Vitamins Required for Oral Soft Tissues and Salivary Glands

Oral Cavity: Early Indicator of Systemic Disease

• Rapid cellular turnover rate

• Constant assault by microorganisms

• Trauma-intense environment

Systemic Circulation → supplies nutrients & removes waste

• Changes in oral tissues=systemic nutritional disorders

• Nutritional deficiencies=signs & symptoms

• Pain, erythema, tissue atrophy, infections

Functions of Saliva:

• Digestion

• Maintains Oral Health

• Supports Lubrication & Taste

• Functions as a Buffer

• Protects & Heals

The average person produces about _-_._ liters of saliva daily

1-1.5

Filiform Papillae:

• Location: Cover most of the tongue's surface.

• Function: Not involved in taste; help m

Fungiform Papillae:

• Location: Scattered across tip & sides of the tongue.

• Function: Contain taste buds, contributing to the detection of taste

Circumvallate Papillae:

• Location: Back of the tongue, arranged in a V-shape.

• Function: Contain a high concentration of taste buds, especially for bitter tastes.

Foliate Papillae:

• Location: Sides of the tongue near the back.

• Function: Also contain taste buds & are involved in taste detection.

Rapid turnover rate → epithelium of tongue, followed by areas around the lips

• Tongue=edematous (swelling), glossitis (inflammation)

• Angular cheilitis=localized to corners of the mouth (oral commissures)

• Angular cheilosis=includes cracking of the lips

Saliva → composition affects taste

• Aids in speech, taste, eating

• Xerostomia=increased caries, stomatitis (inflammation), gingivitis, increased risk of oral infections

Thiamin (Vitamin B1) “the morale vitamin” Physiological Roles:

• Acts as coenzyme in TCA/Krebs/citric acid cycle.

• Provides energy to brain, heart, & CNS

• Vital for growth, development, & cell function

• Necessary for the synthesis of niacin

Thiamin (Vitamin B1) “the morale vitamin” Sources:

Pork, enriched whole grains, milk, legumes, nuts, peas.

Thiamin (Vitamin B1) “the morale vitamin” Hypo States:

• Beriberi

• Wet Beriberi CVS tachycardia, heart failure, & edema

• Dry Beriberi CNS muscle weakness, numbness, & paralysis

• Wernicke-Korsakoff Syndrome

• Severe alcoholism

• Mental confusion & memory loss

• Nystagmus (involuntary rapid movement of the eyeball)

• Ataxia (gait disorder)

Riboflavin (Vitamin B2) Physiological Roles:

• Energy production, antioxidant activity, fat , carbohydrate, & protein metabolism,

skin & eye health

• Essential for growth & production of RBCs

• Prevents cheilitis, cheilosis, glossitis, & anemia

• Necessary for the synthesis of niacin & metabolism of iron

Riboflavin (Vitamin B2) Sources:

• Milk, green leafy vegetables, nuts, & legumes

• ***Sensitive to light→ this is why milk should be stored in cardboard or opaque

containers

Riboflavin (Vitamin B2) Hypo States:

• Ariboflavinosis
• Angular cheilitis, sore throat, redness/swelling of mouth & throat, dry skin, &
glossitis.
• Prolonged deficiency→ impaired energy production→ fatigue & anemia

Niacin (Vitamin B3) Physiological Roles:

• Energy production

• Essential for RNA & DNA synthesis

• Works w/riboflavin in metabolism of fats & proteins

Niacin (Vitamin B3) Sources :

Meat, fish, enriched grains, leafy green vegetables

Niacin (Vitamin B3) Hyper States :

excessive supplements (NOT food sources) *extended-release better

• Vasodilation, flushing of skin, itching, tachycardia, nausea, vomiting, liver damage

Niacin (Vitamin B3) Hypo States :

maize (corn) diet

• Pellagra **4Dsdermatitis, diarrhea, depression or dementia, death

• Bilaterally symmetrical reddish skin rash (hands, feet, face) is characteristic sign

• Painful stomatitis, lesions in GI tract, glossitis, inflamed gingiva mimicking ulcerative

gingivitis

Pantothenic Acid (Vitamin B5) Physiologic Roles:

• Carbohydrate, fat, & protein metabolism

• Synthesis & degradation of triglycerides, phospholipids, & sterols

• Formation of certain hormones & nerve-regulating substances

Pantothenic Acid (Vitamin B5) Sources:

