A Pilot Study Examining Vitamin C Levels in Periodontal Patients.

Molly-Rose Munday,Jenny E Gunton,Michael Fitzpatrick,Victoria M Flood,Rohan Rodricks

doi:10.3390/nu12082255

Abstract

Background: Periodontal disease is the leading cause of tooth loss worldwide. Current periodontal treatment is limited by its dependency on patients learning and maintaining good dental habits, and repeated visits to oral health physicians. Vitamin C’s role in collagen synthesis and immune function makes it important in wound healing and possibly periodontal healing. Therefore, if some patients are deficient, this may worsen patient outcomes. Methods: Patients were invited to participate following assessment and treatment at the Westmead Centre of Oral Health Periodontic Clinic, regardless of current disease stage or treatment. Adults were eligible if they gave informed consent and had current periodontal disease. Study involvement consisted of periodontal assessment and care followed by an interview and measurement of serum vitamin C and C-reactive protein (CRP). Results: A total of 6 out of 20 patients had vitamin C levels less than the institutional normal range, of whom 2 had levels <11.4 μmol/L and one <28 μmol/L. Low vitamin C was associated with higher periodontal disease stage (p = 0.03). Elevated CRP was found in 2/3 of people with low vitamin C and CRP was negatively correlated with vitamin C (p < 0.01). Vitamin C did not correlate with patient-reported fruit or vegetable consumption, but high processed meat intake was associated with lower vitamin C. Conclusion: Although a small study, this rate of vitamin C deficiency in the periodontal clinic is clinically important and correlations with disease severity and CRP suggests biological importance. This warrants further studies to assess vitamin C and whether supplementation improves periodontal outcomes, particularly in deficient subjects.

Highlights

Vitamin C is an essential nutrient involved in a range of bodily processes such as immune function, metabolism and production of structurally sound collagen
This study reports that a significant proportion of patients attending the Periodontics Clinic at the Westmead Centre of Oral Health have vitamin C deficiency
Because low vitamin C correlated with more advanced periodontal disease and with increased C-reactive protein (CRP), a measure of systemic inflammation, it is likely that this finding is biologically important

Summary

Introduction

Vitamin C (ascorbic acid) is an essential nutrient involved in a range of bodily processes such as immune function, metabolism and production of structurally sound collagen. Severe vitamin C deficiency manifests as scurvy [2]. Methods: Patients were invited to participate following assessment and treatment at the Westmead Centre of Oral Health Periodontic. Low vitamin C was associated with higher periodontal disease stage (p = 0.03). Vitamin C did not correlate with patient-reported fruit or vegetable consumption, but high processed meat intake was associated with lower vitamin C. Conclusion: a small study, this rate of vitamin C deficiency in the periodontal clinic is clinically important and correlations with disease severity and CRP suggests biological importance. This warrants further studies to assess vitamin C and whether supplementation improves periodontal outcomes, in deficient subjects

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