Patients with a common type of temporomandibular disorder (TMJ) had lower levels of calcium and vitamin D, indicating that calcium metabolism may be associated with these jaw disorders.
The authors write that patients with reduced TMJ disc displacement (TMD) were deficient in calcium and vitamin D compared with patients who did not have TMJ disorder. And a severe vitamin D deficiency can negatively affect calcium metabolism, causing calcium and magnesium levels to drop, and may pose a risk of developing TMJ disorders.
“These results indicate that vitamin D and calcium deficiencies should be investigated and corrected in patients with TMJ problems,” write the authors, led by Dr. Omer Ekici from Afyonkarahisar University of Medical Sciences in Turkey.
Worldwide, vitamin D deficiency affects more than 1 billion people. Vitamin D influences the proliferation and differentiation of skeletal muscle cells and also transports calcium and phosphorus across skeletal cell membranes. In addition, vitamin D prevents muscle degeneration and eliminates myalgia.
TMJ disorders are common in 12% of the population. However, the etiology and pathogenesis of TMJ is not fully understood, so treatment is not always successful. Thus, a better understanding of the origin of TMJ problems would help to identify and eliminate possible pathogenic factors.
To investigate the relationship between factors affecting calcium metabolism and TMJ, vitamin D levels, and relevant biochemical parameters in patients with these diseases, a prospective observational study was conducted in 100 patients. Half of the patients had a TMJ disorder and the remaining 50 did not.
The diagnostic criteria for TMJ were used to diagnose SDDS. Patients were then compared for levels of alkaline phosphatase, vitamin D, parathyroid hormone, calcium, magnesium, and phosphorus. p value < 0.005 was considered a significant difference.
Calcium levels were lower (p < 0.005) in patients with SDDS than in healthy controls. In addition, severe vitamin D deficiency (<10 ng) was more common in the TMJ group (n=19) than in the control group (n=8).
Limitations of the study included the lack of information on bone mineral density assessment. However, the authors noted that they wished to obtain more precise and reliable results by including only patients with SDDS instead of the heterogeneous TMJ group used in previous studies.
Clinicians should consider evaluating TMJ patients for deficiencies and suggesting specific supplements as needed. More randomized clinical trials should be conducted in the future to better understand the possible association between TMJ and deficiency.
“However, investigating the possible effect on TMJ symptoms in response to vitamin D supplementation in individuals with low vitamin D levels is important to determine the exact role of vitamin D in TMJ,” write Ekiji et al.