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Toothpaste with vitamin A and a control paste without it were used in the
treatment of periodontitis. The paste with vitamin A noticeably reduced gingival
bleeding activity and proved to be effective in the treatment of young patients
and of those with mild periodontitis.

The purpose of this study was to (1) compare crevicular fluid flow in smokers
and nonsmokers with clinically healthy gingiva; (2) compare crevicular fluid
flow of smokers in the areas physically exposed to smoke (maxillary lingual) to
that in areas not physically exposed to smoke (maxillary buccal); and (3)
compare crevicular fluid flow in smokers and nonsmokers before and after 1 month
of (500 mg) twice daily vitamin C supplementation. All sampled areas were
required to exhibit clinical health for all measurements (gingival, plaque, and
bleeding indices at 0). Ten smoking (at least one pack a day) and ten nonsmoking
male dental students were subjects of the study. Areas sampled were midbuccal
and midlingual of teeth 3, 5, 12, and 14. Smokers were found to have
significantly less crevicular fluid flow than did nonsmokers. Lingual areas of
smokers showed no significant difference from buccal areas in crevicular fluid
flow. One month of (500 mg) twice daily vitamin C supplementation resulted in a
significant decrease in crevicular fluid flow in smokers and nonsmokers. The
effect of tobacco smoke on clinically healthy gingiva may be a physiologic
result of vasoconstriction rather than a physical irritation.

Chitosan ascorbate, obtained by mixing chitosan with ascorbic acid and sodium
ascorbate, was produced in a gel form suitable for the treatment of
periodontitis according to current dental surgery. While chitosan ascorbate
underwent degradation in vitro, especially in the presence of atmospheric oxygen
and at pH 6.0, the protection from oxygen offered by the surgical cements and
the physiological pH value permitted chitosan ascorbate to play an important
biological role in vivo, where it kept a honeycomb structure, as indicated by
SEM on biopsies taken on 10 patients. The proliferation and organization of the
cells were thus favoured with a subsequent enhanced capability of reconstructing
a histoarchitectural tissue. Chitosan was progressively reabsorbed by the host,
with very satisfactory clinical recoveries of the 52 defects treated, for which
tooth mobility and pocket depths were significantly reduced.

Maintaining natural dentition is a realistic goal given today's improved caries
control and attention to good oral hygiene. Expanding knowledge in the area of
periodontal diseases provides further insight into health promotion practices
which can be effective in preventing tooth loss. Vitamin C's role in maintaining
the health of teeth and gingivae remains unchallenged. Now clinical evidence
indicates that vitamin C functions in improving host defence mechanisms and is
thereby implicated in preserving periodontal health. Common sense tells us that
the monitoring of the vitamin C status of individuals, especially those at high
risk (e.g., diabetics, smokers, elderly, etc.) for inadequate intakes, will
yield positive results for periodontal health. Patient education programs that
stress the importance of good nutrition, while at the same time providing
practical information for the selection of a well balanced diet, are simple
measures that will benefit many.

Department of Epidemiology, School of Public Health, University of Alabama at
Birmingham 35294.

Data from animal studies and from studies of patients with acute necrotizing
ulcerative gingivitis (ANUG) have provided suggestive evidence for an
association between ascorbate deficiency and disease risk. Further, there is
biological plausibility for such an association, due to the role of ascorbate in
collagen synthesis and leukocyte function. A case-control study of plasma
ascorbate and ANUG was performed on 60 patients with a history of ANUG infection
and 60 age-race-sex-matched controls. No cases had had active lesions for at
least two months prior to their vitamin assay to avoid any potential reduction
of dietary intake of ascorbic acid due to the presence of painful mouth lesions.
According to results obtained by use of a modification of the
2,4-dinitrophenylhydrazine method for determination of total plasma ascorbate,
the mean and standard error of the mean of plasma ascorbate for all ANUG cases
was 0.07 0.006 mmol/L; the mean for all controls was 0.10 0.006 mmol/L.
Paired differences in plasma ascorbic acid concentrations between cases and
controls were significantly different from zero (p less than 0.001). The
unadjusted relative risk (RR) of ANUG as obtained by conditional logistic
regression for subjects whose plasma ascorbic acid concentration was at or below
the median value for controls, relative to subjects with higher values, was 7.3
(90% confidence interval, 3.0 - 17.4; one-sided p value less than 0.001).
Patients with a history of ANUG ingested a daily average of 1.2 0.2 servings
of dietary ascorbic acid, as compared with a daily average of 1.9 0.2
servings for healthy controls.

