Eternal sunshine for better gums
Periodontal (gum) issues are not only preventable but healthy gums can prevent other chronic illnesses. We are on a mission to get this information to as many people as possible.
How a day in the sun melts your troubles away? Something about a day at sea or in the garden sipping a cold one and maybe a bowl of fruit. As the end of August progresses, the euphoric state of mind intensifies. And then, when we hit early autumn, it's the best of both worlds, the afterglow of summer lingering in our bodies with the cooler weather shift. Everything in life is golden, from our tans to the leaves on the trees.
Then shift to the sadness that comes with darker days and longer nights. On the one hand, you want to feel cosy and hibernate, but on the other, tiredness and low moods get in the way. And come January, when the excitement of Christmas and the promise of new possibilities at New-year wean, so does the state of your immunity and mental health. There is a reason for all the poetic emotions. It's a little something called the sunshine nutrient (or, more recently, hormone), Vitamin D.
Worldwide an estimated 1 billion people are experiencing vitamin D deficiency. However, the actual figure is likely much higher as people in sunnier climates of Asia, Africa and the Middle East usually hid from the sun or cover-up due to cultural and religious practices.
Vitamin D is now being considered an upgrade to hormone status. Owing to the fact it acts like a hormone but also because the body on direct sunlight exposure can make it.
Vitamin D regulates inflammation and calcium levels in the body (for cells to function and healthy bones and teeth). It also aids antibacterial and antiviral activities through its influence on antimicrobial cells of the immune system and the immune self-destruction process of periodontitis at bay. It protects in a 360-degree approach to managing bacteria, reducing inflammation, and preventing tooth support tissue loss.
Vitamin D regulates calcium, and chronically low levels in the body may result in osteoporosis. Osteoporosis reduces low bone mass in all bones, including bones in the jaw. Studies have shown that women with lower bone mass density have an increased risk of gum issues, and those who supplement with vitamin D are less likely. Although, the current research is of a lower quality than we'd like it to be.
While the whole purpose of the gum guide is to provide information to facilitate prevention, it may be the case that some readers would be at a stage requiring treatment. So, for people undergoing gum treatment or even gum surgery, research has shown that individuals with low vitamin D levels show worse healing after treatment. So it may be an excellent idea to have a blood test pre-treat met to determine vitamin D levels to ensure optimal outcomes after treatment.
Studies have even shown that pregnant women with lower vitamin D levels are more likely to experience gum issues.
So in the presence of bacterial biofilm (see the previous post on biofilm here), low vitamin D levels in the body may mediate the worsening of periodontal symptoms (losing bone support around the tooth). Some research has shown that low vitamin D levels may increase the risk of losing your teeth through a more advanced and fast-progressing gum disease process. However, the jury is still looking for more robust evidence to provide an accurate verdict.
Moods and energy
It is known that lack of sunshine through the winter months can cause fatigue and seasonal depressive low moods. The exact scientific mechanism isn't fully understood, but it is believed that it is through Vitamin D's influence of calcium in the brain cells. Newer research has also linked vitamin D's role in regulating inflammation as a critical factor in playing a role in depression (again, we don't quite understand how).
But why mention this in relation to gum health here? As mentioned previously, depression and fatigue are risk factors for chronic illnesses such as diabetes. Gum disease is a diabetes complication of the mouth. Furthermore, with depression, there may be a slide towards poor self-care, including oral hygiene. We have highlighted a simplified version of the role of depression and gum health, and we will be covering the whole picture in an upcoming edition.
What do we do in everyday life?
For an adult, the daily-recommended amount is 700IU- 800IU daily. Those with deficiency require around 2000IU daily for a short period. However, a dose greater than 40,000ID daily will likely result in symptoms. These include but aren't limited to kidney stones, calcium build-up in the blood vessels (leading to heart issues), bone pain, nausea and vomiting. For this reason, vitamin D supplementations of greater than 1000IU daily should be under a trained medical professional's guidance and maintained through regular blood testing.
Daily, vitamin D can be made by the body through sunlight exposure to the skin on the face, legs or arms and diet. Through diet, an estimated daily amount of 90IU may be obtained. Sources of vitamin D-containing food include:
Dairy products.
Eggs.
Bread and cereals fortified with Vitamin D.
Fish such as salmon and sardines.
A day's worth of tanning until the skin starts to go red can provide an estimated 10,000 IU daily. Please, note that we do not recommend tanning till the skin goes red as this may increase the risk of sunburn or skin cancer, and this number is for providing context.
Vitamin D, derived from diet D2, differs from Vitamin D, made through sun exposure, D3. D3 is more potent and stores longer than D2. However, D3 can only be made when the sun's rays shine directly, not at an angle. During the spring and summer months, due to the Earth's tilt, we will be exposed to direct sunlight; however, during autumn and winter, this is unlikely to be the case in many countries, including the UK and Ireland.
A note on vitamin D supplementation practices
Most people in the UK and Ireland need to supplement in the autumn-winter months. The expectations are those aged less than one year and those who frequently travel to countries with abundant natural sunlight through these dark and dreary months.
For optimal benefits, it is recommended that vitamin D is taken with fatty foods (eggs, fish, nuts, avocado etc..) to increase uptake and utilisation by the body.
Also, for optimal utilisation, it is recommended that vitamin D is taken in the earlier parts of the day. This is because daylight exposure ( not always the same as sunlight exposure in countries like the UK and Ireland) helps reset the sleep cycle and provide better sleep. Vitamin D release and absorption are linked to this cycle. Vitamin D can also block melatonin production, an essential hormone for sleep. Exposure later in the day, especially with an evening meal, can disrupt sleep.
Although the body is a finely tuned orchestra of nutrient functions, there are some nutrients that work in closer harmony with vitamin D. Nutrients closely linked to vitamin D are calcium, magnesium, and vitamin K2. A diet rich in these will help to maximise vitamin D's potential in the body. Sources of calcium are greens like broccoli, squash vegetables, soya or tofu, dairy products and fish like sardine and salmon. Magnesium is abundant in nuts, seeds, legumes and greens.
Vitamin K2 depletion is an issue with those who take vitamin D long-term. Vitamin D impacts Vitamin K2's activity within the body and results in calcium deposits in the soft tissues (kidneys and blood vessels most common), resulting in an increased risk of blood pressure and kidney stones. Vitamin K2 can now be found in formations of vitamin D supplementation, and we recommend using this formulation. However, if your diet is high in fermented foods like kimchi or sauerkraut or fermented Japanese soya natto, eel, chicken liver, cheese and eggs, you may also get vitamin K2 in your body. Vitamin K2 is also produced in the body by our gut bacteria.
It isn't a coincidence that many of these sources overlap, and that nature has ways for us to utilise nutrients for health.
If you'd like to read more on the technical and scientific details, we recommend you click here and here.Â
We’d like to thank Dr. Varkha Ritu for sending us her recent publication which informed part of this week’s post.
This week’s images are all by the photographer Lucy Rose Laucht, who captures the sun’s best companions, sea and sand, so eloquently in her images.
If you have any questions or feedback, please email or DM us on Instagram @thegumguide. Please note that we cannot diagnose and give personalised health advice ( kindly see your dental professional for that).
Lastly, if you found this post useful (you may have even found it fun!), please share it with friends & family. See you next week ;)
Thanks so much gif this really useful and interesting article. Happy to share this amongst my mental health colleagues in CAMHS if that is ok by you and of course maintaining reference to all contributors?