JKAOH Journal of Korean Academy of Oral Health J Korean Acad Oral Health 1225-388X 2093-7784 Journal of Korean Academy of Oral Health 10.11149/jkaoh.2014.38.2.82 jkaoh-38-82 Original Article Correlation between vitamin C intake and periodontal disease: The Fifth Korea National Health and Nutrition Examination Survey, 2010 PaekKyungWon1 LeeSooJin2 Division of Social Welfare, Baekseok University, Cheonan, Korea Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea Corresponding Author: SooJin Lee Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 Worldcup-ro, Youngtong-gu, Suwon 443-721, Korea Tel: +82-31-219-5303 Fax: +82-31-219-5084 E-mail: sjlee0820@ajou.ac.kr 062014 12062014 38 2 82 89 08052014 19062014 23062014 Copyright © 2014 Journal of Korean Academy of Oral Health 2014 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Objectives

Vitamin C is important for maintaining periodontal health. The purpose of this study was to examine the correlation between vitamin C intake and periodontal disease in adults.

 Methods

The data collected from the 2010 Fifth Korea National Health and Nutrition Examination Survey was retrospectively reviewed. The final sample included 2,878 subjects, aged between 30 and 59 years. These patients had also undergone the required oral examinations and had taken health and nutrition surveys.

 Results

The incidence of periodontal disease was 24.4%. The patients’ gender, age, spouse, education level, smoking habits, brushing frequency, and vitamin C intake were considered to be significant risk factors for periodontal disease based on complex sampling analysis. The multivariate-adjusted odds ratio for occurrence of periodontal disease was 0.69 (95% confidence interval, 0.477-0.987) when the vitamin C intake of subjects in quartile 4 (Q4) and Q1 were compared (P=0.0421).

 Conclusions

The findings of this study suggest that vitamin C intake is significantly associated with periodontal disease, and also provide information that will aid in the prevention of periodontal disease.

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Characteristics of the study subjects

Variable N/M (%/S.D)
Gender Male 1,118 (38.8)
Female 1,760 (61.2)
Age (yrs) 30-39 994 (34.5)
40-49 919 (31.9)
50-59 965 (33.5)
Spouse No 337 (11.7)
Yes 2,538 (88.3)
Education level Elementary or lower 324 (11.3)
Middle school 322 (11.2)
High school 1,088 (37.8)
College or higher 1,144 (39.7)
Income Low 694 (24.4)
Middle-low 712 (25.0)
Middle-high 727 (25.5)
High 715 (25.1)
Smoking habits Never 2,331 (81.1)
Current 545 (18.9)
Drinking Never 1,202 (42.2)
Current 1,646 (57.8)
BMI Normal 1,291 (44.9)
Overweight 698 (24.3)
Obesity 889 (30.9)
Brushing frequency ≤1 229 (8.0)
2 1,400 (48.6)
3≤ 1,249 (43.4)
Vitamin C intake (%) 119.5 (2.45)
Q1 (<51.0) 535 (18.6)
Q2 (51.0-84.9) 704 (24.5)
Q3 (85.0-140.8) 814 (28.3)
Q4 (≥140.9) 825 (28.7)
Periodontal disease No 2,175 (75.6)
Yes 703 (24.4)

N/M are number/mean. S.D, Standard deviation; BMI, Body mass index. The data were analysed by complex samples.

The difference vitamin C intake by subjects

Variable Vitamin C intake x2 P-value
Q1 Q2 Q3 Q4
Gender Male 116 (10.9) 263 (24.6) 345 (32.3) 344 (32.2) 22.388 <.0001
Female 369 (21.0) 441 (25.1) 469 (26.6) 481 (27.3)
Age (yrs) 30-39 200 (20.1) 252 (25.4) 271 (27.3) 271 (27.3) 6.165 0.4050
40-49 160 (17.4) 230 (25.0) 272 (29.6) 257 (28.0)
50-59 175 (18.1) 222 (23.0) 271 (28.1) 297 (30.8)
Spouse No 77 (22.8) 85 (25.2) 85 (25.2) 90 (26.7) 6.802 0.0785
Yes 458 (18.0) 617 (24.3) 728 (28.7) 735 (29.0)
Education level Elementary or lower 82 (25.3) 86 (26.5) 69 (21.3) 87 (26.9) 27.051 0.0014
Middle school 65 (20.2) 63 (19.6) 95 (29.5) 99 (30.7)
High school 191 (17.6) 287 (26.4) 328 (30.1) 282 (25.9)
College or higher 197 (17.2) 268 (23.4) 322 (28.1) 357 (31.2)
Income Low 160 (23.1) 184 (26.5) 178 (25.6) 172 (24.8) 22.072 0.0087
Middle-low 129 (18.1) 185 (26.0) 200 (28.1) 198 (27.8)
Middle-high 126 (17.3) 173 (23.8) 215 (29.6) 213 (29.3)
High 112 (15.7) 155 (21.7) 214 (29.9) 234 (32.7)
Smoking habits Never 417 (17.9) 559 (24.0) 668 (28.7) 687 (29.5) 6.003 0.1115
Current 117 (21.5) 145 (26.6) 146 (26.8) 137 (25.1)
Drinking Never 241 (20.0) 259 (21.5) 330 (27.5) 372 (30.9) 12.281 0.0065
Current 288 (17.5) 439 (26.7) 474 (28.8) 445 (27.0)
BMI Normal 247 (19.1) 317 (24.6) 363 (28.1) 364 (28.2) 0.820 0.9915
Overweight 127 (18.2) 170 (24.4) 201 (28.8) 200 (28.7)
Obesity 161 (18.1) 217 (24.4) 250 (28.1) 261 (29.4)
Brushing frequency ≤1 54 (23.6) 52 (22.7) 62 (27.1) 61 (26.6) 4.979 0.5465
2 271 (19.4) 330 (23.6) 394 (28.1) 405 (28.9)
3≤ 210 (16.8) 322 (25.8) 358 (28.7) 359 (28.7)

