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A higher value of unhealthy diet was associated with higher values of initial periodontitis (SC\u00a0=\u00a00.134; <jats:italic>p<\/jats:italic>\u00a0=\u2009.005) and moderate periodontitis (SC\u00a0=\u00a00.180; <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001). Biofilm mediated the association between higher values of unhealthy diet and all periodontal outcomes (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that both healthy and unhealthy dietary patterns may contribute to reduced or increased extent and severity of periodontitis by local and systemic mechanisms, preceding the effect of other established causes such as smoking and obesity, in younger population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.13625","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T01:10:19Z","timestamp":1649812219000},"page":"580-590","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Investigating oral and systemic pathways between unhealthy and healthy dietary patterns to periodontitis in adolescents: A population\u2010based 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