The prebiotic effect of CPP-ACP sugar-free chewing gum.
OBJECTIVES
To determine if chewing gum containing casein phosphopeptide stabilised amorphous calcium phosphate (CPP-ACP) promoted an increase in the abundance of Streptococcus sanguinis and other species associated with dental health in supragingival plaque in a clinical study.


MATERIALS AND METHODS
Nineteen participants were recruited for a three-leg cross-over, randomised, controlled clinical trial. Participants chewed a sugar-free gum with or without CPP-ACP six times daily for 20 min over two weeks. The study also involved no gum chewing (no gum) for the same two week period. Participants were randomly assigned to one of the test gums or no gum for each intervention period. Participants abstained from oral hygiene and had washout periods of two weeks between intervention periods. After each intervention period, supragingival plaque was collected and analysed for bacterial composition by sequencing the V4 variable region of the 16S rRNA gene. Data were analysed using a linear mixed model.


RESULTS
The CPP-ACP gum intervention produced a significant (p < 0.01) increase in the proportions of S. sanguinis (112%), as well as the commensal species Rothia dentocariosa (127%), Corynebacterium durum (80%) and Streptococcus mitis (55%) when compared with the no gum intervention. All the species that were promoted by the CPP-ACP gum are known to possess one or both of the alkali-producing enzymes arginine deiminase and nitrate reductase.


CONCLUSION
This clinical study demonstrated that chewing a sugar-free gum containing CPP-ACP promoted prebiosis by significantly increasing the proportion of S. sanguinis and other health-associated bacterial species in supragingival plaque.


CLINICAL SIGNIFICANCE
Regular chewing of CPP-ACP sugar-free gum increases the proportions of health-associated commensal species in supragingival plaque to promote prebiosis and oral homeostasis.
['Fernando|James R|JR|', 'Butler|Catherine A|CA|', 'Adams|Geoffrey G|GG|', 'Mitchell|Helen L|HL|', 'Dashper|Stuart G|SG|', 'Escobar|Karen|K|', 'Hoffmann|Brigitte|B|', 'Shen|Peiyan|P|', 'Walker|Glenn D|GD|', 'Yuan|Yi|Y|', 'Reynolds|Coralie|C|', 'Reynolds|Eric C|EC|']
D002364:Caseins D002638:Chewing Gum D018592:Cross-Over Studies D003743:Dental Enamel D003773:Dental Plaque D006801:Humans D056692:Prebiotics D012336:RNA, Ribosomal, 16S D013291:Streptococcus D013298:Streptococcus sanguis D000073893:Sugars D014089:Tooth Remineralization
CPP-ACP Sugar-free chewing gum Prebiosis Supragingival dental plaque microbiome