The Role of Vitamin B Complex in Periodontal Disease: A Systematic Review Examining Supplementation Outcomes, Age Differences in Children and Adults, and Aesthetic Changes.

Among nutritional factors implicated in periodontal health, the vitamin B complex-particularly folate (vitamin B9), cobalamin (B12), thiamine (B1), and riboflavin (B2)-has gained attention for its role in immunomodulation and tissue repair. This systematic review aims to synthesize current evidence on whether adequate vitamin B complex intake or status is associated with improved periodontal outcomes. A systematic search was performed in PubMed, Scopus, and Web of Science for observational studies investigating vitamin B complex intake or status in relation to periodontal disease indicators. Articles were screened according to PRISMA guidelines, and five studies met inclusion criteria. Five observational studies were included. In older adults, each standard deviation increase in serum folate was associated with an approximate 26% reduction in periodontal disease odds ratio (OR = 0.74, 95% confidence interval (CI) 0.58-0.93). Among young adult women, inadequate riboflavin (B2) and pyridoxine (B6) intake correlated with higher community periodontal index (CPI) scores ( < 0.05). In a large NHANES-based cohort, insufficient thiamine (B1) intake yielded a 33% higher likelihood of severe periodontitis ( < 0.05), while adequate riboflavin was protective (OR = 0.90). Another dose-response analysis (n = 8959) indicated up to a 30% risk reduction for moderate folate or B1 intake, but no extra benefit with excessive intake. Finally, a UK Biobank analysis (n = 9476) showed that those in the highest quartile of a "high micronutrient" dietary pattern-including vitamins B6 and folate-had a 24% lower risk of self-reported periodontal disease (OR = 0.76, 95% CI 0.65-0.90) compared to the lowest quartile. Across diverse populations, inadequate vitamin B complex intake-especially folate-was consistently linked to worse periodontal outcomes.