ArticleFrontiers in cellular and infection microbiology2019
Frequency of Tongue Cleaning Impacts the Human Tongue Microbiome Composition and Enterosalivary Circulation of Nitrate.
Article in Frontiers in cellular and infection microbiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
72 citing papers in PubMed, 2 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- The Effect of Chlorhexidine Mouthwash on Blood Pressure: A Systematic Review and Meta-Analysis.International journal of dental hygiene · 2026Pooled it
- Do Changes in Oral Microbiota Correlate With Plasma Nitrite Response? A Systematic Review.Frontiers in physiology · 2019Pooled it
- The effect of dietary nitrate supplementation on resistance exercise performance: A dose-response investigation.European journal of applied physiology · 2025Trial
- [Efficacy of 1% povidone-iodine mouthwash combined with scaling and root planing in the treatment of periodontitis: a randomized, controlled trial].Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology · 2025Trial
- Effect of periodontal therapy on lung function: a twelve-month follow-up intervention study.Respiratory research · 2025Trial
- Pilot randomized trial of the effect of antibacterial mouthwash on muscle contractile function in healthy young adults.PloS one · 2025Trial
- Acute effects of a chewable beetroot-based supplement on cognitive performance: a double-blind randomized placebo-controlled crossover clinical trial.European journal of nutrition · 2024Trial
- The Impact of Mouthwash on the Oropharyngeal Microbiota of Men Who Have Sex with Men: a Substudy of the OMEGA Trial.Microbiology spectrum · 2022Trial
- Topic Application of the ProbioticFrontiers in cellular and infection microbiology · 2020Trial
- Impact of lifestyle factors on salivary nitrite and nitrate concentrations in overweight/obese individuals.Archives of oral biology · 2026Article
- The effect of antibacterial mouthwash on blood pressure in humans: a scoping review.BMC cardiovascular disorders · 2026Article
- Social lives of bacteria as revealed through CLASI-FISH.Essays in biochemistry · 2026Review
- Should chlorhexidine mouthwash be a concern for blood pressure in dental patients?Evidence-based dentistry · 2026Article
- Higher salivary nitrite is associated with improved glycemic control and insulin sensitivity in patients with type 2 diabetes.Nutrition & metabolism · 2026Article
- Evaluating the association between oral microbiota and cardiovascular diseases: evidence from Mendelian randomization analysis.Journal of geriatric cardiology : JGC · 2026Article
- The Effect of Chlorhexidine Mouthwashes on the Microbiota Associated with Peri-Implantitis Lesions: A Pilot Study.Antibiotics (Basel, Switzerland) · 2025Article
- The Hygienic Significance of Microbiota and Probiotics for Human Wellbeing.Probiotics and antimicrobial proteins · 2025Review
- Oral nitrate-reducing capacity and aerobic fitness are impaired in older individuals with heart failure with reduced ejection fraction.American journal of physiology. Heart and circulatory physiology · 2025Article
- Review
- Perspectives on tongue coating: etiology, clinical management, and associated diseases - a narrative review.The Saudi dental journal · 2025Review
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The oral microbiome has the potential to provide an important symbiotic function in human blood pressure physiology by contributing to the generation of nitric oxide (NO), an essential cardiovascular signaling molecule. NO is produced by the human body via conversion of arginine to NO by endogenous nitric oxide synthase (eNOS) but eNOS activity varies by subject. Oral microbial communities are proposed to supplement host NO production by reducing dietary nitrate to nitrite via bacterial nitrate reductases. Unreduced dietary nitrate is delivered to the oral cavity in saliva, a physiological process termed the enterosalivary circulation of nitrate. Previous studies demonstrated that disruption of enterosalivary circulation via use of oral antiseptics resulted in increases in systolic blood pressure. These previous studies did not include detailed information on the oral health of enrolled subjects. Using 16S rRNA gene sequencing and analysis, we determined whether introduction of chlorhexidine antiseptic mouthwash for 1 week was associated with changes in tongue bacterial communities and resting systolic blood pressure in healthy normotensive individuals with documented oral hygiene behaviors and free of oral disease. Tongue cleaning frequency was a predictor of chlorhexidine-induced changes in systolic blood pressure and tongue microbiome composition. Twice-daily chlorhexidine usage was associated with a significant increase in systolic blood pressure after 1 week of use and recovery from use resulted in an enrichment in nitrate-reducing bacteria on the tongue. Individuals with relatively high levels of bacterial nitrite reductases had lower resting systolic blood pressure. These results further support the concept of a symbiotic oral microbiome contributing to human health via the enterosalivary nitrate-nitrite-NO pathway. These data suggest that management of the tongue microbiome by regular cleaning together with adequate dietary intake of nitrate provide an opportunity for the improvement of resting systolic blood pressure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.