Vitamin D intake and periodontal health
Date
2011
DOI
Authors
Alshouibi, Ehab Nafea
Version
OA Version
Citation
Abstract
Objective: Vitamin D is extensively studied and researched in the medical literature. However, fewer studies are available on the potential protective association of vitamin D with periodontal health in particular. The overall objective of this study is to assess the beneficial association of total vitamin D intake with periodontal health parameters, namely: alveolar bone loss, pocket depth, attachment loss, and tooth loss/retention. Furthermore, the dose-response relationship of vitamin D intake with periodontal health parameter is evaluated independently of other important nutrients.
Methods: A subset of the Prospective Veterans Dental Longitudinal Study (DLS) data was used. A sample size of 543 subjects measured at 4 points of time (from examination cycle 6 to cycle 9) was used throughout the statistical analyses, for a total of l ,568 observations. The analytical plan was done on both tooth- and person-level and included descriptive, bivariate, multivariate, and survival statistics. Because the collected data represent correlated repeated measures, Random Mixed Effect Models, Generalized Estimating Equations, and modified Cox proportional hazard with robust sandwich estimate were used. Analyses were controlled for sociodemographic and periodontal disease risk factors.
Results: The study population was all male and predominantly White, with a baseline mean age of 62.9 years. At base line, the average number of teeth, average pocket depth and attachment loss were equal to 21 teeth, 2.1 mm and 2.7 mm per subject, respectively. The baseline mean of total vitamin D, calcium, and vitamin C intake were almost 343 JU, 820 mg and 220 mg per day, respectively. Random Mixed Effect models showed minimal changes in average pocket depth and attachment loss across different levels of total vitamin D intake per person and per tooth. GEE Models showed consistent protective association of vitamin D intake against severe alveolar bone loss up to 1,000 IU/day of total intake. Person-level GEE models showed daily intake of more than 400 JU of Vitamin D was associated with at least 35% less risk of severe bone loss in three or more proximal sites. Tooth-level GEE showed the intake of more than 400 JU/day of Vitamin D was associated with a minimum of 18% less risk of severe bone loss both mesially and distally. Both tooth- and person-level analysis revealed 12% less risk of losing at least three teeth and 11% less risk of any tooth loss, respectively.
Conclusion: Our study showed no association between daily intake of vitamin D on pocket depth and attachment loss. On the other hand, findings suggest a daily intake of 400 -1000 JU of vitamin D may be protective against the risk of alveolar bone loss and tooth loss. Adherence to the daily recommendation of vitamin D intake of at least 400-1000 JU/Day, especially among older adults, may have a great impact on reducing the risk of periodontal disease.
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Thesis (DScD) --Boston University Henry M. Goldman School of Dental Medicine, 2011 (Department of Health Policy and Health Services Research).
Includes bibliographic references: leaves 149-159.
Thesis (DScD) --Boston University Henry M. Goldman School of Dental Medicine, 2011 (Department of Health Policy and Health Services Research).
Includes bibliographic references: leaves 149-159.
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This work is protected by copyright. Downloading is restricted to the BU community. If you are the author of this work and would like to make it publicly available, please contact open-help@bu.edu.