Nutrition in dentistry

Vitamins

Vitamin B1 thiamine 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 B2 riboflavin 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 B2 angular cheilosis conjuctivitis atrophy of filliform papilae

Vitamin B3 niacin, 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 acid Tetrahydrofolic acid function – biosynthesis of purins → DNA Oral signs and symptoms Deficiency: 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 symptoms Deficiency: macrocytic anaemia, diarhea, weight loss

inflamed gingiva aphtous ulcers macrocytic anaemia candidiasis inflamed gingiva aphtous ulcers macrocytic anaemia macrocytes normal RBC

Vitamin B6 pyridoxine 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 B12 cyanocobalamine function – coenzyme, folate metabolism... Oral signs and symptoms Deficiency: 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 symptoms Deficiency: pernicious anaemia, neurological signs

halitosis xerostomia

Vitamin C ascorbic acid function – reducing agent, antioxidant, collagen biosynthesis, iron absorption, immunity... Oral signs and symptoms Deficiency: 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 symptoms Deficiency: fragility of vessel wall, impaired development of bones

Scurvy

Vitamin A retinol function – vision, growth and differentiation of epitels Oral signs and symptoms Deficiency: 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 risk Excess: impaired wound healing Other symptoms Deficiency: night blindness, xerophtalmia, mucosa dryness Excess: hepatosplenomegalia, anaemia, hair loss

desquamation of oral mucosa keratosis gingival hypertrophy and inflammationm

leukoplakia xerostomia disturbed enamel development caries

Vitamin D calcitriol function – hormone, Ca metabolism Oral signs and symptoms Deficiency: osteoporosis, osteomalacia, rickets, incomplete mineralisation of teeth Excess: pulp calcification, enamel hypoplasia Other symptoms Deficiency: osteoporosis, osteomalacia, rickets Excess: Ca mobilisation from bones, kidney stones

pulp calcification enamel hypoplasia osteoporosis rickets

Vitamin K Vitamin E function – blood clotting Oral signs and symptoms Deficiency: increased risk of bleeding tocopherol function – antioxidant Vitamin E

Minerals

Fluoride Oral signs and symptoms Deficiency: decreased resistance to caries Excess: enamel hypoplasia (fluorosis)

Iron Oral signs and symptoms Deficiency: angular cheilosis, pallor of lips and oral mucosa, sore, burning tongue, glossitis Other symptoms Deficiency: anaemia

Calcium Oral 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

Zinc Oral 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

Magnesium Phosphorus Oral signs and symptoms Deficiency: alveolar bone fragility, gingival hypertrophy Deficiency: incomplete mineralisation of teeth, increased susceptibility to caries if deficient during tooth formation, increased susceptibility to periodontal disease Phosphorus

Other nutrients

Carbohydrate Oral signs and symptoms Deficiency: decreased risk of caries Excess (except fibre): caries

Fats Oral signs and symptoms Deficiency: angular cheilosis, pallor of lips and oral mucosa, sore burning tongue, atrophy of filliform papillae, increased risk of candidiasis, glossitis Excess: no effect (teeth) but

Proteins Oral signs and symptoms Deficiency: defect of tooth composition, eruption pattern, resistance to decay, increased susceptibility to soft tissue infraction, poor tissue healing and regeneration Excess: no effect

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