Cross‐Sectional Study of Vitamin D and Calcium Supplementation Effects on Chronic Periodontitis

Abstract

Background Low dietary intakes of vitamin D and calcium hasten bone loss and osteoporosis. Because vitamin D metabolites may also alter the inflammatory response and have anti-microbial effects, we studied whether use of vitamin D and calcium supplements affects periodontal disease status. Methods A cohort of 51 subjects receiving periodontal maintenance therapy was recruited from 2 dental clinics. Of these, 23 were taking vitamin D (≥400 international units/day) and calcium (≥1000mg/day) supplementation, and 28 were not taking such supplementation. All subjects had ≥2 interproximal sites with ≥3 mm clinical attachment loss. Daily calcium and vitamin D intakes (from food and supplements) were estimated by nutritional analysis. The following clinical parameters of periodontal disease were recorded for the mandibular posterior teeth: gingival index, probing depth, cementoenamel junction-gingival margin distance (attachment loss), bleeding upon probing, and furcation involvement. Posterior photostimulable-phosphor bitewing radiographs were taken to determine cementoenamel-junction-alveolar-crest distances (alveolar crest height loss). Data were analyzed with a repeated-measures, multivariate analysis of variance. Results Relative to subjects who did not take vitamin D and calcium supplementation, supplement takers had shallower probing depths, fewer bleeding sites, lower gingival index values, fewer furcation involvements, less attachment loss and less alveolar crest height loss. The repeated-measures analysis indicated that collectively these differences for clinical parameters were borderline significant (P=0.08). Conclusion In these subjects receiving periodontal maintenance therapy, there was a trend for better periodontal health with intake of vitamin D and calcium supplementation. More expanded longitudinal studies are required to determine the potential of this relationship.

The Potential Role of Systemic Calcium in Periodontal Disease

“…Patients are often scheduled for maintenance at regular intervals. One study by Miley DD, et al 28 looked to see whether the use of calcium and vitamin D oral supplementation by those in a periodontal disease maintenance program would have an impact on clinical parameters of periodontal health. They found that all the periodontal parameters assessed (gingival index, probing depth, attachment loss, bleeding on probing, furcation involvement) were worse in those who did not take oral supplementation compared to those who did.…”

“…However, more longitudinal studies need to be done. 28 As a follow up to this study, the group tried to determine if such differences persisted over one year in the same study population. 29 They looked at plaque index, gingival index, calculus index probing depth, Cementoenamel junction-gingival margin distance (CEJ-GM attachment loss), bleeding upon probing and furcation involvement and found that all the clinical parameters were worse in the non-takers at baseline and mostly remained worse throughout the study.…”

Plasma 25-hydroxyvitamin D Status and Tooth Loss: A Case Report with Review of Literature

“…However no many studies related to intake of these nutrients affects tooth health. In a previous study, Miley et al [35] suggested that there was a trend for better periodontal health with intake of vitamin D and calcium supplementation. Likewise, Krall et al [36] reported that intake levels of calcium and vitamin D aimed at preventing osteoporosis have a beneficial effect on tooth retention.…”

Effects of 1,25-dihydroxyvitamin D₃ on Macrophage Cytokine Secretion Stimulated by <i>Porphyromonas gingivalis</i>

“…In recent years, many studies have found that vitamin D can affect periodontal status. Some studies suggest that increased serum vitamin D levels might be beneficial for reducing tooth loss, attachment loss, and gingivitis susceptibility, indicating a significant inverse association between serum concentrations of vitamin D and periodontal disease (9)(10)(11)(12)(13)(14). In contrast, other studies show that serum vitamin D levels in patients with aggressive periodontitis are higher than those in healthy controls and can be systemically and locally reduced after initial periodontal therapy, suggesting a positive relationship between serum vitamin D levels and the severity of periodontal inflammation (15,16).…”