ORAL SIGNS & SYMPTOMS OF SOME NUTRITIONAL ABERATIONS
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VITAMINS
| VITAMIN | DEFICIENCY OR EXCESS |
| Vitamin C | Deficiency: Scurvy-red swollen gingiva; gingival friability; periodontal destruction; increased tooth
mobility & exfoliation; sore burning mouth; soft tissue ulceration; increased risk
of candidiasis; malformed teeth (inadequate dentine). Excess: Body increases metabolism of vitamin C when taken in excess. When dose returned to normal increased metabolism of the vitamin cause deficiency (rebound scurvy). |
| Vitamin D | Deficiency: Abnormal bone regeneration osteoporosis;
osteomalacia; incomplete mineralisation of teeth & alveolar bone; rickets. Excess: Pulp calcification; enamel hypoplasia. |
| Vitamin K | Deficiency: Increased risk of bleeding & candidiasis |
| Vitamin A | Deficiency: Inadequate cell differentiation-impaired
healing & tissue regeneration; desquamation of oral mucosa; keratosis; increased
risk of candidiasis; gingival hypertrophy & inflammation; leukoplakia; decreased taste
sensitivity; xerostomia; disturbed or arrested enamel development; irregular tubular
dentine formation and increased caries risk. Excess: Impairs cell differentiation & epithelialisation-impaired healing (mimics deficiency). |
| Vitamin B2 (Riboflavin) | Deficiency: Angular cheilosis; atrophy of filliform papillae; enlarged fungiform papillae; shiny red lips; magenta tongue; sore tongue. |
| Vitamin B3 (Niacin) | Deficiency: Angular cheilosis; mucositis; stomatitis; oral pain; ulceration; ulcerative gingivitis; denuded tongue; glossitis; glossodynia; tip of tongue is red & swollen; dorsum is dry & smooth. |
| Folic acid | Deficiency: Angular cheilosis; mucositis; stomatitis; sore or burning mouth; increased risk of candidiasis; inflamed gingiva; glossitis oral pain; ulceration; ulcerative gingivitis; denuded tongue; glossitis; glossodynia; tip or borders of tongue red & swollen; slick bald pale; apthous ulcers. |
| Vitamin B6 (Pyridoxine) | Deficiency: Angular cheilosis; sore or burning mouth; glossitis; glossodynia. |
| Vitamin B12 (Cyanocolbalamin) | Deficiency: Angular cheilosis; mucositis; stomatitis; sore or burning mouth; haemorrhage gingiva; halitosis; epithelial dysplasia of oral mucosa; oral parethesia; detachment of periodontal fibres; loss or distortion of taste; glossitis oral pain; ulceration; ulcerative gingivitis; denuded tongue; glossitis; glossodynia; tongue is "beefy", red, smooth & glossy; delayed wound healing; xerostomia; bone loss; apthous ulcers. |
MINERALS
| MINERAL | DEFICIENCY OR EXCESS |
| Fluoride | Deficiency: Decreased resistance to caries. Excess: Disturbed amelogenesis; mottled/stained enamel; enamel hypoplasia (fluorosis) |
| Iron | Deficiency: Angular cheilosis; pallor of lips and oral mucosa; sore, burning tongue; atrophy/denudation of filliform papillae; increased risk of candidiasis; glossitis. |
| Calcium | Deficiency: Incomplete mineralisation of teeth; rickets; osteomalacia; osteoporosis; excessive bone resorption & bone fragility; increased tendency to haemorrhage; increased tooth mobility & premature loss. |
| Copper | Deficiency: Decreased trabeculae of alveolar bone; decreased tissue vascularity; increased tissue fragility. |
| Zinc | Deficiency: Loss or distortion of taste & smell acuity; loss of tongue sensation; delayed wound healing; impaired keratinisation of epithelial cells; epithelial thickening; atrophic oral mucosa, increased susceptibility to periodontal disease, candidiasis, xerostomia & caries if deficient during tooth formation. |
| Magnesium | Deficiency: Alveolar bone fragility; gingival hypertrophy |
| Phosphorus | Deficiency: Incomplete mineralisation of teeth; increased susceptibility to caries if deficient during tooth formation; increased susceptibility to periodontal disease due to effects on alveolar bone. |
OTHER NUTRIENTS
| NUTRIENT | DEFICIENCY OR EXCESS |
| Carbohydrate | Deficiency: Caries rate generally decreases when
carbohydrate intakes decreases. Excess: Increased frequency of intake of all carbohydrates (except fibre) is a causative risk factor for caries |
| Fats | Deficiency: Angular cheilosis; pallor of lips and oral
mucosa; sore, burning tongue; atrophy/denudation of filliform papillae; increased risk of
candidiasis; glossitis. Excess: No direct effect but fats may coat teeth and protect them againts cariogenic challange. |
| Protein | Deficiency: Defects in tooth composition, eruption pattern & resistance to decay; increased susceptibitlity to soft tissue infrection poor healing/tissue regeneration. |
| Water | Deficiency: Dehydration and fragility of of epithelial tissue; decreased muscle strength for chewing; xerostomia; burning tongue. |
Adapted from Modern Nutrition in Health and Disease (9th ed) Editors: Shils; Olsen; Shike & Ross. Published by Williams & Wilkins.