Calcium and periodontitis: Clinical effect of calcium medication

Abstract

In contrast to the generally held concept that periodontal disease is caused by microorganisms, Henriksson (1968) suggested that a nutritional deficiency of calcium might be the cause. He elicited secondary hyperparathyroidism in beagles from a low calcium/high phosphorus diet and found that the osteolytic demineralization of bone that followed seemed to involve alveolar bone more than other bones. In a report on 10 persons with advanced periodontal disease, Krook et al. (1972) stated that the disease was reversed when they were given 1 g Ca/day for 180 days. These results have been disputed. The present study is an attempt to repeat the experiment performed by Krook et al. (1972) under more stringent conditions. The hypothesis that calcium supplementation reverses destructive periodontal disease is tested. 66 persons referred to our clinic for periodontal problems were prescribed at random calcium (1 g) or placebo tablets daily during a trial period of 180 days. Their periodontal status was examined at day 0 and at day 180. The parameters used for comparison were Plaque Index, Gingival Index, probing depth, mobility and furcation involvement. The radiographically registered level of alveolar bone was also recorded, but subsequently discarded since no change could be ascertained. The patients were interviewed as to their consumption of calcium via milk and cheese at days 90 and 180. This was in order to estimate roughly whether or not their dietary calcium consumption was adequate. The recommended allowance of 800 mg/day was used as a reference. During the trial period 7 persons withdrew -- 2 from the test group and 5 from the control group. This was due mainly to digestive disorders, reported by the patients. A comparison at day 0 between the 31 test and 28 control patients revealed no statistical differences concerning the periodontal parameters studied. At day 180 both groups showed a slight improvement in Plaque Index, Gingival Index and probing depth; however, there was still no statistical difference between them. The dietary analysis established a low calcium consumption among 1/3 of the patients. Even in these cases calcium supplementation had no effect. It is concluded that calcium supplementation for 180 days does not influence the periodontal status of patients with moderate to advanced periodontal disease. Secondly, patients on a low calcium diet do not differ from those receiving an adequate supply. Finally, the study cannot support the hypothesis that calcium deficiency is a main cause of destructive periodontal disease.

Relationship between folic acid intake and gingival health in non-smoking adults in Japan

“…In our study, calcium deficiency was not selected as a significant factor for periodontal disease. Likewise, another study also reported that calcium deficiency is not a main cause of periodontal disease, as they did not find any changes in marginal bone level or density in radiographic assessment (Uhrbom and Jacobson, 1984). Further studies are needed to determine the possible micronutrients that contribute to gingival or periodontal health.…”

Micronutritional approaches to periodontal therapy

“…Results showed that the intake of grapefruit leads to an increase in plasma vitamin C levels and improved sulcus bleeding scores. Uhrbom & Jacobson (1984) reported a placebo controlled trial investigating the effect of calcium supplementation (1 g per day for 180 days) on the periodontal condition of periodontitis patients but were unable to show an effect. The use of calcium and vitamin D oral supplements was evaluated retrospectively by Miley et al (2009) in subjects receiving periodontal maintenance therapy.…”

One‐Year Effects of Vitamin D and Calcium Supplementation on Chronic Periodontitis

“…In other studies, low calcium intakes were associated with alveolar bone loss in periodontal disease patients and calcium supplementation decreased inflammation and crestal alveolar bone loss, and reduced probing depth and tooth mobility 24‐27 . However, other investigators were not able to reproduce these results 28 . More recently, analyses of the Third National Health and Nutrition Examination Survey (NHANES III), which included 12,000 adults, revealed significant associations between periodontal health and vitamin D and calcium intakes 29,30 .…”