vitamins definition. discovery, classification , vit c introduction, RDA, sources, functions, deficiency, effect on periodontium

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2. VITAMIN C
AND
PERIODONTAL HEALTH
PRESENTED BY
Dr. RISHABH SRIVASTAVA
PG -1ST YEAR
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3. CONTENTS
 Introduction
 History of vitamin
 Recommended Dietary Allowance
 Sources
 Absorption
 Storage
 Function
 Effect Of Vitamin C On Periodontium
 Deficiency Of Vitamin C
 Toxicity
 Treatment
 Conclusion
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4. INTRODUCTION
DEFINITION
Vitamins are the organic compounds required in
the diet in small amounts to perform specific
biological functions for normal maintenance of
optimum growth and health of the organism.
Since the body is generally unable to synthesize
them (at least in sufficient amounts), they must be
provided by food.
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5. HISTORY OF VITAMINS
 Federick G. Hopkins, a biochemist , reported in 1906 that there
was an unknown something in food essential for life and health.
In 1912, he had experimental data that supported this statement.
 Casimir Funk, a Polish chemist, obtained an antiberiberi
substance from rice polishings.
 He believed that the active factor that he found was a protein,
i.e., an “amino”.
 Casimir called the substances ‘vital amines’. He put the two
words together making ‘vitamines’
 Later the ‘e’ was taken away making ‘VITAMINS’
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6. CLASSIFICATION 6

7. VITAMIN C OR ASCORBIC ACID
 In 1932, C.G. King isolated
vitamin C from lemons and
identified it as the ‘antiscorbutic’
(scurvy preventing) vitamin.
 Because this vitamin was the third to
be discovered, it was called vitamin
C.
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8. RECOMMENDED DIETARY
ALLOWANCE
According to NATIONAL INSTITUTE OF HEALTH (N.I.H)
Adult 60-70mg/day
Lactating females 80 mg/day
Infants 50 mg/day
Children 40 mg/day
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9. DIETARY SOURCES
 Citrus fruits – Amla is the richest natural
source
 Goose berry
 Green vegetables like cabbage and spinach
 Skin of potatoes and tomatoes
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10. ABSORPTION
 Many animals can synthesize ascorbic acid
from glucose via uronic acid pathway
 However in human and other primates, guinea
pig and bats can not synthesize ascorbic acid
due to the deficiency of single enzyme
namely L-gulonolactone oxidase.
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11. STORAGE
 Vitamin C does not have any extensive storage.
 Ascorbic acid is excreted in urine as such, or as its metabolites
diketogulonic acid and oxalic acid.
 Certain tissue such as adrenal cortex, eyes contains relatively large
amount of ascorbic acid.
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12. FUNCTIONS OF VITAMIN C
 As an antioxidant
 Collagen formation
 Bone formation
 Iron and haemoglobin synthesis
 Tryptophan metabolism
 Tyrosin catabolism
 Immunological function
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13. FUNCTIONS OF VITAMIN C
 ACT AS AN ANTIOXIDENT
Two major properties of vitamin C that make it ideal antioxidant
1) First is the low one electron reduction potential of both ascorbate and its one
electron oxidation product
2) The second major property of vitamin c that makes such an effective antioxidant
is the stability and low reactivity of ascorbyl radicals.
( Anitra C Carr and Balz Frei)
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14.  COLLAGEN FORMATION
Vitamin C plays a role of a co enzyme in
hydroxylation of proline and lysine.
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15. Bone formation
 Bone tissue possess an organic matrix, collagen and the inorganic calcium,
phosphate etc. Vitamin C is required for bone formation.
TRYPTOPHAN METABOLISM
 Vitamin C is essential for the hydroxylation of tryptophan (enzyme-
hydroxylase)to hydroxytryptophan in the svnthesis of serotonin
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16. IRON AND HAEMOGLOBIN SYNTHESIS
 Ascorbic acid enhances iron absorption by keeping it in the ferrous form.
This is due to the reducing property of vitamin C.
 lt helps in the formation of ferritin (storage form of iron) and mobilization of
iron from ferritin.
 Vitamin C is useful in the reconversion of methemoglobin to hemoglobin.
 The degradation of hemoglobin to bile pigments requires ascorbic acid.
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TYROSIN CATABOLISM
 Ascorbic acid is required for the oxidation of p-
hydroxyl phenylpyruvate( enzyme hydroxylase) to
homogentisic acid in tyrosine catabolism

