Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Vitamins and plant ingredients

Periodontal conditions in vegetarians: a clinical study

European Journal of Clinical Nutrition volume 67, pages 836–840 (2013)Cite this article

Subjects

Abstract

BACKGROUND/OBJECTIVES:

Investigations about possible correlations between vegetarian diet and periodontal conditions are rare and characterized by small case numbers. The aim of this clinical study was to investigate the influence of a vegetarian diet on periodontal parameters with an appropriate sample size.

SUBJECTS/METHODS:

A total of 200 patients, 100 vegetarians and 100 non-vegetarians, were included in the study. All patients were examined including a full mouth assessment of the periodontal and dental conditions. In addition, a questionnaire was handed out to ask for patients’ oral hygiene habits and level of education. For statistical analysis the Mann–Whitney Test (χ2 for analysis of the questionnaire) was applied (level of significance: P<0.05).

RESULTS:

Well known periodontal risk factors like age, gender and smoking habits were equally distributed within each group (71 females, 29 males, respectively and 10 smokers in each group; mean age: 41.45 years vegetarians versus 41.72 years non-vegetarians). Vegetarians had significantly lower probing pocket depths (P=0.039), bleeding on probing (P=0.001), periodontal screening index (P=0.012), a better hygiene index (P<0.001) and less mobile teeth (P=0.013). Dental examinations revealed significantly less missing teeth (P=0.018) but also more decayed (P=0.001) and eroded (P=0.026) teeth in vegetarians. Furthermore, vegetarians had a higher level of education (P<0.001), but visited dentists significantly less frequent.

CONCLUSIONS:

Vegetarians revealed better periodontal conditions (less inflammation signs, less periodontal damage and a better dental home care). However, it should be considered that vegetarians are not only avoiding meat in their nutrition but are also characterized by an overall healthier life style.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Pihlstrom BL, Michalowicz BS, Johnson NW . Periodontal diseases. Lancet 2005; 366: 1809–1820.

    Article  Google Scholar 

  2. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C . The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005; 83: 661–669.

    PubMed  PubMed Central  Google Scholar 

  3. Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M et al. Treatment of periodontitis and endothelial function. N Engl J Med 2007; 356: 911–920.

    Article  CAS  Google Scholar 

  4. Teeuw WJ, Gerdes VE, Loos BG . Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care 2010; 33: 421–427.

    Article  Google Scholar 

  5. Morita I, Inagaki K, Nakamura F, Noguchi T, Matsubara T, Yoshii S et al. Relationship between periodontal status and levels of glycated hemoglobin. J Dent Res 2012; 91: 161–166.

    Article  CAS  Google Scholar 

  6. Kinane D, Bouchard P, Group E of European Workshop on Periodontology. Periodontal diseases and health: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008; 35: 333–337.

    Article  Google Scholar 

  7. Martínez-Maestre MÁ, González-Cejudo C, Machuca G, Torrejón R, Castelo-Branco C . Periodontitis and osteoporosis: a systematic review. Climacteric 2010; 13: 523–529.

    Article  Google Scholar 

  8. Detert J, Pischon N, Burmester GR, Buttgereit F . The association between rheumatoid arthritis and periodontal disease. Arthritis Res Ther 2010; 12: 218.

    Article  Google Scholar 

  9. Paju S, Scannapieco FA . Oral biofilms, periodontitis, and pulmonary infections. Oral Dis 2007; 13: 508–512.

    Article  CAS  Google Scholar 

  10. Katancik JA, Kritchevsky S, Weyant RJ, Corby P, Bretz W, Crapo RO et al. Periodontitis and airway obstruction. J Periodontol 2005; 76: 2161–2167.

    Article  Google Scholar 

  11. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation 2012; 125: 2520–2544.

    Article  Google Scholar 

  12. Clarke NG, Hirsch RS . Personal risk factors for generalized periodontitis. J Clin Periodontol 1995; 22: 136–145.

    Article  CAS  Google Scholar 

  13. Falagas ME, Kompoti M . Obesity and infection. Lancet Infect Dis 2006; 6: 438–446.

    Article  Google Scholar 

  14. Bistrian B . Systemic response to inflammation. Nutr Rev 2007; 65: 170–172.

    Article  Google Scholar 

  15. Suvan J, D’Aiuto F, Moles DR, Petrie A, Donos N . Association between overweight/obesity and periodontitis in adults. A systematic review. Obes Rev 2011; 12: 381–404.

