Sugar

Sugar intake increases plaque accumulation while decreasing chemotaxis and phagocytosis of polymorphonuclear leukocytes. (1) For example, in a double-blind study, 21 dental students consumed a 75 gram glucose drink 3 times daily, while 21 controls were given an artificially sweetened drink. On the fifth day, mean sulcus depth in the experimental group had increased significantly while the mean sulcus depth in the controls was unchanged. (2) Similarly, mean gingival inflammation in the experimental group significantly increased, while mean gingival inflammation in the controls was slightly reduced. (3)

Vitamins

Folic Acid

Folic acid nutriture has been shown to be directly related to gingival health. In one study, following 30 days during which patients with normal plasma folate levels ingested 2 mg folic acid twice daily or placebo under double-blind conditions, folate increased the resistance of the gingiva to local irritants leading to a reduction in inflammation–even though plasma folate levels were unchanged. (4) Folate mouthwash is also effective, and may be even more effective than dietary supplements. (5)

Vitamin A

A deficiency of vitamin A is well known to predispose to periodontal disease. (6) For example, a group of pregnant women was found to show maximal inflammatory changes of the periodontium in the 8th month when the mean physiologic level of vitamin A declined. Shortly after delivery, by contrast, vitamin A levels became markedly elevated and periodontal inflammation improved, raising the question of whether periodontitis of pregnancy is related to changes in the levels of the vitamin. (7)

Vitamin C

Ascorbic acid protects the oral mucosal epithelium against the infiltration of antigenic materials such as bacterial endotoxins, (8) so it is not surprising that serum vitamin C levels have a significant (although weak) inverse association with periodontitis. (9) Dietary vitamin C intake shows a similar relationship, at least up to an intake of 180 mg daily. (10) Also, 500 mg daily of the vitamin for 90 days has been shown to reduce both dental plaque and stain. (11)

Vitamin E

When 800 mg of vitamin E in capsule form was bitten open and swished in the mouth before swallowing for 21 days, gingival inflammation was reduced. (12) This is a good example of the vitamin’s effects on the inflammatory process in general.