A dental chair can be a danger zone for haemophilia patients

 

  Unless Dentists Know What They Are Doing

---

The research was led by corresponding author Dr. Amit Kumar of the Department of Public Health Dentistry, Santosh Dental College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh, India. Many dentists have never managed a haemophilia patient and lack the training to do so safely, leading to treatment delays, inconsistent practices, and — in the worst cases — uncontrolled bleeding after procedures that could easily have been managed with proper preparation. A new mini-review published in The Open Medicine Journal, authored by Dr. Sanjeev Kumar Singh and Dr. Abhilasha Smith (Department of Dentistry, SMMH Government Medical College, Saharanpur), Dr. Ajit Vishwakarma (Department of Dentistry, Government Medical College, Azamgarh), and Dr. Meena Jain (Department of Public Health Dentistry, Santosh Dental College, Ghaziabad), pulls together the current evidence and clinical guidance on this topic with the aim of equipping dental professionals with what they need to manage these patients confidently and safely.

---

Why a Routine Extraction Is Anything But Routine for Patients Who Cannot Clot Properly

For most people, a tooth extraction or a deep cleaning is a minor inconvenience. For a patient with haemophilia — a hereditary condition in which the blood is missing one of the proteins it needs to form a clot — the same procedure can trigger prolonged, life-threatening bleeding. Haemophilia A, the more common form, affects approximately 1 in every 5,000 males worldwide and involves a deficiency of clotting factor VIII; haemophilia B is rarer and involves factor IX. Both types place patients at serious risk during any dental procedure that breaks the gum or bone tissue, and the oral cavity is a uniquely high-risk site because it is constantly exposed to saliva, chewing forces, and minor trauma.

---

From Clotting Factor Injections to Gene Therapy: What Dentists Need to Know Is Changing Fast

The review covers the full landscape of haemophilia management in dental practice, from the initial assessment all the way through to postoperative care, and makes clear that the field is no longer static. Before any invasive dental procedure — including extractions, deep scaling, or nerve blocks near vascular tissue — patients must be carefully assessed for their specific type of haemophilia, its severity (classified as mild, moderate, or severe based on residual clotting factor levels), and whether they have developed inhibitor antibodies that block the standard replacement therapy. The cornerstone of safe dental management remains clotting factor replacement before and after procedures, guided by a haematologist, and supported by local measures such as absorbable sutures, collagen-based or gelatin-based haemostatic sponges, fibrin sealants, and antifibrinolytic mouthwashes containing tranexamic acid. Crucially, the review also addresses a new generation of treatments — extended half-life clotting factor concentrates, bispecific antibody therapies such as emicizumab that mimic factor VIII activity, and early-stage gene therapies that may one day correct the underlying defect permanently — all of which alter how these patients respond to surgical bleeding and therefore change what the dental team needs to plan for. Dental lasers are also highlighted as a practical tool for minimizing soft tissue bleeding during procedures. The review includes a practical quick-reference clinical decision table covering pre-treatment assessment steps, procedure-specific management decisions, local haemostatic measures, drug prescribing rules, and postoperative instructions, designed to support dentists who do not regularly see these patients.

---

The Gap Between What Dentists Know and What Haemophilia Patients Need Must Close

The overarching message of this review is one of prevention over intervention — and communication over guesswork. Poor oral hygiene, driven largely by fear of bleeding during brushing and flossing, leaves haemophilia patients disproportionately vulnerable to tooth decay and gum disease, conditions that ultimately demand the very invasive procedures they are most at risk from. Breaking this cycle requires dentists who understand the condition well enough to perform regular, low-risk preventive care — check-ups, fluoride applications, fissure sealants — without defaulting to avoidance or unnecessary referral. For more invasive treatment, close collaboration between the dental team and the patient's haematologist is not optional; it is the foundation of safe care. Paracetamol, not aspirin or other anti-inflammatory drugs, must be the default analgesic choice, since the latter interfere with platelet function and increase bleeding risk. The authors acknowledge that this is a narrative review rather than a systematic one, which limits the strength of its conclusions, and call for more standardisoured clinical protocols and ongoing training for dental professionals.

---

 

Read the published article here: https://bit.ly/4p81hFu

Why some oral inflammatory diseases progress much more rapidly than others

 A team of researchers from VCU Massey Comprehensive Cancer Center, the VCU School of Dentistry and the University of Pennsylvania recently published a study in Nature Communications examining why some oral inflammatory diseases progress much more rapidly than others.

