Prospective Study of Serum 25-hydroxy Vitamin D and Tooth Loss

J Dent Res. 2014 Jul;93(7):639-44. doi: 10.1177/0022034514534985. Epub 2014 May 14.


Vitamin D deficiency and oral diseases (periodontitis, caries, and tooth loss) are highly prevalent in Germany. Previous studies suggested that vitamin D might be a modifiable and protective factor for periodontitis, caries, and tooth loss. However, prospective studies investigating such associations are limited. We explored the association between the concentration of serum 25-hydroxy vitamin D (25OHD) and incidence of tooth loss, progression of clinical attachment loss (CAL) ≥ 3 mm, and progression of restorative and caries status in a population-based longitudinal study. We analyzed data from 1,904 participants from the Study of Health in Pomerania with a five-year follow-up. Generalized estimating equation models were applied to evaluate tooth-specific associations between serum 25OHD and incidence of tooth loss, progression of CAL ≥ 3 mm, and progression of restorative and caries status. Age, sex, education, smoking status, alcohol drinking, waist circumference, dental visit frequency, reasons of dental visit, vitamin D or calcium supplements, and season of blood draw were considered as confounders. Serum 25OHD was inversely associated with incidence of tooth loss. A significant dose-response relationship (p = .0022) was observed across the quintiles of serum 25OHD. After adjusting for multiple confounders, each 10-µg/L increase of serum 25OHD was associated with a 13% decreased risk of tooth loss (risk ratio: 0.87; 95% confidence interval: 0.79, 0.96). The association was attenuated for changes of CAL ≥ 3 mm when adjusting for multiple confounders. No significant association was found between serum 25OHD and caries progression. Vitamin D might be a protective factor for tooth loss. The effect might partially be mediated by its effect on periodontitis.

Keywords: Study of Health in Pomerania; caries; clinical attachments loss; cohort study; periodontitis; probing depth.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / epidemiology
  • DMF Index
  • Dental Care / statistics & numerical data
  • Dental Caries / blood
  • Dental Caries / epidemiology
  • Disease Progression
  • Educational Status
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Periodontal Attachment Loss / blood
  • Periodontal Attachment Loss / epidemiology
  • Periodontal Index
  • Periodontitis / blood
  • Periodontitis / epidemiology
  • Population Surveillance
  • Prospective Studies
  • Smoking / epidemiology
  • Tooth Loss / blood
  • Tooth Loss / epidemiology*
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Waist Circumference


  • Vitamin D
  • 25-hydroxyvitamin D