Periodontal conditions in vegetarians: a clinical study

Impact of acidic beverages on composition and surface characteristics of human teeth: scanning electron microscopic, stereomicroscopic and energy dispersive x-ray analyses

OBJECTIVES

The objective of this study was to evaluate the effect of acidic beverages on the surface topography and elemental composition of human teeth.

METHODS

A total of five highly acidic beverages (Red Bull, Pepsi, Apple Cidra, Tang Mosambi, and Tang Orange) were investigated. The tooth specimens of experimental groups were submerged in each beverage and incubated at 37 °C for 7 days, whereas, the tooth specimens of control groups were placed in distilled water. Afterwards, tooth specimens were analyzed using scanning electron microscopic (SEM), stereomicroscopic, and energy dispersive x-ray (EDX) techniques.

RESULTS

All experimental groups revealed a decline in the tooth elements compared to controls, however, such decline was not statistically significant. Nevertheless, comparing the experimental groups, the Red Bull beverage caused a marked reduction in the percentage of both calcium and phosphorus elements compared to the Pepsi, Apple Cidra, Tang Mosambi, and Tang Orange beverages but it was insignificant as well in contrast to its control counterpart. All five acidic beverages demonstrated erosive potential under SEM analysis; however, each group of specimens showed a diverse amount of demineralization. In addition, all experimental groups exhibited significant discoloration of tooth specimens compared to their respective control counterparts.

CONCLUSIONS

Within the limitations of study, all five acidic beverages demonstrated erosive potential in the simulated in vitro conditions under SEM analysis; however, each group of specimens exhibited a different extent of demineralization. In addition, the overall effect of all beverages was insignificant under EDX analysis as no substantial difference was revealed between the elemental composition of experimental and control group specimens.

The association between diets and periodontitis: a bidirectional two-sample Mendelian randomization study

Background

Periodontitis, a complex inflammatory condition, has been associated with dietary habits and antioxidants. While the association between certain dietary patterns and periodontitis has been documented, the bidirectional relationship remains unclear. This study utilizes Mendelian randomization (MR) analysis to investigate the bidirectional associations between dietary factors comprising dietary antioxidants, and periodontitis.

Methods

Employing a two-sample MR approach, this study analyzed genome-wide association study (GWAS) data on diets and periodontitis from large databases and published literature. Instrumental variables (IVs) were selected and filtered based on genetic variants associated with dietary factors and periodontitis, respectively. Various MR methods, including Inverse Variance Weighted, MR-Egger, Weighted Median, Weighted Mode, and Simple Mode were applied to assess the bidirectional associations. Sensitivity analyses were conducted to validate the robustness of the findings.

Results

Our analysis revealed significant associations between certain dietary factors and the risk of periodontitis. Specifically, higher intake of filtered coffee, low-calorie drinks, and other cereals, as well as increased metabolic circulating levels of gamma-tocopherol, were associated with an elevated risk of periodontitis. Conversely, consumption of cheese, white rice, chocolate bars, unsalted peanuts, and higher absolute circulating levels of vitamin C were linked to a reduced risk. Additionally, the study suggests that periodontitis may influence dietary habits, indicating a bidirectional relationship.

Conclusion

This study provides additional evidence of a bidirectional association between dietary factors and periodontitis. It highlights the importance of dietary interventions in the prevention and management of periodontitis. The findings underscore the need for incorporating dietary counseling into periodontal disease management protocols and suggest the potential of personalized dietary strategies for periodontitis patients. Further research is warranted to explore the mechanisms underlying these associations and to confirm these findings in diverse populations.

Mediterranean diet: a potential player in the link between oral microbiome and oral diseases

Background

The oral microbiome is a complex and dynamic assemblage of microorganisms that colonize different sites of the oral cavity maintaining both oral and systemic health. Therefore, when its composition is altered, oral diseases occur. Among oral inflammatory pathologies, periodontal diseases affect the tissues surrounding the teeth, representing the main cause of tooth loss and one of the most important threats to the oral health. Lifestyle and eating habits influence the composition of the human oral microbiota and the development and progression of oral diseases. In this context, the Mediterranean Diet (MD) model, comprising both healthy dietary choices and lifestyle, is linked to the prevention of several metabolic and chronic-degenerative pathological processes, including oral diseases. Indeed, the MD is a plant-based diet, enriched of anti-inflammatory and antioxidant nutrients, which may induce beneficial effects against dental caries and periodontal diseases.

