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ROLE OF VITAMINS AND MINERALS IN MAINTAINING ORAL HEALTH

Dr. Shilpy Bhandari 01 Jul 2021
ROLE OF VITAMINS AND MINERALS IN MAINTAINING ORAL HEALTH

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Our diet directly impacts the state of our oral health. A balanced diet helps in the development and maintenance of the oral cavity and craniofacial regions. Nutritional imbalance may cause defects in the oral mucosa (inner lining of the mouth) and teeth. This can be attributed to a reduction in the body’s response against bacteria, and reduced tissue repairability. 

Nutrients can be divided into two types: Macronutrients and micronutrients. Macronutrients such as carbohydrates, protein, and fats are required in large amounts, and micronutrients such as vitamins and minerals in small amounts. Micronutrients play an important role in maintaining the integrity of the oral cavity and regulating physiological processes. In this article, we discuss how micronutrients contribute to oral health, even though they’re required in small amounts.

Vitamins

Vitamins are classified as fat-soluble (Vitamins A, D, E, and K) and water-soluble (Vitamin C and B complex). In all, there are 13 vitamins. Our bodies cannot synthesize most of the vitamins (except vitamin D and B3) and depend on the food we eat to extract them. Fat-soluble vitamins dissolve in fat and are stored in the body. Water-soluble vitamins dissolve in water and quickly get absorbed by the body tissues. Below are the details of vitamins that play an essential role in oral health and diseases.

Vitamin A

Food sources of vitamin A: Liver, Cod-liver oil, milk, eggs, carrots, leafy vegetables, sweet potatoes, and papaya.

Role of vitamin A in oral health and diseases:

  • Vitamin A helps in the development and maintenance of oral mucosal tissue (inner lining of the oral cavity).
  • The antioxidant properties of vitamin A lower the advancements of periodontal diseases (gum diseases) and improve the health of tooth-supporting structures (e.g., gums, bone, and periodontal ligament).
  • Vitamin A deficiency affects the development of enamel and dentin (outer tissue layers of the tooth), delays oral tissue formation, and increases the risk of gum diseases.
  • Topical application of vitamin A ointment reduces the prevalence of oral mucositis (inflammation and ulceration of mouth) in patients undergoing chemotherapy or radiotherapy.

Vitamin B

Food sources of vitamin B: Salmon, leafy green vegetables, liver, beef, eggs, milk, cereal, sunflower seeds, chicken, and turkey.

Role of vitamin B complex oral health and diseases:  

  • Vitamin B complex includes a combination of 8 vitamins. These include Vitamin B1 (thiamine), Vitamin B2 (riboflavin), Vitamin B3 (niacin), Vitamin B5 (pantothenic acid), Vitamin B6 (pyridoxine), Vitamin B7 (biotin), Vitamin B9 (folic acid), and Vitamin B12 (cobalamin).
  • Vitamin B12 deficiency contributes to the development of several dental defects such as cleft lip, alveolar cleft, cleft palate (opening or split in the two halves of the lip, upper gum line, and palate) and neural tube defects.
  • Vitamin B deficiency may increase the prevalence of tooth decay and gum diseases in children. Research suggests that the supplementation of vitamin B12 lowers the likelihood of decay and improves the health of gums. 
  • Vitamin B12 deficiency is associated with oral conditions such as:
    • Glossitis (inflamed, swollen tongue)
    • Angular cheilitis (red swollen or ulcerated corners of lips)
    • Oral recurrent ulcers (repeated oral ulcers)
    • Oral mucositis (inflammation and ulceration of mouth) 
    • Pale appearance of oral mucosa (inner lining of mouth) 
  • Adequate folic acid levels help maintain the health of gums. Decreased folic acid intake during pregnancy is associated with the risk of cleft palate in the infant (split in the palate observed during childbirth).
  • Supplementation of vitamin B complex accelerates wound healing and tissue repair after gum surgery.

Vitamin C

Food sources of vitamin C: Citrus fruits, berries, tomatoes, broccoli, cauliflower, bell peppers,  and spinach.

Role of vitamin C in oral health and diseases: 

  • Adequate levels of vitamin C help maintain gums, tooth-supporting tissues, and teeth.
  • The vitamin helps in the formation of collagen, which is responsible for wound healing. Vitamin C supplements are used to accelerate wound healing after gum surgery or dental implant surgery.
  • The antioxidant properties of vitamin C reduce the likelihood of tooth decay.

Vitamin D 

Food sources of vitamin D: Milk, cheese, salmon, cereals, egg yolk, and cod liver oil

Role of Vitamin D in oral health and disease:

  • Vitamin D is involved in the formation of hard tissues of teeth (e.g., enamel, dentin) and tooth-supporting bone.
  • It has a role in providing immunity against oral diseases.
  • Vitamin D deficiency during teeth formation causes developmental defects in the tooth, including enamel hypoplasia (white spot, yellow to brown staining, pits or grooves in the enamel surface of teeth).
  • Vitamin D deficiency may negatively impact the periodontium (tooth-supporting tissues), causing bone loss around teeth.
  • In children, vitamin D deficiency is associated with increased prevalence of tooth decay.
  • Research suggests that vitamin D supplementation reduces tooth decay in children and lowers the severity of periodontal disease in adults. 

