Association between different dietary patterns and eating disorders and periodontal diseases

Detrimental effects of chronic sugar-sweetened carbonated soft drink consumption on inflammatory response and the size of apical periodontitis: An animal-based study

AIM

This study aimed to evaluate the effects of chronic consumption of two sugar-sweetened carbonated soft drinks - one containing caffeine (Coca-Cola®) and one without (Sprite®) - on the progression of periapical lesions and the levels of pro-inflammatory cytokines in rats.

METHODOLOGY

Twelve Wistar rats were divided into three groups (n = 4): Control group, Coca-Cola group and Sprite group. The rats in Coca-Cola and Sprite groups were given ad libitum access to their respective soft drinks for 3 months, while the Control group received filtered water. After 2 months of consumption, the pulps of the lower left first molars were exposed for 28 days to induce periapical lesions. Following euthanasia, the jaws were removed, and the periapical lesions were assessed using micro-computed tomography imaging. Blood samples were collected to analyse the pro-inflammatory cytokines IL-1β, IL-6, IL-2, IL-17 and TNF-α via Luminex assay. Non-parametric data were analysed using the Kruskal-Wallis test followed by Dunn's test, while parametric data were analysed using one-way ANOVA followed by Tukey's test (p < 0.05).

RESULTS

Both the Coca-Cola and Sprite groups exhibited periapical lesions with significantly greater volume and diameter compared to the Control group (p < 0.05). Additionally, both soft drink groups had significantly higher levels of IL-1β, IL-6 and IL-2 compared to the Control group (p < 0.05). The Sprite group displayed significantly higher levels of IL-1β than the Coca-Cola group (p < 0.05), while the Coca-Cola group showed significantly elevated TNF-α levels compared to both the Control and Sprite groups (p < 0.05). No significant differences in IL-17 levels were observed among the groups (p > 0.05).

CONCLUSIONS

The chronic consumption of sugar-sweetened carbonated soft drinks, regardless of caffeine content, has detrimental effects on the inflammatory response and progression of apical periodontitis in rats.

Periodontal Status and Herpesiviridae, Bacteria, and Fungi in Gingivitis and Periodontitis of Systemically Compromised Pediatric Subjects: A Systematic Review

BACKGROUND

Gingivitis and periodontitis are microbially associated diseases, with some features characteristic of pediatric age and others linked to systemic diseases. While the role of periodontal pathogenic bacteria is well recognized, the contribution of fungi and viruses, particularly Herpesviridae, remains controversial. Studies in adults have highlighted the presence of Herpesviridae, but evidence in pediatric subjects, especially systemically compromised, is limited. This systematic review aimed to assess periodontal status (e.g., health, gingivitis, periodontitis, necrotizing gingivitis, and/or periodontitis) and the subgingival and/or salivary microbial (bacterial, viral, and fungal) profile in systemically compromised pediatric (≤18 years) subjects with gingivitis and/or periodontitis compared to clinical periodontal health.

METHODS

The review protocol was registered on PROSPERO (CRD42024597695) and followed the PRISMA statement. Data from eight studies were descriptively analyzed and qualitatively assessed through ROBINS-I and JBI tools.

RESULTS

CMV was frequently detected, particularly in necrotizing gingivitis (19.40%). EBV was found in necrotizing gingivitis (20.69%) and periodontitis (10.34%); HSV was mainly associated with gingivitis and necrotizing gingivitis. Bacteria species in periodontitis included Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium, and Campylobacter species. Candida albicans was detected in periodontitis, suggesting a fungal involvement in the disease's pathogenesis. Although the bacterial and fungal profile was not investigated, limited viral presence was noted in subjects with healthy periodontium, indicating a stable microbiome.

CONCLUSIONS

These findings underscore the dynamics of microbial interactions in the progression of periodontal disease in systemically compromised pediatric subjects.

Vitamin B6 status, type 2 diabetes mellitus, and periodontitis: evidence from the NHANES database 2009-2010

BACKGROUND

Periodontitis is a chronic inflammatory disease that seriously affects the quality of patients' life. Diabetes mellitus (DM) is the independent risk factor of periodontitis. The association between vitamin B6 with several inflammatory diseases have been reported in previous studies. However, the effect of vitamin B6 on the association of T2DM and periodontitis remains unclear. This study aimed to explore the effect of vitamin B6 [evaluated by serum pyridoxal 5'-phosphate (PLP)] on the association of T2DM and periodontitis in American population.

METHODS

Data of this cross-sectional study were extracted from the National Health and Nutrients Examination Survey (NHANES) 2009-2010. Serum PLP level was the indicator of vitamin B6 status in vivo and measured by enzymatic assay. Covariates included demographic information, physical examination, lifestyle characteristics, laboratory parameters and complications. The weighted univariate and multivariate logistics regression models were conducted to explore the association of PLP, T2DM and periodontitis, with the odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were further performed to explore these associations based on age, body mass index (BMI), cardiovascular disease (CVD) and dental decay.

RESULTS

Finally, 3,491 eligible adults with the information of periodontitis measurement, T2DM diagnosis and PLP detection were included. Among them, 1,999 (57.26%) had periodontitis. After adjusted confounders, we found adults with T2DM had high odds of periodontitis (OR = 1.45, 95%CI: 1.04-2.02); while no significant association between PLP and periodontitis was observed. Adults with low PLP level (< 67.20 nmol/L) and combined with T2DM had high odds of periodontitis (OR = 1.82, 95%CI: 1.29-2.55), no significant association was found between T2DM and periodontitis in adults with high PLP level (≥ 67.20 nmol/L). These results suggested that serum PLP levels may have the modulatory effect on the association of T2DM and periodontitis. This modulatory effect remains robust in subgroup analysis, especially in adults aged ≥ 60 years (OR = 4.54, 95%CI: 2.15-9.62), with obese (OR = 3.06, 95%CI: 1.31-7.18), without the history of CVD (OR = 2.25, 95%CI: 1.06-4.79) and without dental decay (OR = 2.93, 95%CI: 1.51-5.68) (all P < 0.05).

