As I outlined in my last blog, there is substantial data to show that dental implant failure rates can be as high as 11% in patients that are Vitamin D deficient. The follow-up questions are:
1.
whom do you test?
2.
what do you do about it?
Studies show that 70% of society is Vitamin D deficient. The deficiency relates to lower-quality fast food, an increased demonstrated genetic deficiency, a more "in door" lifestyle and is more pronounced in the aging population….those that most need implant dentistry. Again, this deficiency plays a substantial role in depression, dementia, Alzheimer’s disease, asthma, cancer, cardiovascular disease and diabetes. Vitamin D is also essential for GI absorption of calcium, mineralization of osteoid tissue and maintenance of serum-ionized calcium levels.
I outlined some of the indications in this "early adoption" phase of research results for testing patients. I am now testing the Vitamin D levels for any patient that presents an increased risk profile from normal or has an implant failure. I will be testing patients that are undergoing more extensive implant dentistry in the future. Patients with a significant history of bisphosphonates, SSRI’s, and Proton Pump Inhibitors, patients with autoimmune or immune compromised situations, smokers, and diabetics will be tested.
What should one do, when Vitamin D levels are too low? I’ve had advice from 3 sources: The Endocrine Society recommends 1500 units to 2000 units/day for deficient patients and that obese patients should take 3 times that much. The toxic level of Vitamin D is around 40,000 units. Dr Richard Miron DDS, MS, PhD has focused on this issue extensively in his research. He’s found that it takes 6 months for a patient to get back to a normal level with supplementation.
Dr Miron advocates taking Vitamin D with antioxidants and has worked with plastic surgery vitamin resource companies to come up with a product that will rebound Vitamin D levels in one month. This product contains Vitamin K, which according to Dr Sammy Nombissi, is a critical element in Vitamin D uptake.
As a side note I have Dr Nombissi lecturing in October on Zirconia dental implants: Why we should consider them, what is the harm with titanium implants, when to use them and the pitfalls he’s seen in 10 years of limiting his practice to ceramic implant dentistry.
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