Role of vitamins in integrity of Oro-Facial

tissue
“ 6 Important vitamins and
minerals for healthy teeth

”
 Content
Definition
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Vitamin B
Vitamin C
 What are Vitamins?
➢ Vitamins are defined as organic substance required in
small amount for the maintenance and growth of
living organisms.
 Vitamins

Deficiency Over-dose

certain specific diseases hypervitaminosis

can be cured by the administration

of that specific vitamin.
Vitamins can be classified based on their solubility:

➢ Fat-soluble Vitamins: ➢ Water-soluble Vitamins:

Vitamins A, D, E and K Vitamins B and C

 Fat-soluble Vitamins
(A, D, E and K)

✓ Absorbed in the presence of fats

✓ Stored by the body for longer time than the water-soluble

vitamins
✓ So avoid overdose
 K
E
D
A
✓ Chemical nature and properties of vitamin A
✓ Sources of vitamin A in food
✓ Importance for oral health
Chemical nature and properties of vitamin A

Active form Retinol, Retinal, Retinoic acid

Provitamin A β-carotene
Storage Liver, Adipose tissue of the body
 Sources of vitamin A in food
β-carotene
 like dark leafy green vegetables, spinach, broccoli, carrots,
cabbage, sweet potato, deep orange fruits, mangoes, apricots,
 Sources of vitamin A in food

Retinols
like milk, butter, cheese, cream, eggs, kidney, tomatoes and water
melon.
Health benefits of vitamin A
 The active form of vitamin A, retinoic acid, is
essential for:
1. Maintaining the integrity of mucosal tissues.
2. Proper differentiation of immune system.

✓maintaining some bacteria in adequate level

✓prevention of massive inflammation

 against oxidation
3- It has antioxidant activity
Free radicals

Oxidative
stress
Vitamin A deficiency results in:

1- Epithelial proliferation and maturation

defects.

Epithelium

Connective tissue
2- Night blindness
 enamel

3-Irregular tubular dentin crown

formation

dentin
root

cementum
 4- Enamel hypoplasia.

5- Xerostomia (dry mouth)

marked increase in risk for

caries.
6- Decreased taste sensitivity.
 Inflammation

7- Gingivitis & periodontitis

 Vitamin D is one of the fat-soluble vitamins known for
treatment of Rickets.
 Sources :- cod liver oil, mackerel, salmon, sardines, tuna
and mushrooms
Vitamin D also known as the sunshine vitamin, because the
sterols present in the skin can be converted to vitamin D
with the help of UV rays emitted from the sun
 So far 7 different types of vitamin D have been
discovered. only D1, D2 and D3 are important.

➢Vitamin D2 is ergocalciferol, derived from

ergosterol. (plant origin)
➢Vitamin D3 is cholecalciferol and obtained form
7dehydrochloesterol.(animal origin)

➢The term D1 is no longer used as it is discovered that

it is a mixture of compounds rather than a pure
vitamin
 Function
 Vitamin D maintains the homeostasis of calcium
and phosphorus in the tissues and body fluids.
Effect of vitamin D on oral health
 enamel
1- It has a critical role in
enamel, dentin, and oral
bone formation as
ameloblasts, odontoblasts
and osteoblasts are target
cells for vitamin D.
2- Therefore, deficiency in vitamin
D during periods of tooth
development may also result in
developmental defects including
enamel hypoplasia and dentin
abnormalities .
Enamel and dentin abnormalities
have been considered in children as
caries risk factors.
3- Vitamin D deficiency is associated with caries.
 4- Its deficiency may be a potential risk factor for
aggressive periodontitis
➢ Vitamin D intake was associated
with lower severity of periodontal
disease. Calcium and vitamin D
supplementation has a positive
effect on periodontal health, and
consistent dental care improves
clinical parameters of periodontal
disease .
➢ There is a raise possibility that
vitamin D, at higher doses, may
positively impact on periodontal
disease severity.
 Vitamin E can be found in fortified cereals, seeds
and seed oils like sunflower and green leafy
vegetables like spinach, tomato products, sweet
potato, mangoes & broccoli.
 Found in high quantity in Liver of cattle.

 Small quantities found in the muscles of heart,

kidneys, eggs, kiwi fruit and blue berries.
Health benefits of vitamin E
 1- Being an anti-oxidant

Vitamin E plays an important role to protect the body

cells from the damage caused by free radicals which
are highly reactive and destructive compounds.
 Anticarcinogenic effects of Vitamin E are its
ability to inhibit formation of the carcinogenic
chemicals in some foods, and its ability to
promote immune system function.
2- Vitamin-E is an essential nutrient that is
prevention of precancerous lesions because of its
anti oxidant properties
3- Topical application of Vitamin E had performed better
effect on oral mucositis induced by Cancer
Chemo/Radiotherapy than Vitamin E systemic
administration

The efficacy of Vitamin A topical treatment also

showed reduction in severity of oral mucositis similar
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 The term originated from the German word
Koagulation (clotting of blood).
➢ So, it is also known as the clotting vitamin.
 It is found primarily in leafy green vegetables.
 The dietary requirement is low because the vitamin is
naturally produced by the bacteria in the intestines.

