18 Journal of Indian Society of Periodontology - Vol 15, Issue 1, Jan-Mar 2011

Address for
correspondence:
Dr. Babu Venkateswara,
Narayana Dental
College and Hospital,
Chinthareddypalem,
Nellore - 524002, Andhra
Pradesh, India.
E-mail: drvenki_babu@
yahoo.co.in
Submission: 05-04-2010
Accepted: 17-01-2011
Department of
Periodontics, Narayana
Dental College and
Hospital, Nellore,
Andhra Pradesh, India
INTRODUCTION
F
ood stuff can be regarded functional if
they satisfactorily demonstrate to affect
beneficially one or more target functions in
the body, beyond adequate nutritional effects
to maintain health or reduction of risk of
disease. Green tea has been proved to have
many functional properties and at present its
consumption is widely recommended.
[1-3]

Green tea is widely consumed in China,
Japan, Korea, and Morocco.
[1,4]
It has been
considered as a healthy beverage since ancient
times. The traditional Chinese medicine has
recommended this plant for headaches, body
aches, general pain, digestion, depression, as
an energizer, and in general to prolong life.
[5]

Green tea also has many oral health benefts.
It has cognitive function and positive impact
on bone density, caries, periodontal disease,
and diabetes.
[6]
Since few years numerous epidemiological
and clinical studies have revealed several
physiological responses to green tea that may be
relevant in promoting health and preventing or
treating some chronic diseases.
[5]
HISTORY
The word tea has been used to describe the
shrub camellia sinensis.
[7]
It is the second most
consumed beverage in the world aside from
water, coffee, and carbonated soft drinks.
[8]

Tea originated in China as long as 2700 BC
and became popular worldwide due to its
economic and therapeutic aid in many illnesses.
[7]

Approximately 7678% of the tea produced and
consumed is black tea, 2022% is green tea,
and <2% is oolong tea.
[1]
The fresh leaves of
the tea plant are picked as two and a bud
for processing (also termed Flush). Green tea
is obtained by macerating and heat drying
this flush, whereas black tea is derived by
fermentation of fush before heat drying. Both
types of tea share many pharmacologically
active components although at variable
concentrations.
[7]
COMPOSITION OF THE GREEN TEA
The chemical composition of green tea is
complex. The components are illustrated in
Tables 1 and 2, of which the favonoids are more
important in periodontal health.
Green tea also contains Gallic acid (GA) and
other Phenolic acids such as chlorogenic
acid, caffeic acid, and flavanoids such as
kaempferol, myricetin, and quercetin.
[11]
Wu
and Wei
[4]
indicated a cup of green tea (2.5 g of
green tea leaves/200 ml of water) may contain
90 mg of Epigallocatechin -3 gallate (EGCG).
Lin et al.
[12]
analyzed 31 commercial teas, and
detected that the levels of EGCG and total
catechins were in the following order: Green
tea (old leaves) green tea (young leaves)
an oolong tea black tea and Pu-Erh tea.
The amounts of catechins were always higher
in green tea. EGCG and EGC were major
catechins present with average contents of
7.358% and 3.955%, respectively; ECG and
EC values are 0.910 and 3.556% respectively.
[5]
Green tea extract for periodontal
health
Babu Venkateswara, Sirisha K., Vijay K. Chava
Abstract:
Tea, the commonly consumed beverage, is gaining increased attention in promoting overall health. In specifc,
green tea is considered a healthful beverage due to the biological activity of its polyphenols namely catechins.
Among the polyphenols Epigallo catechin 3 gallate and Epicatechin 3 Gallate are the most predominant catechins.
The antioxidant, antimicrobial, anticollagenase, antimutagenic, and c hemopreventive properties of these catechins
proved to be helpful in the treatment of chronic diseases like periodontal disease. Studies have demonstrated
that the type of processing mainly effects the concentration of catechins. Several epidemiological studies have
proved that green tea also has some general health beneftting properties like antihypertensive, reduction of
cardiovascular risk, antibacterial, antiviral, and antifungal activity. The present review concentrates on the effects
of green tea in periodontal and general health.
Key words:
Catechins, green tea, periodontal health
Review Article
Access this article online
Website:
www.jisponline.com
DOI:
10.4103/0972-124X.82258
Quick Response Code:
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Journal of Indian Society of Periodontology - Vol 15, Issue 1, Jan-Mar 2011 19
PROCESSING OF GREEN TEA
Tea leaves

