The holidays bring plenty of wonderful things – twinkling lights, festive music, gathering with family and friends, giving and getting gifts, hot cocoa in front of a lively fire. But coming in winter, they also take away something crucial: the amount of sunlight we’re exposed to, which our bodies need to make vitamin D.
Without enough of this key nutrient, it’s not just bone health that can suffer but oral health, too.
Here in St. Louis, though – and other places that are above roughly 37° latitude – winter presents a particular challenge. For much of the time from late fall through late winter, the sun sits so low in the sky that most of us can’t make enough vitamin D from normal daily sun exposure – even on bright, clear days. Between that and the amount of time we spend inside during the cold months, vitamin D deficiency becomes a real concern.
And as a new systematic review in BMC Oral Health reminds, low vitamin D levels can affect nearly every aspect of oral health.
As the researchers note, the effects of D deficiency can start quite early. In childhood, it can affect tooth mineralization, creating weaker enamel that’s more vulnerable to decay and damage. One of the studies found that children whose mothers were deficient in D during their third trimester “had over three times the rate of dental caries at age 6.”
The relationship between vitamin D and gum health is something we’ve blogged about before – here and here, to point to just a couple instances – and is especially well-established now. The nutrient appears to support the periodontal tissues through its effects on bone metabolism, as well as its anti-inflammatory properties and by helping gingival cells produce antimicrobial peptides that fight the bacteria behind gum disease. Studies have shown that people with periodontitis consistently show lower levels of vitamin D than those with healthy gums.
In fact, upon completing their review, its authors wrote that
it may be concluded that oral diseases, tooth defects, caries, periodontitis, and unsuccessful oral treatment outcomes are associated with vitamin D (VDD). Better oral growth and health are linked to maintaining adequate 25 (OH)D levels throughout life.
Of course, understanding the problem is one thing. Actually maintaining adequate vitamin D levels from December through March in the Midwest is another. It’s up to us to do what we can to get the D we need.
Unfortunately, there aren’t lots of foods that are naturally high in vitamin D, but there are a few options that traditional cultures have valued for generations:.
Cod liver oil stands out as particularly efficient. A single teaspoon provides roughly 450 IU of vitamin D, with vitamin A and omega-3 fatty acids along for the ride. For families with young children, this is often the simplest daily intervention, and many of our parents have found brands they can tolerate (or even enjoy – yes, really!). For children, the ritual of a daily spoonful becomes as routine as brushing teeth.
Fatty fish – particularly wild-caught salmon, mackerel, sardines, and herring – also provide a good dose of vitamin D. Just three ounces of salmon can deliver 450 to 600 IU, depending on whether it’s wild or farmed. Sardines and mackerel are underappreciated options that are often more affordable and sustainable.
Organ meats, especially liver, contain vitamin D along with other fat-soluble vitamins and minerals. Beef liver provides about 50 IU per serving, but its real value is in the complete nutritional package it offers.
Egg yolks from pastured chickens contain more vitamin D than conventional eggs – about 40 IU per yolk, say, versus 20 IU. If you eat eggs daily, that difference adds up over time.
There aren’t many plant sources of vitamin D, but mushrooms exposed to UV light are. Commercially available mushrooms that have been treated with UV light to boost their D content should be labeled as such. During the summer, you can expose mushrooms yourself at home. Just set them gill-side up in direct midday sun for 30-60 minutes. This won’t work in winter, when the sun’s angle is too low, but it’s a good hack when you’re not sure if your store-bought mushrooms have been pre-treated.
That said, most people in the more northern latitudes will need to supplement in order to maintain optimal D levels through winter. When supplementing, you’ll want a combo of vitamin D3 and K2. D3 is the form your skin produces naturally and your body uses most efficiently. K2 is needed, too, because vitamin D increases your absorption of calcium, and K2 (specifically the MK-7 form) helps guide it into bones and teeth while keeping it from depositing in soft tissues. The two vitamins work as partners.
As for how much D3 you should take, the recommended dietary allowance is 600 to 800 IU daily for most adults, but many integrative doctors recommend more. Individual needs vary a lot, depending on things like baseline levels, weight, health status, and how well you absorb and utilize the vitamin. This is one reason why testing can be invaluable.
In fact, because vitamin D affects healing capacity and bone health, we routinely check levels before surgical procedures. Testing gives us actual data to guide treatment decisions. It can be particularly valuable if you’ve never had your levels checked or aren’t responding to supplementation as expected.
Last, there are lamps designed specifically for vitamin D production. These are different from the bright light therapy lamps used for seasonal affective disorder (SAD), as they specifically emit UVB radiation, similar to sun exposure. To be helpful, though, they do require consistent use (typically 10 to 15 minutes several times a week) and careful attention to skin type and sensitivity. They tend to work best when combined with dietary and supplement strategies rather than as a sole solution.
If you want to track your vitamin D status more actively, apps like D Minder (developed with vitamin D researcher Dr. Michael Holick) can help. D Minder uses your location and personal factors to calculate when you can synthesize vitamin D from sun exposure and estimates your levels based on sun sessions and supplementation. General nutrition tracking apps like Cronometer let you monitor D intake from food and supplements alongside other nutrients.
Winter is inherently harder on our bodies – reduced daylight, more time indoors, holiday stress, less attention to nutrient-dense eating. Being intentional about vitamin D is one concrete way to support your oral health through the season.
Image by Matthew Hurst, via Flickr
