SEMINAR ON

TRACE ELEMENTS & ORAL HEALTH

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 CONTENT
1. Definition
2. Classification of trace elements
3. Essential trace elements
4. Possibly essential trace elements
5. Nonessential trace elements
6. Conclusion
7. References

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 DEFINITION AND
CLASSIFICATION
These elements are present in living
tissues in small amount.
They are classified in three groups as
follows;
1.Essential trace elements.
2.Possibly essential trace elements.
3.Nonessential trace elements.

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ESSENTIAL TRACE ELEMENTS:

1. Iron
2. Copper
3. Iodine
4. Zinc
5. Manganese
6. Cobalt
7. Molybdenum
8. Selenium
9. Chromium
10. Fluorine

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POSSIBLY ESSENTIAL TRACE
ELEMENTS:
1. Nickel
2. Tin
3. Vanadium
3. Silicon

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NONESSENTIAL TRACE
ELEMENTS:
1. Aluminium
2. Boron
3. Germanium
4. Cadmium
5. Arsenic
6. Lead
7. Mercury
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 Iron:
Total iron content of the normal adult : 4-5 gm.

Daily requirement :
Infant 10-15 mg
Children 15 mg
Adult 18 mg
Sources :
Rich sources : liver , heart , kidney,
spleen.
Good sources: egg-yolk ,nuts ,fish,
beans ,apple,banana
Poor sources : milk , wheat flour,
potatoes.

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Absorption :
Iron absorption occur in the upper portion of the
duodenum either as ferrous or ferric salts.

If the tissue are depleted, iron is absorbed

rapidly, if sufficient quantities are present,
absorption is slight.
EXCRETION:
Daily excretion of iron:
Adult male : 0.5-1.5mg in urine.
0.5-1.5mg in sweat.
Adult women: 1.0-3.0mg in urine.
Adult male and female : 0.3-0.7mg in faeces.

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Function:
1. Iron functions mainly in the transport
of oxygen to the tissues.
2. It is also involved in the process of
cellular respiration.
3. It is an essential component of
hemoglobin, myoglobin, cytochromes.
4. The nonheme iron is completely
protein bound which exists in the
form of storage and transport.

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Deficiency of Iron Produce following conditions :
1. Iron deficiency anaemia:
clinical features :
a. spooning of the nails (koilonychia)
b. sore tongue
c. angular chelitis
d. glossitis
e. atrophy of filiform & fungiform papilla
f. mucous membrane of oral cavity is atrophic
g. loss of normal keratinization
h. breathlessness on exertion
i. giddiness
j. pallor of skin

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Treatment of iron deficiency anaemia :

1. Ferrous sulphate tablets for anaemic women

2. For child of below 12 month:
- Mixture of ferrous ammonium citrate
sweetened with
glycerin.
3. For children of 1to 5 years :
- Ferrous ammonium citrate mixture should be
given in curing

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ROLE OF IRON IN ORAL
HEALTH:
● Iron content of Enamel: 0.8-200ppm.

● Iron content of Dentin : 90-1000ppm.

It has antibacterial action in mouth so it

is cariostatic.

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Pulmer–vinson syndrome:

– It is one of the cause for carcinoma

in upper alimentary tract & one of
the cause for oral cancer.
– It is autoimmune phenomenon.

Clinical feature :
1. Lemon tinted pallor of skin
2.
Dysphagia
3. Koilonychia
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Disorders of iron metabolism are:

1. Siderosis:
Occurs when excessive amount of iron are
released in or introduced into the body beyond the
capacity for its utilization.

2. Nutritional siderosis / Bantusiderosis:

- common in Bantus in south africa.

- Bantus cook their food in large iron pots & consume
iron-rich food.

3. Hemochromatosis:

- Hemochromatosis is a rare disease in which large

amount of iron are deposited in the tissues.
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 IODINE
SOURCES :

Rich sources are – sea water , marine vegetable , sea food & vegetables

or fruits grown on seaboard.

At high altitude there is low concentration of iodine so iodine is added in

drinking water in concentration of 1:5000-1:200000.

DAILY REQUIREMENT :
Adults 100-150 μg

In pregnancy 200μg

DISTRIBUTION :
Thyroid gland 70-80 %
Salivary gland
Ovaries small amount
Hair
Pituitary gland
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Blood Iodine 4-10μg/100 ml
ABSORPTION :
Absorbed in small intestine.
EXCRETION :
Faeces 10%
Urine 40-80%
FUNCTION :
Formation of thyroxine & triiodothyronine
hormone
– Cellular oxidation
– Reproduction , growth
– Activity of CNS & ANS

Deficiency states :
In adult – goiter / myxoedema
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 COPPER
Sources :
Liver , kidney , meat , nuts , shellfish ,
milk & its product .