    Article  Google Scholar 

  16. Hujoel P . Dietary carbohydrates and dental-systemic diseases. J Dent Res 2009; 88: 490–502.

    Article  CAS  Google Scholar 

  17. Amaliya, Timmerman MF, Abbas F, Loos BG, Van der Weijden GA, Van Winkelhoff AJ et al. Java project on periodontal diseases: the relationship between vitamin C and the severity of periodontitis. J Clin Periodontol 2007; 34: 299–304.

    Article  CAS  Google Scholar 

  18. Kuzmanova D, Jansen ID, Schoenmaker T, Nazmi K, Teeuw WJ, Bizzarro S et al. Vitamin C in plasma and leucocytes in relation to periodontitis. J Clin Periodontol 2012; 39: 905–912.

    Article  CAS  Google Scholar 

  19. Linkosalo E . Dietary habits and dental health in Finnish Seventh-Day Adventists. Proc Finn Dent Soc 1988; 84: 109–115.

    CAS  PubMed  Google Scholar 

  20. Key TJ, Davey GK, Appleby PN . Health benefits of a vegetarian diet. Proc Nutr Soc 1999; 58: 271–275.

    Article  CAS  Google Scholar 

  21. Larsson CL, Klock KS, Nordrehaug Astrøm A, Haugejorden O, Johansson G . Lifestyle-related characteristics of young low-meat consumers and omnivores in Sweden and Norway. J Adolesc Health 2002; 31: 190–198.

    Article  Google Scholar 

  22. Davey GK, Spencer EA, Appleby PN, Allen NE, Knox KH, Key TJ . EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK. Public Health Nutr 2003; 6: 259–269.

    Article  Google Scholar 

  23. Griffith J, Omar H . Association between vegetarian diet and menstrual problems in young women: a case presentation and brief review. J Pediatr Adolesc Gynecol 2003; 16: 319–323.

    Article  Google Scholar 

  24. Key TJ, Thorogood M, Appleby PN, Burr ML . Dietary habits and mortality in 11,000 vegetarians and health conscious people: results of a 17 year follow up. BMJ 1996; 313: 775–779.

    Article  CAS  Google Scholar 

  25. Key TJ, Appleby PN, Spencer EA, Travis RC, Allen NE, Thorogood M et al. Cancer incidence in British vegetarians. Br J Cancer 2009; 101: 192–197.

    Article  CAS  Google Scholar 

  26. Venugopal T, Kulkarni VS, Nerurker RA, Damle SG, Patnekar PN . Epidemiological study of dental caries. Indian J Pediatr 1998; 65: 883–889.

    Article  CAS  Google Scholar 

  27. AAP–American Academy of Periodotology, ADA–American Dental Association. Launch National Screening Program for Early Periodontal Disease Detection. J Gt Houst Dent Soc 1992; 64: 24–25.

  28. Müller HP . Periodontology–The Essentials. Georg Thieme Verlag: Stuttgart, Germany, 2005.

    Google Scholar 

  29. Hamp SE, Nyman S, Lindhe J . Periodontal treatment of multirooted teeth. Results after 5 years. J Clin Periodontol 1975; 2: 126–135.

    Article  CAS  Google Scholar 

  30. O’Leary TJ, Drake RB, Naylor JE . The plaque control record. J Periodontol 1972; 43: 38.

    Article  Google Scholar 

  31. Fu JH, Yeh CY, Chan HL, Tatarakis N, Leong DJ, Wang HL . Tissue biotype and its relation to the underlying bone morphology. J Periodontol 2010; 81: 569–574.

    Article  Google Scholar 

  32. Klein H, Palmer C . Studies on dental caries. Pub Hlth Rep 1938; 53: 1353–1364.

    Article  Google Scholar 

  33. McEvoy CT, Temple N, Woodside JV . Vegetarian diets, low-meat diets and health: a review. Public Health Nutr 2012; 15: 2287–2294.

