Severe gum disease can be difficult to control, and some patients are given antibiotics in addition to standard dental treatment.
A new clinical trial suggests that a combination of omega-3 fatty acids and low-dose aspirin may produce similar results without relying on antibiotics.
The study was carried out by researchers from Albert Einstein Israelite Hospital, Guarulhos University, the University of Taubaté and the Ribeirão Preto School of Dentistry at the University of São Paulo in Brazil, together with Harvard University in the United States. The findings were published in the Journal of Periodontology.
Periodontitis is a long-lasting infection and inflammation of the tissues that hold teeth in place.
It usually begins when bacteria build up around and below the gum line, causing the gums to become inflamed and creating spaces, known as pockets, between the gums and teeth.
In advanced disease, these pockets can become very deep and difficult to clean. Bacteria can remain inside them, while continuing inflammation can damage the bone around the teeth and eventually cause teeth to loosen or fall out.
Standard treatment includes a deep cleaning procedure below the gum line to remove bacterial deposits from the roots of the teeth. In severe cases, dentists may sometimes add antibiotics such as amoxicillin and metronidazole, but unnecessary antibiotic use can contribute to drug-resistant bacteria.
The new trial followed 109 people with advanced periodontitis for one year. Everyone received the standard deep cleaning treatment, but participants were randomly assigned to receive different additional treatments.
One group received inactive capsules as a comparison. A second group took amoxicillin and metronidazole three times a day for 14 days, while a third group took three grams of omega-3 each day together with a low dose of aspirin for six months.
A fourth group received both approaches, taking the antibiotics for two weeks and omega-3 plus low-dose aspirin for six months. Researchers checked the participants again after three, six and 12 months to see how well their gums had responded.
At the end of the study, about 58% of people who received antibiotics reached the researchers’ treatment goal. This meant they had no more than four deep gum pockets remaining.
The omega-3 and low-dose aspirin group performed almost identically, with 57.7% reaching the same goal. By comparison, only 23.1% of people who received standard cleaning and inactive capsules achieved that result.
Surprisingly, giving antibiotics together with omega-3 and aspirin did not provide an extra advantage. The researchers had expected the combined treatment to perform best, so the similar results from omega-3 and aspirin alone were unexpected.
Omega-3 fats are found naturally in foods such as oily fish and are involved in processes that help the body control inflammation. Rather than simply blocking inflammation, some substances made from omega-3 may help the body bring an inflammatory response to an end and support tissue repair.
The researchers used low-dose acetylsalicylic acid, commonly known as aspirin, because it may help the body produce some of these inflammation-resolving substances. Their idea was that helping the body control its own inflammatory response could improve gum healing after deep cleaning.
The benefits also appeared to last. Participants who stopped taking omega-3 and aspirin after six months still showed similar improvements when they were examined six months later, although researchers do not yet fully understand why the effect continued.
The findings could be important because antibiotic resistance is a growing worldwide health problem. If future studies confirm the results, an approach that reduces antibiotic use could be useful for selected patients, including some people who cannot tolerate commonly used antibiotics.
However, the study does not mean that people with gum disease should start taking high-dose omega-3 and aspirin on their own. Aspirin can increase bleeding risk and may be unsuitable for people with certain medical conditions or those taking particular medicines.
There are also limits to the study. It involved a relatively small group of patients who did not have major systemic or oral diseases, so the results may not apply to everyone with severe periodontitis.
The researchers are now studying how the treatments changed bacteria living inside the gum pockets. Early findings suggest that harmful bacteria may decrease while bacteria linked to healthier gums may become more common, but more work is needed.
Overall, the trial provides encouraging evidence that controlling the body’s inflammatory response may become another tool for treating severe gum disease. The close match with antibiotic results is promising, but larger studies in more diverse patients are needed before dentists can consider omega-3 and low-dose aspirin a routine replacement for antibiotics.
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