Association Between Magnesium Levels and Periodontal Disease: A Systematic Review

Periodontal disease, a persistent inflammatory disorder that damages tissues supporting the teeth, is mainly triggered by an imbalanced microbial biofilm and an overactive immune-inflammatory reaction. Recent studies underscore the possible contribution of micronutrient shortages, especially in magnesium, in the progression of periodontitis. This systematic review synthesizes evidence on the association between magnesium levels, the magnesium/calcium (Mg/Ca) ratio, and periodontal disease, focusing on blood-based measures and dietary intake. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, Cochrane Library, and Google Scholar from inception to May 2024, including 10 observational and experimental studies in adults. Narrative synthesis revealed consistent inverse associations: higher magnesium levels correlated with reduced probing pocket depth, clinical attachment loss, and periodontitis prevalence, while favorable Mg/Ca ratios protected against progression (e.g., odds ratio of 6.28 for low ratios). Systemic associations, particularly with diabetes, showed lower magnesium in comorbid cases, with post-treatment improvements suggesting anti-inflammatory benefits. Heterogeneity precluded meta-analysis. These findings highlight the protective role of magnesium, warranting large-scale trials to guide supplementation and dietary strategies for periodontal management.