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Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 16927

Special Issue Editors

Prof. Dr. Johan Peter Woelber

E-Mail Website
Guest Editor
Department of Operative Dentistry and Periodontology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
Interests: periodontology; operative dentistry; nutrition; diet; communication; motivational interviewing
Special Issues, Collections and Topics in MDPI journals
Dr. Kirstin Vach

E-Mail Website
Guest Editor
Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
Interests: applied statistics; longitudinal data analysis; microbial composition; statistical applications in dentistry; interaction between different scientific disciplines
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce this Special Issue in Nutrients dealing with the emerging field of nutritional dentistry. Although oral hygiene and fluorides have a significant impact on everyone’s oral health, we must not forget that the causes of oral diseases are often related to malnutrition and other unhealthy behaviors, such as smoking. While dental caries is clearly a diet-related disease, there is also growing evidence that gingivitis and periodontitis are greatly influenced by diet. A peculiarity in this context is that malnutrition with far too much sugar and pro-inflammatory fats and a lack of fiber and micronutrients (which is also what the average Western diet represents) shows up extremely quickly in oral diseases. These develop much more quickly than other diseases also caused by Western diets, such as obesity, diabetes, or atherosclerosis.

This in turn presents a great opportunity for dentists and physicians to use nutritional dentistry to initiate healthier diets early on before other secondary diseases manifest themselves—an opportunity for which solely plaque control and fluorides are inadequate.

However, while broad evidence already exists for plaque control and fluorides, more evidence is needed for the efficacy of nutritional dentistry. We are honored to support this process with this Special Issue and look forward to receiving your submissions. We welcome different types of manuscripts, including review and reflection papers.

Prof. Dr. Johan Peter Woelber
Dr. Kirstin Vach
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutrition
  • diet
  • Western diet
  • caries
  • periodontitis
  • gingivitis
  • periodontal disease
  • sugar
  • carbohydrates
  • Omega-3 fatty acids
  • nitrates
  • plant-based whole foods

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Published Papers (7 papers)

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Editorial

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3 pages, 202 KiB  
Editorial
Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Caries, Gingivitis, and Periodontitis
by Johan Peter Woelber and Kirstin Vach
Nutrients 2023, 15(20), 4319; https://doi.org/10.3390/nu15204319 - 10 Oct 2023
Cited by 3 | Viewed by 1839
Abstract
Although oral hygiene and fluorides have a significant impact on people’s oral health, we must not forget that the causes of oral diseases are often related to malnutrition and other unhealthy behavioral factors, such as smoking, being sedentary, and chronic stress [...] Full article
(This article belongs to the Special Issue Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases)

