The new study found that that a moderate dietary intake of the omega-3 polyunsaturated fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) were associated with a decreased prevalence of periodontitis of up to 20 percent.
“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,” wrote the researchers, led by Dr Asghar Naqvi from Harvard Medical School.
“Our results also suggest that DHA ([in] doses recommended by the American Heart Association …) may be as or more potent in influencing periodontitis,” they added.
Bacterial infection
Periodontitis is a common, chronic inflammatory disease that is characterized by gum tissue separation from the tooth – forming a periodontal pocket that can lead to bone and tooth loss.
Traditional therapies for periodontitis focus on targeting the initial bacterial infection, however more recent therapeutic strategies have aimed to target the response to the infection, which is thought to play an important role in the pathogenesis of periodontitis.
A study published earlier this year in Molecular Oral Microbiology (Vol. 25,pp. 75-80) did report potential anti-bacterial effects, extending the benefits beyond inflammation.
Researchers from the University of Kentucky reported that EPA, DHA and ALA (alpha-linolenic acid), as well as their fatty acid ethyl esters could inhibit the growth of oral pathogens, including Streptococcus mutans, Candida albicans, and Porphyromonas ginigivalis at relatively low doses.
The study was said to be the first to demonstrate an antibacterial activity of omega-3 fatty acids and their esters against oral pathogens.
Significant reduction
The new study refocuses attention on the anti-inflammatory potential of the fatty acids for reducing the risk of periodontitis. Dr Naqvi and his colleagues studied data from over 9,000 adults who participated in the National Health and Nutrition Examination Survey between 1999 and 2004, finding a reduction of approximately 20 percent in periodontitis prevalence in people consuming the most dietary DHA.
The reduction association with EPA was smaller found to be smaller but still significant, while the correlation to LNA was not statistically significant, reported the authors.
Well founded
In an accompanying commentary (doi: 10.1016/j.jada.2010.08.017), Prof. Elizabeth Krall Kaye of Boston University said that the findings “of a protective association between higher intakes of omega-3 fatty acids and periodontal disease are well-founded.”
She stated that the significantly reduced odds of periodontal disease were observed at relatively modest intakes of DHA and EPA, and the suggestion of a threshold dose was particularly of note.
“These findings are encouraging in that they suggest it may be possible to attain clinically meaningful benefits for periodontal disease at modest levels of omega-3 fatty acid intakes from foods,” added Prof. Kaye.
Protective effect
“In this nationally representative sample, higher dietary intakes of DHA and, to a lesser degree, EPA, were associated with lower prevalence of periodontitis,” stated the researchers.
However the authors noted that the cross sectional nature of their study only permits the detection of associations, and not a temporal relationship or causation.
“Given the evidence indicating a role for n-3 fatty acids in other chronic inflammatory conditions, it is possible that treating periodontitis with n-3 fatty acids could have the added benefit of preventing other chronic diseases associated with inflammation,” stated the researchers.
They added that further interventional studies are needed to confirm the potential protective effects of omega-3 fatty acids on periodontitis in prospective cohort and randomized clinical trials.
Source: Journal of the American Dietetic Association
Volume 110, Issue 11, Pages 1669-1675., doi: 10.1016/j.jada.2010.08.009
“n-3 Fatty Acids and Periodontitis in US Adults”
Authors: A.Z. Naqvi, C. Buettner, R.S. Phillips, R.B. Davis, K.J. Mukamal