The study was co-led by Kang I. Ko, D.D.S., Ph.D., of the University of Pennsylvania, Jinze Liu, Ph.D., of VCU, and Kevin Matthew Byrd, D.D.S., Ph.D., of VCU, with co-first authors Quinn T. Easter, Ph.D., and Khoa L.A. Huynh, Ph.D. The findings identified previously unrecognized changes in blood vessels that may help researchers better understand tissue destruction in oral disease and provide insights relevant to other inflammatory conditions, including cancer.

To conduct this study, the research team used and expanded a tool they created, the Human Periodontal Atlas—the leading periodontal atlas in the world—as part of the wider Human Cell Atlas, a single cell atlas built from existing publicly available data sets, to examine RNA patterns across different cell types.

“It’s a lot like building really complicated LEGO structures,” said Byrd, a member of the Cancer Biology research program at Massey and assistant professor of oral and craniofacial molecular biology at the VCU School of Dentistry. “Each dataset gives us another set of pieces. By putting them together, we can see which disease patterns are unique to one condition and which ones show up across related inflammatory diseases.”

The study compared three oral inflammatory conditions:

• Peri-implantitis, inflammation and tissue breakdown around dental implants
• Chronic periodontitis, a more common form of gum disease around teeth
• Rapidly advancing periodontitis, a more aggressive form of gum disease marked by faster tissue destruction

The research findings

One of their major findings was that differences in bacterial burden alone did not explain why peri-implantitis and rapidly advancing periodontitis cause more severe tissue destruction. This suggested that changes in the body's own tissue response may play an important role in disease progression.

The key similarity they found was that CD38, a protein associated with inflammation, aging and cellular metabolism, was enriched in blood vessel cells in cases of rapidly progressing periodontitis and peri-implantitis.

By using spatial biology to compare these related diseases directly in human tissue, the team was able to identify a shared blood vessel pattern that may represent a drug-targetable mechanism of rapid tissue destruction.

“This hasn’t been described before in peri-implantitis,” said Easter, research scientist at the VCU School of Dentistry. “This is a new mechanism that could potentially change the way that this disease is thought about or even treated.”

What’s next?

Moving forward, the team plans to continue building single-cell and spatial atlases across more than 20 human diseases, including oral inflammatory diseases and cancer. By integrating these datasets, researchers aim to identify shared disease patterns, uncover potential therapeutic targets and support more precise approaches to treatment.

Collaborators

Using ultrasound to attack oral cancer cells

 

Peer-Reviewed Publication

Indian Institute of Science (IISc)

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Ultrasound mechanostimulation-mediated killing of oral cancer cells and compromised integrity of the capsule-like barrier

view more 

Credit: Rashmita Luha

Oral cancer is a major health challenge in India, where tobacco and areca nut use contribute substantially to the disease burden. Despite advances in surgery, chemotherapy, and radiotherapy, treatment remains difficult because current approaches can damage healthy tissues along with cancer cells, often affecting patients’ quality of life.

In a new study, researchers at the Indian Institute of Science (IISc), in collaboration with clinicians at MS Ramaiah Medical College and Hospitals, explored whether low-frequency ultrasound mechanical stimulation could selectively kill oral cancer cells. The team worked with patient-derived oral tumour samples that better reflect variations among Indian patients.

The team found that oral cancer cells are surprisingly vulnerable to the moderate mechanical stimulations produced by ultrasound. This vulnerability appears to arise from reduced levels of Tropomyosin 2.1, a mechanosensory protein that helps body cells sense and withstand physiologically relevant mechanical stimulation. When exposed to ultrasound-driven mechanical stimulation, oral cancer cells underwent selective cell death, while healthy oral epithelial cells remained unharmed.

“The novelty of this study lies in showing how ultrasound mechanostimulation can selectively target oral cancer cells by exploiting their mechanical weakness,” says Ajay Tijore, Assistant Professor at the Department of Bioengineering, IISc, and corresponding author. “Instead of using heat or drugs, this approach uses moderate mechanical forces to damage cancer cells beyond their ability to recover.”

