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Cited by 167Oral microbiology and periodontitis researchDental Health and Care UtilizationOral Health Pathology and Treatment

The impact of the stone age diet on gingival conditions in the absence of oral hygiene

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Baumgartner, Stefan, Imfeld, Thomas, Schicht, Olivier, Rath, Christian, Persson, Rigmor E., Persson, G. Rutger·2009·Journal of Periodontology
DOI 10.1902/jop.2009.080376
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Abstract

BACKGROUND: The objective of this study was to assess the oral microbiota and clinical data in subjects without access to traditional oral hygiene methods and who ate a diet available in the Stone Age. METHODS: Ten subjects living in an environment replicating the Stone Age for 4 weeks were enrolled in this study. Bleeding on probing (BOP), gingival and plaque indices, and probing depth (PD) were assessed at baseline and at 4 weeks. Microbiologic samples were collected at the mesio-buccal subgingival aspects of all teeth and from the dorsum of the tongue and were processed by checkerboard DNA-DNA hybridization methods. RESULTS: No subject had periodontitis. Mean BOP decreased from 34.8% to 12.6% (P <0.001). Mean gingival index scores changed from 0.38 to 0.43 (not statistically significant) and mean plaque scores increased from 0.68 to 1.47 (P <0.001). PD at sites of subgingival sampling decreased (mean difference: 0.2 mm; P <0.001). At week 4, the total bacterial count was higher (P <0.001) for 24 of 74 species, including Bacteroides ureolyticus, Eikenella corrodens, Lactobacillus acidophilus, Capnocytophaga ochracea, Escherichia coli, Fusobacterium nucleatum naviforme, Haemophilus influenzae, Helicobacter pylori, Porphyromonas endodontalis, Staphylococcus aureus (two strains), Streptococcus agalactiae, Streptococcus anginosis, and Streptococcus mitis. Bacterial counts from tongue samples were higher at baseline (P <0.001) for 20 species, including Tannerella forsythia (previously T. forsythensis), Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans; serotype a), and Streptococcus spp. CONCLUSIONS: The experimental gingivitis protocol is not applicable if the diet (e.g., Stone Age) does not include refined sugars. Although plaque levels increased, BOP and PD decreased. Subgingival bacterial counts increased for several species not linked to periodontitis, whereas tongue bacterial samples decreased during the study period.

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  • 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 [72]

  • 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 [72]

  • Processed carbohydrate consumption has been associated with increased incidence of periodontal disease.

    “Moreover, processed carbohydrate consumption has been associated with increased incidence of periodontal disease.8, 24, 26, 181, 188, 251”

    From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [251]

  • In the Baumgartner study, although plaque amount was higher at endpoint than baseline, decreased bleeding on probing and periodontal pocket depths were noted and, despite abstinence from oral hygiene, gingival inflammation did not increase.

    “Although the amount of plaque on teeth was higher at the experiment endpoint than at baseline, decreased bleeding on probing and periodontal pocket depths were noted and, despite abstinence from oral hygiene, gingival inflammation did not increase.”

    From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [251]

  • Stone-age dietary interventions in the absence of oral hygiene significantly shifted proportions of microbes in dental plaque, with reduced counts of T forsythia, A actinomycetemcomitans, and Streptococcus species from tongue samples after 4 weeks.

    “Baumgartner et al251 additionally identified significant shifts in the proportions of microbes in dental plaque in response to “stone‐age” dietary interventions in the absence of oral hygiene, in which counts of the periodontal pathogens T forsythia and A actinomycetemcomitans, as well as Streptococcus species, from tongue samples were reduced following 4 weeks of dietary intervention.”

    From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [251]

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Authors
Baumgartner, S., Imfeld, T., Schicht, O., Rath, C., Persson, R. E., & Persson, G. R.
Affiliations
  • University of Bern (CH)
  • University of Zurich (CH)
ORCID
Persson, G. Rutger
Venue
Journal of Periodontology
Publisher
Wiley
Published
2009-05
Volume
80
Issue
5
Pages
759-768
ISSN
  • 0022-3492 (ISSN-L)
  • 1943-3670
DOI
10.1902/jop.2009.080376
OpenAlex
W1972917199
Cited by
167
References
46
Citations by year
2026: 7 · 2025: 11 · 2024: 16 · 2023: 7 · 2022: 19 · 2021: 20 · 2020: 9 · 2019: 14 · 2018: 12 · 2017: 10 · 2016: 12 · 2015: 2 · 2014: 6 · 2013: 3 · 2012: 4
FWCI
6.27
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Periodontology (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich)
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
oral microbiota, gingival health, oral hygiene, subgingival bacteria, tongue microbiota, bleeding on probing, probing depth, dental plaque, refined sugar, periodontitis, experimental gingivitis, Bacteroides ureolyticus, Aggregatibacter actinomycetemcomitans, Streptococcus, Helicobacter pylori
MeSH terms
Adolescent, Adult, Child, Dental Plaque, DNA, Bacterial, Female, Gingivitis, Humans, Male, Oral Hygiene, Tongue, Bacterial Typing Techniques, Diet, Carbohydrate-Restricted, Young Adult

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