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Cited by 144Oral microbiology and periodontitis researchGut microbiota and healthDental Health and Care Utilization

A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis

Open access
Santonocito, Simona, Giudice, Amerigo, Polizzi, Alessandro, Troiano, Giuseppe, Merlo, Emanuele Maria, Sclafani, Rossana, Grosso, Giuseppe, Isola, Gaetano·2022·Nutrients
DOI 10.3390/nu14122426PMC PMC9227938
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Abstract

Over the last few decades, studies on the oral microbiome have increased awareness that the balance between the host and the microbial species that coexist in it is essential for oral health at all stages of life. However, this balance is extremely difficult to maintain, and many factors can disrupt it: general eating habits, sugar consumption, tobacco smoking, oral hygiene, and use of antibiotics and other antimicrobials. It is now known that alterations in the oral microbiota are responsible for developing and promoting many oral diseases, including periodontal disease. In this context, diet is an area for further investigation as it has been observed that the intake of particular foods, such as farmed animal meat, dairy products, refined vegetable oils, and processed cereals, affects the composition of the microbiota, leading to an increased representation of acid-producing and acid-tolerant organisms and periodontal pathogens. However, little is known about the influence of diet on the oral microbiome and the creation of a suitable microenvironment for the development of periodontal disease. The aim of the present study is to evaluate current knowledge on the role of diet in the oral dysbiosis underlying periodontal disease.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review synthesizes evidence that diet shapes the oral microbiome and periodontal inflammation, with Westernized/high-refined-carbohydrate, saturated-fat, and animal-protein patterns promoting dysbiosis and periodontitis, while fruits, vegetables, complex carbohydrates, certain vitamins, and probiotics/prebiotics may support periodontal health. Evidence remains limited by few interventional and mechanistic studies, especially on micronutrient–oral microbiome interactions.

Key findings

  • Diet is proposed to drive oral dysbiosis: Westernized patterns rich in farmed animal meat, sugary dairy, refined vegetable oils, and processed grains increase acid-producing/acid-tolerant organisms and periodontal pathogens; archaeological dental calculus shows agricultural/Neolithic onward plaque dominated by caries-associated Veillonellaceae and periodontal taxa *P. gingivalis*, *T. forsythia*, and *T. denticola*.
  • Macronutrient effects include refined/high-glycemic carbohydrates promoting saccharolytic microbes and acidification, protein-rich neutral-alkaline environments favoring periodontal pathogens, and saturated fatty acids positively associated with periodontal lesions in 264 Japanese participants; a vegetarian group (100) had significantly less pocket depth, less bleeding on probing, and better oral hygiene than 100 nonvegetarians.
  • Micronutrient findings include low vitamin C, B12, and D linked to periodontitis; beta-carotene intake ≥7.07 mg/d associated with a lower percentage of sites with probing depth >3 mm after nonsurgical periodontal treatment in nonsmokers; higher vitamin E intake inversely associated with periodontal disease progression over 2 years in 264 patients; and vitamin K supplementation unable to reduce pro-inflammatory factors in periodontal tissue.
  • Probiotic/prebiotic evidence is mixed: *L. rhamnosus* SP1 (2 × 10⁷ CFU daily for 3 months) in 28 patients gave improvements similar to scaling and root planing alone; heat-killed *L. plantarum* L-137 (10 mg daily for 12 weeks) reduced probing depth; a Bacillus probiotic in 40 gingivitis patients reduced plaque and gingivitis after 8 weeks but not significantly versus placebo; no direct evidence exists for micronutrient–oral microbiome interactions.

Methods

  • Narrative review aiming to evaluate current knowledge on the role of diet in oral dysbiosis underlying periodontal disease.
  • Evidence is drawn from cited literature including historical/archaeological dental calculus studies, cross-sectional and cohort studies, clinical trials, and animal/in vitro studies; no systematic search strategy, databases, inclusion/exclusion criteria, or risk-of-bias assessment is reported.
  • Main analysis is a qualitative/narrative synthesis organized by oral microbiome, food texture and diet, macronutrients, micronutrients, and probiotics/prebiotics.

