Oral Manifestations of Vitamin Deficiencies: A Narrative Review of Clinical Insights for Dental Practice

Abstract

This narrative review examines oral manifestations of vitamin deficiencies and their relevance to dental practice. Oral manifestations of vitamin deficiencies can be of clinical importance, and in some patients, may precede the diagnosis of systemic disease. Deficiency conditions may affect the oral mucosa, tongue, lips, periodontium, teeth, salivary function, and wound healing. Among the most clinically relevant deficiencies are those of vitamins B2, B3, B6, B9 (folate), B12, C, A, D, E, and K. Typical manifestations include angular cheilitis, cheilosis, glossitis, atrophic glossitis, recurrent oral ulceration, mucosal erythema, burning sensations, gingival inflammation and bleeding, impaired wound healing, developmental defects of enamel and dentin, and increased susceptibility to oral infection. Vitamin C deficiency leads to the classic picture of scurvy with swollen and bleeding gingivae. Vitamin B12 and folate deficiencies are particularly associated with atrophic glossitis and mucosal changes. The relationship between vitamin D deficiency and tooth mineralization, dental caries, gingival inflammation, and periodontitis has been studied, but the strength of these associations and the evidence for causality remain variable. Vitamin A deficiency may weaken epithelial differentiation and oral immune defense, while vitamin K deficiency may predispose individuals to bleeding. Many oral findings are non-specific, so diagnosis should not rely solely on oral manifestations. It is essential to gather a comprehensive history, including dietary habits, conduct a thorough clinical examination, perform relevant laboratory tests, and consider alternative local and systemic causes. Therefore, dental professionals play a crucial role in identifying potentially nutritional lesions and facilitating appropriate medical investigation and treatment.