Dietary Fiber Intake Is Inversely Associated with Periodontal Disease among US Adults

Balancing the Oral-Gut-Brain Axis with Diet

Background: The oral microbiota is the second largest microbial community in humans. It contributes considerably to microbial diversity and health effects, much like the gut microbiota. Despite physical and chemical barriers separating the oral cavity from the gastrointestinal tract, bidirectional microbial transmission occurs between the two regions, influencing overall host health. Method: This review explores the intricate interplay of the oral-gut-brain axis, highlighting the pivotal role of the oral microbiota in systemic health and ageing, and how it can be influenced by diet. Results: Recent research suggests a relationship between oral diseases, such as periodontitis, and gastrointestinal problems, highlighting the broader significance of the oral-gut axis in systemic diseases, as well as the oral-gut-brain axis in neurological disorders and mental health. Diet influences microbial diversity in the oral cavity and the gut. While certain diets/dietary components improve both gut and oral health, others, such as fermentable carbohydrates, can promote oral pathogens while boosting gut health. Conclusions: Understanding these dynamics is key for promoting a healthy oral-gut-brain axis through dietary interventions that support microbial diversity and mitigate age-related health risks.

Effects of a 4-week free-sugar avoidance during periodontal therapy: An explorative randomized controlled clinical trial

BACKGROUND

This study investigated the effect of a 4-week free-sugar avoidance on periodontal parameters during periodontal therapy.

METHODS

Twenty-one patients with untreated periodontitis and daily free-sugar intake were allocated to a sugar avoidance group (SAG) and a control group (CG). The SAG received a 45-min dietary consultation and was instructed to avoid free sugars during the following 4 weeks after subgingival instrumentation, while the CG continued with their regular diet. Bleeding on probing (BOP), plaque control record, body weight (BW), visceral fat (FATv), and a food frequency questionnaire (FFQ) were collected at baseline (T1), 4 weeks (T2), and 8 weeks (T3) after subgingival instrumentation.

RESULTS

The main outcome parameter BOP was significantly reduced at T2 by 40.3% ± 15.54 in the SAG and 34% ± 12.47 in the CG (intra-p value both <0.001, inter-p value 0.361). A linear regression analysis of changes at patient level adjusted for age and FATv revealed a significant group difference for BOP (regression coefficient = -6.8; p = 0.019). Significant reductions were observed in BW, FATv and mean daily intake of free sugars (-14.4 g/day), and a significant increase of vitamin C derived from fruits (75.89 mg/day) at T2 in the SAG only.

CONCLUSION

This study may indicate additional beneficial effects of a sugar avoidance on periodontal and metabolic parameters, and nutritional intake during periodontal therapy. German Clinical Trials Register (DRKS00026699).

PLAIN LANGUAGE SUMMARY

The current widespread free-sugar consumption is linked to an increasing incidence of chronic non-communicable diseases. Data indicate a relationship between sugar intake and a higher prevalence of periodontitis and increased gingival inflammation. This study showed that free-sugar avoidance after periodontal therapy had additional beneficial effects on periodontal and metabolic parameters in 10 test and 11 control patients. After 4 weeks of avoiding free sugars like sweets, processed white flour, juice, and so forth, periodontal bleeding was significantly reduced in both groups (-40.3% test group, -34% control group). Further regression analysis revealed a significant difference between groups favoring the intervention. Additionally, body weight and visceral fat were significantly reduced in the intervention group, only. To avoid sugar, patients were allowed to replace it with whole fruit, which led to increased levels of micronutrients such as vitamin C. Therefore, free-sugar avoidance may be of therapeutic benefit in addition to periodontal therapy. Further research is needed to investigate this effect in larger cohorts.

Fermented foods and probiotic consumption frequency as protective indicators for peri-implant diseases - a cross-sectional study

BACKGROUND

Due to their modulatory effect on biofilm growth, bacterial gene expressions, and host-modulation effects, fermented foods and probiotic products could potentially have a protective role against peri-implant diseases. This cross-sectional study aimed to examine the association of consumption of fermented foods and products containing probiotics, with peri-implant health and diseases.

METHODS

A total of 126 implants were included. The peri-implant health status (peri-implantitis, peri-implant mucositis, and peri-implant health) was assessed through Chicago's Classification of periodontal and peri-implant Diseases and Conditions. A questionnaire was used to evaluate the consumption patterns of fermented and probiotic foods and product. One-way ANOVA was employed to compare the 3 peri-implant conditions categories in terms of fermented food and probiotic consumption.

RESULTS

There were significant differences in the daily and general consumption of yogurt, probiotic yogurt, kefir, ayran, vinegar, pomegranate syrup, whole meal bread, and homemade butter among peri-implantitis, peri-implant mucositis and peri-implant health (p < 0.05). The peri-implant health group consumed significantly more yogurt, kefir, ayran, vinegar, whole wheat bread, and homemade butter than peri-implant mucositis and peri-implantitis.

CONCLUSION

A higher consumption of fermented and probiotic foods may be associated with peri-implant health. Fermented and probiotic products may be useful for prevention of peri-implant diseases in patients with implants.

Oral Health Status, Dietary Intake, and Oral Health-related Quality of Life among Institutionalized Elderly in Bangalore

Objective

The study aimed to evaluate the association between dietary intake and oral health status and how oral health-related quality of life (OHQoL) influences the institutionalized elderly population of Bangalore.

Methods and Materials

A cross-sectional study was conducted to appraise the oral health and dietary intake of institutionalized elderly. Patients completed a validated questionnaire and a clinical evaluation. CPI index, loss of attachment (LoA), DMFT, prosthetic status, and prosthetic necessity were utilized to contrast OHQoL using the Chi-square test. The diet and OHQoL were compared using ANOVA.

Results

This study surveyed 400 institutionalized elderly populations. The average age of the sample was 70.02 ± 8.149 years. LoA and DMFT were significantly associated with GOHAI's functional domain (P = 0.000). CPI (P = 0.049) and DMFT index (P = 0.003) were associated with GOHAI pain/discomfort and psycho-social domains. The psycho-social domain was associated with an upper arch prosthesis status (P = 0.010). Subjects with good OHQoL consumed 1961.19 ± 479.33 calories, while those with poor OHQoL consumed 1814 ± 432.41 calories (P = 0.002).

Conclusion

According to the study findings, periodontal disease, decay, and missing teeth impaired OHQoL. The OHQoL was significantly declined with dietary intake.

Association of specific nutritional intake with periodontitis

BACKGROUND

The present study aimed to evaluate nutritional intake among a group of male patients in the dental clinic with and without periodontal disease to search for associations between nutritional profile and periodontal health.

METHODS

To this purpose, nutritional intake of macronutrients, fiber, vitamins, and minerals were compared evaluating both clinical parameters and periodontal status. Non periodontitis patients were compared with stage III and IV periodontitis and its extension according to the 2017 classification.

