Vitamin C
Vitamin C, also known as ascorbic acid, is an essential nutrient that is involved in an array of process in our body including immune function, metabolism, and production of collagen [1]. Here is a vitamin C fun fact; Humans, primates, guinea pigs and bats do not synthesize vitamin C and so we/they need it from foods and/or supplementation. Citrus fruits, kiwi, tomatoes, broccoli, and bell peppers [1] are a main part of the diet of the previously listed animals. Unfortunately for the primates, guinea pigs, and bats they do not have access to the supplements humans do!
If we do not get the appropriate amount of vitamin C we become vitamin C deficient which could present as a number of symptoms such as: [1]
- bleeding gums
- tooth loss
- nausea
- fatigue
- possible wound re-opening
- infections
- fractures
- hemorrhages
- delirium
- death
In this article, we will be discussing vitamin C and its benefits on oral health. As you can see, vitamin C deficiency can lead to bleeding gums and tooth loss.
Vitamin C and periodontal disease
Periodontal diseases is a term that covers a range of condition affecting oral health. It is a result of chronic bacterial plaque build-up and inflammation resulting in damage to the underlying gingiva and alveolar bone [1].
- Gingiva is another name for the gums
- Alveolar bone is the part of the jaw that hold the teeth in place
Periodontitis is a chronic version of periodontal disease, it leads to the destruction of the alveolar bone, recession of the gums, and tooth loss if not treated [1]. Treatments for the disease rely on removal plaque through dental cleanings as well as dental oral hygiene changes taken on by the patient. Gingivitis and periodontitis are estimated to occur in 47% of the United States population [1]. 47% is ridiculously substantial! That is almost half of the American population suffering from some kind of oral health issues. Data shows that 10% of the world population suffer from severe periodontal disease.
Why is so much of our population suffering from periodontal disease?
They believe this is due to the systemic inflammatory involvement that results from cardiovascular diseases, rheumatoid arthritis, and type 2 diabetes [1]. Essentially, the reason why we have 10% of our population suffering from severe periodontal disease is due to the Westernization of life styles. Meaning, the SAD – Standard American Diet, and yes the acronym sad couldn’t be more accurate!
Vitamin C and Gingivitis
Gingivitis is the inflammation of the gums due to plaque build up and bacteria. If left untreated it become the more severe version- periodontitis and tooth loss.
There have been studies that looked at the amount of vitamin C in patients with mild to severe gingivitis, vitamin c levels were lower in people with gingivitis. Patients also had less gum bleeding and inflammation when they were supplemented with Vitamin C [1].
There is also evidence that suggests the lower plasma vitamin C levels the more severity of necrotizing, ulcerative gingivitis (NUG) [1]. NUG is an infection of the gums that causes acute pain, bleeding and bad breath. They believe the low levels of vitamin C and NUG are due to the impairment of collagen synthesis, collagen helps the healing processes throughout the body (not just the mouth) and so… when there is a decrease in collagen synthesis there is a decrease in the bodies ability to heal wounds.
And what does Vitamin C do? It helps to create collagen!!
Vitamin C deficiency is more prevalent in smokers, elderly, and people with lower socio-economic status – this put those groups at a larger vulnerability for periodontal disease [1].
Vitamin C and periodontitis
There was a study done by Toraman et al. that investigated local administration of vitamin C on periodontitis in rats, that either had diabetes or did not have diabetes. Diabetes increases the likelihood of periodontitis disease due to the hyperglycemia (increase sugar) and an increase in systemic inflammation. The study showed that locally applied. vitamin C reduces alveolar bone and attachment loss and decreases inflammatory markers in the serum [2].
Vitamin C is not just an antioxidant but it is also a powerful reducing agent. A reducing agent donates an electron to “reactive” species and neutralizes them, this essentially shuts them down. Its similar to calming someone down who is being really angry and destructive!
