E-ISSN :0975-8437 P-ISSN: 2231-2285

ORIGINAL RESEARCH
EFFECT OF BLACK TEA AND GREEN TEA ON PERIODONTAL HEALTH STATUS AMONG DENTAL STUDENTS AT PAKISTAN
Muhammad Nadeem, Fatimah Datoo, Anis Ahmed Bugti, Anum Ayaz, Mutaal Mahfooz

ABSTRACT
The study has goal to assess the effects of black tea and green tea on teeth and it’s Periodontium among dental students
at Liaquat College of Medicine and Dentistry (LCMD) Karachi, Pakistan. A cross sectional study conducted from
November 2012 to January 2013 involving 218 adult volunteers attending LCMD. A total of 240 subjects consulted in
this survey and 218 (90.5%) fulfilled the inclusion criteria and participated in the study. To access the reason of taking
black tea and green tea and their effects on oral health we analysed the Community Periodontal Index Treatment Need
(CPITN) index and Plaque Index on participants. Results have shown that most of the female participants drinking green
tea as compare to male participants. The most common reason of drinking black tea is Addiction on the other hand
health conscious is the key reason of drinking green tea. End of the study we found health gums of those partici-
pants who taking green tea (x2 = 36.57, df= 6, p<0.001) while those participants who taking black tea have more plaque
accumulation (x2 = 30.98, df= 6, p<0.001). Conclusion: The study concludes that green tea have some positive effects on
Periodontium and helps to prevent plaque deposition.

I N T E R N AT I O N A L J O U R N A L O F D E N TA L C L I N I C S
Keywords: Black Tea; Dental students; Green Tea; Periodontal Health

Introduction
Tea, a beverage consumed around the world, has progressed
from casual beverage to medicinal powerhouse through the
centuries.1 There are several different types of tea available on
the market, including green, black, white, herbal, and oolong.
Gingivitis and periodontitis, as the multifactorial diseases, are
mainly derived by interaction between invasions of causative
bacteria and host immune response of varied degrees. 2 Plaque
induced gingivitis is the most common form of gingivitis and
is induced by accumulation of microbial plaque containing
more than 300 types of bacterial species.2,3 this study was
conducted to assess the effects of black tea and green tea on
teeth and it’s Periodontium among dental students at Liaquat
College of Medicine and Dentistry (LCMD) Karachi, Pakistan.
Material and Methods
The Department of Community Dentistry and Periodontology
of the Liaquat College of Medicine and Dentistry in Karachi,
Pakistan organized free dental checkups among dental stu-
to participate in the study thus leaving 218 (90.5%) volunteers.
The dimensions of tea investigated included the type of tea
taken (black or green tea), the duration of green tea consup-
tion in years (<5 years, 5 to 9 years, 10 to 14 years and >14
years), and the reason for drinking tea. A subject was consid-
ered as a tea drinker if she/he taken at least one cup every day.
No attempts were made to identify ex-tea taker.
The sample size estimated for the study (n=218) was originally
calculated considering a precision of 5%, a 95% level of the
confidence interval, and assuming a 50% prevalence in the
underlying referral population. The study protocol was ap-
proved by the Department of Research and Ethics of the Li-
aquat College of Medicine and Dentistry Karachi and a written
informed consent was collected from each participant. All par-
ticipants filled a self-administered questionnaire containing
information on age, gender, smoking status (current smoker/
no smoker); the duration of smoking in years (< 5yrs, 5-9 yrs,

dents at LCMD. The examination was done at the Darul Sehat
hospital from November 2012 to January 2013. The dental stu-
dents come from all area of Karachi and Pakistan that provided
the opportunity for conducting this cross-sectional study. The
exercise did not include acute consultations due to pain or in-
fections and was restricted to intraoral examination and ad-
vice to the participants on how to improve and maintain their
oral health. Participants were also informed on the presence
of plaque and/or need for dental scaling.
| 2014 Volume 6
10-14 yrs and > 14 yrs); and the type of cigarettes smoked
(with or without filter).
A trained final year dental student (AA) and a dentist (MN)
had completed all clinical examinations. The examiners were
blinded to information on tea habits. Each participant was
examined for the presence of plaque on the tooth surface: 1)
No plaque on tooth surface; 2) plaque present less than 1/3
surface of tooth; 3) plaque present 1/3 surface of tooth; and
3) plaque present more than 2/3 surface of tooth; and gum
Issue 4

