Calcium and the risk for periodontal disease

Background: Dietary calcium has long been a candidate to modulate periodont al disease. Animal as well as human studies of calcium intake, bone mineral density, and tooth loss provide a rationale for hypothesizing that low die tary intake of calcium is a risk factor for periodontal disease. Methods: We evaluated the role of dietary calcium intake as a contributing risk factor for periodontal disease utilizing the Third National Health and Nutrition Examination Survey (NHANES III), which is representative of the U.S. civilian non-institutionalized population. Dietary calcium intake was determined from a 24-hour dietary recall. The U.S. Department of Agricultur e Nutrient Database was used as a source of nutrient composition data. Peri odontal disease was measured by attachment loss. In addition, serum calcium was assessed using venous blood samples. Logistic regression analysis was used to examine the association between periodontal disease and dietary cal cium intake or serum calcium levels after adjusting for covariants includin g age, gender, tobacco consumption, and gingival bleeding. Results: The association of lower dietary calcium intake with periodontal d isease was found for young males and females (20 to 39 years of age), and f or older males (40 to 59 years of age). The relationship between low dietar y calcium intake and increased levels of periodontal disease showed an esti mated odds ratio (OR) of 1.84 (95% CI: 1.36 to 2.48) for young males, 1.99 (95% CI: 1.34 to 2.97) for young females, and 1.90 (95% CI: 1.41 to 2.55) f or the older group of males. These odds ratios were adjusted for gingival b leeding and tobacco consumption. The dose response was also seen in females , where there was 54% greater risk of periodontal disease for the lowest le vel of dietary calcium intake (2 to 499 mg) and 27% greater risk in females who took moderate levels of dietary calcium (500 to 799 mg) as compared to those who took 800 mg or more dietary calcium per day. A statistically sig nificant association between low total serum calcium and periodontal diseas e was found in younger females aged 20 to 39 with OR = 6.11 (95% CI: 2.36 t o 15.84) but not for males or older females, after adjusting for tobacco us e, gingival bleeding, and dietary calcium intake. Conclusions: These results suggest that low dietary intake of calcium resul ts in more severe periodontal disease. Further studies will be needed to be tter define the role of calcium in periodontal disease and to determine the extent to which calcium supplementation will modulate periodontal disease and tooth loss.