Annali di Stomatologia | 2026; 17(3): 679-689

ISSN 1971-1441 | DOI: 10.59987/ads/2026.3.679-689

Articles

Coffee and oral health: a narrative review of protective and detrimental effects

Lucia Giannini¹, Antonino Manti², Aia Amin², Gregorio Menozzi^1,2, Andrea Palermo³, Lucia Memè⁴, Francesca Calò⁵, Rosalba Lagioia⁵, Paola Bassi⁵

¹Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

²Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, Italy

³Department of Experimental Medicine, University of Salento, Lecce, Italy

⁴Link Campus University, Rome, Italy

⁵Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy

^*Corresponding author: Lucia Giannini - dott.lucia.giannini@gmail.com

Article History

Received: May 18, 2026

Accepted: July 15, 2026

Published: July 30, 2026

Abstract

Coffee is a chemically complex beverage that interacts directly with the oral environment, influencing dental hard tissues, saliva, the oral microbiome, periodontal tissues, and possibly implications for oral carcinogenesis. This narrative review discusses the current mechanistic, clinical, and epidemiological evidence on the effects of coffee consumption on oral health. The available literature suggests a dual and context-dependent role. On the one hand, bioactive compounds such as chlorogenic acids, trigonelline, melanoidins, and diterpenes may exert antimicrobial, anti-biofilm, antioxidant, anti-inflammatory, and potentially chemoprotective effects. On the other hand, coffee acidity and chromogenic compounds may contribute to enamel surface softening, increased susceptibility to erosion, and extrinsic staining. Caffeine may also influence alveolar bone metabolism, particularly at high intake levels, with possible implications for periodontal health. A key modifying factor is the mode of consumption: unsweetened coffee appears to differ biologically from coffee consumed with added sugars, which can counteract potential protective effects and increase the risk of dental caries. Overall, coffee cannot be considered either inherently beneficial or harmful for oral health; its impact depends on the balance between its bioactive properties, physicochemical characteristics, consumption habits, and host-related factors.

Keywords: coffee; oral health; enamel erosion; oral microbiome; periodontal disease; caffeine; chlorogenic acids; oral cancer; biofilm; sugar consumption.

1. Introduction: The Oral Cavity as Coffee’s First Biological Frontier

Coffee is one of the most widely consumed beverages worldwide and a major dietary source of bioactive compounds, including caffeine, chlorogenic acids, trigonelline, melanoidins, and diterpenes [1–3]. Its systemic effects have been extensively investigated across metabolic, cardiovascular, and neurobiological domains, whereas its interaction with the oral cavity has received comparatively less focused attention [4–5]. This relative gap is noteworthy because the oral cavity is the first biological compartment exposed to coffee, allowing direct and repeated contact between the beverage and dental hard tissues, saliva, the acquired enamel pellicle, oral mucosa, periodontal tissues, and the resident microbial biofilm [6–7].

From an oral biology perspective, coffee is particularly relevant because it is not a chemically inert exposure. Rather, it is a complex matrix in which acidity, phenolic compounds, chromogenic substances, and thermally generated molecules may act simultaneously on different oral targets [8–9]. As a result, coffee has the potential to influence not only surface phenomena, such as enamel softening and tooth staining, but also dynamic biological processes, including bacterial adhesion, biofilm maturation, oxidative balance, inflammatory signaling, and epithelial homeostasis. This multidimensional interaction makes coffee a useful model for studying how a common dietary habit can exert both physicochemical and biological effects within the oral ecosystem.

The initial interaction occurs at the interface between the beverage and the dental surface. Coffee comes into contact with enamel and dentin through a salivary environment that is continuously modulated by pH, buffering capacity, protein composition, and flow rate. In this setting, even a beverage with only moderate erosive potential may contribute to surface softening under conditions of repeated exposure, reduced salivary protection, or unfavorable behavioral habits, such as immediate toothbrushing after intake [10–11]. At the same time, coffee contains chromogenic compounds and roasting-derived pigments that may bind to the acquired enamel pellicle and accumulate more readily on roughened or previously demineralized surfaces, thereby promoting extrinsic discoloration. Thus, structural and aesthetic consequences may coexist and be mutually reinforcing [12].

