Oral Health Implications of Nutritional Deficiencies: A Narrative Review from a Public Health Perspective
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Abstract
Background: Oral diseases affect billions of people worldwide and share determinants with undernutrition and poor diet quality. Nutritional deficiencies may influence tooth development, periodontal health, and oral mucosal integrity, yet the evidence has rarely been synthesised from a public health standpoint.
Objective: To narratively synthesise evidence on the oral health consequences of selected nutritional deficiencies and to discuss implications for prevention, policy, and surveillance.
Methods: A narrative review was conducted following SANRA principles. PubMed and Google Scholar were searched for English-language reviews, meta-analyses, trials, cohort, case–control, cross-sectional and case studies addressing vitamin D, vitamin C, B-complex vitamins, iron, antioxidants, and protein-energy malnutrition in relation to caries, developmental enamel defects, periodontal disease, and oral mucosal conditions.
Results: The strongest, though still heterogeneous, evidence concerns vitamin D: a meta-analysis reported a 22% higher caries risk in vitamin D-deficient children, while controlled trials suggested a protective effect of supplementation with low certainty. Findings on enamel hypomineralisation are inconsistent. Early childhood malnutrition is associated with delayed tooth eruption. Lower antioxidant and vitamin D status are associated with periodontal disease, and vitamin C depletion increases gingival bleeding. Vitamin B12, iron and folate deficiencies commonly present as glossitis and angular cheilitis, which may serve as early clinical signals in primary care.
Conclusions: Nutritional deficiencies are plausible, modifiable contributors to oral disease burden, but causal evidence is limited by observational designs and confounding by sugar intake and socioeconomic status. Public health strategies should integrate oral health with nutrition programmes, strengthen maternal and child micronutrient interventions, address free-sugar consumption, and add nutritional indicators to oral health surveillance.
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