The team also found that ultrasound drastically reduces the cancer cells’ ability to migrate and invade surrounding tissue. Intriguingly, using a 3D co-culture platform that mimics the oral tumour microenvironment, the team found that ultrasound disrupted the dense capsule-like barrier formed by cancer-associated cells around the tumour core. Such barriers prevent drugs and immune cells from reaching the tumour core, resulting in treatment failure.

“What surprised us most was the consistency of the response across cancer cells derived from multiple patients from different cancer stages. They were highly vulnerable to ultrasound, while normal cells were much less affected,” says Rashmita Luha, PhD student in the Department of Bioengineering and first author.

Since ultrasound is non-invasive and already approved for various medical uses, these findings suggest that ultrasound mechanostimulation could exploit the mechanical weakness of oral cancer cells. With further validation in advanced preclinical models, this approach may help develop safer, more targeted treatment strategies for oral cancer and potentially other easily accessible cancers such as breast and skin cancers.

“The clinical collaboration was very important because it allowed us to work with patient-derived oral tumour samples rather than relying only on standard cell lines developed in Western countries,” says Tijore. “In the future, we want to test this approach in more physiologically relevant models and explore whether ultrasound can be combined with existing treatments to improve drug penetration and therapeutic outcomes.”

---

Journal

Materials Today Bio

DOI

10.1016/j.mtbio.2026.103375 

Bleeding gums and kidney disease? Study uncovers a surprising link

Researchers found that severe periodontitis was associated with poorer kidney health and increased albuminuria in adults

Peer-Reviewed Publication

Editorial Office of West China School of Stomatology, Sichuan University

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Mediation analysis of the association between periodontitis and kidney function, showing that systemic inflammation partially mediates the link between periodontitis, estimated glomerular filtration rate, and albuminuria

view more 

Credit: University Medical Center Hamburg-Eppendorf, Dr. Christian Schmidt-Lauber, and Prof. Dr. Ghazal Aarabi Image link: https://doi.org/10.1038/s41368-026-00435-6

Periodontitis is often viewed as a disease limited to the oral cavity, characterized by bleeding gums, progressive tissue destruction, and eventual tooth loss. However, growing evidence suggests that its impact may extend well beyond the mouth. The chronic inflammatory burden associated with periodontitis has been linked to several systemic conditions, including cardiovascular disease and diabetes, prompting researchers to investigate its potential role in chronic kidney disease (CKD). Although previous studies have reported associations between periodontitis and advanced CKD, whether this relationship is already present during the early stages of kidney dysfunction remains less clear.

To address this question, researchers from the University Medical Center Hamburg-Eppendorf, led by Dr. Christian Schmidt-Lauber and Prof. Dr. Ghazal Aarabi, conducted a large population-based study examining the relationship between periodontal disease and early markers of kidney impairment. Dr. Schmidt-Lauber, explains the motivation behind the study, “We aimed to evaluate the relationship between periodontitis and markers of early kidney dysfunction, including reduced renal function and albuminuria, and to explore the potential mediating role of systemic inflammatory markers.” The findings were published in Volume 18 of International Journal of Oral Science on April 6, 2026.

The study included 6,179 participants from the Hamburg City Health Study, a population-based cohort in Germany. All participants underwent detailed periodontal examinations, with disease severity classified according to the 2017 American Academy of Periodontology/European Federation of Periodontology (AAP/EFP) staging system. Kidney health was assessed using estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR), while circulating levels of high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) were measured to evaluate the contribution of systemic inflammation.

The analysis revealed a consistent association between poorer periodontal health and worsening kidney function. The prevalence of severe periodontitis increased from 14% among individuals with normal kidney function to 36% among those with moderately reduced kidney function. A similar pattern was observed for albuminuria, with more advanced periodontal disease becoming increasingly common as urinary albumin levels rose. Measures of cumulative periodontal damage, including clinical attachment loss and tooth loss, also worsened across stages of kidney dysfunction.

Notably, these associations persisted after adjustment for major confounding factors such as age, sex, diabetes, and smoking status. Severe periodontitis remained independently associated with lower eGFR and higher uACR, while greater clinical attachment loss was linked to both declining kidney function and increased albuminuria. These findings suggest that the observed relationship is not simply the result of shared risk factors.

Systemic inflammation appeared to contribute to the association, but only partially. Levels of hsCRP and IL-6 increased with both worsening periodontal disease and declining kidney health. However, mediation analyses indicated that hsCRP accounted for approximately 35% of the association between severe periodontitis and reduced eGFR, and only about 10% of the association with albuminuria. These results imply that additional biological mechanisms may be involved, including microbial dissemination from periodontal tissues, endothelial dysfunction, oxidative stress, and metabolic alterations.