Partial withering

Steaming

Rolling and drying

Final fring

Green tea

Non-oxidized Phenol compound/catechins
(EGCG, EGC, ECG, EC)
CLASSIFICATION
Depending on the manufacturing process, teas are classifed
into three major types:
[6,13]
1. Non-fermented green tea (produced by drying and
steaming the fresh leaves to inactivate the polyphenol
oxidase by nonoxidation).
2. Semi-fermented oolong tea (produced by partial
fermentation of fresh leaves before drying)
3. Fermented black and red tea (Pu-Erh) by post harvest
fermentation before drying and steaming.
MODES OF CONSUMPTION
As beverage
[14,15]
As mouth wash
As local drug delivery
As chewing gum
FACTORS AFFECTING THE CONTENTS OF
CATECHINS
1. Type of processing before drying.
[4,13,16]
2. Type of green tea (e.g., Blended, decaffeinated, instant).
3. Preparation of infusion (e.g. Amounts of the product used,
brew time, temp).
4. Growing conditions (soil, climate, agricultural practices,
fertilizers).
5. Geographical location.
McKay and Blumberg
[6]
reported that decaffeination slightly
reduces the tea catechin content; also instant preparations
and iced and ready-to-drink teas present less content of
catechins.
[16,17]
The production of bottle green tea beverage
encountered a brewing problem mainly caused by oxidation
of catechins.
[18]
BIOAVAILABILITY
Surprisingly, little is known about the bioavailability and
absorption of catechins from tea beverages. In humans, EGCG
may be less bioavailable than other green tea catechins. Peak
plasma levels are reached within 2 to 4 h after ingestion.
[19]

Average peak plasma concentrations after single dose of 1.5
mmol of green tea were 5.0 ml/L-EGC,3.1 mol/L -ECG,
1.3mol/L -EGCG. After 24 h, plasma EGC, and EGCG returned
to base line but plasma levels of ECG remained elevated.
[20]

The effect of green tea drinking may also differ by genotype.
[21]

There appear to be species differences in bioavailability of
EGCG compared to other tea catechins. Addition of milk to
tea does not alter catechin absorption. However, it may affect
the antioxidant potential of tea depending upon milk fat
content and volume of milk added.
[22-26]
Xu et al.
[26]
observed
that epimerization reaction occurring in manufacturing canned
and bottled tea drinks could not signifcantly affect antioxidant
activity and bioavailability of total tea polyphenols. One
hundred milliliter of green tea contains approximately 50100
micrograms of tea catechins.
BIOLOGICAL ACTIVITY OF TEA COMPONENTS
(CATECHINS)
Anti oxidative
Green tea polyphenols are responsible for its antioxidant
activity either directly by scavenging of reactive oxygen and
nitrogen species and chelating redox-active transition of metal
ions like iron and copper or indirectly by inhibition of pro
oxidant enzymes, redox sensitive transcription factors, and
induction of antioxidant enzymes.
[5,27,28]
Capacity to modulate the physical structure of cell membranes
This mechanism may be infuenced by the infuence of catechins
with the cellular phospholipid palisade. EGCG has shown
to induce apoptotic cell death and cell cycle arrest in tumor
cells.
[29-33]
Antimicrobial activity
EGC, EGCG, and ECG constitute the most important
antibacterial agents on methicillin resistant Staphylococcus
aureus, Helicobacter pylori and -Hemolytic streptococcus.
[34-36]
Anticariogenic activity
Catechins are found to be inhibitory against Streptococcus
mutans and Streptococcus sobrin at minimum inhibitory
concentration (MIC) ranging between 501000 g/ml.
[37]
Table 1: Composition of Green tea
[9,10]
Contents % Dry weight
Proteins 1520
Amino acids 14
Fiber 26
Carbohydrates 7
Lipids 7
Pigments 2
Minerals 5
Phenolic compounds 30
Oxidized phenolic compounds 0
Table 2: Catechins
[6]
Catechins Percentage
Epigallocatechin -3 gallate (EGCG) 59 of total catechins
(-) Epigallocatechin (EGC) 19
(-) Epicatechin 3 gallate (ECG) 13.6
(-) Epicatechin (EC) 6.4
Venkateswara, et al.: Green tea extract
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20 Journal of Indian Society of Periodontology - Vol 15, Issue 1, Jan-Mar 2011
Table 3: Studies on effects of green tea on periodontal
health
1993 Masaharu,
Masatomo et al.
[49]
Inhibits collagenase activity
1993 Kaneko et al.
[38]
Reduces halitosis associated with
periodontal disease
1995 Yasuda and
Arakawa
[39]
Reduction of halitosis by deodorizing
methyl mercaptan
1996 Sakanaka et al.
[40]
Inhibition of growth and adherence of
P. gingivalis to buccal epithelial cells
2002 Hirasawa et al.
[14]
Reduction of markers of gingivitis by use of
slow release devices.
Bactericidal activity of green tea cathechins
against P. gingivalis and prevotella
2004 Okamato et al
Sakanaka and
Okada et al
[41, 42]
Neutralises etiological agents like
gingipains, protein tyrosine phosphatase.
2007 Yung,
Pang et al
[45]