Aim

This review summarizes the role of the oral microbiome in the development of the oral diseases and the potential of MD in modulating the oral microbiome leading to implications for oral health.

Conclusions

The data collected highlight the need to promote the MD pattern along with the correct hygiene habits to prevent the development of oral diseases.

Nutraceuticals and Their Contribution to Preventing Noncommunicable Diseases

The high rate of deaths around the world from noncommunicable diseases (NCDs) (70%) is a consequence of a poor diet lacking in nutrients and is linked to lifestyle and environmental conditions that together trigger predisposing factors. NCDs have increased 9.8% of public health spending worldwide, which has been increasing since 2000. Hence, international organizations such as the WHO, the Pan American Health Organization, and the Food and Agriculture Organization of the United Nations have been developing strategic plans to implement government and economic policies to strengthen programs in favor of food security and nutrition. A systematic review is presented to document an analysis of the origin and characteristics of obesity, cardiovascular disease, chronic respiratory diseases, diabetes, and cancers affecting a large part of the world's population. This review proposes a scientifically based report of functional foods including fruits, vegetables, grains, and plants, and how their bioactive compounds called nutraceuticals-when consumed as part of a diet-benefit in the prevention and treatment of NCDs from an early age. Multifactorial aspects of NCDs, such as culture and eating habits, are limitations to consider from the clinical, nutritional, and biochemical points of view of everyone who suffers from them.

Periodontal Disease and Other Adverse Health Outcomes Share Risk Factors, including Dietary Factors and Vitamin D Status

For nearly a century, researchers have associated periodontal disease (PD) with risks of other adverse health outcomes such as cardiovascular disease, diabetes mellitus, and respiratory diseases, as well as adverse pregnancy outcomes. Those findings have led to the hypothesis that PD causes those adverse health outcomes either by increasing systemic inflammation or by the action of periodontopathic bacteria. However, experiments largely failed to support that hypothesis. Instead, the association is casual, not causal, and is due to shared underlying modifiable risk factors, including smoking, diet, obesity, low levels of physical activity, and low vitamin D status. Diabetes mellitus is also considered a risk factor for PD, whereas red and processed meat are the most important dietary risk factors for diabetes. Because PD generally develops before other adverse health outcomes, a diagnosis of PD can alert patients that they could reduce the risk of adverse health outcomes with lifestyle changes. In addition, type 2 diabetes mellitus can often be reversed rapidly by adopting an anti-inflammatory, nonhyperinsulinemic diet that emphasizes healthful, whole plant-based foods. This review describes the evidence that proinflammatory and prohyperinsulinemia diets and low vitamin D status are important risk factors for PD and other adverse health outcomes. We also make recommendations regarding dietary patterns, food groups, and serum 25-hydroxyvitamin D concentrations. Oral health professionals should routinely inform patients with PD that they could reduce their risk of severe PD as well as the risks of many other adverse health outcomes by making appropriate lifestyle changes.

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.

Influence of the vegan, vegetarian and omnivore diet on the oral health status in adults: a systematic review and meta-analysis

OBJECTIVE

This systematic review aimed to evaluate the influence of the nature of diet (vegan, vegetarian, and omnivore) on the oral health status in adults.

METHODS

This systematic review and meta-analysis was performed using the PRISMA guidelines. Electronic databases [PubMed, Embase, CENTRAL], online search engines (Google Scholar), research portals, and hand searches were performed systematically to identify studies. The last literature search was performed February 1st, 2021. Studies were included if they reported on the influence of the nature of diet on the oral health status (oral hygiene, periodontal health, dental status, and salivary function) in adults, by two investigators. Inter-investigator reliability was evaluated using Kappa (κ) statistics. PROSPERO registration number: CRD42020211567.

