Efficacy of vitamin C supplementation as an adjunct in the non-surgical management of periodontitis: a systematic review

Abstract

Background and objective The antioxidant potential of vitamin C is useful in reducing oxidative stress, free radicals, and reactive oxygen species, which may assist in the improved outcomes of periodontal therapy. This systematic review was aimed to evaluate the effectiveness of vitamin C supplementation as an adjunct to non-surgical periodontal therapy, in the management of periodontitis. Data sources PubMed, EMBASE, Cochrane Library, and Web of Science. Study eligibility criteria Randomized controlled trials published between January 1990 and March 2020. Participants People 18 years and older with periodontitis. Study appraisal and synthesis methods The Critical Appraisal Skills Programme (CASP) quality appraisal tool. Results The initial search yielded 441 articles out of which six studies fulfilled the inclusion criteria. Vitamin C supplementation helped improve bleeding indices in gingivitis but did not significantly lead to reduction of probing depths or clinical attachment gain for periodontitis. Conclusion Administration of vitamin C as an adjunct to non-surgical periodontal therapy did not result in clinically significant improvements in pocket probing depths at 3 months in periodontitis patients. With the limited evidence available, no recommendation can be made for supplementation of vitamin C in conjunction with initial periodontal therapy for subjects with periodontitis to improve primary treatment outcome measures.

The association between dietary vitamin C intake and periodontitis: result from the NHANES (2009–2014)

“…In articles related to periodontitis, the possible effect of dietary VC intake has long been noted and researched [ 5 , 22 ]. Studies have pointed out that people with low VC intake are more prone to periodontitis.…”

“…Therefore, in addition to mechanical removal of plaque and other related operations during the treatment process, drugs and diet should also be taken to continuously treat the patient's later oral problems. Vitamin C (VC) in the diet occupies a very important place, and many studies have proved that the physiological role of vitamin C can prevent or treat people suffering from periodontitis [ 5 ].…”

Study Regarding a New Extended-Release Calcium Ascorbate and Hesperidin Solid Oral Formulation

“…In addition, the need for vitamin C increases during intense physical activities [7,8] and in children regularly exposed to cigarette smoke [9,10]. Vitamin C is also recommended in pregnancy and lactation [11], during the growth period of children [12], in diseases such as periodontitis, gingivitis, stomatitis, fractures, osteoporosis [13]. It is also supplemented in haemorrhage due to capillary fragility [14], iron deficiency anaemia (with iron or folic acid), overwork, neurasthenia, prolonged physical effort, serious illness, surgical interventions [15,16].…”

Effects of single rinse with three different types of mouthwashes on VSCs levels in morning breath: Randomized, double‐blind, crossover clinical trial

“…Vitamin C is a water‐soluble vitamin with positive effects since it can help to prevent gum disease and gingivitis. Several studies found a positive correlation between vitamin C and periodontitis 46‐48 . The findings suggested that the ascorbic acid assumed regularly with the diet is transferred to the gums through the microcirculation.…”

“…Several studies found a positive correlation between vitamin C and periodontitis. [46][47][48] The findings suggested that the ascorbic acid assumed regularly with the diet is transferred to the gums through the microcirculation. According to Tada et al, 46 an improvement in periodontal indices has been demonstrated thanks to an antioxidative effect, a cytotoxic action on bacterial growth, that is Porphyromonas gingivalis and the enhancement of the immune system.…”