Diet and nutrition key factors for oral microbiota composition: a systematic review

Abstract

Background: Diet and nutrition are essential in preserving oral health as they influence the microbiota balance and modulate inflammatory responses. The relationship between dietary patterns (DPs) and oral diseases such as caries and periodontitis has garnered significant scientific attention. Objective. This review aims to analyze the impact of various DPs, nutrients, and supplementation with probiotics and prebiotics on oral health and microbiota modulation.

Design: A systematic search was conducted in PubMed, Scopus, and Web of Science databases for clinical studies published between 2010 and 2024. A total of 514 articles were retrieved, 78 were evaluated at the full-text level, and 22 original clinical studies were included based on eligibility criteria. These studies were grouped into three categories: dietary interventions without supplementation, probiotic/prebiotic supplementation, and combined strategies.

Results: Healthy DPs, such as the Mediterranean and vegetarian diets, showed anti-inflammatory effects and positively modulated oral microbiota by reducing pathogenic species linked to oral diseases. In contrast, high sugar consumption was associated with increased acidogenic bacterial species and dental caries. Probiotics, particularly strains of Lactobacillus and Bifidobacterium, demonstrated therapeutic benefits in managing gingivitis, halitosis, and caries, while prebiotics supported the growth of beneficial bacteria, complementing probiotic efficacy.

Discussion: Nutritional interventions modulate oral microbiota by shifting microbial profiles toward eubiosis and attenuating inflammatory responses. The effectiveness of probiotics appears to be strain-dependent and may vary with host conditions, while prebiotics support their colonization and metabolic activity.

Conclusion: Dietary interventions directly influence oral health by modulating microbiota composition and inflammatory responses. Probiotics show clinical promise, though their long-term, strain-specific effects need further study. Prebiotics may enhance these benefits by supporting probiotic activity. A diet rich in plant-based foods and bioactive compounds, combined with targeted supplementation, represents a viable strategy to promote oral health and microbiota balance.