Vitamin D Deficiency: A Cause of Periradicular Bone Loss

The classic manifestations of vitamin D deficiency include rickets and osteomalacia. Here we demonstrate a case of vitamin D deficiency presenting as radiologic bone loss around the apical and marginal periodontal tissues, consistent with periapical cemental dysplasia. Potential mechanisms for this are explored and the importance of dentists in managing such cases is discussed. Case Presentation: An 18‐year‐old female patient was referred with marginal periodontal bone loss. Radiology revealed marginal bone loss and multiple asymptomatic periapical radiolucencies associated with teeth that responded positively to pulp testing. The patient was of Southern Asian descent, wore a headscarf and occlusive clothing for cultural reasons, and was visibly malnourished, reporting a poor diet. A diagnosis of severe vitamin D deficiency was confirmed by serum biochemistry. The patient underwent vitamin D supplementation, after which the radiolucent areas resolved. Conclusions: The prevalence of vitamin D deficiency in patients in the northern hemisphere is under‐recognized, especially in certain ethnic populations. Vitamin D deficiency may contribute (directly or indirectly) to periodontal bone loss either marginally or apically, in susceptible patients. Dental health professionals are well placed to diagnose vitamin deficiencies, including vitamin D, and advise patients on the benefits of a healthy diet and appropriate sun exposure.