Limitations

  • Stated in the paper: little is known about the influence of diet on the oral microbiome and creation of a suitable microenvironment for periodontal disease; few studies exist on vitamin A in periodontal therapy; further randomized controlled interventional studies are needed for vitamin D; interventional studies on prebiotics in periodontal disease are lacking; and there is no direct evidence of interactions between micronutrient intake and the oral microbiome.
  • Evident from the text: as a narrative review, it lacks a systematic protocol or quantitative synthesis, so conclusions rely on heterogeneous observational, animal, and in vitro evidence and cannot establish causality or precise effect sizes.
  • Evident from the text: several cited associations come from small or selected samples (e.g., 28 patients in a probiotic trial, 40 gingivitis patients, 100 vegetarians vs 100 nonvegetarians), and some findings conflict (e.g., no diet-related differences in oral bacterial communities in some studies versus small salivary metabolomic differences in others).

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Integrity signals

Registry

Crossref · 10.3390/nu14122426

Cites

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Statistics

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Claims the paper makes

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  • Premisecitation

    Alterations in the oral microbiota are responsible for developing and promoting many oral diseases, including periodontal disease.

    “It is now known that alterations in the oral microbiota are responsible for developing and promoting many oral diseases, including periodontal disease.”
    • Also stated in: § 1. Introduction · hedged
      “The induction and progression of the disease are promoted by a dysbiosis of the oral commensal microbiota, which may affect the host’s immune defenses, causing an inflammatory response that ultimately leads to irredeemable destruction of the periodontium (i.e., alveolar bone and periodontal ligament) in a susceptible host [7,8,9].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] Avila, 2009, The oral microbiota: Living with a permanent guest, DNA Cell Biol. source

      Not checked in the free run.

    • cites [8] Aas, 2005, Defining the normal bacterial flora of the oral cavity, J. Clin. Microbiol. source

      Not checked in the free run.

    • cites [9] Jakubovics, N.S., and Palmer, R.J. (2013). Detection and culture of novel oral Bacteria. Oral Microbial Ecology—Current Research and New Perspectives, Caister Academic Press.

      Not checked in the free run.

  • Premisecitation

    Intake of particular foods such as farmed animal meat, dairy products, refined vegetable oils, and processed cereals affects the composition of the microbiota, leading to an increased representation of acid-producing and acid-tolerant organisms and periodontal pathogens.

    “it has been observed that the intake of particular foods, such as farmed animal meat, dairy products, refined vegetable oils, and processed cereals, affects the composition of the microbiota, leading to an increased representation of acid-producing and acid-tolerant organisms and periodontal pathogens.”
    • Also stated in: § 1. Introduction · plain
      “The influence of diet on the oral microbiome has become more evident over the last decades while observing a shift toward a “Westernized” dietary pattern characterized by staple foods, such as farmed animal meats, high-sugary dairy products, refined vegetable oils, and processed grains that were accompanied by pathological changes in the oral microbiota, including increased representation of acid-”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [3] Baker, 2019, Exploiting the oral microbiome to prevent tooth decay: Has evolution already provided the best tools?, Front. Microbiol. source

      Not checked in the free run.

    • cites [20] Alhassani, A.A., Hu, F.B., Rimm, E.B., Li, Y., Rosner, B.A., Willett, W.C., and Joshipura, K.J. (2020). Dietary flavonoid intake and risk of periodontitis. J. Periodontol., Online ahead of print. source

      Not checked in the free run.

  • Premisecitation

    Macronutrients and micronutrients can modulate pro-inflammatory and anti-inflammatory cascades, influencing a person's baseline inflammatory status.

    “Evidence indicates that macronutrients and micronutrients can modulate pro-inflammatory and anti-inflammatory cascades, influencing a person’s baseline inflammatory status [19].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] Grosso, G., Laudisio, D., Frias-Toral, E., Barrea, L., Muscogiuri, G., Savastano, S., and Colao, A. (2022). Anti-inflammatory nutrients and obesity-associated metabolic-inflammation: State of the art and future direction. Nutrients, 14. source

      Not checked in the free run.

