Background : There is conflicting evidence on the relationship between vitamin D and periodontal disease. The purpose of this study was to investigate this relationship.

Methods : This study used data from the Canadian Health Measures Survey for respondents aged 13-79 years. Vitamin D status was determined by measuring plasma 25-hydroxyvitamin D (25(OH)D) concentrations. Periodontal disease was defined by gingival index (GI) and calculated loss of attachment (LOA). Statistical analyses included bivariate tests and multiple logistic regression.

Chronic periodontitis is an inflammatory condition of the periodontium that is initiated by microbes that form on the teeth. 1 The bacteria, as well as the host's immune response to them, result in the destruction of the tissues that support the teeth, including the alveolar bone. Because of this tissue destruction, chronic periodontitis is the leading cause of tooth loss in adults. Prevention of this disease is important because tooth loss can affect a person's nutritional status and quality of life. Chronic periodontitis has also been associated with systemic conditions such as cardiovascular disease and type II diabetes mellitus. 

Vitamin D is involved in regulating calcium absorption from the intestines, maintaining plasma calcium concentration and bone mineralization. Studies have found significant positive associations between (OH)D levels and bone density and between vitamin D supplementation and lower fracture risk. 

More recent evidence suggests that vitamin D also has a modulatory effect on the immune response, stimulating the immune response at times while inhibiting it at others. There are many examples of vitamin D's ability to inhibit the immune response. The active form of vitamin D also inhibits the production of inflammatory cytokines in monocytes. 

Because chronic periodontitis is characterized by bone loss caused by a host immune response to a bacterial plaque, vitamin D deficiency may have an effect on the development and progression of periodontal disease. Two large studies found an association between low vitamin D levels and indicators of periodontal disease. However, the largest study to date, as well as the most recent study, found no association between these two entities. Clearly, further research is needed to determine what impact vitamin D status has on the progression of periodontal disease. The objective of this study was to investigate the relationship between (OH)D concentration and periodontal disease measured by the gingival index (GI) and loss of adherence (LOA) using data derived from the Canadian Health Measures Survey (CHMS).