Saturday, June 28, 2008

Prevent Cavities: Vitamin D, Vitamin C, Niacin, and Thiamine

I believe the primary cause of cavities is general poor health. I’m willing to bet that the small fraction of kids in school with perfect attendence for two or more consecutive years have less than half the average number of fillings. I wouldn’t be surprised to learn that they have less than 10% of the average number of fillings.

Vitamins D, C, niacin, and thiamine are special nutrients. They prevent rickets, scurvy, pellagra, and beriberi respectively. Vitamin D is particularly important for preventing cavities. The role of vitamin D in building and maintaining strong, healthy, teeth and bones is will known. Countless children grew up with misshapen bones before vitamin D was added to the food supply (primarily in milk).

Unfortunately, vitamin D has proved difficult to use. The need for vitamin D varies dramatically from person to person, and from time to time during a lifetime. When the British government first added vitamin D to the food supply, rickets disappeared only to be replaced by cases of vitamin D overdose. Protecting the fraction of ht epopulation that needs vitamin D the most endangers the fraction of the population most sensitive to overdosing. The lesson is that individuals have to work with their healthcare providers to learn to take care of themselves and their families.

Nature does not provide vitamin in a steady amount. Vitamin D is the sunshine vitamin. A day under the summer sun wearing nothing but shorts delivers between 10,000 and 50,000 IU (50 to 200 times the RDA) of vitamin D, while a dark winter day provides almost none.

Typical early symptoms of overdose are irritable lungs (unexplained coughing, unusual sensitivity to alcohol vapors…) ringing ears, sensitive teeth (sharp, shooting pain when contacted with cold liquid and food), and nausea.

Vitamin D is fat soluble, and is stored in the liver and other fatty tissue. Both overdosing, and recovery from overdosing are slow processes. The half-life of vitamin D in the body is 30 days. This is not a major problem as long as individuals and physicians are on the look-out for vitamin D overdose. The early symptoms are mild and harmless. Furthermorer, vitamin D status can also be monitored by blood tests. These tests should be considered for inclusion as part of a yearly physical.

With that said, vitamin D is not so hard to use. I recommend taking 4000 IU/day for one month, while remaining on the look-out for side effects. If side effects emerge, vitamin D status is excellent, and there is no need to consider taking any more than the amount in a multivitamin. If side effects don’t emerge, you have learned that you can benefit from extra vitamin D supplements, or extra sunshine. I believe that the supplements are best taken intermittently in large doses (3000 to 8000 IU/day), rather than steadily at a lower dose. This level and strategy for supplement use should be accompanied by physician monitoring (vitamin D blood tests) with the objective of maintaining vitamin D at a “high normal” level.

Thiamine has also proven difficult to use. Thiamine is easily added to the diet in its common, water soluble forms. Unfortunately, it is difficult to get water-soluble thiamine out of the diet and into the cells where it is needed. Thiamine in its fat soluble forms is readily available but obscure. The fat soluble thiamines are fragile molecules that rapidly degrade into water soluble forms in the intestinal tract. Fat soluble thiamines are best utilized by formulating them into creams and applying them to the skin. Needless to say, this practice is even more obscure than fat soluble thiamine supplements. Although far less effective, taking B-complex supplements is a much more socially acceptable way to elevate cellular levels of thiamine. If you refuse to consider fat soluble thiamine, it is much better to take B-complex supplements than to do nothing.

Vitamin C and niacin have been discussed many times before in this column. I recommend 3000 mg/day of vitamin C (most children like the ubiquitous 500 mg orange-flavored chewable tablets) and one half of a 250 mg time release niacin tablet or gelcap two or three times a week.

Optimal doses of vitamin D, thiamine, vitamin C, and niacin can remarkably improve the overall health of children. This can be hard to notice, because there are so few metrics for overall good health and every parent has a tendency to view the ordinary health of their child as the definition of excellent health. In this column, I’m proposing using cavities as a health metric. Some children have zero fillings. To me, that’s a great benchmark. Please consider trying these four fantastically important supplements as a means to prevent cavities in your children’s teeth. There is much to gain and almost nothing to lose.