Using nutritional supplements, including vitamins and antioxidants, along with scaling and root planing (SRP), may improve periodontal treatment outcomes, according to a review recently published in the International Journal of Dentistry.
Furthermore, nutritional supplements may improve periodontal health measures, including bleeding on probing (BOP) and clinical attachment loss (CAL), the authors wrote.
“Herbal extracts, probiotics, melatonin, vitamins, and antioxidants achieve relatively higher periodontal health benefits, and when combined with SRP,” wrote the authors, led by Haonuo Tang of Xiamen University in China (Int Dent J, February 23, 2026, 4249289).
This review aimed to evaluate the clinical effectiveness of supplements as an adjunct to nonsurgical periodontal therapy. Researchers searched the literature from inception to July 2024 and included patients of any age or gender diagnosed with chronic periodontal disease. The test groups received various supplements, including melatonin, antioxidants, multinutrients, probiotics, herbal extracts, minerals, and vitamins, they wrote.
Outcomes included changes in their gingival index (GI), plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) at three- and six-month follow-ups, analyzed as changes from baseline to reduce bias. In total, 79 studies were included.
Herbal antioxidants were the most effective for reducing BOP, showing significant improvements compared to placebo and other supplements (herbal antioxidants vs. placebo: mean difference [MD] = 16.06, 95% confidence interval [CI] = -10.27 to 42.35; p < 0.05). Vitamin D combined with SRP significantly improved CAL at both three and six months, outperforming multiple other interventions (vitamin D vs. placebo: MD = 1.23, 95% CI = 0.32 to 2.16; vitamin D vs. probiotics: MD = 1.12, 95% CI = 0.05 to 2.21; p < 0.05), they wrote.
Probiotics plus SRP were the most effective in reducing the GI, with significant differences compared to antioxidants (MD = 1.02, 95% CI = 0.01 to 2.04) and SRP alone (MD = 0.84, 95% CI = 0.02 to 1.66; p < 0.05). Herbal antioxidants combined with SRP produced the greatest reduction in the PI, significantly outperforming SRP alone (MD = 0.27, 95% CI = 0.09 to 0.44; p < 0.05). Melatonin showed the strongest improvement in PPD at three months, significantly reducing PPD compared to placebo (MD = 1.11, 95% CI = 0.49 to 1.74) and probiotics (MD = 1.00, 95% CI = 0.23 to 1.77; p < 0.05).
However, the study had limitations. Some findings require further validation, as limited studies and a lack of clinical trials for certain interventions may restrict the strength of the evidence, the authors added.
“Their effectiveness still needs exploration by more high-quality clinical studies,” Tang and colleagues concluded.