18. Immunological function
 Vitamin C enhances the synthesis of immunoglobulins (antibodies) and increases
the phagocytic action of leucocyte
Anitra C. Carr , Silvia Maggini
 The role of vitamin C in lymphocytes is less clear but it has shown that it
enhance the differentiation and proliferation of B lymphocyte and T lymphocyte.
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19. DEFICIENCY OF VITAMIN C
 Severe vitamin C deficiency in human can lead
to “SCURVY.”
 A disease which is characterized by
hemorrahagic diathesis and retardation of
wound healing.
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20. CLINICAL FEATURES OF SCURVY
Clinical manifestation includes
1) The disease is characterized by spongy and sore
gums and loose teeth.
2) Haemorrhagic lesion into the muscles of extremities
and joints and sometimes nailbed.
3) Petechial haemorrhage are often around hair follicles
4) Impaired wound healing.
5) Sluggish hormonal function of adrenal cortex and
gonads.
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21. EFFECT OF VITAMIN C DEFICIENCY
ON PERIODONTIUM
 Gingival changes include redness, swelling, tendency
towards bleeding upon minimal stimulation and an
alteration towards spongy consistency.
 Hodges et al 1971. Gingivitis with hemorrhagic,
enlarged bluish-red gingivae is a classic sign of
scurvy
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22.  Alveolar bone may get resorbed early because of the defective
collagen synthesis and collagen is the matrix in which the
calcium is deposited to form bone, so deficiency of vitamin c
would impair bone formation and resorption.
 Barnes (1975) stated that defects in collagen synthesis, its
tertiary structure and turnover may explain the observed
weakness of periodontal fibers in ascorbic acid deficiency.
 Vitamin C deficiency has been found to increase the risk of
periodontal disease among the smokers and diabetic patients.
In vitamin C deficiency, gingiva have decreased ability to
resist inflammation and bleeding, and gingivitis may occur
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23. POSSIBLE ETIOLOGICAL RELATIONSHIP
BETWEEN ASCORBIC ACID AND
PERIODONTAL DISEASE
 Woofle et al in 1980 have been suggested that ascorbic acid may
play a role in periodontal disease by one or more of the following
reason
1) Low levels of ascorbic acid influence the metabolism of collagen
within the periodontium, thereby affecting the ability of the tissue
to regenerate and repair itself.
2) Ascorbic acid deficiency interferes with bone formation, leading to
loss of periodontal bone.
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24. 3) Increasing levels of ascorbic acid enhance both the chemo-tactic and
migratory action of leukocytes and influencing their phagocytic activity.
4) An optimal level of ascorbic acid is apparently required to maintain the
integrity of the periodontal microvasculature
Waerhaug in1958 Acute vitamin C deficiency results in edema and
hemorrhage in the periodontal ligament, osteoporosis of the alveolar bone, and
tooth mobility; hemorrhage, edema, and degeneration of collagen fibers occur
in the gingiva. Vitamin C deficiency also retards gingival healing
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25. TOXICITY
 Ordinarily ascorbic acid is not toxic, because in most cases excessive
amounts are readily excreted by kidneys
 The eyes, adrenal glands and brain have the ability to store high
concentration of vit. C for about 3 months
 The symptoms include gastrointestinal upset, diarrhea, orange-colored urine,
interference with anticoagulants and iron toxicity.
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26. TREATMENT
 In treating infantile scurvy, 50 to 100 mg of ascorbic acid may be added to
the milk four times daily. After a week, the amount of ascorbic acid may be
reduced to about 30 mg/day.
 In treatment of adult scurvy, 250mg should be administered four times daily
for a week, after which the dose may be decreased to 50 to 100mg four
times daily until normal vitamin C plasma levels of 0.6 to 1.5 mg/100 ml
are attained.
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27. CONCLUSION
 Vitamins do not yield energy but enable the body to use
other nutrients. Since the body is generally unable to
synthesize them (at least in sufficient amounts) they must
be provided by food. A well balanced diet supplies in
most instances the vitamin needs of a healthy person. The
minimum intake for the maintenance of health in respect
of many of the vitamins thus appears to be important.
Vitamin C also plays a major role in many of the
important functions of the body, so it is necessary to take
proper amount of vitamin c to maintain proper function of
the body.
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28. REFERENCES
 Lippincott’s biochemistry 5th Edition - Richard Harvey, Denise
Ferrier
 Harper’s Biochemistry, 26th Edition
 Clinical periodontology – Carranza, Newman 9th edition.
 Anitra C Carr and Balz Frei, Toward a new recommended dietary
allowance for vitamin C based on antioxidant and health effects in
humans. Am J Clin Nutr 1999;69:1086–107
 Anitra C. Carr and Silvia Maggini, Vitamin C. Nutrients 2017, 9,
1209-21
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