RESULTS

Twenty-two studies were included for data extraction and final analysis. The meta-analysis revealed that the bleeding on probing measure was higher in omnivores (Z = -4.057, p < 0.0001; 95% CI: -0.684, -0.238; I² = 0.0%) and the overall periodontal health was significantly better in vegan/vegetarians than omnivores (Z = -2.632, p = 0.008; 95% CI: -0.274, -0.073; I² = 29.7%). Vegan/vegetarians demonstrated more dental erosion (Z = 3.325, p = 0.001; 95% CI: 0.170, 0.659; I² = 0.0%). In adults over 60 years old, the prevalence of caries was higher in omnivores (Z = 3.244, p = 0.001; 95% CI: 0.092, 0.371; I² = 0.0%), while complete edentulism was more prevalent in vegetarians (Z = -4.147, p < 0.0001; 95% CI: -0.550, -0.197; I² = 0.0%).

CONCLUSIONS

This review reveals that adults on an omnivore diet may be associated with a higher risk for periodontal problems and dental caries, while vegetarians/vegans may be associated with a higher risk for dental erosion.

Association between the quality of plant-based diets and periodontitis in the U.S. general population

AIM

To investigate the relationship between plant-based diet indices (PDIs) and periodontitis and serum IgG antibodies against periodontopathogens in the U.S.

POPULATION

MATERIALS AND METHODS

We analysed cross-sectional data on 5651 participants ≥40 years of age from the Third National Health and Nutrition Examination Survey. Food frequency questionnaire data were used to calculate the overall PDI, healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Periodontitis was defined using a half-reduced Centers for Disease Control and Prevention and American Academy of Periodontology case definition. Serum antibodies against 19 periodontopathogens were used to classify the population into two subgroups using hierarchical clustering. Survey-weighted multivariable logistic regressions were applied to assess the associations of PDI/hPDI/uPDI z-scores with periodontitis and hierarchical clusters after adjusting for potential confounders.

RESULTS

A total of 2841 (50.3%) participants were defined as having moderate/severe periodontitis. The overall PDI z-score was not significantly associated with the clinical and bacterial markers of periodontitis. By considering the healthiness of plant foods, we observed an inverse association between hPDI z-score and periodontitis (odds ratio [OR] = 0.925, 95% confidence interval [CI]: 0.860-0.995). In contrast, higher uPDI z-score (adherence to unhealthful plant foods) might increase the risk of periodontitis (OR = 1.100; 95% CI: 1.043-1.161). Regarding antibodies against periodontopathogens, the participants in cluster 2 had higher periodontal antibodies than those in cluster 1. The hPDI z-score was positively associated with cluster 2 (OR = 1.192; 95% CI: 1.112-1.278). In contrast, an inverse association between uPDI z-score and cluster 2 was found (OR = 0.834; 95% CI: 0.775-0.896).

CONCLUSIONS

Plant-based diets were associated with periodontitis, depending on their quality. A healthy plant-based diet was inversely related to an increased risk of periodontitis but positively related to elevated antibody levels against periodontopathogens. For an unhealthy plant-based diet, the opposite trends were observed.

Protein Intake and Oral Health in Older Adults-A Narrative Review

Oral health is vital to general health and well-being for all ages, and as with other chronic conditions, oral health problems increase with age. There is a bi-directional link between nutrition and oral health, in that nutrition affects the health of oral tissues and saliva, and the health of the mouth may affect the foods consumed. Evidence suggests that a healthy diet generally has a positive impact on oral health in older adults. Although studies examining the direct link between oral health and protein intake in older adults are limited, some have explored the relationship via malnutrition, which is also prevalent among older adults. Protein-energy malnutrition (PEM) may be associated with poor oral health, dental caries, enamel hypoplasia, and salivary gland atrophy. This narrative review presents the theoretical evidence on the impact of dietary protein and amino acid composition on oral health, and their combined impact on overall health in older adults.

