Dietary Modification as a Part of Prescription in Inflammatory Lesions of Oral Cavity: A Need of the Hour

Gargi S Sarode¹, Sachin C Sarode², Piyush Jain³, Nilesh K Sharma⁴, Shankargouda Patil⁵

^1–3Department of Oral Pathology and Microbiology, Dr DY Patil Dental College and Hospital, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
⁴Cancer and Translational Research Lab, Dr DY Patil Biotechnology and Bioinformatics Institute, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
⁵Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia

Corresponding Author: Gargi S Sarode, Department of Oral Pathology and Microbiology, Dr DY Patil Dental College and Hospital, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India, Phone: +91 9823871462, e-mail: gargi14@gmail.com

How to cite this article Sarode GS, Sarode SC, Jain P, et al. Dietary Modification as a Part of Prescription in Inflammatory Lesions of Oral Cavity: A Need of the Hour. J Contemp Dent Pract 2019;20(11):1239–1240.

Source of support: Nil

Conflict of interest: None

Food is an integral aspect of human life and constitutes major portion of the intake on a daily basis. The dietary patterns are highly distinctive not only for any religion but also for geographic locations. Even a particular geographic location might show vast distinctiveness in terms of consumption of food on a day-to-day basis.

Food and dietary patterns have evolved quite vigorously over the period due to quest for the satisfying taste buds. In contrast to traditional dietary patterns, modern dietary patterns have a majority comprised of fast foods. Fried and baked dietary items have been drastically increased in today’s time as the evolution of food take place.

Recently there is growing evidence that heated oil (frying of food in oil) and associated food items are responsible for the oxidative stress and elevated cytokines in the blood.¹ Moreover, diets such as starches, saturated trans-fats, and sugar are also known to promote inflammation. Westernization of the diets (which is now available across the world due to globalization) has also known to increase C-reactive protein (CRP), interleukin-6, E-selectin, soluble vascular adhesion molecule-1, and soluble intercellular adhesion molecule. Dietary polyunsaturated fatty acids (PUFAs) are also known to modulate gene expression involved in inflammatory disorders by regulating the activity of transcription factor nuclear factor (NF)-κB.²

With growing and consistent evidence associated with dietary factors and inflammation, investigators have developed dietary inflammation index. This index calculates the inflammatory potential of a person’s diet. Numerous studies in the literature have shown a positive correlation between dietary inflammation index, higher serum inflammatory markers, and disease progression.³

Role of nutrition in oral health has been widely investigated in the literature.⁴ Majority of inflammatory disorders as found in the oral cavity by virtue presence of teeth and plethora of microorganisms. Moreover, oral lichen planus, lichenoid reactions, aphthous ulcerations, etc., are some of the commonly occurring immunological disorders, which are characterized by elevation of cytokines and varying degrees of inflammation at the local site. Apart from these, there are many ulcerative and erosive conditions of the oral cavity characterized by oxidative stress and inflammation. Even in oral submucous fibrosis role of cytokines has been found in the initiation and progression of the diseases.^5,6 As discussed previously, literature is flooded with the scientific evidence that suggests dietary factors plays a major role in initiating and promoting inflammation in the body. Thus, it is quite conceivable that even diet could possibly aggravate those conditions of oral cavity. However, there is very limited literature on the role of inflammatory diet on the initiation and progression of inflammatory oral pathologies. There is a dire need for research on this aspect, which will guide clinicians for the incorporation of dietary modifications as a part of therapeutic intervention either alone or supplementary to standard medicinal treatment. We believe that dietary modification has great therapeutic potential that can completely abort the need for standard medicinal treatment. The systematically conducted randomized controlled trial in this regard is the need of the hour.

Dietary modulated inflammation is suggested to relate to epigenetic regulation. Among possible epigenetic regulatory pathways, DNA methylation, histone remodeling, and regulation by small RNAs. The potential involvement of epigenetic modulation by diet to drive inflammation is suggested as a factor behind various pathophysiological disorders, including inflammatory lesions in the oral cavity, colon carcinogenesis, and liver cirrhosis, etc.^7,8 Therefore, molecular studies are warranted to delineate pathways that promote proinflammatory lesion or anti-inflammatory reactions affected due to the dietary choices between high fiber diet and high fat/processed sweeteners. Besides a direct role in the cellular modulations, dietary choices between high fiber diet over high fat/processed sweeteners are having the potential to modulate microbiotas in the local niche of the oral cavity. In summary, a prescription to the potential patient to opt for a choice of high fiber diet over high fat/processed sweeteners may help to alleviate inflammatory lesion via various cellular adaptations, including alleviation of oxidative stress, metabolic reprogramming, epigenetic modulation, and activation of transcriptional factors such as NF-κB.

REFERENCES

1. Mboma J, Leblanc N, Angers P, et al. Effects of cyclic fatty acid monomers from heated vegetable oil on markers of inflammation and oxidative stress in male wistar rats. J Agric Food Chem 2018;66(27):7172–7180. DOI: 10.1021/acs.jafc.8b01836.

2. Marion-Letellier R, Savoye G, Ghosh S. Polyunsaturated fatty acids and inflammation. IUBMB Life 2015;67(9):659–667. DOI: 10.1002/iub.1428.

3. Padin AC, Hébert JR, Woody A, et al. A proinflammatory diet is associated with inflammatory gene expression among healthy, non-obese adults: can social ties protect against the risks? Brain Behav Immu 2019;82:36–44. DOI: 10.1016/j.bbi.2019.07.031.

4. Gondivkar SM, Gadbail AR, Gondivkar RS, et al. Nutrition and oral health. Dis Mon 2019;65(6):147–154. DOI: 10.1016/j.disamonth.2018.09.009.

5. Sarode G, Sarode SC, Deshmukh R, et al. Myofibroblasts could be recruited in a chemokine (C-C motif) ligand 2-dependent manner in pathogenesis of oral submucous fibrosis. J Oral Pathol Med 2017;46(6):443–447. DOI: 10.1111/jop.12543.

6. Panta P, Sarode SC, Sarode GS, et al. Can healthy diet intercept progression of oral potentially malignant disorders? Oral Oncol 2018;85:106–107. DOI: 10.1016/j.oraloncology.2018.08.007.

7. Lod S, Johansson T, Abrahamsson KH, et al. The influence of epigenetics in relation to oral health. Int J Dent Hyg 2014;12(1):48–54. DOI: 10.1111/idh.12030.

8. Fasanelli F, Giraudo MT, Vineis P, et al. DNA methylation, colon cancer and mediterranean diet: results from the EPIC-Italy cohort. Epigenetics 2019;14(10):977–988. DOI: 10.1080/15592294.2019.1629230.

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