Oral Signs of Nutritional Disease

  • Stanislav N. Tolkachjov
  • Alison J. BruceEmail author


Nutritional deficiencies occur when the body’s supply of nutrients is exceeded by its demand. The first signs of vitamin or mineral deficiencies may manifest in the oral cavity due to the unique environment and rapid cell turnover. The aim of this chapter is to outline the oral signs and symptoms occurring with vitamin deficiencies, which the astute clinician may identify. These manifestations are reviewed and treatments suggested. The significance of hematinic deficiencies in burning mouth syndrome management is also discussed.


Oral Nutrition Vitamin Deficiency Zinc Iron Folate Pyridoxine Riboflavin Niacin 


  1. 1.
    Boyd LD, Palmer CA. Nutrition and oral health. Saddle River: Prentice-Hall; 2001.Google Scholar
  2. 2.
    Weinberg MA. Anatomy of the periodontal structures: the healthy state. Saddle River: Pearson Prentice-Hall; 2006.Google Scholar
  3. 3.
    Thomas DM, Mirowski GW. Nutrition and oral mucosal diseases. Clin Dermatol. 2010;28:426–31.PubMedGoogle Scholar
  4. 4.
    Khadim MI. Oral manifestations of malnutrition I. The effect of vitamins. JPMA. 1981;31:44–8.Google Scholar
  5. 5.
    Dreizen S. Oral indications of the deficiency states. Postgrad Med. 1971;49:97–102.PubMedGoogle Scholar
  6. 6.
    Cutright DE, Bauer H. Cell renewal in the oral mucosa and skin of the rat. I. Turnover time. Oral Surg Oral Med Oral Pathol. 1967;23:249–59.PubMedGoogle Scholar
  7. 7.
    Dreizen S. The mouth as an indicator of internal nutritional problems. Pediatrician. 1989;16:139–46.PubMedGoogle Scholar
  8. 8.
    Balducci L, Ershler WB, Krantz S. Anemia in the elderly-clinical findings and impact on health. Crit Rev Oncol Hematol. 2006;58:156–65.PubMedGoogle Scholar
  9. 9.
    Joosten E, Pelemans W, Hiele M, Noyen J, Verhaeghe R, Boogaerts MA. Prevalence and causes of anaemia in a geriatric hospitalized population. Gerontology. 1992;38:111–7.PubMedGoogle Scholar
  10. 10.
    Ania BJ, Suman VJ, Fairbanks VF, Rademacher DM, Melton LJ 3rd. Incidence of anemia in older people: an epidemiologic study in a well defined population. J Am Geriatr Soc. 1997;45:825–31.PubMedGoogle Scholar
  11. 11.
    Chung SD, Sheu JJ, Kao LT, Lin HC, Kang JH. Dementia is associated with iron-deficiency anemia in females: a population-based study. J Neurol Sci. 2014;346(1–2):90–3.PubMedGoogle Scholar
  12. 12.
    Ma G, Li Y, Jin Y, Zhai F, Kok FJ, Yang X. Phytate intake and molar ratios of phytate to zinc, iron and calcium in the diets of people in China. Eur J Clin Nutr. 2007;61:368–74.PubMedGoogle Scholar
  13. 13.
    Zijp IM, Korver O, Tijburg LB. Effect of tea and other dietary factors on iron absorption. Crit Rev Food Sci Nutr. 2000;40:371–98.PubMedGoogle Scholar
  14. 14.
    Lane DJ, Richardson DR. The active role of vitamin C in mammalian iron metabolism: much more than just enhanced iron absorption! Free Radic Biol Med. 2014;75C:69–83.Google Scholar
  15. 15.
    Darby WJ. The oral manifestations of iron deficiency. JAMA. 1946;130:830–5.Google Scholar
  16. 16.
    Jacobs A, Cavill I. The oral lesions of iron deficiency anaemia: pyridoxine and riboflavin status. Br J Haematol. 1968;14:291–5.PubMedGoogle Scholar
  17. 17.
    Monto RW, Rizek RA, Fine G. Observations on the exfolative cytology and histology of the oral mucous membranes in iron deficiency. Oral Surg Oral Med Oral Pathol. 1961;14:965–74.PubMedGoogle Scholar
  18. 18.
    Lu SY, Wu HC. Initial diagnosis of anemia from sore mouth and improved classification of anemias by MCV and RDW in 30 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98:679–85.PubMedGoogle Scholar
  19. 19.
    Wu YC, Wang YP, Chang JY, Cheng SJ, Chen HM, Sun A. Oral manifestations and blood profile in patients with iron deficiency anemia. J Formosan Med Assoc. 2014;113:83–7.PubMedGoogle Scholar
  20. 20.
    Larsson LG, Sandstrom A, Westling P. Relationship of Plummer-Vinson disease to cancer of the upper alimentary tract in Sweden. Cancer Res. 1975;35:3308–16.PubMedGoogle Scholar
  21. 21.
    Richie JP Jr, Kleinman W, Marina P, Abraham P, Wynder EL, Muscat JE. Blood iron, glutathione, and micronutrient levels and the risk of oral cancer. Nutr Cancer. 2008;60:474–82.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Tahara T, Shibata T, Okubo M, Yoshioka D, Ishizuka T, Sumi K, et al. A case of Plummer-Vinson syndrome showing rapid improvement of Dysphagia and esophageal web after two weeks of iron therapy. Case Rep Gastroenterol. 2014;8:211–5.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Prema K, Srikantia SG. Clinical grading of lingual lesions in vitamin B-complex deficiency. Indian J Med Res. 1980;72:537–45.PubMedGoogle Scholar
  24. 24.
    Bamji MS, Prema K, Rama Lakshmi BA, Ahmed F, Jacob CM. Oral contraceptive use and vitamin nutrition status of malnourished women-effects of continuous and intermittent vitamin supplements. J Steroid Biochem. 1979;11:487–91.PubMedGoogle Scholar
  25. 25.
    Tamura F, Kikutani T, Tohara T, Yoshida M, Yaegaki K. Tongue thickness relates to nutritional status in the elderly. Dysphagia. 2012;27:556–61.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Manzo L, Locatelli C, Candura SM, Costa LG. Nutrition and alcohol neurotoxicity. Neurotoxicology. 1994;15:555–65.PubMedGoogle Scholar
  27. 27.