    Article  Google Scholar 

  34. Linkosalo E, Markkanen H . Dental erosions in relation to lactovegetarian diet. Scand J Dent Res 1985; 93: 436–441.

    CAS  PubMed  Google Scholar 

  35. Rahmatulla M, Guile EE . Relationship between dental caries and vegetarian and non-vegetarian diets. Community Dent Oral Epidemiol 1990; 18: 277–278.

    Article  CAS  Google Scholar 

  36. Johansson G, Birkhed D . Effect of a long-term change from a mixed to a lactovegetarian diet on human saliva. Arch Oral Biol 1994; 39: 283–288.

    Article  CAS  Google Scholar 

  37. Johansson G, Ravald N . Comparison of some salivary variables between vegetarians and omnivores. Eur J Oral Sci 1995; 103: 95–98.

    Article  CAS  Google Scholar 

  38. Laffranchi L, Zotti F, Bonetti S, Dalessandri D, Fontana P . Oral implications of the vegan diet: observational study. Minerva Stomatol 2010; 59: 583–591.

    CAS  PubMed  Google Scholar 

  39. Linkosalo E, Ohtonen S, Markkanen H, Karinpää A, Kumpusalo E . Caries, periodontal status and some salivary factors in lactovegetarians. Scand J Dent Res 1985; 93: 304–308.

    CAS  PubMed  Google Scholar 

  40. Sedgley CM, Chu CS, Lo EC, Samaranayake LP . The oral prevalence of aerobic and facultatively anaerobic gram-negative rods and yeasts in semi-recluse human vegetarians. Arch Oral Biol 1996; 41: 307–309.

    Article  CAS  Google Scholar 

  41. Sherfudhin H, Abdullah A, Shaik H, Johansson A . Some aspects of dental health in young adult Indian vegetarians. A pilot study. Acta Odontol Scand 1996; 54: 44–48.

    Article  CAS  Google Scholar 

  42. Linkosalo E, Markkanen H, Syrjänen S . Effects of a lacto-ovo-vegetarian diet on the free amino acid composition of wax-stimulated whole human saliva. J Nutr 1985a; 115: 588–592.

    Article  CAS  Google Scholar 

  43. Tonstad S, Butler T, Yan R, Fraser GE . Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 2009; 32: 791–796.

    Article  Google Scholar 

  44. Jenzsch A, Eick S, Rassoul F, Purschwitz R, Jentsch H . Nutritional intervention in patients with periodontal disease: clinical, immunological and microbiological variables during 12 months. Br J Nutr 2009; 101: 879–885.

    Article  CAS  Google Scholar 

  45. Körber KMTLC. Vollwerternährung. Konzeption einer zeitgemäßen und nachhaltigen Ernährung. Haug: Stuttgart, Germany, 2004.

  46. Al-Dlaigan YH, Shaw L, Smith AJ . Vegetarian children and dental erosion. Int J Paediatr Dent 2001; 11: 184–192.

    Article  CAS  Google Scholar 

  47. Herman K, Czajczyńska-Waszkiewicz A, Kowalczyk-Zając M, Dobrzyński M . Assessment of the influence of vegetarian diet on the occurrence of erosive and abrasive cavities in hard tooth tissues. Postepy Hig Med Dosw 2011; 65: 764–769.

    Article  Google Scholar 

  48. Baines S, Powers J, Brown WJ . How does the health and well-being of young Australian vegetarian and semi-vegetarian women compare with non-vegetarian? Public Health Nutr 2007; 10: 436–442.

    Article  Google Scholar 

  49. Bawadi HA, Khader YS, Haroun TF, Al-Omari M, Tayyem RF . The association between periodontal disease, physical activity and healthy diet among adults in Jordan. J Periodontal Res 2011; 46: 74–81.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany

    I Staufenbiel, K Weinspach, G Förster, W Geurtsen & H Günay

Authors
  1. I Staufenbiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K Weinspach
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G Förster
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W Geurtsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Günay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I Staufenbiel.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Disclaimer

We declare that there were no sources of any support for the work, received in form of grants and/or equipment and drugs.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Staufenbiel, I., Weinspach, K., Förster, G. et al. Periodontal conditions in vegetarians: a clinical study. Eur J Clin Nutr 67, 836–840 (2013). https://doi.org/10.1038/ejcn.2013.101

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2013.101

Keywords

This article is cited by

Search

Advanced search

Quick links