Abstract
The overall aim of the PhD research described in this thesis was to investigate, in an Indonesian population deprived from regular dental care, associations between the periodontal condition assessed by alveolar and periapical bone loss with the plasma levels of vitamin C, vitamin D, HbA1c and CRP, the Hp phenotype, the presence of putative periodontopathic bacteria and viruses, dietary habits and anthropomethrics; and the effect of vitamin C supplementation on the levels of plasma vitamin C, HbA1c, CRP and on putative periodontopathic bacteria and viruses.
On the basis of the data obtained from this population it may be concluded that:
1. Inadequate vitamin C supply contributes to a poor periodontal condition.
2. Large inter-individual differences exist regarding the capacity of vitamin C absorption.
3. Supplementation of 200 mg vitamin C daily is enough to achieve plasma vitamin C levels > 4.0 mg/l, also in subjects with a poor capacity of vitamin C absorption.
4. Daily supplementation of 200 mg vitamin C in combination with 100 mg citrus flavonoids is able to reduce HbA1c and CRP levels in all subjects of this periodontally diseased population.
5. In populations with poor dietary conditions emphasis should be paid by the authorities to improve fruit intake.
6. In most subjects with severe periodontal breakdown it still takes many years before teeth are exfoliated spontaneously. Moreover, it may take more than 24 years before a root remnant is exfoliated.
7. In terms of tooth loss, caries is a bigger problem in this remote population than periodontitis.
8. In populations with poor dental conditions the authorities should pay more attention to prevention of dental and periodontal diseases by means of education and preventive measures.
On the basis of the data obtained from this population it may be concluded that:
1. Inadequate vitamin C supply contributes to a poor periodontal condition.
2. Large inter-individual differences exist regarding the capacity of vitamin C absorption.
3. Supplementation of 200 mg vitamin C daily is enough to achieve plasma vitamin C levels > 4.0 mg/l, also in subjects with a poor capacity of vitamin C absorption.
4. Daily supplementation of 200 mg vitamin C in combination with 100 mg citrus flavonoids is able to reduce HbA1c and CRP levels in all subjects of this periodontally diseased population.
5. In populations with poor dietary conditions emphasis should be paid by the authorities to improve fruit intake.
6. In most subjects with severe periodontal breakdown it still takes many years before teeth are exfoliated spontaneously. Moreover, it may take more than 24 years before a root remnant is exfoliated.
7. In terms of tooth loss, caries is a bigger problem in this remote population than periodontitis.
8. In populations with poor dental conditions the authorities should pay more attention to prevention of dental and periodontal diseases by means of education and preventive measures.
| Original language | English |
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| Qualification | PhD |
| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 18 Dec 2014 |
| Print ISBNs | 9789090287133 |
| Publication status | Published - 2014 |
