A new study indicates that low levels of vitamin C in the bloodstream may be an underlying cause of bleeding gums. Researchers say brushing and flossing might not be enough to reverse this oral health issue.

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When gums bleed, it is often a symptom of underlying oral health issues, such as gingivitis or periodontal disease, an inflammatory condition that affects gum tissue and teeth.

In the early stages of gingivitis, gums may swell and bleed. If left untreated, these symptoms can worsen, causing the gums to pull away from the teeth, resulting in tooth and bone loss.

Traditional treatments for bleeding gums include adding more brushing and flossing to the daily oral hygiene regimen and treating underlying conditions that may contribute to the development of gingivitis.

Disorders linked to an increased risk of gingivitis include diabetes and immune deficiencies. Lifestyle choices, such as smoking, may also play a role.

However, new research found that, although brushing and flossing are critical for overall oral health, lack of adequate vitamin C, also known as ascorbic acid, may be an underlying cause of bleeding gums.

Researchers from the University of Washington, WA, recently published their results in the journal Nutrition Reviews.

Study authors reviewed data from 15 clinical trials in six countries, with 1,140 mostly healthy participants.

They also analyzed National Health and Nutrition Examination Survey data from 8,210 individuals in the United States who had experienced some degree of eye-related hemorrhaging, or bleeding.

The researchers found that participants with low levels of vitamin C in their bloodstream were more likely to have gums that bled upon gentle probing, the tendency for bleeding gums, and a higher rate of bleeding in the eye known as retinal hemorrhaging.

Interestingly, the study authors found that increasing vitamin C intake in participants with low vitamin C plasma levels helped stop their gums from bleeding and reversed eye-related bleeding issues.

Prof. Philippe Hujoel, the study’s lead author and adjunct professor of oral health sciences at the University of Washington School of Dentistry, says the study results are significant, because the tendency for bleeding gums and retinal hemorrhaging could indicate an issue with the microvascular system.

This system encompasses the tiny blood vessels in the body, including the brain, heart, and kidneys. Results suggest that assessing vitamin C plasma levels and rectifying any deficiencies could reverse micro bleeding issues throughout the body.

However, Prof. Hujoel emphasizes that the study findings do not indicate a direct relationship between increasing vitamin C levels and preventing strokes or other microvascular-related conditions.

Instead, the results suggest that current daily vitamin C recommendations are designed to protect against scurvy and may be inadequate to prevent bleeding gums and other related microvascular issues.

The data also indicate that although treating bleeding gums by increasing tooth brushing and flossing is good practice, these actions may not get to the root of the problem.

Prof. Hujoel explains:

“When you see your gums bleed, the first thing you should think about is not, I should brush more. You should try to figure out why your gums are bleeding. And vitamin C deficiency is one possible reason.”

Previous research has also touched on vitamin C and its connection to bleeding gums.

A Korean study published in PLOS ONE found that study participants who had inadequate vitamin C intake were 1.16 times more likely to have periodontitis, a type of gum disease, than those with adequate vitamin C consumption.

According to the National Institutes of Health (NIH), the daily recommended amount of vitamin C for the average adult is 90 milligrams (mg) for men and 75 mg for women.

Prof. Hujoel suggests that people who do not consume enough of this vitamin through diet should consider supplementing with about 100–200 mg of vitamin C per day.

Supplementation is especially important for those on Paleo or other low carbohydrate diets, as foods incorporated with these diet plans may not contain enough of this essential vitamin.

“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. 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,” says Prof. Hujoel.