Research

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10 pages, 1429 KiB  
Article
Breastfeeding Protects from Overjet in Adolescence by Reducing Pacifier Use: A Birth Cohort Study
by Carlos Alberto Feldens, Laura Boianovsky Petracco, Gustavo G. Nascimento, Huihua Li, Márcia Regina Vítolo and Karen Glazer Peres
Nutrients 2023, 15(15), 3403; https://doi.org/10.3390/nu15153403 - 31 Jul 2023
Cited by 2 | Viewed by 1760
Abstract
Increased dental overjet in adolescence is a clinically relevant outcome associated with the complexity and high cost of treatment, indicating the need for prevention strategies. We investigated the long-term impact of breastfeeding and pacifier use on increased overjet (IOVJ) in permanent dentition. A [...] Read more.
Increased dental overjet in adolescence is a clinically relevant outcome associated with the complexity and high cost of treatment, indicating the need for prevention strategies. We investigated the long-term impact of breastfeeding and pacifier use on increased overjet (IOVJ) in permanent dentition. A prospective cohort nested in a randomized controlled trial was conducted from birth to 12 years of age (n = 214). Breastfeeding and pacifier use were recorded monthly until 12 months. Overjet was assessed at age 12 years. We employed a causal mediation analysis using parametric regression models assuming no interaction between breastfeeding and pacifier usage. We found a total protective effect of breastfeeding on IOVJ (OR 0.49; 95% CI 0.28–0.96), where 63.1% were mediated by pacifier use (OR 0.61; 95% CI 0.44–0.87). Breastfeeding directly decreased the odds of IOVJ by 20%; however, the confidence interval included the null estimate (OR 0.81; 95% CI 0.41–1.60). In conclusion, breastfeeding protects by half of the IOVJ in adolescence through reducing pacifier use. Oral and general health professionals should collaborate to support WHO breastfeeding guidelines during individual patient counseling. Guidelines for practice, policy or public information require messages that include a common risk approach to oral and general health. Full article
(This article belongs to the Special Issue Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases)
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13 pages, 1366 KiB  
Article
Influence of Nutrition and Physical Activity on Local and Systemic Inflammatory Signs in Experimentally Induced Gingivitis
by Ingmar Staufenbiel, Knut Adam, Andreas Hahn, Felix Kerlikowsky, Marco Flohr, Nadine Schlueter and Kirstin Vach
Nutrients 2023, 15(15), 3344; https://doi.org/10.3390/nu15153344 - 27 Jul 2023
Cited by 2 | Viewed by 1596
Abstract
Although numerous studies have been published investigating the relationship between various dietary components and inflammatory periodontal disease, it has not yet been possible to clearly distinguish between periodontally healthy and unhealthy diets. This clinical study aimed to assess the association of specific food [...] Read more.
Although numerous studies have been published investigating the relationship between various dietary components and inflammatory periodontal disease, it has not yet been possible to clearly distinguish between periodontally healthy and unhealthy diets. This clinical study aimed to assess the association of specific food ingredients and physical activity on local and systemic inflammatory signs in experimentally induced gingivitis. Thirty-nine non-smoking periodontally healthy volunteers (mean age 23.2 ± 3.8 years) refrained from oral hygiene in the right maxilla for 21 days to induce an experimental gingivitis. Clinical examination (baseline and day 21) included plaque index, bleeding on probing (BOP), gingival crevicular fluid volume and high sensitive C-reactive protein levels (blood sample). Accompanying the intervention, volunteers documented with validated questionnaires their physical activity converted into metabolic equivalent (MET) and their nutrition converted into the dietary inflammatory index (DII). Significantly lower BOP (p = 0.039) was found for subjects with a more anti-inflammatory DII than for those with a more pro-inflammatory DII; higher MET values were correlated with lower BOP at day 21 (correlation coefficient −0.36). The results show an influence of nutrition and physical activity on periodontal inflammation signs. The DII may be a suitable parameter to verify the relationship between nutrition and inflammatory periodontal diseases. Full article
(This article belongs to the Special Issue Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases)
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15 pages, 341 KiB  
Article
Association between an Anti-Inflammatory Dietary Score and Periodontitis—Evidence from the Population-Based Hamburg City Health Study
by Berit Lieske, Nina Moszka, Katrin Borof, Elina Larissa Petersen, Bettina Jagemann, Merle Ebinghaus, Thomas Beikler, Guido Heydecke, Ghazal Aarabi and Birgit-Christiane Zyriax
Nutrients 2023, 15(14), 3235; https://doi.org/10.3390/nu15143235 - 21 Jul 2023
Cited by 9 | Viewed by 2136
Abstract
While the effects of dietary patterns on cardiovascular risk and diabetes have been well studied, the evidence is scarce as to which diet has the greatest anti-inflammatory potential and how dietary patterns are associated with periodontitis. In the Hamburg City Health Study (HCHS), [...] Read more.