Coffee also interacts with the living components of the oral environment, particularly saliva and the microbial biofilm. Experimental evidence suggests that certain coffee constituents, particularly chlorogenic acids and trigonelline, may interfere with bacterial adhesion, glucosyltransferase activity, and biofilm development, thereby limiting the growth or persistence of cariogenic microorganisms under specific conditions [13]. Melanoidins and other phenolic compounds may further contribute through antioxidant, metal-chelating, and antibiofilm actions [14]. However, these potentially protective effects are strongly modified by the mode of consumption [15–16]. In particular, the addition of fermentable carbohydrates may reverse much of the biological advantage of unsweetened coffee by favoring acidogenic and cariogenic microbial activity and creating a more permissive environment for opportunistic colonization [17–19].

Beyond the tooth surface and the supragingival biofilm, coffee may also influence periodontal and mucosal tissues [20]. Phenolic compounds have been associated with anti-inflammatory and redox-modulating effects that may be relevant to gingival and epithelial homeostasis. Conversely, caffeine has been implicated in pathways related to bone metabolism, including mechanisms involving osteoclast activation and the RANKL/OPG axis, suggesting that high levels of exposure may adversely affect alveolar bone dynamics under susceptible conditions [21–23]. These contrasting mechanisms are biologically plausible, but their clinical translation remains difficult to define because human data are heterogeneous and often confounded by factors such as smoking, alcohol consumption, dietary patterns, oral hygiene, and differences in coffee preparation and intake habits [24–25].

The epidemiological literature reflects this complexity. While some studies suggest neutral or potentially protective associations between coffee consumption and outcomes such as periodontal inflammation or oral and pharyngeal cancer risk, others report inconsistent or context-dependent findings [26–28]. Importantly, coffee should not be evaluated as a uniform exposure: black coffee, sweetened coffee, and coffee consumed with additives may have substantially different implications for the oral environment. Likewise, beverage temperature, frequency of intake, exposure duration, and host-related factors such as salivary flow, pellicle composition, microbiome structure, and baseline periodontal status may all modify the final biological effect.

In this context, a narrative review is particularly suitable because it allows the integration of mechanistic, experimental, clinical, and epidemiological evidence into a single interpretative framework. Rather than treating coffee as either inherently harmful or beneficial, this review examines it as a context-dependent exposure whose oral effects arise from a balance between protective bioactive properties and detrimental physicochemical characteristics. The aim of this review is therefore to discuss how coffee and its principal constituents interact with dental hard tissues, saliva, the oral microbiome, periodontal structures, and oral carcinogenesis, with particular attention to the modifying role of consumption habits and host susceptibility.

2. Materials and Methods

This narrative review, based on a structured literature search, was conducted to summarize and critically discuss the current evidence on the relationship between coffee consumption and oral health. The review aimed to examine both the potentially protective and detrimental effects of coffee and its principal bioactive compounds on dental hard tissues, saliva, oral biofilms, periodontal tissues, and oral carcinogenesis. The objective was to provide a descriptive and integrative synthesis of the available literature, consistent with a narrative review methodology.

2.1. Search Strategy

A comprehensive literature search was performed in the electronic databases PubMed, MEDLINE, EMBASE, and the Cochrane Library from database inception up to December 2025. The search combined Medical Subject Headings (MeSH), where applicable, and free-text terms related to coffee and oral health. Searches were restricted to articles published in the English language. The search strategy was developed to identify studies addressing the relationship between coffee consumption and coffee-derived compounds and oral health-related outcomes, including effects on dental hard tissues, saliva, the oral microbiome, periodontal tissues, and oral and pharyngeal cancer.

