New research published in Scientific Reports has found that regular exercise paired with omega-3 supplementation can significantly enhance immune function and reduce the severity of chronic apical periodontitis, a type of inflammation that affects the tip of the tooth root.
Understanding Apical Periodontitis
Apical periodontitis occurs when bacteria from untreated tooth decay spread through the root canal to the apex of the tooth (the root tip), triggering inflammation in the surrounding bone. This infection can gradually destroy bone tissue in the area if left untreated.
The new study is the first to show that moderate exercise combined with omega-3 supplementation can substantially improve this inflammatory condition. Together, these two factors helped control bacterial growth, minimize bone loss, balance the production of inflammatory molecules called cytokines, and stimulate fibroblasts, the cells that repair and maintain tissues.
The Connection Between Oral and Overall Health
Untreated apical periodontitis can lead to tooth loss, but its effects extend beyond the mouth. The condition is closely linked to systemic diseases such as diabetes, metabolic syndrome, arteriosclerosis, and kidney disease. Each can worsen the other, creating a harmful feedback loop between oral inflammation and general health.
“It’s a condition that patients may not even know they have because of its chronic nature, but which can evolve and lead to bone destruction and tooth mobility. In addition, in specific situations, such as a drop in immunity, it can become acute, so the patient starts to feel pain, pus forms at the site, the face can become swollen,” explains Rogério de Castilho, a professor at the Araçatuba School of Dentistry at São Paulo State University (FOA-UNESP) in Brazil. Castilho supervised the study and is supported by FAPESP.
Exercise and Supplements Show Measurable Impact
“In rats, physical exercise alone brought about a systemic improvement, regulating the local immune response. In addition, when combined with supplementation, it further reduced the destructive condition caused by endodontic pathology,” explains Ana Paula Fernandes Ribeiro, the first author of the study, carried out during her doctorate at FOA-UNESP.
To explore these effects, researchers induced apical periodontitis in 30 rats and divided them into three groups. One group received no treatment, the second completed a 30-day swimming routine, and the third both swam and received omega-3 supplements, a fatty acid known for reducing inflammation in chronic diseases.
The swimming-only group showed improved outcomes compared to the untreated animals, but the group that both exercised and took omega-3 supplements demonstrated the greatest improvement in immune regulation and infection control.
Lower Inflammation, Stronger Bone
Detailed immune testing showed that rats receiving both interventions had the lowest levels of the inflammatory cytokines interleukin 17 (IL-17) and tumor necrosis factor alpha (TNF-α). Those that exercised without supplementation also had reduced levels compared to untreated rats, but the combination proved most effective.
Researchers also observed fewer osteoclasts — cells that break down bone — in the exercise and supplement groups, indicating less bone loss. Micro CT scans confirmed these findings: animals that swam had less loss of alveolar bone (the bone that supports teeth) than the control group, and the omega-3 group showed the greatest bone preservation overall.
Implications for Human Health
According to the authors, these results add to growing evidence that exercise and omega-3 fatty acids benefit not only systemic immunity but also oral health.
“To know if the same would be true for humans, we’d need a clinical study with a significant number of patients. However, in addition to the many proven benefits of physical exercise and omega-3 consumption, this is yet another important piece of evidence,” Jacinto says.
The work was supported by FAPESP through Scientific Initiation grants awarded to Michely de Lima Rodrigues (20/13089-3 and 22/04884-0), another co-author of the study.