  • Premisecitation

    Several nutrients have an important impact on periodontal health.

    “Several nutrients have an important impact on periodontal health [18].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] Rosan, 2000, Dental plaque formation, Microbes Infect. source

      Not checked in the free run.

  • Premisecitation

    The rationale for the hypothesis that diet influences oral microbiota relies on historical observation of the Neolithic and Industrial revolutions, which altered macronutrient proportions, glycemic load, fatty acid composition, sodium and potassium levels, micronutrient levels, dietary pH, and fiber content.

    “The rationale for this hypothesis relies on historical observation of two key periods in human history: the Neolithic and Industrial revolutions. These periods represented two critical junctures in our history with repercussions beyond economic, cultural, and social matters. Indeed, the foods and processing techniques that arose in these two historical periods significantly altered the central”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [41] Cordain, 2005, Origins and evolution of the Western diet: Health implications for the 21st century, Am. J. Clin. Nutr. source

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    • cites [50] Halvorsrud, 2019, Effects of starch on oral health: Systematic review to inform WHO guideline, J. Dent. Res. source

      Not checked in the free run.

  • May combine two claims. 28
  • Classified as probably not a substantial claim. 11

  • May combine two claims.

    Premisecitation

    Induction and progression of periodontal disease are promoted by a dysbiosis of the oral commensal microbiota, which may affect the host's immune defenses, causing an inflammatory response that ultimately leads to destruction of the periodontium in a susceptible host.

    “The induction and progression of the disease are promoted by a dysbiosis of the oral commensal microbiota, which may affect the host’s immune defenses, causing an inflammatory response that ultimately leads to irredeemable destruction of the periodontium (i.e., alveolar bone and periodontal ligament) in a susceptible host [7,8,9].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] Avila, 2009, The oral microbiota: Living with a permanent guest, DNA Cell Biol. source

      Not checked in the free run.

    • cites [8] Aas, 2005, Defining the normal bacterial flora of the oral cavity, J. Clin. Microbiol. source

      Not checked in the free run.

    • cites [9] Jakubovics, N.S., and Palmer, R.J. (2013). Detection and culture of novel oral Bacteria. Oral Microbial Ecology—Current Research and New Perspectives, Caister Academic Press.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Periodontitis is a disease with a multifactorial etiology that, following infection induced by bacteria of the periodontal biofilm, can determine tooth loss following host response.

    “Periodontitis is a disease with a multifactorial etiology that, following infection induced by bacteria of the periodontal biofilm, can determine tooth loss following host response [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Isola, 2022, Periodontitis activates the NLRP3 inflammasome in serum and saliva, J. Periodontol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    The actual influence of diet on oral microbiota has been long debated.

    “The actual influence of diet on oral microbiota has been long debated [49].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] Loesche, W., and Gibbons, R. (1966). Influence of nutrition on the ecology and cariogenicity of the oral microflora. The Science of Nutrition and its Application in Clinical Dentistry, Saunders.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The influence of diet on the oral microbiome has become more evident over the last decades while observing a shift toward a Westernized dietary pattern characterized by farmed animal meats, high-sugary dairy products, refined vegetable oils, and processed grains, accompanied by pathological changes in the oral microbiota, including increased representation of acid-producing and acid-tolerant.

    “The influence of diet on the oral microbiome has become more evident over the last decades while observing a shift toward a “Westernized” dietary pattern characterized by staple foods, such as farmed animal meats, high-sugary dairy products, refined vegetable oils, and processed grains that were accompanied by pathological changes in the oral microbiota, including increased representation of acid-”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [3] Baker, 2019, Exploiting the oral microbiome to prevent tooth decay: Has evolution already provided the best tools?, Front. Microbiol. source

      Not checked in the free run.

    • cites [20] Alhassani, A.A., Hu, F.B., Rimm, E.B., Li, Y., Rosner, B.A., Willett, W.C., and Joshipura, K.J. (2020). Dietary flavonoid intake and risk of periodontitis. J. Periodontol., Online ahead of print. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Diet provides nutritional sources for the oral microbiota and exerts a selective pressure favoring the survival and replication of organisms best adapted to utilize specific food resources derived from the host.