The primary search strategy combined terms related to the beverage with terms related to oral biology and oral disease. An example of the core search string was as follows:

(coffee OR caffeine OR Coffea) AND (oral OR dental OR enamel OR dentin OR erosion OR staining OR discoloration OR biofilm OR microbiome OR saliva OR periodontal OR “oral cancer” OR “oral cavity”)

The search syntax was adapted according to the requirements of each database. In PubMed and MEDLINE, MeSH terms were used when appropriate; in EMBASE, the strategy was adapted to database-specific indexing and controlled vocabulary; and in the Cochrane Library, keyword combinations were used to retrieve relevant reviews and indexed records.

In addition, the reference lists of selected articles and relevant reviews were manually screened to identify further potentially eligible studies.

2.2. Eligibility Criteria

Studies were considered eligible if they addressed the relationship between coffee consumption, coffee-derived compounds, or caffeine exposure and at least one oral-health-related outcome. Eligible topics included:

The chemical composition of coffee and its components relevant to oral tissues;
Effects on enamel, dentin, acquired pellicle, erosion, staining, discoloration, or surface microhardness;
Interactions with saliva, oral microbiota, or biofilm formation;
Periodontal inflammation, alveolar bone metabolism, or other periodontal outcomes;
Mechanistic or epidemiological evidence concerning oral and pharyngeal cancer.

The review included systematic reviews, meta-analyses, narrative reviews, observational human studies, clinical studies, in vitro investigations, ex vivo studies, and animal studies, provided that they were relevant to the review objectives.

Studies were excluded if they:

Focused exclusively on beverages other than coffee, unless coffee was included as a direct comparator;
Addressed only systemic, non-oral outcomes;
Were editorials, letters to the editor, opinion papers, or conference abstracts without accessible full text;
They were not written in English.

2.3. Study Selection and Data Extraction

Titles and abstracts were screened for relevance, followed by full-text assessment of potentially eligible records. After duplicate removal, the study selection process was performed independently by two reviewers (P.B. and R.L.). Disagreements were resolved through discussion and, when necessary, by consultation with a third reviewer (A.P.).

For each included publication, the following data were extracted:

Publication year and study design;
Study population or experimental model;
Type of coffee exposure or coffee-derived compound investigated;
Oral outcome(s) assessed;
Principal findings;
Major limitations;
When available, relevant information on dose/exposure conditions and comparison groups.

The overall study selection process is summarized in Figure 1 (PRISMA-style flowchart).

2.4. Quality Assessment

Given the narrative design of the review and the marked heterogeneity of the included literature, no meta-analysis was performed. Nevertheless, methodological rigor and completeness of reporting were considered when interpreting the findings. For systematic reviews and meta-analyses, methodological quality was assessed using the AMSTAR 2 domains. For observational studies, key domains commonly captured by the Newcastle–Ottawa Scale (NOS) or relevant Joanna Briggs Institute (JBI) appraisal tools were considered. For animal studies, risk-of-bias domains consistent with the SYRCLE approach were considered. For in vitro and ex vivo studies, quality was assessed qualitatively based on sample standardization, exposure protocols, control conditions, reproducibility of measurements, and clarity of outcome reporting.

Quality assessment was used to support the interpretation of the evidence and to identify the main methodological strengths and limitations of the included literature. Still, it was not applied as an exclusion criterion.

2.5. Data Synthesis

Evidence was synthesized narratively and organized into thematic domains consistent with the aims of the review:

Chemical composition of coffee relevant to oral biology;
Effects on enamel and dentin;
Interactions with saliva, oral microbiota, and biofilm;
Periodontal tissues and alveolar bone metabolism;
Oral and pharyngeal cancer-related evidence.

The final synthesis aimed to integrate mechanistic, experimental, clinical, and epidemiological findings into a coherent interpretative framework, highlighting both protective and detrimental pathways associated with coffee exposure in the oral environment.

