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of green tea in the field of oral health; still there is a need for more clinical and biological studies to support ... Senior Lecturer, Reader, Post Graduate Student .... unprocessed leaf form and do not change when processed to dry green tea.
University J Dent Scie 2016; No. 2, Vol. 1

University Journal of Dental Sciences

GREEN TEA : ENHANCING ORAL HEALTH Vikas Singh1, Kuldeep2, Ashima Bajaj,3Monika Kalra4 Senior Lecturer, 2Reader, 4Post Graduate Student 1,4 Department of Public Health Dentistry, Teerthanker Mahaveer Dental College & Research Centre, Teerthanker Mahaveer University. 2Department of Prosthodontics and Crown & Bridge, Teerthanker Mahaveer Dental College & Research Centre, Teerthanker Mahaveer University 3 Department of Periodontology, Teerthanker Mahaveer Dental College & Research Centre, TeerthankerMahaveer University 1,3

ABSTRACT : Over the past decade, teas and their molecular components have received increasing attention from researchers in human health. After water, tea is the most widely consumed and popular beverage in the world. It has a cooling effect, slightly bitter and astringent flavor which many is enjoyed by people and its medicinal properties have been widely explored. In addition, its content of certain minerals and vitamins increases the antioxidant potential of this type of tea. There is an increasing interest in the health benefits of green tea in the field of oral health; still there is a need for more clinical and biological studies to support guidelines for green tea intake as part of prevention and treatment of specific oral pathologies.

INTRODUCTION : The most popular beverages consumed worldwide is tea, from the Camellia sinensis plant. It is consumed in different forms like black , green or Oolong tea. Among all of these, consumption of green tea has the most significant effects on human health .1The Chinese have been consuming green tea for four or five thousand years. It is being consumed socially, for medicinal purpose and habitually by people since 3000 BC. It became popular in Britain in the 17th century.2 Tea is the most popular beverage in the world after water. In the last couple of years there is a growing interest in green tea in the Western world due to scientific findings that show the health potentials of the beverage.3 In recent years, the health benefits of consuming green tea, including the prevention of cancer, the anti?inflammatory, cardiovascular diseases, antiarthritic, antibacterial, antiangiogenic , antiviral, antioxidative, neuroprotective and cholesterol ? lowering effects of green tea and isolated green tea constituents are under investigation.4 GREEN TEA COMPOSITION: Chemical composition: Proteins (15- 20% dry weight) whose enzymes constitute an important fraction; Aminoacids (1-4% dry weight) such as teanine or 5-

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Keywords : Tea, Polyphenols, Oral health Source of support : Nil Conflict of interest: None

Nethylglutamine, tryptophan, glutamic acid, glycine, serine, aspartic acid, valine, leucine, threonine, tyrosine, lysine; Carbohydrates (5-7% dry weight) such as cellulose, glucose, fructose, sucrose Lipids as linolenic and linoleic acids; Sterols as stigmasterol; Vitamins (B, C, E); Xanthic bases as caffeine and theophylline ; pigments as chlorophyll and carotenoids; Volatile compounds as aldehydes, esters, lactones, hydrocarbons etc.; Minerals and trace elements (5% dry weight) such as Ca, Mg, Cr, Fe, Cu, Zn, Se, Na, P, K, Co, Sr, Ni, F and Al.5 The beneficial effects generally associated with green tea have been attributed to its polyphenol content, particularly to catechins. Catechins are a group of very active flavonoids that include (+)catechin, (+) gallocatechin, (?)epicatechin (EC) and (?)epigallocatechin (EGC), and the galloyl catechins such as (?) epicatechin gallate (ECg), (?)epigallocatechin gallate (EGCg), (?)catechin gallate (Cg) and (?)gallocatechin gallate(GCg). EGCg is in abundence, comprising about 50% of the catechin pool; EGC accounts for around 20%, ECg 13% and EC 6%. Catechins are water-soluble compounds leading to the bitterness and astringency of green tea.[6]

