BOSTON, MASSACHUSETTS. Periodontal disease is the major cause of tooth loss in middle-aged and elderly people. It involves chronic inflammation of the gums and a gradual loss of tooth attachment. A team of researchers from Germany and the US now report that high body stores of vitamin D (high serum levels of 25-hydroxyvitamin D3) are associated with a reduced risk of periodontal disease. Their study involved 11,202 men and women over the age of 20 years who participated in the 3rd National Health and Nutrition Examination Survey. The researchers analyzed blood serum samples for 25-hydroxyvitamin D3 levels and also measured clinical tooth attachment levels in all participants. The clinical attachment level (AL) is measured with a periodontal probe as the distance between the cemento-enamel junction (roughly where the top of the gum meets the tooth) and the bottom of the pocket in which the tooth is encased. A higher AL level indicates greater loss of attachment and more pronounced periodontal disease.
The researchers found that a lower serum vitamin D concentration was associated with a higher AL in both men and women over the age of 50 years. Men with a vitamin D level equal to or less than 40.2 nmol/L had a 0.39 mm higher AL than did men with a vitamin D level of 85.6 nmol/L or greater. Women in the lowest vitamin D range had a 0.26 mm higher AL than did women with the highest vitamin D levels. The AL values were all adjusted for age, race, smoking, diabetes, calcium intake, body mass index, socioeconomic status, and extent of gum bleeding. No association between AL and vitamin D level was found for participants younger than 50 years of age.
The researchers postulate that vitamin D may favourably affect periodontal health through its beneficial
effects on bone density or through its anti-inflammatory and immune system enhancing effects. As they
found no association between AL and bone mass density, they conclude that vitamin D's known anti-
inflammatory properties underlie its ability to prevent periodontal disease. They conclude that vitamin D is
an important factor in oral health.
Editor's comment: A recent Canadian study found that 97% of participants had vitamin-D3 levels below 80 nmol/L during autumn, while 34% had levels below 40 nmol/L. It is generally known that people living at northern latitudes (at or above 42 degrees N) are likely to be vitamin D deficient. Thus, it is highly likely that many northerners can attribute their periodontal disease to a vitamin D deficiency. Vitamin D is generated in abundant amounts by unprotected exposure to sunshine, but sunscreens prevent its formation in the skin. For those who are not exposed to year-round sunshine vitamin D supplementation, at least during fall and winter, is a must. About 1000 IU/day is considered safe and adequate, but some researchers recommend 4000 IU/day. Vitamin D is also highly effective in the prevention of colon cancer.