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

The DOI matches its Crossref record; 151 of the 153 references it cites were found in a registry or an index; 2 of the 131 sources its claims cite were checked for support.

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

Open access

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.

Overview

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

151 of 151 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1 Composition of the human oral microbiota.
Figure 1 Composition of the human oral microbiota.CC BY · PubMed Central
Figure 2 Evolution of oral microbiome.
Figure 2 Evolution of oral microbiome.CC BY · PubMed Central
Figure 3 Evolution of diet and corresponding microbiome.
Figure 3 Evolution of diet and corresponding microbiome.CC BY · PubMed Central
Figure 4 Possible mechanisms of probiotic action in the oral cavity.
Figure 4 Possible mechanisms of probiotic action in the oral cavity.CC BY · PubMed Central
Figure 5 List and action of the main prebiotics that confer oral health benefits.
Figure 5 List and action of the main prebiotics that confer oral health benefits.CC BY · PubMed Central

Verification

Claims the paper makes

94 Not checked yet · 7 Own interpretation · 1 Partly supported · 1 Couldn’t confirm · accuracy not yet measured

Verify all 129 references — free account

Show all 70 claims

  • It may state two separate claims as one. 28
  • Probably not a substantial claim. 11
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

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6 of 6

Citations

Cites

Show all 153 references

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.

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Metadata

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
Venue
Nutrients
Publisher
MDPI AG
Published
2022-06-11
Volume
14
Issue
12
Pages
2426
ISSN
2072-6643 (ISSN-L)
OpenAlex
W4282561604
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
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 › General Dentistry › 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

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