Nitrate as a potential prebiotic for the oral microbiome

The salivary glands actively concentrate plasma nitrate, leading to high salivary nitrate concentrations (5-8 mM) after a nitrate-rich vegetable meal. Nitrate is an ecological factor that can induce rapid changes in structure and function of polymicrobial communities, but the effects on the oral microbiota have not been clarified. To test this, saliva of 12 healthy donors was collected to grow in vitro biofilms with and without 6.5 mM nitrate. Samples were taken at 5 h (most nitrate reduced) and 9 h (all nitrate reduced) of biofilm formation for ammonium, lactate and pH measurements, as well as 16S rRNA gene Illumina sequencing. Nitrate did not affect biofilm growth significantly, but reduced lactate production, while increasing the observed ammonium production and pH (all p<0.01). Significantly higher levels of the oral health-associated nitrate-reducing genera Neisseria (3.1x) and Rothia (2.9x) were detected in the nitrate condition already after 5 h (both p<0.01), while several caries-associated genera (Streptococcus, Veillonella and Oribacterium) and halitosis- and periodontitis-associated genera (Porphyromonas, Fusobacterium, Leptotrichia, Prevotella, and Alloprevotella) were significantly reduced (p<0.05 at 5 h and/or 9 h). In conclusion, the addition of nitrate to oral communities led to rapid modulation of microbiome composition and activity that could be beneficial for the host (i.e., increasing eubiosis or decreasing dysbiosis). Nitrate should thus be investigated as a potential prebiotic for oral health.