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 followup 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.