Do your gums bleed? Check your vitamin C intake

vitamin C


A concerning sign of the inflammatory condition of early periodontal disease or gingivitis affecting gum tissue and teeth, is bleeding gums. Dentists usually recommend preventive treatment for periodontal disease by advising patients to brush and floss twice daily. Now, a new University of Washington (UW) study published in Nutrition Reviews, says this might not be enough. Instead, the study suggests that the underlying cause of bleeding gums could be low levels of vitamin C in the bloodstream.

The UW study reviewed published studies of 15 clinical trials in six countries.  Results showed bleeding of the gums, such as when brushing teeth or a gentle probing by dental hygienists, was associated with low vitamin C levels.  When gingivitis is in the early stages, it’s not unusual for gums to swell and bleed. When untreated, the gums may begin to pull away from the teeth leading to tooth and bone loss.

Vitamin C’s role in oral health

More than 200 years ago, men who joined the crew of a seagoing ship knew he had only half a chance of returning home alive – not because he might be slain by pirates or die in a storm, but rather because he might contract scurvy, a disease that often killed as many as two-thirds of a ship’s crew on a long voyage. Scurvy is the deficiency disease name of vitamin C and long sea voyages of several months were unequipped to keep rich food sources of vitamin C from spoiling. Over time, sailors would become deficient in vitamin C developing scurvy. Most symptoms of scurvy are attributed to the breakdown of collagen because of the absence of vitamin C: symptoms include loss of appetite, tenderness to the touch, weakness, loose teeth and bleeding gums.

What the study says about vitamin C recommendations

Current vitamin C recommendations are designed primarily to protect against scurvy.  But the study suggests these levels are too low and that anyone with a low vitamin C intake could have a tendency to gums bleeding.

The study’s lead author, Philippe Hujoel, PhD, DDS, a practicing dentist and professor of oral health sciences in the UW School of Dentistry, recommends people pay attention to their vitamin C intake by eating more vitamin C rich foods such as kiwi fruit, oranges, kale, crucifeous vegetables like broccoli and Brussel sprouts, potatoes and red peppers or consider taking a vitamin C supplement of either 100-200 milligrams a day if unable to meet needs with their diet.

Hujoel, pointed out that people who follow the Keto diet, a high fat, moderate protein, low carbohydrate eating pattern, severely restricts the best sources of vitamin C such as fruits and vegetables. When people avoid these foods it can lead to a vitamin C intake that is too low for supporting good gum health which can lead to bleeding gums.

This study is not the first to find an association between gum bleeding and vitamin C levels.  Thirty years ago, two studies published in 1986 and 1991, also identified gum bleeding as a marker for vitamin C levels. However, over time, this knowledge got lost or marginalized by dentists and the American Dental Association’s attention to recommending treating symptoms of bleeding gums with brushing and flossing of teeth rather than treating the cause.

Another finding from the UW study was that “retinal hemorrhaging and cerebral strokes are associated with increased gingival bleeding tendency and that vitamin C supplementation reverses the retinal bleeding associated with low vitamin C plasma levels.”

Takeaway message

The main take away from this study is to discover why gums are bleeding and to consider that vitamin C deficiency may be a possible reason. Brushing teeth and flossing twice daily are still important recommendations but it’s also important to get to the root of the problem.

The Recommended Dietary Guidelines suggests that each day, men ages 19 and older need 90 mg and women need 75 mg of vitamin C. Here are simple ways to make sure you’re getting in adequate vitamin C:

  • Some of the best sources of vitamin C include eating more veggies such as Brussel sprouts, red bell peppers, kale, potatoes, and broccoli. The best fruit sources of vitamin C are kiwi fruit, grapefruit, oranges, mangos, papayas, lemons and limes.
  • Have a vitamin C rich food at every meal.
  • Add vitamin C rich foods to salads, soups, smoothies, and for snacks.
  • If you know you are lacking in food sources of vitamin C, consider taking a vitamin C supplement of around 100 to 200 mg a day. If you are unsure of taking a vitamin C supplement, talk to your healthcare provider.
Do your gums bleed? Check your vitamin C intake
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Dr. David Samadi

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Dr. David Samadi