BMI, Body mass index. Values are Number (%). The data were analysed by complex samples.

The difference between characteristics and periodontal disease

Variable Periodontal disease x2 P-value
No Yes
Gender Male 732 (67.0) 386 (33.0) 71.336 <.0001
Female 1,443 (82.1) 317 (17.9)
Age (yrs) 30-39 880 (86.3) 114 (13.7) 96.587 <.0001
40-49 680 (72.3) 239 (27.7)
50-59 615 (62.8) 350 (37.2)
Spouse No 272 (81.8) 65 (18.2) 7.152 0.0075
Yes 1,900 (73.2) 638 (26.8)
Education level Elementary or lower 197 (60.2) 127 (39.8) 52.720 <.0001
Middle school 204 (63.6) 118 (36.4)
High school 822 (73.6) 266 (26.4)
College or higher 952 (82.2) 192 (17.8)
Income Low 514 (72.3) 180 (27.7) 4.792 0.1877
Middle-low 530 (72.7) 182 (27.3)
Middle-high 557 (76.3) 170 (23.7)
High 556 (77.6) 159 (22.4)
Smoking habits Never 1,832 (78.4) 499 (21.6) 50.391 <.0001
Current 341 (62.6) 204 (37.4)
Drinking Never 953 (77.7) 249 (22.3) 8.276 0.0040
Current 1,197 (72.3) 449 (27.7)
BMI Normal 1,034 (78.4) 257 (21.6) 11.788 0.0028
Overweight 512 (72.7) 186 (27.4)
Obesity 629 (70.7) 260 (29.1)
Brushing frequency ≤1 135 (60.5) 94 (39.5) 33.534 <.0001
2 1,032 (72.6) 368 (27.4)
3≤ 1,008 (80.1) 241 (19.9)
Vitamin C intake Q1 400 (72.1) 135 (27.9) 3.696 0.2962
Q2 532 (74.3) 172 (25.7)
Q3 611 (73.3) 203 (26.7)
Q4 632 (77.1) 193 (22.9)

BMI, Body mass index. Values are Number (%). The data were analysed by complex samples.

Odds ratio of the multiple logistic regression for the periodontal disease by characteristics

Variable OR 95% CI P-value
Gender Female 1.0
Male 2.01 1.517-2.661 <.0001
Age (yrs) 30-39 1.0
40-49 2.16 1.623-2.885 <.0001
50-59 2.76 1.946-3.906 <.0001
Spouse No 1.0
Yes 1.73 1.177-2.552 0.0053
Education level Elementary or lower 1.0
Middle school 0.90 0.571-1.417 0.6468
High school 0.74 0.478-1.156 0.1878
College or higher 0.50 0.297-0.842 0.0092
Income Low 1.0
Middle-low 1.01 0.738-1.382 0.9511
Middle-high 0.91 0.660-1.260 0.5762
High 0.87 0.612-1.242 0.4478
Smoking habits Never 1.0
Current 1.68 1.271-2.221 0.0003
Drinking Never 1.0
Current 1.01 0.803-1.277 0.9168
BMI Normal 1.0
Overweight 1.04 0.786-1.374 0.7865
Obesity 1.20 0.910-1.582 0.1976
Brushing frequency ≤1 1.0
2 0.70 0.489-1.009 0.0561
3≤ 0.59 0.389-0.896 0.0133
Vitamin C intake Q1 1.0
Q2 0.86 0.631-1.175 0.3465
Q3 0.84 0.617-1.130 0.2426
Q4 0.69 0.477-0.987 0.0421

OR, Odds ration; CI, Confidence Interval; BMI, Body mass index. The data were analysed by complex samples.