All the brushing and flossing in the world won’t fix an oral health problem if there is a vitamin deficiency that has been missed. If you have tooth infections, mouth sores, bleeding gums, a burning sensation in the mouth, or other mouth problems, your mouth may be starving for vitamins and minerals. Unfortunately, even an organic, whole foods, healthy diet may not deliver all the vitamins and nutrients your mouth needs. That’s because vitamin deficiencies may show up in the mouth first even while standard blood tests for vitamins are normal. This article has useful tips for consumers and practitioners alike, with specific treatments for oral health challenges.

Nutrition is important to:

• Build strong teeth
• Prevent tooth break-down
• Support healthy mouth tissue and mouth lining
• Keep saliva flowing
• Improve wound healing
• Promote a healthy immune system in the mouth
• Provide a foundation for healthy mouth bacteria
• Ward off oral dysbiosis, or imbalanced bad bacteria in the mouth

If you have oral dysbiosis, then these nutritional recommendations are all the more important for you. Examples of oral dysbiosis include a history of cavities, root canal infections, gingivitis, periodontal disease, and/or bad breath. In addition, certain nutrients have been shown to specifically benefit the mouth. And keeping the tissue in the mouth and the teeth healthy helps keep your oral microbiome healthy.

 

These Vitamins and Minerals are Recommended for Oral Health:

• B vitamins
• Calcium
• Copper
• Coenzyme Q10 (coQ10)
• Folate
• Magnesium
• Phosphorous
• Potassium
• Vitamin A
• Vitamin C
• Vitamin D
• Vitamin E
• Vitamin K2
• Zinc

 

Protein

Protein may not be the first thing we think of for a healthy mouth, but it’s a macronutrient that affects teeth and the mouth. Protein makes tooth enamel stronger.¹ When someone doesn’t get enough protein, it can delay tooth eruption. Low levels of protein interfere with saliva flow, which can harm the mouth and the oral microbiome. Amino acids from protein build the tissues and ligaments in the mouth and are a component of collagen in bones and teeth.

While we are talking about macronutrients, let’s give a nod to carbohydrates. Fermentable carbohydrates and simple sugars promote cavities. But all carbohydrates are generally considered cavity-causing. When we choose processed foods that are low-cost, nutrient-poor, and sugary, instead of fresh, nutritious foods, we are hurting our oral health.¹

Minerals

Teeth are the hardest tissue in the body and can handle lots of wear and tear. Calcium, phosphorus, magnesium, potassium, and sodium help build teeth and keep teeth strong. Enamel is 95% calcium phosphate. Dentin is the material that makes up most of the tooth. Dentin is composed of 10% water, 20% type 1 collagen, and 70% minerals. It is primarily calcium, phosphorus, oxygen, and hydrogen called hydroxyapatite, which is the fundamental hard ingredient in teeth and bones.

Aside from building teeth, minerals help keep your mouth healthy. Low iron or zinc can slow down saliva production, worsening nutrition in the mouth and leaving the mouth defenseless against infection.² If you are low in iron, also known as iron deficiency anemia, it can cause these problems for the mouth: a red, painful tongue with a burning sensation, problems swallowing (known as dysphagia), and a type of mouth sore called angular cheilosis.

Fat-Soluble Vitamins

We need vitamin D for strong teeth and bones and to help teeth erupt on time.¹ Vitamins D and A are necessary for healthy enamel on teeth, while vitamins D and K help direct tooth formation. Vitamin A is needed to form teeth and it is needed for keeping the cells that line the mouth and gums healthy (known as epithelial cells).¹

B Vitamins

Deficiencies of B vitamins can cause inflammation of the lining of the mouth and tongue, a burning sensation of the tongue, and more.² Not getting enough B vitamins can cause angular cheilosis mouth sores. This is a condition of having mouth sores at the corners of your mouth where your lips meet. They might be irritated, inflamed, cracked sores.

B vitamins can help treat canker sores or mouth sores. In a meta-analysis of 16 studies, B vitamins appeared to speed up ulcer healing and lower the chances of recurrence. Researchers said B vitamins have a high value for treating mouth ulcers.³

Here’s a Run-down of the B Vitamins for Oral Health:

Vitamin B1 (thiamin) helps convert energy in the body and is important for muscles and nerves. Without enough B1, you can get cracked lips and angular cheilosis.²

Vitamin B2 (riboflavin) is associated with inflammation in the mouth lining and lining of the genitals. It is important for normal growth, muscle development, and healthy hair. A deficiency of riboflavin can cause inflammation of the tongue, the mouth sores known as angular cheilosis, or ulcerative gingivitis.

