According to a study to be presented at EuroPerio9, the world’s leading congress in periodontology and implant dentistry, just four weeks of a healthy diet can significantly reduce gingivitis (1).
Gingivitis is the inflammation of the gums. Bleeding gums, swelling and difficulty chewing are the primary symptoms of gingivitis. If left untreated, it can lead to periodontitis. Gingivitis has many causes, such as the build up of bacteria in the spaces between the gums and the teeth.
“Previous research (2) has shown a pronounced effect of dietary interventions on gingival inflammation. These studies showed no correlation between plaque and gingival inflammation, so this was quite revolutionary. However, the mechanisms behind this are broadly unknown. Since we know that there is an association between systemic inflammatory parameters like CRP, IL-6 and TNF-a, we wanted to find out how an oral health optimised diet could affect both periodontal and systemic inflammation,” explained lead author, Dr Johan Wölber, from the Department of Operative Dentistry and Periodontology, Centre for Dental Medicine, University Medical Centre Freiburg, Germany.
“To do so, we conducted a randomised clinical trial using the design of our previous study (2), with one group of patients asked to follow a special diet low in processed carbohydrates and animal proteins, but rich in Omega 3-fatty acids, vitamins C and D, antioxidants, plant nitrates and fibers,” said Dr Wölber. “People in the control group did not change their eating habits, following a common Western diet rich in processed carbohydrates and saturated fatty acids, and low in micronutrients. We asked both groups not to clean between their teeth during the study. We assessed the clinical periodontal parameters and systemic inflammatory parameters at baseline and after four weeks.”
Commenting on the results, Dr Wölber said: “We were amazed to find that - after only four weeks - a healthy diet substantially reduced inflammation of the gums. On the whole, we found a significant reduction of gingivitis of about 40% which was, like in the previous study, significantly different from the control group – without interdental cleaning. Regarding the serological parameters, we saw no differences between the control and experimental group, except a significant increase of vitamin D in the group eating healthily. In other words, an optimal diet seems to influence early gingivitis, before systemic inflammation sets in.”
When asked about the next steps, Dr Wölber expressed that he hopes to validate these findings in larger studies, over a longer time. “We will also be carrying out microbiome analysis, to see what happened to the supra- and subgingival plaque.”
Regarding a “take-home” message for patients and professionals, Dr Wölber said: “For patients, it seems clear that a Western diet drives inflammation. This study shows that a change of diet is good for patients with gingivitis, but it may also prove to be favourable for patients with periodontitis. The optimal diet consists of avoiding processed carbohydrates (such as sugar or white flour), saturated and trans-fatty acids, while increasing micronutrients from plants, Vitamin D, Omega-3 fatty acids, fibers and plant nitrates. Due to the low content of processed carbohydrates, this diet also helps prevent caries and promotes weight loss.”
Dr Wölber concluded: “Oral health professionals should feel confident in recommending a healthy diet to their patients, in the same way that they promote oral hygiene, because it will benefit both oral and general health.”
Full bibliographic information
Source: European Federation of Periodontology (EFP)
1) EuroPerio9 abstract PD019: The effect of an oral health optimized diet on periodontal and serological parameters. A randomized controlled trial. Johan Wölber. Session on Adjunctive Periodontal Therapies, 20 June 2018, at 15:45 CEST. 2) Woelber, J. et al. (2016). An oral health optimized diet can reduce gingival and periodontal inflammation in humans - a randomized controlled pilot study. BMC Oral Health. 17. 28. 10.1186/s12903-016-0257-1.