Biological Properties and Antimicrobial Potential of Cocoa and Its Effects on Systemic and Oral Health

Abstract

Cocoa is considered a functional food because it is a natural source of macro- and micronutrients. Thus, cocoa is rich in vitamins, minerals, fiber, fatty acids, methylxanthines and flavonoids. In addition to favoring the metabolism of lipids and carbohydrates, the bioactive components of cocoa can have an antioxidant, anti-inflammatory and antimicrobial effect, providing numerous benefits for health. This literature review presents an overview of the effects of cocoa, fruit of the Theobroma cacao tree, on systemic and oral health. Several studies report that cocoa intake may contribute to the prevention of cardiovascular, neurodegenerative, immunological, inflammatory, metabolic and bone diseases, in addition to reducing the risk of vascular alterations and cognitive dysfunctions. On oral health, in vitro studies have shown that cocoa extract exerted an inhibitory effect on the growth, adherence and metabolism of cariogenic and periodontopathogenic bacteria, also inhibiting acid production, glycosyltransferase enzyme activity and the synthesis of insoluble polysaccharides. Additionally, administration of cocoa extract reduced biofilm accumulation and caries development in animals infected with cariogenic species. Clinical studies also reported that the use of mouthwashes containing cocoa extract reduced Streptococcus mutans counts in saliva and dental biofilm formation. In short, these studies highlight the nutritional value of cocoa, considering its clinical applicability, stability and economic accessibility.

Keywords: antimicrobial; antioxidants; cocoa; flavonoids; health benefits; oral health; systemic health; theobromine.

Figure 1

The bioactive components of cocoa have antioxidant, anti-inflammatory and antimicrobial potential. In addition to favoring the metabolism of carbohydrates and lipids, cocoa also exerts a prebiotic effect. Due to its properties, cocoa intake can contribute to the prevention of various disorders, such as cardiovascular, neurodegenerative, immunological, inflammatory, metabolic and bone diseases.

Figure 2

Cocoa extracts exert an inhibitory effect on the adherence, growth and metabolism of oral bacteria, disturbing biofilm formation. The bioactive components of cocoa inhibit acid production, glycosyltransferase enzyme activity and the synthesis of insoluble polysaccharides.

Figure 3

This illustration presents an overview of the main antimicrobial effects of cocoa on oral bacteria. Cocoa extract inhibited bacterial adherence, growth and metabolism in vitro, reduced biofilm formation and caries development in animal models, and reduced salivary S. mutans counts and plaque index scores in clinical trials.