Plasma 25‐Hydroxyvitamin D Concentrations and Periodontal Disease in Postmenopausal Women

Abstract

Background Vitamin D has anti-inflammatory and anti-microbial properties that, together with its influence on bone health, may confer periodontal benefit. Methods We investigated cross-sectional associations (1997–2000) between plasma 25-hydroxyvitamin D concentrations [25(OH)D] and periodontal measure among 920 postmenopausal women. Chronic measures of disease were defined based on: 1) alveolar crestal height (ACH) measures from intraoral radiographs and tooth loss, and the 2) Center for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) criteria using measures of clinical attachment level (CAL) and probing pocket depth (PD). Acute oral inflammation was assessed by the % of gingival sites that bled upon assessment with a probe. Logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CIs) for periodontal disease among participants with adequate ([25(OH)D]≥50 nmol/L) compared to deficient/inadequate ([25(OH)D]<50 nmol/L) vitamin D status adjusted for age, dental visit frequency, and body mass index. Results No association was observed between vitamin D status and periodontal disease defined by ACH and tooth loss (adjusted OR=0.96, 95% CI: 0.68–1.35). In contrast, women with adequate compared to deficient/inadequate vitamin D status had a 33% lower odds (95% CI: 5%–53%) of periodontal disease defined using the CDC/AAP definition and a 42% lower odds (95% CI: 21%-58%) of having ≥50% of gingival sites that bled. Conclusion Vitamin D status was inversely associated with gingival bleeding, an acute measure of oral health and inflammation and inversely associated with clinical categories of chronic periodontal disease that incorporated PD, an indicator of oral inflammation. However, vitamin D was not associated with chronic periodontal disease based on measures of ACH in combination with tooth loss.

Vitamin D and Its Relevance in the Etiopathogenesis of Oral Cavity Diseases

“…In observations reported by Dietrich et al (2004) and Miley et al (2009) a higher serum vitamin D level in periodontal patients correlated with a less severe loss of the clinical attachment. Millen et al (2013) demonstrated an inverse correlation between the serum vitamin D level and the frequency of gum bleeding and periodontitis in postmenopausal women. However, vitamin D supplementation (400 IU/day for 1 year) did not significantly improve the condition of periodontal tissues during routine periodontal procedures in 23 dental clinic patients (Garcia et al 2011).…”

Higher Intakes of Fruits and Vegetables, β-Carotene, Vitamin C, α-Tocopherol, EPA, and DHA Are Positively Associated with Periodontal Healing after Nonsurgical Periodontal Therapy in Nonsmokers but Not in Smokers

“…Higher intakes of vitamin C (17)(18)(19)(20)(21)(22) b-carotene (18,20), vitamin E (19,20), fruits and vegetables (20), and omega-3 FAs (23,24) have each been associated with greater periodontal health (reviewed in 25). Some (26)(27)(28) but not all (29) studies have shown that higher serum 25-hydroxyvitamin D [25(OH)D] concentrations are associated with better periodontal health. Studies investigating diet and periodontal healing have since emerged.…”

Association Between the Degree of Gingival Inflammation and 25-Hydroxy Vitamin D Status in Postmenopausal Women

“…For example, the Vitamin D receptor is expressed on several human immune cells, decreases the proliferation of the T and B lymphocytes, and inhibits the T-helper (Th1) and Th17 (proinflammatory) cell response, while promoting a Th2 (anti-inflammatory) cell response [23]. Vitamin D may help suppress local inflammation at the site of an oral infection.…”