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Periodontitis is a ubiquitous, chronic inflammatory condition of the tooth-supporting apparatus. Various risk factors/indicators are associated with periodontal diseases, including nutritional status. With oxidative stress driving periodontal inflammation there is credibility in considering additional benefits from phytonutritional supplements when used in conjunction with conventional therapy for periodontal disease. Contemporary research utilizing robust methodology, such as double-blind, randomized, placebo-controlled trials, in conjunction with serum micronutrient levels to assess bioavailability of phytonutrients following nutritional supplementation, may begin to provide an evidence base for delivering nutritional advice as part of periodontal prevention/therapy.
CPD/Clinical Relevance: Some mechanisms underpinning nutritional modulation of inflammatory periodontal disease, as well as the evidence behind the use of Juice Powder Concentrates (JPCs), are of relevance in periodontal therapy.
Article
Periodontitis is a ubiquitous, chronic inflammatory condition of the tooth-supporting apparatus. The current disease paradigm points overwhelmingly towards an aetiology consisting of a ‘dysbiotic’ biofilm leading to an exaggerated host response in susceptible individuals being responsible for the majority of the subsequent periodontal tissue destruction; the literature suggesting that the aberrant host response contributes 80% of the risk of periodontal tissue destruction.1 Whilst resolution of the inflammatory process is achievable for some patients with a combination of non-surgical and surgical debridement, others fail to achieve the desired level of biofilm control, and long-term stability is only achieved with patient education on the various risk factors/indicators associated with periodontal disease, eg poor oral hygiene, smoking, stress, diabetes, micronutritional deficiency. Considering the close associations between nutrition and a variety of inflammatory systemic diseases, such as type 2 diabetes, rheumatoid arthritis and atherogenic cardiovascular disease (all of which also share associations with periodontitis2, 3, 4), it is not surprising that there has been a surge in research on the effects of nutrition and its potential impact on the biological and structural processes underlying periodontitis. The importance of nutritional advice as part of primary prevention in both periodontal disease and general health was highlighted in the Consensus of the Seventh European Workshop on Periodontology. This recommended that the dental team should advise on increased dietary intake of fibre, fish oils, fruit, vegetables and berries, as well as reducing intake of refined carbohydrates.5
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