Vitamin C helps maintain the integrity of the gums…
The gingiva (gums) are also mostly made out of collagen as the main component of their connective tissue, because of this, the use of vitamin C helps maintain the integrity of the gums. When there is chronic inflammation in the body, a large amount of antioxidants (vitamin C) is sequestered from the surrounding tissues. This causes the systemic amount of vitamin C to drop dramatically. A large amount of vitamin C would have to be administered in conditions of chronic inflammation like that seen in periodontitis. Sometimes large amounts of vitamin C (I mean large! Intravenously administered etc. way more than the amount you receive from a supplement) could make people sick, because of this, the study investigated the use of vitamin C been administered locally.
Local injection of vitamin C has been shown to provide the correct dose of vitamin C, this study has opened up an array of therapeutics for local injection of vitamin C for inflammatory disease found in the gingiva and oral cavity [2].
Inflammation has been associated with both diabetes mellitus (DM) and periodontitis. There was significant increases in serum levels of inflammation markers in both disease states.
“Vitamin C has been reported to present anti-inflammatory properties…inflammatory markers were significantly decreased in patients with DM treated with 500 mg of Vitamin C twice a day for 8 weeks compared to controls.”
[2]
Vitamin C and its control on inflammation
In the same study by Toraman et al. they researched inflammation found in diabetic patients with periodontitis. They found increased alveolar bone and attachment loss (attachment loss leads to tooth loss). The results suggest diabetes is associated with bone loss and tissue distruction by the increase in oxidative stress. Low levels of vitamin C were negatively associated with attachment loss [2]. Attachment and bone loss were lower in the locally administered vitamin C group than the diabetic and periodontitis group that did not receive the locally administered vitamin C.
We can conclude that locally administered vitamin C positively affects inflammatory markers and oxidative stress [2].
As we’ve previously discussed, Vitamin C is amazing at getting rid of oxidative stress. It is a powerful antioxidant, and it aids in the prevention and possible therapeutic of many, many diseases.
A healthy life style makes all the difference…
As we can figure out from the reading of this article, a healthy lifestyle promotes good health. Its not a hard concept, but it is a hard for people to make lifestyle changes in a positive direction, especially when all of us (now globally unfortunately) are constantly bombarded with the SAD (standard American diet!). We can fight back against the unhealthy food choices that are presented in front of us. We can make sure our diet directs us away from type 2 diabetes and chronic inflammation.
Making sure we get the appropriate nutrients through our diets and supplementation is essential. Poor health leads to chronic inflammation and chronic inflammation leads to using up all of our antioxidant stores (our bodies just eat up Vitamin C when we are inflamed). We need to constantly protect our bodies with powerful antioxidants like vitamin C. This will aid in our bodies ability to bounce back fast from inflammation.
Another thing people don’t realize is…
Vitamin C is essential for the production of collagen, collagen keeps us young and helps promote wound healing! If our bodies are in a state of chronic inflammation due to our poor diets, all of our vitamin C is being utilized. If all of our vitamin C is being utilized then we won’t have it to keep our faces young and are bodies healing properly.
Eat healthy, live healthy, keep inflammation away!
Frequently Asked Questions
I think taking a vitamin C supplement would be the best thing to do. As long as you don’t have chronic inflammation like periodontitis, I don’t think rubbing vitamin C on your gums will help with cavities. But cutting sugar out of your diet, and making sure you are getting the appropriate nutrition is the best medicine. Talk to your dentist about ways to combat cavities.
Stay away from fast food restaurants and processed foods. Eat locally, and healthy. Drink plenty of water, limit screen time, and get adequate sleep. That is how you stay away from the SAD!
Yes, as long as you aren’t on any medication and you’re in good health, a vitamin C supplement alone with a good diet is always a good idea! I had the same issue with my gums, sometimes this can be from brushing too hard as well. Talk to your dentist in order to find the underlying issues of your receding gums.
Because you are pregnant, you definitely need to check with your doctor. The toxicity of vitamin C is so low, that I am sure it will be fine, but definitely talk to your doctor. I understand your worry, being pregnant can suck the nutrients right out of your teeth. Definitely keep taking your prenatal.