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Title A High-Fiber Diet Is Effective at Reducing Periodontal Disease Risk in Adults
Clinical Question In adults, how effective is a high-fiber diet compared to a low-fiber diet in preventing periodontal disease?
Clinical Bottom Line A high-fiber diet is effective at reducing periodontal disease risk in adults. This is supported by a systematic review of several longitudinal studies in which adults who had a diet containing higher amounts of fiber showed lower rates of periodontal disease as opposed to a low-fiber diet. Nutritional counseling with emphasis on higher fiber intake is well within the capacity of any dental professional.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 31397482O'Connor/20202,348 adults >60 in 9 studiesSystematic review
Key resultsOf the included nine studies, Schwartz/2012 suggested a positive association between dietary intake of fiber and periodontal health among adults >60 years, showing a CI of 0.6-0.95 for alveolar bone loss from and CI of 0.53-0.97 for tooth loss. The upper limits of these intervals are close to 1, which may suggest little association between the two.
#2) 27798338Nielsen/20166,052 adults participating in NHANESRetrospective Cohort study
Key resultsAn inverse relationship between fiber intake and periodontal disease was found in US adults ≥30 yrs. It was mostly associated with low whole-grain intake. Lowest quartile of fiber intake was associated with moderate-severe periodontitis compared to the highest quartile range; OR=1.3 (95% CI: 1.00, 1.69).
Evidence Search Pubmed: Keyword “dietary fiber” and “periodontal disease”
Comments on
The Evidence
The best evidence addressing this clinical question was a prospective cohort study; this study design has its limitations as for desirable results but is the best study design for this subject. It would be difficult to withhold a positive treatment for patients to use as a control group. The Nielsen (2016) study design is presumably cross-sectional, which does not infer cause and effect but association only.
Applicability Dietary fiber intake can and should be used as a preventive measure for periodontal disease and for overall periodontal health. This can be applied to all ages at a relatively low cost to the patient. Proper nutritional instructions and guidelines should be incorporated into general practice as much as, or in conjunction with, oral hygiene instructions. Due to lack of knowledge of what are high fiber dietary sources, it will be on the clinician to properly instruct the patient on how to incorporate more fiber into their diet and the importance of this change.
Specialty/Discipline (Public Health) (General Dentistry) (Periodontics) (Prosthodontics)
Keywords Dietary fiber, Periodontal disease
ID# 3477
Date of submission: 12/09/2021spacer
E-mail mcwhorterr1@uthscsa.edu
Author Kellen McWhorter, DMD
Co-author(s) Cynthia Udeh, DDS
Co-author(s) e-mail udeh@uthscsa.edu
Faculty mentor/Co-author Konstantina Angelara, DDS
Faculty mentor/Co-author e-mail angelara@uthscsa.edu
Basic Science Rationale
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