Clinical Implications of Vitamin D in Oral Diseases- A Review

Oral health is a reflection of systemic health. The various nutritional deficiencies not only affect the systemic health but also have an impact on oral health. The prevalence of Vitamin D deficiency (VDD) is rampant globally. Vitamin D (VD) is not only essential for skeletal growth during childhood and adulthood but has a great impact on oral tissues and odontogenesis. VDD has several implications on oral health from childhood to adulthood. VD can negatively influence the oral health of the mother and child and VD supplementation brings positive outcomes during and after pregnancy. In children, severe VDD can impair tooth mineralization, resulting in defects of enamel and dentin and predispose patients to caries. A remarkably high prevalence of periodontitis is seen in VDD and has implications on systemic health as well. A high prevalence of VDD is seen in oropharyngeal cancers. This review aims to provide the biological role of VD and its receptor, its implication on oral health and future strategies for targeted therapies in oral pathologies.

Vitamin D Deficiency and its Effects on Tooth Structure and pulpal changes

Vitamin D is a steroid hormone that produced primarily by sunlight exposure or obtained from dietary sources, including supplements. The persons who are normally at risk of Vitamin D deficiency are those with scarce of sun exposure and diminished intestinal absorption or limited oral intake. Teeth are nothing but mineralized structure which is enclosed by alveolar bone and are developed by 3 different hard tissues such as dentin, enamel, and cementum. Vitamin D plays a predominant vital part in the tooth and bone mineralization, and it can result in rachitic tooth when the levels get unregulated. Studies suggest that Vitamin D deficiency causes hypocalcified dentin and delayed tooth eruption; thus, representing that Vitamin D has a crucial role in dentin formation as well. The beneficial effects of vitamin D on oral health are not only limited to the direct effects on the tooth mineralization but are also applied through ability to stimulate the production of anti-microbial peptides. In this article, we will briefly discuss the influence on Vitamin D level on the oral and pulpal health.

Effects of Enzyme Replacement Therapy for Primary Teeth in a Patient with Infantile Hypophosphatasia

Hypophosphatasia (HPP) is a skeletal disorder characterized by hypomineralization of bone, with early exfoliation of primary teeth. Alkaline phosphatase enzyme replacement therapy (ERT) has been shown to improve bone hypomineralization for patients with HPP, although its dental effects are unknown. A 20-month-old Japanese boy diagnosed with infantile HPP was referred to our clinic because of early exfoliation of primary teeth. The patient had been followed by a pediatrician since the age of 3 months, due to slow weight gain. At the age of 12 months, primary incisors showed sudden exfoliation; at the age of 19 months, a diagnosis of HPP was made based on bone and dental manifestations. ERT was initiated at the age of 21 months. The patient demonstrated stable periodontal conditions of primary molars that erupted after initiation of ERT, due to improved alveolar bone and tooth mineralization. Thus, ERT may improve both dental and systemic conditions.

Vitamin D Deficiency and Oral Health: A Comprehensive Review

Vitamin D (VD) levels have been gaining growing attention in Oral Health. During growth and adulthood, VD deficiency (VDD) is associated with a wide variety of oral health disorders, and impaired VD synthesis may expedite some of these conditions. In children, severe VDD can induce defective tooth mineralization, resulting in dentin and enamel defects. As a consequence, these defects may increase the risk of the onset and progression of dental caries. Further, VDD has been associated with higher prevalence of periodontitis and gingival inflammation, and several recent preclinical and clinical studies have unveiled potential pathways through which Vitamin D may interact with the periodontium. VDD correction through supplementation may contribute to a successful treatment of periodontitis; however, alveolar bone regeneration procedures performed in baseline VDD patients seem more prone to failure. Vitamin D may also be linked with some oral pathology entities such as certain oral cancers and events of osteonecrosis of the jaw. This review aims to provide comprehensive evidence of how VD levels should be considered to promote good oral health, and to summarize how VDD may hamper oral development and its role in certain oral conditions.

Human and Nonhuman Primate Lineage-Specific Footprints in the Salivary Proteome

Proteins in saliva are needed for preprocessing food in the mouth, maintenance of tooth mineralization, and protection from microbial pathogens. Novel insights into human lineage-specific functions of salivary proteins and clues to their involvement in human disease can be gained through evolutionary studies, as recently shown for salivary amylase AMY1 and salivary agglutinin DMBT1/gp340. However, the entirety of proteins in saliva, the salivary proteome, has not yet been investigated from an evolutionary perspective. Here, we compared the proteomes of human saliva and the saliva of our closest extant evolutionary relatives, chimpanzees and gorillas, using macaques as an outgroup, with the aim to uncover features in saliva protein composition that are unique to each species. We found that humans produce a waterier saliva, containing less than half total protein than great apes and Old World monkeys. For all major salivary proteins in humans, we could identify counterparts in chimpanzee and gorilla saliva. However, we discovered unique protein profiles in saliva of humans that were distinct from those of nonhuman primates. These findings open up the possibility that dietary differences and pathogenic pressures may have shaped a distinct salivary proteome in the human lineage.

Tooth Mineralization: A Technical Note on the Moorrees-Fanning-Hunt Standards

One of the largest, longitudinal studies of tooth mineralization is that described by Moorrees, Fanning and Hunt (J Dent Res, 1963) based on children growing up in Boston, Massachusetts, and Yellow Springs, Ohio. This short communication provides tables of the means and standard deviations, by sex, in order to make the data more accessible and usable than the graphic form of the information in the original article. Characteristics of the study and applications are discussed.

Dental Age: Effects of Estimating Different Events During Mineralization

The extent of tooth mineralization affords apractical method for assessing an individual’s biologicalage. Dental age is useful for evaluating a child’sgrowth status, and for assessing the ages of subjects inanthropological, forensic, and medicolegal settings.Historically, some data have been collected from serialstudies (e.g., Stuart’s Harvard Study, and the BurlingtonStudy) while most studies are cross-sectional, where eachchild is examined just once. Serial and cross-sectionalstudies traditionally have been used to estimate differentsorts of information, namely the onset at a stage and theaverage age in a stage, respectively. This paper discussesthe differences of the analyses, and then presents anempirical comparison of two large sets of data on thelower third molar in American whites, showing how theconventional uses of serial data—that estimate the onsetof an event—precede the age of occurrence derived fromcross-sectional data (age at stage). Inter-group differencesfor tooth stages can exceed one year, so it is important torecognize the nature of the ‘standards’ available in theliterature.