Impact of Vitamin D3 Supplementation on Recurrent Aphthous Ulcer

Abstract

Vitamin D is a well-known secosteroid hormone, which exerts multiple essential roles in bone physiology, cell growth and differentiation, the neuromuscular system, immunomodulatory functions and autoimmune diseases. Deficiency of vitamin D has been linked to many oral disorders including tooth decay, periodontitis, oral cancer, oral candidiasis, oral lichen planus and recurrent aphthous ulcers. Many studies have revealed a significant lower serum vitamin D level in recurrent aphthous ulcer patients compared with healthy volunteers. This proposes that vitamin D supplementation may reduce the severity of the lesion. To evaluate the efficacy of vitamin D3 replacement on recurrent aphthous ulcer severity is the objective of the study. This study involved 65 patients with idiopathic minor recurrent aphthous ulcer and vitamin D deficiency/insufficiency. These patients received vitamin D3 supplement over 1 y. Severity of the disease was delineated by the duration of episodes, the number of ulcers per attack and the frequency of recurrence. Severity parameters were compared before and after vitamin D3 intake. In addition, 25-hydroxy vitamin D3 concentrations were measured before and after administration of vitamin D3 by enzyme-linked immunosorbent assay technique. We found a significant decrease in the frequency of attacks and the number of ulcers in each attack with p-value<0.05 following vitamin D replacement. Moreover, a highly significant lowering in the duration of episodes was detected with p-value<0.001. Gender specific analysis showed no statistically significance regarding severity parameters at any point of the study stages. Correlation studies revealed the only detectable correlation was between serum 25-hydroxy vitamin D3 level at baseline and the number of ulcers before and after vitamin D correction. Vitamin D3 supplementation has a safe and positive impact on improving the severity of recurrent aphthous ulcer with regards to the number of lesions, the frequency of recurrence and the duration of episodes, in patients who have vitamin D deficiency/insufficiency.