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Several types of vitamin deficiencies can affect oral health. Inadequate levels of vitamin B are among the most common deficiencies related to oral health problems. Such deficiencies typically cause a burning sensation of the tongue and mouth. Patients may have swallowing difficulties and the tongue may feel like it is swollen. Deficiencies of some B vitamins may cause paleness and weakness of the tissue in the inner cheek and tongue. Tissue may break apart easily or slough off. Other oral symptoms associated with vitamin B deficiencies include mouth lesions, loss of taste, excessive salivation and enlarged salivary glands.

Patients with deficiencies of B vitamins may experience a plunge in their level of red blood cells, causing anemia. In addition, low levels of specific types of B vitamins may cause their own symptoms. People who are deficient in vitamin B12 (cobalamin) may experience gastrointestinal symptoms and numb or tingling limbs. People with low levels of vitamin B9 (folic acid) may also experience numb or tingling limbs in addition to a burning sensation in the mouth. Some researchers believe that reduced amounts of certain B vitamins may increase the risk of oral cancers. Other oral health problems attributed to B vitamin deficiencies include:

• Angular cheilitis. Inflammation and cracking of the corners of the mouth typically due to a fungal infection. It is often associated with deficiency of riboflavin (vitamin B2) or folic acid.
  
  
• Atrophic glossitis. Condition in which the taste buds on the tongue begin to deteriorate, affecting the sense of taste. This symptom is often associated with a lack of folic acid.
  
  
• Chronic oral mucosal candidiasis. Fungal infection of the mouth. This fungus is normally present in the mouth but can develop into an infection when a person has B vitamin deficiencies.
  
  
• Recurrent aphthous stomatitis. These are recurring canker sores caused by anemia. This symptom is often associated with a lack of niacin (vitamin B3).

Vitamin C is essential to the maintenance and repair of the tissue collagen. A vitamin C deficiency most often occurs as the result of eating inadequate amounts of fresh fruit and vegetables and is more likely to occur in winter, when such foods may be less abundant. Vitamin C deficiency was formerly known as scurvy and was common in people deprived of fresh fruits and vegetables, such as sailors. People who smoke are at a greater risk of developing vitamin C deficiency because smoking decreases the level of vitamin C in the body.

Deficiency of vitamin C may cause gums to bleed easily. Other symptoms include fatigue and tendency to bruise readily all over the body. A dentist can help determine if the patient has low levels of vitamin C or has an oral condition like gingivitis, which also causes the gums to bleed easily.

Vitamin A contributes to skin cell growth and repair and is involved in the formation of tooth enamel. Diseases that can cause this deficiency include cystic fibrosis, cholestasis (liver/bile duct problems), pancreatic insufficiency and chronic diarrhea.

Deficiency of vitamin A can lead to delayed healing of sores in the mouth, incomplete tooth development or cavities in young children. Because of the liver's ability to store vitamin A, it may take up to a year before the signs of deficiency are apparent in some patients. Excessive levels of vitamin A can lead to oral health problems such as gingivitis and fissures (tears) of the oral mucosa.

Vitamin D plays a key role in the regulation of calcium and phosphate metabolism. It is essential to the formation of strong bones and teeth. Patients on low-fat diets and those with malabsorption syndromes are at higher risk for this deficiency. Others who may be at risk include people who eat a vegan diet, which prohibits foods from animal origin, and people taking anticonvulsant or sedative-hypnotic drugs.

Deficiency of vitamin D can lead to weakening and brittleness of the bones. In the mouth, this may cause a jaw fracture or periodontal disease. When it occurs in young children, it can negatively impact tooth formation.