Is Diet a Determining Factor in the Induction of Gingival Inflammation by Dental Plaque? A Secondary Analysis of Clinical Studies

Johan Peter Woelber; Valentin Bartha; Stefan Baumgartner; Christian Tennert; Ulrich Schlagenhauf; Petra Ratka-Krüger; Kirstin Vach

doi:10.3390/nu16070923

Is Diet a Determining Factor in the Induction of Gingival Inflammation by Dental Plaque? A Secondary Analysis of Clinical Studies

Nutrients. 2024 Mar 22;16(7):923. doi: 10.3390/nu16070923.

Authors

Johan Peter Woelber¹, Valentin Bartha², Stefan Baumgartner³, Christian Tennert⁴, Ulrich Schlagenhauf⁵, Petra Ratka-Krüger⁶, Kirstin Vach^{7

8}

Affiliations

¹ Policlinic of Operative Dentistry, Periodontology, and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
² Center for Conservative Dentistry and Periodontology, Heidelberg University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
³ Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland.
⁴ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland.
⁵ Department of Periodontology, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany.
⁶ Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
⁷ Hannover Medical School, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
⁸ Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany.

Abstract

The aim was to determine the association between plaque and gingival inflammation reported by dietary interventions. Data of four clinical studies dealing with changed nutrition and gingival examination were reanalyzed with regard to gingival inflammation (GI), plaque (PI), and bleeding on probing (BOP). Dietary changes basically involved avoiding sugar, white flour and sweetened drinks and focusing on whole foods for 4 weeks. The control groups were to maintain their usual diet. All participants had to reduce their oral hygiene efforts. Linear regression models taking the clustering of the data due to several studies into account were applied. In total, data of 92 participants (control groups: 39, test-groups 53) were reanalyzed. While both groups showed a slight increase in dental plaque, only the test groups showed a significant decrease in inflammatory parameters: GI (mean value difference End-Baseline (Δ): -0.31 (±SD 0.36)) and BOP (Δ: -15.39% (±16.07)), both p < 0.001. In the control groups, there was a constant relation between PI and GI, while the experimental group showed a decreasing relationship in GI/PI (p = 0.016), and even an inverted relationship BOP/PI under a changed diet (p = 0.031). In conclusion, diet seems to be a determining factor how the gingiva reacts towards dental plaque.

Keywords: diet; gingival inflammation; gingivitis; human; nutrition; plaque.

MeSH terms

Dental Plaque*
Diet / adverse effects
Gingiva
Gingivitis* / etiology
Humans
Inflammation

Grants and funding

This study was solely based on institutional funding. The study of Woelber et al., 2019 [27] was funded by the German Research Foundation (DFG; WO2030/1-1). Baumgartner et al., 2009 [15] was supported by the Clinical Research Foundation, University of Bern; Woelber et al., 2016 [26] and Bartha et al., 2021 [23] were self-funded by the authors and their institutions.