Nutrition is critical to the oral health of the individual.
Vitamins, minerals, and other nutrients are vital to the growth,development, maintenance, and repair of healthy dentition andoral tissues as well as the body systems in general. Nutritionaldeficiencies and unhealthy habits can cause or contribute to oralpathoses such as scurvy, cleft palate, enamel hypoplasia, poormineralization, caries, squamous cell carcinoma, and others.Dentists can play an important role in educating patients on theimportance of good nutrition to oral and systemic health.
From gestation through the end of life, nutrition influences
the integrity and function of the teeth and
supporting oral structures and has a direct effect on health in
A well-balanced diet is key to ensuring that individuals
receive the nutrients they need. Some commonly prescribed medications are associated
with nutritional deficiencies!
Poor nutrition and unhealthy habits “can affect the development
and integrity of the oral cavity as well as the progression
of oral diseases.
Dentists who are knowledgeable about nutrition
are equipped to ask patients relevant questions about dietary
habits that may affect oral and systemic health and to provide
guidance that promotes healthy lifestyles.
Folate and B complex vitamins
Folate (vitamin B9) is a critical component to power the amino
acid metabolism required for cell division. It is an essential vitamin
and cannot be created in the human body.
Due to its role in
nucleic acid synthesis and the rapid cell creation of the growing
fetus, the demands for folate increase during pregnancy.
For this reason it is recommended that all women of child-bearing age,
even if not currently pregnant, take a daily supplement containing
0.4-0.8 mg of folic acid. Although folate deficiency is most
often associated with neural tube defects, recent studies have
found a reduced occurrence of cleft lip with or without cleft
palate when pregnant women take supplemental folic acid.
Because B vitamins frequently exist in the same foods, they are
commonly referred to as the B complex vitamins. A deficiency
in one is likely to be accompanied by deficiencies in others.
Deficiencies in B2, B3, B6, and B12 will typically manifest in the oral
cavity as stomatitis-inflammation in the mouth, glossitis-inflammation of the tongue, and oral ulcers.
Risk factors for vitamin B deficiencies include older age, medications, chronic alcohol
abuse, malabsorptive syndromes, and vegetarian and vegan diets.
Another essential nutrient, vitamin C is required for the synthesis
of collagen, which almost exclusively constitutes the
protein portion of teeth and bones. Collagen, and thus vitamin C, are necessary for the
creation of dentin, pulp, cementum, periodontal fibers, blood
vessels, gingival nerves, connective tissues, and periodontal
ligaments. Vitamin C continues to be necessary for the
turnover of bone, tooth, and connective tissue throughout
the life span.
Inadequate intake of vitamin C will eventually manifest as
scurvy. Initial symptoms of scurvy include inflammation of
the gingiva. As the deficiency progresses, collagen synthesis is
impaired and connective tissues are weakened, causing poor
wound healing; inflamed, bleeding gingiva; and loosening of
teeth as a result of tissue and capillary fragility.
All fruits and vegetables contain vitamin C, but those with
the highest content include oranges, berries, broccoli, and red
Apart from its role in healthy vision, vitamin A functions as an
important component required to maintain the mucosal membranes,
salivary glands, and teeth. Deficiency in this vitamin will result in various abnormalities,
including tooth brittleness, salivary gland degeneration,
and increased risk of caries.
A natural hormone of the human body, vitamin D plays an
important role in the absorption of calcium, phosphorus, and
magnesium from the gut, allowing the proper mineralization
of bones and teeth. Like insufficient vitamin A, a deficiency in
vitamin D is associated with enamel and dentin hypoplasia-deficiency of cells or structural elements.
Inadequate levels of vitamin D during tooth formation may
result in delayed eruption as well as lamina dura and cementum
loss that leads to tooth loss.
Calcium and phosphorus
The mineralization of the protein matrix is completed with the
deposition of hydroxyapatite- the principle storage form of calcium and phosphorus in bone,
giving bones and teeth their compressive
Bone growth continues through childhood and into adolescence.
Inadequate intake of calcium will lead to osteopenia, or
decreased bone density and mass. If this deficiency remains
unaddressed, it will lead to osteoporosis, a disorder wherein the
bones become porous, brittle, and subject to fracture. Tooth
mobility and premature tooth loss may result. Although not
the most common site of fractures, the jaw and oral alveoli will
exhibit reduced strength due to the paucity of these minerals.
Just as numerous oral disease conditions are related to a lack of nutrients
in the diet, the presence of certain substances and qualities of
food, either in excess or outright, will also manifest in disparate
ways in the oral cavity.