Can Cranberry Juice Help Protect Your Teeth? A Study Explores Its Potential

Kristin Baumann
NUTR 8104: Advanced Normal Nutrition
Nutrition for a General Audience: Article Summary
Dr. Satya S. Jonnalagadda
December 7, 2024

Dental caries, or tooth decay, remains a widespread public health concern. The Global Burden of Disease (GBD) study published in 2020 reported 2.3 billion cases of untreated dental caries in permanent teeth and 532 million untreated caries in primary (or baby) teeth. Fluoride has been the standard in preventing tooth decay since the 1930s; however, some people avoid it due to safety concerns and may seek natural alternatives. One such alternative that is gaining attention is cranberry juice. Cranberry juice may offer a natural way to protect teeth by targeting the bacteria that cause cavities. A 2021 study explored whether cranberry juice and a cranberry-based beverage could help combat tooth decay.

What causes tooth decay?

Dental caries is the single most common and preventable oral disease worldwide. In its simplest definition, dental caries is a weakened area of the tooth. Dental caries results from the interaction between specific bacteria and elements of the diet, where mineral components are removed from the tooth, and the tooth structure begins to dissolve. This harmful process causes a soft tooth surface, commonly known as a cavity.

The disease process of dental caries requires a susceptible tooth, microorganisms, and fermentable carbohydrates (or simple sugars) for decay to occur. Dental plaque contains many microorganisms; however, Streptococcus mutans is the most prominent cariogenic (or caries-producing) bacteria in the mouth. S. mutans, as the primary contributor, is highly acidogenic (or acid-producing) and acid-tolerant.

Immediately after tooth brushing, a thin layer called the acquired pellicle forms on the tooth surface. This layer consists mainly of salivary proteins that provide a foundation for bacteria to stick to. Bacteria stick to the pellicle using specific proteins called adhesins that bind to receptors on the tooth surface. Plaque is a sticky, colorless film of bacteria that constantly forms on the teeth. The plaque is composed of around 700 distinct microbial species, predominantly bacteria, with a few yeasts and viruses present. A matrix forms from a combination of bacteria, saliva, and other fluids, which facilitates the circulation of nutrients and waste products among the microbial community. When fermentable carbohydrates like sugar are consumed, they fuel bacterial metabolism. Microorganisms, notably S. mutans, break down these sugars to produce lactic acid. Lactic acid production decreases the pH of the mouth and gradually breaks down the tooth enamel (the hard, protective outer layer of the teeth).

Over time, repeated acid attacks from lactic acid production cause the breakdown of the enamel's mineral structure, mainly releasing calcium and phosphate ions. Early tooth damage, known as demineralization, can sometimes be reversed through remineralization, where minerals like calcium and phosphate are restored to the enamel. However, if left unchecked, this process leads to the development of dental caries or cavities.

The role of cranberry juice in oral health

Cranberries are well known for their ability to help prevent urinary tract infections. Recent research suggests that cranberries may be beneficial for oral health. Cranberries contain compounds called proanthocyanidins, which are believed to have antimicrobial properties. These compounds can prevent harmful bacteria from sticking to teeth and forming biofilms. A 2021 study established that S. mutanswas susceptible to the antimicrobial activity of cranberry juice. More recent research published in 2024 has shown that cranberry-based mouth rinse can inhibit the ability of S. mutans from sticking to teeth, potentially preventing the formation of cavities. Additionally, theydemonstrated that cranberries are as effective as fluoride in reducing S. mutans collection. Another study of 60 childrenwith at least one cavity found that combining cranberry extract with pre- and probiotics containing a strain of lactic acid bacteria (Ligilactobacillus salivarius) commonly found in the mouth and gut may prevent the progression of early caries in caries-active children. L. salivarius is known for its potential health benefits, particularly in maintaining a healthy microbial balance in the mouth and gut.

What does this mean for your teeth?

These studies support the idea that cranberry juice may help protect your teeth from decay. The proanthocyanidins in cranberry juice may reduce S. mutan's ability to stick to your teeth and form biofilms, thus stopping decay. So, cranberry juice may be a beneficial addition to oral health routines, especially for people who prefer natural or herbal remedies over fluoride.

Conclusion

Dental caries is preventable, and while fluoride remains the cornerstone of cavity prevention, cranberry juice may offer an interesting natural alternative. The antimicrobial properties of cranberry juice show the potential to inhibit the harmful bacteria that contribute to cavities. This could provide a safe and natural option for those who want to avoid fluoride. As always, maintaining good oral hygiene habits – brushing, flossing, and regular dental checkups – remains essential for optimal oral health.

So, the next time you reach for a glass of cranberry juice, you might be doing more than quenching your thirst – you might be giving your teeth a little extra protection against cavities!

References

GBD 2017 Oral Disorders Collaborators, Bernabe, E., Marcenes, W., Hernandez, C. R., Bailey, J., Abreu, L. G., Alipour, V., Amini, S., Arabloo, J., Arefi, Z., Arora, A., Ayanore, M. A., Bärnighausen, T. W., Bijani, A., Cho, D. Y., Chu, D. T., Crowe, C. S., Demoz, G. T., Demsie, D. G., Dibaji Forooshani, Z. S., … Kassebaum, N. J. (2020). Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study. Journal of dental research, 99(4), 362–373. https://doi.org/10.1177/0022034520908533

National Institute of Dental and Craniofacial Research. The story of fluoridation. https://www.nidcr.nih.gov/health-info/fluoride/the-story-of-fluoridation. Accessed December 4, 2024.

Nowaczyk PM, Bajerska J, Lasik-Kurdys M, Radziejewska-Kubzdela E, Szwengiel A, Wozniewicz M. The effect of cranberry juice and a cranberry functional beverage on the growth and metabolic activity of selected oral bacteria. BMC Oral Health. 2021;21:660:1–11. doi:10.1186/s12903-021-02025-w.

Bansal, K., Shamoo, A., Mohapatra, S. et al.Comparative evaluation of cranberry extract and sodium fluoride as mouth rinses on mutans counts in children: a double-blind randomized controlled trial. Eur Arch Paediatr Dent 25, 801–809 (2024). https://doi.org/10.1007/s40368-024-00939-x

Olczak-Kowalczyk D, Turska-Szybka A, Twetman S, et al. Effect of tablets containing a paraprobiotic strain and the cranberry extract on caries incidence in preschool children: A randomized controlled trial. Dent Med Probl. Published online July 18, 2024. doi:10.17219/dmp/171895

Williams G, Stothart CI, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2023;11(11):CD001321. Published 2023 Nov 10. doi: 10.1002/14651858.CD001321.pub7

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