Apple phenolic compounds enhance dental remineralization in human: a multifactorial in situ study

INTRODUCTION: Excessive consumption of sugar-sweetened beverages is a major contributor to dental caries and a global public health concern due to its negative effects on oral health. Phenolic compounds found in edible plants have shown promising effects on caries prevention. Several studies indicate that these bioactive substances can inhibit caries formation through various mechanisms. However, studies which consider the complex interplay of the various factors are missing. In particular, human studies on the caries reducing effects of phenolic compounds in the co-presence of fermentable sugars are lacking. OBJECTIVE: This human intervention study investigated the effect of daily consumption of an apple juice-based drink enriched with phenolic compounds on caries development, compared to the exact same drink without phenolic compounds. METHODS: 30 healthy male participants were enrolled in a double-blind, randomized, cross-over design. Caries development was measured using lesion depth in bovine tooth enamel samples installed in a removable dental appliance. A mixed model was used to analyze the data, including treatment effects, various oral parameters and interaction terms. RESULTS: The analysis showed that consumption of the drink enriched with phenolic compounds resulted in a significant reduction in enamel lesion depth compared to the control, after adjustment for oral parameters and their interactions. CONCLUSION: Enrichment of phenolic compounds could be a promising strategy to mitigate the cariogenic effects of fermentable sugars in beverages. Analyzing the complex interactions between the oral parameters and treatment we bridge the translational gap of in vitro studies and achieve physiological relevance.