Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Vitamin

Vitamin B6 (Pyridoxine)

Likelihood in at-risk patientsLow

Likelihood of deficiency within an at-risk group, not the general population.

Evidence confidenceModerate

Strength of the peer-reviewed evidence.

Food sources

Poultry, Bananas, Potatoes, Fortified grains, Legumes

Typical intake: 1.3 mg/day for most adults (RDA).

Upper limit: 100 mg/day for adults.

Dental & oral effects of deficiency

  • Sore, inflamed tongue (glossitis)

    Sore, inflamed tongue associated with B6 deficiency.

  • Cracked, sore mouth corners and lips (angular cheilitis/cheilosis)

    B6 deficiency causes cracking at the corners of the mouth and lip scaling, often with glossitis and sometimes canker sores.

    Clinical management: When angular cheilitis persists despite local treatment, consider B-vitamin deficiency (alcohol use, kidney disease/dialysis, isoniazid or other B6-antagonist drugs) and suggest medical testing.

Associated with deficiency

  • Microcytic anemia: Impaired hemoglobin synthesis.
  • Peripheral neuropathy: Numbness, tingling, and nerve dysfunction.

Dental & oral effects of surplus / excess

  • Numbness, tingling or burning of the mouth and lips (oral paresthesia)

    Chronic high-dose B6 supplementation can cause sensory neuropathy, with oral/perioral burning or numbness as an early symptom, a striking mirror of the deficiency-side glossitis.

General toxicity (not necessarily oral-specific)

  • Sensory neuropathy: Chronic high-dose supplementation (often well above the UL, sustained over months) causes a usually reversible sensory neuropathy.

Sources

  1. Vitamin B6: Health Professional Fact Sheet. National Institutes of Health, Office of Dietary Supplements. NIH Office of Dietary Supplements, 2026.
  2. A Prescription for Change: Food as Medicine & the Vital Role of Nutrition in Patient Care. teethFirst. Continuing education course material, 2025.
  3. The Impact of Vitamin Deficiencies on Oral Manifestations in Children. Lešić S, Ivanišević Z, Špiljak B et al. Dentistry journal, 2024.
  4. Cutaneous signs of nutritional disorders. Wong CY, Chu DH. International journal of women's dermatology, 2021.