3. Results

3.1. Search Results

The structured literature search identified 218 records from PubMed, MEDLINE, EMBASE, and the Cochrane Library. After removing 21 duplicates, 197 records were screened by title and abstract. Of these, 143 reports were sought for retrieval and assessed for eligibility, and no reports were unavailable for full-text evaluation. A total of 123 full-text reports were excluded because they focused on tea consumption, did not address oral health, were not in English, or were editorials, letters, or conference abstracts without accessible full text. Ultimately, 20 records met the inclusion criteria and were included in the narrative synthesis (Figure 1).

**Figure 1.** PRISMA-style flow diagram summarizing the structured literature search and study selection process.

3.2. Chemical Composition of Coffee Relevant to Oral Biology

Across the included literature, coffee emerged as a chemically complex exposure rather than a simple dietary beverage. Its oral effects appear to be driven by interactions among multiple bioactive compounds and physicochemical characteristics, including acidity, chromogenic potential, and preparation-related variability. The most relevant constituents identified in the literature were caffeine, chlorogenic acids, trigonelline, melanoidins, and diterpenes such as cafestol and kahweol, each contributing differently to the oral environment.

Caffeine was primarily discussed in relation to inflammatory signaling, salivary dynamics, and bone metabolism. Chlorogenic acids were consistently described as redox-active phenolic compounds with antioxidant and potentially antimicrobial properties. Trigonelline was associated with anti-adhesive and antibiofilm effects, whereas melanoidins were linked to both antimicrobial/metal-binding activity and the chromogenic behavior responsible for dental discoloration. Diterpenes, particularly cafestol and kahweol, were described as biologically active compounds with anti-inflammatory and potentially chemoprotective properties. Taken together, these data support the concept that the oral effects of coffee arise from the balance between protective bioactivity and detrimental physicochemical exposure.

3.3. Effects on Enamel and Dentin

The included literature suggests that coffee may adversely affect dental hard tissues mainly through two pathways: surface alteration and extrinsic staining. Although coffee is generally less erosive than soft drinks or citrus-based beverages, its acidity may still promote softening of the enamel surface under conditions of repeated exposure, reduced salivary buffering, or unfavorable post-consumption behaviors such as immediate toothbrushing. Experimental findings cited in the manuscript indicate that repeated exposure may reduce microhardness and increase surface porosity, thereby making enamel more vulnerable to wear.

A second recurrent finding was the role of coffee in tooth discoloration. Staining appears to be mediated by the interaction of melanoidins and polyphenolic chromogens with the acquired enamel pellicle. This process may be amplified when erosion, bleaching procedures, or pre-existing wear already roughen the surface. Overall, the evidence supports the view that the structural and aesthetic consequences of coffee exposure may coexist, with surface changes favoring greater pigment retention over time.

3.4. Interactions with Saliva, Oral Microbiota, and Biofilm

The literature included in the synthesis indicates that coffee may also interact with the living components of the oral ecosystem. Several sources described potential antimicrobial and antibiofilm effects, especially for chlorogenic acids and trigonelline, including interference with bacterial adhesion, glucosyltransferase activity, and sucrose-dependent biofilm maturation. These mechanisms support the hypothesis that unsweetened coffee may exert a modest protective effect against the development of cariogenic biofilm under specific conditions.

At the same time, these potentially favorable effects appear highly dependent on the mode of consumption. The current manuscript already emphasizes that adding sugar may substantially reverse the biological advantage of unsweetened coffee by promoting acidogenic and cariogenic activity. Salivary changes also appear relevant: short-term decreases in oral pH after coffee intake may be followed by recovery patterns influenced by salivary buffering, oral hygiene, and the presence of sugar. Thus, the effect of coffee on saliva and biofilm should be considered context-dependent rather than uniformly protective.

