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Nutrition and Dentistry: How Nutrition Effects Oral Health

Alee Dutell

Lane Community College

DH 237 Community Dental Health

Jill Jones

November 24th, 2022

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Many things contribute to the overall health of the oral cavity. One thing in particular

that is of great importance is nutrition. Good nutrition not only helps build and repair the oral

tissues, but it can help fend off pathogens and disease as well. Many studies have shown the

link between nutrition and oral health. These include studies on the state of oral health in the

presence and deficiency of vitamins and minerals.

Vitamin D is one such nutrient where having a deficiency can cause manifestations in

the oral cavity. A study was published in 2018 titled “A Cross-Sectional Study on the Association

Between Vitamin D Levels and Caries in the Permanent Dentition of Korean Children,” where

researchers studied the link between vitamin D and caries occurrence. Data was collected from

the Korea National Health and Nutrition Examination survey from the years 2008-2013. The

survey examined 1,688 Korean children, ages 10-12. Along with testing the children’s vitamin D

levels, they used DMFT index, and used statistical analysis such as chi-square tests, complex

samples logistic regression analysis, and Pearson’s correlations (Kim et al., 2018).

After data collection was complete, results showed the children with vitamin D levels

that were lower than 50 nmol/L had a higher incidence of caries in their permanent dentition

and permanent first molar than the children whose vitamin D levels were higher than 50

nmol/L. When accounting for external factors such as the sex of the child, vitamin D levels had

no significant correlation with caries except in those of the first molar. They concluded that the

vitamin D levels and DMFT scores in these children had a negative correlation and that vitamin

D deficiency could be a risk factor for dental caries (Kim et al., 2018).

Additionally, Similar findings were shown in a different study titled “Low Vitamin D

Status Strongly Associated with Periodontitis in Puerto Rican Adults”. In this case control/cross
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sectional study, 24 adult male and female Puerto Ricans ages 35-64 with periodontitis were

compared with healthy individuals of the same sex, BMI, and age. Excluded were those with

less than 14 teeth, type I or uncontrolled diabetes, osteoporosis, or those needing

premedication, those who were pregnant, smokers, and those undergoing ortho therapy. All

participants and their matched controls were then given a full periodontal assessment, a

socioeconomic questionnaire, and a blood test for vitamin D levels (Abreu et al., 2016).

Results of this study yielded the findings that mean serum vitamin D levels were

signifyingly lower in cases then controls. They found that the odds of periodontal disease were

greater when the patient’s 25(OH) D levels were lower. In conclusion of this study researchers

reported that serum vitamin D levels were significantly associated with periodontitis in Puerto

Rican adults (Abreu et al., 2016).

In a more diverse study called “Oral Health in Young Women Having a Low Calcium and

Vitamin D Nutritional Status,” the link between vitamin D and oral health was once again

explored, along with calcium deficiency. In this study, 106 women ages 23-24 were evaluated

for calcium and 25-hydroxyvitamin D (25OHD) levels, protein intake, DMFT index, PI index, and

SI index (Antonenko et al., 2014).

The results of their analysis revealed that 59% of woman were calcium deficient. Among

those 71% of them had a 25OHD level of <30 ng/mL. This is not considered deficient, but it is

less than ideal. 72% of these women consumed soft drinks daily, 100% of the woman had

gingivitis and 39% were missing at least one tooth. When examining a third of the group with

the highest DMFT score, these women had significantly lower calcium and vitamin D scores. The
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conclusion of this study suggested an association between high caries risk, severity of oral

health disease, and vitamin levels of calcium and vitamin D (Antonenko et al., 2014).

Other studies have also shown the relationship between nutrient deficiencies and oral

disease. In a study titled “The Association Between Serum Folate Levels and Periodontal

Disease in Older Adults: Data from the National Health and Nutrition Examination Survey

2001/02,” researchers assessed the relationship between serum folate levels and periodontal

disease in a geriatric sample. 844 elderly adults age 60 and up underwent a complete

periodontal exam and lab testing for folate, vitamin B12, and homocysteine levels. They also

underwent examination for controls of demographics, education levels, BMI, chronic diseases

and health behaviors (Yu et al., 2007).

After accounting for all controls, there was a significant negative association between

folate levels and periodontal disease. The study concluded that folate was independently

associated with periodontal disease. The researchers felt that levels of serum folate could be an

important indicator for oral health interventions (Yu et al., 2007).

Nutritional deficiencies have also been linked to infection of opportunistic pathogens in

the oral cavity. The overgrowth of the residential flora oral candidiasis has been associated with

deficiency of vitamin C. In a study titled “Oral Candidiasis and Nutritional Deficiencies in Elderly

Hospitalized Patients,” geriatric patients were evaluated based on status of oral candidiasis. 97

geriatric hospitalized patients had a complete oral evaluation upon entrance to the hospital.

These patients were also assessed nutritionally via dietary intake, and blood serum levels of

proteins, ferritin, zinc, folate, and vitamins B and C. Of these Patients 37% had candidiasis

(Paillaud et al., 2004).

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The patients were put into two groups, group I was candidiasis present and group II was

candidiasis deficient. After examining all factors, it was determined that vitamin C deficiency

was the largest significant independent risk factor to the contribution of Oral candidiasis. The

results indicated to researchers that the overgrowth of oral candidiasis could be attributed to a

vitamin C deficiency (Paillaud et al., 2004).

Even though many things contribute to the overall health of the oral cavity, the

contribution of nutrition is one of vast importance that should not be overlooked. The absence

or deficiency of such vitamins and minerals, can have substantial effects on our oral health.

Studies have repeatedly demonstrated that deficiency of many nutrients can have negative

effects on the periodontium and the oral cavity as a whole.

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Sources

Abreu, O. J., Tatakis, D. N., Elias-Boneta, A. R., López Del Valle, L., Hernandez, R., Pousa, M. S., &
Palacios, C. (2016). Low vitamin D status strongly associated with periodontitis in Puerto
Rican adults. BMC Oral Health, 16(1). https://doi.org/10.1186/s12903-016-0288-7

Antonenko, O., Bryk, G., Brito, G., Pellegrini, G., & Zeni, S. N. (2014). Oral Health in young
women having a low calcium and vitamin D nutritional status. Clinical Oral Investigations,
19(6), 1199–1206. https://doi.org/10.1007/s00784-014-1343-x

Kim, I.-J., Lee, H.-S., Ju, H.-J., Na, J.-Y., & Oh, H.-W. (2018). A cross-sectional study on the
association between vitamin D levels and caries in the permanent dentition of Korean
children. BMC Oral Health, 18(1). https://doi.org/10.1186/s12903-018-0505-7

Paillaud, E., Merlier, I., Dupeyron, C., Scherman, E., Poupon, J., & Bories, P.-N. (2004). Oral
candidiasis and nutritional deficiencies in elderly hospitalised patients. British Journal of
Nutrition, 92(5), 861–867. https://doi.org/10.1079/bjn20041264

Yu, Y.-H., Kuo, H.-K., & Lai, Y.-L. (2007). The association between serum folate levels and
periodontal disease in older adults: Data from the National Health and Nutrition
Examination Survey 2001/02. Journal of the American Geriatrics Society, 55(1), 108–113.
https://doi.org/10.1111/j.1532-5415.2006.01020.x