Can diet really reduce gum disease?

We, as practitioners, have to keep up with many clinical journals. Sometimes it seems like there's not enough time to keep up with research in our own field, much less that outside our specialty. But, when performed properly, clinical research can present knowledge or proof that was previously unknown. Below, I describe two clinical research papers that have offered knowledge and proof that was previously unknown about gum disease.

One paper was published in 2009, and the other was published in 2016. They are the only studies that I have found that were well-designed and clearly showed how a healthy diet could reverse the signs and symptoms of gum disease.

These are not just anecdotal comments. These are clinical facts, published in peer-reviewed journals. These facts contribute serious knowledge to those who want to know.

1st study

Alvin Danenberg, DDS.

The first study was published in 2009 in the Journal of Periodontology (May 2009, Vol. 80:5, pp. 759-768). The paper was titled "The impact of the Stone Age diet on gingival conditions in the absence of oral hygiene" and included 10 individuals. For four weeks, their diet consisted of primal foods endemic to their area in Switzerland about 5,700 years ago. No processed foods were available for them to eat. These participants had to gather and forage for the majority of their food. In addition, these individuals were not able to brush or floss their teeth during the entire four weeks. Signs of gum infection were measured, and cultures of bacteria in their dental plaque were taken before and after the study.

At the end of the four-week study, there was a significant decrease in signs of gum disease even though all 10 participants could not brush or floss their teeth for the duration of the study. Although amounts of dental plaque increased, disease-producing bacteria did not increase in the plaque. These positive findings surprised the investigators.

The bottom line of that study was that a diet that completely removes processed foods reduces the signs and symptoms of gum disease.

2nd study

The second study was published in this past July in BMC Oral Health (July 26, 2016; erratum published October 6, 2016). The study, "An oral health optimized diet can reduce gingival and periodontal inflammation in humans -- a randomized controlled pilot study" was a randomized control trial consisting of 15 adult participants. Randomized control trials are well-designed and the gold standard of medical research. This type of research design is highly respected in the scientific world. In this instance, the erratum concerned the authors' forgetting to list their funding sources in the original manuscript, not a clinical issue.

The trial consisted of 15 people who had signs of gum disease and were eating a diet heavily based on carbohydrates. Ten individuals made up the experimental group, and five made up the control group.

The participants in the experimental group had to change their diet. Their new diet consisted of foods low in carbohydrates, rich in omega-3 fatty acids, and abundant in vitamins C and D, antioxidants, and fiber. The control group participants did not change their eating habits. As far as oral hygiene was concerned, researchers told all 15 participants not to clean between their teeth with dental floss or interdental brushes. However, they did not have to change the way they brushed their teeth.

The four-week study began after each group had a few weeks to acclimate to these changes. Researchers recorded the signs of gum disease in all participants at the start and end of the study.

At the conclusion of the trial, the researchers found that all disease parameters decreased significantly in the experimental group by about 50% from the starting point. In contrast, all inflammatory markers increased from the starting point in the control group.

The bottom line was that a diet that eliminates sugars and processed grains and includes nutrient-dense foods can reduce the signs and symptoms of gum disease.

Take-home message

Nutrient-dense, anti-inflammatory foods frequently can reverse the signs and symptoms of gum disease. This type of diet is what I have been preaching for the last four years, and this type of diet is what I have embraced personally with observable health benefits.

A version of this column first ran on Dr. Danenberg's blog. DrBicuspid.com appreciates the opportunity to reprint it.

Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is drdanenberg.com.

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