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Several factors can impair wound healing such as oxygenation defects, aging, and overall stress. Furthermore, a number of other factors such as infection found in periodontal disease, diabetes, alcohol overuse, smoking and impaired nutritional status may also result in deficient wound healing. Growing evidence suggests that reactive oxygen species(ROS) are crucial regulators of several phases of wound healing. In recent years, ROS has gained attention because of their central role to the progression of many inflammatory diseases.¹ Excessive production of ROS or impaired ROS detoxification causes oxidative damage, which has been shown to be a main cause of non-healing chronic wounds and tissue degeneration.^{2, 3}

In simple terms, ROS are oxygen free radicals and other non-radical oxygen derivatives involved in tissue degradation.⁴ They are produced during normal cellular metabolism by cells in most tissues. To combat oxidative stress, all cells in the body are equipped with an intrinsic store of molecules known as “antioxidants” which prevents tissue damage.⁵ When this balance is shifted however, high levels and activity of ROS causes DNA damage, protein damage, and lipid peroxidation. This in term leads to impaired wound healing and many long-term chronic degenerative diseases and whole body tissue inflammation, are linked to common diseases such as dementia and various cancers.

Unfortunately a large percentage of the population today suffers from vitamin and mineral deficiencies which help increase antioxidant levels. In particular, absorption of vitamins and minerals is decreased with poor diet, aging, diabetics, those treated with immunosuppressive drugs, as well as chemo- or radiotherapy. Furthermore, alcohol consumption,⁶ smoking⁷ and hypertension⁸ are all associated with higher rates of vitamin deficiencies and/or oxidative stress and its associated with oral health diseases such as periodontitis.

Supplementation with low molecular weight antioxidants and ROS-detoxifying enzymes has become vital for many individuals with deficiencies.⁹ There are 2 categories of antioxidants including 1) enzymatic antioxidants such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase/reductase, DNA repair enzymes, and various metal ion sequestrators. Secondly, scavenging antioxidants or chain breaking antioxidants such as ascorbic acid (vitamin C), carotenoids (including retinol-vitamin A), uric acid, a-tocopherol (vitamin E), coenzyme Q, and polyphenols (flavenoids) are all potent antioxidants commonly associated with improved wound healing.

An effort toward the maintenance of optimal levels of the aforementioned antioxidants, as well as the overall desire for patients to improve general health, additional supplementation with vitamins and minerals to treat nutritional deficiencies have become routine in modern culture.