RESULTS

After multivariate analysis, statistically significant associations were found between the dietary intake of energy, total fat, cholesterol, calcium, saturated fat, monounsaturated fat and folic acid and iodine and periodontitis status. This study reports an inverse association between cholesterol and iodine and periodontitis and a direct association with saturated fat, monounsaturated fat, and folic acid.

CONCLUSIONS

Maintaining an adequate intake of fat, iodine, calcium, and cholesterol and avoiding an excessive intake of energy, saturated fat, monounsaturated fat, and folic acid could be important to controlling periodontitis.

Association between weight-adjusted-waist index and periodontitis risk: A cross-sectional study

BACKGROUND

There may be an association between obesity and periodontitis, yet no studies have investigated the correlation between the new obesity indicator, the weight-adjusted-waist Index (WWI), and periodontitis.

OBJECTIVE

This study aims to investigate the association between the novel obesity index, weight-adjusted-waist index, and periodontitis.

SUBJECTS AND METHODS

WWI was utilized to assess obesity, through measuring waist circumference (WC) and body weight. We analyzed cross-sectional NHANES data from 2009 to 2014 (1) using multivariate logistic regression to explore WWI's association with moderate/severe periodontitis; (2) conducting subgroup analyses and interaction tests; and (3) fitting smoothed curves to the age-stratified logistic regression model.

RESULTS

The study involved 11,256 individuals, with 48.55% having moderate/severe periodontitis. Upon adjusting for all relevant variables, a significant correlation between WWI and moderate/severe periodontitis was observed (OR = 1.08, 95% CI: 1.01-1.17). Compared to the lowest quartile of WWI, there was a significant increase in the likelihood of moderate/severe periodontitis in Quartile 2 (OR = 1.21, 95% CI: 1.06-1.39) and Quartile 3 (OR = 1.23, 95% CI: 1.07-1.42). Subgroup analyses for gender, age, education, smoking, and diabetes highlighted a positive association between WWI and moderate/severe periodontitis in all subgroups, except for the diabetic population and individuals aged 65 years and older.

CONCLUSION

The analysis revealed a positive correlation between WWI, a novel obesity index, and moderate/severe periodontitis prevalence through diverse modeling approaches.

The association between plain water intake and periodontitis in the population aged over 45: a cross-sectional study based on NHANES 2009-2014

BACKGROUND

Numerous studies have demonstrated the impact of beverage consumption on overall health and oral health. Specifically, high consumption of sugar-sweetened beverages and coffee has been associated with an increased risk of metabolic disorders and periodontitis. Conversely, high intake of plain water has been linked to various health benefits, including weight management and reduced energy intake. However, no previous studies have explored the potential association between plain water intake and the risk of periodontitis.

OBJECTIVES

Our objective was to investigate the relationship between plain water consumption and periodontitis in a middle-aged and elderly population.

METHODS

The present cross-sectional study was conducted among participants aged ≥ 45 in the 2009-2014 National Health and Nutrition Examination Surveys. Multivariable regression analysis, subgroup analysis and smooth fitting tests were conducted to explore the independent relationship between plain water intake and periodontitis.

RESULTS

A total of 5,882 participants were enrolled,62.02% have periodontitis. Periodontitis patients have lower plain water intake. The multivariable regression tests showed that the risk of periodontitis decreased with increased plain water intake quartiles (Q4 OR = 0.78; 95%CI 0.62-0.96) after fully adjustment. Subgroup analysis and interaction tests showed that gender, age, smoking, diabetes, hypertension or BMI does not significantly interact with the association. However, the relation was significant in males (Q4 OR = 0.64; 95%CI 0.47-0.86) but not in females (Q4 OR = 0.97;95% CI 0.71-1.31). In the smoothed curve fits stratified by gender, the curve for male participants displayed as a U-shape, with an optimal plain water intake at 1200 ml/day. For males drinking plain water less than 1200 ml/day, the risk of periodontitis decreased by 24% with each increase of 500 ml plain water intake (OR = 0.76, 95%CI 0.66-0.87, p < 0.001).

CONCLUSIONS

Together, the results showed that plain water intake is negatively associated with periodontitis risk in US middle aged and elderly population. Further studies are needed to investigate the mechanism unites this association. Attention should be given to adequate plain water intake when considering dietary suggestions to the population at high risk of developing periodontitis, especially for men.

Association between carbohydrate-to-fiber ratio and the risk of periodontitis

Background/purpose

Periodontitis is a chronic multifactorial inflammatory disease with dental plaque accumulation. This study aimed to analyze the association between carbohydrate-to-fiber ratio and periodontitis risk.

Materials and methods

In this cross-sectional study, the data of 6470 participants aged ≥30 years with available oral health exam data of periodontal status were collected from NHANES 2009-2014. Participants were divided into no & mild periodontitis group (n = 3309) and moderate & severe periodontitis group (n = 3161). The possible correlation between the carbohydrate-to-fiber ratio and the risk of periodontitis was explored via univariate and multivariable logistic regression analyses. Odds ratio (OR) and 95% confidence interval (CI) were applied as the effect size.

Results

After adjusting for all the confounding factors, carbohydrate-to-fiber ratio <10.89 (OR = 0.82, 95% CI: 0.69-0.97), carbohydrate-to-fiber ratio of 10.89-14.02 (OR = 0.74, 95% CI: 0.63-0.87), carbohydrate-to-fiber ratio of 14.03-18.47 (OR = 0.83, 95% CI: 0.71-0.97) were correlated with reduced risk of periodontitis. In people aged ≥65 years, carbohydrate-to-fiber ratio of 10.89-14.02 (OR = 0.54, 95% CI: 0.30-0.95) and carbohydrate-to-fiber ratio of 14.03-18.47 (OR = 0.56, 95% CI: 0.37-0.86) were correlated with reduced risk of periodontitis in comparison with carbohydrate-to-fiber ratio ≥18.48 group. The decreased risk of periodontitis was also found in males with carbohydrate-to-fiber ratio of 10.89-14.02 (OR = 0.69, 95% CI: 0.49-0.97) and carbohydrate-to-fiber ratio of 14.03-18.47 (OR = 0.73, 95% CI: 0.56-0.95). In people without diabetes, we found that those with carbohydrate-to-fiber ratio <10.89 (OR = 0.75, 95% CI: 0.61-0.93), carbohydrate-to-fiber ratio of 10.89-14.02 (OR = 0.68, 95% CI: 0.53-0.88) and carbohydrate-to-fiber ratio of 14.03-18.47 (OR = 0.84, 95% CI: 0.70-0.99) were linked with lower risk of periodontitis.

Conclusion

Low carbohydrate-to-fiber ratio was associated with decreased risk of periodontitis.

Is inflammatory potential of the diet related to oral and periodontal health?

