Gum Bleeding Could Be Sign of Vitamin C Deficiency

Although current advice from the American Dental Association states that bleeding gums could be a sign of gingivitis, new research from the University of Washington (UW) suggests that it could also mean individuals need more vitamin C in their diets.

The study, published in Nutrition Reviews, analyzed published studies of 15 clinical trials in 6 countries, involving 1140 predominantly healthy participants, and data from 8210 US residents in the CDC’s Health and Nutrition Examination Survey. The results found that bleeding of the gums on gentle probing as well as retinal hemorrhaging were associated with low vitamin C levels in the bloodstream. Furthermore, the investigators said that increasing daily intake of vitamin C in those with low vitamin C plasma levels helped to reverse these bleeding issues.

“When you see your gums bleed, the first thing you should think about is not ‘I should brush my teeth more.’ You should try to figure out why your gums are bleeding, and vitamin C deficiency is one possible reason,” said lead author Philippe Hujoel, DDS, PhD, MSD, MS, a practicing dentist and professor of oral health sciences in the UW School of Dentistry, in a press release.

Hujoel noted that both a gum bleeding tendency and retinal bleeding could be a sign of general trouble in the microvascular system, specifically of a microvascular bleeding tendency in the brain, heart, and kidneys.

The study findings do not imply that successful reversing of an increased gingival bleeding tendency with vitamin C will prevent strokes or other serious health outcomes, Hujoel said. However, the results do suggest that vitamin C recommendations designed primarily to protect against scurvy are too low, and that such a low vitamin C intake can lead to a bleeding tendency, according to the study authors.

Based on these findings, Hujoel said he recommends that people attempt to monitor their vitamin C intake through incorporation of non-processed foods, such as kale, peppers, or kiwis. If they cannot find palatable foods rich in vitamin C, he said they should consider a supplement of about 100 to 200 milligrams per day. Furthermore, patients on special diets, such as paleo, should examine their vitamin C intake.

“Vitamin C-rich fruits such as kiwis or oranges are rich in sugar and thus typically eliminated from a low-carb diet,” Hujoel said.

According to a press release, the association between gum bleeding and vitamin C levels was recognized more than 30 years ago. Two studies, published in 1986 and 1991, identified gum bleeding as a biomarker for vitamin C levels, although this connection somehow disappeared in dental conversations around gum bleeding.

“There was a time in the past when gingival bleeding was more generally considered to be a potential marker for a lack of vitamin C,” Hujoel explained in a statement. “But over time, that’s been drowned out or marginalized by this over attention to treating the symptom of bleeding with brushing or flossing, rather than treating the cause.”

REFERENCE

Bleeding gums may be a sign you need more vitamin C in your diet [news release]. EurekAlert; February 1, 2021. https://www.eurekalert.org/pub_releases/2021-02/uow-bgm020121.php. Accessed February 3, 2021.