Hypothesis: Periodontal disease is related to vitamin D – 2010

Are Hill's criteria for causality satisfied for vitamin D and periodontal disease?

Dermatoendocrinol. 2010 Jan–Mar; 2(1): 30–36. doi: 10.4161/derm.2.1.12488. PMCID: PMC3084963
William B Grant 1 wbgrant@infionline.net and Barbara J Boucher 2
1Sunlight, Nutrition; and Health Research Center (SUNARC); San Francisco, CA USA
2Centre for Diabetes; Bart's and The London School of Medicine and Dentistry; Queen Mary University of London; Blizard Institute of Cell and Molecular Science; London, UK

There is mounting evidence that periodontal disease (PD) is linked to low serum 25-hydroxyvitamin D 25(OH)D concentrations in addition to recognized risk factors like diet and smoking.
This paper reviews this evidence using Hill's criteria for causality in a biological system.
Evidence for strength of association, consistency, cohesion and ‘dose-effects’ (biological ‘gradients’) include strong inverse correlations between serum 25(OH) and PD cross-sectionally and that PD is consistently more prevalent in darker vs. lighter skinned people and increases at higher latitudes with analogy for gingivitis and for disorders associated with PD whose risks also increase with hypovitaminosis D.

Evidence for plausibility includes that

• vitamin D increases calcium absorption and protects bone strength;
• induces formation of cathelicidin and other defensins that combat bacterial infection;
• reduces tissue production of destructive matrix metalloproteinases actively associated with PD and that
• prevalence of PD varies with common vitamin D receptor polymorphisms.

Experimental evidence from limited supplementation studies (using calcium and vitamin D) shows that supplementation reduces tooth loss. Thus, existing evidence for hypovitaminosis D as a risk factor for PD to date meets Hill's criteria for causality in a biological system.
Further experimental evidence for effectiveness and temporality, preferably from randomized controlled trials of vitamin D supplementation (adjusting for other PD risk factors including diet and smoking to reduce confounding) are necessary to confirm causality. If confirmed, dentists and periodontists could perform a valuable service to their patients by discussing the importance of adequate vitamin D status and how to avoid deficiency.

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See also VitaminDWiki

• Great Teeth if 10X more fat-soluble vitamins (Vitamin D) - 1935
• Periodontal disease 1.5 times more likely if low vitamin D – Sept 2016
• All items in Vitamin D and Dental 116 items
• CLICK HERE for >100 articles mentioning WB Grant
• Vitamin Deficiency Underlies Tooth Decay – 2009 and 1931
• Teeth and vitamin D - from Book - Sunlight Solution
• More sunshine: more teeth (1862), fewer cavities (1934) – Oct 2011
  • On pages 105-107, she describes how teeth health was known since the 1930's to be improved with vitamin D, sunshine, and full spectrum bulbs in classrooms.
• UVB and Vitamin D might decrease dental caries better than floride – July 2011

See also web

• A review of the role of solar ultraviolet-B irradiance and vitamin D in reducing risk of dental caries Dr. Grant, 2011 full text online