By Dr. Surinder Arora
Dr. Arora is a member of the IABDM who practices biological dentistry at Nuffield Dental Jewel in Singapore. To find a biological dentist near you, explore our directory.
Vitamin D is a group of steroid hormone precursors rather than an actual “vitamin.” It begins as provitamin D and on activation in the liver and kidneys, is converted to calcitrol. This makes it biologically available for many processes within the body. Vitamin D2 is produced internally by consumption of food, and vitamin D3 is produced after exposure to the sun or can be consumed via supplements or can be found in oily fish (such as salmon, mackerel, and herring) and oils from fish such as cod liver oil.
It has been estimated that 1 billion people globally are vitamin D deficient.
Vitamin D
- is essential for survival.
- increases the absorption of calcium, magnesium and phosphate.
- is responsible for many vital functions in all systems of the body.
- is available for free from sunlight (darker skin tones need more).
- improves cognition, longevity, depression, bone structure, autoimmunity, and respiratory illness.
Vitamin D and Oral Disease
Both calcium and vitamin D have a role in mineralization of enamel and dentine of teeth, as well as alveolar bone. Vitamin D receptors are located in cells involved with bone and calcium regulation and immune response in the cells of the oral cavity.
The health of the periodontium is directly affected by the surrounding tissues, vitamin D, and calcium. Vitamin D has been associated with the arrest and prevention of dental caries by enamel mineralization. Dental caries may have a relationship to vitamin D in diet and sunlight. It has been suggested that high levels of vitamin D may have protective effects on the teeth and bone. Mellanby and colleagues in 1918 documented the ability of vitamin D to influence the tooth enamel of permanent teeth, the rate of tooth eruption, and the position of teeth.
This diagram taken from McMahon et al. (2011), shows the effects of vitamin D deficiency on the tooth. The left side shows a healthy tooth and periodontium. The right side shows possible effects of vitamin D deficiency on the tooth and surrounding periodontium.
A deficiency in vitamin D can result in compromised immunity, bacterial growth within the oral cavity, an increase in local inflammation, and an increase in development of periodontal disease. Severe vitamin D deficiency in children can lead to poor mineralization of enamel and dentine, which may increase the risk of dental caries. It may also be linked with some oral pathology entities such as certain oral cancers and events of osteonecrosis of the jaw. Vitamin D toxicity may also result in poor tooth formation and oral bone growth.
Absorption
Absorption of vitamin D is important and can be affected by the gut, the ski,n and cofactors. Leaky gut, irritable bowel disease, and autoimmune conditions can all contribute to poor absorption.
Skin factors that affect Vitamin D include
- the amount of skin exposed.
- skin melanin content (the more, the less Vitamin D can absorb).
- the amount of pollution in the air (as this can block UVB rays and sunlight).
- the amount of skin exposed.
- your location.
- use of sunscreen.
- cofactors including vitamin K2, magnesium, zinc, and boron are also important for absorption.
If you’re unsure about your vitamin D levels, get them checked, as they could make a tremendous difference to your oral and overall health.
References
Angeline, M. E., Gee, A. O., Shindle, M., Warren, R. F., & Rodeo, S. A. (2013). The Effects of Vitamin D Deficiency in Athletes. The American Journal of Sports Medicine, 41(2), 461–464.
Botelho, J., Machado, V., Proença, L., Delgado, A. S., & Mendes, J. J. (2020). Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients, 12(5), 1471. https://doi.org/10.3390/nu12051471
Borel P., Caillaud D., Cano N.J. Vitamin D bioavailability: State of the art. Crit. Rev. Food Sci. Nutr. 2015;55:1193–1205. doi: 10.1080/10408398.2012.688897.
Holick M.F., Chen T.C. Vitamin D deficiency: A worldwide problem with health consequences. Am. J. Clin. Nutr. 2008;87:1080–1086. doi: 10.1093/ajcn/87.4.1080S
Jordan E., Davis S., Rakes P., McCauley L.K., Bashutski J. (2013) Vitamin D and dental health. In: Watson R.R. (eds) Handbook of vitamin D in human health. Human Health Handbooks, vol 4. Wageningen Academic Publishers, Wageningen. https://doi.org/10.3920/978-90-8686-765-3_19
McMahon, L., Schwartz, K., Yilmaz, O., Brown, E., Ryan, L. K., & Diamond, G. (2011). Vitamin D-mediated induction of innate immunity in gingival epithelial cells. Infection and immunity, 79(6), 2250–2256. https://doi.org/10.1128/IAI.00099-11
Mellanby E (1918) The part played by an “accessory factor” in the production of experimental rickets. J Physiol (Lond) 52:xi–xii
Papagerakis, P., Hotton, D., Lezot, F., Brookes, S., Bonass, W., Robinson, C., Forest, N. and Berdal, A., 1999. Evidence for regulation of amelogenin gene expression by 1,25-dihydroxyvitamin D(3) in vivo. Journal of Cellular Biochemistry 76, 194–205.