Patient Experiences of a Four-Week Sugar Avoidance During Periodontal Therapy: A Qualitative Analysis of a randomized controlled clinical trial

Background and Aim: Excessive sugar intake is a central cause for caries and is associated with gingival inflammation and periodontitis. Although dietary changes have demonstrated clinical benefits, little is known about the practicability and patient perspective on sugar avoidance. Aim of this qualitative study was to explore experiences of patients who undertook a four-week sugar avoidance as an adjunct to non-surgical periodontal therapy (Step 1–2). Methods: Patients of the experimental group from a randomized controlled trial were interviewed using semi-structured phone interviews. Interviews were analyzed software-based using structured qualitative content analysis per Kuckartz and Rädiker’s framework. Categories were generated inductively and deductively with an intercoder reliability of > 0.8. Results: From ten patients of the experimental group (sugar-avoidance group), eight patient interviews could be analyzed. The qualitative analysis showed that three patients experienced initial withdrawal (e.g., headaches, cravings). Seven patients reported improved well-being, increased dietary awareness, and sustained reduction in sugar consumption. Challenges of sugar avoidance included social pressure, emotional dependency on sweets, and lack of governmental support. Conclusions: A structured four-week sugar avoidance adjunctive to non-surgical periodontitis therapy was perceived by patients as challenging initially but ultimately beneficial for physical, psychological, and sensory well-being. Patient-centered nutritional counseling should consider possible withdrawal symptoms and social challenges when addressing sugar avoidance. Trial registration: DRKS00026699, Date of registration: 14.10.2021