Inflammation is among the risks of periodontal diseases. The relationship between the inflammatory load of the diet and inflammation has been shown in previous studies, but the relationship between periodontal diseases and the inflammatory load of the diet is not clear. In this study, it was aimed to examine the relationship between dietary inflammatory index (DII) and periodontal health. Board approved the protocol. Information about the study was given to the patients who met the criteria of the study and agreed to participate in the study. Oral health status was evaluated by measuring the Decayed, Missing, and Filled Teeth (DMFT). Periodontal health status was determined using the plaque index (PI) and gingival index (GI). Twenty-four-hour dietary record was taken for 1 day to calculate the inflammatory load gained from daily diet, and the DII score was used. The study group consisted of 138 participants. DMFT scores were found with median 4.0, and no statistically significant difference was observed between DII quartiles. 65.8% of the participants had absence or small amount of plaque accumulation, while 39.2% had moderate or dense amount of plaque accumulation according to the PI classification. While DII did not differ by PI classification, DII quartile between second and third found a difference according to the GI classification. The new definition of periodontal health has been proposed as the absence of clinically detectable inflammation. It seems that pro-inflammatory properties of the diet and periodontal health are related. But future randomized controlled trials are needed.

Anemia and frailty in the aging population: implications of dietary fiber intake (findings of the US NHANES from 2007-2018)

BACKGROUND

Frailty has long been seen as an indicator of reduced physical functions in the elderly, which may be caused by a variety of chronic illnesses or cancerous tumors. Dietary fiber was connected with anemia and frailty, whereas it was uncertain if dietary fiber consumption modifies the impact of anemia on frailty in elderly adults.

METHODS

We performed a secondary analysis using older adults aged 60 years and over from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 cycles. Dietary fiber intake was estimated using two 24-h dietary recalls. Participants were dichotomized as frail or non-frail based on a modified Fried physical frailty phenotype from previous NHANES studies. The weighted logistic regression was used to estimate the odds ratio (OR) and confidence interval (CI) for the associations between hemoglobin levels and frailty at high- and low-dietary fiber intake levels.

RESULTS

A total of 9644 older adults were included in this study, and the weighted sample was 56,403,031, of whom 3,569,186 (6.3%) were deemed to be frail, and the remainder were deemed to be non-frail. Among the low dietary fiber intake group, higher hemoglobin was significantly associated with a lower risk of frailty (OR = 0.79, 95% CI: 0.71-0.87), and anemia was associated with an almost threefold elevated risk of frailty (OR = 3.24, 95% CI:1.98-5.29) in the fully adjusted model. However, this phenomenon was not observed in groups with high dietary fiber intake. In addition, L-shaped dose response relationship was found in the high dietary fiber intake group (P overall association < 0.001; P non-linear association = 0.076). Whereas the dose response relationship was not significant in the high dietary fiber intake group (P overall association 0.752; P non-linear association = 0.734).

CONCLUSIONS

Frailty was positively associated with the severity of anemia in older adults with low, but not high, dietary fiber intake. Adequate fiber intake may be an innovative dietary strategy to reduce frailty in older adults.

A pro-inflammatory diet is associated with an increased odds of periodontitis: finding from a case-control study

OBJECTIVE

This study aimed to evaluate the inflammatory effect of diet using the dietary Inflammatory Index (DII) on the odds of periodontitis. We hypothesized that a diet with high DII scores (a pro-inflammatory diet) is associated with high chronic and systematic inflammation resulting in periodontitis. Periodontitis is one of the most common inflammatory diseases that affect the tissues around the tooth and results from the interaction of bacterial infection and the host immune response. The DII shows the association between different food components and the level of specific inflammatory biomarkers.

METHOD

The food intake of 87 cases with diagnosed periodontitis and 87 control was assessed using a 163-item valid food frequency questionnaire (FFQ). The DII was calculated based on the FFQ data. Logistic and linear regression models adjusting for multivariable confounders were used to investigate the odds ratio (OR) and 95% confidence intervals (CI) of developing periodontitis.

RESULTS

There was a significant difference between the mean intake of micronutrients and food groups, including saturated fatty acids (SFAs), iron, magnesium, manganese, vitamin C, crude fiber, selenium, chromium, whole fiber, caffeine, dairy, and meat, between patients with periodontitis and the control group (p-value˂0.05). DII scores in this study ranged from -3.13 to + 0.99. However, the periodontitis OR in the raw and multivariable-adjusted models was not statistically significant (multivariable-adjusted OR tertiles 1 vs. tertiles 3 = 2.00, 95%CI: 0.4-90.42, p-value = 0.08). A similar result was also observed in the continuous model of DII (multivariable-adjusted OR DII continuous = 1.93, 95%CI: 0.30-98.79, p-value = 0.05).

CONCLUSION

Although the OR was not statistically significant in crude models, a significant trend was found in multivariable-adjusted models. The results were promising since this is the first study to examine the association between diet-induced inflammation and dental disease. It is advisable to conduct additional studies with high sample sizes and other designs, such as prospective studies.

Role of Dietary Fibre in Managing Periodontal Diseases-A Systematic Review and Meta-Analysis of Human Intervention Studies

BACKGROUND

Periodontitis is a chronic multifactorial inflammatory disease, that leads to tooth loss and is associated with other systemic diseases. The role of dietary fibre in the prevention and management of periodontal diseases is not well understood. The objective of this systematic review and meta-analysis was to assess how an intake of dietary fibre affects periodontal diseases in humans and any concomitant effects on systemic inflammation.

METHODOLOGY

Human interventional studies investigating the effects of oral fibre intake on various clinical parameters of periodontal diseases were included. Search strategy with MeSH and free-text search terms was performed on the following database: CINAHL Complete, EMBASE, MEDLINE, SciVerse Scopus®, and Web of Science Core Collection on 21 October 2021 and updated on 19 February 2023 to identify relevant studies. Articles were filtered using the Covidence© web-based platform software. Data were pooled using random effects meta-analysis.

RESULTS

From all databases, a total of 19,971 studies were obtained. Upon title and abstract screening, 101 studies were included for full-text screening. Upon full-text screening, six studies were included for analysis. Of these, five were randomised controlled trials, and one was a sequential feeding trial involving fibre-rich daily diet for a 4-8 weeks period. Fibre-rich dietary intervention significantly reduced Clinical Attachment Loss/Level by 0.48 mm/tooth (95% CI, -0.63 to -0.33, p < 0.001), Bleeding On Probing by 27.57% sites/tooth (95% CI -50.40 to -4.74, p = 0.02), Periodontal Inflamed Surface Area by 173.88 mm2 (95% CI -288.06 to -59.69, p = 0.003), Plaque Index by 0.02 (95% CI -0.04 to -0.00, p = 0.04), and Gingival Index by 0.41 (95% -0.67 to -0.16, p= 0.002). A non-significant reduction was observed for Probing Depth (-0.17 mm/tooth; 95% CI, -0.37 to 0.02, p = 0.09).

CONCLUSIONS

Fibre-rich dietary interventions are associated with a reduction of clinical and particularly inflammatory markers of periodontal diseases. This shows a promising effect of dietary fibre as an intervention for inflammatory conditions like periodontal diseases.

