Vitamin D and Periodontal Health: A Systematic Review

Abstract

The role of vitamin D in maintaining gum well-being is crucial. However, scientific research reported that the connotations of cholecalciferol and periodontal health have been divested in the present literature. However, there is enormous heterogeneity in the data available. The current review aims to systematically review and appraise the available literature investigating the role of vitamin D in maintaining periodontal health. Studies included randomized controlled trials and clinical trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and cohort studies reporting associations between vitamin D and oral health in systemically healthy patients. Databases such as PubMed, Google Scholar, Scopus, Embase, and other sources, including hand search, were searched until May 2023 using together-equipped search sequences. Altogether, scientific articles that conform to the inclusion principles underwent a thorough eminence evaluation. All papers meeting inclusion criteria were subject to quality assessment, and the method used to assess the risk of bias was the Cochrane risk of bias tool. The search identified 1883 papers, among which 1435 were excluded after title evaluation. After abstract and title screening, 455 were excluded, and six full texts were assessed. After full-text evaluation, two articles were excluded, and only four were included. The data shows vitamin D's association with oral health maintenance. Along with its action on bone metabolism, it has extended function, which provides for its action as an anti-inflammatory agent and production of anti-microbial peptides, which help maintain oral health. Although the literature available is immense, there is enormous heterogenicity in the papers conducted to appraise the association between vitamin D and oral health. This systematic review has filtered all the data to review a few essential aspects of the role of vitamin D in maintaining oral physiology. Vitamin D has a linear relationship with periodontal health; however, the evidence is insufficient, and further studies must be done.

Keywords: cholecalciferol; gum disease; mouth cavity; nutrition; oral physiology; periodontal disease; periodontal health; vitamin d; vitamins; well-being.

Figure 1. A simplified PRISMA flow chart showing the literature search

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses This figure has been drawn with the premium version of BioRender (https://biorender.com/ accessed on October 11, 2023) with the license number XP25YIQG2X. Image credit: Susmita Sinha

Figure 2. Traffic light plot for risk of bias of included RCTs

RCT: Randomized control trial Hiremath et al. 2011 [101], Woelber et al. 2016 [102], Tennert et al. 2020 [103]

Figure 3. Summary plot for risk of bias of included RCTs

RCT: Randomized control trial Hiremath et al. 2011 [101], Woelber et al. 2016 [102], Tennert et al. 2020 [103]

Figure 4. Schematic diagram showing the protective effects of vitamin D on periodontal health

This figure has been drawn with the premium version of BioRender (https://biorender.com/ accessed on October 9, 2023) with the license number NW25YA0QJR. Image Credit: Susmita Sinha

Figure 5. Schematic diagram showing the role of vitamin D in innate immunity

This figure has been drawn with the premium version of BioRender (https://biorender.com/ accessed on October 9, 2023) with the license number BE25Y9UD7X. Image Credit: Susmita Sinha