Scurvy (vitamin C deficiency) over 20 years in a patient with periodontitis and gingival bleeding — what is the UNDERLYING CAUSE?

Correct answer: C. Nutritional deficiency of vitamin C → impaired collagen synthesis → poor periodontal ligament and gingival connective tissue maintenance

• A. No hormonal imbalance is involved in scurvy.
• B. Genetic predisposition is a separate risk factor from nutritional deficiency.
• C. Correct. Vitamin C (ascorbic acid) is ESSENTIAL for collagen synthesis — it is required for hydroxylation of proline and lysine residues in collagen. Without adequate vitamin C: collagen is weak and unstable → periodontal ligament fibers fail, gingiva becomes edematous and hemorrhagic, teeth loosen, wounds fail to heal. After 20 years of vitamin C deficiency, severe periodontitis with gingival bleeding reflects the direct consequence of nutritional deficiency impairing connective tissue integrity.
• D. While poor immunity occurs in scurvy, the primary dental/periodontal mechanism is collagen synthesis failure.