• Margareta A. Christianti


There is a famous saying in Indonesia: “It is better to have a broken heart rather than toothache”. Although people are still debating about this due to the pain of losing a relationship, it is undeniable that toothache is very scary. Tooth decay is one of the most common dental illnesses around the world. It is a damage caused by bacteria infections, specifically by Streptococcus mutans. Since we do not want these bacteria to colonize our mouth, we need to do something to prevent it.

Then, what can we use to prevent this disease?

The answer is: Betel leaf! Piper betle L., also known as the betel, is a medicinal plant that is commonly found in tropical countries, such as India and the other Southeast Asian countries. Betel contains various active ingredients that can be used for treating diseases due to its antioxidant, antibacterial, or anti-inflammation activity.1

Betel leaves is the part of the plant that is beneficial to dental health. These heart-shaped leaves can give many benefits to our mouth, such as preventing bad breath, hardening the gum and conserving the teeth.2 In some Asian countries, people chew a mixture of betel leaves with lime, areca nuts and tobacco which is called betel quid or paan. People often misunderstand betel leaves as betel quid due to their similar appearances, but actually it is because betel quid use betel leaves as “wrapper”. Despite their similar appearance, betel leaves and betel quid have completely different effect. People assume that both of them can cause oral cancer, when in fact it is not entirely the truth. Indeed, while areca nuts and tobacco are well known to cause cancer, betel leaf has nothing to do with it and some studies even show that betel leaf might even prevent tumours.3-5

Regarding tooth decay, betel leaf contains a component called hydroxychavicol which is the main actor for its antibacterial activity. Studies by Nalina & Rahim in 2007 and Singh et al. in 2018 proved that hydroxychavicol in betel leaf extract is able to kill bacteria, hence making it an effective weapon against tooth decay.6-7 To this aim, toothpaste containing betel extract is currently available on the market, but limited to Asian countries due to the fact that it is a tropical plant. Nevertheless, due to its beneficial effects, it is foreseeable that in the future the business will grow and reach other countries. Moreover, it is not easy to get the right intake of fluoride from water, toothpaste or supplements,8 and products containing betel extracts might represent an additional tool to protect teeth, even in children.

Although tooth decay is not a life-threatening disease, it might be extremely disturbing and affect our daily life. With betel leaf, we have a tool to prevent the disease and say goodbye to the decay.


1. Dwivedi, V. & Tripathi, S. Review Study on Potential Activity of Piper betle. Journal of Pharmacognosy and Phytochemistry. 2014, 3, 93.

2. Rai, M.P. et al. Piper Betel Linn (Betel Vine), the Maligned Southeast Asian Medicinal Plant Possesses Cancer Preventive Effects: Time to Reconsider the Wronged Opinion. Asian Pacific Journal of Cancer Prevention. 2011, 12, 2149.

3. https://edition.cnn.com/2013/11/04/world/asia/myanmar-betel-nut-cancer/index.html (accessed on November 10, 2019).

4. https://www.bbc.com/news/health-31921207 (accessed on November 10, 2019).

5. Padma, P. R. et al. Anticarcinogenic effect of betel leaf extract against tobacco carcinogens. Cancer Letters. 1989, 45, 195.

6. Nalina, T. & Rahim, Z. H. A. The Crude Aqueous Extract of Piper betle L. and its Antibacterial Effect Towards Streptococcus mutans. American Journal of Biotechnology and Biochemistry. 2007, 3, 10.

7. Singh, D. et al. Hydroxychavicol, a key ingredient of Piper betle induces baterial cell death by DNA damage and inhibition of cell division. Free Radical Biology and Medicine. 2018, 120, 62.

8. https://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation/fluoridation-faq (accessed on November 17, 2019).

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