While the effects of dietary patterns on cardiovascular risk and diabetes have been well studied, the evidence is scarce as to which diet has the greatest anti-inflammatory potential and how dietary patterns are associated with periodontitis. In the Hamburg City Health Study (HCHS), we developed an anti-inflammatory dietary score using a data-driven approach based on the relationship of relevant selected food groups with inflammatory biomarkers (hsCRP and IL-6). The aim of this cross-sectional study was to evaluate the association between the anti-inflammatory dietary score and the incidence of periodontitis in Hamburg, Germany. A total of n = 5642 participants fit the required inclusion criteria and were selected for analysis. Periodontal disease was assessed using probing depth, gingival recession, and bleeding on probing. Dietary intake was measured using a food frequency questionnaire (FFQ). A self-developed anti-inflammatory dietary score served as the key explanatory variable. Higher scores reflected lower inflammatory processes (measured through the biomarkers hsCRP and IL-6). Several covariates were included in the regression analysis. Regressions revealed that a higher anti-inflammatory dietary score was significantly associated with lower odds to be affected by periodontal disease in an unadjusted model (OR 0.86, 95% CI 0.82–0.89, p < 0.001) and in an adjusted model (age, sex, smoking, diabetes, hypertension, and physical activity) (OR 0.93, 95% CI 0.89–0.98, p = 0.003). Our study demonstrated a significant inverse association between an anti-inflammatory dietary score and periodontitis. Individuals with higher intake of proinflammatory nutrition should be specifically addressed to avoid periodontitis. Full article
(This article belongs to the Special Issue Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases)
10 pages, 580 KiB  
Article
Examining the Composition of the Oral Microbiota as a Tool to Identify Responders to Dietary Changes
by Kirstin Vach, Ali Al-Ahmad, Annette Anderson, Johan Peter Woelber, Lamprini Karygianni, Annette Wittmer and Elmar Hellwig
Nutrients 2022, 14(24), 5389; https://doi.org/10.3390/nu14245389 - 19 Dec 2022
Cited by 2 | Viewed by 2387
Abstract
Background: The role of diet and nutrition in the prevention of oral diseases has recently gained increasing attention. Understanding the influence of diet on oral microbiota is essential for developing meaningful prevention approaches to oral diseases, and the identification of typical and atypical [...] Read more.
Background: The role of diet and nutrition in the prevention of oral diseases has recently gained increasing attention. Understanding the influence of diet on oral microbiota is essential for developing meaningful prevention approaches to oral diseases, and the identification of typical and atypical responders may contribute to this. Methods: We used data from an experimental clinical study in which 11 participants were exposed to different dietary regimens in five consecutive phases. To analyse the influence of additional nutritional components, we examined changes in bacterial concentrations measured by culture techniques compared to a run-in phase. A measure of correspondence between the mean and individual patterns of the bacterial composition is introduced. Results: The distance measures introduced showed clear differences between the subjects. In our data, two typical and three atypical responders appear to have been identified. Conclusions: The proposed method is suitable to identify typical and atypical responders, even in small datasets. We recommend routinely performing such analyses. Full article
(This article belongs to the Special Issue Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases)
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10 pages, 654 KiB  
Article
Periodontitis Is Associated with Consumption of Processed and Ultra-Processed Foods: Findings from a Population-Based Study
by Luisa Schertel Cassiano, Marco A. Peres, Janaína V. S. Motta, Flávio F. Demarco, Bernardo L. Horta, Cecilia C. Ribeiro and Gustavo G. Nascimento
Nutrients 2022, 14(18), 3735; https://doi.org/10.3390/nu14183735 - 10 Sep 2022
Cited by 15 | Viewed by 3116
Abstract
The association between periodontitis and lifestyle factors has been widely investigated. However, an association between periodontitis and dietary patterns has not been explored. Therefore, this study investigated the association between periodontitis and food consumption among a Southern Brazil population. Data from the 1982 [...] Read more.
The association between periodontitis and lifestyle factors has been widely investigated. However, an association between periodontitis and dietary patterns has not been explored. Therefore, this study investigated the association between periodontitis and food consumption among a Southern Brazil population. Data from the 1982 Pelotas Birth Cohort were used (n = 537). The exposure, periodontitis, was clinically measured and classified using the AAP/CDC system, then two latent variables were defined: ‘initial’ and ‘moderate/severe’ periodontitis. The consumption of in natura, processed, and ultra-processed foods (NOVA classification) was the outcome and measured in calories using the food frequency questionnaire (FFQ). Confounders were sex, maternal education, smoking status, xerostomia, and halitosis. Data were analyzed by structural equation modeling. ‘Initial’ periodontitis was associated with a higher consumption of in natura food (standardized coefficient (SC) 0.102; p-value = 0.040), versus processed (SC 0.078; p-value = 0.129) and ultra-processed (SC 0.043; p-value = 0.400) foods. ‘Moderate/severe’ periodontitis was associated with higher consumption of ultra-processed foods (SC 0.108; p-value = 0.024), versus processed (SC 0.093; p-value = 0.053) and in natura (SC 0.014; p-value = 0.762) foods. ‘Moderate/severe’ periodontitis appears to be associated with the consumption of processed and ultra-processed foods. Full article
(This article belongs to the Special Issue Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases)
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Other

