VITAMI

NC
Sophia Gomes DH1
WHAT IS
VITAMIN C?
An essential vitamin needed by
our bodies’ systems to provide:

oBlood function
oIron absorption
oCollagen/Connective tissue
formation
oImmune support
oBone formation
oHormone Synthesis
 WHY VITAMIN C IS
IMPORTANT
Blood Function: Blood vessels and
promoting iron absorption, which in
turn stimulates the production of new
red blood cells.
These red blood cells aid in dispersing
oxygen from the lungs to the rest of the
body, and inversely transport carbon
dioxide to the lungs, which is then
exhaled from the body.
Antioxidant: Stimulates production of
white blood cells, improving the
immune system’s ability to fight
infection, reduce allergic reactions, and
protect the body from harmful free
radicals like pollutants, smoke, toxins,
and radiation via the sun.
CONTINUED…

Hormone Synthesis: Growth and Oral health: Maintaining the

healing of our skin, bones, and longevity of our teeth (bones), and
connective tissue (collagen to repair and maintain gum health
formation). (connective tissue).
 HOW DO WE
OBTAIN
VITAMIN C?
This nutrient can not be stored
within our body naturally. It must
be taken daily via supplementation
or acquired within our diet.

oSupplements include packets,

tablets, or pills.
oDiet includes fruits and vegetables
such as citrus, papaya, cantaloupe,
broccoli, potatoes, peppers,
tomatoes, and strawberries.
 WHAT ABSORPTION
HAPPENS
TO THE Due to vitamin C being water soluble it is
VITAMIN delivered to the body via the process of passive
diffusion; movement of a nutrient from an area of
ONCE high concentration (bloodstream) to a lower
concentration (cell).
INGESTED
? This process is considered a concentration
gradient, requiring zero energy, and allowing
molecules to easily pass through biological
membranes and redistribute throughout the body.
 When an individual does not get enough vitamin C it can
cause oral and systemic issues.

Scurvy is a systemic disease typically caused by a lack of

VITAMIN fruits, vegetables, or vitamin C supplements within one’s
diet.
C Signs of scurvy include irritability, weakness, fatigue,
and joint pain. Left untreated it can result in
DEFICIEN roughened/scaly skin, bruising, hair loss, abnormal
CY bleeding (capillary hemorrhage), loose or exfoliating
teeth, anemia, muscle degeneration, swollen gums, and
wounds that will not heal.
 The connection between
vitamin C deficiency and
scurvy first became apparent
among sailors, who often spent
months at sea without fresh
fruits or vegetables.
“In 1747, the Scottish
physician James Lind was
serving as a surgeon for the
British Navy. He discovered
that eating oranges and lemons
was an effective treatment for
scurvy. [....] In 1795, the
British Navy followed his
advice and began issuing daily
HISTORY OF rations of citrus juice to its
men” (Funk & Wagnalls,

SCURVY 2018).
 Vitamin C in excess is non-toxic to humans. However, our
intestines have a limited capacity to absorb it. If intake
exceeds 2000mg a day, any excess amount is excreted via
urine.
EXCESS
AMOUNTS Excess amounts of vitamin C can saturate the body’s tissue,

OF decreasing its capacity for absorption. This can cause

adverse issues that may also interfere with other vitamin

VITAMIN absorption.

C According to (Vitamin C, 2023), “Excess of Vitamin C

results in diarrhea, digestive upset, formation of kidney
stones, uric acid (risk factor for gout), and an increase of
iron absorption.” Excess iron in the blood can lead to life
threating conditions such as liver disease, heart issues, and
diabetes.
 The common misconception that increasing
consumption of that which we are deficient in
EXCESS will result in finding equilibrium.