    Long L, Cai XD, Bao J, Wu AM, Tian Q, Lu ZQ. Total parenteral nutrition caused Wernicke’s encephalopathy accompanied by wet beriberi. Am J Case Rep. 2014;15:52–5.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Wooley JA. Characteristics of thiamin and its relevance to the management of heart failure. Nutr Clin Pract. 2008;23:487–93.PubMedGoogle Scholar
  29. 29.
    Aykroyd WR. Nutritional problems of urban communities. Proc Nutr Soc. 1970;29:148–50.PubMedGoogle Scholar
  30. 30.
    Dahlberg K. Medical care of Cambodian refugees. JAMA. 1980;243:1062–5.PubMedGoogle Scholar
  31. 31.
    Thanangkul O, Whitaker JA. Childhood thiamine deficiency in northern Thailand. Am J Clin Nutr. 1966;18:275–7.PubMedGoogle Scholar
  32. 32.
    Tang CM, Rolfe M, Wells JC, Cham K. Outbreak of beriberi in The Gambia. Lancet. 1989;2:206–7.PubMedGoogle Scholar
  33. 33.
    Wong AY, Chan EW, Chui CS, Sutcliffe AG, Wong IC. The phenomenon of micronutrient deficiency among children in China: a systematic review of the literature. Public Health Nutr. 2014;17:2605–18.PubMedGoogle Scholar
  34. 34.
    Pepersack T, Garbusinski J, Robberecht J, Beyer I, Willems D, Fuss M. Clinical relevance of thiamine status amongst hospitalized elderly patients. Gerontology. 1999;45:96–101.PubMedGoogle Scholar
  35. 35.
    Jensen GL, Binkley J. Clinical manifestations of nutrient deficiency. JPEN. 2002;26:S29–33.Google Scholar
  36. 36.
    Harper CG, Giles M, Finlay-Jones R. Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry. 1986;49:341–5.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Becker DA, Ingala EE, Martinez-Lage M, Price RS, Galetta SL. Dry Beriberi and Wernicke’s encephalopathy following gastric lap band surgery. J Clin Neurosci. 2012;19:1050–2.PubMedGoogle Scholar
  38. 38.
    Sechi G, Serra A. Wernicke’s encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol. 2007;6:442–55.PubMedGoogle Scholar
  39. 39.
    Rolfe M, Walker RW, Samba KN, Cham K. Urban beriberi in The Gambia, West Africa. Trans R Soc Trop Med Hyg. 1993;87:114–5.PubMedGoogle Scholar
  40. 40.
    Johnson KA, Bernard MA, Funderburg K. Vitamin nutrition in older adults. Clin Geriatr Med. 2002;18:773–99.PubMedGoogle Scholar
  41. 41.
    Schlosser BJ, Pirigyi M, Mirowski GW. Oral manifestations of hematologic and nutritional diseases. Otolaryngol Clin N Am. 2011;44:183–203, vii.Google Scholar
  42. 42.
    Eisen D, Lynch DL. The mouth: diagnosis and treatment. St. Louis: Mosby-Year Book; 1998.Google Scholar
  43. 43.
    Haisraeli-Shalish M, Livneh A, Katz J, Doolman R, Sela BA. Recurrent aphthous stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:634–6.PubMedGoogle Scholar
  44. 44.
    Nolan A, Mcintosh WB, Allam BF, Lamey PJ. Recurrent aphthous ulceration: vitamin B1, B2 and B6 status and response to replacement therapy. J Oral Pathol Med. 1991;20:389–91.PubMedGoogle Scholar
  45. 45.
    Mendoza CE, Rodriguez F, Rosenberg DG. Reversal of refractory congestive heart failure after thiamine supplementation: report of a case and review of literature. J Cardiovasc Pharmacol Ther. 2003;8:313–6.PubMedGoogle Scholar
  46. 46.
    Weisberger D. Lesions of the oral mucosa treated with special vitamins. Am J Orthod. 1941;27:25.Google Scholar
  47. 47.
    Stones HH. Oral manifestations in systemic diseases; hypervitaminoses and blood dyscrasias. Ann R Coll Surg Engl. 1951;9:234–44.PubMedPubMedCentralGoogle Scholar
  48. 48.
    Latt N, Dore G. Thiamine in the treatment of Wernicke encephalopathy in patients with alcohol use disorders. Intern Med J. 2014;44:911–5.PubMedGoogle Scholar
  49. 49.
    Powers HJ. Riboflavin (vitamin B-2) and health. Am J Clin Nutr. 2003;77:1352–60.PubMedGoogle Scholar
  50. 50.
    Oppenheimer SJ, Bull R, Thurnham DI. Riboflavin deficiency in Madang infants. Papua New Guinea Med J. 1983;26:17–20.Google Scholar
  51. 51.
    Boisvert WA, Castaneda C, Mendoza I, Langeloh G, Solomons NW, Gershoff SN, et al. Prevalence of riboflavin deficiency among Guatemalan elderly people and its relationship to milk intake. Am J Clin Nutr. 1993;58:85–90.PubMedGoogle Scholar
  52. 52.
    Wilson JM. Riboflavin deficiency in late pregnancy: a problem in south Asia too? Trans R Soc Trop Med Hyg. 1988;82:656.PubMedGoogle Scholar
  53. 53.
    Nichols EK, Talley LE, Birungi N, McClelland A, Madraa E, Chandia AB, et al. Suspected outbreak of riboflavin deficiency among populations reliant on food assistance: a case study of drought-stricken Karamoja, Uganda, 2009–2010. PLoS One. 2013;8:e62976.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Bates CJ, Prentice A, Cole TJ, Van Der Pols JC, Doyle W, Finch S, et al. Micronutrients: highlights and research challenges from the 1994–5 national diet and nutrition survey of people aged 65 years and over. Br J Nutr. 1999;82:7–15.PubMedGoogle Scholar
  55. 55.
    Cimino JA, Epel R, Cooperman JM. Effect of diet on vitamin deficiencies in retarded individuals receiving drugs. Drug Nutr Interact. 1985;3:201–4.PubMedGoogle Scholar
  56. 56.
    Pelliccione N, Pinto J, Huang YP, Rivlin RS. Accelerated development of riboflavin deficiency by treatment with chlorpromazine. Biochem Pharmacol. 1983;32:2949–53.PubMedGoogle Scholar
  57. 57.
    Jacobs EC. Oculo-oro-genital syndrome: a deficiency disease. Ann Intern Med. 1951;35:1049–54.PubMedGoogle Scholar
  58. 58.
    Jen M, Yan AC. Syndromes associated with nutritional deficiency and excess. Clin Dermatol. 2010;28:669–85.PubMedGoogle Scholar
  59. 59.
    Rosenblum IA, Jallaffe N. The oral manifestations of vitamin deficiencies. JAMA. 1941:2245–8.Google Scholar
  60. 60.
    Jolliffe N, Fein HD, Rosenblum IA. Riboflavin deficiency in man. N Engl J Med. 1939;221:921.Google Scholar
  61. 61.
    Lo CS. Riboflavin status of adolescents in southern China. Average intake of riboflavin and clinical findings. Med J Aust. 1984;141:635–7.PubMedGoogle Scholar
  62. 62.
    Tavares NR, Moreira PA, Amaral TF. Riboflavin supplementation and biomarkers of cardiovascular disease in the elderly. J Nutr Health Aging. 2009;13:441–6.PubMedGoogle Scholar
  63. 63.
    Mulliken RA, Casner MJ. Oral manifestations of systemic disease. Emerg Med Clin N Am. 2000;18:565–75.Google Scholar
  64. 64.
    Durso SC. Oral manifestations of disease. New York: McGraw Hill; 2008.Google Scholar
  65. 65.
    Sebrell WH, Butler RE. Riboflavin deficiency in man: preliminary note. Public Health Rep. 1938;53:2282.Google Scholar
  66. 66.
    Vinodkumar M, Rajagopalan S. Efficacy of fortification of school meals with ferrous glycine phosphate and riboflavin against anemia and angular stomatitis in schoolchildren. Food Nutr Bull. 2009;30:260–4.PubMedGoogle Scholar
  67. 67.
    Sun A, Wu KM, Wang YP, Lin HP, Chen HM, Chiang CP. Burning mouth syndrome: a review and update. J Oral Pathol Med. 2013;42:649–55.PubMedGoogle Scholar
  68. 68.
    Zaridze DG, Trapeznikov NN. Risk factors for cancer of the oral cavity and esophagus in a high incidence region. Vopr Onkol. 1986;32:31–6.PubMedGoogle Scholar
  69. 69.
    Podlodowska J, Szumilo J, Podlodowski W, Staroslawska E, Burdan F. Epidemiology and risk factors of the oral carcinoma. Pol Merkur Lekarski. 2012;32:135–7.PubMedGoogle Scholar
  70. 70.
    Petridou E, Zavras AI, Lefatzis D, Dessypris N, Laskaris G, Dokianakis G, et al. The role of diet and specific micronutrients in the etiology of oral carcinoma. Cancer. 2002;94:2981–8.PubMedGoogle Scholar
  71. 71.
    Joosten E, Van Den Berg A, Riezler R, Naurath HJ, Lindenbaum J, Stabler SP, et al. Metabolic evidence that deficiencies of vitamin B-12 (cobalamin), folate, and vitamin B-6 occur commonly in elderly people. Am J Clin Nutr. 1993;58:468–76.PubMedGoogle Scholar
  72. 72.
    Kjeldby IK, Fosnes GS, Ligaarden SC, Farup PG. Vitamin B6 deficiency and diseases in elderly people – a study in nursing homes. BMC Geriatr. 2013;13:13.PubMedPubMedCentralGoogle Scholar
  73. 73.
    Gonzalez-Gross M, Sola R, Albers U, Barrios L, Alder M, Castillo MJ, et al. B-vitamins and homocysteine in Spanish institutionalized elderly. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. J Int Vita Nutr. 2007;77:22–33.Google Scholar
  74. 74.
    McCormick DB. Vitamin B6. In: Bowman BA, Russell RM, editors. Present knowledge in nutrition. 9th ed. Washington, DC: International Life Sciences Institute; 2006.Google Scholar
  75. 75.
    Ulvik A, Midttun O, Pedersen ER, Eussen SJ, Nygard O, Ueland PM. Evidence for increased catabolism of vitamin B-6 during systemic inflammation. Am J Clin Nutr. 2014;100:250–5.PubMedGoogle Scholar
  76. 76.
    Rall LC, Meydani SN. Vitamin B6 and immune competence. Nutr Rev. 1993;51:217–25.PubMedGoogle Scholar
  77. 77.
    Moriwaki K, Kanno Y, Nakamoto H, Okada H, Suzuki H. Vitamin B6 deficiency in elderly patients on chronic peritoneal dialysis. Adv Perit Dial. Conference on Peritoneal Dialysis. 2000;16:308–12.PubMedGoogle Scholar
  78. 78.
    Masse PG, Boudreau J, Tranchant CC, Ouellette R, Ericson KL. Type 1 diabetes impairs vitamin B(6) metabolism at an early stage of women’s adulthood. Appl Physiol Nutr Metab. 2012;37:167–75.PubMedGoogle Scholar
  79. 79.
    Corken M, Porter J. Is vitamin B(6) deficiency an under-recognized risk in patients receiving haemodialysis? A systematic review: 2000–2010. Nephrology. 2011;16:619–25.PubMedGoogle Scholar
  80. 80.
    Wilson SM, Bivins BN, Russell KA, Bailey LB. Oral contraceptive use: impact on folate, vitamin B(6), and vitamin B(1)(2) status. Nutr Rev. 2011;69:572–83.PubMedGoogle Scholar
  81. 81.
    Zhou Y, Jiao Y, Wei YH, Zhang GR, Zhang JP, Ren JX, et al. Effects of pyridoxine on the intestinal absorption and pharmacokinetics of isoniazid in rats. Eur J Drug Metab Pharmacokinet. 2013;38:5–13.PubMedGoogle Scholar
  82. 82.
    Snider DE Jr. Pyridoxine supplementation during isoniazid therapy. Tubercle. 1980;61:191–6.PubMedGoogle Scholar
  83. 83.
    Stone OJ. Pyridoxine deficiency and antagonism produce increased ground substance viscosity with resulting seborrheic dermatitis and increased tumor resistance. Med Hypotheses. 1989;30:277–80.PubMedGoogle Scholar
  84. 84.
    Clayton PT. B6-responsive disorders: a model of vitamin dependency. J Inherit Metab Dis. 2006;29:317–26.PubMedGoogle Scholar
  85. 85.
    Radler DR, Lister T. Nutrient deficiencies associated with nutrition-focused physical findings of the oral cavity. Nutr Clin Pract. 2013;28:710–21.PubMedGoogle Scholar
  86. 86.
    Foca FJ. Motor and sensory neuropathy secondary to excessive pyridoxine ingestion. Arch Phys Med Rehabil. 1985;66:634–6.PubMedGoogle Scholar
  87. 87.
    Schaumburg H, Kaplan J, Windebank A, Vick N, Rasmus S, Pleasure D, et al. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med. 1983;309:445–8.PubMedGoogle Scholar
  88. 88.
    Gupta AK, Damji A, Uppaluri A. Vitamin B12 deficiency. Prevalence among South Asians at a Toronto clinic. Can Fam Physician. 2004;50:743–7.PubMedPubMedCentralGoogle Scholar
  89. 89.
    Gudgeon P, Cavalcanti R. Folate testing in hospital inpatients. Am J Med. 2015;128(1):56–9.PubMedGoogle Scholar
  90. 90.
    Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009;89:693S–6S.PubMedGoogle Scholar
  91. 91.
    Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349:g5226.PubMedGoogle Scholar
  92. 92.
    Cuffe K, Stauffer W, Painter J, Shetty S, Montour J, Zhou W. Update: vitamin B12 deficiency among Bhutanese refugees resettling in the United States, 2012. MMWR. 2014;63:607.PubMedGoogle Scholar
  93. 93.
    Snow CF. Laboratory diagnosis of vitamin B12 and folate deficiency: a guide for the primary care physician. Arch Intern Med. 1999;159:1289–98.PubMedGoogle Scholar
  94. 94.
    Wickramasinghe SN. Diagnosis of megaloblastic anaemias. Blood Rev. 2006;20:299–318.PubMedGoogle Scholar
  95. 95.
    Pontes HA, Neto NC, Ferreira KB, Fonseca FP, Vallinoto GM, Pontes FS, et al. Oral manifestations of vitamin B12 deficiency: a case report. J Can Dent Assoc. 2009;75(7):533–7.PubMedGoogle Scholar
  96. 96.
    Field EA, Speechley JA, Rugman FR, Varga E, Tyldesley WR. Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency. J Oral Pathol Med. 1995;24:468–70.PubMedGoogle Scholar
  97. 97.
    Graells J, Ojeda RM, Muniesa C, Gonzalez J, Saavedra J. Glossitis with linear lesions: an early sign of vitamin B12 deficiency. J Am Acad Dermatol. 2009;60:498–500.PubMedGoogle Scholar
  98. 98.
    Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc. 2003;134:200–7.PubMedGoogle Scholar
  99. 99.
    Stoopler ET, Kuperstein AS. Glossitis secondary to vitamin B12 deficiency anemia. Can Med Assoc J. 2013;185:E582.Google Scholar
  100. 100.
    Itoh I, Ikui A, Ikeda M, Tomita H, Souhei E. Taste disorder involving Hunter’s glossitis following total gastrectomy. Acta Otolaryngol Suppl. 2002:159–63.Google Scholar
  101. 101.
    Kuzminski AM, Del Giacco EJ, Allen RH, Stabler SP. Oral cobalamin therapy in patients who absorb it normally. Blood. 1998;92:4879–80.PubMedGoogle Scholar
  102. 102.
    Kuzminski AM, Del Giacco EJ, Allen RH, Stabler SP, Lindenbaum J. Effective treatment of cobalamin deficiency with oral cobalamin. Blood. 1998;92:1191–8.PubMedGoogle Scholar
  103. 103.
    Hess SY, Zimmermann MB, Brogli S, Hurrell RF. A national survey of iron and folate status in pregnant women in Switzerland. Int J Vitam Nutr Res Int J Vitam Nutr Res. 2001;71(5):268–73.PubMedGoogle Scholar
  104. 104.
    Serdula MK, Nichols EK, Aburto NJ, Masa’d H, Obaid B, Wirth J, et al. Micronutrient status in Jordan: 2002 and 2010. Eur J Clin Nutr. 2014;68(10):1124–8.PubMedPubMedCentralGoogle Scholar
  105. 105.
    Ma AG, Chen XC, Wang Y, Xu RX, Zheng MC, Li JS. The multiple vitamin status of Chinese pregnant women with anemia and nonanemia in the last trimester. J Nutr Sci Vitaminol. 2004;50:87–92.PubMedGoogle Scholar
  106. 106.
    Hillman RS, Mcguffin R, Campbell C. Alcohol interference with the folate enterohepatic cycle. Trans Assoc Am Phys. 1977;90:145–56.PubMedGoogle Scholar
  107. 107.
    Smith AD. Folic acid fortification: the good, the bad, and the puzzle of vitamin B-12. Am J Clin Nutr. 2007;85:3–5.PubMedGoogle Scholar
  108. 108.
    Okey R, Pencharz R, Lepkovsky S, Vernon ER, Jerome D, Marquette M. Dietary constituents which may influence the use of food cholesterol. I. Eggs: biotin and avidin. J Nutr. 1951;44:83–99.PubMedGoogle Scholar
  109. 109.
    White HB 3rd, Whitehead CC. Role of avidin and other biotin-binding proteins in the deposition and distribution of biotin in chicken eggs. Discovery of a new biotin-binding protein. Biochem J. 1987;241:677–84.PubMedPubMedCentralGoogle Scholar
  110. 110.
    Mock DM, Dyken ME. Biotin catabolism is accelerated in adults receiving long-term therapy with anticonvulsants. Neurology. 1997;49:1444–7.PubMedGoogle Scholar
  111. 111.
    Mock DM, Mock NI, Nelson RP, Lombard KA. Disturbances in biotin metabolism in children undergoing long-term anticonvulsant therapy. J Pediatr Gastroenterol Nutr. 1998;26:245–50.PubMedGoogle Scholar
  112. 112.
    Fujimoto W, Inaoki M, Fukui T, Inoue Y, Kuhara T. Biotin deficiency in an infant fed with amino acid formula. J Dermatol. 2005;32:256–61.PubMedGoogle Scholar
  113. 113.
    Tammachote R, Janklat S, Tongkobpetch S, Suphapeetiporn K, Shotelersuk V. Holocarboxylase synthetase deficiency: novel clinical and molecular findings. Clin Genet. 2010;78:88–93.PubMedGoogle Scholar
  114. 114.
    Zempleni J, Hassan YI, Wijeratne SS. Biotin and biotinidase deficiency. Expert Rev Endocrinol Metab. 2008;3:715–24.PubMedPubMedCentralGoogle Scholar
  115. 115.
    Moslinger D, Stockler-Ipsiroglu S, Scheibenreiter S, Tiefenthaler M, Muhl A, Seidl R, et al. Clinical and neuropsychological outcome in 33 patients with biotinidase deficiency ascertained by nationwide newborn screening and family studies in Austria. Eur J Pediatr. 2001;160:277–82.PubMedGoogle Scholar
  116. 116.
    Mock DM. Biotin. Washington, DC: ILSI Nutrition Foundation; 1996.Google Scholar
  117. 117.
    Fiume MZ. Final report on the safety assessment of biotin. Int J Toxicol. 2001;20(Suppl 4):1–12.PubMedGoogle Scholar
  118. 118.
    Ravindran RD, Vashist P, Gupta SK, Young IS, Maraini G, Camparini M, et al. Prevalence and risk factors for vitamin C deficiency in north and south India: a two centre population based study in people aged 60 years and over. PLoS One. 2011;6:e28588.PubMedPubMedCentralGoogle Scholar
  119. 119.
    Hampl JS, Taylor CA, Johnston CS. Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994. Am J Public Health. 2004;94:870–5.PubMedPubMedCentralGoogle Scholar
  120. 120.
    Schleicher RL, Carroll MD, Ford ES, Lacher DA. Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003–2004 National Health and Nutrition Examination Survey (NHANES). Am J Clin Nutr. 2009;90:1252–63.PubMedGoogle Scholar
  121. 121.
    Wrieden WL, Hannah MK, Bolton-Smith C, Tavendale R, Morrison C, Tunstall-Pedoe H. Plasma vitamin C and food choice in the third Glasgow MONICA population survey. J Epidemiol Community Health. 2000;54:355–60.PubMedPubMedCentralGoogle Scholar
  122. 122.
    Mosdol A, Erens B, Brunner EJ. Estimated prevalence and predictors of vitamin C deficiency within UK’s low-income population. J Public Health (Oxf). 2008;30:456–60.Google Scholar
  123. 123.
    Cahill LE, El-Sohemy A. Vitamin C transporter gene polymorphisms, dietary vitamin C and serum ascorbic acid. J Nutrigenet Nutrigenomics. 2009;2:292–301.PubMedGoogle Scholar
  124. 124.
    Villalpando S, Garcia-Guerra A, Ramirez-Silva CI, Mejia-Rodriguez F, Matute G, Shamah-Levy T, et al. Iron, zinc and iodide status in Mexican children under 12 years and women 12–49 years of age. A probabilistic national survey. Salud Publica Mex. 2003;45(Suppl 4):S520–9.PubMedGoogle Scholar
  125. 125.
    Chiplonkar SA, Agte VV, Mengale SS, Tarwadi KV. Are lifestyle factors good predictors of retinol and vitamin C deficiency in apparently healthy adults? Eur J Clin Nutr. 2002;56:96–104.PubMedGoogle Scholar
  126. 126.
    Raynaud-Simon A, Cohen-Bittan J, Gouronnec A, Pautas E, Senet P, Verny M, et al. Scurvy in hospitalized elderly patients. J Nutr Health Aging. 2010;14:407–10.PubMedGoogle Scholar
  127. 127.
    Netto BD, Moreira EA, Patino JS, Beninca JP, Jordao AA, Frode TS. Influence of Roux-en-Y gastric bypass surgery on vitamin C, myeloperoxidase, and oral clinical manifestations: a 2-year follow-up study. Nutr Clin Pract. 2012;27:114–21.PubMedGoogle Scholar
  128. 128.
    Weinstein M, Babyn P, Zlotkin S. An orange a day keeps the doctor away: scurvy in the year 2000. Pediatrics. 2001;108:E55.PubMedGoogle Scholar
  129. 129.
    Firth N, Marvan E. Oral lesions in scurvy. Aust Dent J. 2001;46:298–300.PubMedGoogle Scholar
  130. 130.
    Yudkin J. Evolution, history, and nutrition: their bearing on oral disease and other diseases of civilization. Dent Pract Dent Rec. 1965;16:60–4.PubMedGoogle Scholar
  131. 131.
    Bacci C, Sivolella S, Pellegrini J, Favero L, Berengo M. A rare case of scurvy in an otherwise healthy child: diagnosis through oral signs. Pediatr Dent. 2010;32:536–8.PubMedGoogle Scholar
  132. 132.
    Gokhale NH, Acharya AB, Patil VS, Trivedi DJ, Thakur SL. A short-term evaluation of the relationship between plasma ascorbic acid levels and periodontal disease in systemically healthy and type 2 diabetes mellitus subjects. J Diet Suppl. 2013;10:93–104.PubMedGoogle Scholar
  133. 133.
    Levine M. New concepts in the biology and biochemistry of ascorbic acid. N Engl J Med. 1986;314:892–902.PubMedGoogle Scholar
  134. 134.
    Amaliya, Timmerman MF, Abbas F, Loos BG, Van Der Weijden GA, Van Winkelhoff AJ, Winkel EG, et al. Java project on periodontal diseases: the relationship between vitamin C and the severity of periodontitis. J Clin Periodontol. 2007;34:299–304.PubMedGoogle Scholar
  135. 135.
