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Could Vitamin D Influence Risk for Periodontal Disease—to “D” or Not to “D”?

  • Host Parasite Interactions in Periodontal Disease (C Genco and D Kinane, Section Editors)
  • Published:
Current Oral Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to discuss the literature on associations between vitamin D and periodontal disease, including its strengths and weaknesses. Future direction for continued work in this area is provided.

Recent Findings

Research in cross-sectional cohorts, surveys, and case-control studies provide support for a role of vitamin D in periodontal disease, especially using clinical indicators such as bleeding on probing and clinical attachment loss. However, these studies have a number of limitations. They cannot establish temporality of these associations. Most case-control studies have been limited in sample size and have inconsistent findings. A number of cross-sectional studies are restricted to select populations (e.g., persons with HIV, diabetes, rheumatoid arthritis) limiting extrapolation of findings to the general aging population. Fewer prospective studies have been conducted, and only three have examined associations using a biomarker for vitamin D that reflects exposure from all its sources (sunlight, diet, and supplements). One study is limited by using self-reported measures of disease outcomes, and only two used measures of alveolar crestal height. However, of the prospective studies published, there is a suggestion that vitamin D might prevent against tooth loss. Only two randomized controlled trials have examined these associations, and they support the effects of vitamin D supplementation on prevention of tooth loss and gingival bleeding.

Summary

We strongly suggest that new research should focus on prospective study designs with follow-up of participants longer than a decade and long-term clinical trials. Such studies should incorporate measures of alveolar bone loss and tooth loss with indication for reason for tooth loss. Such clinical trials should be designed to examine both the influence of vitamin D supplementation alone as well as with other nutrients (e.g., calcium) or therapeutic medications (e.g., bisphosphonates). Currently, there is no strong evidence to suggest that vitamin D protects against development of periodontal disease.

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Acknowledgments

The Authors would like to acknowledge members of the OsteoPerio working group and their contributions to the investigations of vitamin D and periodontal disease with Dr. Robert Genco. These include the OsteoPerio Principal Investigator, Dr. Jean Wactawski-Wende; OsteoPerio Co-Investigators, Dr. Michael J. LaMonte and Dr. Christopher A. Andrews; OsteoPerio Research Team Members, Kathleen M. Hovey, and Dr. Millen's former students: Melissa Kluczynski, Elizabeth McLean-Plunket, Jennifer Meng, Dr. Michelle Sahli, and Sarah Twardowski.

Funding

This research is supported by National Institutes of Health (NIH) grants 1R21DE020918 (awarded to Dr. Amy E Millen) and 1R01DE13505 (awarded to Dr. Jean Wactawski-Wende) from the National Institute of Dental and Craniofacial Research (NIDCR) and a grant awarded to Dr. Jean Wactawski-Wende from the Department of Defense (DAMD179616319).

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Authors and Affiliations

  1. Farber Hall 270F, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, 14214, USA

    Amy E. Millen

  2. Buffalo General Medical Center 6D501, Department of Orthopedic Surgery, Jacobs School of Medicine and Biomedical Science, University at Buffalo, State University of New York, 100 High St., Buffalo, NY, 14203, USA

    Sonja Pavlesen

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  1. Amy E. Millen
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Correspondence to Amy E. Millen.

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Dr. Pavlesen declares no conflict of interest. Dr. Millen reports grants from National Institute of Dental and Craniofacial Research and the Department of Defense, during the conduct of the study.

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This article is part of the Topical Collection on Host Parasite Interactions in Periodontal Disease

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Millen, A.E., Pavlesen, S. Could Vitamin D Influence Risk for Periodontal Disease—to “D” or Not to “D”?. Curr Oral Health Rep 7, 98–111 (2020). https://doi.org/10.1007/s40496-020-00253-7

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