The oral cavity contains about 700 species of bacteria (1). Periodontitis affects 40%-90% of the population, with the majority being over 65 years old (2).
Chronic periodontitis is a common cause of tooth loss. Preventing tooth loss in the elderly is important for nutritional status and quality of life. Vitamins and other nutrients may help teeth, gums, and periodontal health.
What is Periodontal Disease?
Periodontal diseases are inflammatory conditions affecting the tissue around the teeth and their supporting structure (3). Periodontal disease and gum disease are frequently used interchangeably.
In periodontal disease when plaque forms and bacteria increases, inflammation occurs. This leads to tissue breakdown and if untreated, tooth loss (4). It is the primary cause of tooth loss in old age (5).
Periodontal Disease Classifications
The American Academy of Periodontology has broken up periodontal diseases into several classifications.
Gingivitis
Gingivitis is inflammation of the gums, usually caused by poor oral hygiene. It is an early form of gum disease.
Periodontitis
When gingivitis is untreated it can lead to periodontitis. Periodontitis is inflammation around the teeth, shrinking gums, and causing teeth to loosen.
Periodontal Manifestations of Systemic Diseases and Developmental and Acquired Conditions
Some systemic conditions and medications affect periodontal tissue and can lead to periodontitis (6). Examples include:
- Down syndrome
- Leukocyte adhesion deficiency (LAD) syndromes
- Papillon-Lefevre syndrome
- Haim-Munk syndrome
- Chediak-Higashi syndrome
- Neutropenia
- Immunodeficiency diseases
- Cohen syndrome
- Epidermolysis bullosa
- Plasminogen deficiency
- Ehlers-Danlos syndrome
- Angioedema
- Lupus
- Gaucher disease
- Glycogen storage disease
- Hypophosphatasia
- Hypophosphatemic rickets
- Hajdu-Cheney syndrome
- Diabetes (DM)
- Osteoporosis
- HIV
- Epidermolysis bullosa acquisita
- Inflammatory Bowel Disease (IBD)
- Arthritis
- Depression
- Neoplasms
- Granulomas
- Hyperparathyroidism
- Systemic sclerosis
Peri-Implant Disease and Conditions
Peri-implant diseases cause inflammation of gum tissue around a dental implant. They are broken into two categories:
- Peri-implant Mucositis: inflammation of the soft tissue around the dental implant without presence of bone loss
- Peri-implantitis: gum inflammation with breakdown of the bone supporting the implant.
Risk Factors
Older adults are especially at risk for periodontal disease due to age related physiological changes. Other risk factors include:
- Smoking
- Genetics
- Oral hygiene
- Teeth misalignment
- Uncontrolled diabetes
- High sugar diet
- Tooth loss
- Taste changes
- Poor appetite
- Difficulty chewing
- Drug abuse
- Cardiovascular disease
Nutrition and Periodontal Health
Various nutrients have evidence of positively impacting periodontal disease. Maintaining oral health is especially important for older adults as to not further limit food choices.
Vitamins for Teeth and Gum Health
Poor oral health can lead to malnutrition and vice versa. Research suggests some vitamins have preventative effects or ability to improve traditional periodontal treatment.
B Vitamins
B vitamins are a category of water soluble vitamins including vitamin B12, biotin, folate, niacin, riboflavin, thiamin, vitamin B5, and vitamin B6. B complex vitamins help healing after surgery for chronic periodontitis (7).
Vitamin C
Vitamin C is an antioxidant found in citrus fruits, peppers, broccoli, tomatoes, among others. It improves periodontal disease and may have preventative effects also (8). Inadequate vitamin C contributes to bleeding gums (9).
Vitamin D
Vitamin D is a fat soluble vitamin needed for calcium absorption, bone metabolism, and other bodily functions. It is found in oily fish, fortified milk, supplements, and formed from sunlight exposure.
Vitamin D deficiency can progress periodontal disease, increase risk for gingivitis, and chronic periodontitis (10). Supplementation may be a beneficial prophylaxis prior to dental work (11). These oral health benefits may be related to vitamin D’s anti-inflammatory properties (12).
Vitamin E
Vitamin E is a fat soluble vitamin that acts as an antioxidant. It is found in nuts, seeds, and plant oils. Vitamin E may improve the effectiveness of periodontitis treatment (13).
Other Nutrients for Periodontal Health
Lycopene
Lycopene is the red color found in foods such as tomatoes. It may improve periodontal health, however how this works is unclear (14).
Calcium
Calcium is needed for bone and teeth maintenance. Deficiency increases risk for periodontitis (15). Supplementation improves non-surgical periodontal treatment (16).
Magnesium
Magnesium is needed for bone formation. It is found in nuts, seeds, whole grains, and legumes. Consuming magnesium foods or supplementation may improve periodontal non-surgical intervention (17).
Carbohydrates
Carbohydrates are the main source of energy for the body, especially the brain. Some carbs are complex with fiber such as fruits, vegetables, whole grains, etc. Others are simple like sugar.
Sugar intake can cause increased plaque. This leads to bacteria forming, then acid, which can cause cavities and breakdown of tooth structure (18).
Omega 3 Fatty Acids
Omega 3 fatty acids are essential fats found in fish, nuts, seeds, some plant oils, and supplements. When consumed in addition to traditional periodontitis treatment, omega 3 fatty acids may improve outcomes (19).
Polyphenols
Polyphenols are compounds found in plant foods having health benefiting properties such as anti-inflammatory effects. Consuming foods with polyphenols may positively impact periodontal disease prevention and treatment (20).
Final Thoughts
Poor oral health, mouth pain, and periodontal disease can negatively impact nutritional intake in older adults. Research shows that consuming certain vitamins and other nutrients can improve oral health.
Eating a varied diet including many plant foods may assist in preventing periodontal disease and/or improve its treatment.
This was very informative. It confirms why I am blessed with good teeth. I will share this with my husband who is not so fortunate. Thank you Lori.
I enjoyed this article on a personal level. It gave me pause to consider how I might improve my own dietary intake for better oral health. Thank you Lori.