Effect of Nutritional Antioxidants on Periodontal Disease and Periodontal Therapy

Oxidative stress plays a significant role in the pathophysiology of periodontal disease (PD). Therefore, it is reasonable to suggest that a diet rich in antioxidants, such as several vitamins and essential minerals, may positively affect periodontal health. However, the evidence from the relevant literature is yet inconclusive. Studies evaluating the levels of intake of nutritional antioxidants in relation to periodontal status demonstrate contradictory results. This inconsistency could be attributed to heterogeneity in study design and methodological limitations, such as the small sample size, the assessment of periodontal status based on partial mouth measurements that usually underestimate the actual severity of PD, the lack of adjustment for confounders, which may obscure any potential but weak effect of nutrition, and the use of a 24 h recall to assess nutrient intake. Regarding the intervention studies that evaluated the effect of nutritional antioxidant supplementation as an adjunct to periodontal therapy, again, the results are not consistent. Few studies are randomized, and often different nutritional supplements are combined, making it difficult to distinguish the actual effect of each nutrient. Moreover, the dosage and duration of use of these supplements vary, rendering comparisons impossible. Therefore, better designed studies are necessary for the future. The assessment methods used for both PD and vitamin/mineral intake need to be more accurate and standardized to improve comparability. Also, prospective longitudinal and randomized controlled studies are important to establish the optimal dosing and the long-term effects of vitamin/mineral supplementation on periodontal health in different patient populations.