3.5. Periodontal Tissues and Alveolar Bone Metabolism

Evidence regarding periodontal tissues and alveolar bone was more limited and heterogeneous than the evidence on staining or surface effects. Some included sources supported the biological plausibility of beneficial effects through antioxidant and anti-inflammatory pathways, suggesting that coffee phenolics may modulate inflammatory signaling and oxidative stress in periodontal tissues. However, other data suggested a possible adverse effect of caffeine on bone remodeling, particularly regarding osteoclastic activity and alveolar bone metabolism. Taken together, the available evidence does not support a uniformly beneficial or harmful periodontal effect. Rather, it suggests that periodontal implications may depend on exposure level, host susceptibility, and confounding variables such as oral hygiene, smoking, diet, and baseline inflammatory status. In this regard, the current literature appears biologically suggestive but still insufficiently standardized to support strong clinical conclusions.

3.6. Coffee and Oral/Pharyngeal Cancer

The oncologic domain was among the most relevant epidemiological areas addressed in the included literature. The current manuscript already cites systematic and observational evidence indicating that coffee consumption may be associated with a reduced risk of oral and pharyngeal cancer, particularly in analyses of higher intake categories. These findings are consistent with the proposed antioxidant, anti-inflammatory, and chemoprotective roles of chlorogenic acids and diterpenes.

However, the interpretation of these associations remains cautious. Studies on oral and pharyngeal cancer are particularly vulnerable to confounding by smoking, alcohol consumption, dietary habits, and broader lifestyle factors. Therefore, while the epidemiological signal may be favorable, the available data should be interpreted as supportive of a possible protective association, rather than as definitive evidence of causality.

3.7. Overview of Included Studies

The 20 records included in the narrative synthesis were methodologically heterogeneous and comprised review articles, systematic reviews and meta-analyses, experimental studies, observational investigations, and animal models. Collectively, they covered the five thematic domains predefined in the data synthesis strategy: coffee composition relevant to oral biology; effects on enamel and dentin; interactions with saliva and oral biofilm; periodontal and alveolar bone implications; and oral/pharyngeal cancer-related evidence. The main characteristics of the included records are summarized in Table 1.

Table 1. Main characteristics of the 20 records included in the narrative synthesis.

