Healthy Dietary Patterns on Clinical Periodontal Parameters: A GRADE Compliant Systematic Review and Meta-analysis

Purpose of review To evaluate the impact of healthy dietary patterns compared to the Western diet on periodontal indices in adults, used in the prevention and treatment of periodontal diseases. Recent findings Four RCTs and seven case–control studies were included on a critical appraisal of the evidence using GRADE, based on random effects meta-analysis by methodological subgroups for periodontal indices, and a narrative synthesis. There is a clinically significant reduction on bleeding on probing, Gingival Index and periodontal inflamed surface area, Calculus and Debris Index and incidence of tooth loss on healthy dietary patterns group, with a very low to moderate certainty of the evidence. Methodological complementation between included studies allows to consider “real-world data” that RCTs ignore, which have a significant effect on this association. Although biological plausibility is reported, more studies are required to clarify these results. Summary healthy dietary patterns could impact on periodontal health–disease status, reducing the global burden of periodontal diseases by improving the results of the standard care actions, such as toothbrushing, interdental cleaning and periodontal therapy. Further research is required to improve the quality of the evidence.