Vitamin C intake and periodontal disease

Key Points

• Previous published data have suggested that a lack of vitamin C increases the risk of periodontal disease. This study shows that periodontitis patients, especially smokers, have significantly lower plasma vitamin C levels than healthy subjects.

• Vitamin C is involved in immunological functions, eg phagocytosis, wound healing and shows antioxidant properties. These functions make it relevant for periodontal therapy and prevention.

• In this study the consumption of grapefruit improved the vitamin C supply in periodontitis patients and decreased the sulcus bleeding index. Possibly, the recommendation of vitamin C rich foods could support the management of periodontal disease.

Abstract

Objective Previous studies demonstrate a relationship between a lack of vitamin C and increased risk of periodontal disease. In the present study we examine the vitamin C plasma levels and inflammatory measures in periodontitis patients before and after the consumption of grapefruit.

Subjects and methods Fifty-eight patients with chronic periodontitis were assigned to the test group (non-smokers n=21, smokers n=17) and a diseased control group (non-smokers n=11, smokers n=9). Furthermore, 22 healthy subjects were recruited to compare vitamin C plasma levels between periodontally diseased and healthy subjects. Clinical evaluations, including plaque index (PI), sulcus bleeding index (SBI), probing pocket depths (PPD) and plasma vitamin C levels, were performed at baseline, and after two weeks of grapefruit consumption.

Results At baseline, we observed significantly reduced plasma vitamin C levels in the test group and diseased controls in comparison with the healthy controls. On principle, smokers showed lower levels of vitamin C (mean 0.39±0.17 mg dl⁻¹) than non-smokers (mean 0.56±0.29 mg dl⁻¹). After grapefruit consumption, the mean plasma vitamin C levels rose significantly in the test group compared to the diseased controls (non-smokers: 0.87±0.39 mg dl⁻¹, smokers: 0.74±0.30 mg dl⁻¹). Furthermore the SBI was reduced in the test group (non-smokers: from 1.68±0.6 to 1.05±0.6, p<0.001), whereas PI and PPD were unaffected.

Conclusion The present results show that periodontitis patients are characterised by plasma vitamin C levels below the normal range, especially in smokers. The intake of grapefruit leads to an increase in plasma vitamin C levels and improves sulcus bleeding scores. Longer term studies are necessary to determine whether other periodontal outcomes improve with such supplementation especially in smokers.

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