Vitamin D Deficiency – Its Impact on Oral and Systemic Health

Vitamin D deficiency – could this be contributing to your periodontal disease problem?

Vitamin D deficiency is a common problem world wide and is gaining much attention with researchers.  Vitamin D deficiency may be a major risk factor for many chronic diseases, such as:  periodontal disease, bone loss in the jaw and tooth loss, many types of cancer, numerous cardiovascular diseases, several auto-immune conditions, metabolic syndrome (weight gain and high BMI, prediabetes and type II diabetes, hypertension, low HDL cholesterol and high LDL cholesterol levels, high triglycerides), low mineral bone density (osteopenia), and osteoporosis.

What is significant about this is that periodontal disease in and of itself has been associated with many of the chronic diseases mentioned above.    We encourage anyone with any degree of periodontal disease to have the necessary blood tests performed to determine vitamin D levels.

Published papers and more information about vitamin D deficiency:

J Tenn Dent Assoc. 2011 Spring;91(2):30-3; quiz 34-5.
Vitamin D and its impact on oral health–an update. Stein SH, Tipton DA.


Department of Periodontology, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA.


Vitamin D has been shown to regulate musculoskeletal health by mediating calcium absorption and mineral homeostasis. Evidence has demonstrated that vitamin D deficiency may place subjects at risk for not only low mineral bone density/osteoporosis and osteopenia but also infectious and chronic inflammatory diseases. Studies have shown an association between alveolar bone density, osteoporosis and tooth loss and suggest that low bone mass may be a risk factor for periodontal disease. Several recent reports demonstrate a significant association between periodontal health and the intake of vitamin D. An emerging hypothesis is that vitamin D may be beneficial for oral health, not only for its direct effect on bone metabolism but also due to its ability to function as an anti-inflammatory agent and stimulate the production of anti-microbial peptides. Eur J Intern Med. 2011 Aug;22(4):355-62. Epub 2011 May 31.

Novel roles of vitamin D in disease: What is new in 2011? Makariou S, Liberopoulos EN, Elisaf M, Challa A.


Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece; Department of Child Health, Medical School, University of Ioannina, Ioannina, Greece.


Vitamin D is a steroid molecule, mainly produced in the skin that regulates the expression of a large number of genes. Until recently its main known role was to control bone metabolism and calcium and phosphorus homeostasis. During the last 2 decades it has been realized that vitamin D deficiency, which is really common worldwide, could be a new risk factor for many chronic diseases, such as the metabolic syndrome and its components, the whole spectrum of cardiovascular diseases, several auto-immune conditions, and many types of cancer as well as all-cause mortality. Except for the great number of epidemiological studies that support the above presumptions, vitamin D receptors (VDRs) have been identified in many tissues and cells. The effect of vitamin D supplementation remains controversial and the need for more persuasive study outcomes is intense.

Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. Mol Nutr Food Res. 2011 Jan;55(1):96-108. doi: 10.1002/mnfr.201000174. Epub 2010 Sep 7.

A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Schwalfenberg GK.


University of Alberta, Edmonton, Alberta, Canada.


This review looks at the critical role of vitamin D in improving barrier function, production of antimicrobial peptides including cathelicidin and some defensins, and immune modulation. The function of vitamin D in the innate immune system and in the epithelial cells of the oral cavity, lung, gastrointestinal system, genito-urinary system, skin and surface of the eye is discussed. Clinical conditions are reviewed where vitamin D may play a role in the prevention of infections or where it may be used as primary or adjuvant treatment for viral, bacterial and fungal infections. Several conditions such as tuberculosis, psoriasis, eczema, Crohn’s disease, chest infections, wound infections, influenza, urinary tract infections, eye infections and wound healing may benefit from adequate circulating 25(OH)D as substrate. Clinical diseases are presented in which optimization of 25(OH)D levels may benefit or cause harm according to present day knowledge. The safety of using larger doses of vitamin D in various clinical settings is discussed.

Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim. J Environ Pathol Toxicol Oncol. 2009;28(1):1-4.

Modern concepts in the diagnosis and treatment of vitamin D deficiency and its clinical consequences. Edlich R, Fisher AL, Chase ME, Brock CM, Gubler K, Long WB 3rd.


University of Virginia Health System, Charlottesvill, VA, USA.


It is the purpose of this comprehensive report to outline a revolutionary strategy to prevent vitamin D deficiency in our nation. Vitamin D is a unique vitamin. Its metabolic product, calcitriol, is a profound secosteroid hormone that has impact on over 1000 genes in the human body. Recent clinical research has implicated vitamin D deficiency as a major factor in the etiology of rickets, a wide variety of cancers, as well as hypertension, stroke, heart attack, diabetes, bone fractures, periodontal disease, and even multiple sclerosis. There are two forms of vitamin D utilized in the human body: D2 and D3. Measurement of 25(OH)D is the most reliable method of detecting vitamin D deficiency. Several methods, including high-performance liquid chromatography (HPLC), chemoluminescence, and radioimmunoassay (RIA), have been developed for the measurement of total 25(OH)D levels. Prevention and treatment of vitamin D deficiency is accomplished by regulated sun exposure as well as vitamin D, supplementation. This information describing our plan to prevent vitamin D deficiency in the patients and employees of Legacy Health System is a landmark accomplishment that should be replicated in every healthcare setting in our country to prevent vitamin D deficiency.

Important re vitamin D. When vitamin D is converted to its active form, vitamin K and small amount of vitamin A are needed (found in orange veggies or supplements). Vitamin K can be supplemented or found in the following foods: parsley, kale, spinach, Brussels sprouts, Swiss chard, green beans, asparagus, broccoli, kale, mustard greens, turnip greens, collard greens, thyme, romaine lettuce, sage, oregano, cabbage, celery, sea vegetables, cucumber, leeks, cauliflower, tomatoes, and blueberries.

The ideal vitamin D level is 50-80, some physicians do check vitamin K when they discover this deficiency. The Cleveland Clinic recommends a multivitamin at least daily for all. We like to see our patients take nano-vitamins (LifePak Nano) by Pharmanex, or other comparable high quality supplement for greater absorption. We are also giving our patients a list of foods to add to their diet. Most people have never been taught what or how to eat to be healthy.

In our experience most adults need a minimum of 2000IU vitamin D supplementation, even more in the winter months. If someone is severely deficient they will be put on high doses (Rx by their physician – 50K IU per week), then retested in 8-12 weeks. The patient is then put on a maintenance dose daily and monitored. Vitamin D is found in fish and fortified foods but one would have to eat a lot of fish and get sun daily with no sun screen to keep normal levels typically (most do not have this lifestyle). Many find it hard to believe that all that milk drinking and taking a multivitamin is not enough. If you are not supplementing you can assume you are deficient, its a given usually. Get tested.