Correlation between bone mineral density, vitamin D deficiency, and oral health in women with breast cancer

Abstract

Breast cancer (BC) survivors treated with aromatase inhibitors (AIs) typically exhibit various pathological issues, including bone loss, poor oral health, and vitamin D deficiency. Nonetheless, chronic oral disorders are even often neglected in women with BC, and explicit indications regarding oral health screening, evaluation, and treatment to prevent cancer treatment-induced bone loss (CTIBL) are lacking. A close link between oral health status and CTIBL might be explained, in part, by the systemic inflammation that characterizes both conditions. In this scenario, the effects of vitamin D (as an inflammation down-regulator) on immune systems are widely acknowledged. Vitamin D might facilitate upregulation of MAP kinases and inhibit the NF-kB signaling pathway, with crucial implications for cytokine serum levels, the prostaglandin inflammation pathway, and the immune cell system. Vitamin D deficiency, smoking, and insufficient usage of dental floss have been found to harm oral health in women with BC receiving AIs. Consequently, vitamin D deficiency screening and supplementation and an appropriate oral rehabilitation strategy should be advised and implemented in the comprehensive therapeutic approach to women with BC treated with AIs. KEY WORDS: Vitamin D, vitamin D deficiency, oral health, periodontal diseases, breast cancer.