Dietary vitamin C and the risk for periodontal disease

Background: Vitamin C has long been a candidate for modulating periodontal disease. Studies of scorbutic gingivitis and the effects of vitamin C on ex tracellular matrix and immunologic and inflammatory responses provide a rat ionale for hypothesizing that vitamin C is a risk factor for periodontal di sease. Methods: We evaluated the role of dietary vitamin C as a contributing risk factor for periodontal disease utilizing the Third National Health and Nutr ition Examination Survey (NHANES III) which is representative of the U.S. c ivilian, non-institutionalized population. Results: A sample of 12,419 adults (20 to 90+ years of age), with dental me asurements and assessment of dietary information as well as demographic and medical histories were included in the studies. Dietary vitamin C was esti mated by a 24-hour dietary record. Individuals with periodontal disease wer e arbitrarily defined as those who had mean clinical attachment levels of g reater than or equal to1.5 mm. Using multiple logistic regression analysis, we found a relationship between reduced dietary vitamin C and increased ri sk for periodontal disease for the overall population (odds ratio [OR] = 1. 19; 95% CI: 1.05 to 1.33). Current and former tobacco users who were taking less dietary vitamin C showed an increased risk of periodontal disease wit h OR of 1.28, 95% CI: 1.04 to 1.59 for former smokers, and an OR of 1.21, 9 5% CI: 1.02 to 1.43 for current tobacco users. There was a dose-response re lationship between the levels of dietary vitamin C and periodontal disease with an OR of 1.30 for those taking 0 to 29 mg of vitamin C per day, to 1.1 6 for those taking 100 to 179 mg of vitamin C per day as compared to those taking 180 mg or more of vitamin C per day. Conclusion: Dietary intake of vitamin C showed a weak, but statistically si gnificant, relationship to periodontal disease in current and former smoker s as measured by clinical attachment. Those taking the lowest levels of vit amin C, and who also smoke, are likely to show the greatest clinical effect on the periodontal tissues.