Which diet causes periodontitis?

Most dietary patterns do not contribute to periodontitis extent, but one rich in salad, fruit, and vegetables and with plain water or tea to drink is associated with lower clinical attachment loss (CAL) extent, suggests a recent study.

The authors used two 24-hour dietary recalls and periodontal examination data from the cross-sectional US NHANES (2009–2014; n=10,010) to examine potential associations between diet and periodontitis. They extracted dietary patterns using treelet transformation, a data-driven hierarchical clustering and dimension reduction technique.

Robust logistic quantile regression, adjusting for age, sex, ethnicity, education level, smoking, body mass index, and diabetes, was used to estimate associations between each pattern (treelet component [TC]) and extent of periodontitis (proportion of site with CAL ≥3 mm).

Eight TCs explained 21 percent of variation in diet, of which one (TC1) correlated with CAL extent. High TC1 scores were characterized by a diet rich in salad, fruit, vegetables, poultry and seafood, and plain water or tea to drink.

A substantial negative gradient was noted in CAL extent from the lowest to the highest decile of TC1 (median proportion of sites with CAL ≥3 mm: decile 1, 19.1 percent; decile 10, 8.1 percent; decile 10 vs decile 1 odds ratio, 0.67, 95 percent confidence interval, 0.46–0.99).

“Treelet transformation may be a useful approach for calculating dietary patterns in nutrition research,” the authors said.

Periodontitis is a major cause of tooth loss globally and is associated with age, smoking, and diabetes.