Dietary carbohydrates and dental-systemic diseases

Hujoel, P.

doi:10.1177/0022034509337700

Cited by 156Dental Health and Care UtilizationOral microbiology and periodontitis researchNutritional Studies and Diet

Dietary carbohydrates and dental-systemic diseases

Hujoel, P.·2009·Journal of Dental Research

DOI 10.1177/0022034509337700

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Abstract

Two contradictory hypotheses on the role of dietary carbohydrates in health and disease shape how dental-systemic associations are regarded. On one side, Cleave and Yudkin postulated that excessive dietary fermentable carbohydrate intake led-in the absence of dental interventions such as fluorides-first to dental diseases and then to systemic diseases. Under this hypothesis, dental and systemic diseases shared-as a common cause-a diet of excess fermentable carbohydrates. Dental diseases were regarded as an alarm bell for future systemic diseases, and restricting carbohydrate intake prevented both dental and systemic diseases. On the opposite side, Keys postulated the lipid hypothesis: that excessive dietary lipid intake caused systemic diseases. Keys advocated a diet high in fermentable carbohydrate for the benefit of general health, and dental diseases became regarded as local dietary side effects. Because general health takes precedence over dental health when it comes to dietary recommendations, dental diseases became viewed as local infections; interventions such as fluorides, sealants, oral hygiene, antimicrobials, and dental fillings became synonymous with maintaining dental health, and carbohydrates were no longer considered as a common cause for dental-systemic diseases. These opposing dietary hypotheses have increasingly been put to the test in clinical trials. The emerging trial results favor Cleave-Yudkin's hypothesis and may affect preventive approaches for dental and systemic diseases.

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A diet abundant in complex carbohydrates, with no increase in total energy intake, may lower the risk of gingivitis and periodontitis.
“Recent evidence suggests that consumption of high-glycemic foods alone might increase gingival and periodontal inflammation and bleeding as well, while a diet abundant in complex carbohydrates, with no increase in total energy intake, may lower the risk of gingivitis and periodontitis [72,73,74,75,76,77].”
From A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis (2022) · cites this paper as [74]
Consumption of high-glycemic foods alone might increase gingival and periodontal inflammation and bleeding.
“Recent evidence suggests that consumption of high-glycemic foods alone might increase gingival and periodontal inflammation and bleeding as well, while a diet abundant in complex carbohydrates, with no increase in total energy intake, may lower the risk of gingivitis and periodontitis [72,73,74,75,76,77].”
From A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis (2022) · cites this paper as [74]
Caries and periodontal disease are polymicrobial, plaque-mediated infections thought to result from perturbation of a healthy, ecologically balanced oral biofilm that can occur from dietary changes such as increased consumption of fermentable carbohydrates.
“Caries and periodontal disease are both polymicrobial, plaque-mediated infections, thought to result from perturbation of a healthy, ecologically balanced oral biofilm23,24 that can occur from dietary changes, such as the increased consumption of fermentable carbohydrates25,26.”
From Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions (2013) · cites this paper as [25]
The frequency of systemic diseases has risen over the last few decades.
“However, whilst the frequency of these systemic diseases has risen over the last few decades25, our data show that the abundance of periodontal disease-associated bacteria has been relatively stable since the introduction of farming (e.g., Figure 3, P. gingivalis).”
From Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions (2013) · cites this paper as [25]
Lowered consumption of carbohydrates has been determined to decrease markers of gingival and periodontal inflammation.
“Lowered consumption of carbohydrates has additionally been determined to decrease markers of gingival and periodontal inflammation.”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [276]

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The oral microbiome: Role of key organisms and complex networks in oral health and disease
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Pathogens and host immunity in the ancient human oral cavity
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Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions
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Self-citation
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The Role of Nutrition in Periodontal Health: An Update
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Integrated hypothesis of dental caries and periodontal diseases
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An oral health optimized diet can reduce gingival and periodontal inflammation in humans - a randomized controlled pilot study
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Nutritional Ecology and Human Health
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Crystal Structure of Glucansucrase from the Dental Caries Pathogen Streptococcus mutans
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A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis
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Association of Endodontic Infection with Detection of an Initial Lesion to the Cardiovascular System
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Stimulation of the nitrate‐nitrite‐ NO ‐metabolism by repeated lettuce juice consumption decreases gingival inflammation in periodontal recall patients: a randomized, double‐blinded, placebo‐controlled clinical trial
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Effect of the Mediterranean diet on gingivitis: A randomized controlled trial
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Global Burden of Sugar-Related Dental Diseases in 168 Countries and Corresponding Health Care Costs
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Inter-Individual Differences in the Oral Bacteriome Are Greater than Intra-Day Fluctuations in Individuals
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Bidirectional relations between cognitive function and oral health in ageing persons: a longitudinal cohort study
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Are Hill's criteria for causality satisfied for vitamin D and periodontal disease?
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Effects of Short-Chain Fatty Acids on Human Oral Epithelial Cells and the Potential Impact on Periodontal Disease: A Systematic Review of In Vitro Studies
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Obesity and Dental Decay: Inference on the Role of Dietary Sugar
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Periodontal conditions in vegetarians: A clinical study
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Dietary Factors Affecting the Prevalence and Impact of Periodontal Disease
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Chapter 13: Diet and periodontal diseases
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Added Sugar Consumption and Chronic Oral Disease Burden among Adolescents in Brazil
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Diet-borne systemic inflammation is associated with prevalent tooth loss
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High‐Fiber Foods Reduce Periodontal Disease Progression in Men Aged 65 and Older: The Veterans Affairs Normative Aging Study/Dental Longitudinal Study
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Sports Diet and Oral Health in Athletes: A Comprehensive Review
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Human enamel thickness and ENAM polymorphism
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Authors: Hujoel, P.
Affiliations: University of Washington (US)
Corresponding author: Hujoel, P.
ORCID: Hujoel, P.
Venue: Journal of Dental Research
Publisher: SAGE Publications
Published: 2009-06
Volume: 88
Issue: 6
Pages: 490-502
ISSN: 0022-0345 (ISSN-L)
1544-0591
DOI: 10.1177/0022034509337700
OpenAlex: W2027732320
Cited by: 156
References: 154
Citations by year: 2026: 5 · 2025: 10 · 2024: 15 · 2023: 11 · 2022: 12 · 2021: 13 · 2020: 14 · 2019: 12 · 2018: 10 · 2017: 6 · 2016: 8 · 2015: 8 · 2014: 9 · 2013: 6 · 2012: 9
FWCI: 0.97
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of Dental Research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords: dietary carbohydrates, fermentable carbohydrates, lipid hypothesis, dental caries, systemic disease, dietary intervention, fluoride, dental disease prevention
MeSH terms: Cardiovascular Diseases, Chronic Disease, Dental Caries, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Dietary Fats, Humans, Interprofessional Relations, Periodontal Diseases, Risk Factors, Smoking

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Dietary carbohydrates and dental-systemic diseases

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