The Study
Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability
This study found that people with gum disease have fewer good bacteria in their mouth that help turn veggies into something healthy for the heart. But it didn't prove that the gum disease caused the bacteria to disappear — maybe people with gum disease eat different foods or brush less. So we can say they're linked, but not that one causes the other.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
Good gum bacteria turn nitrate from veggies into nitric oxide, which helps your blood vessels. Bad gum disease kills these helpful bacteria, so your body can't make enough nitric oxide after eating nitrate-rich foods.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 546 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — if you eat nitrate-rich foods like spinach or beets, your body may not get the full heart-healthy benefits if you have gum disease.
- 2People with gum disease couldn't convert 8 mmol/L nitrate to nitrite in saliva; after gum treatment, their ability returned to normal.
- 3Rothia bacteria (a key nitrate-turner) increased after treatment.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
International Journal of Oral Science
Year
2023
Authors
B. Rosier, W. Johnston, M. Carda-Diéguez, Annabel Simpson, Elena Cabello-Yeves, K. Piela, Robert Reilly, A. Artacho, Chris Easton, M. Burleigh, Shauna Culshaw, Á. Mira
Related Content
Claims (6)
Nitrate from food is converted to nitrite by bacteria in the mouth, and that nitrite is then turned into nitric oxide in the bloodstream.
People with gum disease show a lower ability to convert nitrate to nitrite in saliva, and this ability returns to normal after non-surgical gum treatment lasting 90 days, which indicates that the bacteria in the mouth directly affect nitrate metabolism.
People with periodontitis have lower levels of specific nitrate-reducing bacteria in their gum plaque compared to people without periodontitis, and these bacteria increase after non-surgical gum treatment.
After non-surgical periodontal treatment in patients with periodontitis, the number of Rothia bacteria in plaque rises, and this rise is closely linked to the return of nitrate-reducing bacteria.
Treating gum disease does not change levels of nitrate or nitrite in the blood of patients with gum disease, unless they consume more dietary nitrate.
In people with periodontitis, the ability of saliva to reduce nitrate is not detectable at normal levels but becomes measurable only when dietary nitrate is present at a concentration of 8 mmol/L.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.