Vitamin B3 (niacin) is important for enzymes and helps transfer hydrogen between molecules. This vitamin is also important to prevent an inflamed tongue, angular cheilosis mouth sores, and gingivitis.²

Vitamin B5 helps break down carbohydrates, fats, and proteins in to energy in the body.

Vitamin B6 is involved in the metabolism of fats and amino acids and is used by many enzyme reactions. People who don’t get enough vitamin B6 can develop periodontal disease. Low levels of B6 can cause sore tongue or a burning sensation in the mouth.^1,2

Vitamin B9 (folate) is involved in red blood cell health and too little of it can lead to neural tube defects, poor pregnancy outcomes, and cancer. It works together with vitamin B12. If you don’t have good levels of folate (the synthetic version is called “folic acid”), you are more likely to develop periodontal disease.

How Does Folate Keep Gum Tissue Healthy?⁴

• Builds strong gums, ligaments, and bone
• Helps to resist oral infections
• Promotes healthy blood supply and oxygen to the mouth
• Minimizes bleeding gums
• Reduces gum inflammation
• Decreases irritation and sensitivity of the gums
• Prevents gum overgrowth, or enlarged gums, due to certain medications
• Fights gum disease
• Is depleted with smoking

 

Vitamin B12 (cobalamin) helps make red blood cells in the bone marrow. If you’re low in B12, you may find that you have angular cheilosis mouth sores, bad breath, bone loss, bleeding gums, loose teeth due to periodontal fibers breaking down, or painful ulcers in the mouth.²

 

CoQ10

Some studies have shown that people with gum disease and bleeding gums have low levels of CoQ10 in their gums. CoQ10 treatment can reduce gingivitis and bleeding gums. It can calm inflammation in the gums and it may reduce pocket depth in periodontal patients. It may improve oxygen use by the gums.⁵

Antioxidants like CoQ10 and vitamins A, D, E, and C help protect the mouth from the dangers of smoking, tobacco products, and alcohol consumption.

Vitamin C

Vitamin C helps with wound healing. It is necessary for making dentin and healthy tooth pulp. Vitamin C helps produce strong collagen, which makes strong teeth and connective tissue (such as cartilage and ligaments) that help teeth stay in place firmly in the jaw. Collagens form the basic framework of the mouth tissues so vitamin C is essential. Not getting enough vitamin C can also cause bleeding gums.¹ It can sometimes cause ulceration of the gums and loss of teeth.

Infamous for killing millions of sailors in the 18^th century, scurvy was a dreaded disease caused by vitamin C deficiency and cured by citrus juice. It started with weakness, tiredness, sore arms and legs, but worsened to low red blood cells, gum disease, hair changes, and bleeding from the skin. Treating gums with vitamin C can improve gingivitis and bleeding gums.

Nutritional Deficiencies Can Show Up First in the Mouth

The mouth may be the first place you see a nutritional deficiency. Maybe you eat a nutritious diet with lots of fresh, whole foods and plenty of vegetables and protein. You have extremely inflamed gums but it can’t be a B vitamin deficiency because your blood levels look great, right? Wrong. You may still have a vitamin deficiency even if your blood levels look healthy and your doctor says you have nothing to worry about. Researchers in the 1970s realized that the gums can show an “end-organ deficiency” of the B vitamin folate. Essentially, people could show severely inflamed gums due to folate deficiency, even though their blood levels were completely normal. What this means is that you and your dentist or doctor may want to overshoot the mark with oral health vitamins, if you are struggling with hard-to-resolve mouth infections or gingivitis.

Why Do I Have to Worry About Vitamins for the Mouth?

Some people think malnutrition is only a problem in developing countries or in countries where food is scarce. If you eat a diet of junk food, fast food, or lots of packaged foods, you may not have good nutrition. If you don’t eat the rainbow of vegetables, you may be malnourished. If you have a chronic illness, your body may be drained of vital nutrients. If you weren’t breastfed, you might have had a poor nutritional start. If you suspect that you have a weak nutritional foundation, you should see a clinician who can test your levels and replenish these fundamental nutrients with diet and supplements (see list at the end of this article). Your oral health—and your bodily health—depends on it.