Effects of multigrain rice and white rice on periodontitis: an analysis using data from the Korea National Health and Nutrition Examination Survey 2012-2015

OBJECTIVES

Numerous studies have investigated the efficacy of whole grains; however, research on multigrain remains limited. Grains exhibit combined positive effects against various diseases. The purpose of this study was to examine the impact of multigrain and white rice consumption on periodontitis.

METHODS

We analyzed data from the Korea National Health and Nutrition Examination Survey V-3 and VI, collected between 2012 and 2015, which included 12,450 patients (4,859 male and 7,591 female) aged 19-64 years. The World Health Organization's Community Periodontal Index (CPI) was utilized to assess the presence of periodontitis, with periodontitis defined as a CPI index score of ≥3. Multivariable logistic regression analysis was performed after adjusting for potential confounding variables.

RESULTS

The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.69 to 0.93). When stratified by sex, the risk of periodontitis demonstrated a 24% decrease in female who consumed only multigrain rice (OR, 0.76; 95% CI, 0.62 to 0.93). A similar result was observed in the age group of 40-64 years (OR, 0.84; 95% CI, 0.71 to 0.99). In the diabetes stratification model, the normal group that consumed only multigrain rice exhibited a 25% decrease in the odds of periodontitis (OR, 0.75; 95% CI, 0.62 to 0.91).

CONCLUSIONS

Our findings suggest that the prevalence of periodontitis may vary depending on the type of rice consumed.

Association of vitamin K, fibre intake and progression of periodontal attachment loss in American adults

BACKGROUND

Periodontitis-related attachment loss is accompanied by mucosal bleeding and inflammatory lesions. Dietary vitamin K and fibre intake are known to be correlation factors of haemostasis and anti-inflammation, respectively.

OBJECTIVE

To explore the association between severe periodontal attachment loss and vitamin K or fibre intake in American adults.

METHODS

A cross-sectional analysis was conducted including 2747 males and 2218 females in the National Health and Nutrition Examination Surveys (NHANES) from 2009 to 2014. The number of teeth with severe periodontal attachment loss (above 5 mm attachment loss) was used as the dependent variable. The main independent variables included the intake of vitamin K and dietary fibre. The association among variables was examined using multivariable linear regression models, hierarchical regression, fitted smoothing curves, and generalized additive models.

RESULTS

Based on the indicators of 4965 subjects, we found that severe attachment loss tended to occur in elderly individuals or males and was accompanied by less intake of vitamin K or dietary fibre, as well as lower educational qualification. Vitamin K intake was stably negatively associated with attachment loss progression in each multivariable linear regression model. In subgroup analyses, a negative association between fibre intake and attachment loss progression was identified in all races except blacks (β = 0.0005, 95% CI: -0.0005 to 0.0016). The relationship between fibre intake and attachment loss progression was a broad U-shaped curve (inflection point: 753.4 mg), which especially manifested in males (inflection point: 967.5 mg).

CONCLUSION

There was an inverse association between vitamin K intake and the progression of periodontal attachment loss in American adults, while dietary fibre should be moderate in intake (below 753.4 mg), especially in males (below 967.5 mg).

Anti-Inflammatory Benefits of Food Ingredients in Periodontal Diseases

Periodontitis is a multi-faceted inflammatory disease that impacts the gingiva and the structures that support our teeth, and may eventually increase tooth mobility and the risk of tooth loss. Inflammation is a viable therapeutic target of periodontitis for both biologic (dietary) and host modulatory agents/drugs. Conventional therapeutic approaches for periodontitis, including nonsurgical or surgical periodontal therapy as well as occasional adjunctive antimicrobial therapy, have been only marginally effective. Malnutrition, or at least poor dietary habits, can be highly prevalent among patients with periodontal diseases. As several food nutrients can aid in periodontal healing and regeneration, there is a critical need to evaluate natural dietary sources and supplement ingredients that can counterbalance the inflammatory processes and improve the periodontal status of our patients. Here, we reviewed the current state of knowledge (search period: 2010 to 2022; PubMed and Web of Science) on the anti-inflammatory actions of food ingredients and supplements in clinical studies of patients with periodontal diseases. A diet that includes fruits and vegetables, omega-3 polyunsaturated fatty acids, and supplements of vitamins and plant-derived compounds seems to counteract gingival inflammation and has a promising therapeutic impact in patients with periodontal diseases. Despite the positive indications that several nutrients can be used as an adjunct to periodontal therapy, additional studies with bigger sample sizes and longer follow-up periods are needed to elucidate their therapeutic benefits and the most effective doses and administration.

Relationship between Diet Quality and Periodontal Disease in South Korean Adults Aged ≥40 Years

The purpose of this study was to investigate the relationship between diet quality and periodontal disease, in adults aged ≥40 years, using data from the 7th (2016-2018) Korea National Health and Nutrition Survey (KNHANES), representing South Koreans. The subjects of this study were 7935 people aged ≥40 years, who responded to the items in the Korea Healthy Eating Index (KHEI) and underwent periodontal examination. Complex sample univariate and multivariate logistic regression analyses were conducted, to analyze the relationship between the diet quality and periodontal disease. The group with a low diet quality for energy intake balance, showed a higher risk of periodontal disease than the group with a high diet quality for energy intake balance, and it was confirmed that the diet quality in adults aged ≥40 years was related to periodontal disease. Therefore, regular diet evaluations, and the counseling of gingivitis and periodontitis patients by dental experts, will have a positive effect on the restoration and improvement of periodontal health in adults.

Evaluation of food and nutrient intake in a population of subjects affected by periodontal disease with different levels of bone mineral density

INTRODUCTION

Both osteoporosis and periodontitis are pathologies characterized by an imbalance in the bone tissue. Vitamin C is an important factor involved in maintaining the health of the periodontium; its deficiency causes characteristic lesions to periodontal tissues such as bleeding and redness of the gums. Among the essential minerals for the health of the periodontium we find instead calcium.Objectives of the study: The objectives of the proposed study are to study the association between the presence of osteoporosis and periodontal disease. We tried to identify the possible connections between particular dietary patterns and therefore the etiopathogenesis of periodontal disease and secondarily of osteoporosis.Materials and methods: 110 subjects were recruited in a single-center observational cross-sectional study carried through the collaboration between the University of Florence and the private institute of dentistry Excellence Dental Network based in Florence, suffering of periodontitis, 71 osteoporotic/osteopenic and 39 non-osteoporotic/osteopenic. Anamnestic data and information on eating habits were collected.

RESULTS

The population showed eating habits that do not meet the intake levels recommended by the L.A.R.N. Regarding the relationship between nutrient intake and plaque index, it appears that in the population, the higher the intake of vitamin C through food, the lower the plaque index value is. This result could reinforce the scientific evidence that there is a protective factor in the onset of periodontal disease by the consumption of vitamin C which to date is still the subject of investigation. In addition, the same type of trend would also have been observed for calcium intake, but a larger sample size would be required to make this effect significant.

