The interrelationship between Nutrition and Periodontal Health among Children and Adults: A Literature Review

Document Type : Review Article


1 Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University-Varna, Varna, Bulgaria

2 Department of Conservative Dentistry and Oral Pathology, Faculty of Dental Medicine, Medical University-Varna, Varna, Bulgaria


Background and aim: Complex oral prophylaxis addressed to children and adults is conceptually related to contemporary dental medicine science and practice. Today, periodontitis is widely distributed worldwide, affecting between 40% to 90% of the global population. Many profound studies have been devoted to exploring, analyzing, and implementing the specifics of the interrelationship between dietary patterns and periodontal disorders. The purpose of the review is to investigate the interrelationship between periodontal health and nutrition among children and adults.
Material and methods: An initial analysis of 229 articles was performed. We investigated all the titles, abstracts, and available full-length texts, and, based on definite criteria, these papers were elected corresponding to the interrelation between various nutrients and periodontal health in children and adults. The analyzed 61 scientific resources, including reviews, clinical reports, and research articles from PubMed, Google Scholar, NIMH, and Elsevier, have been published in the last 15 years.
Results: Maintaining normal development and solid health corresponds to adequately arranged and properly performed dietary habits. Nutrition influences the health status during pregnancy and childbirth, through the stages of childhood development, and among adults.
Conclusions: Scientists established that the deviations from physiologically based nutrition, such as obesity and malnutrition, can affect periodontal health throughout the life of individuals. Future investigations can be useful for the clarification of the multi-aspect interrelations between nutrition and periodontal health.


