Vitamins and Mineral

Oral Health
General / Systemic Health
Diet / Nutrition

- formally the RDAs
- provide guidelines for determining nutritional needs of healthy individual, and detail

A
D
E
K

1) maintains health of retina
2) growth & health of skin & mucous membrane
3) development of teeth, soft tissue and skeletal tissue

1) More common—fatal
2) Related to birth defects in the head and neck regions
3) Healing of epithelial and periodontal tissues
4) Manifest as a yellow or orange color in tissues

1) Rare in USA
2) Inability to heal
3) Xerosis (drying of eye)
4) Xeropthalmia ( drying and opaqueness of cornea)
5) Changes in taste due to xerostomia
6) High rate of co morbidity and mortality with infectious diseases (respiratory and diarrhea)

1) Promotes the body's absorption of calcium, essential to development of bones and teeth

Toxic effects occur in adults receiving 2500 µg (100,000 IU)/day for several months

1) Vitamin D deficiency a pandemic problem in 40%-60% of adults and teens
2) Insufficient Sun Exposure
3) Elderly
4) Malabsorption
5) Kidney failure

1) Osteoporosis
2) Vitamin D may be protective against some cancers
3) Low levels may increase risk for heart attack
4) Rickets
5) Osteomalacia

1) Protects cell membranes & tissues from oxidation
2) Formation of red blood cells & use of vitamin K
3) Function of a healthy circulatory system

1) Research suggests an increase in mortality with supplementation
2) Occasionally, muscle weakness, fatigue, nausea, and diarrhea have occurred in persons taking 800 to 3200 mg/day
3) Most significant effect at >1000 mg/day is antagonism to vitamin K action and enhancement of the effect of oral anticoagulants

1) Mild hemolytic anemia associated with increased erythrocyte hemolysis
2) Peripheral neuropathy
3) Subsequent decline in physical function

1) Sickle cell anemia
2) Smokers
3) Those on an extremely low-fat diets

Blood clotting

1) Results from risk factors
2) No specific oral manifestations except for possible excess bleeding

1) Celiac disease, sprue
2) Diarrheal diseases
3) Hemorrhagic disease of the newborn
4) Marginal dietary intake due to trauma, extensive surgery, or long-term parenteral nutrition
5) Anticonvulsants, anticoagulants, certain antibiotics (particularly cephalosporins), salicylates, and megadoses of vitamin A or E

No noted reports

1) B1 - Thiamine
2) B2 - Riboflavin
3) B3 - Nicotinic Acid/ Niacin
4) B6 - Pyroxidine
5) B12 - Cobalamin
6) B9 - Folate/ Folic Acid
7) Biotin & Pantothenic Acid
8) Vitamin C

1) helps the body convert food to energy
2) aid in function of heart, cardiovascular, brain and nervous system

Excess no apparent adverse side effects

1) Rare in developing countries
2) Classic Beriberi ( I cannot) related to alcoholism
3) Wernicke-Korsakoff Syndrome
4) Burning Tongue
5) Sensitive and Burning Mucosa
6) Loss of Taste
7) Loss of Appetite

1) promotes healthy growth and tissue repair
2) helps release energy from carbohydrates
3) healthy skin
4) healthy red blood cell production

Not reported

1) Congenital facial deformities due to mom’s deficiency
2) Watch phenothiazines and antibiotics
3) Watch vegans
4) Added stress, alcoholism, surgery, malabsorption

1) Uncommon unless at risk
2) Needed for B6 and Niacin so similar secondary symptoms
3) Angular cheilosis
4) Dermatitis
5) Anemia

1) helps release energy from carbohydrates
2) healthy nerves
3) healthy digestive system

1) Abnormal liver function
2) Gout

1) Alcoholics
2) Dependent on corn/maize
3) Prolonged treatment with Isoniazids

1) Pellegra (3D’s dermatitis, diarrhea, & dementia/depression)
2) Stomatitis
3) Red, painful, edematous tongue, loss of papilla

1) healthy brain function
2) formation of red blood cells
3) breakdown of protein
4) synthesis of antibodies that support the immune system

1) Uncommon
2) Megadose - ataxia & neuropathy

1) Alcoholics
2) Elderly
3) Medications that reduce absorption: TB drugs, penicilliamine, theophylline, and oral contraceptives

1) With other B Vitamins
2) CNS Abnormalities
3) Cheilosis
4) Dermatitis
5) Glossitis
6) Impaired immune response
7) Anemia

1) Metabolism
2) formation of RBC
3) maintenance of central nervous system (brain & spinal cord)

1) NO benefit/ may mask
2) Too much Folic acid masks a deficiency

1) 5-20% Elderly
2) Vegans
3) Xerostomia
4) Excessive Vitamin C
5) Gastric bypass
6) Tummy meds

