Effect of yogic breathing (pranayama) on periodontal health status, salivary oxidative stress, and antioxidant levels in adults aged 35 to 44 in India: a cross-sectional study.

BACKGROUND: The overproduction of oxygen-derived free radicals and their byproducts, as well as a deficiency in antioxidants, are key factors in the progression of periodontitis. Pranayama, a yogic practice, involves deliberate, rhythmic, and intense movements and expansion of the respiratory organs. Engaging in rhythmic breathing exercises has been proven to lower resting levels of inflammatory cytokines and enhance the oxidant-antioxidant defence system. The objective of this study is to analyse the levels of salivary total antioxidant capacity (TAC) and salivary oxidative stress markers in individuals who regularly practice pranayama. MATERIALS AND METHOD: This cross-sectional study included 224 participants aged between 35 and 44 years, divided into two groups: 112 individuals practicing pranayama regularly (exposed group) and 112 individuals with no history of pranayama practice (control group). The periodontal health status of both exposed and unexposed group was evaluated using Community Periodontal Index (CPI). Salivary TAC and Malondialdehyde (MDA) levels were assessed using the double antibody sandwich Enzyme-Linked Immunosorbent Assay (ELISA) and the Thiobarbituric Acid Reactive Substances (TBARS) method, respectively. RESULTS: The pranayama group showed a significantly higher mean salivary TAC (0.58 +/- 0.098) compared to the control group (0.50 +/- 0.090) (p = 0.000). In contrast, the mean salivary MDA levels were notably lower in the pranayama group (0.44 +/- 0.09) than in the control group (0.60 +/- 0.11) (p = 0.000). CONCLUSION: The findings indicate that regular pranayama practice lowers salivary oxidative stress levels while increasing salivary antioxidant levels. Therefore, pranayama may serve as a complementary approach for promoting periodontal health. CLINICAL RELEVANCE: Pranayama has demonstrated positive effects on stress by lowering cortisol levels, a key stress marker. It also promotes phagocytosis and regulates the production of fibroblasts and epithelial cells, thereby improving periodontal health. Consequently, pranayama could be considered a complementary alternative therapy alongside conventional periodontal treatments in the future.