Researchers Investigate Links Between MedDiet Adherence and Oral Health

A review arti­cle pub­lished in the Journal of Oral Microbiology has cat­a­loged the pos­i­tive influ­ences of the Mediterranean diet on oral health.

The researchers found that adher­ence to the Mediterranean diet ​“is linked to the pre­ven­tion of sev­eral meta­bolic and chronic degen­er­a­tive patho­log­i­cal processes, includ­ing oral dis­eases” and that the diet ​“may rep­re­sent a poten­tial player in the link between oral micro­biome and oral dis­eases.”

The oral micro­biome is the sec­ond largest and most diverse micro­biome after the gut. Comprising approx­i­mately 700 species of microor­gan­isms, it is a com­plex sys­tem whose equi­lib­rium is vul­ner­a­ble to changes in com­po­si­tion.

This sys­tem includes bac­te­ria, fungi, viruses, archaea (sin­gle-celled organ­isms such as methanogens) and pro­to­zoa (sin­gle-celled organ­isms such as Entamoeba gin­gi­valis).

According to the United States Centers for Disease Control (CDC), there is a strong cor­re­la­tion between oral dis­ease, espe­cially peri­odon­ti­tis, and chronic sys­temic dis­eases.

The orga­ni­za­tion ref­er­ences sev­eral stud­ies report­ing that peo­ple with peri­odon­ti­tis (inflam­ma­tory gum dis­ease) are at higher risk of ischemic or hem­or­rhagic stroke.

The CDC has also found that tooth loss is another sig­nif­i­cant risk fac­tor for stroke, and peri­odon­tal dis­ease sig­nif­i­cantly increases the risk of chronic obstruc­tive pul­monary dis­ease.

The World Health Organization fur­ther notes that poor oral health is a reg­u­lar cause of pneu­mo­nia in older adults.

The authors note that the oral cav­ity serves as a reser­voir of Staphylococcus aureus, a bac­terium that, while ordi­nar­ily harm­less, can become an oppor­tunis­tic pathogen caus­ing res­pi­ra­tory and sinus infec­tions.

It is also a lead­ing cause of death among antimi­cro­bial- and antibi­otic-resis­tant pathogen strains such as MRSA, a strain of Staphylococcus aureus.

Research has shown that polyphe­nols have antimi­cro­bial effects on oral pathogens such as Staphylococcus aureus and Porphyromonas gin­gi­valis, a bac­terium linked to numer­ous dis­eases, includ­ing peri­odon­ti­tis, Alzheimer’s dis­ease and rheuma­toid arthri­tis.

Among patients usu­ally prone to severe peri­odon­ti­tis, adher­ence to the Mediterranean diet cor­re­lated pos­i­tively with health­ier oral habits, includ­ing increased tooth count and improved den­tal plaque removal.

The Mediterranean diet con­tains numer­ous ele­ments rich in polyphe­nols: extra vir­gin olive oil, which con­tains oleo­can­thal, oleu­ropein and hydrox­y­ty­rosol; nuts, which con­tain proan­tho­cyani­dins; fruits, veg­eta­bles, red wine and herbs, which con­tain com­pounds such as narin­genin, api­genin and kaempferol; and many oth­ers.

The Mediterranean diet is also rich in fiber, which has been shown to pro­mote oral eubio­sis, a state of equi­lib­rium in which ben­e­fi­cial micro­bial species dom­i­nate.

The authors ref­er­ence three stud­ies in par­tic­u­lar when dis­cussing evi­dence sup­port­ing the pos­i­tive effects of the Mediterranean diet on patients with peri­odon­tal inflam­ma­tion com­pared to the Western-type diet.

The first, pub­lished in 2022, demon­strated a sig­nif­i­cant decrease in peri­odon­tal bleed­ing and sur­face inflam­ma­tion in peri­odon­tal inflam­ma­tory patients after fol­low­ing the Mediterranean diet for six months.

These find­ings con­trast notably with stud­ies from 2005 and 2019, which showed an increased gin­gi­val inflam­ma­tory response in peo­ple fol­low­ing a Western-type diet char­ac­ter­ized by the high con­sump­tion of refined grains and sug­ars.

The researchers con­cluded the review arti­cle by empha­siz­ing the need to study fur­ther the link between adher­ence to the Mediterranean diet, oral dis­eases and the oral micro­biome.

They also called on den­tists to be more proac­tive in dis­sem­i­nat­ing infor­ma­tion about how diet impacts oral health.

“The den­tist plays a fun­da­men­tal role in pro­mot­ing and dis­sem­i­nat­ing the cor­rect dietary habits based on healthy food choices among the pop­u­la­tion that, together with lifestyle, may sig­nif­i­cantly improve their gen­eral and oral health sta­tus,” they con­cluded.