    “Diet provides nutritional sources for the oral microbiota and exerts a selective pressure, favoring the survival and replication of organisms best adapted to utilize specific food resources derived from the host [8].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8] Aas, 2005, Defining the normal bacterial flora of the oral cavity, J. Clin. Microbiol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Carbohydrates are an essential source of energy for the body and are involved in fat metabolism.

    “Carbohydrates are an essential source of energy for the body and are involved in fat metabolism [65].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [65] Schifferle, 2005, Nutrition and periodontal disease, Dent. Clin.

      Not checked in the free run.

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    Premisecitation

    Several animal studies have shown the relationship between oral health and the texture of food eaten: wild animals have a higher oral health status because domestic animals eat refined foods that do not require intense chewing effort.

    “Several animal studies have shown the relationship between oral health and the texture of food eaten: wild animals have a higher oral health status because domestic animals eat refined foods that do not require intense chewing effort [59].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Crittenden, A.N., Sorrentino, J., Moonie, S.A., Peterson, M., Mabulla, A., and Ungar, P.S. (2017). Oral health in transition: The Hadza foragers of Tanzania. PLoS ONE, 12. source

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    Premisecitation

    Streptococci, in particular, play a major role in obtaining sugar residues from glycoproteins.

    “Streptococci, in particular, play a major role in obtaining sugar residues from glycoproteins [60].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Schmitt, 2004, Patterns and universals of adult romantic attachment across 62 cultural regions: Are models of self and of other pancultural constructs?, J. Cross-Cult. Psychol. source

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    Premisecitation

    The transition from hunter-gatherer to agrarian lifestyles introduced dairy products, refined carbohydrates, vegetable oils, and alcohol into the human diet, which are staples of the modern diet.

    “Therefore, the transition from hunter-gatherer to agrarian lifestyles introduced dairy products, refined carbohydrates, vegetable oils, and alcohol into the human diet, which are staples of the modern diet [53].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53] Zhang, 2021, Extending the vitamin D pathway to vitamin D3 and CYP27A1 in periodontal ligament cells. 2021;9:44-53, J. Periodontol.

      Not checked in the free run.

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    Premisecitation

    The introduction of these foods into the daily human routine has been linked with a decline in oral health and several other diseases, including cardiovascular disease, inflammatory bowel disease, rheumatic diseases, many cancers, and obesity.

    “The introduction of these foods into the daily human routine has been linked with a decline in oral health and several other diseases, including (but not limited to) cardiovascular disease, inflammatory bowel disease, rheumatic diseases, many cancers, and obesity [55].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] 2004, Dietary fiber intake and dental health status in urban-marginal, and rural communities in central Mexico, J. Nutr. Health Aging

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    Premisecitation

    Recent human studies have shown no difference in the growth rates of oral bacteria in the presence or absence of food, indicating no relationship between diet and the composition of oral bacterial communities.

    “Recent human studies have shown no difference in the growth rates of oral bacteria in the presence or absence of food, indicating no relationship between diet and the composition of oral bacterial communities [60,61].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [60] Schmitt, 2004, Patterns and universals of adult romantic attachment across 62 cultural regions: Are models of self and of other pancultural constructs?, J. Cross-Cult. Psychol. source

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    • cites [61] Beckers, 1982, Growth rates of Actinomyces viscosus and Streptococcus mutans during early colonization of tooth surfaces in gnotobiotic rats, Infect. Immun. source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Macronutrients are the main foods that need to be consumed in large quantities, as they are the most important source of energy for the human organism.

    “Macronutrients are the main foods that need to be consumed in large quantities, as they are the most important source of energy for the human organism.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [64] Najeeb, S., Zafar, M.S., Khurshid, Z., Zohaib, S., and Almas, K. (2016). The role of nutrition in periodontal health: An update. Nutrients, 8. source

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    Premisecitation

    Men who lived in the bush did not maintain the similar oral health status of their female counterparts, presumably due to cultural influences, such as high honey ingestion and tobacco consumption.

