Vitamins 2/certified fixed orthodontic courses by Indian dental academy

INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

Learning objectives
• At the end of the lecture student should be able to
• Enlist the sources, daily requirements and
functions of vitamin B complex and vitamin K

• All vitamin K forms are
naphthoquinone derivatives
• 3 naturally occuring vit k
1. K1(phylloquinone)- derived- animal & vegetable
2. K2(farnoquinone)- derived- synthesized by
bacteria flora & found in hepatic tissue.
3. K3(menadione)- provitamin
Sources: green leafy vegetables, butter,
margarine, vegetable oil.

Functions

Deficiency
• Primary vit K deficiency is rare.
• Newborns are susceptible to vit K deficiency and
hypoprothrombinemia.
• Secondary vit K deficiency may occur in adults
due to impaired fat absorption.
• Oral manifestation: gingival bleeding
• When prothrombin level is below 20%,
spontaneous gingival bleeding.

• Colorless basic compound
• Composed of sulphated pyrimidine rings.
• Readily absorbed from small and large intestine.
• In tissue found as thiamine pyrophosphate.

Deficiency
• DRY BERI-BERI :
• Associated with neurological manifestations resulting in
peripheral neuritis.
• Characterized by paresthesia of toes, burning of feet,
muscle cramps in the calves and pain in the legs.
• Degeneration can occur in all tracts of the spinal cord.

• WET BERI-BERI : characterized by edema of
legs, face, trunk and serous cavities causing
extreme peripheral vasodilatation and leakage
of fluid through capillaries.
• calf muscle is slightly swollen with complains
of ‘pins &needle’ on pressure.
• Tachycardia, high cardiac output, sweating,
warm skin and lactic acidosis develop

• INFANTILE BERI-BERI : occur in infants born
to mothers suffering from thiamine deficiency.
 characterized by tachycardia, vomiting,
convulsions and if untreated death.
• WERNICKE-KORSAKOFF SYNDROME :
seen in in chronic alcoholics.
 Characterized by loss of memory, apathy and
rhythmical to and fro motion of the eyeball due
to 6th nerve palsy, nystagmus and
ophthalmoplegia.

• Fully dialyzable
• Yellow color
• Water soluble
• Decomposed by light
• It floursces green under UV light
• Readily absorbed from the intestinal tract.
• Constitutes 2 different groups: FMN and FAD

Deficiency
• Mild deficiency: glossitis which begins with
soreness of the tip/lateral border of tongue.
• Filiform papillae become atrophic
• Fungiform papillae remain normal or become
engorged and mushroom shaped
• Tongue surface redened and coarsely granular
appearance.

• Severe deficiency: tongue may become glazed
and smooth.
• Complete atrophy of papillae.
• Angular chelitis with paleness
of lips.
• scaly, greasy desquamation
chiefly seen around the ears,
nose and nasolabial folds.

• Niacin is chemically pyridine- 3 – carboxylic acid.
• Occurs in the tissues as nicotinamide.
• First discovered as an oxidation product of
nicotine.
• The term niacin is used in two different ways-
nicotinic acid and nicotinamide.

SYMPTOMS
• PELLAGRA :Italian word meaning rough skin.
• Occurs in areas where maize forms a major part
of the diet.
• Characterized by three D’s- DERMATITIS,
DIARRHEA AND DEMENTIA.
• If untreated leads to death.

• Cutaneous lesions : primarily located on the sun
exposed areas of face- malar prominence,
dorsal aspect of hand and nape of neck.
• The dermatitis progresses from an erythematous
often pruritic rash to vesicles and blisters with
scales and fissures.

• CASAL’s necklace refers to characteristic
advanced skin lesions of pellagra and sunlight
also causes butterfly- shaped lesions on the
face.
• Mucous membrane symptoms : primarily affect
the mouth, vagina and urethra.
• Scarlet glossitis and stomatitis are characteristic
of acute deficiency.

• The tips and margins of tongue and the mucosa
around the stenson’s duct are affected first.
• As the lesion progresses, the entire tongue and
oral mucous membrane becomes bright scarlet
followed be sore mouth, increased salivation
and edema of the tongue.

• Ulcerations may appear, especially under the
tongue, mucosa of lower lip and opposite the
molar teeth and are often covered by a grayish
slough containing vincent’s organism.

• GI symptoms : include burning of the mouth,
pharynx and esophagus with abdominal
discomfort and distension, diarrhea is often
bloody because of hyperemia and ulceration.
• CNS symptoms : patchy degeneration of myelin
sheath most commonly involving posterior and
lateral column.

• Complex of three related
substances: pyridoxine,
pyridoxal and pyridoxamine.
• Oral lesion : angular cheilosis

• Folic acid is the synthetic form of folate that is
found in supplements and added to fortified
foods.
• Folate gets its name from the Latin word
‘FOLIUM’ for leaf.

• Folic acid is found in green leafy vegetables,
liver, lima beans and whole grain cereals.
• Functions : help produce and maintain new
cells, especially important during periods of
rapid cell division and growth such as infancy
and pregnancy.

Summary
• the sources, daily requirements and functions of
vitamin B complex and vitamin K.

BIBLIOGRAPHY
 Text book of oral pathology Shafer's, 5 & 6th edition
 Color Atlas of Oral Diseases Cawson, R. 2nd edition
 Oral and Maxillofacial Pathology Neville, Brad W.
2nd
 Lucas’s Pathology Of Tumor’s of the Oral Tissues
Cawson, R. A., Bennie, W. H 5th edition

Vitamins 2/certified fixed orthodontic courses by Indian dental academy

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