Unhealthy lifestyle = worse treatment outcomes?
PD Dr. Kristina Bertl, PhD MSc MBA
What factors contribute to an unhealthy lifestyle? The following factors are often taken into consideration, among others: poor nutrition, lack of physical activity, insufficient sleep and/or poor sleep quality, high stress level, excess alcohol consumption, regular tobacco use, etc.
In previous reports, we have talked about the effect of such individual factors on periodontal health and on the outcome of periodontal treatment. In addition to this, the S3 treatment guidelines for stage I to III periodontitis patients, particularly in the first treatment step, address improving the patient’s attitude, which, in turn, involves a reduction in any risk factors. Whilst, for example, the data situation relating to tobacco use is clear, the evidence relating to nutrition and physical activity is still somewhat inconclusive. Even more fascinating is the idea behind a current prospective clinical trial from Italy (Marruganti et al. 2023).
In this study, 120 periodontitis patients (stage II or III) were treated in accordance with the current guidelines with the first two treatment steps and re-evaluated after three months. In addition to this, data on the patients’ lifestyle was collected according to the factors listed above: poor nutrition, lack of physical activity, insufficient sleep and/or poor sleep quality, high stress level, excess alcohol consumption and regular tobacco use. The following criteria were defined as the desired treatment objective for the first two treatment steps (non-surgical periodontal treatment):
- no pocket probing depth ≥ 4 mm, exhibiting bleeding after probing
- no pocket probing depth ≥ 6 mm
Three months after treatment, the following interesting results were revealed:
- poor sleep quality, regular tobacco use and excess alcohol consumption each significantly reduced the likelihood of attaining the desired treatment outcome.
- A combination of multiple factors that contributed to a poor lifestyle (i.e. poor nutrition, little physical activity, high stress levels and poor sleep quality), significantly increased the number of residual pocket probing depths with ≥ 6 mm and significantly reduced the likelihood of attaining the desired treatment outcome.
This study therefore confirms the suspicion that a poor treatment outcome can sometimes be expected following non-surgical periodontal treatment for patients with a poor lifestyle. It will be interesting to see to what extent, and above all over what time frame, improving a poor lifestyle can actually make a positive contribution towards the treatment outcome.
- Marruganti, C., Romandini, M., Gaeta, C., Cagidiaco, E. F., Discepoli, N., Parrini, S., Graziani, F., & Grandini, S. (2023). Healthy lifestyles are associated with a better response to periodontal therapy: A prospective cohort study. Journal of Clinical Periodontology, 50(8), 1089–1100.