The Role of Oral Nitrate-Reducing Bacteria in the Prevention of Caries: A Review Related to Caries and Nitrate Metabolism
Open accessAbstract
Circulating nitrate is actively absorbed by salivary glands and secreted into the oral cavity, where it is reduced to nitrite by oral nitrate-reducing bacteria. This process has previously been considered harmful because nitrate and nitrite can promote the formation of potentially carcinogenic N-nitrosamines. However, recent studies have shown that nitrate may have other physiological functions, and it can serve as a precursor for the systemic production of nitric oxide (NO) and perform NO-like functions, such as promoting vasodilation, regulating metabolic diseases, alleviating senescence, and protecting the digestive system. Inside the oral cavity, NO is likely to inhibit sensitive species as part of the nonspecific oral immune system. Exogenous administration of nitrate can maintain a balance in the pH of saliva. Oral nitrate-reducing bacteria can control the progression of caries by metabolizing lactic acid and reducing its accumulation, which is beneficial to the homeostasis of the oral microecology. In the current manuscript, we reviewed nitrate-reducing bacteria and their nitrate-metabolizing functions during the development of caries. Furthermore, we listed the effects of probiotics and dietary modification, which may be a promising method to prevent the occurrence of caries. We believe that this review provides novel ideas for the prevention of caries and treatment in clinical settings.
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Antibacterial mouthwashes can hinder nitrate reduction by reducing nitrite formation, thereby attenuating vascular benefits.
“However, antibacterial mouthwashes can hinder this process by reducing nitrite formation, thereby attenuating vascular benefits [31,81].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [81]
Beetroot is one of the richest dietary sources of inorganic nitrate (250-400 mg/100 g fresh weight), depending on agronomic and storage conditions.
“Depending on agronomic and storage conditions, it is also one of the richest dietary sources of inorganic nitrate (250–400 mg/100 g fresh weight) [80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [81]
Around 25% of circulating nitrate is concentrated in the salivary glands, where it is reduced to nitrite by oral bacteria; this critical step is influenced by diet, the composition of the oral microbiome, and hygiene practices.
“Around 25% of circulating nitrate is concentrated in the salivary glands, where it is reduced to nitrite by oral bacteria. This critical step is influenced by diet, the composition of the oral microbiome, and hygiene practices.”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [81]
The reduction of nitrate to nitrite is dependent on oral bacteria located on the dorsal tongue.
“The reduction of nitrate to nitrite is dependent on oral bacteria located on the dorsal tongue [31,81].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [81]
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- Authors
- Feng, J., Liu, J., Jiang, M., Chen, Q., Zhang, Y., Yang, M., & Zhai, Y.
- Affiliations
- Henan University (CN)
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine (CN)
- Venue
- Caries Research
- Publisher
- S. Karger AG
- Published
- 2023
- Volume
- 57
- Issue
- 2
- Pages
- 119-132
- ISSN
- 0008-6568 (ISSN-L)
- 1421-976X
- OpenAlex
- W4317037199
- Cited by
- 28
- References
- 100
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 7
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Caries Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Rochester
- Health Commission of Henan Province (Wjlx2020017)
- Henan University
- National Health Commission of the People's Republic of China
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- dental caries prevention, nitrate metabolism, nitric oxide, nitrite, nitrosamines, salivary nitrate, lactic acid, probiotics, dietary change, oral immune system
- MeSH terms
- Bacteria, Dental Caries Susceptibility, Humans, Mouth, Nitrates, Nitric Oxide, Nitrites, Saliva
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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