Common oral diseases include gingivitis (inflammation of soft ‘gum’ tissue), periodontitis (infection of hard and soft tissues around teeth) and caries (infection of teeth). These conditions are influenced by the body’s immune function as well as its ability to promote mineralization of hard tissues in the area. As a mediator of mineralization and immunity, vitamin D levels may influence these conditions. Vitamin D has anti-inflammatory and anti-bacterial roles in the oral cavity. Its anti-inflammatory effects are a result of many different interactions including activation of both acquired and innate immunity.
The presence of vitamin D also provides indirect antimicrobial effects through increasing cathelicidin levels, which destroy both gram negative and gram positive bacteria. As a result, vitamin D deficiency may compromise immunity and allow bacterial growth within the oral cavity, ultimately increasing local inflammation and the development of periodontal disease. Vitamin D is also necessary for mineralization of dental tissues including alveolar bone, enamel, and dentin. Inadequate mineralization of these tissues as a result of vitamin D deficiency can contribute to decreased integrity of these structures, placing them at higher risk for disease.In the presence of inflammation and pathogenic bacteria, which is also exacerbated by vitamin D deficiency, oral conditions such as periodontitis and caries may be at higher risk of development. While most evidence shows an association between vitamin D deficiency and conditions of the oral cavity, it is important to remember that oral diseases are often multifactorial. Evidence linking vitamin D deficiency with increased risk for oral disease requires more investigation to show causality and determine the magnitude of the contribution. Vitamin D is involved in many vital aspects of mineralization, immunity, and tissue integrity that suggest a key role in preventing oral disease.