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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Oral Manifestations, continued
Vitamin Deficiencies

Vitamin C
Most common in children 6-12 months of age who are fed a diet deficient in citrus fruits and vegetables. Clinical manifestations of scurvy include malaise, anorexia, limb tenderness and swelling, costochondritic enlargement, easy bruisability, and petechiae. Oral manifestations include gingival swelling and discoloration with petechial hemorrhages on the mucous membranes, loosening of the teeth, and early tooth loss.

Vitamin D
Vitamin D deficiency presents as Rickets with bony manifestations of craniotabes, rachitic rosary, delayed fontanelle closure, and long bone deformities. Dental manifestations can also occur, including delayed eruption, enamel defects, and dental caries.
Enamel: Intensely hard calcareous substance that forms a thin layer partly covering the teeth; the hardest substance of the animal body; consists of minute prisms arranged at right angles to the surface and bound together by a cement substance.

Vitamin K
Several factors in the clotting cascade are Vitamin K dependent, so deficiency results in excess bleeding and easy bruisability. Vitamin K deficiency may manifest as bleeding of the gums, especially with brushing.
Fast Facts
Many systemic conditions are known to adversely affect the mouth or teeth, and these patients require additional oral care and management.
Gingival bleeding may be a sign of vitamin C or K deficiency.
Vitamin C and Vitamin D deficiency may present with both bone and dental abnormalities.

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