Effect of ‘Manuka Honey with Cyclopower™’ on dental plaque activity and gingival health in young adults

Abstract

Introduction Manuka Honey with Cyclopower™ (MMHC) is a low glycaemic index chewable tablet which offers sustained-release delivery of high grade New Zealand Manuka honey. It is marketed as a ‘tooth-friendly’ dietary supplement, containing high strength methylglyoxal, xylitol and Cyclopower™. Methylglyoxal is found in Manuka honey and is responsible for much of the honey’s antibacterial properties. CycloPower™ is an alpha-cyclodextrin: a cyclic oligosaccharide molecule derived from plants. Xylitol, a naturally occurring sugar alcohol, has been shown to effectively decrease caries risk. Aim To compare the effects of MMHC with a xylitol tablet on dental plaque pH, salivary characteristics, gingival health and dental plaque accumulation. Methodology The project was undertaken in two parts. Part I. Cross-over, randomised control trial involving 12 healthy participants over five appointments (each 7-days apart). Dental plaque pH was measured for 40 minutes after consuming the MMHC, xylitol tablet, Manuka honey, or sucrose (10% w/v, 20 mL). Part II. A randomised control, single blind, parallel group trial involving 31 healthy participants over 56 days. Participants chewed either a MMHC or a xylitol tablet three times daily for 28 days. Oral health and dental plaque pH changes (following 10% sucrose), were measured at Day 1, 14, 28 and 56. The minimum pH reached, area under the pH curve (AUC5.7) and maximum decrease in pH were recorded. Linear mixed models were used to compare treatment groups for both parts. Results Part I. Minimum pH (mean ± SD): MMHC (5.3 ± 0.3) vs sucrose (4.9 ± 0.2; p<0.001); vs xylitol (6.3 ± 0.4; p<0.001); and vs Manuka honey (5.0 ± 0.4; p<0.001). The AUC5.7 (mean ± SD) was larger for sucrose (13.3 ± 11.6) than xylitol (0.1 ± 0.2; p<0.05), but did not differ between sucrose and either Manuka honey (16.5 ± 15.6; p=0.506) or MMHC (4.9 ± 9.6; p=0.124). Part II. The mean plaque pH, following challenge with sucrose, decreased below the critical pH (5.7) for both groups. No differences were evident between groups in any test parameters. Conclusion MMHC consumption resulted in a plaque pH decrease below critical pH 5.7. Therefore, the MMHC tablet should be used with caution in individuals at high caries-risk. This project was funded by Manuka Health New Zealand Ltd.