title: The impact of the stone age diet on gingival conditions in the absence of oral hygiene.
abstract: BACKGROUND
  The objective of this study was to assess the oral microbiota and clinical data in subjects without access to traditional oral hygiene methods and who ate a diet available in the Stone Age.
  
  
  METHODS
  Ten subjects living in an environment replicating the Stone Age for 4 weeks were enrolled in this study. Bleeding on probing (BOP), gingival and plaque indices, and probing depth (PD) were assessed at baseline and at 4 weeks. Microbiologic samples were collected at the mesio-buccal subgingival aspects of all teeth and from the dorsum of the tongue and were processed by checkerboard DNA-DNA hybridization methods.
  
  
  RESULTS
  No subject had periodontitis. Mean BOP decreased from 34.8% to 12.6% (P <0.001). Mean gingival index scores changed from 0.38 to 0.43 (not statistically significant) and mean plaque scores increased from 0.68 to 1.47 (P <0.001). PD at sites of subgingival sampling decreased (mean difference: 0.2 mm; P <0.001). At week 4, the total bacterial count was higher (P <0.001) for 24 of 74 species, including Bacteroides ureolyticus, Eikenella corrodens, Lactobacillus acidophilus, Capnocytophaga ochracea, Escherichia coli, Fusobacterium nucleatum naviforme, Haemophilus influenzae, Helicobacter pylori, Porphyromonas endodontalis, Staphylococcus aureus (two strains), Streptococcus agalactiae, Streptococcus anginosis, and Streptococcus mitis. Bacterial counts from tongue samples were higher at baseline (P <0.001) for 20 species, including Tannerella forsythia (previously T. forsythensis), Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans; serotype a), and Streptococcus spp.
  
  
  CONCLUSIONS
  The experimental gingivitis protocol is not applicable if the diet (e.g., Stone Age) does not include refined sugars. Although plaque levels increased, BOP and PD decreased. Subgingival bacterial counts increased for several species not linked to periodontitis, whereas tongue bacterial samples decreased during the study period.
authors.affiliation: Laboratory of Oral Microbiology, Department of Clinical Research, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Baumgartner
authors.forename: Thomas
authors.initials: T
authors.lastname: Imfeld
authors.forename: Olivier
authors.initials: O
authors.lastname: Schicht
authors.forename: Christian
authors.initials: C
authors.lastname: Rath
authors.forename: Rigmor E
authors.initials: RE
authors.lastname: Persson
authors.forename: G Rutger
authors.initials: GR
authors.lastname: Persson
mesh_terms: D000293:Adolescent; D000328:Adult; D015373:Bacterial Typing Techniques; D002648:Child; D004269:DNA, Bacterial / Q000032:analysis; D003773:Dental Plaque / Q000382:microbiology*; D050528:Diet, Carbohydrate-Restricted; D005260:Female; D005891:Gingivitis / Q000382:microbiology*; D006801:Humans; D008297:Male; D009910:Oral Hygiene; D014059:Tongue / Q000382:microbiology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial