Oral cavity is a screen for many underlying systemic conditions or diseases, many Doctors looks for oral symptoms to help in their diagnosis and your mouth acts as a screen or a pathway to diagnose Vitamin Deficiencies as well. There are many Vitamins which play a major role in normal functioning of the oral cavity and any deficiency of these Vitamins from the normal levels will lead to problems in the normal functioning of the human body. Some or most of the Vitamins have a direct or indirect role in having a healthy oral cavity. It is important to know the various Oral manifestations of Vitamin deficiencies which can help in the differential diagnosis of various medical conditions.

Oral manifestations of Vitamin deficiencies

There are many Vitamins which are essential to the human body like – Vitamin A, Vitamin D or Anti rachitic vitamin, Vitamin E or anti sterility vitamin, Vitamin K or Coagulation Vitamin, Vitamin C or Ascorbic acid, Vitamin B or anti beri-beri or anti-neuritic vitamin, Vitamin B2 or Riboflavin, Vitamin B5 or Pathothenic acid or chick anti-dermatitis factor, Vitamin B6 or Pyridoxine, Biotin or anti-egg white injury factor, Niacin, Folic acid, Vit B12 or anti pernicious vitamin or extrinsic factor of castle.

Let us look at the various Oral manifestations or Oral Signs and symptoms seen in deficiencies of the Vitamins mentioned above:

Oral signs and symptoms of Vitamin A deficiency:

  • There is an increase in keratin formation caused due to keratinising Metaplasia of epithelium
  • Due to increased keratin formation, salivary gland ducts can be blocked by keratin
  • There is a delay in Eruption of teeth
  • Enamel is severely affected – Enamel Hypoplasia, atypical Dentin formation is seen
  • Pulpal tissue is invaded by Epithelial tissue

Oral Signs and Symptoms of Vitamin D deficiency:

Vitamin D is known to act more like a Hormone as compared to like a Vitamin and it is known to affect the bone. It is known as the anti-rachitic vitamin

  • Delayed Eruption of primary and permanent teeth
  • Developmental anomalies of dentin and enamel, with the teeth showing wide predentin zone with increased interglobular dentin in it
  • Pulp is also affected, the pulp horns are elongated and reach the dentinoenamel junction
  • Malocclusion of teeth is seen in the oral cavity

Oral Signs and Symptoms of Vitamin E deficiency:

Vitamin E is also called as anti sterility vitamin and there are no Oral manifestation seen in its deficiency

Oral Signs and Symptoms of Vitamin K deficiency:

Vitamin K is also called as Coagulation Vitamin and its deficiency is known to be uncommon but in case of deficiency we can see the following oral manifestations

  • Spontaneous gingival hemorrhages are seen when the prothrombin level falls below 20%
  • Gingival bleeding is seen after brushing when the prothrombin level falls below 35%

Oral Signs and Symptoms of Vitamin C deficiency:

It is also called as Ascorbic acid and deficiency leads to Scurvy, the oral manifestations are

  • Gums are Swollen and Spongy, the clinical appearance of Scurvy buds is seen which is involvement of interdental papillae
  • In severe Vit C deficiency cases there is hemorrhage or bleeding of preiodontal membranes and loosening or mobility of teeth is seen which is due to bone loss

Oral Signs and Symptoms of Vitamin B1 deficiency:

It is also called as anti beri-beri or anti-neuritic vitamin which is seen in people consuming polished rice. There are no known Oral manifestations due to deficiency of Vit B1.

Oral Signs and Symptoms of Vitamin B2 deficiency:

It is also known as Riboflavin and deficiency is seen mostly in children who do not drink milk

 

  • Cheilosis: It is the inflammation or cracking of the corners of the mouth which is also called as cheilitis or Angular cheilitis as it is seen in the angles of the mouth
  • Glossitis: In simple terms, it is the inflammation of the tongue where the filiform papillae become atrophic and the fungiform papillae become engorged and mushroom shaped which gives it the characteristic magenta colored tongue

Oral Signs and Symptoms of Vitamin B12 deficiency:

It is also called as anti pernicious vitamin or extrinsic factor of castle

  • Hunter’s glossitis or Moeller’s glossitis – similar to “bald tongue” which is seen in pellagra
  • Beefy red tongue with glossopyrosis, glossitis and glossodynia is sometimes seen

Oral Signs and Symptoms of Folic Acid deficiency:

Most common clinical symptom is Macrocytic anemia

  • Glossitis: In simple terms, it is the inflammation of the tongue where the filiform papillae become atrophic and the fungiform papillae become engorged and mushroom shaped which gives it the characteristic magenta colored tongue

There are no Oral Signs and symptoms for Deficiency os Vitamins – B5, B6 and Biotin. Vitamins are very important for normal functioning of the human body and Vitamins are mostly absorbed into the body through food, some vitamins like Vitamin B2 or Riboflavin is seen in milk and children who do not drink milk can get Vit B2 deficiency and in such cases supplements in the form of tablets should be regularly given to compensate.