Vitamin D deficiency and periodontal clinical attachment loss in HIV-seropositive women: A secondary analysis conducted in the Women's Interagency HIV Study (WIHS)

Vitamin D deficiency and oral health: a systematic review of literature

BACKGROUND

Vitamin D (VD) levels are gaining increasing interest in dentistry due to their association with several oral diseases.

OBJECTIVE

This study aimed to evaluate the relationship between vitamin D deficiency and various oral disorders.

MATERIALS AND METHODS

A broad search on the MEDLINE database via the PubMed interface and on the Spring Link platform was carried out using keywords related to the subject. An additional electronic search of gray literature was conducted via Google Scholar. Inclusion criteria were listed for the selection of articles and a reading grid was designed for the extraction of data relating to the research question. The quality of included studies was assessed using JBI's critical appraisal tools.

RESULTS

A total of 57 studies were identified. After reading the full text, 16 studies were included and selected for qualitative analysis. There is an association between vitamin D deficiency and different oral disorders. Indeed, ten publications assessed the association between vitamin deficiency and periodontal disease, three examined the relationship between vitamin D deficit and dental caries, and one examined the intriguing relationship between vitamin D deficiency and tooth mineralization and two articles interested in vitamin D deficiency and stomatitis.

CONCLUSION

The analysis of these selected articles shows that Vitamin D deficiency can lead to various oral health disorders during growth and adulthood. Indeed, it can be linked to tooth mineralization defects and increasing the risk of dental caries. Severe Vitamin D deficiency also increases the prevalence of periodontitis and gingival inflammation. It may also be linked to certain oral pathology entities, such as oral cancers and jaw osteonecrosis.

Could Vitamin D influence risk for Periodontal Disease - to "D" or not to "D"?

PURPOSE OF REVIEW

The purpose of this review is to discuss the literature on associations between vitamin D and periodontal disease, including its strengths and weaknesses. Future direction for continued work in this area is provided.

RECENT FINDINGS

Research in cross-sectional cohorts, surveys, and case-control studies provide support for a role of vitamin D in periodontal disease, especially using clinical indicators such as bleeding on probing and clinical attachment loss. However, these studies have a number of limitations. They cannot establish temporality of these associations. Most case-control studies have been limited in sample size and have inconsistent findings. A number of cross-sectional studies are restricted to select populations (e.g., persons with HIV, diabetes, rheumatoid arthritis) limiting extrapolation of findings to the general aging population.Fewer prospective studies have been conducted, and only three have examined associations using a biomarker for vitamin D that reflects exposure from all its sources (sunlight, diet and supplements). One study is limited by using self-reported measures of disease outcomes, and only two used measures of alveolar crestal height. However, of the prospective studies published, there is a suggestion that vitamin D might prevent against tooth loss. Only two randomized controlled trials have examined these associations, and they support the effects of vitamin D supplementation on prevention of tooth loss and gingival bleeding.

SUMMARY

We strongly suggest that new research should focus on prospective study designs with followup of participants longer than a decade and long-term clinical trials. Such studies should incorporate measures of alveolar bone loss and tooth loss with indication for reason for tooth loss. Such clinical trials should be designed to examine both the influence of vitamin D supplementation alone as well as with other nutrients (e.g., calcium) or therapeutic medications (e.g., bisphosphonates). Currently, there is no strong evidence to suggest that vitamin D protects against development of periodontal disease.