    “Men who lived in the bush did not maintain the similar oral health status of their female counterparts, presumably due to cultural influences, such as high honey ingestion and tobacco consumption, among others [55].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] 2004, Dietary fiber intake and dental health status in urban-marginal, and rural communities in central Mexico, J. Nutr. Health Aging

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    Premisecitation

    A study of 161 subjects observed a large baseline microbiota in more than 98% of the subjects tested, with no differences in relation to diet type (omnivorous, ovo-lacto-vegetarian, or vegan).

    “In line with this hypothesis, a study of 161 subjects observed a large baseline microbiota in more than 98% of the subjects tested, with no differences in relation to diet type (omnivorous, ovo-lacto-vegetarian, or vegan) [62].”
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    • cites [62] De Filippis, F., Vannini, L., La Storia, A., Laghi, L., Piombino, P., Stellato, G., Serrazanetti, D.I., Gozzi, G., Turroni, S., and Ferrocino, I. (2014). The same microbiota and a potentially discriminant metabolome in the saliva of omnivore, ovo-lacto-vegetarian and vegan individuals. PLoS ONE, 9. source

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    Premisecitation

    These bacteria can cause demineralization of dental enamel and development of carious lesions, and promote bacterial acidogenicity and acidification by increasing cell membrane permeability to protons, induction of H+-ATPase activity, and stimulation of metabolic pathways involved in acid neutralization and alkalinization.

    “These bacteria can cause demineralization of dental enamel and development of carious lesions, and on the other hand, promote bacterial acidogenicity and acidification by increasing cell membrane permeability to protons, induction of H+- ATPase activity, and stimulation of metabolic pathways involved in acid neutralization and alkalinization [83].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83] Takahashi, 2015, Oral microbiome metabolism: From “Who Are They?” to “What Are They Doing?”, J. Dent. Res. source

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    Premisecitation

    Prevotella intermedia, Prevotella nigrescens, and Porphyromonas increased their growth in the presence of glucose; at the same time, they significantly reduced the production of cytotoxic end products (succinate, isobutyrate, isovalerate, and ammonia) and proteolytic activities (immunoglobulin, albumin, and casein degradation activities).

    “It has been observed that Provetella intermedia, Prevotella nigrescens, and Porphyromonas increased their growth in the presence of glucose; at the same time, they significantly reduced the production of cytotoxic end products (succinate, isobutyrate, isovalerate, and ammonia) and proteolytic activities (immunoglobulin, albumin, and casein degradation activities).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [84] Saito, 2001, Effects of glucose on formation of cytotoxic end-products and proteolytic activity of Prevotella intermedia, Prevotella nigrescens and Porphyromonas gingivalis, J. Periodontal Res. source

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    Premisecitation

    Saccharolytic microbes have a favorable nutritional environment and are able to become the predominant micro-organisms in the oral microbiota, outcompeting slower-growing species with alternative nutritional requirements.

    “These microbes have a favorable nutritional environment and are able to become the predominant micro-organisms in the oral microbiota, outcompeting slower-growing species with alternative nutritional requirements [81].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Satokari, R. (2020). High intake of sugar and the balance between Pro- and anti-inflammatory gut bacteria. Nutrients, 12. source

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    Premisecitation

    The intake of refined carbohydrates has increased more and more in recent years, promoting the growth of saccharolytic microbes.

    “The intake of refined carbohydrates has increased more and more in recent years, promoting the growth of saccharolytic microbes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Satokari, R. (2020). High intake of sugar and the balance between Pro- and anti-inflammatory gut bacteria. Nutrients, 12. source

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    Premisecitation

    Saccharolytic bacteria include Streptococcus, Actinomyces, and Veillonella, which have the unique ability to degrade carbohydrates via the Embden-Meyerhof-Pernas pathway, producing acidic by-products including lactate, acetate, ethanol, and formate.