Daily requirement :
Adult 2.5 mg
Infant & children: 0.05 mg/kg
body weight.
Distribution :
Muscles 64 mg of the total
Bones 23 mg of the total
Liver 18 mg of the total
Blood copper 90 μg/100 ml

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Absorption :
In duodenum
Excretion :
Urine – 10-60 μg/day
Functions :
1.Haemoglobin synthesis
2.Melanin formation , phospholipids synthesis &
collagen synthesis
3.Iron absorption
4.constituents of several enzymes such as
cytochrome oxidase , ascorbic acid oxidase.

Deficiency states:
1.Microcytic hypochromic anaemia.
2.Wilson’s disease.
3.Menke’s syndrome
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ROLE OF COPPER IN ORAL
HEALTH:
● Copper content of Enamel: 0.1-130ppm.

● Copper content of Dentin : 0.2-100ppm.

● Epidemiological data suggest copper is

cariogenic but in bacteriological studies
copper is cariostatic by reducing
acidogenicity of plaque.

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 ZINC
Source:
Meat ,Egg,Liver, Milk, Nuts ,Vegetables and
Fruits
Daily requirement:
Infant: 3-5mg.
Adults: 15mg.
Pregnancy: 30mg.
Distribution:
Whole body content: 1.4-2.3 gm
Skin: 20%

Absorption:
In intestine and duodenum.
Excretion:
Faeces:90%
Urine: 5%
Retain in body:5%
Excessive sweating cause excessive loss of
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Function:
1. Healing of wound.
2. Essential for normal growth.
3. Maintain normal concentration of
vitamin A in plasma.
4. Essential constituent of enzymes such
as carbonic anhydrase, alkaline
phosphatase, Lactose dehydrogenase.
5. Requires for preparation of insulin
and increase duration of insulin
action.
Deficiency state:
1. Dwarfism and hypogonadism.
2. Disorders involving loss of
taste,decrease bone growth, wound
healing and reproduction.
3. Diabetes mellitus.
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ROLE OF ZINC IN ORAL
HEALTH:
● Zinc content of Enamel: 60-1800ppm.
● Zinc content of Dentin : --

In deficiency state:
1.Thickening of epithelium of tongue.
2.Flattened filiform papillae.
3.Increased susceptibility to periodontal
disease.

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 MANGANESE
Source:
Nuts, Vegetables, Fruits, Seafood and
fish.
Daily requirement:
2.5-7 mg
Distribution:
Total body content: 12-20mg
Kidney and liver are the main storage
organ
Blood content:
4-20μg /100ml
Absorption:
In small intestine.
Excretion:
Faeces: 95-96%
Urine : 4%
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Function:
1. Essential for normal bone structure
2. Reproduction
3. For normal functioning of CNS
4. Helps in activation of enzymes
Deficiency:
1.Bone deformities.
2.Enzymes activites are reduced.
Overdose:
Manganese poisoning
Parkinsons’ disease.
Psychotic syndrome.
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ROLE OF MANGANESE IN ORAL
HEALTH:
● Manganese content of Enamel:
0.8-20ppm.
● Manganese content of Dentin : 0.6-
1000ppm.
● Elevated concentration of manganese in
salivary plaque and enamel are
associated with increased caries.

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 COBALT
SOURCE :
Foods of animal origin
DAILY REQUIREMENT :
0.045-0.09 μg
DISTRIBUTION :
Liver, kidney, bones
most of it is present vitamin
B12
ABSORPTION :
Small intestine
EXCRETION :
Urine and faeces
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FUNCTION :
Required as a constituent of vitamin
B12.
DEFICIENCY :
Anorexia

Nutritional macrocytic anaemia

OVERDOSE :
Polycythemia (increase in number of
erythrocyte in blood)

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 MOLYBDENUM
SOURCE : Plants

DAILY REQUIREMENT : Unknown

DISTRIBUTION : Unknown

ABSORPTION: Small intestine

EXCRETION : Urine

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FUNCTION:
1.Nitrogen fixation
2.Essential component of xanthine oxidase
and sulfide oxidase.

DEFICIENCY:
Unknown

OVERDOSE:
Severe diarrhoea

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ROLE OF MOLYBDENUM IN
ORAL HEALTH:
● Molybdenum content of Enamel:
0.7-39ppm.
● Molybdenum content of Dentin :
1-10ppm.
● Molybdenum a trace element present
in teeth may inhibit caries formation.
Suggested by RODENT STUDIES.

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 SELENIUM

SOURCE : Plants, Meat.

DAILY REQUIREMENT : Unknown

DISTRIBUTION : Renal cortex, liver

ABSORPTION : Unknown

EXCRETION : Unknown
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FUNCTION:
1. Essential for normal growth.
2. Involved in immune mechanism.

DEFICIENCY :
1. Liver cell necrosis
2. Muscular dystrophy
3. Thrombosis

OVERDOSE:
1. Brittle nails
2. Loss of hair
3. Chronic dermatitis

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ROLE OF SELENIUM IN ORAL
HEALTH:
• Selenium content of Enamel: 0.1-10ppm.
• Selenium content of Dentin : 10-100ppm.