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University J Dent Scie 2016; No. 2, Vol. 1 BIOLOGICAL EFFECTS OF TEA Anticariogenic properties Because tea consumption has been shown to have protective effects against a variety of diseases, cancer chemopreventive effects of green tea or its polyphenols largely focused on i. Protect against mutagenicity and genotoxicity, ii. Inhibits biochemical markers of tumor initiation, iii. Inhibits biochemical markers of tumor promotion, iv. Effects on detoxification enzymes, v. Trapping of activated metabolites of carcinogens, and vi. Antioxidant and free radical scavenging activity.[7] Antiviral properties Tea catechins exhibit a protective effect against human immunodeficiency virus (HIV) infection, partly mediated by inhibiting virions to bind to the target cell surface. Kawai et al. investigated the mechanism of the anti-HIV effect of green tea polyphenols and clearly demonstrated that EGCg (but not ECG) directly binds to the cell-surface CD4 molecules.[8] Anti-fungal properties Combined treatment with catechin allows the use of lower doses of anti-mycotics and induces multiple antifungal effects. EGCG enhances the anti-fungal effect of amphotericin B or fluconazole against anti-mycoticsusceptible and resistant C. albicans. It is observed that this may avoid the side effects of anti-mycotics.[9] Antioxidant properties Antioxidant activity of green tea, as measured by different methods, is usually higher than the antioxidant activity of black tea or oolong tea.10 EGCG inhibited TPA-induced oxidative DNA base modification in HeLa cells, inhibited Cu2+ mediated oxidation of low-density lipoprotein (LDL), reduced tert-butyl hydroperoxide-induced lipid peroxidation and blocked the production of reactive oxygen species derived from NADPH-cytochrome P450-mediated oxidation of the cooked meat carcinogen, 2-amino3methylimidazo[4,5- f] quinoline. When using the oxygen radical absorbance capacity, it was seen thatgreen tea have a greater antioxidant activity than brussel sprouts, garlic, kale and spinach.[9] GREEN TEA AND ORAL HEALTH DENTAL WEAR : Tooth wear is a multifactorial condition caused by chemical (erosion) and mechanical (abrasion and attrition) processes, since the soft zone by erosion is more susceptible to mechanical forces, such as abrasion. Among the proteases that can chemically degrade the organic matrix of dentin are matrix metalloproteinases (MMPs) present in dentin and saliva 31 MMPs get activated when the pH drops in the presence of acids from cariogenic challenges. Green tea polyphenols, especially epigallocatechin-3-gallate (EGCG),

were found to have distinct inhibitory activity against MMPs. It may be concluded that the green tea reduces the dentin wear under erosive/ abrasive conditions. [11] HALITOSIS : Halitosis is the main concern for oral cavity now a days . breath odour derived from oral cavity is mainly due to by volatile sulpher compound such as H2S and CH3HS produced through the puterification activity of oral microorganisms.[12] These compounds result from the proteolytic degradation by predominantly anaerobic Gram negative oral microorganisms of various sulfur-containing substrates in food debris, saliva, blood and epithelial cells The deodorizing effect of EGCG involves a chemical reaction between EGCG and MSH. The reaction involves introduction of a methylthio and/or a methylsulfinyl group into the B ring of EGCG. During this reaction, a methylthio group is added to the orthoquinone form of the catechin generated by oxidation with atmospheric oxygen and helps in reducing halitosis. 13 There is a reduction of CH3HS concentration in mouth after intake of green tea.[12] PERIODONTAL HEALTH : Periodontal disease is a chronic disease that is prevalent in adults. The progression and incidence of periodontal disease is related causally to periodontal pathogens, and to various host and environmental factors. Several in vitro studies have suggested that green tea catechins, such as (-)epigallocatechin gallate (EGCg), inhibit periodontal pathogens and the destruction of periodontal tissue. 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 nigrescens and Prevotella intermedia and the adherence of P. gingivalis on human buccal epithelial cells. Green tea catechins with the steric structures of 3-galloyl radial, EGCg, (-)-epicatechin gallate (ECg), and (-)gallocatechin gallate, are the major tea polyphenols,which inhibit toxic end metabolites production of P. gingivalis.14 Oxidative stress plays an important role in the pathogenesis of periodontal disease and many other disorders. It is believed that it can defend against inflammatory diseases due to its antioxidant property. The periodontal pathogens produce matrix metalloproteinases (MMPs) and exhibit collagenase activity. The green tea catechins have been shown to inhibit the collagenase activity.[15] Nakamura et al. (2009) have demonstrated that green tea catechins had inhibitory effect on osteoclastic bone resorption and osteoclast formation either by suppression of LPSinduced alveolar bone resorption or by blocking interleukin-1 production.[16]

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University J Dent Scie 2016; No. 2, Vol. 1 DENTAL CARIES : Tea leaves are rich in fluoride, so they are likely to enhance dental health and prevent dental caries. Among hundreds of microorganisms in the oral cavity, only the cariogenic streptococci, especially Streptococcus mutans, play an important role in causing dental caries. Several green tea polyphenols have preventative effects on dental caries Cariogenic bacteria synthesize water-soluble and - insoluble glucans using glucosyltransferase (GTase). Highly branched glucans are responsible for bacterial cell adherence to the tooth surface (Hamada and Slade, 1980). ECG, GCG and EGCG strongly inhibit GTase and inhibit adherence of the bacteria to dental surfaces13. These phytochemicals have various actions. The alkaloids interfere with microbial cell division, where as flavonoids possess antiglucosyltransferase activity and inhibit bacterial adherence. Tannins, on the other hand, inhibit bacterial growth with their strong iron binding capacity and also inhibit glucosyl transferase activity and bacterial adhesion. It has been seen that tea polyphenols do not effect on de/remineralization of enamel blocks, rather tea polyphenols exert an anti-caries effect via an antimicrobial mode of action. Green tea has been recommended for its various health benefits, including its anticariogenic effects.[17]