CONCLUSIONS

The relationship between osteoporosis and periodontitis and the role of nutrition in influencing the evolution of these pathologies still seems to be deeply explored. However, the results obtained seem to consolidate the idea that there is a relationship between these two diseases and that eating habits play an important role in their prevention.

Periodontal Therapy in Bariatric Surgery Patients with Periodontitis: Randomized Control Clinical Trial

Background: Bariatric surgery (BS) patients may experience the progression of periodontitis during recovery. We aimed to determine whether non-surgical periodontal therapy before BS improves the periodontal and systemic health parameters after the surgery. Methods: BS candidates with periodontitis were randomized into the test (TG) and control group (CG). One month before BS (pre-BS), patients in the TG (n = 15) received non-surgical periodontal therapy, while patients in the CG (n = 15) received only mechanical plaque removal. Patients were re-examined 3 and 6 months after BS. Differences between the TG and CG in clinical periodontal parameters, systemic health-related serum biomarkers, parameters of obesity, and prevalence of obesity-related diseases were evaluated. Results: From the 30 included patients, 26 were re-examined at 3 months and 20 patients at 6 months. Periodontal parameters bleeding on probing (p = 0.015), periodontal pocket dept (PPD, p = 0.0015), % PPD > 4 mm (p < 0.001), and full-mouth plaque levels (p = 0.002) were lower in the TG than in the CG at 6 months after BS. There is a general improvement in systemic health after BS without significant differences (p > 0.05) between the TG and CG at the 6-month follow-up. The TG shows a tendency for improvement in metabolic syndrome components at the 6-month follow-up compared to pre-BS (p < 0.05). Conclusions: Non-surgical periodontal therapy in periodontitis patients before the BS may improve periodontal health 3 and 6 months after the surgery. The possible benefits of periodontal therapy on the overall health of BS patients should be further explored.

Features of the oral microbiome in Japanese elderly people with 20 or more teeth and a non-severe periodontal condition during periodontal maintenance treatment: A cross-sectional study

Introduction

The aim of the present study was to characterize the profile and diversity of the oral microbiome of a periodontally non-severe group with ≥20 teeth in comparison with a severe periodontitis group of elderly Japanese people.

Methods

A total of 50 patients who had ≥20 teeth and aged ≥60 years were recruited, and 34 participants (13 non-severe participants) were analyzed. After oral rinse (saliva after rinsing) sample collection, the V3–V4 regions of the 16S rRNA gene were sequenced to investigate microbiome composition, alpha diversity (Shannon index, Simpson index, richness, and evenness), and beta diversity using principal coordinate analysis (PCoA) based on weighted and unweighted UniFrac distances. A linear discriminant analysis effect size was calculated to identify bacterial species in the periodontally non-severe group.

Results

The periodontally non-severe group showed lower alpha diversity than that of the severe periodontitis group (p <0.05); however, the beta diversities were not significantly different. A higher relative abundance of four bacterial species (Prevotella nanceiensis, Gemella sanguinis, Fusobacterium periodonticum, and Haemophilus parainfluenzae) was observed in the non-severe group than that in the severe periodontitis group.

Conclusion

The oral microbiome in elderly Japanese people with ≥20 teeth and a non-severe periodontal condition was characterized by low alpha diversity and the presence of four bacterial species.

Chemical features and biological functions of water-insoluble dietary fiber in plant-based foods

Insoluble dietary fiber (IDF) is a nutritional component constituting the building block of plant cell walls. Our understanding of the role of IDF in plant-based foods has advanced dramatically in recent years. In this Review, we summarize research progress on the subtypes, structure, analysis, and extraction methods of IDF. The impact of different food processing methods on the properties of IDF is discussed. The role of gut microbiota in the health benefits of IDF is introduced. This review provides a better understanding of the chemical features and biological functions of IDF, which may promote the future application of IDF in functional food products. Further investigation of the mechanisms underlying the health benefits of IDF enables the development of effective strategies for the prevention and treatment of human diseases.

Dietary carbohydrate intake is associated with the subgingival plaque oral microbiome abundance and diversity in a cohort of postmenopausal women

Limited research exists on carbohydrate intake and oral microbiome diversity and composition assessed with next-generation sequencing. We aimed to better understand the association between habitual carbohydrate intake and the oral microbiome, as the oral microbiome has been associated with caries, periodontal disease, and systemic diseases. We investigated if total carbohydrates, starch, monosaccharides, disaccharides, fiber, or glycemic load (GL) were associated with the diversity and composition of oral bacteria in subgingival plaque samples of 1204 post-menopausal women. Carbohydrate intake and GL were assessed from a food frequency questionnaire, and adjusted for energy intake. The V3-V4 region of the 16S rRNA gene from subgingival plaque samples were sequenced to identify the relative abundance of microbiome compositional data expressed as operational taxonomic units (OTUs). The abundance of OTUs were centered log(2)-ratio transformed to account for the compositional data structure. Associations between carbohydrate/GL intake and microbiome alpha-diversity measures were examined using linear regression. PERMANOVA analyses were conducted to examine microbiome beta-diversity measures across quartiles of carbohydrate/GL intake. Associations between intake of carbohydrates and GL and the abundance of the 245 identified OTUs were examined by using linear regression. Total carbohydrates, GL, starch, lactose, and sucrose intake were inversely associated with alpha-diversity measures. Beta-diversity across quartiles of total carbohydrates, fiber, GL, sucrose, and galactose, were all statistically significant (p for PERMANOVA p < 0.05). Positive associations were observed between total carbohydrates, GL, sucrose and Streptococcus mutans; GL and both Sphingomonas HOT 006 and Scardovia wiggsiae; and sucrose and Streptococcus lactarius. A negative association was observed between lactose and Aggregatibacter segnis, and between sucrose and both TM7_[G-1] HOT 346 and Leptotrichia HOT 223. Intake of total carbohydrate, GL, and sucrose were inversely associated with subgingival bacteria alpha-diversity, the microbial beta-diversity varied by their intake, and they were associated with the relative abundance of specific OTUs. Higher intake of sucrose, or high GL foods, may influence poor oral health outcomes (and perhaps systemic health outcomes) in older women via their influence on the oral microbiome.

Behavioral risk factors and periodontal disease in Malang, Indonesia

OBJECTIVE

This study aimed to analyze the relationship of behavioral risk factors for periodontal disease among 19-64 age group in Malang City.

METHOD

A non-experimental quantitative analytic with a cross sectional study approach was used in this study. The respondents were 331 patients who visited the dental clinics of the Health Centers in Malang City. A cluster random sampling technique was used in this study. The instrument used was questionnaire. The data analysis was done through multivariate analyses use logistic-regression.