(abundant in many foods) → Corn, sunflower seeds, tuna, avocado, eggs

Pantothenic Acid (Vitamin B5) Hypo States:

Very rare, though may occur along w/other B-vitamin deficiencies

Pyridoxine (Vitamin B6) Physiologic Roles:

• Protein Metabolism

• Neurotransmitter Synthesis

• Hemoglobin Production

Pyridoxine (Vitamin B6) Sources:

Meat, poultry, fish, bananas, white potatoes, sweet potatoes

Pyridoxine (Vitamin B6) Hypo States:

Rare, though may occur along w/other B-vitamin deficiencies

Pyridoxine (Vitamin B6) Hyper States:

(due to supplementation)

• Peripheral neuropathy (nerve damage) numbness, tingling in limbs

• Ataxia

• Heightened sensitivity to touch

Biotin (Vitamin B7) Physiological Roles:

• Energy metabolism

• Fatty acid synthesis

• Hair, skin, & nail health

Biotin (Vitamin B7) Sources:

Cauliflower,cooked eggs, peanuts, cheese

Biotin (Vitamin B7) Hypo and Hyper States (Rare):

• Prolonged consumption of raw egg whites→contains avidin, which prevents absorption

• Hair thinning/loss, scaly red rash around eyes, nose, & mouth, brittle nails

Folate (Vitamin B9) Physiological Roles:

• DNA & RNA synthesis

• RBC formation→prevents megaloblastic anemia

• Neural tube development→prevents spina bifida

Folate (Vitamin B9) Sources:

Dark green leafy vegetables, citrus fruits, eggs, avocado

Folate (Vitamin B9) Hypo States:

• Fatigue, weakness, irritability

• Megaloblastic anemia

• Glossitis, mouth sores

Folate (Vitamin B9) Hyper States:

(due to over-supplementation)

• Mask vitamin B12 deficiency, delaying diagnosis & leading to neurological damage

MTHFR (methylenetetrahydrofolate reductase) gene is essential for processing _____ properly

folate

Variants of MTHFR gene reduce enzyme activity →

folate deficiency

People w/MTHFR gene variants may need…

supplementation of folate in its active form

Why is Folate and MTHFR Gene Important?

• Folate deficiencies=increased risk for periodontitis & ankyloglossia

• Sensitivity to N2O

• Impaired healing

Cobalamin (Vitamin B12) Physiological Roles:

• RBC production → prevents anemia

• DNA synthesis

• Nervous system function →maintains myelin sheath

• Myelin: lipid substance insulating nerve fibers & effects transmission of nerve impulses

Cobalamin (Vitamin B12) Sources:

Fish, eggs, dairy, beef, fortified nutritional yeast

Cobalamin (Vitamin B12) Hypo States:

Pernicious Anemia→ inability to absorb due to lacking intrinsic factor

• Abnormally large RBCs, glossitis, GI disturbances, weakness, neurological manifestations

• Achlorhydria→decreased hydrochloric acid in stomach

• Glossopyrosis→ unexplained tongue pain/burning

• Loss of filiform & fungiform papillae

• Tongue may be completely smooth, shiny, deeply reddened

Cobalamin (Vitamin B12) Hyper States:

rare

What are Vitamin B12 Injections?

Common treatment for addressing deficiency

• Delivery directly into bloodstream, bypassing digestive system.

• Useful for individuals w/absorption issues & vegans/vegetarians & older adults

Benefits of Vitamin B12 Injections?

• Quickly restore B12 levels

• Prevents megaloblastic anemia & neurological issues

• Improves energy levels, mood, & cognitive function

Multi-Functionality of Nutrients; Vitamin C

• Enhances WBC activity

• Protects from bacterial toxins & plaque microorganisms

• Collagen formation weak collagen leads to gingivitis & poor wound healing

Multi-Functionality of Nutrients; Vitamin A

• Maintains integrity of epithelial tissues

• Oral & oropharyngeal cancers

• Development & maintenance of salivary glands

• Squamous metaplasia=keratin production in salivary glands

• Decreased salivary secretions & xerostomia

• Stimulates growth & metabolism

Multi-Functionality of Nutrients; Vitamin E

• Neutralizes free radicals

• Protects cell membranes

• Prevents periodontal inflammation

• Promotes integrity of mucosal cell membranes