Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Vitamin

Vitamin C

Likelihood in at-risk patientsLow

Likelihood of deficiency within an at-risk group, not the general population.

Evidence confidenceHigh

Strength of the peer-reviewed evidence.

Food sources

Citrus fruit, Bell peppers, Strawberries, Broccoli

Typical intake: 90 mg/day for men, 75 mg/day for women; smokers need an additional 35 mg/day. Average US intake runs 70–100 mg/day.

Upper limit: 2,000 mg/day for adults.

Dental & oral effects of deficiency

  • Gingival bleeding and inflammation

    Classic early sign of vitamin C deficiency: swollen, bleeding gums even with good plaque control.

  • Delayed wound healing

    Impaired collagen synthesis slows healing after any oral surgery.

  • Loosening teeth and gum breakdown (scorbutic periodontitis)

    In established scurvy, spongy, bleeding gums can progress to tissue breakdown and loose teeth; at a population level, lower vitamin C intake is associated with more periodontal disease.

    Clinical management: Suspect deficiency when gum bleeding and swelling are out of proportion to plaque, especially with restricted diets, alcohol use, smoking or eating disorders; refer for medical assessment, as tooth mobility usually improves once vitamin C is replaced. Defer elective surgery until treated.

Associated with deficiency

  • Scurvy: Severe deficiency: bleeding gums, tooth loosening/loss, poor wound healing, fatigue.

Dental & oral effects of surplus / excess

  • Acid wear of enamel from chewable vitamin C (dental erosion)

    Chewable or effervescent vitamin C tablets are acidic; frequent contact with teeth can erode enamel over time. Advise a non-chewable form or rinsing with water afterward.

General toxicity (not necessarily oral-specific)

  • GI upset: Diarrhea and cramping at very high doses; excess is otherwise excreted in urine.

Sources

  1. The Relationship between Vitamin C and Periodontal Diseases: A Systematic Review. Tada A, Miura H. International Journal of Environmental Research and Public Health, 2019.
  2. A Prescription for Change: Food as Medicine & the Vital Role of Nutrition in Patient Care. teethFirst. Continuing education course material, 2025.
  3. Cutaneous signs of nutritional disorders. Wong CY, Chu DH. International journal of women's dermatology, 2021.
  4. Vitamin intake and periodontal disease: a meta-analysis of observational studies. Mi N, Zhang M, Ying Z et al. BMC oral health, 2024.