RESULTS

The Wald test results on logistic-regression models showed there is no significant effect of smoking habits and consumption patterns on periodontal disease. There is a significant effect of systemic disease on periodontal disease with a significance value of 0.000 (p<0.05).

CONCLUSIONS

There was a significant relationship and effect between systemic disease and periodontal disease in this study.

Association between Dietary Pattern and Periodontitis-A Cross-Sectional Study

The aim of the study was to investigate the relationship between specific known dietary patterns and the prevalence of periodontal disease in a northern population-based cohort study. We evaluated data from 6209 participants of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Dietary intake was assessed with the food frequency questionnaire (FFQ2). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Ordinal logistic regression models were used to determine the association. Ordinal regression analyses revealed a significant association between higher adherence to the DASH diet/Mediterranean diet and lower odds to be affected by periodontal diseases in an unadjusted model (OR: 0.92; 95% CI: 0.87, 0.97; p < 0.001/OR: 0.93; 95% CI: 0.91, 0.96; p < 0.001) and an adjusted model (age, sex, diabetes) (OR: 0.94; 95% CI: 0.89, 1.00; p < 0.0365/OR: 0.97; 95% CI: 0.94, 1.00; p < 0.0359). The current cross-sectional study identified a significant association between higher adherence to the DASH and Mediterranean diets and lower odds to be affected by periodontal diseases (irrespective of disease severity). Future randomized controlled trials are needed to evaluate to which extent macro- and micronutrition can affect periodontitis initiation/progression.

Oral health and atherosclerotic cardiovascular disease: A review

Periodontal disease (PD) is common in the US and globally. Evidence suggests that poor oral health is associated with atherosclerotic cardiovascular disease (ASCVD); however, this relationship has not been a major focus in clinical cardiology. This manuscript will review the growing evidence linking PD to ASCVD, including pathophysiologic mechanisms and coexistent risk factors. Public health considerations with a focus on disparities, social determinants, preventive strategies, and a call to action to reduce the burden of coincident ASCVD and PD are also reviewed.

The oral microbiome: Role of key organisms and complex networks in oral health and disease

States of oral health and disease reflect the compositional and functional capacities of, as well as the interspecies interactions within, the oral microbiota. The oral cavity exists as a highly dynamic microbial environment that harbors many distinct substrata and microenvironments that house diverse microbial communities. Specific to the oral cavity, the nonshedding dental surfaces facilitate the development of highly complex polymicrobial biofilm communities, characterized not only by the distinct microbes comprising them, but cumulatively by their activities. Adding to this complexity, the oral cavity faces near-constant environmental challenges, including those from host diet, salivary flow, masticatory forces, and introduction of exogenous microbes. The composition of the oral microbiome is shaped throughout life by factors including host genetics, maternal transmission, as well as environmental factors, such as dietary habits, oral hygiene practice, medications, and systemic factors. This dynamic ecosystem presents opportunities for oral microbial dysbiosis and the development of dental and periodontal diseases. The application of both in vitro and culture-independent approaches has broadened the mechanistic understandings of complex polymicrobial communities within the oral cavity, as well as the environmental, local, and systemic underpinnings that influence the dynamics of the oral microbiome. Here, we review the present knowledge and current understanding of microbial communities within the oral cavity and the influences and challenges upon this system that encourage homeostasis or provoke microbiome perturbation, and thus contribute to states of oral health or disease.

Intervention with inulin prior to and during sanative therapy to further support periodontal health: study protocol for a randomized controlled trial

Background

Periodontal disease is a chronic state of inflammation that can destroy the supporting tissues around the teeth, leading to the resorption of alveolar bone. The initial strategy for treating periodontal disease is non-surgical sanative therapy (ST). Periodontal disease can also induce dysbiosis in the gut microbiota and contribute to low-grade systemic inflammation. Prebiotic fibers such as inulin can selectively alter the intestinal microbiota and support homeostasis by improving gut barrier functions and preventing inflammation. Providing an inulin supplement prior to and post-ST may influence periodontal health while providing insight into the complex relationship between periodontal disease and the gut microbiota. The primary objective is to determine if inulin is more effective than the placebo at improving clinical periodontal outcomes including probing depth (PD) and bleeding on probing (BOP). Secondary objectives include determining the effects of inulin supplementation pre- and post-ST on salivary markers of inflammation and periodontal-associated pathogens, as these outcomes reflect more rapid changes that can occur.

Methods

We will employ a single-center, randomized, double-blind, placebo-controlled study design and recruit and randomize 170 participants who are receiving ST to manage the periodontal disease to the intervention (inulin) or placebo (maltodextrin) group. A pilot study will be embedded within the randomized controlled trial using the first 48 participants to test the feasibility for the larger, powered trial. The intervention period will begin 4 weeks before ST through to their follow-up appointment at 10 weeks post-ST. Clinical outcomes of periodontal disease including the number of sites with PD ≥ 4 mm and the presence of BOP will be measured at baseline and post-ST. Salivary markers of inflammation, periodontal-associated pathogens, body mass index, and diet will be measured at baseline, pre-ST (after 4 weeks of intervention), and post-ST (after 14 weeks of intervention).

Discussion

We expect that inulin will enhance the positive effect of ST on the management of periodontal disease. The results of the study will provide guidance regarding the use of prebiotics prior to and as a supportive adjunct to ST for periodontal health.

Trial registration

ClinicalTrials.gov NCT04670133. Registered on 17 December 2020.

Relation between Activator Factors and Compliance Behavior of Using Personal Protective Equipment on Technician Workers at PT ARPS Surabaya

Introduction: Equipment that must be used by workers for work safety when working with potential work hazards or accidents is personal protective equipment (PPE). The purpose of this study was to analyze the factors associated with the use of PPE in the workforce of technicians at PT. APRS in terms of PPE usage. Methods: This research was an analytic observational study, with cross sectional design. The subjects of this study were all of the technician workforce in the section of Blow molding, Maintenance and Injection Molding unit, totalling 39 respondents. Results: This study showed that activator factors such as perception (r = 0.108), knowledge of occupational health and safety (r = -0.104), and PPE regulation (r = -0.166) had a weak relationship with safety behavior on compliance with PPE implementation. Conclusions: The workforce behaved poorly in using PPE in the workplace. In the Blow Molding, Maintenance and Injection Molding unit, workers who had a moderate level of perceptions, workers who had a moderate level of knowledge, and workers who had a enough ability to comply with PPE regulations.Keywords: knowledge, perception, personal protective equipment, policy

Needs Assessment Towards Development of an Integrated Diabetes-Oral Health Nutrition Education Module: A Qualitative Study

INTRODUCTION

The diabetes mellitus-periodontitis relationship has advocated several strategic management approaches on effective glycaemic control and oral health improvement for diabetic patients and periodontitis patients with diabetes. We aimed to identify the challenges of providing health education to patients with diabetes and/or periodontitis among healthcare professionals and needs for an integrated nutrition-oral health education module.