    “The saccharolytic bacteria include Streptococcus, Actinomyces, and Veillonella, which have the unique ability to degrade carbohydrates via the Embden−Meyerhof−Pernas pathway, producing acidic by-products including lactate, acetate, ethanol, and formate [1,82].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Moye, 2014, Fueling the caries process: Carbohydrate metabolism and gene regulation by Streptococcus mutans, J. Oral Microbiol. source

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    • cites [82] Klein, 2009, Structural and molecular basis of the role of starch and sucrose in Streptococcus mutans biofilm development, Appl. Environ. Microbiol. source

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    Premisecitation

    Digestion of carbohydrates begins in the oral cavity through the enzyme salivary α-amylase, which catalyzes the hydrolysis of starch by breaking down the α-1,4-glycosidic bonds to produce small saccharide units, such as maltose, maltotriose, and alpha-limit dextrins.

    “The digestion of carbohydrates begins in the oral cavity through the enzyme salivary α-amylase, which catalyzes the hydrolysis of starch by breaking down the α- 1,4-glycosidic bonds to produce small saccharide units, such as maltose, maltotriose, and alpha-limit dextrins [79].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [79] Bornhorst, 2012, Bolus formation and disintegration during digestion of food carbohydrates, Compr. Rev. Food Sci. Food Saf. source

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    Premisecitation

    Refined sugar intake among adults in the United States has risen by more than 30% over the past three decades.

    “A 2014 study indicated that refined sugar intake among adults in the United States has risen by more than 30% over the past three decennia [71].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Ng, 2014, Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013, Lancet source

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    Premisecitation

    Refined carbohydrates are a risk factor for both caries and periodontal disease.

    “A seminary investigation has indicated that refined carbohydrates are a risk factor for both caries and periodontal disease. [78].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78] Chapple, 2017, Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: Consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases, J. Clin. Periodontol. source

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    Premisecitation

    Although glucose is an essential nutrient for the survival of oral bacteria, its exogenous supply can be discontinuous, and the depth of the periodontal pocket can influence its concentration within a periodontal pocket.

    “In one study, it was seen that although glucose is an essential nutrient for the survival of oral bacteria, its exogenous supply can be discontinuous, and the depth of the periodontal pocket can influence its concentration within a periodontal pocket.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [84] Saito, 2001, Effects of glucose on formation of cytotoxic end-products and proteolytic activity of Prevotella intermedia, Prevotella nigrescens and Porphyromonas gingivalis, J. Periodontal Res. source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In the Staufenbiel study, vegetarian patients presented a higher level of education and healthier lifestyle than non-vegetarians.

    “Moreover, the authors pointed out that the vegetarian patients presented a higher level of education and healthier lifestyle than the non-vegetarians [89].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [89] Staufenbiel, 2013, Periodontal conditions in vegetarians: A clinical study, Eur. J. Clin. Nutr. source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Vegetable protein is linked to a decreased risk of cardiovascular disease, type 2 diabetes mellitus, and kidney disease.

    “Instead, vegetable protein has been linked to a decreased risk of cardiovascular disease, type 2 diabetes mellitus, and kidney disease [88].”
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    • cites [88] Richter, 2015, Plant protein and animal proteins: Do they differentially affect cardiovascular disease risk?, Adv. Nutr. source

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    Premisecitation

    In a cross-sectional clinical study of 100 vegetarian subjects compared with 100 nonvegetarian individuals, the vegetarian group had significantly less pocket depth, less bleeding on probing, and better oral hygiene.

    “A cross-sectional clinical study by Staufenbiel et al. evaluated the periodontal status of 100 vegetarian subjects compared with that of 100 nonvegetarian individuals. The findings indicated that the vegetarian group had significantly less pocket depth, less bleeding on probing, and better oral hygiene when compared with the nonvegetarian group.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [89] Staufenbiel, 2013, Periodontal conditions in vegetarians: A clinical study, Eur. J. Clin. Nutr. source

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    Premisecitation

    Trans fatty acids are the result of overheating fats and are typical of particular forms of cooking foods, such as frying, baking, or roasting.

    “Trans fatty acids are the result of overheating fats and are therefore typical of particular forms of cooking foods, such as frying, baking, or roasting [91].”
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    • cites [91] 2009, Trans fatty acids (tFA): Sources and intake levels, biological effects and content in commercial Spanish food, Nutr. Hosp.

