| 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. | |