 It is probably incorporated into the enamel

during amelogenesis.

 Excessive selenium may promote dental

caries when given pre-eruptively.

 Whereas moderatelu high level cause

cariostatic effect.

 Increased dental caries rate observed where

the food www.fourthmolar.com
and water contain higher levels of
 CHROMIUM

SOURCE : Dietary foods

DAILY REQUIREMENT : Unknown

DISTRIBUTION : Tissues.

ABSORPTION : Small intestine.

EXCRETION : Urine, bile, faeces.

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FUNCTIONS:
1. Improve glucose tolerance in diabetes
mellitus.

DEFICIENCY:
1. Impaired growth.
2. Disturbance in glucose, lipid and protein
metabolism.

OVERDOSE:
1. Growth disturbances.
2. Liver and kidney damage.

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ROLE OF CHROMIUM IN ORAL
HEALTH:
● Chromium content of Enamel:
<0.1-100ppm.

● Chromium content of Dentin:

1-100ppm.

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 FLUORINE
SOURCE : Food , water, tea.

DAILY REQUIREMENT : 1-2 ppm

DISTRIBUTION : Unknown

ABSORPTION : Intestine

EXCRETION : Urine

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FUNCTION:
1. tooth and bone development.
2. hardening of surface of enamel.
3. cariostatic effect.
DEFICIENCY:
unknown.

OVERDOSE:
1. Fluorosis.
2. osteoflourosis.

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POSSIBLY ESSENTIAL TRACE
ELEMENTS
1. Nickel

Source: grains, nuts and chocolate.

● Nickel deficiency results in suboptimal

growth in animal.

● Inadequate nickel alter the trace elements

composition of bone and impairs iron
utilization.

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ROLE OF NICKEL IN ORAL
HEALTH:
● Nickel content of Enamel: 10-100ppm.

● Nickel content of Dentin : 10-100ppm.

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 2. TIN
ROLE OF TIN IN ORAL HEALTH:

● Tin content of Enamel: 0.03-0.9ppm.

● Tin content of Dentin : --

● Stannous fluoride exhibit more cariostatic activity

than other fluoride compound by reducing plaque
accumulation and gingivitis.

● Stannous fluoride is active ingredient in some

self applied dentifrices and mouth rinses.

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 3. VANADIUM:

Source: shellfish, mushrooms.

ROLE OF VANADIUM IN ORAL HEALTH:

● Vanadium content of Enamel: 0.01-0.03ppm.

● Vanadium content of Dentin : 1-10ppm.

● vanadium is readily incorporated into areas

of rapid mineralization of bone and tooth
dentin.

● Cariostatic effect.
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 4. Silicon:

Source: grains and root vegetables.

ROLE OF SILICON IN ORAL HEALTH:

● Silicon content of Enamel: 26-1000ppm.

● Silicon content of Dentin : 90-1000ppm.

● present in enamel in larger amount than other trace

elements.

● Deficiency results in depressed collagen in bone and

long bone.

● Resulting in malformed joints and defective bone

growth.
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NONESSENTIAL TRACE
ELEMENTS:
1. Aluminium:

● aluminium accumulated in bone and has been observed to

cause osteodystrophy in clients who have received
aluminium from routes other than through the
gastrointestinal tract.

ROLE OF ALUMINIUM IN ORAL HEALTH:

● Aluminium content of Enamel: 1.5-700ppm.

● Aluminium content of Dentin : 10-100ppm.

● Aluminium is also present in all dental tissues.

● Dental caries may be reduced because aluminium enhances

the uptake and retention of fluoride and enhances
the cariostatic activity of fluoride.
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 2. LEAD:

● The effect of lead stored in the

bones and teeth are unknown.

ROLE OF LEAD IN ORAL HEALTH:

● Lead content of Enamel: 1.3-100ppm.

● Lead content of Dentin : 10-100ppm.

● The deposited in the enamel

matrix has been associated with
pitting hypoplasia.
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 3. BORON:

ROLE OF BORON IN ORAL HEALTH:

● Boron content of Enamel: 0.5-39ppm.

● Boron content of Dentin : 1-10ppm.

● boron is necessary for the development and

maintenance of strong healthy bones.

● Boron deficiency affects mineral metabolism.

● Cause OSTEOPOROSIS.

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 CONCLUSION:-
• Besides major elements, trace elements are
also necessary for the development of teeth
and for good oral hygiene.
• Some elements like manganese, boron,
nickel, copper, selenium have cariogenic
effect in oral cavity.
• While some elements like aluminium,
vanadium, molybdenum, tin have cariostatic
effect.

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۞ REFERENCES
1. Oral medicine- BURKETS’

2. Fundamentals of biochemistry- HARPER`S.

3. Fundamentals of biochemistry- Dr. A.C.DEB

4. Nutrional care- CYNTHIA A.

STAGEMAN
JUDI RATLIFF DAVIS

5. Textbook of oral pathology- SHAFER`S

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