Nutritional Treatments to Boost Oral Health

Pretty much everyone needs a foundational nutrition plan that includes a diet of healthy proteins, complex carbohydrates, essential fatty acids (including linolenic and alpha-linoleic acids), plenty of vegetables, and supplements, including a multivitamin-mineral and a probiotic. In addition to the basics, vitamins and minerals may be needed if there are mouth ulcers or sores, bleeding gums, gingivitis, periodontitis, cavities, tooth infections, bad breath or other signs of oral dysbiosis. While I didn’t come across too many vitamins for dry mouth, there are some other nutrients that can help. Protein, zinc, and iron can help with dry mouth. Here are dosing considerations for professionals. Consumers, please work with a functional medicine provider who can customize your nutritional protocol based on your specific needs.

Nutrients for Oral Health	Dosing Considerations
B vitamins	Vitamins B1 50 mg/d, B2 50 mg/d, B3 50 mg/d, B5 500 mg/d, B12 1,000 mcg/d
Folate	1,000 – 2,000 mcg/d
Calcium	1,000-1,300 mg/d
Copper	2-10 mg/d
CoQ10	200 – 400 mg/d
Magnesium	500-800 mg/d
Phosphorous	Supplementation unnecessary; plentiful in the diet
Potassium	150-300 mg/d
Vitamin A	5,000-10,000 IU/d
Vitamin C	1,000-5,000 mg/d
Vitamin D3	1,000-5,000 IU/d
Vitamin E	200 – 1,500 IU/d
Vitamin K2	500- 1,000 mcg/d
Zinc	30- 50 mg/d

These nutrient doses serve as a guideline only. They are higher than the recommended daily intake (RDI) and are intended to replenish body stores over the course of 3-6 months in patients who have inadequate levels.

 

You can deliver nutrients directly to teeth and gums by using a toothpaste such as Revitin Prebiotic Toothpaste, which contains CoQ10, vitamins C, D, K, calcium carbonate and prebiotics.^2,5-7

Learn more about the oral microbiome and oral health in my book, Heal Your Oral Microbiome!

Your Mouth May Be Starving for Vitamins and Minerals

If you are having mouth problems such as mouth ulcers, cavities, gingivitis, gum disease, root canals, then your mouth may be begging for the nutrients it needs to heal, defend, and prevent illness. Or it could be making it harder for your mouth to recover from other issues such as mouth infections or oral surgery. Since diet alone often isn’t enough for most people, consider supplementation with the vitamins, minerals, and nutrients for oral health mentioned in this blog. Be sure to buy high-quality vitamins when shopping. You can review my Buyer’s Guide to high-quality nutritional supplements. You can also work with a functional nutritionist to make sure your diet is on point and that you are getting plenty of nutrients for oral health. Testing is another way to figure out if your levels are normal or if you need additional vitamin or mineral supplements for oral health.

Find an integrative and functional medicine clinician near you.

• Institute for Functional Medicine– “Find a Practitioner”
• Diagnostic Solutions Laboratory– ask for a clinician in your zip code
• Genova Diagnostics– ask for a clinician in your zip code
• Doctor’s Data– ask for a clinician in your zip code
• Kresser Institute Directory– practitioners who have completed ADAPT training

References

1. Tungare S, Paranjpe AG. Diet and Nutrition To Prevent Dental Problems. StatPearls. Treasure Island (FL)2022.
2. Sheetal A, Hiremath VK, Patil AG, Sajjansetty S, Kumar SR. Malnutrition and its oral outcome – a review. Journal of clinical and diagnostic research : JCDR. 2013;7(1):178-180.
3. Shi J, Wang L, Zhang Y, Zhi D. Clinical efficacy of vitamin B in the treatment of mouth ulcer: a systematic review and meta-analysis. Ann Palliat Med. 2021;10(6):6588-6596.
4. George JP, Shobha R, Flemingson L. Folic acid: A positive influence on periodontal tissues during health and disease. International Journal of Health & Allied Sciences. 2013;2(3):145-152.
5. Manthena S, Rao MV, Penubolu LP, Putcha M, Harsha AV. Effectiveness of CoQ10 Oral Supplements as an Adjunct to Scaling and Root Planing in Improving Periodontal Health. Journal of clinical and diagnostic research : JCDR. 2015;9(8):Zc26-28.
6. Littarru GP, Nakamura R, Ho L, Folkers K, Kuzell WC. Deficiency of coenzyme Q 10 in gingival tissue from patients with periodontal disease. Proc Natl Acad Sci U S A. 1971;68(10):2332-2335.
7. Chatterjee A, Kandwal A, Singh N, Singh A. Evaluation of Co-Q10 anti-gingivitis effect on plaque induced gingivitis: A randomized controlled clinical trial. Journal of Indian Society of Periodontology. 2012;16(4):539-542.