The importance of B complex vitamins for oral health (2025)

Vitamin B₃ (niacin)

Niacin, vitamin B₃, plays a vital role in the aerobic respiration pathway in the Krebs cycle and the synthesis of many molecules in the body, including cholesterols.² Niacin is a precursor of nicotinamide adenine dinucleotide (NAD+), the coenzyme needed for more than 400 enzymes to catalyze reactions in the body, including those involved in repairing damaged DNA.²

Patients with Crohn’s disease, dermatitis, or who abuse alcohol may be at greater risk for deficiency.² One study in Korean adults suggests inadequate intake of vitamin B₃ is associated with an increased risk of developing periodontitis, particularly among women and 40- to 59-year-old people.⁴ Vitamin B₃ is found in most animal products, beans, nuts, and seeds.

Vitamin B₅ (pantothenic acid)

Pantothenic acid, vitamin B₅, is vital in the synthesis of coenzyme A, a cofactor used in the Krebs cycle, and it contributes to brain cell structure and function through the synthesis of metabolites and neurotransmitters.⁵ Vitamin B₅ is available in a wide variety of foods such as fruits, vegetables, fortified cereals, and most animal products. Patients who suffer from eating disorders are at risk for deficiency, as are those who have a genetic anomaly of the pantothenate kinase gene 2, which affects the conversion of vitamin B₅ to coenzyme A2.

Vitamin B₆ (pyridoxine)

Pyridoxine, vitamin B₆, is used during the metabolism of carbohydrates, fats, and proteins.² An observational study showed high B6 intake is associated with a decreased risk of periodontal disease.¹ Patients who are malnourished or abuse alcohol are at risk for deficiency. Vitamin B₆ is found in an abundance of foods such as pork, poultry, fish, whole wheat, nuts, and beans.²

Vitamin B₇ (biotin)

Biotin, vitamin B₇, aids in gene signaling and replication.³ Biotin is used in the metabolism of carbohydrates, fats, and proteins, but is commonly associated with hair, skin, and nail health. Deficiency can result in skin rashes, hair loss, and brittle nails. Deficiency is rare but can present itself with certain genetic anomalies. Biotin can be acquired through diet and is found in egg yolks, dairy products, soybeans, and leafy vegetables.

Vitamin B₉ (folate)

Folate, vitamin B₉, participates in the synthesis and replication of DNA. Deficiency is often due to alcohol abuse, malabsorption disorders, or increased requirements for folate during pregnancy.² Inadequate intake during pregnancy can result in neural tube defects such as spina bifida or cleft palate.

Women of childbearing age and pregnant women should obtain adequate folate intake through diet and supplementation. High B₉ daily intake is associated with a lower risk of periodontal disease.¹ Folate can be acquired through green leafy vegetables, beans, nuts, eggs, and other animal products.

Vitamin B₁₂ (cobalamin)

Cobalamin, vitamin B₁₂, is required for red blood cell formation and DNA synthesis and aids in nervous system function. Patients with Crohn’s or celiac disease or older adults may be at a greater risk for developing a deficiency due to impaired absorption.³

Prolonged deficiency can cause megaloblastic anemia or a change in red blood cells, as well as neurological changes such as cognitive impairment and neuropathy.³ Since B₁₂ is primarily found in animal products, supplementation may be appropriate for vegetarians and vegans.

The B complex vitamins provide daily energy, synthesize and repair DNA, and work to support various systems throughout the body. These vitamins are not able to be made or stored by the body and need to be consumed daily and are found in many whole foods. Adequate daily consumption of B vitamins may correspond with oral health, as a meta-analysis of observational studies showed a lower risk of periodontal disease associated with higher intake of certain B vitamins.

It's important to know patients’ medical histories and diets to learn if they’re at risk for a vitamin B deficiency. This is especially true if you see physiological signs of deficiency such as fatigue or oral manifestations like cheilitis and glossitis. While we don’t diagnose a deficiency, we can provide patients with valuable knowledge about the vitamin B complex and refer to their primary care physician if we suspect a deficiency.

Editor's note:This article appeared in the January/February 2025 print edition ofRDHmagazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.

References

1. Mi N, Zhang M, Ying Z, Lin X, Jin Y. Vitamin intake and periodontal disease: a meta-analysis of observational studies. BMC Oral Health. 2024;24(1):117. doi:10.1186/s12903-024-03850-5

2.Bayram-Weston Z, Knight J, Andrade M. Vitamin B complex: B group vitamins and their role in the body. Nursing Times. February 26, 2024. Accessed September 26, 2024. https://www.nursingtimes.net/nutrition-and-hydration/vitamin-b-complex-b-group-vitamins-and-their-role-in-the-body-26-02-2024/

3. Edited by LeBlanc JG. B-Complex Vitamins. Sources, Intakes, and Novel Applications. Published in London, United Kingdom. February 23, 2022.

4. Lee JH, Lee SA, Kim HD. Periodontitis and intake of thiamine, riboflavin and niacin among Korean adults. Community Dent Oral Epidemiol. 2020;48(1):21-31. doi:10.1111/cdoe.12496

5. Kennedy DO. B vitamins and the brain: mechanisms, dose and efficacy–a review.Nutrients. 2016;8(2):68. doi:10.3390/nu8020068