METHODS

This study involved semi-structure in-depth interview with fifteen healthcare professionals from a training hospital focused on: (i) the existing issues and challenges encountered while managing patients for their nutrition and care and (ii) issues related to the current practice among healthcare professionals. Details pertaining to the participants' verbal and non-verbal responses were recorded, transcribed ad verbatim and analysed using themes codes.

RESULTS

Patients' attitude and behaviour, language barriers and prioritising time were found as the common problems with patients, while limited knowledge on the relationship between diabetes-periodontitis, limited availability of appropriate and cultural-based health educational tools, lack of inter-professional multidisciplinary collaboration in managing patients, and constrains in time as well as costly therapy were common issues in the current practice.

CONCLUSIONS

Cost-effective efforts must be focused on overcoming these issues besides emphasizing the needs on developing an integrated module to achieve better management outcomes.

Influence of Micronutrient Intake, Sociodemographic, and Behavioral Factors on Periodontal Status of Adults Assisted by a Public Health Care System in Brazil: A Cross-Sectional Multivariate Analysis

The lack of access to a balanced diet, rich in vitamins and minerals, can predispose people to inflammatory diseases such as obesity, diabetes mellitus, and periodontitis. We aimed to evaluate the relationship between micronutrient intake, sociodemographic behavioral characteristics, and periodontal health in adults assisted by a public health care system. Participants (n = 450) answered a food frequency questionnaire and were submitted to anthropometric and oral clinical examinations. Principal component analysis was used to summarize the number of components emerging from 17-micronutrient intake. Subsequently, cluster analysis was employed. The prevalence of at least one periodontal pocket ≥ 4 mm was 67.4%. Three clusters were identified according to periodontal status. Cluster 1 "poor periodontal status" was characterized by older individuals (n = 202; 85% females) with poor periodontal status, lower education level, mainly smokers with non-transmissible chronic diseases (NTCD), with lower energy, omega-3, fiber, Zn, K, Cu, and vitamin C intake. Cluster 3 "healthy periodontal status" included younger individuals (n = 54) with the healthiest periodontal status, a higher education level, without NTCD, and with higher energy, omega-3, fiber, Zn, calcium, retinol, and riboflavin intake. Cluster 2 was labeled as "intermediate periodontal status". Micronutrient ingestion was associated with periodontal status and may be considered in health promotion actions for low-income populations.

Diet quality and periodontal disease: Results from the oral infections, glucose intolerance and insulin resistance study (ORIGINS)

AIMS

This study examined the cross-sectional association between diet quality and periodontal disease.

MATERIALS AND METHODS

In the Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS), 923 individuals completed the National Cancer Institute's validated Diet History Questionnaire 1, from which the Alternative Healthy Eating Index (AHEI) scores and A Priori Diet Quality Scores (APDQS) were calculated. Mean probing depth (MPD), mean clinical attachment loss (MAL) and % of sites bleeding on probing (%BOP) were derived from full-mouth periodontal exams. Multivariable adjusted linear and logistic regression models assessed the associations between diet quality and MPD, MAL, %BOP, and the odds of periodontitis (defined via the CDC/AAP classification).

RESULTS

Alternative Healthy Eating Index and APDQS were not associated with MPD, MAL, or periodontitis. While AHEI was also not associated with %BOP, the APDQS was associated with %BOP (p = .03). Higher nut consumption was related to lower MPD (p = .03) and periodontitis odds (p = .03). Higher red meat consumption was associated with higher MPD (p = .01) and %BOP (p = .05). Higher trans-fatty acid consumption was also associated with increased %BOP (p = .05).

CONCLUSION

Overall diet quality scores were not associated with periodontal status. Future studies are necessary to replicate the associations observed in this study to minimize the risk of false discovery.

The associations between major dietary patterns and risk of periodontitis

AIM

To prospectively investigate the associations between major dietary patterns and incidence of periodontitis.

METHODS

We included 34,940 men from the Health Professionals Follow-Up Study, free of periodontal disease and major illnesses at baseline. Detailed medical and dental history was collected through biennial mailed questionnaires, and dietary information was provided through quadrennial food frequency questionnaires. Using principal component analysis, we identified two major dietary patterns ("prudent" and "Western"). We used Cox proportional hazard models to examine the associations between the two dietary patterns and self-reported incidence of periodontitis over a 24-year follow-up period. We investigated each pattern separately.

RESULTS

There was no overall association between Western or prudent dietary patterns and periodontitis. Among obese, however, the Western dietary pattern was significantly associated with incident periodontitis. The hazard ratio for those in the highest quintile of Western diet versus those in the lowest (reference) was 1.83 (95% confidence interval: 1.21-2.76).

CONCLUSIONS

There was no overall association between Western or prudent dietary patterns and periodontitis; however, in subgroups analysis, the Western diet was significantly associated with higher periodontitis risk only among obese men, a finding that requires replication and biological explication.

Distinct maternal microbiota clusters are associated with diet during pregnancy: impact on neonatal microbiota and infant growth during the first 18 months of life

Nutrition during pregnancy plays an important role in maternal-neonatal health. However, the impact of specific dietary components during pregnancy on maternal gut microbiota and the potential effects on neonatal microbiota and infant health outcomes in the short term are still limited. A total of 86 mother-neonate pairs were enrolled in this study. Gut microbiota profiling on maternal-neonatal stool samples at birth was carried out by 16S rRNA gene sequencing using Illumina. Maternal dietary information and maternal-neonatal clinical and anthropometric data were recorded during the first 18 months. Longitudinal Body Mass Index (BMI) and Weight-For-Length (WFL) z-score trajectories using the World Health Organization (WHO) curves were obtained. The maternal microbiota was grouped into two distinct microbial clusters characterized by Prevotella (Cluster I) and by the Ruminococcus genus (Cluster II). Higher intakes of total dietary fiber, omega-3 fatty acids, and polyphenols were observed in Cluster II compared to Cluster I. Higher intakes of plant-derived components were associated with a higher presence of the Christensellaceae family, Dehalobacterium and Eubacterium, and lower amounts of the Dialister and Campylobacter species. Maternal microbial clusters were also linked to neonatal microbiota and infant growth in a birth-dependent manner. C-section neonates from Cluster I showed the highest BMI z-score at age 18 months, along with a higher risk of overweight. Longitudinal BMI and WL z-score trajectories from birth to 18 months were shaped by maternal microbial cluster, diet, and birth mode. Diet was an important perinatal factor in early life that may impact maternal microbiota; in particular, fiber, lipids and proteins, and exert a significant effect on the neonatal microbiome and contribute to infant development during the first months of life.

ABBREVIATIONS

NCDs: Non-Communicable Diseases, C-section: Cesarean Section, BMI: Body Mass Index; WL: Weight for length; EPA: Eicosapentanoic Acid; DHA: Docosahexaenoic Acid; DPA: Docosapentaenoic Acid; SCFA: Short Chain Fatty Acids; MD: Mediterranean Diet; FFQ: Food Frequency Questionnaire; CHI: Calinski Harabasz Index.

