Reversal of Subgingival pH by Ascorbic Acid: A Weapon against Periopathogens

Abstract

Background: Periodontal pocket is a dynamic environment. Several interacting factors within this microenvironment play an important role in initiation and progression of periodontal diseases. Power of hydrogen (pH) is one of the important governing factor. Evidence suggests that pH of healthy gingival sulcus is between mildly acidic to neutral. A shift toward alkaline pH is observed in periodontal pocket which favors growth of gram-negative periopathogenic bacteria. Thus, the aim of the current study is to assess possible role of ascorbic acid in rever sing subgingival alkaline pH and to determine optimum con centration of ascorbic acid for bacteriocidal effects. Materials and methods: Subgingival plaque samples from 37 generalized chronic periodontitis patients were collected. Growth inhibition of periodontal pathogens with four different concentrations of ascorbic acid was examined anerobically after 48 hours. Photometric analysis and disk diffusion method were employed to quantify inhibitory effects. Results: Evidence obtained by both the methods demonstrated possible bactericidal activity of ascorbic acid at 5 mg/ml. At this concentration, ascorbic acid showed stronger pH dependent inhibition toward gram-negative periopathogens. Conclusion: Ascorbic acid can inhibit growth of periodontal pathogens at high concentration. Subgingival vitamin C administration could lead to prevention of plaque induced diseases. Due to its acidic nature, it should be used cautiously around teeth but recommended for maintenance of implants.