Adherence to the food-based Japanese dietary guidelines and prevalence of poor oral health-related quality of life among older Japanese adults in the Kyoto-Kameoka study

Although better diet quality is inversely related to the risk of geriatric disorders, the association of adherence to dietary guidelines with oral health-related quality of life (OHRQoL) is unclear. We aimed to investigate this association in older Japanese adults. This cross-sectional study included 7984 Japanese participants aged ≥ 65 years from the population-based Kyoto-Kameoka study. Dietary intake was estimated using a validated self-administered FFQ. The scores for adherence to the Japanese Food Guide Spinning Top (range: 0 (worst) to 80 (best)) were calculated. These scores were stratified into quartiles (Qs). Poor OHRQoL was defined as a score ≤ 50 using a 12-item Geriatric Oral Health Assessment Index. The OR and 95 % CI were calculated using multivariable logistic regression and the spline model. Higher adherence score was associated with a lower prevalence of poor OHRQoL (Q1-Q4:36·0 %, 32·1 %, 27·9 % and 25·1 %, respectively). An inverse association was found between the score for adherence to the food-based Japanese dietary guidelines and the OR of poor OHRQoL among all the participants (Q1: reference; Q2: OR, 0·87 (95 % CI: 0·75, 1·00); Q3: OR, 0·77 (95 % CI: 0·66, 0·90); Q4: OR, 0·72 (95 % CI: 0·62, 0·85); P_{for trend} < 0·001). These relationships were similar to the results in the spline model. Higher adherence to the food-based Japanese dietary guidelines is inversely associated with the prevalence of poor OHRQoL in older adults. Our results may provide useful insights to improve and maintain oral health.

Inflammation as a link between periodontal disease and obesity

Nutrition plays a critical role in the homeostatic balance, maintenance of health, and longevity. There is a close link between inflammatory diseases and nutritional health. Obesity is a severe pathological process with grave implications on several organ systems and disease processes, including type 2 diabetes, cardiovascular disease, osteoarthritis, and rheumatoid arthritis. The impact of obesity on periodontal inflammation has not been fully understood; the association between nutritional balance and periodontal inflammation is much less explored. This review is focused on the potential mechanistic links between periodontal diseases and obesity and common inflammatory activity pathways that can be pharmacologically targeted.

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

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.

The Importance of Nitrate Reduction for Oral Health

Salivary glands concentrate plasma nitrate into saliva, leading to high nitrate concentrations that can reach the millimolar range after a nitrate-rich vegetable meal. Whereas human cells cannot reduce nitrate to nitrite effectively, certain oral bacteria can. This leads to an increase in systemic nitrite that can improve conditions such as hypertension and diabetes through nitric oxide availability. Apart from systemic benefits, it has been proposed that microbial nitrate reduction can also promote oral health. In this review, we discuss evidence associating dietary nitrate with oral health. Oral bacteria can reduce nitrite to nitric oxide, a free radical with antimicrobial properties capable of inhibiting sensitive species such as anaerobes involved in periodontal diseases. Nitrate has also been shown to increase resilience against salivary acidification in vivo and in vitro, thus preventing caries development. One potential mechanism is proton consumption during denitrification and/or bacterial reduction of nitrite to ammonium. Additionally, lactic acid (organic acid involved in oral acidification) and hydrogen sulfide (volatile compound involved in halitosis) can act as electron donors for these processes. The nitrate-reducing bacteria Rothia and Neisseria are consistently found at higher levels in individuals free of oral disease (vs. individuals with caries, periodontitis, and/or halitosis) and increase when nitrate is consumed in clinical studies. Preliminary in vitro and clinical evidence show that bacteria normally associated with disease, such as Veillonella (caries) and Prevotella (periodontal diseases and halitosis), decrease in the presence of nitrate. We propose nitrate as an ecologic factor stimulating eubiosis (i.e., an increase in health-associated species and functions). Finally, we discuss the preventive and therapeutic potential, as well as safety issues, related to the use of nitrate. In vivo evidence is limited; therefore, robust clinical studies are required to confirm the potential benefits of nitrate reduction on oral health.

A randomised clinical trial to investigate the effect of dietary protein sources on periodontal health

AIM

The aim was to assess two macronutrient interventions in a 2x2 factorial dietary design to determine their effects on oral health.

MATERIALS AND METHODS

Participants (65-75 years old) with a BMI between 20-35 kg/m² of a larger RCT who consented to an oral health assessment were recruited. They had ad libitum access to one of four experimental diets (omnivorous higher fat or higher carbohydrate, semi-vegetarian higher fat or higher carbohydrate) for 4 weeks. Periodontal examination included periodontal probing depth (PPD), clinical attachment level (CAL) and bleeding on probing. Oral plaque and gingival crevicular fluid (GCF) were collected before and after the intervention.

