early dental care for their children, a new national poll finds.


One in 6 parents who did not receive advice from a health care provider believed children should delay dentist visits until age 4 or older - years later than what experts recommend - according to this month's C.S. Mott Children's Hospital National Poll on Children's Health.

The American Academy of Pediatrics and the American Dental Association both recommend starting dental visits around age one when baby teeth emerge.

"Visiting the dentist at an early age is an essential part of children's health care," says Mott poll co-director Sarah Clark. "These visits are important for the detection and treatment of early childhood tooth decay and also a valuable opportunity to educate parents on key aspects of oral health."

"Our poll finds that when parents get clear guidance from their child's doctor or dentist, they understand the first dental visit should take place at an early age. Without such guidance, some parents turn to family or friends for advice. As recommendations change, they may be hearing outdated information and not getting their kids to the dentist early enough."

The nationally representative poll is based on responses from 790 parents with at least one child aged 0-5.

More than half of parents did not receive guidance from their child's doctor or a dentist about when to start dentist visits. Among parents who were not prompted by a doctor or dentist, only 35 percent believed dentist visits should start when children are a year or younger as is recommended.

Over half of parents (60 percent) reported their child has had a dental visit with most parents (79 percent) believing the dentist visit was worthwhile.

Among the 40 percent of parents whose child has not had a dental visit, common reasons for not going were that the child is not old enough (42 percent), the child's teeth are healthy (25 percent), and the child would be scared of the dentist (15 percent).

Experts say starting dental visits early helps set children up for healthy oral hygiene, with parents learning about correct brushing techniques, the importance of limiting sugary drinks, and the need to avoid putting children to bed with a bottle.

Early childhood caries (dental decay in baby teeth) may also be detected at young ages, allowing for treatment of decay to avoid more serious problems. In young children with healthy teeth, dentists may apply fluoride varnish to prevent future decay.

A quarter of parents who had delayed dental visits said their child's teeth are healthy but Clark notes it is unlikely that a parent could detect early tooth decay.

"Parents may not notice decay until there's discoloration, and by then the problem has likely become significant," she says. "Immediate dental treatment at the first sign of decay can prevent more significant dental problems down the road, which is why having regular dentist visits throughout early childhood is so important."

Another factor that may delay dental care is that healthcare recommendations for early childhood are often focused on well-child visits with medical providers, Clark notes.

"Parents hear clear guidelines on when they should begin well-child visits for their child's health and often schedule the first visit before they even bring their baby home from the hospital. Doctors typically prompt parents to stick to a standard schedule for immunizations and other preventive care," she says.

"Parents get much less guidance, however, on when to start taking their child to the dentist, with less than half saying they have received professional advice. This lack of guidance may mean many parents delay the start of dental visits past the recommended age."

Parents with higher income and education, and those with private dental insurance, were more likely to report that a doctor or dentist provided guidance on when to start dental visits.

"Our poll suggests that families who are low-income, less educated, and on Medicaid are less likely to receive professional guidance on dental care. This is particularly problematic because low-income children have higher rates of early childhood tooth decay and would benefit from early dental care," Clark says.

"Providers who care for at-risk populations should dedicate time to focus on the importance of dental visits. Parents should also ask their child's doctor or their own dentist about when to start dentist visits and how to keep their child's teeth healthy."