CONTINU However, Chambial et. al (2013) states that in

ED… specific, medically monitored settings,
“Megadoses of Vitamin C have been used to
treat disorders like diabetes, atherosclerosis,
common cold, cataracts, glaucoma, macular
degeneration, stroke, heart diseases, and cancer.”
 TREATING VITAMIN C
DEFICIENCY

1 2 3
Rule out any other Refer the patient to After a vitamin C
etiology that may be their primary care deficiency is confirmed.
causing inflamed gums, physician for a Begin supplementing
bleeding gingiva, definitive diagnosis. the patient’s diet,
impaired wound increasing their
healing, etc. consumption of the
vitamin.
 NUTRITIONAL
COUNSELING
WITH AN RDH
oRecommend eating plenty of fruits
and vegetables or incorporating
vitamin C supplements via oral
tablets, packets, pills, or intravenously.

o Follow up appointment, this occurs

after supplemental recommendations
have been incorporated into the
patient’s diet.

oPatient provides a 3–5-day dietary log

(tracking of daily nutrition) to their
clinician.
COUNSELING CONTINUED..

Evaluation of the dietary

These findings should be
log is performed, as well as
documented in the patient's
an evaluation of the oral
chart and continued to be
cavity, checking for signs
monitored at each
of improvement within the
appointment.
gum tissues health.
DENTAL CONSIDERATION
Vitamin C is essential in maintaining oral health, and a
deficiency may result in complications such as the inhibition of
fibroblasts, osteoblasts, and odontoblasts-or the connective tissue
and bone.

Highly beneficial for healing, with studies showing that fruit

consumption can increase a patient’s vitamin C levels, while
also helping their bleeding score improve.

According to Harris et al. (2014, p.296), “The odds of having

periodontal disease are 1.2 times greater in low dietary vitamin
C intake individuals.”

This proves the role vitamin C (ascorbic acid) plays in the

resistance to oral infections, due to the formation of leukocytes
and phagocytosis, which further prevents periodontal disease.
 Harris et al. (2014) performed a study in which monkeys
were placed on a diet lacking in proper vitamin C for 12
weeks.
o4th week, researchers noted the hydroxyproline of the
VITAMIN C gingiva began to decline at a rate much faster than the
outer tissue/skin of the monkeys’ bodies.
DEFICIENC o8th week, the monkeys’ gum tissue had become

Y-ORAL completely impaired, resulting in excessive gingival

pocket depths and tooth mobility.
HEALTH oResearchers postulated these results occurred because of

STUDY collagen degradation between the tooth and the gum

tissue, in an area called the periodontal ligament.
Therefore, it can be concluded that a vitamin C deficiency
is connected to weakened collagen formation, which can
lead to gingivitis, poor oral wound healing, and
candidiasis.
VITAMIN C OVERVIEW
Understanding the effects a vitamin C deficiency can have
on the gingival tissue is an important role as a registered
dental hygienist, not only to help prevent periodontal
disease, but also to improve a patient's overall health.
A dental hygienist is in a unique position to potentially be
the first individual to bring this deficiency to the attention
of a patient when evaluating the oral cavity and gum
health.
We have come to understand that the oral cavity is a
window to our entire body and overall health.
What is happening within the oral cavity is likely a
potential sign or symptom of a greater illness or disease
happening within the body.
 SOURCES
Bowen, D. M., & Pieren, J. A. (2019). Darby and Walsh Dental Hygiene: Theory and Practice (5th ed.). Saunders.

Boyd, L. D., Mallonee, L. F., Wyche, C. J., & Halaris, J. F. (2020). Wilkins’ Clinical Practice of the Dental Hygienist (13th ed.). Jones & Bartlett Learning.

Chambial, S., Dwivedi, S., Shukla, K. K., John, P. J., & Sharma, P. (2013). Vitamin C in Disease Prevention and Cure: An Overview. Indian Journal of

Clinical Biochemistry, 28(4), 314–328. https://doi.org/10.1007/s12291-013-0375-3

Harris, N. O., García-Godoy, F., & Nathe, C. N. (2014). Primary Preventive Dentistry (8th ed.).

Scurvy: Symptoms, Causes & Treatment. Cleveland Clinic. (2022, October 20). https://my.clevelandclinic.org/health/diseases/24318-scurvy

Vitamin C. (2023, March 7). The Nutrition Source. https://www.hsph.harvard.edu/nutritionsource/vitamin-c/

Vitamin C. (2018). Funk & Wagnalls New World Encyclopedia, 1.

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vitamin-c-than-an-orange