A total of 240 subjects aged 19-27 years consulting for check-
ups were invited to participate in the study. Exclusion criteria
included self-reported diabetes, self-reported hypertension,
self-reported complains of bleeding gums, having received
radiation therapy, having clinical signs of oral carcinoma, and
history of pan and/or betel nut use. From the group of eligible
subjects, five because they presented with diabetes or hyper-
tension, and 14 were not included because of pan and/or be-
tel nut consumption. A total of three individuals did not want
status: 1) healthy gums; 2) bleeding gums; 3) calculus present
surrounding gums and 4) periodontal pocketing present. For
the purpose of the present analysis, the site with most effec-
tive was considered at the individual level.
Statistical Analysis: The data collected were analysed by χ2
statistics to compare overall differences between groups, the
differences between proportions and the corresponding 95%
confidence intervals for the differences between groups.

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Nadeem et al

Results
The study group comprised 118 green tea drinkers and 58
black tea drinkers and 42 non-tea drinkers who don’t like to
drink tea at all. We were examined plaque index and CPITN in-
dex of all participants. According to the following study most
of the females like to drink green tea (106/174) on the other
hand, most of the males like to drink black tea (31/ 44).
Periodontal health status: Based on CPITN index green tea
drinkers have more healthy gums (66.95%), as compared to
black tea drinkers who has more bleeding gums (31.03%). (Ta-
ble 1).
Plaque accumulation: Based on plaque index, green tea
drinkers has highest numbers of participants with no plaque
(72.38 %), on contrary the black tea drinkers had highest num-
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Discussion
This study was conducted at Liaquat College of Medicine and
Dentistry and Darul Sehat hospital is situated in south Karachi
to assess reason of taking tea and their effects on oral health.
Oxidative stress plays an important role in the pathogenesis of
periodontal disease, as well as many other disorders.4-6
Tea originated in China, possibly as long ago as 2700 BC. For
thousands of years, tea has anecdotally been considered to
have health-giving properties; this has been amply confirmed
in recent years by an accelerating research effort.7
The most abundant components in green tea are polyphe-
nols, in particular flavonoids such as the catechins, catechin
gallates and roanthocyanidins.7 The fresh leaves contain caf-
feine, theobromine and other methylxanthines, lignin, organ-

ber of participants with plaque present on 1/3 tooth surface
(40.30%). The absence of plaque was significantly associ-
ated with the drinking habit of green tea (x2 = 30.98, df= 6,
p<0.001) (Table 2).
Reason for tea drinking: Based on this study data most of the
participants are drinking green tea because they are health
conscious (76.30%). On the other hand the main reason for
drinking black tea is addiction (44.80%).
Duration of Tea drinking vs. Periodontal Health Status:
Based on CPITN index, the highest number participants who
have healthy gum were drinking green tea for last 10 to 14
I N T E R N AT I O N A L J O U R N A L O F D E N TA L C L I N I C S
ic acids, chlorophyll and free amino acids, in addition to the
unique amino acid theanine; numerous ‘flavour compounds’
are also present in much lower amounts.7,8
Bacterial biofilm development in the marginal gingiva and
periodontal pockets is important in the pathogenesis of peri-
odontal disease.9 Previous in vitro studies showed that green
tea catechin inhibits the growth of Porphyromonas gingivalis,
Prevotella intermedia, and Prevotella nigrescens and the ad-
herence of P. gingivalis onto human buccal epithelial cells.4,10,11
In addition, green tea catechins with major tea polyphenols,
inhibit the production of toxic end metabolites of P. gingiva-
lis.6,9,11,12 These reports of the inhibitory effects of catechin con-

years (78.05%). Similarly second highest are those who drink tained in green tea on periodontal pathogens may provide
green tea between 5 to 9 years (77.78%). (x2 = 25.42, df= 6, the basis for the beneficial effect of the daily intake of green
p<0.001). tea on periodontal health.2,6

