Greater omega-3 fatty acid intake linked with lower risk of periodontitis
An article published in the Journal of the American Dietetic Association reports that periodontitis, a disease characterized by inflammation of the gums and the development of pockets between the teeth and gums that can lead to tooth loss, is less prevalent among those with a higher intake of omega-3 fatty acids. Omega-3 fatty acids include eicosapentaenoic acid, docosahexaenoic acid and alpha-linolenic acid, and are often reduced in the average Western diet in comparison with omega-6 fatty acids.
Asghar Z. Naqvi, MPH, MNS of Beth Israel Deaconess Medical Center in Boston and colleagues from Harvard Medical School and Harvard School of Public Health evaluated data from 9,182 men and women who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004. Dental examinations determined the presence of periodontitis, and dietary questionnaire and interview responses were assessed for the intake of EPA, DHA and linolenic acid from food and supplements.
Periodontitis was detected in 8.2 percent of the subjects. Among those whose intake of DHA from diet and supplements was among the top one-third of participants, there was a 20 percent lower risk of the disease compared with those whose intake was among the lowest third. For subjects in the top third of EPA intake, the risk averaged 15 percent lower. No statistically significant association was observed between periodontitis and linolenic acid.
"We found that omega-3 fatty acid intake, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are inversely associated with periodontitis in the US population," Dr Naqvi concluded. "To date, the treatment of periodontitis has primarily involved mechanical cleaning and local antibiotic application. Thus, a dietary therapy, if effective, might be a less expensive and safer method for the prevention and treatment of periodontitis. Given the evidence indicating a role for omega-3 fatty acids in other chronic inflammatory conditions, it is possible that treating periodontitis with omega-3 fatty acids could have the added benefit of preventing other chronic diseases associated with inflammation, including stroke as well."
In an accompanying editorial, Elizabeth Krall Kaye, PhD of Boston University Henry M. Goldman School of Dental Medicine notes that prior to the current research few studies had evaluated the effect of omega-3 or omega-6 polyunsaturated fatty acids on periodontal disease. "The strength of the association provides compelling grounds for future longitudinal studies and clinical trials to define optimal intake levels and omega-3 sources for the prevention and treatment of periodontal disease," she writes. "Future studies should also investigate how periodontal disease and systemic inflammatory diseases interact with respect to omega-3 requirements so that a unified set of dietary recommendations can be developed that ensure benefits for the largest possible segment of the population."
Periodontal diseases, including gingivitis and periodontitis, are inflammatory diseases that affect the supporting structures that anchor the teeth in place (periodontium). Gingivitis and periodontitis are related conditions: if left untreated, gingivitis, or inflammation of the gingival tissue (gums), can progress to periodontitis, a more serious condition.
During periodontitis, the healthy gum tissue is transformed from pink and firm, with knife-edge margins between the soft tissue and the tooth, to inflamed and red. Eventually, the tissue pulls away from the tooth, allowing pockets to form. These pockets can be measured with a special probe during a standard dental check-up. Any pocket over 3 millimeters in depth signifies gingivitis; a pocket over 5 millimeters usually signifies periodontitis.
Because of the association between gum disease and systemic inflammation, researchers have begun looking at anti-inflammatory nutrients in the context of gum disease. In one study, 30 adults with gum disease were given a variety of polyunsaturated fatty acids, including omega-3 fatty acids from fish oil (up to 3000 mg daily) and omega-6 fatty acids from borage oil (up to 3000 mg daily). At the end of the study, clinically significant improvements were measured in both gingival inflammation and the depth of gum pockets (Rosenstein ED et al 2003). Another preliminary human study found that omega-3 fatty acids tended to reduce inflammation, but called for more thorough research (Campan P et al 1997). However, in light of the established connection between omega-3 and omega-6 fatty acids and inflammation, and the fatty acids' lack of side effects, it is reasonable for people with gum disease to consider using these supplements. Other anti-inflammatory supplements include ginger and curcumin, though neither of these has been studied in the context of inflammatory gum disease.
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