1) Pernicious anemia (large RBCs)
2) Glossopyrosis (unexplained pain of the tongue)
3) Altered taste sensation
4) Glossitis
5) Cheilosis
6) Stomatitis or pale/yellowish mucosa
7) Hemorrhagic gingiva/bone loss
8) Gastrointestinal disturbances
9) Neurologic manifestations, numbness and tingling
10) Stunted growth

1) RBC production
2) Synthesis of DNA
3) helps digest & use proteins

1) May mask vitamin B12 deficiency
2) Kidney damage
3) Risk of cognitive decline reported in elderly persons

1) Secondary to alcohol abuse
2) Pregnancy/lactation
3) Oral contraceptive & anticonvulsant medications
4) Kidney dialysis
5) Liver disease
6) Gastrointestinal disease
7) Bariatric surgery

1) Neural tube defects
2) Megaloblastic anemia
3) Elevated blood homocysteine levels
4) Glossitis (fiery red, denuded of papillae)
5) Impairs immune response

1) Energy
2) Metabolism
3) Hair & nail growth

None reported

Antibiotic use

1) Can be produced by ingestion of avidin, the protein found in raw egg whites
2) Pallor of tongue
3) Patchy atrophy of lingual papillae along the lateral borders of the tongue

None reported

None reported

1) healthy immune system
2) helps wounds heal
3) maintains connective tissue
4) aid in absorption of iron

1) Marginal intakes
2) Deficiency does not CAUSE gingivitis or periodontal disease, but may be a contributing factor
3) Delayed wound healing
4) Poor bone and tooth development
5) Scurvy

-- Vitamin C aids absorption of iron so Vitamin C is combined with or recommend take Iron with Vitamin C
-- Linus Pauling

1) Uncommon
2) Megadose - ataxia & neuropathy

1) Alcoholics
2) Elderly
3) Medications that reduce absorption: TB drugs, penicilliamine, theophylline, and oral contraceptives

1) With other B Vitamins
2) CNS Abnormalities
3) Cheilosis
4) Dermatitis
5) Glossitis
6) Impaired immune response
7) Anemia

1) Metabolism
2) formation of RBC
3) maintenance of central nervous system (brain & spinal cord)

1) Hemochromatosis
2) Poison for children

alcoholics

1) Plummer-Vinson Syndrome
--- Dysphagia due to anomalies in the esophagus (such as cervical esophageal webs)
--- Iron deficiency anemia
--- Glossitis/Burning Tongue/Angular Chelitis

1) Reduced growth
2) Increase susceptibility to infection
3) Delayed wound healing
4) Loss of taste and smell
5) Xerostomia
6) Atrophic mucosa
7) Link to Vitamin A & night blindness
8) Important for pregnant women

1) Impairs bone and cartilage growth
2) Hair loss
3) Fingernail discoloration and loss
4) Breath odor
5) Caries… DMF indices higher in areas where the soil has high concentrations of selenium

Fluorosis

1) Helps absorb calcium
2) Helps hydroxyapatite crystal formation and growth
3) Hypocalcification
4) Hypercalcification

1) Dizziness, flushing, nausea/vomiting, severe constipation, kidney stone formation, irregular heartbeat, tingling sensations, xerostomia, fatigue and high blood pressure
2) May inhibit iron and zinc absorption

1) Hyperparathryoidism
2) Overdoses of cholecalciferol
3) Vitamin D poisoning

1) Rickets
--- Abnormal ossification from vitamin D, calcium deficiency
2) Osteoporosis
--- “Osteoporosis is a disease of adolescence”
>> 90% of peak bone mass is attained by age 16.9 + 1.3 yr and 99% by age 26.2 + 3.7 yr
>> Decreased BMD
>> 50% of difference in hip fracture rates in postmenopausal years

1) Hyperphosphatemia (serum level above 2.6 mg/dl) may occur in:
--- Hypoparathyroidism
--- Renal insufficiency
2) Excessive amounts of phosphorus bind with calcium, resulting in tetany and convulsions

1) Long-term ingestion of aluminum hydroxide antacids
2) Malabsorption conditions (sprue and celiac disease)

1) During tooth development, deficiency results in:
--- Incomplete calcification of teeth
--- Failure of dentin formation
--- Increased susceptibility to caries

1) alendronate Fosamax
2) etidronate (not approved by FDA for osteoporosis) Didronel
3) ibandronate Boniva
4) risedronate Actonel
5) risedronate with calcium carbonate Actonel with Calcium
6) zoledronic acid Reclast

1) Because of the rapid turnover rate of oral tissues, the first signs of nutritional Hypostate(B-complex vitamins, vitamins C and K, iron, and protein) are frequently evident in the oral cavity
2) Angular cheilitis or cheilosis (cracks around the corners of the mouth) and glossitis (inflammation of the tongue) are commonly associated with nutrient deficiencies

1) Help evaluate the patient for vitamin deficiencies.
2) Be aware that water-soluble vitamin and mineral deficiencies have many oral manifestations.
3) Talk with the patient about the patient’s dietary intake or any health problems.
4) Encourage the patient to see his or her health care provider for appropriate therapy.