Vitamin E

Food sources of vitamin E: Green leafy vegetables, almonds, and vegetable oils such as sunflower, canola, and soybean.

  • Vitamin E exhibits anticarcinogenic properties. It prevents the formation of cancer-causing chemicals (nitrosamines from nitrites) present in some foods. 
  • The vitamin boosts the functioning of the body’s immune system.
  • Antioxidant properties of vitamin E prevent the occurrence of precancerous lesions that develop in the oral cavity before oral cancer. The lesions include:
  • Leukoplakia and erythroplakia (white and red patches inside the mouth)
  • Lichen planus (while patches causing burning sensation) 
  • Oral submucous fibrosis (fibrosis inside mouth resulting in decreased mouth opening)
  • Topical application of vitamin E treats oral mucositis (inflammation and ulceration of mouth) induced by chemotherapy or radiotherapy. 

Minerals

Minerals are inorganic substances required in small amounts in the body. They are essential for the formation of bones and teeth. Minerals are absorbed better by the body when taken from food instead of supplements. Some minerals are required in large quantities than others (e.g., calcium, magnesium, phosphorus, potassium, sodium), and some in small amounts (e.g., iron, zinc, iodine, fluoride). Here are some of the critical minerals that have a role in oral health and diseases.

Minerals are inorganic substances required in small amounts in the body. They are essential for the formation of bones and teeth. Minerals are absorbed better by the body when taken from food instead of supplements. Some minerals are required in large quantities than others (e.g., calcium, magnesium, phosphorus, potassium, sodium), and some in small amounts (e.g., iron, zinc, iodine, fluoride). Here are some of the critical minerals that have a role in oral health and diseases.

Fluoride

Food sources: Fish, tea, fluoridated water.

Fluoride strengthens tooth enamel and makes it resistant to tooth decay. It also helps in the remineralization of initial tooth decay. However, excess ingestion of fluoride can lead to toxicity which manifests as nausea, vomiting, diarrhea, abdominal cramps, abnormal sensation, central nervous system depression, and hypotension. Chronic (long-standing) fluoride toxicity can affect the teeth and bone. As a result, teeth may appear opaque or white, lack luster, and develop yellow patches. 

Calcium

Food sources: Dairy products (such as milk, cheese, and yogurt), broccoli, spinach, soy milk, and tofu.

Calcium is mainly found in bones and teeth. It is part of the mineral composition of teeth and helps in increasing the density of tooth-supporting bone. So, decreased calcium levels can increase the risk of tooth decay and gum diseases.

Phosphorous

Food sources: Dairy products, beef, chicken, salmon, eggs, and whole wheat bread.

After calcium, phosphorous is the second most abundant mineral in the teeth. Depletion of phosphorous may result in increased calcium excretion, which creates a negative calcium balance. Phosphorous deficiency during tooth development may inhibit the formation of dentin (outer tooth layer) and cause incomplete mineralization of teeth. This increases the risk of tooth decay. 

Magnesium

Food sources: Whole wheat, spinach, quinoa, almonds, black beans, banana, and avocado.

Magnesium is the third most prevalent mineral in the teeth. It helps maintain calcium balance and prevents structural abnormalities. Magnesium deficiency negatively impacts the enamel- and dentin-producing cells of teeth resulting in underdevelopment of teeth. It also affects the formation of tooth-supporting bone and causes overgrowth of gums. 

Zinc

Food sources: Meat, chicken, oyster, beans, almonds, peanuts, and cashews.

Zinc is naturally present in saliva and enamel. Zinc is used in several oral care products such as toothpaste and mouth rinses to reduce bad breath and delay tartar formation. It aids in protection against gingivitis (inflammation of gums) and other gum diseases. Zinc prevents demineralization of enamel and protects against decay. In addition to this, it has a role in taste functions and its deficiency can lead to taste disturbances. 

Iodine

Food sources: Seafood, dairy products, and iodized salt.

Iodine deficiency may result in the underdevelopment of upper and lower jaws, enlargement of tongue, delayed eruption of permanent teeth, and over-retained milk teeth. 

Potassium

Food sources: Legumes, dried apricots, meats, chicken, dairy products, nuts, whole-wheat flour, and brown rice.

Potassium deficiency may cause soreness of the tongue, and burning sensation in mouth while eating and drinking. It can also cause gum bleeding.

Iron

Food sources: Lean meat, seafood, nuts, beans, vegetables, and cereals.

Decreased iron levels in the body lead to iron deficiency anemia. The oral symptoms of iron deficiency include soreness or cracks in the corners of lips, redness of the tongue, stomatitis (soreness of mouth), and fungal infections.

Conclusion

Besides general symptoms, malnutrition can affect oral health resulting in oral diseases. Therefore, good dietary habits are essential to eradicate malnutrition. Patients should take the dentist’s advice on nutritional habits to follow to maintain oral health.

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About the Author:
Dr. Shilpy Bhandari is an experienced dental surgeon, with specialization in periodontics and implantology. She received her graduate and postgraduate education from Rajiv Gandhi University of Health Sciences in India. Besides her private practice, she enjoys writing on medical topics. She is also interested inevidence-based academic writing and has published several articles in international journals.

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