Because CKD frequently progresses without symptoms until substantial kidney damage has occurred, identifying early indicators of risk remains a major clinical challenge. “By demonstrating an association between periodontitis and markers of early kidney dysfunction, this study highlights oral health as a potential window into kidney health,” shares Prof. Dr. Aarabi. The findings may inform future screening approaches and provide a rationale for interventional studies investigating whether periodontal treatment can help preserve renal function. The study’s large sample size, standardized periodontal assessments, and comprehensive evaluation of kidney biomarkers further strengthen the reliability of the results.

In conclusion, the study provides strong evidence that periodontitis is independently associated with reduced kidney function and increased albuminuria, even at early stages of CKD. While systemic inflammation appears to explain part of this relationship, much of the association likely involves additional biological pathways. Together, these findings reinforce the growing recognition that oral and kidney health are closely interconnected and underscore the importance of considering periodontal disease within the broader context of systemic health.

 

Reference

Biology underlying oral health issues in Down syndrome

Researchers at NYU College of Dentistry have uncovered what may be biologically driving oral health issues unique to Down syndrome.

Their study, published in Cell Reports, describes a molecular mechanism—a defect in calcium signaling—behind low saliva production, along with other factors that may contribute to gum disease.

“Understanding the processes responsible for low saliva in Down syndrome and developing therapies to restore salivation could have a transformative impact on the oral and overall health of people with Down syndrome,” said Rodrigo Lacruz, professor of molecular pathobiology at NYU College of Dentistry and the study’s senior author.

A challenge to oral health

Down syndrome is a common genetic disorder that results in intellectual differences and physical issues, including an increased risk for hearing loss and heart disease. It's less well-known that the majority of those with Down syndrome have gum disease—around 60-90 percent of individuals under the age of 35, a rate that far exceeds that of people without Down syndrome, including those with other intellectual disabilities.

“Of the diverse health challenges that individuals with Down syndrome face, their higher risk of oral disease remains largely unexplored,” said Ga-Yeon Son, a senior research scientist in the Department of Molecular Pathobiology at NYU College of Dentistry and the study’s first author. “While dietary and oral hygiene factors may contribute to dental issues in some with Down syndrome, we observed changes in saliva, calcium signaling, and the microbiome, all of which could contribute to poor oral health.”

Studies increasingly show that people with Down syndrome produce less saliva, a condition known as hyposalivation. Hyposalivation can alter the oral microbiome—the balance of microbes in the mouth—and increase infection-causing bacteria that promote gum disease and tooth decay. This greater risk of gum disease, in turn, increases the risk of other health issues, including Alzheimer’s disease, which occurs in most people with Down syndrome as they age.

Altered signals, microbiome

To gain a deeper understanding of oral health biology in Down syndrome, the researchers studied a widely used mouse model of the genetic disorder. They found several changes to the mice’s saliva that mirror what studies show in people with Down syndrome: they produce much less saliva, but the saliva is more acidic and contains elevated levels of certain immune markers.

Notably, store operated calcium entry—a calcium signaling process required for saliva secretion—was decreased in the mice’s salivary glands.

“This dysfunction in calcium signaling is likely responsible for hyposalivation in Down syndrome,” said Lacruz. “Decreased saliva flow can have systemic consequences, advancing periodontal disease and impacting the microbial ecosystem."

Additional analyses showed high levels of inflammatory markers in gum tissue and increased inflammation as well as decreased mitochondrial function in the salivary glands.

“Altered mitochondrial function has been widely reported in individuals with Down syndrome.  What is particularly compelling about these studies is that they provide evidence of a pathway through which changes in mitochondrial function and calcium handling in salivary glands may be having a system-wide impact on the health of individuals with Down syndrome,” said Beverly Rothermel, a study author and professor at UT Southwestern Medical Center.

The researchers also discovered certain autoantibodies in the mice that are used to diagnose Sjögren’s disease, an autoimmune condition marked by low saliva production. Through additional tests, they found hints that those with Down syndrome may be at increased risk for Sjögren’s.

