Eating fresh fruits and vegetables gives us the vitamins and minerals we need to live a healthy life. The nutrition you get from food contributes to your oral health as well. Not eating enough nutritious foods can contribute to vitamin and mineral deficiencies that can negatively impact oral health.

What are the main oral manifestations of nutritional deficiencies?

Generally, mineral deficiencies affect the hard structures (teeth and bones) whilst vitamin deficiencies affect soft tissues. A common early sign of vitamin deficiency is the development of ulcers in the mouth, which vary in size and can last up to three weeks.

Vitamin A deficiency is associated with very low-fat diets and liver problems and affects the skin in the mouth. It is necessary for growth of soft tissues and bones. A severe deficiency can affect the development of teeth resulting in smalls pits or grooves in the visible part of the tooth.

Vitamin B deficiencies are typically caused by restrictive diets, such as veganism, digestive disorders and stress. This can lead to painful sores on the side of mouth and lips and swelling and cracking of the tongue which appears very red, shining and swollen.

Vitamin C deficiency, which is rare in the UK, is caused by poor fruit and vegetable intake and causes gum swelling and bleeding. Blood blisters can also form in the floor of the mouth under the tongue due to a lacking of integrity of the blood vessels.

Vitamin D deficiency is very common in the UK, particularly among those who do not get much sunlight exposure or who are on a dairy-free diet. Not getting enough Vitamin D affects the calcification and strength of teeth and bone. Another common sign is developmental issues which are seen on thumb nails.

Essential fatty acids/omega 3 deficiency usually presents as rough scaly skin and can be noticed as dry flaky lips or flaky skin under the eyes.

Iron deficiency may cause a dry mouth, a burning feeling in your mouth, sore, red cracks at the corners of your mouth and a swollen, red, shiny tongue.

Magnesium insufficiency can result is a tic or twitch which can sometimes be seen as a quivering tongue when it is at rest. High levels of stress can cause a deficiency as we need more magnesium when we are stressed.

Zinc deficiency may lead to a loss of appetite, delayed healing of wounds, eye and skin problems and taste disturbances. Recurrent mouth ulcers could be a sign of a zinc deficiency.

A balanced diet, with plenty of fruit and vegetables, nuts, good sources of calcium and high-quality protein, is essential. If a diet is restricted through choice or for medical reasons, a high-quality multi-vitamin is a good back up. It is important not to take single vitamins in isolation (apart from vitamin D and those prescribed by a doctor) as they compete for absorption in the intestines and an excess of one can lead to deficiency in another. Always seek advice from an appropriate healthcare professional when it comes to recommending taking any supplements.

While all foods can form part of a healthy balanced diet, it is important to eat from all the major food groups. Avoiding sugary and acidic food and drink (including lemon water) between meals is important, as the acids and sugars increase a patients’ risk of dental decay and erosion. When opting for sugary and acidic food and drink, encourage these to be indulged at mealtime only to minimise the impact, with no more than three or four attacks per day.

Avoiding sugary snacks and drinks between meals will also help to keep blood sugars more stable and will help to avoid spikes and drops in blood sugars, which can improve energy levels and appetite regulation.

As part of an overall balanced diet, patients are advised to eat plenty of plants, lean protein, nuts, and healthy fats, and avoid processed foods and refined carbohydrates including white bread, pasta, and processed meats.

As dental professionals we should ensure that we review patients' dietary habits during their appointments to provide a comprehensive and integrated approach to not only oral health but overall health. We can also signpost patients to other healthcare professionals and learn from “The Eatwell Guide” policy tool used to define government recommendations on eating healthily and achieving a balanced diet.

Author: