Bleeding gums may be a sign of gingivitis, an early stage of periodontal disease, but the researchers’ advice to check Vitamin C deficiency along with brushing and flossing twice a day. “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,” says Philippe Hujoel, a practicing dentist and professor of oral health sciences in the University of Washington School of Dentistry.
Hujoel is the lead author of a study published in Nutrition Reviews which analyzed published studies of 15 clinical trials in six countries. The study shows that bleeding of the gums on gentle probing, or gingival bleeding tendency, and also bleeding in the eye, or retinal hemorrhaging, were associated with low vitamin C levels in the bloodstream. And, the researchers found that increasing daily intake of vitamin C in those people with low vitamin C plasma levels helped to reverse these bleeding issues.
“Both a gum bleeding tendency and retinal bleeding could be a sign of general trouble in one’s micro vascular system, of a micro vascular bleeding tendency in the brain, heart and kidneys,” says Hujoel.
However, the study does not imply that successful reversing of an increased gingival bleeding tendency with vitamin C will prevent strokes or other serious health outcomes. But, the results do suggest that vitamin C recommendations designed primarily to protect against scurvy — a deadly disease caused by extremely low vitamin C levels — are too low, and that such a low vitamin C intake can lead to a bleeding tendency, which should not be treated with dental floss.
Hujoel does recommend people attempt to keep tabs on their vitamin C intake by eating non-processed foods like kale, peppers or kiwis into the diet. Vitamin C supplement of about 100 to 200 milligrams a day can be an alternative. People who exclusively eat lean meats and avoid offal, the vitamin-rich organ meats, may be at a particularly high risk for a low vitamin C intake.
If someone is on a specialized diet, such as a paleo diet, it’s important that they take a look at their vitamin C intake, Hujoel said. “Vitamin C-rich fruits such as kiwis or oranges are rich in sugar and thus typically eliminated from a low-carb diet.”
The gum bleeding and vitamin C level connection was recognized more than 30 years ago. There have been previous studies in 1986 and 1991 which identified gum bleeding as a biological marker for vitamin C levels. However, this connection somehow got lost in dental conversations around bleeding gums.
“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 over attention to treating the symptom of bleeding with brushing or flossing, rather than treating the cause,” Hujoel said.