Omega-3 Supplementation in Combination With Exercise Could Aid Tooth Root Infections

Physical exercise in combination with omega-3 supplementation was reported to improve the immune response and reduce the severity of chronic apical periodontitis, according to findings published by investigators in the journal Scientific Reports. The study authors noted that the regimen improves symptoms caused by the inflammatory condition by limiting bacterial progression, reducing bone tissue loss, regulating the release of proinflammatory cytokines, and stimulating the activity of fibroblasts.^1,2

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Overview of Apical Periodontitis

As an inflammatory condition, apical periodontitis occurs following bacterial contamination of the pulp tissue, causing infiltration of microorganisms into the root canal system. When an infection reaches a tooth’s apex, a periapical lesion forms, intensifying the body’s immune response. If this response fails to control bacteria, immune cells release mediators like tumor necrosis factor-alpha (TNF-α) and IL-17, which promote osteoclastogenesis (bone-resorbing cell formation) and lead to bone loss. Tartrate-resistant acid phosphatase (TRAP), an enzyme from osteoclasts, further degrades bone and is a key marker for this inflammation-driven bone destruction, according to investigators.¹

“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, and the face can become swollen,” Rogério de Castilho, a professor at the Araçatuba School of Dentistry at São Paulo State University (FOA-UNESP) in Brazil, said in a news release.²

Exercise Alone or Combined with Omega-3 Supplementation

Physical exercise is known to promote immunomodulation while enhancing the host’s immune response. Additionally, omega-3 polyunsaturated fatty acid is reported to have therapeutic effects against chronic inflammatory diseases. However, there is limited research on how physical exercise alone, or in combination with omega-3 supplementation, could impact apical periodontitis.^1,2

In an experimental study, researchers included a total of 30 male Wistar rats that were aged 6 weeks, weighed around 200 g, and had apical periodontitis. The rats were divided into 3 groups: control (C), physical exercise (PE), and physical exercise + omega-3 (PEO). In group C, 10 rats were included without physical exercise and supplementation, as 10 rats in PE were subjected to moderate physical exercise and no supplementation, and the remaining 10 rats partook in moderate physical exercise and supplementation. The rats were maintained in a temperature-controlled room with a 12-hour light-to-dark cycle, and physical activity included 60 minutes of swimming.¹

The results demonstrated that all rat teeth samples displayed pulp necrosis and periapical lesion formation after 30 days. Group C showed significantly higher inflammatory infiltrate intensity, with 3 out of 10 samples scoring a 2, 4 out of 10 scoring a 3, and the remaining 3 scoring a 4. This differs from the PE group and the PEO group, where no significant difference was observed between the 2 groups.^1,2

“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,” Ana Paula Fernandes Ribeiro, the first author of the study, who received her doctorate at FOA-UNESP, said in the news release.²

The findings suggest that the rats who did not receive treatment had moderate levels of cytokines, those that only exercised had lower levels, and those that exercised in combination with omega-3 supplementation had the lowest.^1,2

“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 said in the news release.²

REFERENCES

1. Ribeiro, A.P.F., de Lima Rodrigues, M., Loureiro, C. et al. Physical exercise alone or combined with omega-3 modulates apical periodontitis induced in rats. Sci Rep 15, 8760 (2025). https://doi.org/10.1038/s41598-025-90029-9

2. A combination of exercise and omega-3 reduces the severity of tooth root infections. EuerkAlert!. News release. June 11, 2025. Accessed June 18, 2025. https://www.eurekalert.org/news-releases/1087189