Duration of Tea drinking vs. Plaque accumulation: Based on Conclusion

plaque index, the highest numbers of participants who have In conclusion, the health consciousness is the main reason
no plaque accumulation are those who drink green tea for last for taking green tea in Pakistani student population. Green
10 to 14 years (82.93%). Similarly second highest are between tea takers presented less plaque accumulation as compare
5 to 9 years (73.33%) (x2 = 25.42, df= 6, p<0.001). to black tea takers and the relationship suggested a dose-re-
sponse effects.
CPITN
Tea Acknowledgments
Healthy Bleeding Calculus Pocket Total
The authors appreciate the support received from the Liaquat College
Non Drinker 13 10 13 6 42 of Medicine and Dentistry Research Centre, in Karachi in the person
of Dr. Ali Farhan and the input received from dental block of Liaquat
Green Tea 79 28 7 4 118 College of Medicine and Dentistry and Darul Sehat Hospital during
Black Tea 19 18 14 7 58 the examination of participants. The statistical advice received from
Associate Professor Dr. M. Ather Majeed Khan head of Community
Total 111 56 34 17 218
Medicine is greatly appreciated.
Table 1. Periodontal health status basedon habit of drinking tea
(x2 = 36.57, df= 6, p<0.001) Authors Affiliations
1. Muhammad Nadeem, MIPH(Australia), BDS, C-Implant (UTF, Cana-
Plaque Index
Tea da), Assistant Professor and Head, Department of Community Den-
No 1/3 > 1/3 > 2/3 Total tistry and Periodontology, Liaquat College of Medicine and Dentistry,
Darul Sehat Hospital, Gulistan‐e‐Jauhar, Karachi, Pakistan, 2. Fatimah
Non Drinker 14 13 10 5 42 Datoo, RDH, BDSc, Research Section, Department of Dental Hygiene,
Green Tea 76 27 9 6 118 Oxford College of Art, Business and Technology, Scarborough, Ontar-
io, Canada, 3. Anis Ahmed Bugti, 3rd year BDS Student, Liaquat College
Black Tea 15 27 10 6 58 of Medicine and Dentistry, Darul Sehat Hospital, Karachi, Pakistan, 4.
Total 105 67 29 17 218 Anum Ayaz, 4th year BDS Student, Liaquat College of Medicine and
Dentistry, Dental Block, Darul Sehat Hospital, Karachi, Pakistan, 5. Mu-
Table 2. Plaque accumulation on tooth surface based onplaque taal Mahfooz, BDS, Dentist, Liaquat College of Medicine and Dentist-
index ry, Dental Block, Darul Sehat Hospital, Karachi, Pakistan.

2

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How cite this article
Nadeem M, Datoo F, Bugti AA, Ayaz A, Mahfooz M. Effects of black tea
and green tea on periodontal health status among dental student at
Pakistan. International Journal of Dental Clinics. 2014;6(4):1-3.
Address for Correspondence
I N T E R N AT I O N A L J O U R N A L O F D E N TA L C L I N I C S
Muhammad Nadeem, MIPH(Australia), BDS, C-Implant
(UTF, Canada),
Assistant Professor and Head,
Department of Community Dentistry and Periodontology,
Liaquat College of Medicine and Dentistry,
Darul Sehat Hospital, St 19, Block 15,
Gulistan‐e‐Jauhar Karachi, Pakistan.
Email: dr_nt01@hotmail.com
| 2014Volume6Issue4
Source of Support: Grant from the Liaquat College of
Medicine and Dentistry and Darul Sehet Hospital
Conflict of Interest: None Declared