Serum vitamin B12 is inversely associated with periodontal progression and risk of tooth loss: a prospective cohort study

Research output: Contribution to journalArticlepeer-review


  • Geng Zong
  • Birte Holtfreter
  • Ann E. Scott
  • Henry Völzke
  • Astrid Petersmann
  • Rachel S. Newson
  • Thomas Kocher

Colleges, School and Institutes

External organisations

  • Unilever Research and Development; Vlaardingen the Netherlands
  • Unit of Periodontology; University Medicine, Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
  • Unilever
  • Institute for Community Medicine; University Medicine, Ernst-Moritz-Arndt-University Greifswald; Germany
  • Institute of Clinical Chemistry and Laboratory Medicine; University Medicine, Ernst-Moritz-Arndt-University Greifswald; Germany
  • University of Birmingham


Aim: The aim of this study was to investigate theassociation of serum vitamin B12 with the progression of periodontitis and riskof tooth loss in a prospective cohort study.

Materials and Methods: In the Study of Health in Pomerania, 1648 participantswere followed from 2002–2006 to 2008–2012 (mean duration 5.9 years). Serumvitamin B12 was measured by chemiluminescent enzyme immunoassay. Probing pocketdepth (PD) and clinical attachment loss (CAL) were measured to reflectperiodontal status on a half‐mouth basis at each survey cycle. Tooth numbersare based upon a full‐mouth tooth count.

Results and Conclusions: In multivariate regression models, baseline vitaminB12 was inversely associated with changes in mean PD (Ptrend = 0.06) and meanCAL (Ptrend = 0.01), and risk ratios of tooth loss (TL; Ptrend = 0.006) overtime. Compared to participants in the highest vitamin B12 quartile, those inthe lowest quartile had 0.10 mm (95%CI: 0.03, 0.17; Pdifference = 0.007)greater increase in mean PD, 0.23 mm (95%CI: 0.09, 0.36; Pdifference = 0.001)greater increase in mean CAL and a relative risk of 1.57 (95%CI: 1.22, 2.03;Pdifference < 0.001) for TL. Stratified analyses showed strongerassociations between vitamin B12 and changes in mean CAL among never smokers(Pinteraction = 0.058). Further studies are needed to understand the potentialmechanisms of these findings.


Original languageEnglish
Pages (from-to)2-9
Number of pages8
JournalJournal of Clinical Periodontology
Issue number1
Early online date27 Nov 2015
Publication statusPublished - Jan 2016


  • clinical attachment loss, probing depth, smoking, tooth loss, vitamin B12