Biochemical indices of AA clearly showed that the young men in this study were
brought into various states of AA depletion and repletion according to their
dietary AA intakes. While previous studies have postulated that supplemental
intakes of AA may adversely affect body status of vitamins B6 and B12, we found
no changes in the B vitamin status of the young men receiving varying AA
intakes. Moderate AA supplementation (605 mg/day) showed no antagonistic effect
on markers of vitamins B6 and B12. Blood markers of fat-soluble vitamins A and E
and iron status were not affected by AA intakes. The propensity of the gingiva
to become inflamed or bleed on probing was reduced after normal (65 mg/day) AA
intakes as compared to deficient (5 mg/day) intakes and upon supplementary (605
mg/day) AA intakes as compared to normal intakes. The results suggest that AA
status may influence early stages of gingival inflammation and crevicular
bleeding, and warrant further study of the relationship between AA and
periodontal health.

To determine if systemic levels of vitamin C influence periodontal health,
changes in plaque accumulation, gingival health and periodontal probing depth
were measured in healthy subjects housed for 3 months in a nutrition suite that
provided controlled periods of ascorbic acid depletion and supplementation.
Eleven healthy, nonsmoking men, aged 19 to 28 years, ate a rotating 7-day diet
adequate in all nutrients except ascorbic acid. This basal diet, which contained
less than 5 mg/day ascorbic acid, was supplemented with 60 mg/day ascorbic acid
for 2 weeks, 0 mg/day ascorbic acid for 4 weeks, 600 mg/day ascorbic acid for 3
weeks and 0 mg/day ascorbic acid for 4 weeks. Plasma, urine and leukocyte
ascorbate levels, Plaque Index, Gingival Index, Bleeding Index and probing
depths were monitored throughout the study. A uniform oral hygiene program was
maintained in which oral hygiene instructions were reinforced bi-weekly.
Ascorbate concentrations in body fluids and leukocytes responded rapidly to
changes in ascorbic acid intake. No mucosal pathoses or changes in plaque
accumulation or probing depths were noted during any of the periods of depletion
or supplementation. However, measures of gingival inflammation were directly
related to the ascorbic acid status. The results suggest that ascorbic acid may
influence early stages of gingivitis, particularly crevicular bleeding.

A 9-year-old girl had the insidious development of lethargy, gingival erosions,
and follicular hyperkeratosis with perifollicular hemorrhage. A dietary history
disclosed that she consumed only one kind of sandwich and beverage and took no
other foods. A skin biopsy specimen was consistent with the diagnosis of scurvy,
and marked improvement occurred with ascorbic acid therapy. Although it is an
uncommon disorder in the United States, scurvy may occur in persons with
prolonged and peculiar dietary habits.

The effect of vitamin C on the genotoxicity of three pesticides (Endosulfan,
Phosphamidon, Mancozeb) was monitored by screening meiotic (metaphase I)
chromosomes in the primary spermatocytes of Swiss albino mice, Mus musculus. A
dose-dependent amelioration by vitamin C was observed in the
Phosphamidon-treated group where quadruple the therapeutic dose produced maximum amelioration. In Endosulfan- and Mancozeb-treated groups, no further
amelioration was achieved beyond the double dose of vitamin C, and the damage
frequency did not come down to the control level. The possible mechanism of this
effect is discussed.

The effects of vitamins C and E on bone marrow chromosomes of the mouse exposed
to 1 Gy of whole-body gamma-irradiation were studied. These vitamins, dissolved
in water/peanut oil, were administered orally as acute doses, either 2 h before,
immediately after, or 2 h after irradiation. Both vitamins significantly reduced
the frequencies of micronuclei and chromosomal aberrations in bone marrow cells;
radioprotection by vitamin E was, however, appreciably greater than that
afforded by vitamin C. Administration of the vitamins to mice immediately after
irradiation was as effective as that 2 h before irradiation. A sequential
treatment consisting of both these vitamins did not result in additional
radioprotection over that afforded by vitamin E alone. The probable mechanisms
of radioprotection are discussed.