Yun, Kim et al
[46]
Inhibits bone resorption by preventing
expression of MMP-9 from osteoblasts
induced by P. gingivalis extracts.
2009 Nakamura,
Ukai et al.
[47]
Inhibition of bone resorption by inducing
apoptotic cell death of osteoclasts, via
caspases.
Inhibition of nuclear translocation of NF-
kappa beta activated by lipopolysacharide.
Inhibits IL-1 production, directly inhibits
osteoclastogenesis Inhibit Oncostatin M
induced CXCL-10 production in human
gingival fbroblasts
Inhibits IL-17A induced CCL-20 production
in human gingival fbroblasts.
EFFECTS OF GREEN TEA ON PERIODONTAL
HEALTH
Kaneko et al.
[38]
1993 found that a four-week regimen of mouth
washing with a dilute catechin solution reduced the mouth
odor (halitosis) associated with periodontal disease. Tea
catechins especially EGCG deodorizes methyl mercaptain,
the main cause of halitosis.
[39]
EGCG (active at 250500 g/
ml) inhibited growth and adhesion of Porphyromonas gingivalis
to buccal epithelial cells.
[40]
Hirasawa et al.
[14]
demonstrated
bactericidal activity of green tea catechins against prevotella
and P. gingivalis at concentration of 1 mg/ml. They found
signifcant reduction in markers of gingivitis after the use of
slow release buccal delivery system applied over a period of
8 weeks. More recent studies have shown that some virulence
factors (toxic metabolites, protein tyrosine phosphatase, and
gingipains) and aetiological agents of periodontal disease are
neutralised by EGCG [Table 3].
[41,42]
Effects on various periodontal pathogens
Green tea polyphenols inhibit the collagenase activity of oral
bacteria. EGCGs the predominant component of green tea
polyphenols inhibits both eukaryotic and prokaryotic cell
derived collagenase activity. EGCG completely inhibits the
growth of three strains of P. gingivalis at concentration of
250 or 500 g/ml and that of P. melaninogenicus at MICs of
2000 g/ml.
[43]
Other polyphenols were not as effective
as EGCGs and their MICs against P. gingivalis and P.
melaninogenicus were 1000 g/ml or >2000 g/ml. The
numbers of adherent bacterial cells decrease in a dose
dependent manner. This inhibitory effect was pronounced
with polyphenols having a galloyl moiety linked with an
ester linkage i.e. (EGCG, GCG, ECG) linkage with 3-OH of
catechin structural molecules. The higher the concentration
of EGCG and ECG the more severe the inhibition. This
mechanism is mainly by binding of polyphenols to fmbriae
of P. gingivalis. Inhibitory activity was observed against
r-gingipain and to lesser extent against K-gingipain of P.
gingivalis. Green tea catechins inhibit enzymatic activities
of P. gingivalis, in a manner similar to that of Chlorhexidine,
Doxycycline, and non-antimicrobial chemically modifed
tetracycline derivatives. EGCG inhibit protein tyrosine
phosphatase activity in P. intermedia. It also possesses
bactericidal activity against a variety of microorganisms like
Helicobacer pylori and inhibits extracellular release of verotoxin
from enterohaemorrhagic Escheresia coli. Epigallacto catechin
gallate is synergistic with lactams for effective killing of
methicillin-resistant Staphalococcus aureus. Epigallacto catechin
gallate also inhibits the histamine release from rat basophilic
leukemia cell, and exhibit selective immunomodulatory effect
on cytokine formation.
Effects on host defense, human gingival cells, and
infammatory response
Green tea catechins were reported to be effective in preventing
gingival and periodontal infammation. EGCG inhibit the
m-RNA expression of COX-2, MMP-1, IL-1, 6 and 8 by cultured
cells. Effective concentration to achieve these effects was 1
g/ml. EGCG inhibit the activation of NF-kB (Nuclear Factor
kappa B), which is one of the key positive regulators of COX-
2 expression.
[44]
Effects on bone and bone cells
EGCG inhibited bone resorption by inducing the apoptotic cell
death of osteoclasts and osteoclasts like multinucleated cells in a
dose dependent manner (25100 m) mainly by involvement of
caspases. Caspases are major regulatory enzymes in apoptotic
pathway predominantly caspase 3. However, the mechanism
by which EGCG modulates caspase activation is yet to be
elucidated. EGCG is highly effective in inhibiting the survival
of cell-derived osteoclasts in vitro. EGCG prevents increased
matrix metalloproteinase expression from osteoblasts induced
by P. gingivalis extracts. EGCG caused the reduction in MMP
activities by inhibiting the gene expression of MMP-2 and
MMP-9 via Mitogen Activated Protein Kinase) signaling
pathway. EGCG inhibited the osteoclast formation induced by
1 , 25 (OH)
2
D 3 (10
-8
M). Several signaling pathways could
also be involved in EGCG-induced apoptosis of oseoclasts as
well as caspase activity. EGCG has an effect on differentiated
osteoclasts but not on undifferentiated cells, i.e., at appropriate
dose inhibits osteoclasts but not osteogenic cells.
[45, 46]
EGCG
may not have advantage as a chemopreventive agent specifc
for osteoclasts. So these in vitro effects need to be studied in
vivo to develop EGCG as a therapeutic agent for treatment of
bone diseases.
Effect of catechin on lipopolysacharide induced bone
resorption in vivo
The alveolar bone resorption and IL-1 expression induced
by lipopolysacharide in gingival tissue were signifcantly
decreased by injection or oral administration of green tea
catechins (GTC). GTC inhibits nuclear translocation of NF-
kappa activated by LPS.
[47]

