Background. Periodontitis (PD) is presented by the imbalance that results in the proliferation of certain pathogenic bacteria that alter the symbiotic community and cause oral dysbiosis. Non-surgical periodontal treatment helps to eliminate the pathogenic plaque present, and it is of interest to seek adjuvant treatments that contribute to an improvement in oral health. The oral microbiota plays an essential role in the human nitro-reduction process, since specific bacteria reduce exogenous nitrate to nitrite, to later convert into nitric oxide within the body. Vegetables, mainly green leafy ones and some others like beets, are a rich source of nitrate. Nitrate metabolism has shown benefits to the body and there are recent studies that agree that the consumption of nitrates from vegetables can modify the oral microbiota by increasing species with nitrate-reducing capacity, which are also bacteria that are associated with oral health. Therefore, our hypothesis maintains that the consumption of vegetables can be an adjunct to the recovery and improvement of the condition in patients receiving non-surgical periodontal treatment.~Objective. To evaluate the effect of the consumption of vegetables rich in nitrate on the nitrate-reducing capacity and composition of the oral microbiota in patients with PD.~Material and methods. A parallel randomized clinical trial (RCT) will be conducted in 60 PD patients who are candidates for non-surgical periodontal treatment (NSPT) and they will be randomized into two groups. The control group will receive the NSPT and instructions to continue with their usual diet, while the intervention group, in addition to the NSPT, will receive a nutritional intervention to promote the daily consumption of foods rich in nitrate. The nutritional intervention will be based on the theory of the wheel of behavior change to achieve the consumption of vegetables rich in nitrate that provide ~ 350 mg of this compound. Both groups will be evaluated before and after the study: clinical, dental, and nutritional parameters. Likewise, samples will be taken of blood to perform blood chemistry, saliva to perform a nitrate reduction test and quantify the number of nitrates and nitrites, as well as subgingival plaque and tongue scraping, which will be sequenced to obtain the diversity and abundance of nitro-reducing bacteria at the beginning and end of the study in both groups.
Vegetables, mainly green leafy ones and some others like beets, are a rich source of nitrate. Nitrate metabolism has shown benefits to the body and there are recent studies that agree that the consumption of nitrates from vegetables can modify the oral microbiota by increasing species with nitrate-reducing capacity, which are also bacteria that are associated with oral health.