RESULTS

Between baseline and follow up the number of sites with a CAL <5 mm (mean difference (MD) -5.11±9.68, P=0.039) increased and the GCF amount (MD -23.42±39.42 Periotron Units (PU), P=0.050) decreased for the semi-vegetarian high fat diet. For the mean proportion of sites with PPD reduction >1 mm and CAL gain >1 mm significant differences were calculated between the diets investigated. The clinical parameters were not associated with changes of the oral microbiota.

CONCLUSION

The results of this study provided evidence that a semi-vegetarian higher fat diet provides benefits to clinical parameters of periodontal health. ACTRN12616001606471. This article is protected by copyright. All rights reserved.

[Association between diet of the vegan population and self-perception of periodontal state in Metropolitan Lima]

OBJECTIVE

to determine the association between vegan diet and self-perceived periodontal status in a vegan population of Metropolitan Lima, Peru.

MATERIALS AND METHODS

a total of 240 people (120 vegans and 120 non-vegans) were surveyed in this study during the months of August to December 2020 in a virtual way. To evaluate self-perception of periodontal status and oral hygiene habits, the self-report of periodontal disease was used, which is validated with a Cronbach's alpha of 0.77. In addition, other variables such as age, sex, socioeconomic level, educational level, and tobacco consumption were registered. A Poisson regression with robust variance estimator was used both for the association of variables, and prevalence ratios were reported in a crude and adjusted model. The confidence level was 95 % and the significance level was p < 0.05.

RESULT

a statistically significant association was found between the appearance of reddish and/or swollen gums (PR = 0.67; 95 % CI: 0.25-0.54) and poor perception of the state of the gums (PR = 0.43; 95 % CI: 0.33-0.56) with the vegan diet. Finally, for the gum bleeding dimension during brushing, no statistically significant differences were observed between vegans and non-vegans.

Inflammatory, oxidative and DNA damage status in vegetarians: is the future of human diet green?

The health benefit of a vegetarian diet is still under debate as it may result in a higher intake of some beneficial micronutrients, while others may be reduced, thus influencing various metabolic pathways and health-related biomarkers. This scoping review discusses inflammatory, oxidative and DNA damage status in vegetarians and vegans compared to omnivores. Most of the reviewed studies indicated favorable effects of a vegetarian diet on oxidative status compared to omnivores but did not clearly associate particular dietary habits to genome damage. The evidence on the effect of vegetarian diet on the inflammatory and immunological biomarkers is poor, which could at least partly be explained by methodological constraints such as small sample size, short duration of vegetarianism and inconsistent definitions of the omnivorous diet. The only inflammatory biomarker that seems to be associated with the vegetarian diet was inflammatory mediator C-reactive protein, which in several studies showed lower values in vegetarians as compared to omnivores. There were very few studies on immunological markers and the results on the difference between vegetarians and omnivores were inconclusive. Although several biomarkers involved in oxidative stress and inflammation showed a beneficial association with the vegetarian diet, further research in well-defined and sufficiently sized cohorts is needed to provide more evidence.

[Association between age-related macular degeneration and periodontal disease]

PURPOSE

To evaluate the association between age-related macular degeneration (AMD) and periodontal disease, two frequent conditions in the elderly, with some risk factors in common.

METHODS

Single center, pilot, case-control study performed in a center specialized in the diagnosis and management of AMD. Periodontal status was evaluated in 43 AMD patients and 19 controls. Fundus examination and a complete periodontal examination were performed in all subjects.

RESULTS

AMD patients have a greater percentage of 3-4mm clinical attachment loss compared to controls (47% vs. 38%, [P=0.039]). However, no significant difference was found between the groups with regard to the prevalence of severe periodontitis.

CONCLUSIONS

These results suggest an association between AMD and attachment loss characteristic of periodontal disease and support the need for larger prospective studies to elucidate the relationships between these 2 highly prevalent and potentially severe diseases.

Contemporary diagnosis and management of dental erosion

OBJECTIVE

This article is aimed at providing an overview of the topic of erosive tooth wear (ETW), highlighting the clinical signs, diagnosis, and management of dental erosion.

