Vitamin Deficiencies and Oral Manifestations

Key Vitamin Deficiencies to Evaluate

• Riboflavin (vitamin B2) deficiency manifests with oral-buccal lesions including cheilosis, angular stomatitis, and lip inflammation, and is often associated with deficiencies of other B vitamins, such as pyridoxine, folate, and niacin, which can compound oral symptoms 1
• Vitamin C deficiency can present with gingival swelling, bleeding, and mucosal changes, and clinical suspicion of scurvy warrants plasma vitamin C measurement 2

Risk Factors for Vitamin Deficiencies

• Malabsorption conditions, such as short bowel syndrome and celiac disease, increase the risk of vitamin deficiencies, including riboflavin deficiency 1
• Inflammatory bowel disease, particularly Crohn's disease with small bowel involvement, is a risk factor for vitamin deficiencies, including vitamin B12 and folate deficiencies 3

Diagnostic Approach

• Measuring plasma riboflavin levels using the erythrocyte glutathione reductase activity test is preferred to assess tissue saturation and long-term status 1
• Considering vitamin C levels in patients with gingival involvement or petechial hemorrhages is important for diagnosing vitamin C deficiency 2

Treatment Considerations

• The daily recommended dose of riboflavin is 1.3 mg for males, 1.1 mg for females, and 1.4-1.6 mg during pregnancy and lactation, and higher supplementation doses may be required for patients with chronic malabsorption 1
• For patients with vitamin C deficiency, a dose of 200-500 mg/day may be provided, especially in cases of chronic oxidative stress or malabsorption 2