Can dark chocolate really be good for your teeth?

We’re all aware of all sorts of health and inspirational claims for chocolate (for more on the ones about your heart see here, aphrodisiacs see here, the nonsense about raw chocolate see here and a general overview see here). So when I was first asked about this at a coffee and chocolate pairing event at Prufrock the other week, I was intrigued.

Could this really be the case given all the horror stories about sugar and oral hygiene and tooth decay? Unsurprisingly the claims for chocolate being good for your teeth are all for dark chocolate, and moderate consumption. Remember, a 75% dark craft chocolate bar has only around three tea spoons of sugar in it. This is less than half the sugar of a low fat vanilla yogurt (25-35g for a 150g pot), less than the 15-20g of sugars in an apple – and the 12-15g of sugar in an orange is roughly the same as the 12-15g of sugar in a 60g, 75% dark chocolate bar. And most of us don’t power through a whole craft chocolate bar in one sitting!

A trawl through the literature turned up a tonne of dentists and orthodontists weighing in, and also a couple of academic studies (see the blog for more on these sources). The “toothful” benefits come from a bunch of compounds:

1. Polyphenols, flavonoids and other antioxidants: These limit harmful oral bacteria, neutralize bad breath, and prevent bacteria from turning sugar into acids. Intriguingly a 2019 study, whose results were published in the Journal of Agricultural and Food Chemistrydetermined that “polyphenols in dark chocolate inhibited streptococcus mutans growth and reduced plaque adhesion, lowering the risk of fillings” (aka cavities if you are in the US). The data here has been backed up by a more recent “meta-analysis” of data from 500,000+ middle-aged individuals held by the UK Biobank.
2. Theobromine: Theobromine strengthens tooth enamel, making it more resistant to decay and destroys harmful bacteria (Actinomyces naeslundii and streptococcus mutans). A study at Tulane University suggested that Theobromine could harden tooth enamel 30% more effectively than fluoride, protecting against acid erosion, etc. (Note: we’ve not been able to find any plans to replace fluoride in our water supplies with theobromine, but if anyone has access to RFK Jr, they might want to send him this study…)
3. Tannins: Tannins have antibacterial properties that can help prevent plaque formation (ie preventing bacteria breaking down teeth enamel) and therefore can reduce the risk of fillings.  There is also some evidence that anti-inflammatory properties within some tannins may help prevent gum swelling and infection (note: this sort of claim is also made for teas, red wine and many other delightful treats).  However tannins can also cause discoloration and staining of teeth enamel – so rinsing and brushing is important here too

Unfortunately most of these studies don’t contain “dosage” recommendations. One that does suggest a daily allowance is from Mihai I University in Romania in 2023 where they suggest that “consuming 10g post-meal reduced acidogenic bacteria by 45%, minimizing plaque and halitosis (bad breath)”.

These studies also are observational and / or “in vitro” studies (i.e. in limited laboratory controlled conditions), and there aren’t any long term, longitudinal research studies that track dark chocolate’s impact on fillings, enamel strength, etc.

And as all the dentists make VERY clear, eating – and even savouring – craft chocolate is not a substitute for brushing and flossing! And it’s definitely not a free pass to scoffing a sugar-laden bit of confectionery with ‘chocolate’ on the packet.

Finally, none of these studies distinguish between “craft” and “mass produced / ultra-processed” chocolate; they just argue for 70% and above dark chocolate and focus on the importance of theobromine, polyphenols and other antioxidants. Again, there are only a few studies on the impact of “processing” (pressing, roasting, fermenting, grinding, etc.) on these beneficial compounds. Those that do exist argue for an approach based on coaxing the flavour from high quality beans; over roasting (ie what happens with most mass produced supermarket dark chocolate) damages polyphenols and antioxidants. The same is true for how the beans are fermented and dried – but again, lots more work is needed on this.

So bottom line, what does seem POSSIBLE is that savouring some craft chocolate after a meal can not only aid digestion (see here for more on your second stomach), plus – combined with flossing, bruising, etc. may provide one treat that can actually help your teeth enamel whilst also preventing fillings / cavities and bad breath.

So if you still haven’t done your Valentine’s shopping, or need a bit of encouragement, what more do you need?

Thanks as ever for your support (and smiles?)

DETAILS OF PRIMARY RESEARCH
https://www.organscigroup.us/articles/IJOCS-9-161.php
https://www.nature.com/articles/s41405-024-00190-y
https://pmc.ncbi.nlm.nih.gov/articles/PMC6823004/

https://pmc.ncbi.nlm.nih.gov/articles/PMC6364351/

SECONDARY STUDIES FROM DENTISTS ETC.
https://artofdentalcare.co.uk/the-impact-of-dark-chocolate-on-gums-not-the-result-you-might-expect/
https://www.alpinedental.org/dark-chocolate-your-dental-health-ally-on-world-chocolate-day/
https://www.gilbertarizonadental.com/how-dark-chocolate-can-benefit-your-dental-health/

OTHER SOURCES
https://www.sciencedirect.com/science/article/abs/pii/S0963996916301028
https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2017.01207/full