Gum Bleeding May Indicate Vitamin C Deficiency

Although guidance 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 that individuals need more vitamin C in their diets.

The study, published in Nutrition Reviews in February, 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. Bleeding of the gums on gentle probing and retinal hemorrhaging both were associated with low vitamin C levels in the bloodstream, the results showed. Furthermore, the investigators said that increasing daily intake of vitamin C in those with low vitamin C plasma levels helped 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 1 possible reason," lead author Philippe P. Hujoel, DDS, PhD, MSD, MS, a dentist and professor of oral health sciences at the UW School of Dentistry in Seattle, said in a news release.

He noted that both gum bleeding and retinal bleeding could be signs of general trouble in the microvascular system, specifically a microvascular bleeding tendency int he 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 that he recommends that individuals increase their vitamin C intake with nonprocessed foods such as kale, kiwis, or peppers.

If foods rich in vitamin C are not palatable, he said, individuals should consider a supplement of 100 to 200 mg per day.

Furthermore, individuals 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-carbohydrate diet," Hujoel said.

The association between gum bleeding and vitamin C levels was recognized more than 30 years ago, according to the news release.

Two studies, published in 1986 and 1991, identified gum bleeding as a biomarker for vitamin C levels, though 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 said. "But over time, that's been drowned out or marginalized by this overattention 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. University of Washington. February 1, 2021. Accessed February 3, 2021. https:/www.eurekalert.org/pub_releases/2021-02/uow-bgm020121.php