OVERVIEW

With the increased prevalence of ETW, it is important that oral health professionals are able to recognize the early signs. Early clinical signs of dental erosion are characterized by loss of enamel texture, a silky glossy appearance, and sometimes a dulling of the surface gloss, referred to as the "whipped clay effect, cupping, and restorations 'standing proud'." The progression of ETW should be monitored by means of diagnostic models or clinical photographs. ETW can be as a result of acid attack of extrinsic or intrinsic origin.

CONCLUSION

There is an increase of ETW that is being recognized by the profession. The first step in diagnosing and management is to recognize as early as possible that the process is occurring. At that point a determination of whether the primary etiology is either intrinsic or extrinsic should be made. If these findings are confirmed, appropriate prevention, and management strategies can be adopted followed by appropriate restorative therapy.

CLINICAL SIGNIFICANCE

The prevalence of ETW continues to increase. It is therefore important that oral health care providers have a better understanding of the etiology, pathophysiology, and management of this condition. This review aims to provide the guidelines for diagnosis and management of dental erosion.

Dietary Factors Affecting the Prevalence and Impact of Periodontal Disease

In the last few decades, growing evidence have shown a possible impact of diet and nutrients on oral health. This review aims to describe, in the light of current knowledge, the role of diet, nutrients, and micronutrients in periodontal health and periodontal diseases. A variety of macronutrients and micronutrients could have an impact on periodontal health. The balanced intake of unprocessed complex carbohydrates, vegetable proteins, omega-3 fatty acids, minerals, and vitamins positively affects periodontal inflammation. On the other way, refined carbohydrates, non-vegetable proteins, proinflammatory saturated fatty acids and an unbalanced supply of vitamins and minerals may increase periodontal inflammation. This review will discuss the current evidence that shows how a healthy and balanced diet has anti-inflammatory and protective effects on periodontal health. Therefore, it appears that adopting a correct lifestyle and diet should be encouraged in patients with oral and periodontal disease.

Effects of raw vegan diet on periodontal and dental parameters

Objectives:

Macronutrients and micronutrients present in different types of diet could influence different aspects of both inflammatory and immune responses; thereby, diets could influence oral health and the periodontal condition. The raw vegan diet is a subset of vegetarianism in which only uncooked plant-derived foods are consumed. The present study's aim was to evaluate the effect of the raw vegan diet on periodontal and dental health parameters.

Materials and Methods:

A total of 118 participants (59 raw vegans and 59 controls) were interviewed about their level of education and oral health habits. Samples of unstimulated whole saliva were collected for pH analysis, and dental and periodontal parameters were examined. Then, statistical analysis was performed.

Results:

Raw vegans had better oral hygiene (P = 0.001). The decayed-missing-filling indices were relatively equal in both groups. The probing depth, bleeding on probing (BOP), and simplified oral hygiene index were significantly lower in raw vegans (P = 0.047, P = 0.017, and P = 0.001, respectively). Multiple regression analyses disclosed that probing depth and BOP were significantly related to debris index.

Conclusion:

Based on this study's results, it can be presumed that the better periodontal condition in raw vegans is a result of their better oral care and lifestyle.

Vegetarian diet and its possible influence on dental health: A systematic literature review

Objectives

People following a vegetarian diet could be more prone to oral health problems than people following a nonvegetarian diet. The aim of this systematic review was to examine the possible impacts of following a vegetarian diet on dental hard tissues, focusing on caries development, dental erosion and number of natural teeth.

Methods

PubMed, EMBASE, Web of Science and CINAHL were searched systematically up until 17 April 2019. Original studies comparing dental health (exclusively focusing on dental hard tissues) in vegetarians and nonvegetarians were selected. Study characteristics and outcome data were extracted, and the quality of the studies was assessed using the Newcastle‐Ottawa Scale. When a dental health characteristic was reported in three or more papers in a comparable way, a meta‐analysis was performed.