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    Interpretationcitation

    N-acetyl-D-mannosamine, succinic acid, and the di-peptide Met-Pro are promising oral prebiotic compounds, which have beneficial effects on maintaining and improving oral health.

    “N-acetyl-D-mannosamine, succinic acid, and the di-peptide Met-Pro are promising oral prebiotic compounds, which have beneficial effects on maintaining and improving oral health.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The efficacy of N-acetyl-D-mannosamine in a nutrient-rich environment recreated similar to that of the oral cavity is not reduced.

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    Premisecitation

    Several studies investigate the role of probiotics on periodontal health, while there is a lack of interventional studies on the effects of prebiotics on periodontal disease.

    “Several studies investigate the role of probiotics on periodontal health, while there is a lack of interventional studies on the effects of prebiotics on periodontal disease [151].”
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    • cites [151] Slomka, 2018, Oral prebiotics and the influence of environmental conditions in vitro, J. Periodontol. source

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    Premisecitation

    Some bacteria in the gut microbiota, lactic acid bacteria and bifidobacteria, can produce vitamins, including vitamin B12.

    “It is well established that some bacteria in the gut microbiota, lactic acid bacteria (LAB) and bifidobacteria, can produce vitamins, including vitamin B12.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [123] LeBlanc, 2013, Bacteria as vitamin suppliers to their host: A gut microbiota perspective, Curr. Opin. Biotechnol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a recent in vitro study, treatment of multi-species biofilms with N-acetyl-D-mannosamine, succinic acid, and the di-peptide Met-Pro resulted in a significant increase in the proportion of beneficial species in the oral microbiota and a concomitant reduction in the proportion of pathogenic species.

    “A recent in vitro study showed that treatment of multi-species biofilms with N-acetyl-D-mannosamine, succinic acid, and the di-peptide Met-Pro resulted in a significant increase in the proportion of beneficial species in the oral microbiota and a concomitant reduction in the proportion of pathogenic species.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [152] Feghali, 2012, Cranberry proanthocyanidins: Natural weapons against periodontal diseases, J. Agric. Food Chem. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 40 patients with generalized gingivitis, probiotic products containing bacilli significantly reduced plaque and gingivitis indices after 8 weeks, but there were no statistically significant differences between the placebo and probiotic groups.

    “Plaque and gingivitis indices were significantly reduced after 8 weeks of treatment but showed no statistically significant differences between the placebo and probiotic groups [141].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [141] Slomka, 2017, Nutritional stimulation of commensal oral bacteria suppresses pathogens: The prebiotic concept, J. Clin. Periodontol. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Proteins and simple carbohydrates favor inflammation.

    “Among foods, with the greatest impact on periodontal disease, we find proteins and simple carbohydrates, which on the one hand favor the establishment of a microenvironment with an acid pH and, on the other, favor inflammation.”
    Quote in the paperSubstantial claim
33 of 33

  • The paper relies on this without support.

    Little is known about the influence of diet on the oral microbiome and the creation of a suitable microenvironment for the development of periodontal disease.

    “However, little is known about the influence of diet on the oral microbiome and the creation of a suitable microenvironment for the development of periodontal disease.”

  • The paper relies on this without support.

    The balance between the host and the microbial species that coexist in the oral microbiome is essential for oral health at all stages of life.

    “studies on the oral microbiome have increased awareness that the balance between the host and the microbial species that coexist in it is essential for oral health at all stages of life.”

  • The paper relies on this without support.

    Little evidence of dental and periodontal disease exists for pre-neolithic hunter-gatherer societies.

    “Little evidence of dental and periodontal disease exists for pre-neolithic hunter-gatherer societies.”

  • The paper relies on this without support.

    There is no direct evidence in the literature of interactions between micronutrient intake and the oral microbiome.

    “Currently, there is no direct evidence in the literature of interactions between micronutrient intake and the oral microbiome.”

  • The paper relies on this without support.

    The positive periodontal effects of a vegetarian diet are not due to the higher education and healthier lifestyle of vegetarians.

    “Therefore, the vegetarian diet appears to affect periodontal health positively.”

  • The paper relies on this without support.