Looking beyond the mouth, the researchers studied the blood and gut microbiome of the mice with Down syndrome. The mice had high levels of succinate—a metabolic byproduct linked to inflammation and gum disease—in their blood, as well as succinate-producing bacteria in the gut and mouth.

“This systemic alteration of succinate and changes to the oral and gut microbiome appear to be influencing the biology of Down syndrome,” said study author Deepak Saxena, professor of molecular pathobiology and director of research innovation and entrepreneurship at NYU College of Dentistry. “While more research is needed to understand how these differences influence one another—and ultimately drive hyposalivation and gum disease—the findings provide clues about the unique oral health challenges in this population.”

A path toward treatment

According to the researchers, addressing oral health for individuals with Down syndrome could include efforts to both improve oral hygiene—for instance, more frequent dental visits or implementing practices in group homes related to diet and toothbrushing—and treat the underlying biological factors.

People who experience dry mouth due to Sjögren’s or who have undergone radiation for head and neck cancer are often prescribed pilocarpine, a medication that stimulates saliva and tear production and appears on the World Health Organization’s Essential Medicines List. The researchers found that giving pilocarpine to mice with Down syndrome increased salivation.

“Targeting hyposalivation to boost saliva production could potentially improve some of the systemic disruptions that individuals with Down syndrome experience. This is our next research focus,” said Lacruz.

Additional study authors include Guilherme H. S. Bomfim, Fangxi Xu, Scott C. Thomas, Kristen Rosenberg, Tommy Kim, Eleni Rice, Enkhnaran Budjab, Rebecca Jones, Yin-Hu Wang, Erna Mitaishvili, Stefan Feske, Drew R. Jones, and Edwin Rosado-Olivieri of NYU. The research was supported by the National Institute of Dental and Craniofacial Research (NIDCR) (DE032846), National Institute of Allergy and Infectious Diseases (AI80128), and NYU Academic Enhancement Funds.

---

Journal

Cell Reports

DOI

10.1016/j.celrep.2026.117619 

Postbiotic foods for improving gum health

Foods containing heat-inactivated bacteria help reduce gum bleeding and improve inflammatory conditions

Peer-Reviewed Publication

Institute of Science Tokyo

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Foods containing  heat-inactivated Lactiplantibacillus pentosus can help prevent gingivitis and maintain oral health.

view more 

Credit: Institute of Science Tokyo (Science Tokyo), Japan

Continuous consumption of foods containing heat-inactivated Lactiplantibacillus pentosus can help reduce gum bleeding, report researchers from Institute of Science Tokyo. These postbiotic foods can improve inflammatory conditions and enhance gum health in adults with mild gingivitis. The study suggested that these postbiotic foods offer a simple and practical way to support oral health in daily life without altering oral care habits. The findings also aid in the prevention of early-stage periodontal disease.

Gum disease, also known as periodontal disease, affects millions of people worldwide. In early stages, known as gingivitis, the gums become swollen and are prone to bleeding. While professional dental care and regular oral hygiene is important for prevention of the disease, researchers are exploring innovative approaches that can support gum health in everyday life. One promising strategy is the use of probiotic (beneficial bacteria) for maintaining gum health. However, these usually disturb the natural balance of microorganisms in the oral cavity. Also, these probiotics possess a shorter shelf life and are less stable.

Addressing this issue, a research team led by Professor Takanori Iwata along with Assistant Professor Shogo Maekawa, and Visiting Lecturer Anhao Liu from the Department of Periodontology, Institute of Science Tokyo (Science Tokyo), Japan, in collaboration with Associate Professor Megumi Ishiguro of the Health Science Research and Development Center, Science Tokyo, Otsuka Pharmaceutical Co., Ltd., and Tokyo Center Clinic, Japan, investigated if postbiotic foods containing heat-inactivated bacteria (Lactiplantibacillus pentosus ONRICb0240) could help improve gum health and reduce bleeding without disrupting normal oral bacteria. The findings were published online in the Journal of Periodontology on April 19, 2026.

“We conducted a clinical trial on 116 adults who were suffering from mild gingival inflammation,” explains Iwata. The participants were randomly allocated to receive either the gummies containing heat-inactivated bacteria or placebo (non-loaded) gummies. The gummies were consumed twice daily for six weeks. The participants were not given any special instructions regarding tooth brushing or additional oral care, which allowed the researchers to evaluate the effectiveness of the gummies under realistic conditions.