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14. CONCLUSION : This review shows that tea has a high level of antioxidant activity. Polyphenols of green tea exist as catechins in unprocessed leaf form and do not change when processed to dry green tea. Humans that have tea compounds in their drinking water develop fewer dental caries and less plaque formation. Halitosis is decreased with the consumption of green tea. Green tea is an important product in enhancing oral health and overall health. REFERENCES : 1. ChackoSM, Thambi PT, Kuttan R , Nishigaki I. Beneficial effects of green tea: A literature review. Chinese Medicine 2010; 5:13. 2. Anand K, Mariyam I A , Srivastava R K , Wadhwani P , Khanna R . Green Tea (A Natural Herb): Future Perspects in Medicine & Dentistry. International Ayurvedic Medical Journal 2013; 1( 6) : 223-231. 3. Narotzki B, Reznick A Z , Aizenbud D, Levy Y .Green tea: A promising natural product in oral health .a r c h i v e s o f o r a l b i o l o g y 2 0 1 2 ;57: 4 2 9 - 4 3 5. 4. Gupta D , Bhaskar D J , Gupta R K ,Gupta V, Agali C , Punia H , Karim B , Jain A. Green tea? boon for oral health .Int.J.A.PS.BMS 2013;2(2): 112?119. 5. Cabrera C , Artacho R , Gimenez R . Beneficial Effects of Green Tea- A Review. Journal of the American College of Nutrition 2006 ;25(2 ): 79-99. 6. Soni S , Jain P, Chaudhary V K . "Benificial effects of polyphenolic beverage on oral and Periodontal health".

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Journal of contemporary dental sciences; 1 (1): 33-41. Mukhtar H and Ahmad N. Tea polyphenols: prevention of cancer and optimizing health1- Am J Clin Nutr 2000;71:1698S-1702S. Cooper R , Morre J , Morre D M . Medicinal Benefits of Green Tea: Part I. Review of Noncancer Health Benefits. The journal of alternative and complementary medicine 2005; 11(3): 521-528 Sinija V. R., Mishra H. N. Green tea: Health benefits. Journal of Nutritional & Environmental Medicine 2008; 17(4): 232-242 Yashin A , Yashin Y, Nemzer B . Determination of Antioxidant Activity in Tea Extracts, and Their Total Antioxidant Content. American Journal of Biomedical Sciences 2011; 3(4): 322-335 Kato M T, Magalhães A C, Rios D, Hannas A R, Attin T, Buzalaf M A R . Protective effect of green tea on dentin erosion and abrasion. J Appl Oral Sci 2009; 17(6):560-4 Lodhia P ,Yeagaki K. Effects of green tea on volatile sulfer compounds in mouth air.Journal of nutritional science and vitaminology 2008;54:89-94. Arab H, Maroofian A , Golestani S, shafaee H , Sohrabi K and Forouzanfar A. Review of The therapeutic effects of Camellia sinensis (green tea) on oral and periodontal health. Journal of Medicinal Plants Research; 5(23): 5465-5469. Kushiyama M, Shimazaki Y, Murakami M , YamashitaY . Relationship between Intake of Green Tea and Periodontal Disease. Journal of Periodontology 2009;80:372-377. Deshpande N, Deshpande A , Mafoud S. Evaluation of intake of green tea on gingival and periodontal status: An experimental study. Journal of Interdisciplinary Dentistry 2012 ; 2(2 ) :108-112. Nakamura H, Ukai T, Yoshimura A, Kozuka Y, Yoshioka H, Yoshinaga Y, et al. Green tea catechin inhibits lipopolysaccharideinduced bone resorption in vivo. Journal of Periodontal Research 2010;45:23-30. Subramaniam P, Eswara U, Maheshwar Reddy KR. Effect of different types of tea on Streptococcus mutans: An in vitro study. Indian J Dent Res 2012; 23: 43-8.

CORRESPONDING AUTHOR: Dr. Vikas Singh Senior Lecturer Department of Public Health Dentistry, Teerthanker Mahaveer Dental College & Research Centre Teerthanker Mahaveer University Moradabad -244001 Email : [email protected]

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