Polyphenols in Oral Health: Homeostasis Maintenance, Disease Prevention, and Therapeutic Applications

Abstract

Polyphenols, a class of bioactive compounds with phenolic structures, are abundant in human diets. They have gained attention in biomedical fields due to their beneficial properties, including antioxidant, antibacterial, and anti-inflammatory activities. Therefore, polyphenols can prevent multiple chronic or infectious diseases and may help in the prevention of oral diseases. Oral health is crucial to our well-being, and maintaining a healthy oral microbiome is essential for preventing various dental and systemic diseases. However, the mechanisms by which polyphenols modulate the oral microbiota and contribute to oral health are still not fully understood, and the application of polyphenol products lies in different stages. This review provides a comprehensive overview of the advancements in understanding polyphenols' effects on oral health: dental caries, periodontal diseases, halitosis, and oral cancer. The mechanisms underlying the preventive and therapeutic effects of polyphenols derived from dietary sources are discussed, and new findings from animal models and clinical trials are included, highlighting the latest achievements. Given the great application potential of these natural compounds, novel approaches to dietary interventions and oral disease treatments may emerge. Moreover, investigating polyphenols combined with different materials presents promising opportunities for developing innovative therapeutic strategies in the treatment of oral diseases.

Keywords: functional food; halitosis; oral cancer; oral caries; oral microbiota; periodontal diseases; polyphenols.

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Flowchart of the search strategy and the literature selection process.

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Polyphenols in dental caries, periodontal diseases, halitosis, and oral cancers. In dental caries, polyphenols have been investigated for their antibacterial properties, effectively suppressing bacterial growth and adhesion. They also inhibit glycosyltransferase enzyme (GTF) activity, reduce the cariogenic impact of exopolysaccharides (EPS), and disrupt biofilm formation. In conditions involving inflammation, bleeding, and gum recession, polyphenols offer antimicrobial effects, enhance immunomodulation, and exhibit anti-inflammatory properties. They help mitigate oxidative stress, a critical factor in periodontal diseases. For halitosis, polyphenols possess antibacterial and antioxidant properties. In the meantime, they help reduce the volatile sulfur compounds (VSC), the primary source of halitosis. Regarding oral cancers, polyphenols have a multifaceted impact on oral cancer cells, including the inhibition of growth and division, decreased invasion and migration, enhanced apoptotic activity, and reduced expression of inflammatory cytokines such as IL-1β, IL-6, and IL-8. The small blue arrows indicate the upregulation/promotion or downregulation/inhibition of the biomarkers or behaviors.

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Current approaches and prospects of polyphenols-based oral hygiene. Diverse strategies are employed in polyphenols-based oral hygiene, ranging from conventional methods to cutting-edge developments in biomaterials. Current approaches include widely-used products for routine cleaning, e.g., toothpaste and mouthwash; saliva stimulation, e.g., chewing gum and lozenges; or even polyphenols-containing gels and tinctures. Emerging trends include the development of hydrogels, human-like collagen, and other new biomaterials, such as nanoparticles, programmed core-shell nanofibers, and ceramic granulated biomaterials.