The occurrence of periodontal diseases and its correlation with different risk factors among a convenient sample of adult Egyptian population: a cross-sectional study

Background: Even though extensive studies on the prevalence of periodontal diseases in various populations worldwide have been carried out, data for the Egyptian population is limited.  The present study was carried out to evaluate the occurrence and the severity of periodontal disease and its correlation with different risk factors. Methods: Periodontal examination was performed on 343 adults attending the outpatient clinics of the Faculty of Dentistry, Cairo University, as well as three private clinics. Socio-demographic data, brushing frequency, body mass index (BMI) and dietary habits were recorded using a questionnaire. Results: It was found that 58.9% of participants had calculus deposits. The occurrence of periodontitis was 89.8%, where 70.8% of participants had stage I and 15.2% had stage II, while only 4.4% and 2.05% suffered from stage III and stage IV, respectively. Calculus was positively correlated with age, grains, and sugar in drinks and negatively correlated with socioeconomic status, education level, brushing frequency and milk. Calculus was not correlated with gender and BMI. Periodontitis was positively correlated with age, carbohydrates other than bread, grains, and crackers, as well as caffeinated drinks, while negatively correlated with gender, socioeconomic status, brushing frequency. Periodontitis was not correlated with BMI or education level. Conclusion: The present study clarifies that age, brushing frequency, carbohydrates and caffeinated drinks consumption are significant factors influencing the occurrence and the severity of periodontal diseases.

The occurrence of periodontal diseases and its correlation with different risk factors among a convenient sample of adult Egyptian population: a cross-sectional study

Background: Even though extensive studies on the prevalence of periodontal diseases in various populations worldwide have been carried out, data for the Egyptian population is limited.  The present study was carried out to evaluate the occurrence and the severity of periodontal disease and its correlation with different risk factors.

Methods: Periodontal examination was performed on 343 adults attending the outpatient clinics of the Faculty of Dentistry, Cairo University, as well as three private clinics. Socio-demographic data, brushing frequency, body mass index (BMI) and dietary habits were recorded using a questionnaire.

Results: It was found that 58.9% of participants had calculus deposits. The occurrence of periodontitis was 89.8%, where 70.8% of participants had stage I and 15.2% had stage II, while only 4.4% and 2.05% suffered from stage III and stage IV, respectively. Calculus was positively correlated with age, grains, and sugar in drinks and negatively correlated with socioeconomic status, education level, brushing frequency and milk. Calculus was not correlated with gender and BMI. Periodontitis was positively correlated with age, carbohydrates other than bread, grains, and crackers, as well as caffeinated drinks, while negatively correlated with gender, socioeconomic status, brushing frequency. Periodontitis was not correlated with BMI or education level.

Conclusion: The present study clarifies that age, brushing frequency, carbohydrates and caffeinated drinks consumption are significant factors influencing the occurrence and the severity of periodontal diseases.

Effects of Starch on Oral Health: Systematic Review to Inform WHO Guideline

A systematic review was conducted to update evidence on the effect of total dietary starch and of replacing rapidly digestible starches (RDSs) with slowly digestible starches (SDSs) on oral health outcomes to inform updating of World Health Organization guidance on carbohydrate intake. Data sources included MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, LILACS, and Wanfang. Eligible studies were comparative and reported any intervention with a different starch content of diets or foods and data on oral health outcomes relating to dental caries, periodontal disease, or oral cancer. Studies that reported total dietary starch intake or change in starch intake were included or where comparisons or exposure included diets and foods that compared RDSs and/or SDSs. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statement, and evidence was assessed with the GRADE Working Group guidelines. From 6,080 papers identified, 33 (28 studies) were included in the RDS versus SDS comparison: 15 (14 studies) assessed the relationship between SDS and/or RDS and dental caries; 16 (12 studies) considered oral cancer; and 2 studied periodontal disease. For total starch, 23 papers (22 studies) were included: 22 assessed the effects on dental caries, and 1 considered oral cancer. GRADE assessment indicated low-quality evidence, suggesting no association between total starch intake and caries risk but that RDS intake may significantly increase caries risk. Very low-quality evidence suggested no association between total starch and oral cancer risk, and low-quality evidence suggested that SDS decreases oral cancer risk. Data on RDS and oral cancer risk were inconclusive. Very low-quality data relating to periodontitis suggested a protective effect of whole grain starches (SDS). The best available evidence suggests that only RDS adversely affects oral health.

Better-quality diet is associated with lower odds of severe periodontitis in US Hispanics/Latinos

AIM

We investigated the cross-sectional association between diet quality and severe periodontitis in a sample of diverse Hispanics from the Hispanic Community Health Study/Study of Latinos.

MATERIALS AND METHODS

A total of 13,920 Hispanic/Latinos aged 18-74 years of different heritages underwent a full-mouth oral examination and completed two 24-hr dietary recalls during 2008-2011. Severe periodontitis was defined as having ≥30% tooth sites with clinical attachment loss ≥5 mm. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI-2010). We evaluated the association of diet quality with severe periodontitis adjusting for age, sex, nativity status, income, education, last dental visit, current insurance, cigarette smoking, diabetes, and energy intake.

RESULTS

Relative to those at the lowest quartile of diet quality, individuals at the highest quartile had significantly lower odds of severe periodontitis (adjusted OR = 0.57, 95% CI: 0.39-0.82), with evidence of a dose-response relationship across AHEI quartiles. Among AHEI-2010 components, higher consumption of whole grains and fruits, and lower consumption of red/processed meats were associated with lower odds of severe periodontitis.

CONCLUSION

Better-quality diet was associated with lower prevalence of severe periodontitis although the causal pathways need to be clarified in future work.

Impact of a vegan diet on the human salivary microbiota

Little is known about the effect of long-term diet patterns on the composition and functional potential of the human salivary microbiota. In the present study, we sought to contribute to the ongoing elucidation of dietary effects on the oral microbial community by examining the diversity, composition and functional potential of the salivary microbiota in 160 healthy vegans and omnivores using 16S rRNA gene amplicon sequencing. We further sought to identify bacterial taxa in saliva associated with host inflammatory markers. We show that compositional differences in the salivary microbiota of vegans and omnivores is present at all taxonomic levels below phylum level and includes upper respiratory tract commensals (e.g. Neisseria subflava, Haemophilus parainfluenzae, and Rothia mucilaginosa) and species associated with periodontal disease (e.g. Campylobacter rectus and Porphyromonas endodontalis). Dietary intake of medium chain fatty acids, piscine mono- and polyunsaturated fatty acids, and dietary fibre was associated with bacterial diversity, community structure, as well as relative abundance of several species-level operational taxonomic units. Analysis of imputed genomic potential revealed several metabolic pathways differentially abundant in vegans and omnivores indicating possible effects of macro- and micro-nutrient intake. We also show that certain oral bacteria are associated with the systemic inflammatory state of the host.