Vitamine D, the Immune system, and not only

Vitamin D, should I take supplements, is nutrition rich enough in Vit D, does it help against cancer… it is a hot subject nowadays with studies pros and cons. According to #ZOE chief scientist Dr. Sarah Berry, balanced nutrition and maybe a multivitamin supplement should be enough. A Vit D-specific supplement might be helpful during darker months if you live in an environment with less available sun. Yale University’s scientists (https://www.yalemedicine.org/news/vitamin-d-myths-debunked) also agree that too many supplements of Vit. D is not healthy; too much sun (through exposure to UVB light, the skin generates its own Vit D) increases the risk of melanoma. For a healthy individual, 600 IU per day as a supplement is fine; for those over 70 years of age, 800 IU is fine (especially women due to menopause). Are you eating Vitamine D fortified foods (soy, almond or oat milk, rainbow trout, sockeye salmon…)?! Then, you might not need supplements.

How about the teeth, gums, the mouth — where does systemic health start? A deficiency of Vit.D increases the risk of tooth caries and gum inflammation. Especially for children, it can lead to deficient mineralization of developing teeth due to a deficient Calcium and Phosphate balance in the body. (Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients. 2020 May 19)

Furthermore, Vitamin D. modulates the expression of a considerable number of genes, and it is estimated to do so for 5–10% of the entire genome (Morris H.A., Anderson P.H. Autocrine and paracrine actions of vitamin D. Clin. Biochem. Rev. 2010;31:129–138.)

As a dentist, I often see in adults certain teeth structural-developmental defects, and I can’t help but wonder: “When patients were children and teeth were developing inside the jaw, did they experience a high fever, a traumatic shock — which can lead to anomalies in the tooth formation, or was it a temporary Vit. D deficiency?! Nowadays, we know that maternal Vit D. deficiency at 12–16, 20–32, and 36–40 weeks of pregnancy results in hypoplasia/mineralization defects in the baby’s upper central incisor — upper third, middle third, and cervical third. (Prenatal vitamin D and enamel hypoplasia in human primary maxillary central incisors: A pilot study. Pediatr. Dent. J. 2017)

The European consensus is that an inadequate vitamin D status also impacts periodontal health and oral functions. (Interaction of lifestyle, behavior or systemic diseases with dental caries and periodontal diseases: Consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J. Clin. Periodontol. 2017) Recent research quantifies the significant impact of Vit.D levels on deficient dental implant integration (osseointegration). When Vit D. was supplemented, the osseointegration was more successful, specifically in cases with systemic diseases, such as vitamin D deficiency, diabetes mellitus, osteoporosis, and chronic Kidney disease. (Does vitamin D have an effect on osseointegration of dental implants? A systematic review. International Journal of Implant Dentistry).

The conclusion is that healthy levels of Vit D. are important and should be supplemented when recommended but not exaggerated or fall into the marketing traps of an unregulated market of vitamin supplements. If medical procedures are necessary, such as surgery, gum disease treatment — periodontal therapy, dental implants, testing of Vit. D levels might be wise. Today, we can easily do it in a dental practice (#dentognostics testing) during regular oral prophylaxis appointments.