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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