Mastic resin, or gum, from the mastic tree (Pistacia lentiscus), is well known for its antioxidant and anti-inflammatory effects, as well as bactericidal effect against Helicobacter pylori.[i] However, it also has a history of cultural use, as a gum, for maintenance of oral health. Historically, chewing of mastic was popular in many regions of the Ottoman Empire during the 18th and 19th century. [ii] Trade from the island of Chios, the primary region in which the mastic tree was found, boomed due to high international demand. It was noted to promote oral hygiene, as well as pleasant and fragrant breath. Other beneficial qualities of chewing this resin as a gum were reported to be strengthening of the heart, the expulsion of phlegm, and resolution of catarrh and fever. Now we well understand that symptoms such as phlegm, catarrh, and fever are associated with infection, and this observation supports the antimicrobial effects of mastic which we now know to exist.[iii]
A recent study investigated the potential for the use of mastic gum for periodontal health.[iv] Specifically, the antimicrobial effect of mastic gum against pathogens known to contribute to periodontal disease was assessed. Mastic extract was found to have a significantly higher inhibition effect on potential periodontal pathogens (P. gingivalis, S. oralis, A. actinomycetemcomitans, F. nucleatum, and P. intermedia) compared with 3% hydrogen peroxide (H2O2) (p ≤ 0.016). Not only that, rather than having a cytotoxic effect on epithelial cell lines, mastic extract was found to have a beneficial effect on cell viability. The cell lines treated with mastic extract had a significantly higher viability than cells treated with 3% H2O2 or chlorhexidine digluconate. Chlorhexidine digluconate is commonly used to limit bacterial plaque formation, however it has been shown to potentially have adverse effects on oral tissue health.[v] These findings support the use of mastic extract for prevention of periodontal disease, as both infectious aspects and tissue decay play into the disease pathology.
Although no effect was seen in this study on Streptococcus mutans, an anaerobic, gram-positive bacteria that is a significant contributor to tooth decay, multiple clinical studies have shown mastic gum to reduce salivary levels of S. mutans.[vi] In a comparison study in which participants either chewed mastic gum or paraffin, significantly lower levels (p < 0.001) of the bacteria were found in saliva of those chewing mastic gum, and levels observed to progressively reduce with time spent chewing the gum.[vii] Additionally supporting the use of mastic for oral health, mastic gum was shown to significantly reduce deposition of plaque and gingival inflammation as compared to placebo chewing gum after a 7-day period without additional mechanical oral hygiene.[viii]
[iii] Koutsoudaki C, Krsek M, Rodger A. Chemical composition and antibacterial activity of the essential oil and the gum of Pistacia lentiscus Var. chia. J Agric Food Chem. 2005 Oct 5;53(20):7681-5. View Abstract
[v] Mirhadi H, Azar MR, Abbaszadegan A, et al. Cytotoxicity of chlorhexidine-hydrogen peroxide combination in different concentrations on cultured human periodontal ligament fibroblasts. Dent Res J (Isfahan). 2014 Nov;11(6):645-8. View Full Paper
[vi] Biria M, Eslami G, Taghipour E, Akbarzadeh Baghban A. Effects of Three Mastic Gums on the Number of Mutans Streptococci, Lactobacilli and PH of the Saliva. J Dent (Tehran). 2014 Nov;11(6):672-9. View Full Paper
[vii] Aksoy A, Duran N, Koksal F. In vitro and in vivo antimicrobial effects of mastic chewing gum against Streptococcus mutans and mutans streptococci. Arch Oral Biol. 2006 Jun;51(6):476-81. View Abstract
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