Nutrition in dentistry

Vitamins

Vitamin B1thiamine

function – coenzyme (oxidative decarboxylation...)

Symptoms

Deficiency: beri-beri exudative (wet) form – heart insufficiency, oedema dry form – polyneuritis, Wernicke-Korsakoff

syndrome

B1 deficiency – chronic alcoholism

Beri-beri

Vitamin B2riboflavin

function – coenzyme (redox reactions... )

Oral signs and symptoms

Deficiency: angular cheilosis, atrophy of filliform papilae, shiny red lips, sore tongue

Other symptoms

conjuctivitis, dermatitis, anaemia, mental retardation

Vitamin B2angular cheilosis

conjuctivitis

atrophy of filliform papilae

Vitamin B3niacin, nicotinic acid

function – coenzyme (redox reactions...)

Oral signs and symptoms

Deficiency: angular cheilosis, mucositis, stomatitis, oral pain, ulceration, denuded tongue, glositis, glossodynia, red and swollen tip or borders of tongue, dorsum is dry and smooth

Other symptoms

Deficiency: Pelagra (3D) – dermatitis, diarhea, dementia

cheilosis mucositis glositis

glossodynia Pelagra - dermatitis

Folic acidTetrahydrofolic acidfunction – biosynthesis of purins → DNA

Oral signs and symptomsDeficiency: angular cheilosis, mucositis, stomatitis, oral pain, sore or burning mouth, increased risk of candidiasis, inflamed gingiva, glossitis, glossodynia, red and swollen tips or borders of tongue, aphtous ulcers

Other symptomsDeficiency: macrocytic anaemia, diarhea, weight loss

candidiasis

inflamed gingiva aphtous ulcers macrocytic anaemia

macrocytes

normal RBC

Vitamin B6pyridoxine

function – coenzyme (amino acid metabolism...)

Oral signs and symptoms

Deficiency: angular cheilosis, sore or burning mouth, glossitis, glossodynia

Other symptoms

Deficiency: neuritis, diarhea, dermatitis, anaemia, seizures

Vitamin B12cyanocobalaminefunction – coenzyme, folate metabolism...

Oral signs and symptomsDeficiency: angular cheilosis, mucositis, stomatitis, sore or burning mouth, haemorrhage gingiva, halitosis, dysplasia of oral mucosa, loss of taste, oral pain, ulceration, glossitis, glossodynia, red tongue, xerostomia, aphtous ulcers

Other symptomsDeficiency: pernicious anaemia, neurological signs

halitosis

xerostomia

Vitamin Cascorbic acidfunction – reducing agent, antioxidant, collagen biosynthesis, iron absorption, immunity...

Oral signs and symptomsDeficiency: Scurvy – red swollen gingiva, gingival friability, periodontal destruction, increased tooth mobility and exfoliation, sore burning mouth, soft tissue ulceration, increased risk of candidiasis, malformed teeth (inadequate dentine)

Other symptomsDeficiency: fragility of vessel wall, impaired development of bones

Scurvy

Vitamin Aretinolfunction – vision, growth and differentiation of epitels

Oral signs and symptomsDeficiency: impaired tissue healing and regeneration, desquamation of oral mucosa, keratosis, increases risk of candidiasis, gingival hypertrophy and inflammation, leukoplakia, decreased taste sensitivity, xerostomia, disturbed enamel development, increased caries riskExcess: impaired wound healing

Other symptomsDeficiency: night blindness, xerophtalmia, mucosa drynessExcess: hepatosplenomegalia, anaemia, hair loss

desquamation of oral mucosa keratosis

gingival hypertrophy and inflammationm

leukoplakia xerostomia

disturbed enamel development caries

Vitamin Dcalcitriolfunction – hormone, Ca metabolism

Oral signs and symptomsDeficiency: osteoporosis, osteomalacia, rickets, incomplete mineralisation of teethExcess: pulp calcification, enamel hypoplasia

Other symptomsDeficiency: osteoporosis, osteomalacia, ricketsExcess: Ca mobilisation from bones, kidney stones

pulp calcification enamel hypoplasia

osteoporosis

rickets

Vitamin Kfunction – blood clotting

Oral signs and symptoms

Deficiency: increased risk of bleeding

tocopherol

function – antioxidant

Vitamin E

Minerals

FluorideOral signs and symptoms

Deficiency: decreased resistance to caries

Excess: enamel hypoplasia (fluorosis)

IronOral signs and symptoms

Deficiency: angular cheilosis, pallor of lips and oral mucosa, sore, burning tongue, glossitis

Other symptomsDeficiency: anaemia

CalciumOral signs and symptoms

Deficiency: incomplete mineralisation of teeth, rickets, osteomalacia, osteoporosis, bone fragility, increased tooth mobility and premature loss

Other symptoms

Deficiency: rickets, osteomalacia, osteoporosis

ZincOral signs and symptoms

Deficiency: loss of taste and tongue sensation, delayed wound healing, increased susceptibility to periodontal disease, candidiasis, xerostomia, caries

Other symptoms

Deficiency: impaired immune function

MagnesiumOral signs and symptoms

Deficiency: alveolar bone fragility, gingival hypertrophy

Oral signs and symptoms

Deficiency: incomplete mineralisation of teeth, increased susceptibility to caries if deficient during tooth formation, increased susceptibility to periodontal disease

Phosphorus

Other nutrients

CarbohydrateOral signs and symptoms

Deficiency: decreased risk of cariesExcess (except fibre): caries

FatsOral signs and symptoms

Deficiency: angular cheilosis, pallor of lips and oral mucosa, sore burning tongue, atrophy of filliform papillae, increased risk of candidiasis, glossitisExcess: no effect (teeth)

but

ProteinsOral signs and symptoms

Deficiency: defect of tooth composition, eruption pattern, resistance to decay, increased susceptibility to soft tissue infraction, poor tissue healing and regenerationExcess: no effect

WaterOral signs and symptoms

Deficiency: dehydratation and fragility of epitelial tissue, decreased muscle strength for chewing, xerostomia, burning tongue