First author (Year)	Study design	Population	Exposure/focus	Main outcomes
Butt (2011) [1]	Narrative review	Not applicable	Coffee composition, bioactive compounds, and health effects	Summarized the dual biological profile of coffee, highlighting both potentially beneficial and adverse effects of major constituents, including caffeine, chlorogenic acids, cafestol, and kahweol.
Raise-Abdullahi (2024) [29]	Narrative review	Not applicable	Coffee and cognitive function	Included as background literature on the biological activity of coffee and caffeine; useful for contextualizing systemic neuroactive effects relevant to mechanistic interpretation.
Rai (2024) [30]	Narrative review	Not applicable	Coffee, antioxidants, and inflammation	Included as background on antioxidant and anti-inflammatory actions of coffee bioactives; relevant to mechanistic interpretation of oral-tissue effects.
O’Keefe (2013) [4]	Narrative review	Not applicable	Habitual coffee consumption and long-term health outcomes	Provided background on coffee as a complex chronic exposure and on dose-related systemic effects potentially relevant to host susceptibility.
Aguiar (2015) [6]	Narrative review	Not applicable	Coffee consumption and oral health	Reviewed the effects of coffee on dental plaque, caries-related mechanisms, staining, restorative materials, bleaching stability, and halitosis, emphasizing the modifying role of sugar.
Baspinar (2017) [24]	Narrative review	Not applicable	Coffee and metabolic syndrome	Included as systemic background on metabolic and inflammatory pathways that may influence interpretation of oral-health associations.
De Melo Pereira (2020) [2]	Narrative review	Not applicable	Chemical composition and health properties of coffee and coffee byproducts	Detailed the major coffee bioactives, including caffeine, chlorogenic acids, trigonelline, diterpenes, and melanoidins, providing the compositional framework for the review.
Ding (2014) [31]	Systematic review and dose-response meta-analysis	Prospective cohort studies	Long-term coffee consumption and cardiovascular risk	Included as background on chronic coffee exposure and dose-response interpretation; supported a non-uniform risk profile rather than a uniformly detrimental one.
Manno (2018) [10]	Experimental study	Rat dental tissues/spectroscopic analysis	Coffee-induced staining and mineral changes in enamel/dentin	Reported coffee-related staining together with elemental changes consistent with structural alteration of dental tissues, supporting an erosive/discoloration pathway.
Godos (2014) [32]	Narrative review	Not applicable	Coffee components and cardiovascular risk	Included as mechanistic background on beneficial and detrimental actions of major coffee constituents.
Maughan (2003) [33]	Narrative review	Not applicable	Caffeine ingestion and fluid balance	Used as background for the discussion of caffeine, hydration, and potential salivary implications, particularly in habitual versus acute exposure contexts.
Rebollo-Hernanz (2019) [14]	In vitro experimental study	Adipocyte cell model	Phenolic compounds from coffee by-products	Provided mechanistic support for anti-inflammatory and redox-modulating effects of coffee phenolics, relevant to periodontal tissue homeostasis.
Dos Santos (2025) [21]	Animal experimental study	Male Wistar rats after tooth extraction	Coffee ingestion and alveolar bone repair	Examined the influence of coffee ingestion on post-extraction alveolar bone healing, supporting the section on bone metabolism and periodontal implications.
Miranda (2017) [26]	Systematic review and meta-analysis	13 case-control and 4 cohort studies	Coffee consumption and oral/pharyngeal cancer risk	Reported an inverse association between high coffee consumption and oral/pharyngeal cancer risk, supporting a possible protective role.
Galeone (2010) [27]	Pooled analysis of case-control studies	5,139 cases and 9,028 controls	Coffee and tea intake in relation to head and neck cancer	Found an inverse association between caffeinated coffee intake and risk of oral cavity and pharyngeal cancer, particularly at higher intake levels.
Al-Dakkak (2011) [34]	Evidence commentary/summary	Not applicable	Coffee, tea, and oral cancer risk	Summarized evidence suggesting a protective association between caffeinated coffee and oral cavity/pharyngeal cancer risk.
Radoi (2013) [35]	Population-based case-control study	ICARE study population	Tea and coffee consumption and oral cavity cancer	Reported inverse associations between oral cavity cancer and tea or coffee consumption.
Levrini (2025) [17]	Clinical observational study	14 healthy adult volunteers	Salivary pH after coffee with and without sugar	Showed a short-term decrease in salivary pH after coffee intake, with a more favorable profile for unsweetened coffee and after oral hygiene.
Machado (2024) [9]	Narrative review	Not applicable	Mechanisms of action of coffee bioactive compounds	Framed the “coffee paradox” by linking coffee chemistry to divergent biological effects across tissues and exposure patterns.
Ludwig (2014) [3]	Narrative review	Not applicable	Coffee biochemistry and health impact	Provided biochemical background on roasting-derived compounds and major phytochemicals relevant to antioxidant, inflammatory, and physicochemical effects.

4. Discussion

The present narrative review supports the concept that coffee has a dual and context-dependent relationship with oral health. Rather than acting as a uniformly beneficial or harmful exposure, coffee appears to influence the oral cavity through a combination of bioactive, physicochemical, and behavioral factors. This interpretation is already consistent with the abstract, introduction, and data synthesis strategy of the manuscript, all of which frame coffee as an exposure whose effects depend on the balance between protective compounds and adverse surface-related properties.

