Defense Date


Document Type


Degree Name

Master of Public Health


Preventive Medicine & Community Health


Background: Studies of gingival bleeding and the effects of antioxidants on extracellular matrix and immunologic and inflammatory responses provide a rationale for hypothesizing that antioxidants reduce the risk for gingival bleeding.Methods: This study evaluated the role of antioxidants as contributing risk factors for gingival bleeding utilizing the Third National Health and Nutrition Examination Survey (NAHNES III). A sample of 18,825 adults (20 to ≥ 90 years of age), with dental measurement and assessment of serum levels of antioxidants were included in the study. Gingival bleeding was defined as those who had more than 30 percent of gingival bleeding in 28 sites examined. SPSS version 11.0 software and Epi-info 2000 were used to perform the statistical analysis.Results: Using multiple logistic regression in five separate antioxidants, the study showed an association between increased plasma levels of vitamin C (ascorbic acid) and decreased risk for gingival bleeding (OR= 0.33; 95% CI 0.15 to 0.72). An inverse relationship was also found between gingival bleeding and serum levels of beta carotene (OR=1.93; 95% CI 1.05 to 3.54). However, negative association was found between gingival bleeding and vitamin A (OR=2.60; 95% CI 1.04 to 6.50). No statistically significant association was observed between gingival bleeding and serum levels in vitamin E (alpha tocopherol) and selenium.Conclusion: Antioxidants, vitamin C, vitamin A, and beta carotene, were significant risk factors for gingival bleeding. This should be emphasized for improving the oral health of the U.S. adult population.


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Date of Submission

June 2008