“…Severe protein deficiency (kwashiorkor) is associated with an increased incidence and severity of acute necrotizing gingivitis, periodontitis and cancrum oris (noma) (70,182). Protein deficiency in animal models has demonstrated osteoporosis in alveolar bone, degeneration of the periodontal ligament, decreased cementum deposition and delayed wound healing; however, periodontal pocketing does not occur in the absence of plaque (37,42,80,(217)(218)(219). An alteration in resistance to periodontal disease due to mild protein deficiency has not been supported in the literature (43,44).…”