10 Lip and Mouth Changes That Signal Nutritional Deficiencies

5. Swollen and Bleeding Gums - Vitamin C Deficiency (Scurvy)

Swollen, bleeding, and tender gums represent the classic oral manifestation of vitamin C deficiency, historically known as scurvy, demonstrating the critical role of ascorbic acid in maintaining healthy connective tissue throughout the oral cavity. Vitamin C serves as an essential cofactor for collagen synthesis, the primary structural protein that provides strength and integrity to gums, blood vessel walls, and other connective tissues. When vitamin C intake falls below adequate levels, typically less than 10 mg daily for extended periods, the body's ability to maintain and repair gum tissue becomes severely compromised, leading to characteristic changes that progress from subtle inflammation to severe tissue breakdown. Initial symptoms include gum tenderness and slight bleeding during brushing or flossing, which many individuals mistakenly attribute to aggressive oral hygiene rather than nutritional deficiency. As the condition progresses, gums become increasingly swollen, purple or red in color, and may bleed spontaneously or with minimal provocation. Advanced cases can result in tooth loosening, gum recession, and secondary bacterial infections that further complicate the clinical picture. While frank scurvy remains relatively rare in developed countries due to food fortification and availability of fresh produce, subclinical vitamin C deficiency affects significant portions of certain populations, particularly elderly individuals, smokers, and those with limited access to fresh fruits and vegetables. Treatment requires immediate vitamin C supplementation combined with dietary modifications to include citrus fruits, berries, leafy greens, and other ascorbic acid-rich foods, typically resulting in noticeable gum improvement within days to weeks of adequate intake restoration.