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Díaz-Fabregat B, Ramírez-Carmona W, Cannon ML, Monteiro DR, Pessan JP, Antoniali C. Are salivary NO 2- / NO 2- and NO 3- levels biomarkers for dental caries in children? Systematic review and meta-analysis. Nitric Oxide 2024; 144:11-19. [PMID: 38185241 DOI: 10.1016/j.niox.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/15/2023] [Accepted: 01/05/2024] [Indexed: 01/09/2024]
Abstract
The literature is conflicting regarding salivary nitrite (NO2-)/nitrite and nitrate (NO2- and NO3-) levels in children affected by dental caries. For this reason, a systematic review to provide a consensus on the subject was propose, whose objective is to verify whether these molecules could be used as biomarkers in children with caries. A comprehensive search was performed on online database and eleven articles were included in the meta-analysis. The methodological quality of studies was assessed by Newcastle-Ottawa Scale recommended for case-control studies and by AXIS tool for cross-sectional studies. Grading of Recommendations Assessment, Development and Evaluation was used for the assessment of the certainty of the evidence for each outcome. The results showed lower NO2- levels in the group of children affected by dental caries (SMD = -2.18 [-3.24, -1.13], p < 0.01). Age, saliva collection and methods of evaluation can impact the results. When evaluating the severity of the condition, an important variation was detected in relation to the different evaluation methods NO2-/NO2- and NO3-. In conclusion, based on the evidence presented, the results suggest that NO2- levels in saliva are a possible biomarker of dental caries. Results should be evaluated with caution due to the very low evidence from primary studies. Longitudinal studies are necessary to strengthen this hypothesis.
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Affiliation(s)
- Beatriz Díaz-Fabregat
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil
| | - Wilmer Ramírez-Carmona
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil
| | - Mark Lloyd Cannon
- Feinberg School of Medicine, Northwestern University, Ann and Robert Lurie Childrens Hospital, 420 E Superior St, Chicago, IL, 60611, USA
| | - Douglas Roberto Monteiro
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil; University of Western São Paulo (UNOESTE), Postgraduate Program in Health Sciences, Rua José Bongiovani 700 Presidente Prudente, SP, Zip code 19050-920, Brazil
| | - Juliano Pelim Pessan
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil
| | - Cristina Antoniali
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Basic Science, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil.
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Zhang H, Qin L. Positive feedback loop between dietary nitrate intake and oral health. Nutr Res 2023; 115:1-12. [PMID: 37207592 DOI: 10.1016/j.nutres.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/12/2023] [Accepted: 04/22/2023] [Indexed: 05/21/2023]
Abstract
Nitrate was once thought to be an inert end-product of endothelial-derived nitric oxide (NO) heme oxidation; however, this view has been radically revised over the past few decades. Following the clarification of the nitrate-nitrite-NO pathway, accumulated evidence has shown that nitrate derived from the diet is a supplementary source of endogenous NO generation, playing important roles in a variety of pathological and physiological conditions. However, the beneficial effects of nitrate are closely related with oral health, and oral dysfunction has an adverse effect on nitrate metabolism and further impacts overall systemic health. Moreover, an interesting positive feedback loop has been identified between dietary nitrate intake and oral health. Dietary nitrate's beneficial effect on oral health may further improve its bioavailability and promote overall systemic well-being. This review aims to provide a detailed description of the functions of dietary nitrate, with an emphasis on the key role oral health plays in nitrate bioavailability. This review also provides recommendations for a new paradigm that includes nitrate therapy in the treatment of oral diseases.
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Affiliation(s)
- Haoyang Zhang
- Department of Oral and Maxillofacial & Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Lizheng Qin
- Department of Oral and Maxillofacial & Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
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