Main Subjects

[1] James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdollahpour I. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1789-858.
[2] World Health Organization. Oral health.; 148th session EB148.R1. Agenda item 6. 2021.
[3] GBD 2017 Oral Disorders Collaborators, Bernabe E, Marcenes W, Hernandez CR, Bailey J, Abreu LG, Alipour V, Amini S, Arabloo J, Arefi Z, Arora A. Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study. Journal of dental research. 2020;99(4):362-73.
[4] Peres MA, Macpherson LM, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, Guarnizo-Herreño CC, Kearns C, Benzian H. Oral diseases: a global public health challenge. The Lancet. 2019;394(10194):249-60.
[5] Seitz MW, Listl S, Bartols A, Schubert I, Blaschke K, Haux C, van der Zande MM. Current knowledge on correlations between highly prevalent dental conditions and chronic diseases: an umbrella review.
[6] Barros SP, Offenbacher S. Modifiable risk factors in periodontal disease: epigenetic regulation of gene expression in the inflammatory response. Periodontology 2000. 2014;64(1):95-110.
[7] Stegeman C, LD C. The role of food and nutrients in oral health. Dimensions of Dental Hygiene. 2013:26-30.
[8] Van der Velden U, Kuzmanova D, Chapple IL. Micronutritional approaches to periodontal therapy. Journal of clinical periodontology. 20111;38:142-58.
[9] Varela-López A, Giampieri F, Bullón P, Battino M, Quiles JL. A systematic review on the implication of minerals in the onset, severity and treatment of periodontal disease. Molecules. 2016;21(9):1183.
[10] Naqvi AZ, Buettner C, Phillips RS, Davis RB, Mukamal KJ. n-3 fatty acids and periodontitis in US adults. Journal of the American Dietetic Association. 2010;110(11):1669-75.
[11] Touger-Decker R, Mobley C. Position of the Academy of Nutrition and Dietetics: oral health and nutrition. Journal of the Academy of Nutrition and Dietetics. 2013;113(5):693-701.
[12] Freeland-Graves JH, Nitzke S. Position of the academy of nutrition and dietetics: total diet approach to healthy eating. Journal of the Academy of Nutrition and Dietetics. 2013;113(2):307-17.
[13] Dhingra K. Methodological issues in randomized trials assessing probiotics for periodontal treatment. Journal of periodontal research. 2012;47(1):15-26.
[14] Slawik S, Staufenbiel I, Schilke R, Nicksch S, Weinspach K, Stiesch M, Eberhard J. Probiotics affect the clinical inflammatory parameters of experimental gingivitis in humans. European journal of clinical nutrition. 2011;65(7):857-63.
[15] Marra MV, Boyar AP. Position of the American Dietetic Association: nutrient supplementation. Journal of the American Dietetic Association. 2009;109(12):2073-85.
[16] Sheetal A, Hiremath VK, Patil AG, Sajjansetty S, Kumar SR. Malnutrition and its oral outcome–a review. Journal of clinical and diagnostic research: JCDR. 2013;7(1):178-80.
[17] Russell SL, Psoter WJ, JEAN‐CHARLES GE, Prophte S, Gebrian B. Protein‐energy malnutrition during early childhood and periodontal disease in the permanent dentition of Haitian adolescents aged 12–19 years: a retrospective cohort study. International Journal of Paediatric Dentistry. 2010;20(3):222-9.
[18] Pontes HA, Neto NC, Ferreira KB, Fonseca FP, Vallinoto GM, Pontes FS, dos Santos Pinto Jr D. Oral Manifestations of Vitamin B 12 Deficiency: A Case Report. Journal of the Canadian Dental Association. 2009;75(7).
[19] Santonocito S, Polizzi A, Palazzo G, Indelicato F, Isola G. Dietary factors affecting the prevalence and impact of periodontal disease. Clinical, Cosmetic and Investigational Dentistry. 2021;13:283-92.
[20] Woelber JP, Tennert C. Diet and periodontal diseases. The impact of nutrition and diet on oral health. 2020;28:125-33.
[21] Vach K, Al-Ahmad A, Anderson A, Woelber JP, Karygianni L, Wittmer A, Hellwig E. Analysing the Relationship between Nutrition and the Microbial Composition of the Oral Biofilm—Insights from the Analysis of Individual Variability. Antibiotics. 2020;9(8):479.
[22] Anderson AC, Rothballer M, Altenburger MJ, Woelber JP, Karygianni L, Lagkouvardos I, Hellwig E, Al-Ahmad A. In-vivo shift of the microbiota in oral biofilm in response to frequent sucrose consumption. Scientific reports. 2018;8(1):1-3.
[23] Mazur M, Bietolini S, Bellardini D, Lussi A, Corridore D, Maruotti A, Ottolenghi L, Vozza I, Guerra F. Oral health in a cohort of individuals on a plant-based diet: a pilot study. La Clinica Terapeutica. 2020;171(2):e142-8.
[24] Iwasaki M, Manz MC, Moynihan P, Yoshihara A, Muramatsu K, Watanabe R, Miyazaki H. Relationship between saturated fatty acids and periodontal disease. Journal of dental research. 2011;90(7):861-7.
[25] Yan K, Lin Q, Tang K, Liu S, Du Y, Yu X, Li S. Substance P participates in periodontitis by upregulating HIF-1α and RANKL/OPG ratio. BMC Oral Health. 2020;20(1):1-8.
[26] Lee JH, Shin MS, Kim EJ, Ahn YB, Kim HD. The association of dietary vitamin C intake with periodontitis among Korean adults: Results from KNHANES Ⅳ. PLoS One. 2017;12(5):e0177074.
[27] Gonçalves de Carvalho CM, Ribeiro SM. Aging, low-grade systemic inflammation and vitamin D: a mini-review. European journal of clinical nutrition. 2017;71(4):434-40.
[28] Varela-López A, Giampieri F, Bullón P, Battino M, Quiles JL. A systematic review on the implication of minerals in the onset, severity and treatment of periodontal disease. Molecules. 2016;21(9):1183.
[29] Gondivkar SM, Gadbail AR, Gondivkar RS, Sarode SC, Sarode GS, Patil S, Awan KH. Nutrition and oral health. Disease-a-month. 2019;65(6):147-54.
[30] Algra Y, Haverkort E, Kok W, Etten-Jamaludin FV, Schoot LV, Hollaar V, Naumann E, Schueren MD, Jerković-Ćosić K. The association between malnutrition and oral health in older people: A systematic review. Nutrients. 2021;13(10):3584.