    Kroser LS. A four year clinical evaluation of Vitron-C. A new hematinic containing ferrous fumarate and ascorbic acid. West Med. 1965;6:314–5.Google Scholar
  136. 136.
    De Cassia Ribeiro-Silva R, Nunes IL, Assis AM. Prevalence and factors associated with vitamin A deficiency in children and adolescents. J Pediatr. 2014;90:486–92.Google Scholar
  137. 137.
    Mora JO, Gueri M, Mora OL. Vitamin A deficiency in Latin America and the Caribbean: an overview. Rev Panam Salud Publica. 1998;4:178–86.PubMedGoogle Scholar
  138. 138.
    Ahmed F. Vitamin A deficiency in Bangladesh: a review and recommendations for improvement. Public Health Nutr. 1999;2:1–14.PubMedGoogle Scholar
  139. 139.
    Gorstein J, Shreshtra RK, Pandey S, Adhikari RK, Pradhan A. Current status of vitamin A deficiency and the national vitamin A control program in Nepal: results of the 1998 national micronutrient status survey. Asia Pac J Clin Nutr. 2003;12:96–103.PubMedGoogle Scholar
  140. 140.
    Demissie T, Ali A, Mekonen Y, Haider J, Umeta M. Magnitude and distribution of vitamin A deficiency in Ethiopia. Food Nutr Bull. 2010;31:234–41.PubMedGoogle Scholar
  141. 141.
    Luo M, Estivariz CF, Schleicher RL, Bazargan N, Leader LM, Galloway JR, et al. Prospective analysis of serum carotenoids, vitamin A, and tocopherols in adults with short bowel syndrome undergoing intestinal rehabilitation. Nutrition. 2009;25:400–7.PubMedGoogle Scholar
  142. 142.
    Rana M, Wong-See D, Katz T, Gaskin K, Whitehead B, Jaffe A, et al. Fat-soluble vitamin deficiency in children and adolescents with cystic fibrosis. J Clin Pathol. 2014;67:605–8.PubMedGoogle Scholar
  143. 143.
    Goskowicz M, Eichenfield LF. Cutaneous findings of nutritional deficiencies in children. Curr Opin Pediatr. 1993;5:441–5.PubMedGoogle Scholar
  144. 144.
    Miller SJ. Nutritional deficiency and the skin. J Am Acad Dermatol. 1989;21:1–30.PubMedGoogle Scholar
  145. 145.
    Jolly M. Vitamin A deficiency: a review. II. J Oral Ther Pharmacol. 1967;3:439–51.PubMedGoogle Scholar
  146. 146.
    Sherwin JC, Reacher MH, Dean WH, Ngondi J. Epidemiology of vitamin A deficiency and xerophthalmia in at-risk populations. Trans R Soc Trop Med Hyg. 2012;106:205–14.PubMedGoogle Scholar
  147. 147.
    Hillman JD. Principles of microbial ecology and their application to xerostomia-associated opportunistic infections of the oral cavity. Adv Dent Res. 1996;10:66–8.PubMedGoogle Scholar
  148. 148.
    Silverman S Jr, Eisenberg E, Renstrup G. A study of the effects of high doses of vitamin a on oral leukoplakia (hyperkeratosis), including toxicity, liver function and skeletal metabolism. J Oral Ther Pharmacol. 1965;2:9–23.PubMedGoogle Scholar
  149. 149.
    Rhodus NL, Brown J. The association of xerostomia and inadequate intake in older adults. J Am Diet Assoc. 1990;90:1688–92.PubMedGoogle Scholar
  150. 150.
    Wilson HO, Datta DB. Complications from micronutrient deficiency following bariatric surgery. Ann Clin Biochem. 2014;51(Pt 6):705–9.PubMedGoogle Scholar
  151. 151.
    Yetley EA. Assessing the vitamin D status of the US population. Am J Clin Nutr. 2008;88:558S–64S.PubMedGoogle Scholar
  152. 152.
    Taksler GB, Cutler DM, Giovannucci E, Keating NL. Vitamin D deficiency in minority populations. Public Health Nutr. 2014:1–13.Google Scholar
  153. 153.
    Cashman KD, Muldowney S, Mcnulty B, Nugent A, Fitzgerald AP, Kiely M, et al. Vitamin D status of Irish adults: findings from the National Adult Nutrition Survey. Br J Nutr. 2013;109:1248–56.PubMedGoogle Scholar
  154. 154.
    Brito A, Cori H, Olivares M, Fernanda Mujica M, Cediel G, Lopez De Romana D. Less than adequate vitamin D status and intake in Latin America and the Caribbean: a problem of unknown magnitude. Food Nutr Bull. 2013;34:52–64.PubMedGoogle Scholar
  155. 155.
    Guessous I, Mcclellan W, Kleinbaum D, Vaccarino V, Zoller O, Theler J, et al. Comparisons of serum vitamin d levels, status, and determinants in populations with and without chronic kidney disease not requiring renal dialysis: a 24-hour urine collection population-based study. J Ren Nutr. 2014;24:303–12.PubMedGoogle Scholar
  156. 156.
    Martini LA, Verly E Jr, Marchioni DM, Fisberg RM. Prevalence and correlates of calcium and vitamin D status adequacy in adolescents, adults, and elderly from the Health Survey-Sao Paulo. Nutrition. 2013;29:845–50.PubMedGoogle Scholar
  157. 157.
    Holick MF. McCollum award lecture, 1994: vitamin D – new horizons for the 21st century. Am J Clin Nutr. 1994;60:619–30.PubMedGoogle Scholar
  158. 158.
    Signorello LB, Williams SM, Zheng W, Smith JR, Long J, Cai Q, et al. Blood vitamin d levels in relation to genetic estimation of African ancestry. Cancer Epidemiol Biomark Prev. 2010;19:2325–31.Google Scholar
  159. 159.
    Goodman JR, Gelbier MJ, Bennett JH, Winter GB. Dental problems associated with hypophosphataemic vitamin D resistant rickets. Int J Paediatr Dent. 1998;8:19–28.PubMedGoogle Scholar
  160. 160.
