Science Update

Recent Systematic Review Investigates Potential Supportive Role of Micronutrients for Periodontal Health

Periodontal health refers to the health of the mouth and gums. Age-related changes in periodontal health have been associated with increases in oxidative stress and a chronic inflammatory response. Disruptions to optimal cellular function have also been observed in cases of pathological age-related changes to periodontal health, such as periodontitis. A recently published systematic review by Woebler and colleagues explored the potential connection between certain micronutrients and periodontal health. 

Vitamin E is one agent that was found in this systematic review to have a significant positive influence on periodontal parameters. Of note, the form of vitamin E was not specified in this review. However, in other studies regarding periodontal health, tocotrienols have been shown to help support antioxidative status, a normal inflammatory response, and age-related changes. Tocotrienols are a form of vitamin E shown in research to possess distinct properties that support antioxidative status and a healthy inflammatory response. Tocotrienols have also been shown to inhibit the nuclear factor-kappa B (NF-κB) pathway and to help suppress interleukin (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein, and malondialdehyde. Microbes that promote the progression of periodontal disease have specifically been shown to activate inflammatory responses, including the NF-κB pathway and certain pro-inflammatory cytokines, including TNF-α. 

Several studies included in the systematic review investigated the potential efficacy of omega-3 fatty acids on parameters related to periodontal health. One controlled clinical study involved a blend of ingredients including daily administration of 2.6 g of eicosapentaenoic acid (EPA) and 1.8 g of docosahexaenoic acid (DHA) for 3 months. After the treatment period, improvements in periodontal parameters, such as depth of pocket probing, bleeding on probing, clinical attachment loss, and the prevalence of pro-inflammatory cytokines, such as IL-12 and IL-17 were observed. 

Other micronutrients included in this systematic review include vitamin D, certain fruits and vegetables, and green tea. The authors reported that flavonoid intake from certain fruits and vegetables may be associated with lower levels of salivary IL-1β. Certain phytochemicals found in a Mediterranean-type diet have been shown to support antioxidative status, a normal response to inflammation, and periodontal health. In addition, the polyphenols found in green tea have been associated with helping to support antioxidative status.

More research is needed, particularly in the clinical setting. However, Woelber and colleagues conclude that certain micronutrients, such as vitamin E, polyphenols, and flavonoids, may help support periodontal health. They may also help support age-related changes to health status, antioxidative status, and the inflammatory response. 

By Dr. C Ambrose, ND, MAT