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Lack of vitamin C can worsen the development of periodontal disease

Lack of vitamin C can worsen the development of periodontal diseasePeriodontal is the leading global cause of tooth loss. It is a problem to prevent and to treat this condition because large population groups are neither able to nor used to taking proper care of their teeth and because it is expensive to see a dentist. A group of Australian scientists have decided to take a closer look at vitamin C’s role in dental health and determine how important it is to get enough vitamin C from the diet and from supplements. Another substance is important for preventing periodontal disease. You can read more about that in the article.

Periodontal disease has several stages and normally begins with inflammation in the gums that surround the tooth and the bone in which the tooth is rooted. This condition is caused by dental plaque and tartar (calcified plaque) at the gum line, where harmful bacteria produce tissue-eroding enzymes. It may eventually lead to chronic inflammation of the gingival pockets and subsequent bleeding from the gums. As time advances, the depth of the gingival pockets increases, causing the underlying bone to become porous. Once the process has reached its fourth stage, there is a risk that the affected teeth become detached and fall out.
Because periodontal disease is associated with chronic inflammation, it is generally damaging to your health, as the body is exposed to a tremendous free radical load. Also, harmful bacteria may migrate from the diseased gums through the bloodstream to other tissues in the body. For instance, studies have shown a link between gum disease and cardiovascular disease. That is why it is so important to prevent periodontal disease or, in case the disease has already developed, to keep it in under control.

Smoking, impaired immunity, diabetes, dry mouth, and ageing are all factors that increase the risk of periodontal disease.

Vitamin C has a number of functions that benefit dental health

Vitamin C is a building block of collagen in our connective tissue, which is important for the structural strength of teeth, bones, blood vessels, and skin. Vitamin C is also important for the immune defense and for wound healing. The vitamin is even a powerful antioxidant that protects cells against free radicals.
Most animals are able to produce the vitamin C required to meet their own needs. In contrast, humans, apes, bats, and a few other animal species have lost this ability to evolution. We therefore need to get vitamin C from our diet. Some of the best sources are vegetables like cabbage, broccoli, red bell pepper, citrus fruits, kiwi, berries, potatoes, tomatoes, horse radish, spinach, and herbs. Storage and cooking tend to deplete the vitamin C content in food.
Long-term vitamin C deficiency eventually leads to scurvy with symptoms such as fatigue, bleeding gums, tooth loss, infections, internal bleeding, delirium, and death. Although scurvy is rarely seen in modern society, the condition appears to be resurfacing. Medical science sometimes uses the term “subclinical scurvy”, where people typically have problems like fatigue, bleeding gums, bruising, and impaired immunity.
In their new study, which is published in Nutrients, the Australian researchers looked at vitamin C’s role in dental health. The study was carried out in a periodontal clinic before it was closed down because of COVID-19. A total of 20 patients with periodontal disease participated. Most of the subjects had entered stage 3 or 4 of the disease. Several had additional conditions such as hypertension and diabetes. Blood samples were drawn at the clinic to measure the patients’ levels of vitamin C and C-reactive protein (CRP), which is an inflammation marker. Six of the patients had vitamin C levels that were critically below normal values. Most subjects with low vitamin C levels also had elevated CRP levels. Low levels of vitamin C were generally associated with increased systemic inflammation and faster progression of their periodontal disease.
The scientists underline the importance of testing vitamin C levels in patients with periodontal disease, especially if the patients display other signs of subclinical scurvy, and if their gums fail to heal properly following treatment.
The researchers call for larger studies in the future to show the link between vitamin C and periodontal disease. Still, it is safe even at this point to state that the body needs plenty of this essential vitamin, simply because there are so many benefits besides those that relate to the gums and teeth.

How do we get enough vitamin C – and what causes deficiency?

As mentioned, fruit and vegetables are excellent sources of vitamin C, so sticking with the official dietary guidelines should guarantee an adequate intake of the nutrient. However, things like smoking, chronic disease, stress, ageing, poisoning, lesions, and excessive use of alcohol and other stimulants increase the need for vitamin C. The same goes for sugar, which is because sugar and vitamin C compete for the same channels that lead into the cells. The more sugar you consume, the less you benefit from vitamin C. Certain exposed population groups may need more vitamin C than officially recommended.
Vitamin C supplements typically contain 500-750 mg of vitamin C or more. It is a good idea to choose supplements with non-acidic vitamin C sources like calcium ascorbate that are gentle towards the stomach.

Fun fact

A single 750 mg-tablet delivers the same amount of vitamin C as you would get by eating around 12 oranges or 53 apples.

Periodontal disease and Q10

Coenzyme Q10 is a compound that is important for the cellular energy metabolism. It also works as an antioxidant. The body is able to synthesize most of the Q10 for its own needs but the endogenous production of the compound begins to decrease from the age of 20 or so. The body’s production of Q10 is also inhibited by certain diseases, and cholesterol-lowering statins blocks the Q10 synthesis in the body, as well.
Numerous studies have shown that patients with periodontal disease have low levels of Q10 in their gum tissue, and Q10 supplementation appears to have a positive impact on the dreaded disease. The body has difficulty with absorbing Q10 from supplements so it is vital to choose a high-quality brand with documented bioavailability.

An important element in preventing periodontal disease is thorough dental hygiene after each meal and regular removing of dental plaque.

References:

Molly-Rose Munday et al. A Pilot Study Examining Vitamin C Levels in Periodontal Patients. Nutrients 2020

William V. Cody. Coenzyme Q10. An Insider´s Guide. Ny Videnskab 2018

https://netdoktor.dk/sygdomme/fakta/parodontose.htm

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