Gum Disease and the Sun

evolution rYou’ve heard many times that exposure to the sun causes cancer. That’s what everybody tells us. That’s true for repeated sunburn and overexposure. But, our bodies are designed to use the sun’s UVB rays to make vitamin D in our skin through an efficient and natural way. We should not deny our bodies of what they require, but we need to be careful and not overdo it.
Vitamin D has been shown to be critical in many metabolic and physiologic processes. In the peer-reviewed literature, there have been several articles discussing Vitamin D and its relationship to gum disease.(1,2)
To become metabolically active, vitamin D that is produced on the skin from sun exposure is first converted in the liver to calcidiol [25(OH)D], which is clinically measured by the 25-Hydroxy Vitamin D serum test. It is then further converted in the kidneys into the active form of vitamin D called calcitriol [1,25(OH)2D].
Most people don’t get enough vitamin D. It is estimated that 42% of the US population has a vitamin D deficiency with the highest rate seen in African Americans (82.1%), followed by Hispanics (69.2%).(3) Vitamin D deficiency is defined as a serum 25-Hydroxy Vitamin D concentration of less than 20 ng/mL.
In a paper published in 2008, Bischoff-Ferrari suggested that an ideal serum level to help prevent cancer would be 36-48 ng/mL.(4) The only way to know if you have a deficiency is to have a 25-Hydroxy Vitamin D blood test done.
In 2013, Alshouibi et al showed that total daily vitamin D3 intake greater than 800 IU was associated with lower odds of severe periodontal disease relative to taking less than 400 IU/day. The authors reported that Vitamin D3 intake may protect against the progression of periodontal disease.(5)
In 2014, Martelli et al performed a literature search and detemined that a decreased level of Vitamin D may increase the risk of developing periodontal disease by way of (1) an effect on bone mineral density or (2) other metabolic pathways such as those involved in immune response and chronic inflammation.(6)
Also in 2014, Andrukhov et al suggested that vitamin D might play an important role in the modulation of periodontal inflammation by way of the regulation of cytokine production by cells of the periodontal ligament.(7)
The amount of sun you need to stimulate Vitamin D production depends on the time of day, the season of the year, where you are in relation to the equator, the color of your skin, how old you are, and how much clothing you are wearing while in the sun. You also need to know how much Vitamin D is already in your body and how much you get from other sources like foods or supplements.
The best way to manufacture vitamin D is to be in the sunshine. The next best way is to eat fatty fish like wild caught salmon, pastured organ meats like liver, and pastured egg yolks. The third way would be to take an appropriate dose of a vitamin D3 supplement.
It is important to note that vitamin D does not work by itself in the body. There is an important relationship between vitamin D and the bioavailability of various nutrients like vitamins A and K2, calcium, magnesium, zinc, boron and others from the foods you consume in order for vitamin D to be effective.
To help determine how much sun you may require for your body, there is an app called DMinder(8) for smartphones and tablets that also helps track your exposure in the sun based on the variables I have described.
Bottom Line: to assist in overall health and periodontal health, you might want to strive to maintain a serum level of approximately 50 ng/mL of 25-Hydroxy Vitamin D obtained not only from the sun but also from a combination of nutrient-dense food choices and supplementation if necessary.
1 Antonoglou, GN; Knuuttila M; et al. Low serum level of 1,25(OH)2 D is associated with chronic periodontitis. J Periodontal Res. 2014 Jul 7. doi: 10.1111/jre.12207. [Epub ahead of print]
2 Anand, N; Chandrasekaran, SC; et al. Vitamin D and periodontal health: Current concepts. J Indian Soc Periodontol. 2013 May-Jun; 17(3): 302–308.
3 Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011 Jan;31(1):48-54.
4 Bischoff-Ferrari, HA. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes. Adv Exp Med Biol. 2008;624:55-71.
5 Alshouibi, EN; Kaye, EK; et al. Vitamin D and Periodontal Health in Older Menl. J Dent Res. Aug 2013; 92(8): 689–693.
6 Martelli, SM; Martelli, M; et al. Vitamin D: relevance in dental practice. Clin Cases Miner Bone Metab. 2014 Jan-Apr; 11(1): 15–19.
7 Andrukhov, O; Andrukhova, O; et al. Both 25-Hydroxyvitamin-D3 and 1,25-Dihydroxyvitamin-D3 Reduces Inflammatory Response in Human Periodontal Ligament Cells. PLoS One. 2014; 9(2): e90301. Published online Feb 28, 2014. doi:  10.1371/journal.pone.0090301
PMCID: PMC3938673