CONCLUSION

Our study suggested that adults with T2DM had the high odds of periodontitis, and serum PLP may plays a modulatory effect in this association. T2DM patients maintaining a higher intake of vitamin B6 may have potential benefits in reducing the periodontitis risk.

Probiotics as an adjunctive therapy in periodontitis treatment-reality or illusion-a clinical perspective

Periodontitis, a prevalent oral health issue, involves various microorganisms and clinical effects. This review examines probiotics as adjunctive therapy for periodontitis by analyzing forty clinical studies. Findings showed mixed results due to differences in study design, probiotic types, and clinical parameters; however, probiotics improved outcomes in severe cases. Caution is advised when interpreting these results, as longer follow-up periods reveal variability and potential regression in effects.

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.

Dietary patterns and periodontitis: A systematic review

The systematic review aimed to investigate the associations between index-based dietary patterns and the risk and severity of periodontitis. Four public databases were searched for relevant published articles. Two independent researchers conducted the study selection, quality assessment, and data extraction. Methodological quality of the selected studies was evaluated using Joanna Briggs Institute Checklists. The review was registered with PROSPERO (CRD42023395049). Twenty-five studies were eligible for this review, including 23 cross-sectional studies and two prospective cohort studies. The most utilized dietary indices were the Healthy Eating Index (HEI), the Mediterranean Diet Score (MDS), and the Dietary Inflammatory Index (DII). The results indicated a positive association between higher diet quality (i.e., higher HEI and MDSs and lower DII scores) and healthier periodontal status. Subgroup meta-analysis for four studies utilizing HEI and CDC/AAP case definition indicates the protective effect of higher HEI scores on the risk of periodontitis (OR [95% CI] = 0.77[0.68, 0.88]) with statistical significance (Z = 3.91 [p < 0.0001]). Dietary assessment was conducted by validated food frequency questionnaires (FFQ) in 52% of the studies and 24-h dietary recalls in 36% of the studies. One study utilized a validated 15-item questionnaire to measure patients' adherence to the Mediterranean Diet (QueMD). The quality assessment showed that all studies were of high quality. High HEI and MDSs and low DII scores were associated with a low risk of periodontitis and better periodontal conditions. The standardized and repeatable diet guidelines might be provided for preventing periodontitis. Future prospective studies and clinical trials are needed to confirm this causal association.

Potential effects of specific gut microbiota on periodontal disease: a two-sample bidirectional Mendelian randomization study

Introduction

Periodontal disease (PD) presents a substantial global health challenge, encompassing conditions from reversible gingivitis to irreversible periodontitis, often culminating in tooth loss. The gut-oral axis has recently emerged as a focal point, with potential gut microbiota dysbiosis exacerbating PD.

Methods

In this study, we employed a double-sample bidirectional Mendelian randomized (MR) approach to investigate the causal relationship between specific gut microbiota and periodontal disease (PD) and bleeding gum (BG) development, while exploring the interplay between periodontal health and the gut microenvironment. We performed genome-wide association studies (GWAS) with two cohorts, totalling 346,731 (PD and control) and 461,113 (BG and control) participants, along with data from 14,306 participants' intestinal flora GWAS, encompassing 148 traits (31 families and 117 genera). Three MR methods were used to assess causality, with the in-verse-variance-weighted (IVW) measure as the primary outcome. Cochrane's Q test, MR-Egger, and MR-PRESSO global tests were used to detect heterogeneity and pleiotropy. The leave-one-out method was used to test the stability of the MR results. An F-statistic greater than 10 was accepted for instrument exposure association.

Results and conclusion

Specifically, Eubacterium xylanophilum and Lachnoclostridium were associated with reduced gum bleeding risk, whereas Anaerotruncus, Eisenbergiella, and Phascolarctobacterium were linked to reduced PD risk. Conversely, Fusicatenibacter was associated with an elevated risk of PD. No significant heterogeneity or pleiotropy was detected. In conclusion, our MR analysis pinpointed specific gut flora with causal connections to PD, offering potential avenues for oral health interventions.

Diet Traps during Eating Disorders among Dentate Patients at an Oral Health Glance

Persons suffering from eating disorders (ED) may often experience a recurrence/persistence symptoms despite the completion of psychiatric therapy. In most cases, their general health status is linked to current nutritional behaviors. Medical professionals, general practitioners (GPs), dieticians, and dentists may see those patients in their practices. At the same time, due to low sense of illness, some patients may delay or never seek professional medical care. The aim of this article is to analyze the main ED types according to dietary behaviors causing oral health problems and discuss oral health complications in affected dentate patients. The second objective is to update oral preventive measures and technological innovations together with active agents for oral hygiene care that might effectively support oral health maintenance during the presence of long-term symptoms. The research method involved a review of clinical reports as a synthesis of the electronic research in the Pubmed, Web of Science, and Google Scholar databases. Based on the research, ED patients were found to present related incidences of oral complications. Studies have reported that the possible course of an ED and comorbidities may be an imbalance in the oral environment. The results showed an association between biological (malnutrition, etc.), behavioral (binge eating episodes, vomiting, acidic diet, poor oral hygiene), and pharmacotherapeutic (addiction, hyposalivation) factors that may threaten oral health. Early diagnosis of the past and present symptoms is essential to eliminate and take control of destructive behaviors. Oral changes need to be tackled with medical insight, and additionally, the perception of dietary interactions is recommended.