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Milk Products in Dental Health: Summary of Evidence
For more than 50 years, many studies have consistently provided evidence for the benefits of milk and milk products on dental health.
Highlights
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Synopsis
Studies to date have demonstrated that milk and milk products play a key role in preventing adverse dental issues such as dental caries and periodontitis (inflammation of gum tissue around the teeth).1,2
Additionally, in human trials, milk has been shown to be essentially “tooth-friendly,” and its consumption does not increase plaque acidity.1
Studies on milk and periodontal health also indicate that a low dietary intake of calcium resulted in more severe periodontal disease, whereas increased calcium and vitamin D intake seemingly yielded protective effects against tooth loss.2
The Evidence
In a comprehensive review, the relationship between dairy intake and health outcomes was assessed among children and adolescents in developed countries. With regard to dental health, the authors found the following:3
- Out of 11 observational studies examined, all found an inverse association between dairy intake and dental caries;
- Several studies observed that yogurt and cheese consumption specifically was inversely associated with dental caries.
Findings from the Danish European Youth Heart Study Follow-Up Study also suggest that previous dairy intake among children and adolescents may predict the future risk of dental caries.4
- Dairy intake at 9 years old was associated with fewer dental caries experiences from 9 to 12 years, as well as from 9 to 15 years;
- Calcium, whey and casein intake was associated with lower caries incidence over 3 and 6 years of follow-ups.
As well, in the Danish Monitoring Trends and Determinants in Cardiovascular Disease study, Adegboye et al. investigated how the source of dietary calcium intake (dairy vs. non-dairy calcium) may affect tooth loss among men and women.5
- The intake of calcium from dairy sources was associated with a reduced risk of tooth loss in both men and women;
- No association was observed between non-dairy calcium intake and tooth loss.
Regarding chocolate milk and other flavoured milk products (such as sugar and fruit juice sweetened milk products), a 2001 review paper indicated that their cariogenic load is negligible to low and that they are a preferable alternative to similarly sweetened soft drinks.6
Potential Mechanisms
Cheese
Cheese has a cariostatic effect by efficiently increasing the concentration of calcium in saliva and plaque.1 Several studies have demonstrated that cheese consumption, especially aged cheese, after or before exposure to sugary foods prevents a drop in plaque pH and has enamel-protective effects.2
Yogurt
There is evidence to indicate that yogurt consumption decreases the number of salivary mutans streptococci as well as lactobacilli, which are often found in dental plaque.7
Caseins
Caseins, which account for the largest percentage of milk proteins (80%), contain bioactive peptides. They are thought to have a beneficial effect on cariogenesis via two mechanisms:1
- Prevention of demineralization;
- Inhibition of bacterial attachment and/or biofilm formation.
A complex of casein phosphopeptide and amorphous calcium phosphate is formed upon digestion of milk and inhibits dental caries lesions by increasing the level of amorphous calcium phosphate in dental plaque so as to depress enamel demineralization and enhance remineralization.8
The adherence of oral bacteria to saliva-coated hydroxylapatite in tooth enamel has been found to be inhibited by three milk-derived compounds, namely casein phosphopeptide, sodium caseinate and glycomacropeptide.8
Lactoferrin
It has been shown that the bovine milk protein, lactoferrin, inhibits the aggregation and adherence of Streptococcus mutans (S. mutans), the main bacteria involved in dental caries, to salivary film.9
Probiotics
Some studies have shown that probiotics in milk products reduced S. mutans counts, possibly by modifying the composition of salivary film and preventing bacterial adhesion.10
Conclusion
There is consistent scientific evidence that milk and milk products are beneficial to dental health due to the bioactive peptides they contain.
More studies are needed to determine the association between milk products and dental health among children, as well as that between calcium intake and periodontitis.
Further studies are needed to find out whether there is a difference in the benefits provided by unsweetened and sweetened varieties of milk products.
Moreover, additional research on the contribution of probiotics to dental health is also needed.
References
- Merritt J et al. Milk helps build strong teeth and promotes oral health. J Calif Dent Assoc 2006;34:361-366.
- Kashket S and DePaola DP. Cheese consumption and the development and progression of dental caries. Nutr Rev 2002;60:97-103.
- Dror DK and Allen LH. Dairy product intake in children and adolescents in developed countries: trends, nutritional contribution, and a review of association with health outcomes. Nutr Rev 2014;72:68-81.
- Lempert SM et al. Association between dairy intake and caries among children and adolescents. results from the Danish EYHS follow-up study. Caries Res 2015;49:251-258.
- Adegboye AR et al. Intake of dairy calcium and tooth loss among adult Danish men and women. Nutrition 2012;28:779-784.
- Levine RS. Milk, flavoured milk products and caries. Br Dent J 2001;191:20.
- Petti S et al. A randomized clinical trial of the effect of yoghurt on the human salivary microflora. Arch Oral Biol 2001;46:705-712.
- Aimutis WR. Bioactive properties of milk proteins with particular focus on anticariogenesis. J Nutr 2004;134:989S-995S.
- Oho T et al. A peptide domain of bovine milk lactoferrin inhibits the interaction between streptococcal surface protein antigen and a salivary agglutinin peptide domain. Infect Immun 2004;72:6181-6184.
- Stamatova I and Meurman JH. Probiotics: health benefits in the mouth. Am J Dent 2009;22:329-338.
Keywords: dental health , tooth decay , casein , peptides , bioactive peptides , calcium , flavoured milk , chocolate milk
