356 



ASCORBIC ACID 



As the deficiency of ascorbic acid becomes more severe, the gums become 

 swollen, blue-red, spongy, and very friable (see Fig. 9). They bleed with 

 slight trauma, though the hemorrhages are usually small and stop quickly. 

 At first the gum lesions are small purpuric spots at the gingival margin of 

 the interdental papillae. Bleeding into the tissues and thrombosis of small 



Fig. 10. Infarcted gangrenous inteixlental papillae and gingival margins in a jia- 

 tient with severe scurvv. 



vessels occur, producing the swelling and the blue-red color. The swelling 

 may become so great that gum tissue completely encases and hides the 

 teeth. The swollen devitalized gum becomes secondarily infected, and the 

 breath becomes foul and salivation excessive. Ultimately these lesions 

 progress to complete infarction and gangrene of the gums from the tooth 

 ro6ts to the gingival margin (see Fig. 10). The gum lesions occur only when 

 natural teeth, Avorn-down snags, or embedded and hidden tooth roots re- 

 main in the mouth (see Fig. 11). A scorbutic patient who is apparently 