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20 pages, 3159 KiB  
Systematic Review
Dietary and Nutraceutical Interventions as an Adjunct to Non-Surgical Periodontal Therapy—A Systematic Review
by Johan Peter Woelber, Katharina Reichenbächer, Tara Groß, Kirstin Vach, Petra Ratka-Krüger and Valentin Bartha
Nutrients 2023, 15(6), 1538; https://doi.org/10.3390/nu15061538 - 22 Mar 2023
Cited by 8 | Viewed by 2791
Abstract
The aim of this study was to conduct a systematic literature review on the influence of dietary and nutraceutical interventions as an adjunct to non-surgical periodontal therapy (NSPT). A literature search for randomized, controlled clinical trials (RCTs) was performed in PubMed, the Cochrane [...] Read more.
The aim of this study was to conduct a systematic literature review on the influence of dietary and nutraceutical interventions as an adjunct to non-surgical periodontal therapy (NSPT). A literature search for randomized, controlled clinical trials (RCTs) was performed in PubMed, the Cochrane Library, and the Web of Science. Trial inclusion criteria included the application of a defined nutritional intervention (food, beverages, or supplements) adjunctive to NSPT compared to NSPT alone with at least one measured periodontal parameter (pocket probing depths (PPD) or clinical attachment level (CAL)). Of 462 search results, 20 clinical trials relating to periodontitis and nutritional interventions were identified, of which, in total, 14 studies could be included. Eleven studies examined supplements containing lycopene, folate, chicory extract, juice powder, micronutrients and plant extracts, omega-3 fatty acids, vitamin E, or vitamin D. Three studies examined food-based interventions (kiwifruit, green or oolong tea). Due to limited information on within-group differences in the studies, results were descriptively analyzed. A significant positive effect on periodontal parameters (PPD, bleeding on probing) was found for vitamin E, chicory extract, juice powder, green tea, and oolong tea. Heterogeneous effects were found for lycopene, folate, omega-3 fatty acids, and vitamin D. No effects on PPD were found for adjunct kiwifruit (in combination with NSPT). Risk of bias via RoB2 revealed a low risk of bias with some concerns. There was a high heterogeneity in the type of nutritional interventions. The adjunctive use of various supplements and green/oolong tea led to positive and significant effects of the nutritional interventions on clinical periodontal outcome parameters. In the context of non-surgical periodontal therapy, an adjunctive intake of micronutrients, omega-3 fatty acids, green/oolong tea, and polyphenols and flavonoids could be beneficial. Long-term clinical studies with full data reports (especially within-group differences) are needed for conducting a meta-analysis. Full article
(This article belongs to the Special Issue Healthier Smile: The Role of Diet and Nutrition in the Prevention and Therapy of Oral Diseases)
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