RESUMEN
Aims and Objective: Sugar is not only associated with dental diseases but also, along with carbohydrates, is linked to various health issues including obesity, cancer, diabetes, heart, liver, and kidney-related diseases. At the same time, a polyphenol present in unrefined sugar and starch (UReSS) is shown to inhibit microbial growth and prevent biofilms and dental plaque. The question arises, "is sugar the causative agent for dental diseases, or is its refined form the cause?" The objective of this study is to conduct in-vivo studies of the impact of refined and unrefined sugar and starch on the microbiota of dental biofilm. Materials and Methods: An in-vivo study was performed using saliva and dental biofilm samples collected from 75 healthy subjects. For this study, healthy volunteers (n = 75) were randomly divided into five groups and were given sweet meals either made with refined white sugar and white rice (ReSS) or with unrefined brown sugar and red rice (UReSS). This was followed by using or not using a polyphenolic mouthwash. Before and after 4 h of eating a sweet meal, the saliva and dental plaque were collected and the DNA was analyzed by 16s metagenomic sequencing. The results were expressed in fold change of bacteria from 0 to 4 h. Statistical analyses have been performed by logarithmic linear discriminant analysis (LDA), Student's t-test, and Wilcoxon signed-rank test. Results: Upon LEfSe and statistical analysis, in-vivo experiments clearly showed that UReSS significantly decreased bacteria associated with dental diseases. In contrast, ReSS showed a significant increase in Actinomyces, Streptococcus, and Selenomonas with a high LDA score (Log 4.2) and statistical significance (P < 0.003). Mouthwash significantly decreased bacterial taxa associated with diseases in both the ReSS and UReSS groups. The in-vivo study showed a significant increase and decrease in Streptococcus levels in refined and unrefined sugar groups, respectively. Conclusion: In conclusion, polyphenols aid in the prevention of dental caries. This study recommends using polyphenol-rich unrefined sugars and carbohydrates for both oral and general health. This study is the first of its kind to bring awareness to the effects of refined and unrefined starch and sugars on the oral microbiota.
RESUMEN
AIM: Dental diseases can be prevented by reducing early bacterial colonization in biofilm, a precursor to mature dental plaque. Most studies on dental disease pathogenesis focus on mature plaque and fail to address the impact of oral cleaning on biofilm formation. Here we used next-generation metagenomics to assess the effects of a new method of regular, simple biofilm disruption on the oral metagenome. MATERIALS AND METHODS: This was a randomized, controlled study of 45 healthy children divided into three groups. Participants avoided oral cleaning for 3 days and then performed 10 days of oral cleaning either by: (1) brushing and tongue cleaning twice a day (BT) with toothpaste; (2) Gum and tooth rubbing with Index Finger Tongue cleaning and water Swishing (GIFTS) after each meal, snack, and drink; or (3) GIFTS twice a day with nano-charcoal and tongue cleaning (CT) (n = 15 per group). Saliva, plaque, and tongue scraping samples were collected on day 0 and 10 for quantitative polymerase chain reaction (qPCR) and next-generation metagenomics sequencing to analyze microbiome taxa differences between groups. RESULTS: GIFTS more significantly reduced (P < 0.004) total bacteria in saliva than BT (P < 0.02). Metagenomics revealed a significant reduction in Firmicutes in GIFTS and CT tongue samples compared to BT samples. BT and CT saliva samples showed significantly more Streptococcus species than GIFTS saliva samples. In the plaque samples, GIFTS cleaning significantly reduced early colonizers, including Streptococcus, compared to the BT and CT methods. CONCLUSION: Here, we introduce the "frequent disruption of biofilm" concept for enhanced oral hygiene. GIFTS can be used to prevent early bacterial colonization of biofilm and plaque formation in both small children and adults. Frequent biofilm disturbance more effectively disrupts early bacterial colonization than twice oral cleaning, is nonabrasive, and is, therefore, a practical and straightforward complement to regular toothbrushing for improved oral hygiene and disease prevention.