At the end of the study, the researchers evaluated the gum health and gingival index (a measure of gum inflammation) of the participants. Surprisingly, the participants who had consumed the postbiotic gummies experienced less gum bleeding and their gums appeared healthier and stronger overall, compared to those who received the placebo gummies. For the gingival index, no significant difference was observed between the groups; however, a significant improvement from baseline was observed in the test group.

“By evaluating the gummies under normal daily living conditions, we were able to better understand their practical potential for supporting gum health,” says Iwata.

The significance of the study lies in the use of heat-inactivated bacteria rather than live probiotics strains. Heat-inactivated bacteria are generally more stable during manufacturing and storage, making them easier to convert into consumer products than live bacteria. In addition to this, the researchers believe that the anti-inflammatory effects of the postbiotic gummies might be responsible for the reduction in gum bleeding. Since gum bleeding is one of the earliest warning signs of gingivitis, reducing inflammation at this stage could help prevent the progression to more serious periodontal disease.

Overall, the research provides a simple and convenient method that can be added to routine oral care practices. It also highlights the growing potential of functional foods and probiotic-derived ingredients in preventive healthcare. Looking ahead, the researchers plan to investigate the underlying biological mechanisms and evaluate the long-term benefits of these gummies for periodontal health.

Fasting-mimicking diet reduces gum disease inflammation

 

People who follow a short-term low-calorie diet may have reduced markers of inflammation associated with gum disease.

Peer-Reviewed Publication

King's College London

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

People who follow a short-term low-calorie diet may have reduced markers of inflammation associated with gum disease.

A new study by King’s College London highlights how lifestyle modifications could be important alongside plaque control in managing gum disease.

While fasting has been linked to reduced inflammation around the body, this is the first to establish a relationship with gum disease too. The findings offer new insights into how oral and wider body health are closely intertwined.

Dr Giuseppe Mainas, first author of the study, King’s College London, said: “Our study suggests lifestyle modifications could be important alongside proper tooth brushing for patients.”

Periodontitis, a serious form of gum disease, affects millions of people worldwide and has been linked to wider health problems, including heart disease and diabetes. While standard treatment focuses on cleaning infected areas around the teeth, researchers are increasingly exploring whether diet can play a role in improving outcomes.

The research included 28 patients from across hospitals in Spain, split into two groups – those who followed a five-day restrictive diet, versus a control group who continued their usual diet.

Patients who fasted ate 1,100 calories for two days, then 750 calories for three days. The sixth day gently introduced more calories with soft foods – then their diets returned to normal by the seventh day. This was repeated three times in six months, with patients reporting the diet easy to stick to.

After six months, samples were analysed from the patients’ blood and gingival crevicular fluid – liquid that comes from the small space between your tooth and gum, which helps gums stay healthy and fight germs.

Those who fasted had reduced markers of inflammation in samples from blood and gum tissue compared to those whose diets stayed the same, including lower levels of C-reactive protein, a general indicator of inflammation around the body. The fasting group also had reduced molecules linked to inflammation specifically in the gums, compared to controls.

Senior-author Prof Luigi Nibali, King’s College London, said: “There may be multiple reasons why fasting is beneficial to gum disease patients. Fasting reduces oxidative stress in the body, a common cause of inflammation, which can damage cells and DNA.

“Intake of high calorific foods and refined carbohydrates, for example in cakes and biscuits, can also cause inflammation – so restricting these foods also reduces oxidative stress in the body.

“It may also be that fasting has beneficial effects on the microbiome – the body’s community of bacteria that help to keep it healthy. However, further research is needed to confirm this relationship.”

Dietary approaches such as fasting-mimicking diets could be investigated in the future as supporting approaches alongside conventional therapies for gum disease, such as professional cleaning and oral hygiene support.

Dr Mainas added: “Now we have established this relationship, we would like to do a larger study, before potentially incorporating into gum disease treatment in the future. There may be patients where restricting foods can be dangerous, such as those with diabetes, so the advice will need to be targeted to specific patient groups. We are currently investigating how we could implement these benefits in high-risk groups who may not be able to fast.”

The study builds on long-standing research by King’s College London investigating the relationship between gum disease and wider health. Last year, researchers at King’s discovered following the mediterranean diet reduces gum disease, and that successful dental treatment reduces risks of diabetes and heart disease.

This study was published in Journal of Clinical Periodontology (JCP).