Periodontal disease linked to lower Vitamin D levels

The Otassha Study revealed that lowered levels of serum vitamin D levels affected periodontal health in a group of the Japanese population. The study results were published in the Journal of Clinical Periodontology. 

Periodontitis (PD) is a complex, non-communicable polymicrobial disease of the periodontia caused due to an unbalanced interaction between the oral microbial and the individual inflammatory response. It is characterized by gingivitis and the loss of the supporting tissues of the teeth. Management includes various periodontic therapeutic modalities as per the patient's periodontal status. Previous literature shows that vitamin D levels can affect the periodontal health of an individual. It was shown that lower vitamin D levels have been associated with higher periodontal destruction and severe periodontitis stages. Hence researchers from the Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan conducted a study to evaluate the association between vitamin D status and periodontal inflammation as determined by the periodontal inflamed surface area (PISA) in community-dwelling older adults in Japan. 

A cross-sectional study was carried out on 467 Japanese adults with a mean age of 73.1 years who underwent full-mouth periodontal examinations and measurements of serum levels of 25-hydroxyvitamin D (25(OH)D). Linear regression models and restricted cubic spline models were used to analyze the association between exposure (serum 25(OH)D) and outcome (PISA). 

Key findings:

• After adjusting for potential confounders, participants in the lowest quartile of serum 25(OH)D had 41.0 mm2 more PISA than the reference group as per the linear regression model. 
• There was a non-linear association between serum 25(OH)D and PISA as per the spline model and restricted to the low 25(OH)D range.
• There was an initial sharp decrease in PISA as serum 25(OH)D increased, and then the decreasing trend slowed and plateaued.
• The inflection point with the minimum PISA value was a serum 25(OH)D level of 27.1 ng/mL, above which there was no decreasing trend in PISA with increasing serum 25(OH)D levels. 

Thus, an L-shaped association was seen with an initial rise and plateau formation between the Japanese population's Vitamin D levels and periodontal health. 

further reading: Masanori Iwasaki et al. Serum levels of vitamin D and periodontal inflammation in community-dwelling older Japanese adults: The Otassha Study.  https://doi.org/10.1111/jcpe.13834