Topical prebiotic nitrate: optimizing the ‘hang-time’, source and dose for specific oral or systemic effects
Open accessAbstract
In our opinion, the ‘hang-time’ of nitrate-containing products discussed in the letter by Green and Green is an interesting variable that should be considered when nitrate-based treatment or prevention strategies are designed. However, due to direct nitrate recycling after nitrate intake, products with a long ‘hang-time’ (e.g., chewing gum) may not always have an advantage compared to products with a short ‘hang-time’ (e.g., vegetable juices). We argue that extending the ‘hang-time’ is especially relevant and potentially beneficial for different applications, such as using a low nitrate dose to stimulate the oral effects, reaching oral tissues that may otherwise not be exposed to dietary nitrate (e.g., periodontal pockets), and providing a longer nitrate exposure in individuals with an impaired salivary flow. Apart from the ‘hang-time’, other important variables are the nitrate dose and source (e.g., different salts and vegetable extracts), as well as the desired effect (e.g., an oral effect versus systemic effects). Finally, we believe that the alterations in salivary microbiota observed before and after chewing three nitrate-rich gums over a period of ~5 h, as reported by Green and Green, could be considered beneficial. However, the oral microbiota composition is affected by the circadian rhythm and the effect of gum mastication should be evaluated. These results should thus be confirmed by a placebo-controlled study, where these confounding factors can be accounted for.
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The timing of optimal intake may affect the efficiency of oral bacterial nitrate reduction.
“the timing of optimal intake may affect the efficiency of oral bacterial nitrate reduction [106,252,271,292].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [292]
The paper’s Abstract says nitrate-reducing oral bacteria fluctuate over the hours of the day and describes changes in salivary nitrate after intake. These observations make a timing effect plausible, but the paper does not establish that an optimal intake time affects the efficiency of bacterial nitrate reduction. (LLM, conf=0.78)
Experimental — accuracy not yet measuredHighly processed beetroot products may exhibit reduced nitrate stability and diminished physiological impact.
“highly processed beetroot products may exhibit reduced nitrate stability and diminished physiological impact [106,252,271,292].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [292]
The paper’s Fig. 2 passage reports that a nitrate-rich beetroot supplement limited oral acidification but did not affect blood pressure. It does not connect either result to how heavily the product was processed. Searches for beetroot processing, storage, and nitrate stability found no passage addressing whether processing reduces nitrate stability or physiological impact. (LLM, conf=0.71)
Experimental — accuracy not yet measured
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- Authors
- Rosier, B. T., & Mira, A.
- Affiliations
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (ES)
- Corresponding author
- Rosier, Bob T.
- ORCID
- Rosier, Bob T.
- Venue
- npj Biofilms and Microbiomes
- Published
- 2024-07-18
- Volume
- 10
- Issue
- 1
- Pages
- 58-58
- ISSN
- 2055-5008 (ISSN-L)
- PMC
- PMC11258277
- OpenAlex
- W4400778946
- Cited by
- 6
- References
- 22
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- npj Biofilms and Microbiomes (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Ministerio de Ciencia, Innovación y Universidades (10.13039.501100011033, 10.13039, .13039/501100011033, 501100011033)
- European Regional Development Fund (10.13039/501100011033, 13039/501100011033, 501100011033)
- Agencia Estatal de Investigación (501100011033, 10.13039/501100011033, 13039, .13039/501100011033, 10.13039)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Dentistry › Periodontics › Oral Health Pathology and Treatment
- Keywords
- dietary nitrate, topical nitrate, chewing gum, nitrate sources, oral microbiota, salivary flow, periodontal pockets, circadian rhythm, nitrate recycling
- MeSH terms
- Fruit and Vegetable Juices, Administration, Topical, Chewing Gum, Humans, Mouth, Nitrates, Saliva, Prebiotics, Microbiota
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