The Relationship between Periodontal Disease and Vitamin D

Abstract

Background: As vitamin Dis known to have functions in bone homeostasis and immune system regulation, it is plausible that vitamin D levels could affect the progression of periodontal disease. Currently, there is conflicting evidence regarding the role of vitamin D in the progression of periodontal disease. The purpose of this study was to explore the relationship between plasma 2S{OH}D concentration and periodontal disease measured by gingival inflammation {GI} and loss of attachment {LOA}. It is hypothesized that lower 2S{OH}D levels will be associated with higher measures for GI and LOA. Methods: This cross-sectional study used data from the Canadian Health Measures Survey {CHMS} on subjects aged 13 - 79 years of age. Vitamin D status was determined by measuring plasma 25{OH}D concentrations in nmol/L. Periodontal disease was measured by assessing (GI} using Lee's gingival index and by calculating (LOA}. Student's t-tests and chi-square tests were used to perform a bivariate analysis between potential independent variables including 2S(OH}D and the dependent variables of GI and LOA. Multiple logistic regression analyses were then performed for GI and LOA to determine the adjusted correlation between 2S{OH}D and GI and 25{OH}D and LOA and to control for potential confounding variables. Results: Plasma 25{OH}D concentration less than 50 nmol/L and less than 75 nmol/L, but not mean plasma 2S{OH}D concentration, were associated with GI at the bivariate level. However, no association was found between mean plasma 25(OH}D concentration, 2S(OH}D concentration less than 50 nmol/, or 25(OH}D concentration less than 75 nmol/L and GI in the multiple regression analysis. None of mean plasma 25{OH}D concentration, 25{OH}D concentration less than 50 nmol/L, or 2S(OH}D concentration less than 75 nmol/L were associated with LOA at the bivariate level. A statistically significant association was observed between 2S(OH}D concentration less than 75 nmol/L and LOA in the multiple regression analysis, but not mean plasma 2S{OH}D concentration or 2S{OH}D concentration less than 50 nmol/L. Conclusion: Vitamin D status was inversely associated with GI at the bivariate level, but not at the multivariate level. Conversely, vitamin D status was not associated with LOA at the bivariate level, but it was inversely associated with LOA at the multivariate level. These results provide modest evidence supporting a relationship between low plasma 25(OH}D concentrations and periodontal disease as measured by GI and LOA.