    Rathore R, Nalawade TM, Pateel D, Mallikarjuna R. Oral manifestations of vitamin D resistant rickets in orthopantomogram. BMJ Case Rep. 2013;12:2013.Google Scholar
  161. 161.
    Souza AP, Kobayashi TY, Lourenco Neto N, Silva SM, Machado MA, Oliveira TM. Dental manifestations of patient with vitamin D-resistant rickets. J Appl Oral Sci. 2013;21(6):601–6.PubMedPubMedCentralGoogle Scholar
  162. 162.
    Su JM, Li Y, Ye XW, Wu ZF. Oral findings of hypophosphatemic vitamin D-resistant rickets: report of two cases. Chin Med J. 2007;120:1468–70.PubMedGoogle Scholar
  163. 163.
    Glorieux FH, Pettifor JM. Vitamin D/dietary calcium deficiency rickets and pseudo-vitamin D deficiency rickets. Bonekey Rep. 2014;3:524.PubMedPubMedCentralGoogle Scholar
  164. 164.
    Balion C, Griffith LE, Strifler L, Henderson M, Patterson C, Heckman G, et al. Vitamin D, cognition, and dementia: a systematic review and meta-analysis. Neurology. 2012;79:1397–405.PubMedPubMedCentralGoogle Scholar
  165. 165.
    Zambrano M, Nikitakis NG, Sanchez-Quevedo MC, Sauk JJ, Sedano H, Rivera H. Oral and dental manifestations of vitamin D-dependent rickets type I: report of a pediatric case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:705–9.PubMedGoogle Scholar
  166. 166.
    Dietrich T, Joshipura KJ, Dawson-Hughes B, Bischoff-Ferrari HA. Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr. 2004;80:108–13.PubMedGoogle Scholar
  167. 167.
    Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B. Calcium and vitamin D supplements reduce tooth loss in the elderly. Am J Med. 2001;111:452–6.PubMedGoogle Scholar
  168. 168.
    Jou PC, Tomecki KJ. Sunscreens in the United States: current status and future outlook. Adv Exp Med Biol. 2014;810:464–84.PubMedGoogle Scholar
  169. 169.
    Zeeb H, Greinert R. The role of vitamin D in cancer prevention: does UV protection conflict with the need to raise low levels of vitamin D? Deutsches Arzteblatt Int. 2010;107:638–43.Google Scholar
  170. 170.
    Bilinski K, Talbot P. Vitamin d supplementation in Australia: implications for the development of supplementation guidelines. J Nutr Metab. 2014;2014:374208.PubMedPubMedCentralGoogle Scholar
  171. 171.
    Schoon EJ, Muller MC, Vermeer C, Schurgers LJ, Brummer RJ, Stockbrugger RW. Low serum and bone vitamin K status in patients with longstanding Crohn’s disease: another pathogenetic factor of osteoporosis in Crohn’s disease? Gut. 2001;48:473–7.PubMedPubMedCentralGoogle Scholar
  172. 172.
    Shea MK, Booth SL, Miller ME, Burke GL, Chen H, Cushman M, et al. Association between circulating vitamin K1 and coronary calcium progression in community-dwelling adults: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2013;98:197–208.PubMedPubMedCentralGoogle Scholar
  173. 173.
    Urano A, Hotta M, Ohwada R, Araki M. Vitamin K deficiency evaluated by serum levels of undercarboxylated osteocalcin in patients with anorexia nervosa with bone loss. Clin Nutr. 2015;34(3):443–8.PubMedGoogle Scholar
  174. 174.
    Vermeer C. Vitamin K: the effect on health beyond coagulation – an overview. Food Nutr Res. 2012;56.Google Scholar
  175. 175.
    Nowak JK, Grzybowska-Chlebowczyk U, Landowski P, Szaflarska-Poplawska A, Klincewicz B, Adamczak D, et al. Prevalence and correlates of vitamin K deficiency in children with inflammatory bowel disease. Sci Rep. 2014;4:4768.PubMedPubMedCentralGoogle Scholar
  176. 176.
    Sikkens EC, Cahen DL, Koch AD, Braat H, Poley JW, Kuipers EJ, et al. The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis. Pancreatology. 2013;13:238–42.PubMedGoogle Scholar
  177. 177.
    Corbo MD, Lam J. Zinc deficiency and its management in the pediatric population: a literature review and proposed etiologic classification. J Am Acad Dermatol. 2013;69:616–624 e1.PubMedGoogle Scholar
  178. 178.
    Tuerk MJ, Fazel N. Zinc deficiency. Curr Opin Gastroenterol. 2009;25:136–43.PubMedGoogle Scholar
  179. 179.
    Wuehler SE, Peerson JM, Brown KH. Use of national food balance data to estimate the adequacy of zinc in national food supplies: methodology and regional estimates. Public Health Nutr. 2005;8:812–9.PubMedGoogle Scholar
  180. 180.
    Siyame EW, Hurst R, Wawer AA, Young SD, Broadley MR, Chilimba AD, et al. A high prevalence of zinc- but not iron-deficiency among women in rural Malawi: a cross-sectional study. Int J Vitam Nutr Res Int Z Vitam Ernahrungsforschung J Int Vitaminologie Nutr. 2013;83:176–87.Google Scholar
  181. 181.
    Hambidge M. Human zinc deficiency. J Nutr. 2000;130:1344S–9S.PubMedGoogle Scholar
  182. 182.
    Miletta MC, Bieri A, Kernland K, Schoni MH, Petkovic V, Fluck, et al. Transient neonatal zinc deficiency caused by a heterozygous G87R mutation in the zinc transporter ZnT-2 (SLC30A2) gene in the mother highlighting the importance of Zn (2+) for normal growth and development. Int J Endocrinol. 2013;259189.Google Scholar
  183. 183.
    Qian L, Wang B, Tang N, Zhang W, Cai W. Polymorphisms of SLC30A2 and selected perinatal factors associated with low milk zinc in Chinese breastfeeding women. Early Hum Dev. 2012;88:663–8.PubMedGoogle Scholar
  184. 184.