Results

Twenty‐one papers reporting on 18 studies were included in this review. In meta‐analyses, the vegetarian diet was associated with a higher risk for dental erosion (odds ratio: 2.40 [95% confidence interval: 1.24, 4.66]; P = .009) and a lower decayed, missing and filled teeth (DMFT) score (mean difference: −0.15 [95% confidence interval: −0.29, −0.02]; P = .023), although the quality of most included studies was poor and the findings for DMFT score became insignificant when only studies on adults were included in the meta‐analysis. A meta‐analysis for the other dental characteristics was not possible due to the limited number of eligible studies. There was inconsistent evidence for a link between following a vegetarian diet and dental caries or the number of natural teeth.

Conclusions

Within the limitations of the present study, the findings suggest that following a vegetarian diet may be associated with a greater risk of dental erosion.

PERIODONTAL DISEASE AND AGE-RELATED MACULAR DEGENERATION: Results From the National Health and Nutrition Examination Survey III

PURPOSE

To study the association between periodontal disease (PD) and age-related macular degeneration (AMD).

METHODS

For this cross-sectional analysis, 8,208 adults aged 40 years or older with retinal photographs graded for AMD were used from the National Health and Nutrition Examination Survey III. National Health and Nutrition Examination Survey III standardized dental measurements of PD status (defined as loss of >3 mm of attachment between the gum and tooth in at least 10% of sites measured). Participants were stratified into 60 years or younger and older than 60 years of age groups. Association between PD and AMD was assessed while controlling for sex, race, education, poverty income ratio, smoking, hypertension, body mass index, cardiovascular disease, and C-reactive protein.

RESULTS

In this population, a total of 52.30% had PD, and the prevalence of AMD was 11.45%. Logistic regression model controlled for confounders and stratified by age 60 years or younger versus older than 60 years showed PD to be independently associated with an increased risk for AMD (odds ratio = 1.96, 95% confidence interval = 1.22-3.14, P = 0.006) for those aged 60 years or younger but not for subjects older than 60 years (odds ratio = 1.32, confidence interval = 0.93-1.90, P = 0.120).

CONCLUSION

In this population-based study, PD is independently associated with AMD in those aged 60 years or younger.

Periodontal health status and treatment needs of the rural population of India: A cross-sectional study

Background:

Periodontal disease is of public health concern and hence data on its prevalence rate are necessary. We have documented the prevalence pattern of periodontal disease in a rural population of Belgaum district, India, and identify the optimal treatment needs (TNs).

Materials and Methods:

A cross-sectional study was carried on 1680 dentate adult subjects, examined from 12 villages in Belgaum district, Karnataka, India for prevalence of periodontal status and their TNs (using Community Periodontal Index for Treatment Needs [CPITN]).

Results:

Increase in CPITN score positively correlated with age. Only 4.3% (13) of subjects in the age-group of 20-29 had a CPITN score of 4 indicative of pockets of 6 mm or more when compared to 26% (91) of subjects in the age-group of 45-60 years. 92% (569) of the subjects in the age-group of 30-44 were having a TN score 2 whereas only 5.3% (33) of subjects were having a TN score 0 in the same age-group. Significantly higher need for treatment was observed in males, smokers and subjects using finger and tooth powder. Surprisingly diet of the subjects did not influence TNs.

Conclusion:

Increased prevalence of periodontal diseases and TNs was observed. There is a need for initiating adequate awareness regarding oral hygiene, specifically primary prevention could help in reducing the prevalence of periodontal disease.

The plasminogen activation system in periodontal tissue (Review)

The plasminogen activation system (PAS) plays an essential role in tissue proteolysis in physiological and pathological processes. Periodontitis is a chronic infection associated with increased proteolysis driven by plasminogen activation. In this comprehensive review, we summarise the effects of PAS in wound healing, tissue remodelling, inflammation, bacterial infection, and in the initiation and progression of periodontal disease. Specifically, we discuss the role of plasminogen activators (PAs), including urokinase PA (uPA), tissue-type PA (tPA), PA inhibitor type 1 (PAI-1) and 2 (PAI-2) and activated plasminogen in periodontal tissue, where their concentrations can reach much higher values than those found in other parts of the body. We also discuss whether PA deficiencies can have effects on periodontal tissue. We conclude that in periodontal disease, PAS is unbalanced and equalizing its function can improve the clinical periodontal tissue condition.