The association of dietary vitamin C intake with periodontitis among Korean adults: Results from KNHANES Ⅳ

PLoS One. 2017 May 10;12(5):e0177074. doi: 10.1371/journal.pone.0177074. eCollection 2017.


Backgrounds: The association of dietary vitamin C (vit C) on periodontitis requires more valid evidence from large representative samples to enable sufficient adjustments. This study aimed to evaluate the association between dietary vit C intake and periodontitis after controlling for various confounders in the representative Korean adult population.

Method: A total of 10,930 Korean adults (≥19 years) from the fourth Korean National Health and Nutrition Examination Survey data set were included in this cross-sectional study. Periodontitis was defined as community periodontal index score of 3 or 4. Dietary vit C intake was estimated from a 24-hour dietary record, and categorized into adequate and inadequate according to the Korean Estimated Average Requirement value. Potential confounders included age, sex, income, frequency of tooth brushing, use of floss, dental visit, drinking, smoking, diabetes, hypercholesterolemia, hypertension, and obesity. A multivariable logistic regression analysis and stratified analysis were applied.

Results: Those with inadequate dietary vit C intake were more likely by 1.16 times to have periodontitis than those with adequate dietary vit C intake (adjusted odds ratio [aOR] = 1.16, 95% confidence interval = 1.04-1.29). Lowest and middle-low quartile of dietary vit C intake, compared to highest quartile of dietary vit C intake, showed significant association (aOR = 1.28 and 1.22 respectively), which was in a biological-gradient relationship (trend-p <0.05).

Conclusions: Our data showed that inadequate dietary vit C intake was independently associated with periodontitis among Korean adults. Hence, adequate intake of dietary vitamin C could be substantially important on the promotion of periodontal health among Korean adults.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / epidemiology
  • Ascorbic Acid / therapeutic use*
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Income
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Obesity / epidemiology
  • Odds Ratio
  • Periodontal Index
  • Periodontitis / epidemiology*
  • Periodontitis / prevention & control*
  • Republic of Korea / epidemiology
  • Smoking / epidemiology
  • Toothbrushing
  • Vitamins / therapeutic use*
  • Young Adult


  • Vitamins
  • Ascorbic Acid

Grant support

This work was supported by a grant from the National Research Foundation of Korea through the Oromaxillofacial Dysfunction Research Center for the Elderly (No. 2015-048003) at Seoul National University, Korea. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.