    The efficacy of N-acetyl-D-mannosamine in a nutrient-rich environment recreated similar to that of the oral cavity is not reduced.

    “It is important to specify that the efficacy of N-acetyl-D-mannosamine in a nutrient-rich environment, recreated similar to that of the oral cavity, is not reduced.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Microbiome-mediated links between diet and health have been prevalently investigated by considering the role of the abiotic components of foods.

    “Microbiome-mediated links between diet and health have been prevalently investigated by considering the role of the abiotic components of foods. 35-41”

    From Unexplored microbial diversity from 2,500 food metagenomes and links with the human microbiome. (2024) · cites this paper as [40]

    The Introduction and section 4 discuss research on dietary nutrients, food composition, and their effects on the oral microbiome. But the paper does not establish that microbiome-mediated diet–health links have been investigated predominantly through abiotic food components; its scope is chiefly oral health and periodontitis, and section 7 also discusses research on probiotics. (LLM, conf=0.79)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Dodington finding cites a paper by Aas

    Minor

    The finding is attributed to Dodington et al. but cites reference 8, whose listed authors begin with Aas and whose title concerns normal oral flora. A Dodington paper is instead listed as reference 125.

  • Slomka prebiotic study cites different authors

    Minor

    The named Slomka et al. study is cited as reference 76, but reference 76 is by Jenzsch et al. A Slomka prebiotic study appears elsewhere in the reference list as reference 141.

  • Vitamin D case-control claim cites a vitamin C paper

    Minor

    The text attributes a vitamin D case-control finding to Laky et al. at reference 115, but reference 115 lists Lindblad et al. and concerns vitamin C homeostasis.

  • Claim about human studies cites a rat study

    Minor

    The sentence describes its cited evidence as human studies, but reference 61 explicitly describes research in gnotobiotic rats.

  • Refined carbohydrates assigned to two historical transitions

    Minor

    The paper places the refining of carbohydrates with mechanical milling during the Industrial Revolution, but then says the earlier transition to agriculture introduced refined carbohydrates.

  • Conclusion reverses the stated pH effect of protein fermentation

    Minor

    The conclusion says proteins favor an acidic microenvironment. Earlier, the paper says amino-acid fermentation neutralizes acidic environments.

6 of 6

Cites

Flagged first, then by citations

2 of the 153 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Jakubovics, N.S., and Palmer, R.J. (2013). Detection and culture of novel oral Bacteria. Oral Microbial Ecology—Current Research and New Perspectives, Caister Academic Press.
  2. Loesche, W., and Gibbons, R. (1966). Influence of nutrition on the ecology and cariogenicity of the oral microflora. The Science of Nutrition and its Application in Clinical Dentistry, Saunders.
  3. Aufderheide, A.C., Rodriguez-Martin, C., and Langsjoen, O. (1998). The Cambridge Encyclopedia of Human Paleopathology, Cambridge University Press.

Cited by

Sorted by citations

Related

Authors
Santonocito, S., Giudice, A., Polizzi, A., Troiano, G., Merlo, E. M., Sclafani, R., Grosso, G., & Isola, G.
Affiliations
  • University of Catania (IT)
  • Magna Graecia University (IT)
  • University of Foggia (IT)
  • University of Messina (IT)
Corresponding author
  • Polizzi, Alessandro
  • Grosso, Giuseppe
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2022-06-11
Volume
14
Issue
12
Pages
2426
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu14122426
PMC
PMC9227938
OpenAlex
W4282561604
Semantic Scholar
bb7c18b5738ad38e230c391570d7e5db5f5f956a
Cited by
144
References
153
Citations by year
2026: 25 · 2025: 63 · 2024: 34 · 2023: 20 · 2022: 2
FWCI
5.53
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Prof. G. Isola, University of Catania, Catania, Italy
Topics
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
Keywords
diet, oral microbiota, periodontitis, periodontal disease, oral dysbiosis, inflammation, immune response, sugar consumption, acidogenic bacteria, periodontal pathogens
MeSH terms
Animals, Diet, Immune System, Inflammation, Periodontal Diseases, Periodontitis, Microbiota, Dysbiosis

About these checks

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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