Thursday, January 29, 2009

How soon will you lose your teeth? With vitamin D, maybe you won’t!

AOL just asked the tooth-loss question on their front page; unfortunately, the article they linked to never mentioned vitamin D as a prophylactic against dental disease and loss of teeth. I was immediately reminded of research showing that periodontal (gum) disease and cavities were both related to low levels of vitamin D deficiency. Yes, you heard that correctly. Vitamin D plays a vital role in dental health, especially the health of gums and bones.

So before you subject your teeth to $20,000 worth of cosmetic dentistry in order to display those pearly whites, be sure your gums are healthy; otherwise, those beautiful teeth may not hang around very long. Beyond vitamin D, good oral hygiene and good nutrition are also vital.

Periodontal disease (PD) attacks the gums and bone around the teeth, causing inflammation, bone loss and subsequent loss of teeth. It is the number-one cause of tooth loss.[1] When the reasons for tooth extraction are analyzed, about 51% of teeth are extracted due to PD.

I previously wrote about the close relationship of inflammation to cardiovascular disease (CVD). In that article I established that vitamin D was anti-inflammatory, and that high vitamin D levels related to a 60% reduction in heart attacks. There is also a close relationship between CVD and PD. Men with PD who are under 50 years of age have a 72% greater risk of CVD.[2]

In the case of PD, bacteria that live in dental plaque cause an immune cell response that releases inflammatory chemicals—the body’s way of trying to destroy the bacteria. Unfortunately, these chemicals cause inflammation of the gum and bone tissue, leading to PD.[3] It is not surprising, then, that the anti-inflammatory properties of vitamin D would reduce both CVD and PD.

Vitamin D and sunlight are also known to dramatically prevent or even reverse osteoporosis. (See my earlier blogs). The bone that holds the teeth is called the alveolar ridge, and if it degenerates, tooth loss is increased. Research has shown that that osteoporosis is closely related to alveolar ridge bone loss and loss of teeth.[4] So does vitamin D reduce the risk of alveolar bone and thereby prevent tooth loss? One study showed that subjects who were supplemented with both calcium and vitamin D had a rate of tooth loss that was 60% lower than those not supplemented![5]

It might seem that using an osteoporosis drug might be the answer to maintaining the alveolar ridge, but don't even think about going there. One of the most popular anti-osteoporosis drugs, Fosomax, may cause bone death in the jaw, resulting in pain, swelling, gum infections, poor healing of gums and loose teeth. Not the result we want to maintain our dental health![6]

The message: maintain optimal vitamin D levels; it will help protect agains teeth loss with none of the side effects of noxious osteoporosis drugs.

[1] dental 2006.
[2] DeStefano, F. et al. BMJ 1993;306:688-9.
[3] Page, R Compend Contin Educ Dent 2002;23:11-14.
[4] Tezal, M. J Periodontol 2000;71:1492-8.
[5] Krall, E. et al. Am J Med 2001;111:452-56