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ABSTRACT
Gingivitis is one of the most common oral infections in humans. While sugar alcohols such as erythritol are suggested to have caries-preventive properties, it may also have beneficial effects in prevention of gingivitis by preventing maturation of oral biofilms. The aim of this study was to assess the effect of erythritol on the microbial ecology and the gingivitis phenotype of oral microcosms. Biofilms were inoculated with stimulated saliva from 20 healthy donors and grown in a gingivitis model in the continuous presence of 0 (control group), 5, and 10% erythritol. After 9 days of growth, biofilm formation, protease activity (gingivitis phenotype), and microbial profile analyses were performed. Biofilm growth was significantly reduced in the presence of erythritol, and this effect was dose dependent. Protease activity and the Shannon diversity index of the microbial profiles of the biofilms were significantly lower when erythritol was present. Microbial profile analysis revealed that presence of erythritol induced a compositional shift from periodontitis- and gingivitis-related taxa toward early colonizers. The results of this study suggest that erythritol suppresses maturation of the biofilms toward unhealthy composition. The gingivitis phenotype was suppressed and biofilm formation was reduced in the presence of erythritol. Therefore, it is concluded that erythritol may contribute to a healthy oral ecosystem in vitro.
ARTICLE HISTORY
Received 20 December 2016
Accepted 16 May 2017
KEYWORDS
In vitro oral biofilms; gingivitis; microbiome; polyol; biofilm maturation; biofilm phenotype
Introduction
In the oral cavity, two major plaque-induced diseases occur: dental caries and gingivitis. Caries is a consequence of frequent consumption of dietary fermentable sugars. This leads to frequent and prolonged periods of acid production by microbes residing in dental plaque. Acid production by dental plaque can result in dissolving the hard tissues in the oral cavity and tooth decay [1]. Gingivitis is inflammation of the gums. When left untreated, prolonged periods of inflammation can ultimately lead to periodontitis, which is the progressive loss of the alveolar bone surrounding the teeth [2-4].
Oral diseases can be prevented by good oral hygiene, including the use of fluoride, combined with a lower frequency of dietary fermentable sugar consumption [5,6]. In addition, replacement of dietary fermentable sugars by artificial sweeteners, such as sugar alcohols, has been suggested to have a caries-preventive effect [7]. Polyol...