    Changela A, Javaiya H, Changela K, Davanos E, Rickenbach K. Acrodermatitis enteropathica during adequate enteral nutrition. JPEN. 2012;36:235–7.Google Scholar
  185. 185.
    Mayo-Wilson E, Imdad A, Junior J, Dean S, Bhutta ZA. Preventive zinc supplementation for children, and the effect of additional iron: a systematic review and meta-analysis. BMJ Open. 2014;4:e004647.PubMedPubMedCentralGoogle Scholar
  186. 186.
    Mayo-Wilson E, Junior JA, Imdad A, Dean S, Chan XH, Chan ES, et al. Zinc supplementation for preventing mortality, morbidity, and growth failure in children aged 6 months to 12 years of age. Cochrane Database Syst Rev. 2014;5:CD009384.Google Scholar
  187. 187.
    Gehrig KA, Dinulos JGH. Acrodermatitis due to nutritional deficiency. Curr Opin Pediatr. 2010;22:107–12.PubMedGoogle Scholar
  188. 188.
    Lott JP, Reeve J, Ko C, Girardi M. Periorificial dermatitis and erosive inguinal plaques in a 57-year-old woman. Acquired zinc deficiency acrodermatitis enteropathica (ADE). JAMA Dermatol. 2013;149:357–63.PubMedGoogle Scholar
  189. 189.
    Heath ML, Sidbury R. Cutaneous manifestations of nutritional deficiency. Curr Opin Pediatr. 2006;18:417–22.PubMedGoogle Scholar
  190. 190.
    Touger-Decker R. Oral manifestations of nutrient deficiencies. Mt Sinai J Med New York. 1998;65:355–61.Google Scholar
  191. 191.
    Dubas LE, Waymire DM, Adams BB. Resident rounds: part II study aid: nutritional deficiencies. J Drugs Dermatol. 2013;12:816–7.Google Scholar
  192. 192.
    Spies TD, Cooper C. The diagnosis of pellagra. Intern Clin. 1937:4.Google Scholar
  193. 193.
    Oldham MA, Ivkovic A. Pellagrous encephalopathy presenting as alcohol withdrawal delirium: a case series and literature review. Addict Sci Clin Pract. 2012;7:12.PubMedPubMedCentralGoogle Scholar
  194. 194.
    Paulionis L, Kane SL, Meckling KA. Vitamin status and cognitive function in a long-term care population. BMC Geriatr. 2005;5:16.PubMedPubMedCentralGoogle Scholar
  195. 195.
    Jacobson EL. Niacin deficiency and cancer in women. J Am Coll Nutr. 1993;12:412–6.PubMedGoogle Scholar
  196. 196.
    Ishii N, Nishihara Y. Pellagra among chronic alcoholics: clinical and pathological study of 20 necropsy cases. J Neurol Neurosurg Psychiatry. 1981;44:209–15.PubMedPubMedCentralGoogle Scholar
  197. 197.
    Castiello RJ, Lynch PJ. Pellagra and the carcinoid syndrome. Arch Dermatol. 1972;105:574–7.PubMedGoogle Scholar
  198. 198.
    Shah GM, Shah RG, Veillette H, Kirkland JB, Pasieka JL, Warner RR. Biochemical assessment of niacin deficiency among carcinoid cancer patients. Am J Gastroenterol. 2005;100:2307–14.PubMedGoogle Scholar
  199. 199.
    Isaac S. The “gauntlet” of pellagra. Int J Dermatol. 1998;37:599.PubMedGoogle Scholar
  200. 200.
    Lin HP, Wang YP, Chen HM, Kuo YS, Lang MJ, Sun A. Significant association of hematinic deficiencies and high blood homocysteine levels with burning mouth syndrome. J Formosan Med Assoc. 2013;112:319–25.PubMedGoogle Scholar
  201. 201.
    Kohorst JJ, Bruce AJ, Torgerson RR, Schenck LA, Davis MD. A population-based study of the incidence of burning mouth syndrome. Mayo Clin Proc. 2014;89(11):1545–52.PubMedPubMedCentralGoogle Scholar
  202. 202.
    Sun A, Lin HP, Wang YP, Chen HM, Cheng SJ, Chiang CP. Significant reduction of serum homocysteine level and oral symptoms after different vitamin-supplement treatments in patients with burning mouth syndrome. J Oral Pathol Med. 2013;42:474–9.PubMedGoogle Scholar
  203. 203.
    Lamey PJ, Hammond A, Allam BF, Mcintosh WB. Vitamin status of patients with burning mouth syndrome and the response to replacement therapy. Br Dent J. 1986;160:81–4.PubMedGoogle Scholar
  204. 204.
    Cho GS, Han MW, Lee B, Roh JL, Choi SH, Cho KJ, et al. Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects. J Oral Pathol Med. 2010;39:722–7.PubMedGoogle Scholar
  205. 205.
    Murray EL. Burning mouth syndrome response to high-dose vitamin C. Headache. 2014;54:169.PubMedGoogle Scholar
  206. 206.
    Hugoson A, Thorstensson B. Vitamin B status and response to replacement therapy in patients with burning mouth syndrome. Acta Odontol Scand. 1991;49:367–75.PubMedGoogle Scholar
  207. 207.
    Vucicevic-Boras V, Topic B, Cekic-Arambasin A, Zadro R, Stavljenic-Rukavina A. Lack of association between burning mouth syndrome and hematinic deficiencies. Eur J Med Res. 2001;6:409–12.PubMedGoogle Scholar
  208. 208.
    Aravindhan R, Vidyalakshmi S, Kumar MS, Satheesh C, Balasubramanium AM, Prasad VS. Burning mouth syndrome: a review on its diagnostic and therapeutic approach. J Pharm Bioallied Sci. 2014;6:S21–5.PubMedPubMedCentralGoogle Scholar
  209. 209.
    Samaranayake LP, Lamb AB, Lamey PJ, MacFarlane TW. Oral carriage of Candida species and coliforms in patients with burning mouth syndrome. J Oral Pathol Med. 1989;18:233–5.PubMedGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Surgical Dermatology GroupBirminghamUSA
  2. 2.Department of DermatologyMayo ClinicJacksonvilleUSA

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