 Two natural forms exist: vitamins K1 and K2.

 Vit K2 is absorbed better than K1, and stay in the blood
longer
 Vit K1 is found in green leaves, Vit K2 in fermented food and
animal products
It's a multifunctional vitamin
(have a role in a wide range of biological activities)
1- cell growth and proliferation

2- regulation of calcium metabolism in tissues

3-Vitamin K2 has been shown to have an
antioxidant potential.

antioxidant

4- plays an essential role in normal blood clotting,

5- promoting bone strength

 In bone, vitamin K exerts its anabolic effect as promoting
osteoblast differentiation
6- Vitamin K is considered as anticaries agent in vitrue by its
enzyme inhibiting activity in the carbohydrate degradation
cycle.
Demineralization of
tooth structure
 They include
vitamin B1 (thiamine)
vitamin B2 (riboflavin)
vitamin B3 (niacin)
vitamin B5 (pantothenic acid)
vitamin B6 (pyridoxine)
vitamin B7 or B8 (biotin)
vitamin B9 (folic acid)
vitamin B12 (cobalamin)
 Vitamin B-complex is important for cell growth and metabolism.

 Each member of the B-complex has a unique structure and

performs unique functions.

➢ Vitamins B1, B2, B3, and biotin (B7 & B8) participate in
different aspects of energy production.
 building blocks of proteins

 Vitamin B6 (pyridoxine) is essential for amino acid

metabolism.
 Vitamin B12 and folic acid facilitate steps required for cell
division.
➢ Vitamin B12 is one of the important micronutrients for
brain development and function.
Effect of vitamin B-complex on oral health
1- Vitamin B12 deficiency may cause an increase in
prevalence of dental caries and gingival diseases in
children.
2- Subjects suffering from cobalamin (B12) deficiency
may exhibit some oral signs and symptoms, including

➢ glossitis ➢ angular cheilitis ➢ recurrent oral ulcer

➢ oral candidiasis ➢ pale oral mucosa.

➢ diffuse erythematous mucositis

3- Folic acid (B9) is required for essential biochemical reactions
for the synthesis of amino acids, purines, and deoxyribonucleic
acid (DNA) & integrity of gingival tissues.
4- Insufficient intake of folic acid during the pregnancy has
been suggested to increase the risk for cleft lip & palate.
5- Vitamin B-complex supplementation has also demonstrated
positive effects on wound healing after periodontal surgery
and enhance wound repair.
Dr. Nesma Khalil
 Vitamin C (also known as ascorbic acid) is naturally found
in
➢ citrus fruits (oranges, lemons, limes, grapefruits)
➢ and vegetables (potatoes, broccoli, spinach, red peppers).

Dr. Nesma Khalil

 Additionally, vitamin C is heat sensitive so, boiling or
cooking has removed the nutritional value.
 Ascorbic acid is absorbed from the intestinal tract and
has a biological half-life of approximately 30 minutes.

 There is no storage site in the body; however, some

tissues carry higher concentrations (white blood cells,
adrenal glands, pituitary gland)
1- Ascorbic acid plays an essential role in the
hydroxylation of collagen. This crucial biochemical
pathway enables each collagen fibril to form a
uniform and flexible triple helix configuration in the
body’s connective tissues.
 Some tissues such as skin, gums, mucus membranes,
and bones contain a greater concentration of
collagen and thus are more susceptible to
deficiencies.
2- Ascorbic acid is also needed in the synthesis of
dopamine, norepinephrine & epinephrine.
3- It has antioxidant properties

4- It can enhance iron absorption from the

intestinal tract.
 8 to 12 weeks of irregular or inadequate intake of vitamin
C.

Scurvy
anemia, myalgia, bone pain, easy bruising, swelling, gum disease
5- Vitamin C associate positively with periodontal health
and using vitamin C supplementation improves
postoperative healing following dental implant surgery in
patients with chronic periodontitis
6- It is evident that serum and salivary vitamin C level
decreases with increase in caries activity suggesting the
powerful antioxidant property of vitamin C.
7- Deficiency of Vitamin C is well recognized as producing
severe changes in the periodontal tissue and pulps of the
teeth.
 Take home messages

✓ Vitamins are essential for general growth, health

✓ Required in small controlled amounts

✓ Act as antioxidants

✓ Your diet should contain vegetables & fruits as they

are natural sources of vitamins
✓ Sun shine vitamin (Vitamin D)

✓ Supplements (deficiency, old age, pregnancy)

✓ Avoid hypervitaminosis especially fat soluble vitamins

THANK YOU