Dietary Component [Reference] |
Study Type |
Characteristics of Participants |
Intervention Duration |
Intervention/Comparison Groups |
Outcomes |
|
|
Number |
Age |
Clinical Condition |
|
Control |
Treatment |
|
Macronutrients with Potential Anti-Inflammatory Activity |
Saturated fat, PUFA, cholesterol [10] |
Prospective, randomized study |
250 parents from 148 families |
Mean age: 34.2 y |
|
29 mo |
"Normal diet†|
Anti-atherosclerotic diet (high PUFA/SFA, low SFA, low serum cholesterol, high HDL) |
NS differences in periodontal health. |
SFAs [11] |
Prospective |
264 |
75 y |
Dentate |
|
|
|
Non-smokers in the highest quartile of saturated fatty acids intake had an increased risk for periodontal disease events (ARR = 1.92, highest quartile). |
DHA, EPA, LNA [14] |
Cross-sectional study NHANES 1999-2004 |
9182 |
≥ 20 y |
Dentate |
|
|
|
Those in the highest tertile of DHA intake had lower odds of periodontal disease (OR = 0.78, highest tertile). NS associations with either EPA or LNA acid. |
DHA, EPA [15] |
Prospective |
36 |
74 y |
Dentate |
|
|
|
Those in the lowest tertile of DHA intake had increased incidence of periodontal disease events (IRR = 1.49, lowest tertile). NS associations with EPA. |
Long chain n-3 PUFA, γ-linolenic acid [12] |
Pilot study |
30 |
Adult |
With periodontitis |
12 wk |
3 g placebo |
3 g fish oil, or 3 g borage oil, or 1.5 g of each |
Improvement in probing depth and gingival inflammation for borage oil group, trend for fish oil and combination groups. No significant differences in plaque index. |
n-6 PUFA, n-3 PUFA [16] |
Prospective |
235 |
75 y |
Dentate |
|
|
|
Those in highest tertile of total n-6 PUFA compared to total n-3 PUFA intake were at a greater risk of periodontal disease events (ARR = 1.29, highest tertile). |
Total CHO [17] |
Single-blind crossover study |
20 |
Young adults |
|
3 wk |
Low sugar diet |
High sugar diet |
Higher bleeding scores in high sugar group. No significant differences in plaque score. |
Dietary fibre [18] |
Prospective observation study, Health Professionals Follow-Up Study |
34160 |
40-75y |
Excluded those with periodontitis, MI, stroke, diabetes hyperchol- esterolemia at beginning of study |
12 y |
|
|
Those in highest quintile of whole grain intake were 23% less likely to get periodontitis than those in lowest quintile. Periodontitis was not associated with refined grain intake. Periodontal risk was inversely related to cereal fibre. |
Micronutrients with Potential Osteogenic Activity |
Calcium [19] |
Longitudinal study |
189 |
59 y |
Healthy, dentate, post-menopausal women with normal spine density |
2 y |
Placebo taken daily |
500 mg elemental calcium either in calcium citrate malate or calcium carbonate daily |
Greater proportion of non-smoking placebo group lost teeth than non-smoking supplemented group. Those who lost teeth during 7 y follow up had greater reduction of BMD at whole body, femoral neck, and spine. For each 1%/y decrement in BMD, there was a higher relative risk of losing tooth. |
Calcium [20] |
Randomized, clinical study |
59 |
|
With advanced periodontal disease |
180 d |
1 g placebo tablets daily |
1 g calcium tablet daily |
No significant differences in probing depth, gingival inflammation or plaque score. |
Calcium [21] |
Cross- sectional study, NHANES III |
|
|
|
|
|
|
Association of lower calcium intake with periodontal disease for young males and females (20-39 y) and older males (40-59 y). Dose response in females (54% greater risk for lowest level of intake (<499 mg), 27% greater risk for moderate intake (500-799 mg) compared to those with higher intakes (>800 mg)). Association between low total serum calcium and periodontal disease in younger females 20-39 y but not for males or older females. |
Calcium, vitamin D [22] |
Cross- sectional study |
228 |
Mean age: 63.6 y |
With periodontal disease |
|
|
|
Only 7% of participants met RDAs of calcium and vitamin D. 66% did not take oral supplements. More males than females who did not take calcium supplements. |
Dairy intake [23] |
Cross-sectional study, NHANES III |
12764 |
|
|
|
|
|
Prevalence of periodontitis was 41% lower for people in highest quintile of dairy intake than those in lowest quintile. |
Calcium, vitamin D [7] |
Cross- sectional study |
51 |
|
With 2 or more interproximal sites with 3 mm clinical attachment loss or more |
|
Not taking supplements |
1000 mg calcium and 400 IU vitamin D daily |
Trend in shallower probing depths, fewer bleeding sites, lower gingival index values, fewer furcation involvements, less attachment loss, and less alveolar crest height loss but results were not significant. |
Calcium, vitamin D [8] |
Double-blind, randomized, placebo-controlled study |
145 |
>65 y |
Healthy |
3 y |
Placebo pills |
500 mg calcium and 700 IU vitamin D daily |
Lower odds of tooth loss were associated with supplement status during study period, and total calcium intake during follow up. NS differences in probing depths. |
Vitamin D [19] |
Longitudinal study |
189 |
59 y |
Healthy, dentate, post-menopausal, with normal spine density |
1 y |
Placebo with 377 mg calcium daily |
400 IU vitamin D with 377 mg calcium daily |
