Association between Dietary Habit and Clinical Parameters in Patients with Chronic Periodontitis Undergoing Supportive Periodontal Therapy

Abstract

The recurrence risk evaluation has been emphasized in periodontal stabilization during supportive periodontal therapy (SPT). However, nutritional factors, e.g., dietary habits such as the frequency of eating vegetables, are rarely included in the evaluation. In this study, the effect of nutritional factors on clinical periodontal parameters was examined in a lifestyle-related investigation and a periodontal examination in patients with periodontitis undergoing SPT. A total of 106 patients were recruited. Tendencies toward a negative correlation were found between rate of a probing depth (PD) of 4–5 mm, rate of PD ≥ 6 mm, the bleeding on probing (BOP) rate, periodontal inflamed surface area (PISA), and various nutritional factors. The number of teeth was a clinical parameter with a significantly high R2 (≥0.10) influenced by environmental factors, whereas PD, PD of 4–5 mm, the BOP rate, and PISA were influenced by nutritional factors. These results suggested that environmental factors reflected clinical parameters showing long-term pathophysiology, such as the PD rate. Nutritional factors tended to affect the current inflammatory pathophysiology, such as the BOP rate, PISA, and PISA/periodontal epithelial surface area. Therefore, environmental and nutritional factors appear to be useful for evaluating the risk of periodontitis during SPT.

Identification of Nutritional Factors to Evaluate Periodontal Clinical Parameters in Patients with Systemic Diseases

“…The results of the questionnaires on lifestyle habits regarding nutritional and environmental factors are shown in Table S2 , and a frequency table is shown in Table S3 [ 18 ]. Histograms close to the normal distribution were seen for most of the nutritional factors; however, rice was concentrated around scores 6 and 7.…”

“…The Br index and body mass index (BMI) [ 37 ] were calculated from the data. The items in the nutritional questionnaire, including dietary habits, were selected and modified based on the 2017 National Health and Nutrition Survey in Japan ( Table S1 ) [ 18 ]. The questionnaires were self-reported by the participants.…”

“…According to the results of the multiple regression analysis, six clinical parameters (number of teeth, PD, CAL, BOP rate, PISA, PESA, and PISA/PESA) were selected and stratified by the clinical standard [ 6 , 38 ], and then stratified descriptive statistics were performed between the clinical parameters and environmental and nutritional factors. The sample sizes were confirmed using the effect size (dose: 0.873) that calculated Yogurt score in evaluating the frequency by same guide ( Table S1 ), an alpha risk of 0.05 in a two-sided test by software (G*Power 3.1.9.7) [ 18 ]. The calculated sample size was over 29 subjects in each group.…”

“…Close links have been reported between periodontal disease and nutritional status, including vitamin A [ 15 ], vitamins C and E, calcium [ 16 ], carotenoids, which have antioxidant effects, and calcium and magnesium, which are associated with bone metabolism [ 17 ]. Our previous study showed that the intake frequencies of dark green vegetables and yogurt influenced periodontal status, as confirmed by statistical analysis between questionnaire scores for nutritional factors and clinical parameters in patients with periodontitis undergoing supportive periodontal therapy (SPT) [ 18 ]. The results suggested that β-carotene antioxidants and changes in the gut microbiome after yogurt consumption affect periodontal status.…”

“…Patients with these systemic diseases receive instruction in regard to their dietary habits [ 30 , 31 , 32 , 33 ]; therefore, these instructions may influence the association between periodontal parameters and nutritional factors. However, our previous study demonstrated that the frequency of yogurt and dark green vegetable consumption had positive effects on periodontal stabilization [ 18 ].…”