October 6, 2020

A recently published review and meta-analysis and two clinical trials reveal significant effects for omega 3 fatty acid supplementation against the common gum disease known as periodontitis. Periodontitis is the sixth most prevalent human disease worldwide and is characterized by inflammation of the gums that can result in bone and tooth loss, as well as associations with chronic diseases that include cardiovascular diseases, diabetes, cancer and respiratory diseases.

A review and meta-analysis published on May 21, 2020 in Lipids in Health and Disease included six studies that involved the use of the omega 3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the treatment of periodontitis. Dosages of EPA and DHA and duration of treatment varied. Studies reported data concerning clinical attachment level of the teeth, probing depth, gingival index, bleeding on probing and plaque index.

Meta-analysis of clinical attachment level and probing depth revealed significant improvement in association with omega 3 supplementation compared to a placebo in four of the six studies. Three studies found an association between omega 3 supplementation and gingival index. Plaque index was also reduced in association with omega 3 in three studies. “Supplementation of omega-3 fatty acids might be an easy way to improve treatment in the short and long term in patients with periodontitis,” Anne B. Kruse and her associates wrote. “The intake of fish oil capsules during periodontal therapy is easy and not too expensive to generally include it in a regular regimen. It might be harder for patients to obtain the same amount of DHA and EPA only by changing the composition of their meals.”

A randomized trial reported on May 19, 2020 in the Indian Journal of Dental Research evaluated the effects of omega 3 supplementation in 90 men and women with chronic moderate periodontitis. Forty-eight participants received 180 mg EPA and 120 mg DHA twice daily for a month in addition to subgingival scaling and root planing, while a control group received scaling and root planing only. Clinical attachment level, probing depth and plaque and gingival indexes were assessed at the beginning of the study and at one and three months.

Clinical attachment level improved at both one and three months among participants who received omega 3 in comparison with the control group and compared to levels measured at the beginning of the study. While the gingival index was reduced in both groups, the reduction was significant at the study’s conclusion among those who received omega 3.

And in another randomized trial, published on August 27, 2020 in the journal Nutrients, 30 patients with stage III and IV periodontitis received scaling and root planing while 16 of the subjects additionally received 2.6 grams EPA and 1.8 grams DHA per day. Periodontal examination conducted at the beginning and end of the study documented significant improvement in clinical attachment loss, bleeding on probing and probing depth in the group that received omega 3. Proinflammatory cytokines were lower and the anti-inflammatory cytokine IL-10 was significantly higher in salivary samples of supplemented participants than those who did not receive the supplements.

These studies provide growing evidence that omega 3 supplementation could be a promising adjunct to standard periodontitis therapy. As the authors of the review and meta-analysis noted, an alternative to antibiotics used in periodontal therapy could help solve, in part, the potential problem of antibiotic resistance in this group of patients.