J Periodontal Implant Sci.  2020 Dec;50(6):368-378. 10.5051/jpis.2002540127.

Low serum 25-hydroxyvitamin D levels, tooth loss, and the prevalence of severe periodontitis in Koreans aged 50 years and older

  • 1Department of Periodontology, Dental Science Research Institute, Chonnam National University School of Dentistry, Gwangju, Korea
  • 2Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
  • 3Department of Oral and Maxillofacial Radiology, Dental Science Research Institute, Chonnam National University School of Dentistry, Gwangju, Korea
  • 4Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Korea
  • 5Department of Preventive Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
  • 6Department of Oral Pathology, Dental Science Research Institute, Chonnam National University School of Dentistry, Gwangju, Korea


Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss.
Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008–2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions. Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed.
Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis.
This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.


Cross-sectional studies; Periodontitis; Tooth loss; Vitamin D
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