Vitamin D Deficiency and Oral Health

Introduction:

Vitamin D is a fat-soluble vitamin that helps the body absorb calcium, magnesium, and phosphate, allowing for appropriate bone formation and preservation. To maintain a healthy vitamin D level, a circulating level of 25-hydroxyvitamin D greater than 30 ng/mL is required. Vitamin D insufficiency can cause a variety of issues, the most common of which are rickets in children and osteoporosis in adults.

Vitamin D aids calcium absorption in the body. One of the most important components of bone is calcium. Vitamin D is also important for the neurological, muscular, and immunological systems. Vitamin D can be obtained through the skin, diet, and supplementation. After being exposed to sunlight, the body produces vitamin D. However, because too much sun exposure can cause skin aging and cancer, many seek vitamin D from alternative sources.

What Is the Recommended Amount of Vitamin D?

The daily vitamin D needs are determined by age. The following are the recommended amounts in international units (IU):

People at a greater risk of vitamin D insufficiency may require more vitamin D. It is advisable to consult the doctor to determine the vitamin D requirement of each individual.

What Are the Causes of Vitamin D Deficiency?

A variety of factors can cause vitamin D insufficiency. These include:

• Insufficient Dietary Intake or Reduced Absorption:

Vitamin D deficiency (VDD) can be linked with a variety of malabsorption syndromes, including short bowel syndrome, celiac disease, gastric bypass, inflammatory bowel disease, cystic fibrosis, and chronic pancreatic insufficiency. Oral vitamin D deficiency is more common in the elderly population.

• Reduced Exposure to the Sun:

About half to ninety percent of vitamin D is absorbed through the skin when exposed to sunlight, with the balance coming from food. Vitamin D insufficiency can be prevented by spending 20 minutes a day in the sun with more than 40 % of the skin exposed. Vitamin D synthesis in the skin decreases as people get older. Vitamin D production in the skin is lower in dark-skinned people. Vitamin D insufficiency can also be caused by a lack of sun exposure, as observed in those who are institutionalized or have been in the hospital for a long time. Individuals who use sunscreen regularly have less effective solar exposure.

• Endogenous Synthesis Is Reduced:

Individuals with chronic liver disease, such as cirrhosis, may have a failure in 25-hydroxylation, resulting in a vitamin D deficiency. Hyperparathyroidism,1-alpha hydroxylase insufficiency, and renal failure are all symptoms of a problem with 1-alpha 25-hydroxylation.

• Hepatic Catabolism Is Increased:

Hepatic p450 enzymes are activated by medications such as Phenobarbital, Dexamethasone, Carbamazepine, Spironolactone, Nifedipine, Clotrimazole, and Rifampin, which cause vitamin D degradation.

• End Organ Resistance:

In familial vitamin D-resistant rickets, end-organ resistance to vitamin D can be found.

What Are the Sources of Vitamin D?

There are a few foods that contain vitamin D naturally, which include:

• Salmon, tuna, and mackerel types of fatty fish.

• Liver or beef.

• Cheese.

• Mushrooms.

• Yolks of eggs.

Vitamin D is also found in fortified foods such as:

• Milk.

• Cereals.

• Orange juice.

• Yogurt and other dairy items.

• Drinks made from soy.

• Multivitamins that contain vitamin D. Vitamin D supplements are now available in pill and liquid form for newborns.

The treatment for vitamin D deficiency is to take supplements. A doctor must be consulted about how much, how often, and how long one should take supplements.

What Are the Oral Effects of Vitamin D Deficiency?

Caries and Tooth Mineralization:

Teeth are mineralized organs with three separate hard tissues: enamel, dentin, and cementum. They are bordered by alveolar bone. Although tooth mineralization is comparable to skeletal mineralization, problems similar to those seen in bone tissue will ensue if mineral metabolism is disrupted. Vitamin D is important for bone and tooth mineralization. When levels are out of control, it can result in the "rachitic tooth," a deficient and hypo mineralized organ prone to fracture and decay.

Periodontitis:

Periodontitis is a complicated polymicrobial illness caused by plaque and characterized by long-term chronic inflammation. According to the most recent in vitro studies, vitamin D has obvious fine-tuning, anti-inflammatory, and mineralization effects on the periodontium. When comparing periodontitis patients to periodontally healthy patients, low salivary levels of vitamin D were linked to higher levels of inflammatory biomarkers, indicating the presence of an inflammatory milieu. Vitamin D, through its metabolic pathway, may be involved in the etiology of periodontitis by affecting tooth mineral density and being negatively connected with periodontal disease severity, according to preclinical and clinical research.

Orthodontic Treatment:

Facial esthetics, including the smile, have been a concern for teenagers and adults as aesthetic criteria have grown important. As a result, orthodontic procedures are becoming more popular. Tooth movement is based on the application of specified forces that result in mechanical stimuli involving two processes: bone resorption on the pressure site via osteoclastic activity and bone creation on the tension site via osteoblastic activity. According to preliminary findings, Vitamin D may play an essential role in tooth movement during orthodontic therapy. Despite the fact that much of the information is based on animal observation, growing evidence suggests that the local application of vitamin D causes faster tooth movement. Nonetheless, in animal models, VDD (vitamin D deficiency) produces a reduced rate of tooth movement, necessitating therapy.

Oral Cancers:

Though further research is needed, vitamin D may have a significant role in the initiation and progression of certain oral malignancies. Vitamin D deficiency is more common in patients with oral neoplastic lesions.

Conclusion:

Vitamin D deficiency has been associated with an increased incidence of tooth decay, caries, periodontitis, and the failure of oral therapies. Although the influence of VDD correction with supplementation has been proven to be connected with better oral development and health throughout life, more research is needed to draw factual findings and prospective treatment guidelines. Nonetheless, 25-hydroxyvitamin D levels should be considered to maintain balanced oral health. These levels should be evaluated before treating any oral disorders to assure successful treatment outcomes.