[31] Suzman R, Beard J. Global health and aging. NIH Publ. 2011;1(4):273-7.
[32] Muzi-Filho H, Jannuzzi LB, Bouzan AC, Alves-Barros S, Alves-Bezerra DS, Pereira-Acácio A, Ferreira BS, Silva-Pereira D, Costa-Sarmento G, Vieyra A. Histone deacetylase activity and the renin-angiotensin-aldosterone system: key elements in cardiorenal alterations provoked by chronic malnutrition in male adult rats. Cell Physiol Biochem. 2020;54(6):1143-62.
[33] Agarwal E, Miller M, Yaxley A, Isenring E. Malnutrition in the elderly: a narrative review. Maturitas. 2013;76(4):296-302.
[34] Sobotka L, Forbes A. Basics in clinical nutrition. Galen; 2019.
[35] Gil-Montoya JA, Ponce G, Lara IS, Barrios R, Llodra JC, Bravo M. Association of the oral health impact profile with malnutrition risk in Spanish elders. Archives of gerontology and geriatrics. 2013;57(3):398-402.
[36] Kshetrimayum N, Reddy CV, Siddhana S, Manjunath M, Rudraswamy S, Sulavai S. Oral health‐related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India. Gerodontology. 2013;30(2):119-25.
[37] Boulos C, Salameh P, Barberger-Gateau P. Factors associated with poor nutritional status among community dwelling Lebanese elderly subjects living in rural areas: results of the AMEL study. The journal of nutrition, health & aging. 2014;18(5):487-94.
[38] Sheetal A, Hiremath VK, Patil AG, Sajjansetty S, Kumar SR. Malnutrition and its oral outcome–a review. Journal of clinical and diagnostic research: JCDR. 2013;7(1):178-80.
[39] Azzolino D, Passarelli PC, De Angelis P, Piccirillo GB, D’addona A, Cesari M. Poor oral health as a determinant of malnutrition and sarcopenia. Nutrients. 2019;11(12):2898.
[40] Toniazzo MP, Amorim PD, Muniz FW, Weidlich P. Relationship of nutritional status and oral health in elderly: Systematic review with meta-analysis. Clinical nutrition. 2018;37(3):824-30.
[41] Kazemi S, Savabi G, Khazaei S, Savabi O, Esmaillzadeh A, Keshteli AH, Adibi P. Association between food intake and oral health in elderly: SEPAHAN systematic review no. 8. Dental research journal. 2011;8(l1):S15-S20.
[42] Schoo WH, Bizzarro S. 34 Parodontale chirurgie bij de behandeling van parodontitis. InParodontologie 2009;361-401.
[43] Gonsalves WC, Wrightston AS, Henry RG. Common oral conditions in older persons. American family physician. 2008;78(7):845-52.
[44] El Osta N, Hennequin M, Tubert-Jeannin S, Naaman NB, El Osta L, Geahchan N. The pertinence of oral health indicators in nutritional studies in the elderly. Clinical nutrition. 2014;33(2):316-21.
[45] Kiesswetter E, Hengeveld LM, Keijser BJ, Volkert D, Visser M. Oral health determinants of incident malnutrition in community-dwelling older adults. Journal of dentistry. 2019;85:73-80.
[46] Lindmark U, Jansson H, Lannering C, Johansson L. Oral health matters for the nutritional status of older persons—A population‐based study. Journal of clinical nursing. 2018;27(5-6):1143-52.
[47] Alam I, Fawad B. Oral health and nutritional status of the free-living elderly in Peshawar, Pakistan. Saudi medical journal. 2010;31(6):713-15.
[48] Smits KP, Listl S, Jevdjevic M. Vegetarian diet and its possible influence on dental health: A systematic literature review. Community dentistry and oral epidemiology. 2020;48(1):7-13.
[49] Woelber JP, Bremer K, Vach K. Kö nig D, Hellwig E, Ratka-Krüger P, et al. An oral health optimized diet can reduce gingival and periodontal inflammation in humans—a randomized controlled pilot study. BMC Oral Health. 2016;17:28.
[50] Lula EC, Ribeiro CC, Hugo FN, Alves CM, Silva AA. Added sugars and periodontal disease in young adults: an analysis of NHANES III data. The American journal of clinical nutrition. 2014;100(4):1182-7.
[51] Staufenbiel I, Weinspach K, Förster G, Geurtsen W, Günay H. Periodontal conditions in vegetarians: a clinical study. European journal of clinical nutrition. 2013;67(8):836-40.
[52] Najeeb S, Zafar MS, Khurshid Z, Zohaib S, Almas K. The role of nutrition in periodontal health: an update. Nutrients. 2016;8(9):530.
[53] Muniz FW, Nogueira SB, Mendes FL, Rösing CK, Moreira MM, de Andrade GM, de Sousa Carvalho R. The impact of antioxidant agents complimentary to periodontal therapy on oxidative stress and periodontal outcomes: A systematic review. Archives of oral biology. 2015;60(9):1203-14.
[54] Adegboye AR, Boucher BJ, Kongstad J, Fiehn NE, Christensen LB, Heitmann BL. Calcium, vitamin D, casein and whey protein intakes and periodontitis among Danish adults. Public health nutrition. 2016;19(3):503-10.
[55] Keukenmeester RS, Slot DE, Rosema NA, Van Loveren C, Van der Weijden GA. Effects of sugar‐free chewing gum sweetened with xylitol or maltitol on the development of gingivitis and plaque: a randomized clinical trial. International journal of dental hygiene. 2014;12(4):238-44.
[56] Belludi SA, Verma S, Banthia R, Bhusari P, Parwani S, Kedia S, Saiprasad SV. Effect of lycopene in the treatment of periodontal disease: A clinical study. The Journal of Contemporary Dental Practice. 2013;14(6):1054.
[57] Kulkarni V, Bhatavadekar NB, Uttamani JR. The effect of nutrition on periodontal disease: a systematic review. Journal of the California Dental Association. 2014;42(5):302-11.
[58] Üçkardeş Y, Özmert EN, Ünal F, Yurdakök K. Effects of zinc supplementation on parent and teacher behaviour rating scores in low socioeconomic level Turkish primary school children. Acta Paediatrica. 2009;98(4):731-6.
[59] Yoshihara A, Iwasaki M, Miyazaki H. Mineral content of calcium and magnesium in the serum and longitudinal periodontal progression in Japanese elderly smokers. Journal of clinical periodontology. 2011;38(11):992-7.
[60] Adegboye AR, Christensen LB, Holm-Pedersen P, Avlund K, Boucher BJ, Heitmann BL. Intake of dairy products in relation to periodontitis in older Danish adults. Nutrients. 2012;4(9):1219-29.