Venkateswara, et al.: Green tea extract
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Journal of Indian Society of Periodontology - Vol 15, Issue 1, Jan-Mar 2011 21
Effects on chondrocytes
EGCG inhibits IL-1 induced cartilage proteoglycan
degradation and expression of MMP-1 and MMP-13 in human
chondrocytes at micromolar concentration. Complete inhibition
of MMP-1 and MMP-13 at a concentration of 100 g EGCG
was observed. This concentration can be achieved only by
local administration and not by oral consumption. MMP-13 is
more sensitive to the inhibitory effect even at lower conc. This
inhibitory effect is by inhibition of IL-1 induced expression of
m-RNAs signifying that the effect is at transcriptional level.
[48]

So EGCG may inhibit the activities of MMPs involved in the
degradation of native collagen and this may have suppressive
effects on the cartilage degradation in arthritic joints.
Effect on collagenase activity
Among the tea catechins ECG and EGCG with galloyl radical,
showed the most potent inhibition effect on collagenase activity
when an optimal concentration of tea catechins (100 g/ml)
was added to reaction mixture containing collagenase and
collagen.
[49]
The steric structure of 3 galloyl radical is important
for inhibition of collagenase activity. Tea catechins may
aggregate rather than denature collagenase molecule which
results in inhibition of enzyme activity (unpublished data).
Effect on cxcl-I0 (Cxc chemokine ligand 10) production from
oncostatin-M stimulated human gingival gibroblasts
EGCG and ECG inhibits Oncostatin M (OS-M) induced
CXCL-10 production in Human Gingival Fibroblasts (HGFS).
CXC chemokine ligand 10 (CXCL 10) plays a pivotal role in
recruitment of Th1 cells, and thus, in the development of
periodontal disease.
[50]
Effect on Ccl20 (Chemokine ligand 20) production in Il-17 A
stimulated human gingival fbroblasts
Catechins (EGCG and ECG) inhibit IL- 17 A-induced CCL 20
production in human gingival fbroblasts.
[51]
Inhibition of P38
MAPK or extracellular signal regulated Kinase (ERK) decreased
IL -17A induced CCL 20 production.
SCOPE FOR RESEARCH IN APPLICATION OF
GREEN TEA CATECHINS FOR PERIODONTAL
HEALTH
As green tea extract has so many effects on periodontal
pathogens and periodontal tissues its application as local
delivery systems like strips, chips, and fbers for the treatment
of periodontal disease or in combination with regenerative
materials to improve periodontal regeneration should be
focused.
CONCLUSION
The changing trends in the etiopathogenesis and prevention
of periodontal disease are innumerable. From the point of
eradication of the periodontal pathogens to regeneration of
complete periodontium various treatment modalities are
suggested. Green tea extract may have numerous effects on
periodontal pathogens and periodontal tissues. Greater the
concentration of catechins better the health benefts. So the
consumption of green tea in comparison to other beverages
may be widely recommended.
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How to cite this article: Venkateswara B, Sirisha K, Chava VK. Green
tea extract for periodontal health. J Indian Soc Periodontol 2011;15:18-22.
Source of Support: Nil. Confict of Interest: None declared.
Venkateswara, et al.: Green tea extract
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