No effect on tooth loss. Those who lost teeth during 7 y follow-up had greater reduction of BMD at whole body, femoral neck, and spine. For each 1% per y decrement in BMD, higher relative risk of losing tooth. |
Vitamin D [19] |
Longitudinal study |
189 |
59 y |
Healthy, dentate, post-menopausal, with normal spine density |
2 y |
100 IU vitamin D with 500 mg calcium daily |
700 IU vitamin D with 500 mg calcium daily |
No effect on tooth loss. Those who lost teeth during 7 y follow-up had greater reduction of BMD at whole body, femoral neck, and spine. For each 1%/y decrement in BMD, higher relative risk of losing tooth. |
Vitamin D [9] |
Cross- sectional study, NHANES III |
3781 |
>50 y |
|
|
|
|
Inverse relationship between attachment loss and serum 25(OH)D |
Vitamin D [24] |
Cross- sectional study, NHANES III |
6700 |
>13 y |
Never smokers |
|
|
|
Participants in highest quintile of serum 25(OH)D were 20% less likely to bleed on probing. |
Magnesium [25] |
Cross- sectional study |
2931 |
>40 y |
33% had hypo-magnesemia |
|
|
|
Inverse relationships between serum Mg and lower probing depth and attachment loss |
Fluoride [26] |
Double-blind, randomized, parallel study |
70 |
>18 y (mean age of 30 y) |
Generalized gingival inflammation with some dentinal sensitivity, no acute gingival or periodontal condition |
4 wk |
Placebo(de-ionized water) |
Natural mineral dietary supplement with 3.6 mg I-1 of F and other minerals in trace amounts (Si, HCO3, Na, Cl, K, Ca etc) |
No significant differences in gingival inflammation. |
Micronutrients and Food Bioactives with Potential Antioxidant Activity |
Vitamin C [30] |
Cross-sectional study, NHANES III |
12419 |
>20 y |
|
|
|
|
Reduction of dietary vitamin C was related with attachment level of >= 1.5 mm in overall population. Higher risk for current smokers and former smokers who took less dietary vitamin C. Dose response relationship exists (OR=1.3, 0-29 mg vitamin C; OR=1.16, 100-179 mg vitamin C, OR=1, 180 mg+ vitamin C) |
Vitamin C [31] |
Cross- sectional study |
413 |
70 y |
|
|
|
|
Inverse relationship between serum vitamin C and clinical attachment loss. |
Vitamin C [32] |
Case-matched study |
10 |
>30 y |
Non-deficient in vitamin C, with gingivitis |
6 wk |
Placebo, 4 pills daily |
250 mg ascorbic acid in each pill, 4 pills daily |
No significant differences in probing depth, attachment level, gingival inflammation, and plaque level. |
Vitamin C [33] |
Single-blind study |
30 |
>20 y |
≥ 12 remaining teeth, ability to develop calculus, otherwise healthy |
3 mo |
Vitamin C and sugar free chewing gum, 5 times daily or No chewing gum |
60 mg vitamin C in each sugar free chewing gum, 5 times daily |
Lower bleeding scores in vitamin C gum chewers than non gum chewers. Lower visible plaque index in gum chewers than non gum chewers. |
Vitamin C [34] |
Longitudinal, single- blinded randomized study |
80 |
22-75y |
With chronic periodontitis, n=58 These subjects were divided into a test group (n=38) and diseased control group (n=20) 22 healthy subjects were also studied. |
2 wk |
No consumption of grape-fruits for patients with chronic perio-dontitis or No consumption of grape-fruit for healthy subjects |
Two grapefruits daily for patients with chronic periodontitis |
Lower sulcus bleeding index. No effect on probing depth and plaque index. |
Vitamin E [29] |
Randomized study |
409 |
55-74y |
Smokers |
3 yrs |
ASA or Neither vitamin E nor ASA |
50 mg vitamin E supplement-ation daily or Both vitamin E and ASA daily |
Gingival inflammation was more common in vitamin E supplemented group than non receivers. Highest risk in group that received both. Higher prevalence of dental plaque in vitamin E supplemented group. |
Vitamin C, vitamin E (α-tocopherol) [27] |
Prospective |
224 |
71 y |
Dentate |
|
|
|
Middle and lowest tertiles of serum ascorbic acid levels increased risk of periodontal disease events (RR = 1.12, middle tertile; RR = 1.30, lowest tertile). Lowest tertile of serum α-tocopherol level increased risk of periodontal disease events (RR = 1.15, lowest tertile). |
Vitamin C, vitamin E, β-carotene [28] |
Prospective study |
264 |
75 y |
Dentate |
|
|
|
Middle and highest tertiles of vitamin C intake decreased periodontal disease progression (IRR = 0.76, middle tertile; IRR = 0.72, highest tertile). Middle and highest tertiles of vitamin E intake decreased periodontal disease progression (IRR = 0.79, middle tertile; IRR = 0.55, highest tertile). Highest tertile of β-carotene intake decreased periodontal disease progression (IRR = 0.73, highest tertile). |
Lycopene [35] |
Randomized, double-blind, parallel, split mouth, clinical study |
20 |
|
Signs of gingivitis but healthy individuals |
2 wk |
Placebo daily |
8 mg lycopene daily |
Reduction in bleeding, gingival, and plaque indices. |
Green tea [36] |
Cross- sectional study |
940 |
49-59y |
|
|
|
|
Inverse relationship between green tea intake and probing depth, attachment loss, and gingival inflammation |
Green tea extract [37] |
Double-blind randomized study |
47 |
Mean age: 25.76 |
|
4 wk |
8 placebos with same flavour daily |
8 chew candies with green tea extracts daily |
Improved sulcus bleeding and proximal plaque indices in the treatment group from week 3 to week 1. Worsened bleeding index in placebo group from week 3 to week 1. |