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Potential mechanisms underpinning the nutritional modulation of periodontal inflammation
Abstract
Background Periodontitis results from an inappropriate host response to pathogenic biofilms. Because traditional management approaches have failed to reduce disease prevalence, the research focus has shifted toward managing host-mediated inflammation. In this article, the author reviews the role of nutrition in the development and resolution of inflammation.Methods The author reviewed the biomedical literature to elucidate mechanisms by which dietary factors affect inflammatory processes and to establish what evidence exists for macronutritional and micronutritional modulation of inflammation at a cellular and molecular level.Conclusions Hyperinflammation characterizes the periodontitis phenotype, and oxidative stress is a key orchestration point for the diverse signaling pathways, which control inflammation. Oxidative stress is modulated by diet, as well as by infection. Recent research has demonstrated that subtle shifts in nutritional status are associated independently with the prevalence of periodontitis. Moreover, the results of contemporary animal and human studies have demonstrated the role of specific micronutrients in the modulation of the host's inflammatory response by reducing inflammatory biomarkers and bone loss.Clinical implications The scientific community is starting to realize the health benefits of diets containing foods naturally rich in antioxidants and omega-3 polyunsaturated fatty acids, as well as the dangers of diets that are high in refined carbohydrates. Nutritional intervention studies in patients with inflammatory periodontitis are needed to evaluate the effect of nutritional approaches to periodontal management.
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“Such dysbiosis is prompted by various factors, including host diet, inflammatory responses, systemic disruptions, and habits such as alcohol intake, smoking tobacco and consuming alcohol.50, 180, 181, 182, 183, 184, 185, 186”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [182]
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BackgroundFunctional foods/ingredients and periodontal diseases
Laine, M. L., & Wim Crielaard, A. (2012) · European Journal of Nutrition · doi:10.1007/s00394-012-0325-5 · Cited by 7
“In a recent review on the relationship between dietderived antioxidants and the control/prevention of periodontal disease, a similar conclusion was drawn: although antioxidants are important in the control/prevention of periodontal diseases, the effects are systemical, via modulation of the host’s inflammatory respons…”
BackgroundAlcohol Consumption May Increase the Risk for Periodontal Disease in Some Adult Populations
AlSharief, M., & Krall, E. A. (2017) · Journal of Evidence Based Dental Practice · doi:10.1016/j.jebdp.2017.01.009 · Cited by 7
Periodontal disease and systemic disease
Chapple, I., Busby, M., Clover, H., & Matthews, R. (2014) · Journal of the Royal Society of Medicine · doi:10.1177/0141076813518770 · Cited by 7
Self-citationRelationship between Diet Quality and Periodontal Disease in South Korean Adults Aged ≥40 Years
Lee, M.-R. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20065039 · Cited by 6
“Therefore, the reduction in oxidative stress due to the increased intake of antioxidants through one’s diet, will have a positive effect on relieving gingival and periodontal inflammation, as the host’s immune response is regulated [23].”
BackgroundAntioxidant Micronutrients and Oxidative Stress Biomarkers
Chapple, I., Griffiths, H. R., Milward, M. R., Ling, M. R., & Grant, M. M. (2016) · Methods in molecular biology · doi:10.1007/978-1-4939-6685-1_4 · Cited by 6
Self-citationGingival RAGE Expression in Calorie‐Restricted Versus ad Libitum–Fed Rats
Aris, J. P., Elios, M. C., Bimstein, E., Wallet, S. M., Cha, S., Kesavalu, L. N., & Katz, J. (2010) · Journal of Periodontology · doi:10.1902/jop.2010.100019 · Cited by 5
Mahendra, J., Suresh, S., Saketharaman, P., Sivsankar, P., Selvakumar, J. P., & Elangovan, R. (2022) · The Journal of Contemporary Dental Practice · doi:10.5005/jp-journals-10024-3361 · Cited by 5
Effects of oral health problems in athletic performance
Soileau, K. M., Le, A., & Bresky, I. (2024) · International Journal of Preventive and Clinical Dental Research · doi:10.4103/ijpcdr.ijpcdr_6_24 · Cited by 4
Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic
Johnston, B. D., Fritz, P. C., & Ward, W. E. (2013) · Nutrients · doi:10.3390/nu5041110 · Cited by 4
“The antioxidant activity [4] of nutrients such as vitamin C [10,11], and α-tocopherol [12], and the anti-inflammatory activity [7] of polyunsaturated fatty acids (docosahexaeonic acid (DHA) [13,14]) may attenuate the development of periodontal disease.”
BackgroundHong, I., Park, J., Noh, Y.-H., Jeon, S.-H., Paik, J., Lee, J., Choi, S., & Cha, J. (2021) · Antioxidants · doi:10.3390/antiox10101586 · Cited by 4
“Host modulation therapy such as intake of functional foods or antioxidative nutrients like vitamin was suggested to enhance host defense system and down-regulate periodontal inflammation [8,9].”
BackgroundRelationship Between Periodontal Disease and Nutrition
Winning, L., & Moore, C. (2021) · Springer eBooks · doi:10.1007/978-3-030-80526-5_6 · Cited by 3
The eminence of nutrition in periodontal health and therapy—a review
Elumalai, A., Caleb, C. L., Anitha, V., Balachandran, A., & Muthukali, S. (2024) · Nutrire · doi:10.1186/s41110-023-00246-3 · Cited by 3
Azizah, Z., Wahyuni, P. S., Haris, M. N., & Sari, V. (2024) · International Journal of Pharmaceutical Sciences and Medicine · doi:10.47760/ijpsm.2024.v09i02.003 · Cited by 3
Sayar, F., Ahmadi, R. S., & Montazeri, M. (2019) · Journal of Advanced Periodontology & Implant Dentistry · doi:10.15171/japid.2019.004 · Cited by 3
“As a result, the antioxidant system will not be able to eliminate all the ROS molecules, and the disease will take a destructive course.(13) It is assessed that between 1 and 3 billion ROS molecules are produced daily in the body, which is controlled by the antioxidant system.”
