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Vitamins, Micronutrients And Periodontal Health

  • The three most common deficiencies in the United States are for Vitamin B, Iron, and Vitamin D. Less common deficiencies include those for vitamin A, vitamin E, and folate.
  • Reactive oxygen species (ROS) or Free radicals are unstable atoms split from oxygen molecules that can damage cells and are linked to various diseases. Inflammation leads to oxidative stress, which is an imbalance between free radicals and antioxidants in the body.
  • The performance of periodontal therapy, such as scaling and root planing, can restore a healthy total antioxidant capacity to the gingival crevicular fluid by reducing local inflammation.
  • Vitamin A functions as an antioxidant, scavenging for free radicals, and helps to maintain the integrity of epithelial cells.
  •    Vitamin C dietary supplementation with grapefruit for 2 weeks increases plasma vitamin C levels and improved sulcular bleeding scores. Vitamin C may also weaken the cytotoxic effects of Porphyromonas gingivalis, a known periodontal pathogen, on human gingival fibroblasts.
  •     Vitamin E plays important antioxidant and anti-inflammatory roles, and it has been suggested that it improves periodontal treatment outcomes.
  • Vitamin B2, B3, B6, and B12 deficiencies have been linked to hemorrhagic gingivitis and periodontitis. These vitamins support healthy immune functions by strengthening epithelial barriers as well as cellular and humoral immune responses.
  •  Vitamin D and the vitamin D receptor complex interact with receptor activator of nuclear factor kappa-B ligand (RANKL) expression and downregulate osteoprotegerin, deficiency thereby increasing differentiation and activation of osteoclasts and consequently bone resorption.
  • Iron plays an important role in maintaining alveolar bone homeostasis, has functions in the innate and adaptive immune responses.
  • Selenium, zinc, and copper, have antioxidant enzymes that can aid in neutralizing ROS and prevent tissue damage, and they also play important roles in regulating immune function and wound healing.
  Effects of Micronutrients on Periodontal Health and Disease: Mengyi Shi, DMD; Andrea Pizzini, DDS, MS; and Maria L. Geisinger, DDS, MS November 2021 Issue Inside Dentistry