Periodontitisis a prevalent multifactorial inflammatory condition characterised by loss ofsupporting periodontium and aggressive destruction of gingival tissues. Factorsaffecting periodontal health are malnutrition, oral hygiene, genetic and epigeneticfactors, systemic health, and nutrition etc. It is caused when host resistanceis reduced and the virulence factor of an organism is increased resulting inperiodontitis. Deficiency ofvitamins cause periodontal destruction, though the exact mechanism is stillunknown.
Vitamin deficiency may affect any of the basic periodontal defencefactors such as the integrity of the dentogingival barrier and the turnover ofits constituent cells. Therefore, nutritional imbalance throughout the lifecycle can impair healing and tissue regeneration leading to increase susceptibilityto oral infections .The B-complex vitamins are involved cell metabolism, repairand regeneration. They are quintessential for the synthesis of DNA and RNA. Cobalaminreduces ribonucleotides as it acts as a hydrogen-acceptorco-enzyme. Thereforeit has a pivotal role in growth and marrow haemopoiesis.
This makes themessential for the production of new cells for tissue formation and maintenance. Deficiency ofVitamin B12, an essential dietary nutrient,produces serious complications. Themost common oral symptoms found in Vit B12 deficiency is Glossitis (Inflammation of tongue) and Glossalgia (A burning or painfulsensation in the tongue. Also called glossodynia).
Classical ‘beefy red tongue’ is also found .Deficiency occurs due to loss of the integrity of the oral mucosa. Theoral manifestations include pale mucosa, atrophic tongue , eryethematouspatches on labial or buccal mucosa , psuedomembranous or erythematous candidiasis, angular cheilitis, recurrentaphthous stomatitis ,glossitis, taste degeneration and a burning mouth.. SevereB12 deficiency can result in macrocytic anemia or megaloblastic anemia due toimpaired erythropoiesis , derangedmental status, myelopathy, loss ofmemory, paresthesia,. B12 deficient mothers can develop growth abnormalities,anemia, and convulsions in infants that are breast fed. Deficiency ofVitamin B12, an essential dietary nutrient,produces serious complications.
Vitamin B12 is only found in foods of animal origin and is absent in vegetablesand fruit. Vitamin B 12 foundas cobalamin ( containing cobalt ) is not derived from plants or animals, theyare produced by small microorganisms likeyeast, fungi and molds. They have various synonyms like cobrynamide, cobamide, cyanocobalamin,cobinamide, aquocobalamin, cobalamin, , hydroxcobalamin, and nitrotocobalamin.This vitamin requires a substance called ‘ Intrinsic factor’ for its entry intothe Gastro – intestinal tract . IF is an unique protein ( glycoprotein)secreted by parietal cells of gastric mucosa which helps in the absorption ofVitB12 in distal part of ileum and facilitates its transport across stomach andthe intestines. Malabsorption in the intestines is often the main cause for thedeficiency of this vitamin.
B12 is often inadequately absorbed in deficiency ofintestinal transport proteins of cobalamin or because of impaired production ofIntrinsic factor in conditions like pernicious anaemia, gastrectomy orgastrointestinal diseases, medications, vegetarianism and inadequate nutrientintake.