One of the clearest findings emerging from the synthesis is that the mode of consumption is a decisive modifier of oral outcomes. Unsweetened coffee may retain some antimicrobial, antibiofilm, antioxidant, and potentially anti-inflammatory properties. In contrast, sugar addition may negate these potential advantages and shift the balance toward cariogenicity and acidogenic biofilm behavior. In practical terms, this means that “coffee” should not be interpreted as a single exposure category in oral-health research: black coffee, sweetened coffee, and coffee consumed with additives may have substantially different biological implications [35–37].

A second important observation is the marked heterogeneity of the available literature. The narrative synthesis includes reviews, epidemiological studies, in vitro investigations, animal models, and a limited number of direct oral clinical observations. This breadth is useful for mechanistic interpretation, but it also limits comparability. Surface staining, enamel alteration, salivary changes, periodontal biology, and cancer epidemiology are not measured through a common methodological framework, and the underlying exposure definitions vary considerably across studies. As a result, the current evidence base is better suited to supporting biological plausibility and thematic synthesis than to providing strong quantitative clinical guidance [38].

The review also highlights a difference in evidentiary strength across domains. The evidence for staining and surface interactions is relatively intuitive and consistent. In contrast, the evidence for periodontal and bone effects is more heterogeneous and more susceptible to confounding and model-specific limitations. The evidence regarding oral and pharyngeal cancer is epidemiologically relevant and potentially encouraging, but causal inference remains limited by the observational nature of much of the literature and the difficulty of disentangling coffee intake from broader lifestyle patterns [33].

From a clinical perspective, the findings suggest that coffee consumption should be discussed with patients in a nuanced way. It would be inaccurate to portray coffee as universally damaging to the oral cavity; however, it would be equally misleading to emphasize only its potential protective bioactivity. Clinicians should consider consumption habits, sugar intake, frequency of intake, timing of oral hygiene, baseline enamel condition, salivary status, and periodontal susceptibility when interpreting the potential oral impact of coffee [28,31].

This review has several limitations. First, the included evidence is heterogeneous in design and quality. Second, not all included records are directly oral-specific, since some were incorporated to provide biochemical or mechanistic background relevant to the interpretative framework adopted in this manuscript [29–30,32]. Third, the structured search supports transparency, but the narrative design does not eliminate the possibility of interpretative selection bias. Future research should aim to improve exposure standardization and outcome reporting. Studies should more clearly distinguish between sweetened and unsweetened coffee, quantify frequency and preparation methods, and assess oral outcomes through standardized clinical, microbiological, salivary, and patient-centered measures. More robust prospective studies would be particularly valuable for clarifying the relationship between coffee consumption, periodontal outcomes, and oral/pharyngeal cancer risk [39,34].

5. Conclusion

Coffee exerts a complex and context-dependent influence on oral health. The available evidence suggests that its oral effects cannot be interpreted as uniformly beneficial or detrimental, as they arise from interactions between protective bioactive compounds and adverse physicochemical properties. On the one hand, constituents such as chlorogenic acids, trigonelline, melanoidins, and diterpenes may contribute to antimicrobial, antibiofilm, antioxidant, anti-inflammatory, and potentially chemoprotective effects. On the other hand, coffee acidity, chromogenic compounds, and caffeine-related effects on mineralized tissues may favor enamel surface softening, extrinsic staining, and possible alterations in alveolar bone metabolism under susceptible conditions. A major determinant of the final oral impact is the mode of consumption, particularly the addition of sugar, which may counteract potential protective effects and promote cariogenic and acidogenic changes. Overall, coffee should be regarded as a biologically active exposure whose oral consequences depend on consumption habits, host susceptibility, and the balance between protective and detrimental mechanisms. Further standardized clinical and prospective studies are needed to clarify the long-term implications of coffee consumption for oral tissues, periodontal health, and oral cancer risk.

Funding:

This study was partially funded by the Italian Ministry of Health – Current Research IRCCS.

Institutional Review Board Statement:

Not applicable.

Data Availability Statement:

Data sharing does not apply to this article, as no new datasets were generated or analyzed.

Conflicts of Interest:

The authors declare no conflicts of interest.

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