Lack of vitamin D is rather common and is associated with a host of diseases that affect the teeth and gums. In children, a vitamin D deficiency may result in fragile teeth with weak enamel and an increased risk of cavities. Later in life, the vitamin deficiency may also increase the risk of periodontal disease and certain types of oral cancer, according to an article that is published in the scientific journal Nutrients. The authors refer to a number of clinical studies that point to vitamin D’s different functions with regard to dental health. Also, they mention that vitamin D deficiencies are widespread and write that it may be necessary to take a supplement for proper dental health.
Science is growing increasingly aware of the importance of enough vitamin D in the blood and its role in dental health during fetal development, growth, and adulthood. Firstly, vitamin D is necessary for the body’s uptake of calcium, which is the single most important mineral for tooth structure. Secondly, vitamin D regulates around 5-10 percent of cellular genes by controlling their on-off switches. Thirdly, vitamin D is important for the immune system’s ability to fight bacteria, fungus, and virus. And finally, vitamin D prevents the immune system from overreacting with chronic inflammation that can damage healthy tissue. Therefore, being vitamin D-deficient impairs the construction of healthy teeth and increases the risk of cavities, while making the mouth more vulnerable to infection and other complications such as stomatitis, periodontal disease, and certain types of oral cancer.
Vitamin D’s importance for the child’s tooth development
The development of teeth begins during the fetal stage. The first stage starts when the fetus is six weeks of age. This is when the basic substance of the tooth forms. After that, the hard tissue that surrounds the teeth is formed at around three to four months of gestation. Most babies are born with tooth-less gums. Their first primary teeth start showing around six months of age, but it can vary. It is highly important that the pregnant mother gets plenty of vitamin D to ensure proper calcium uptake. The Danish health authorities recommend a daily 10-microgram supplement during the entire pregnancy. A Danish study, however, has found that many pregnant women forget to take their vitamins.
Because breastmilk is not able to ensure optimal levels of vitamin D, the Danish Health Authority recommends giving white infants 10 micrograms of vitamin D every day from they are two weeks of age until the end of their first year. Dark-skinned babies are advised to get a vitamin D supplement until the age of three. Still, many children can benefit from getting vitamin D during their entire childhood, especially because vitamin D deficiencies are so common, primarily during the winter period. Because of sun awareness campaigns and the fact that people spend far too much time indoors, many children even fail to get enough vitamin D during the summer period and remain pale without sufficient vitamin D stored in their liver.
Tooth decay (dental caries)
Caries occurs when decay-causing bacteria in food debris stuck on the teeth convert sugar into acid. If the bacteria remain on teeth for longer periods of time, the acid formation may cause the tooth enamel to erode. The erosion eventually makes a hole and may cause pain.
It is commonly known that proper mouth hygiene is the best way to prevent caries, but it is also a good idea to limit your intake of sugar and soft drinks. However, the body’s vitamin D status is also important. Research has shown that the majority of children without cavities have optimal vitamin D levels in the blood, while most children with tooth decay have low vitamin D status.
It is believed that vitamin D helps prevent tooth decay by strengthening the immune defense against the bacteria that turn sugar into acid. Vitamin D also promotes the production of certain peptides that are a part of the innate immune defense against fungus and virus.
Blood levels of vitamin D
Blood levels of vitamin D are normally grouped as deficiency (below 30 nmol/L), insufficiency (30-50 nmol/L), and sufficiency (above 50 nmol/L). According to international studies, however, blood levels should ideally be above 75 nmol/L.
Periodontal disease is rather common and begins with inflammation of the gums (gingivitis) caused by dental plaque and tartar, where harmful bacteria produce tissue-eroding enzymes. When the immune system reacts, chronic inflammation may develop in the gingival pockets, which causes the gums to bleed.
The inflammation may stop by itself if the plaque is removed. However, if the condition continues, the inflammation spreads and may develop into periodontal disease. In addition, the gingival pockets become even deeper with the risk of tooth detachment.
Numerous studies show a relation between lack of vitamin D and development of periodontal disease. Also, there is increasing evidence linking periodontal disease to an increased risk of diabetes, heart attacks, cardiovascular disease, rheumatoid arthritis, gastro-intestinal diseases, stress, and premature delivery. Altogether, vitamin D deficiency seems to increase the risk of a host of diseases, all of which have involve chronic inflammation.
On the other hand, different studies show that people with the highest blood levels of vitamin D have fewer problems with bleeding and chronically inflamed gums. This is because vitamin D regulates T cells (a type of white blood cell) and several pro-inflammatory cytokines.
Supplements of vitamin D and calcium have demonstrated a moderately positive effect on periodontal disease when administered by the dentist, also when given to pregnant women with this condition. Although periodontal disease does not cause pain, it is vital to see your dentist at regular intervals. The dentist measures the depth of the gingival pockets and cleanses them. It is important to maintain thorough dental hygiene after each meal.
Just for the record, studies have demonstrated that supplements with coenzyme Q10 also have a positive effect.
Vitamin D and oral cancer
It is commonly known that smoking, alcohol abuse and snuff can increase the risk of certain types of cancer in the oral cavity and esophagus. It also appears that lack of vitamin D may play a role in the development of these cancers, but more research is needed. A small study has shown that vitamin D supplementation can significantly reduce therapy-related side effects in the late stages of oral cancer, thereby increasing the quality of life and life expectancy.
Vitamin D is believed to have the following anti-cancer mechanisms: It strengthens the immune defense and helps it destroy abnormal cells, and it inhibits inflammation by regulating the many gene activities and by controlling cell growth.
Joäo Botelho et al. Vitamin D deficiency and Oral Health: A Comprehensive Review. Nutrients 2020
Collaborative research with Nihon University: Effect of the reduced form of Q10 (Ubiquinol) on oral environment in periodontal disease. Kaneka Corporation
Varun Samji et al. Role of vitamin D supplementation for primary prevention of cancer: Meta-analysis of randomized trials. Journal of Clinical Oncology, 2019
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