BackgroundMethodAn Association between Vitamin Intakes and Established Periodontitis in Korean Adult Population
Cheon, S. H., & Jeong, S. H. (2014) · Journal of dental hygiene science · doi:10.17135/jdhs.2014.14.4.468 · Cited by 3
Al-Abdaly, M. M. A. A., Alghamdi, A. S., Alshehri, A. H., & Nasser, F. A. A. A. (2021) · Open Journal of Stomatology · doi:10.4236/ojst.2021.113010 · Cited by 3
“Ascorbic Acid is an antioxidant can decrease the generation of reactive oxygen species that are associated with inflammatory reaction in periodontal diseases, and cause more destruction of periodontal tissues [24] [25].”
BackgroundThe role of neutrophil extracellular traps in the pathogenesis of periodontal diseases
White, P. C. (2016) · University of Birmingham Institutional Research Archive (University of Birmingham) · Cited by 3
Antioxidant Micronutrients and Oxidative Stress Biomarkers
Dias, I. H. K., Griffiths, H. R., Milward, M. R., Ling, M. R., Chapple, I., & Grant, M. M. (2022) · Methods in molecular biology · doi:10.1007/978-1-0716-2780-8_4 · Cited by 2
Self-citationGuo, S., Feng, J., Wang, Y., & Li, H. (2024) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637486.2024.2420265 · Cited by 2
“In addition to controlling major risk factors by reducing smoking and maintaining good oral hygiene, recent research has shown that subtle dietary shifts are independently associated with periodontitis risk (Chapple 2009).”
Smith, H. R., Thomas, D. T., Vázquez-Morales, G. N., Puckett, L., Rodriguez, M. D. M., Stromberg, A. J., Shaddox, L. M., Santamaria, M. P., Pearce, K. A., & Andriankaja, O. M. (2025) · Frontiers in Oral Health · doi:10.3389/froh.2025.1468995 · Cited by 3
The Impact of Women’s Oral Health on Systemic Health
Haskin, C., & Mobley, C. C. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-384978-6.00100-x · Cited by 2
Zhou, M., & Zuo-lin, W. (2018) · PubMed Central · doi:10.7518/hxkq.2018.02.002 · Cited by 2
Nutrigenomics and its Role in Periodontal Health – A Review
Behura, S. S. (2020) · Indian Journal of Forensic Medicine & Toxicology · doi:10.37506/ijfmt.v14i4.11732 · Cited by 2
Meisel, P., Springmann, C., & Kocher, T. (2009) · Nutrition · doi:10.1016/j.nut.2009.08.028 · Cited by 2
Zhou, Y., Wen, C., Zhang, Q., Gu, Z., Lian, L., Xue, K., Xu, T., Lin, Z., Wang, W., & Zhu, H. (2025) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2025.106347 · Cited by 1
The effects of macronutrients and micronutrients on halitosis: a scoping review of current evidence
Babalola, A. E., Adinnu, C. M.-G., Oyediran, T. O., Ngwu, F. A., Babalola, D. O., Entonu, A. I., Giwa, K. A., Muratova, A., & Ogieuhi, I. J. (2026) · Nutrire · doi:10.1186/s41110-026-00446-7 · Cited by 1
The importance of health histories and disclosure
Bridges, M. (2015) · Dental Nursing · doi:10.12968/denn.2015.11.11.668 · Cited by 1
Micronutrition in periodontal treatment: Antioxidants
Toker, H. (2016) · DergiPark (Istanbul University) · doi:10.7126/cdj.58140.5000003000 · Cited by 1
Die Rolle der Ernährung in der Ätiologie parodontaler Erkrankungen
Schlagenhauf, U. (2017) · Zahnmedizin up2date · doi:10.1055/s-0043-104882 · Cited by 1
“Antioxidantien, die freie Sauerstoffradikale binden und damit die zuvor beschriebene destruktive Oxidation von Körpergewebe infolge oxidativen Stresses verhindern können [5].”
Metadata
- Authors
- Chapple, I. L. C.
- Affiliations
- University of Birmingham (GB)
- Corresponding author
- Chapple, Iain L.C.
- ORCID
- Chapple, Iain L.C.
- Venue
- The Journal of the American Dental Association
- Publisher
- Elsevier BV
- Published
- 2009-02
- Volume
- 140
- Issue
- 2
- Pages
- 178-184
- ISSN
- 0002-8177 (ISSN-L)
- OpenAlex
- W2099633200
- Semantic Scholar
- 7e4460a958177152ab8200c331272aedf490584b
- Cited by
- 126
- References
- 40
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 11 · 2023: 4 · 2022: 8 · 2021: 7 · 2020: 5 · 2019: 7 · 2018: 11 · 2017: 5 · 2016: 9 · 2015: 6 · 2014: 11 · 2013: 6 · 2012: 10
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of the American Dental Association (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
- Health Sciences › Dentistry › Periodontics › Periodontal Regeneration and Treatments
- Keywords
- periodontitis, periodontal inflammation, nutrition, oxidative stress, hyperinflammation, micronutrients, macronutrients, omega-3 polyunsaturated fatty acids, antioxidants, refined carbohydrates, bone loss, periodontal disease management
- MeSH terms
- Blood Glucose, Diet, Dietary Carbohydrates, Humans, Nutritional Status, Periodontal Diseases, Oxidative Stress
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