Abstract
BACKGROUND: Theobromine, a methylxanthine mainly found in chocolate, has been suggested to possess various health-promoting properties. This study aimed to investigate the long-term effect of salivary theobromine levels on periodontitis severity using 7- and 10-year follow-up data from the prospective Studies of Health in Pomerania (SHIP-TREND and SHIP-START). MATERIALS AND METHODS: We conducted a non-targeted metabolomics analysis of salivary methylxanthines in 679 participants from SHIP-TREND and 953 participants from SHIP-START. Inverse-probability-of-treatment-weighted generalised linear models were used to assess the relationship between salivary theobromine and periodontal variables, including bleeding on probing, probing depth and clinical attachment loss. RESULTS: Higher salivary theobromine levels were significantly associated with improved periodontal health, as evidenced by lower mean probing depth and a reduced percentage of sites with probing depth ≥ 3 mm. The results were successfully replicated in the SHIP-START data and extended to a lower clinical attachment loss. DISCUSSION: Our cohort studies suggest that elevated salivary theobromine levels are associated with improved periodontal parameters over 7 and 10 years. These results indicate the potential for theobromine-containing products to support periodontal health, warranting further investigation through randomised controlled trials.