Vitamin D is fat soluble vitamin produced in the skin following exposure to sunlight or as a result of dietary consumption. Insufficient vitamin D intake has been associated the range of systemic conditions (eg. cardiovascular disease, diabetes, cancer), a beneficial effect for vitamin D on periodontal tissues has also been suggested period
The aim of this was to assess if patients with low vitamin D levels have higher risk for periodontal disease and whether periodontal treatment outcomes are improved by adjuvant vitamin D supplementation
Methods
Searches were conducted in the PubMed/Medline, Embase, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Studies publishes in English were included if they had measured serum vitamin D levels or vitamin D intake and any periodontal parameter. Animal in-vitro studies, case reports, letters to editors and literature reviews were excluded.
Two reviewers independently screened the studies, abstracted data and assessed risk of bias. The Newcastle-Ottawa Scale was used for case-control and cohort studies, The Agency for Health Care Research and Quality checklist for cross-sectional studies. and separate tools for case series and randomised controlled trials (RCTs). A narrative summary was presented.
Results
- 27 studies (13 cross-sectional, 6 case-controlled, 4 cohorts, 2 RCTs and 1 case-series) were included.
- 12 studies were considered to have a low risk of bias, 9 a high risk and 6 moderate risk.
- 65% of the cross-sectional studies reported significant associations between low vitamin D levels and poor periodontal parameters.
- None of the observational longitudinal studies found that periodontal disease progression could be attributed to lower vitamin D levels.
- No interventional studies that evaluated the use of vitamin D supplementation as a solely adjuvant to periodontal treatment was found.
Conclusions
The authors concluded: –
The data to support or refute the association between vitamin D levels and periodontal disease are inconclusive at the moment. More rigorously designed longitudinal studies with standardized definitions of periodontal disease and vitamin D are necessary.
Comments
The reviewers have searched a wide range of databases and included a broad range of study designs for this review. However, restricting the inclusion to the English language only may have excluded some relevant papers. Only one study addressed the adjuvant use of vitamin D supplementation and its effects on periodontal treatment. A majority of the included studies were cross-sectional in nature and while the majority demonstrated a positive association no temporal association was seen in the available longitudinal studies. Variations in the definitions of periodontal status and vitamin D status used in the included studies also have implications for interpretation of the findings. As the authors indicate the quality of the currently available evidence means that any link any link between vitamin D levels and periodontal disease is uncertain.
Links
Primary Paper
Pinto JPNS, Goergen J, Muniz FWMG, Haas AN. Vitamin D levels and risk for periodontal disease: A systematic review. J Periodontal Res. 2018 Mar 1. doi:10.1111/jre.12531. [Epub ahead of print] Review. PubMed PMID: 29492977.
Other references
Dental Elf- 3rd Feb 2016
