Nutrition Final: Review Ch. 17,19,6, 9,10, 11,Test 1 Biochemistry

T/F If partially hydrogenated oil is the first ingredient on the label, the trans fatty acid content will be lower than if the first ingredient listed is vegetable oil

False

T/F Vitamin B12 shots are a necessary treatment for pernicious anemia.

False

Which are inorganic nutrients?

Minerals and water.

Long-term use of prescribed drugs may cause malabsorption of fat-soluble vitamins & folic acid.

Patients may be taking anticoagulants Increase risk of bleeding

Which BEST explains the process of hydrolysis?

Splitting of large molecule into smaller water-soluble ones.

Oxidation can be defined as a gain of electrons, or an increase in charge. Reduction can be defined as a gain of electrons or a decrease in charge.

The first statement is false; the second statement is true.

An enzymatic deficiency in the gastrointestinal tract results in some nutrients not being digested. Even if the nutrients are not digested, their absorption is assured.

The first statement is true; the second statement is false.

Foods that provide substantial amounts of vitamins and minerals, but relatively few kilocalories are called

nutrient-dense.

What is the primary initiating agent for periodontal disease?

plaque biofilm accumulation around the teeth

T/F An imbalance of more than one nutrient is required to affect a person's immune response.

True

T/F Cholesterol has important functions as a constituent of the brain and nervous tissue.

True

T/F Even though cheese is recommended for consumption after eating carbohydrates to restore oral pH to neutral, it is not recommended for all people due to its high fat content.

True

T/F Fats with a high proportion of unsaturated fatty acids may become rancid, resulting in unpleasant flavors or odors.

True

T/F Fermentable carbohydrates enhance plaque biofilm formation by providing substrates for bacterial growth and biofilm maturation.

True

T/F Generally, minor periodontal surgical procedures on a healthy patient with an adequate dietary intake does not require special dietary modifications.

True

T/F Increased nutrients and energy are required by periodontal patients experiencing infection.

True

T/F Indirectly, nutritional status may alter development, resistance, or repair of the periodontium.

True

T/F Initiation and progression of periodontitis do not occur unless plaque biofilm and calculus are present.

True

T/F Oral lesions can be a reflection of a disease elsewhere

True

T/F Oral lesions can develop as a result of treatments designed to cure diseases.

True

T/F Protein, Vitamin C or B complex deficiencies are contributing factors to NUG because of lowered host resistance.

True

T/F Surgery on a chronic alcoholic or a patient with an eating disorder could require preoperative replenishment of nutrient reserves.

True

T/F The extent and severity of the periodontal disease is affected, indirectly, by nutrient deficiencies.

True

T/F The inflammatory process of gingivitis and periodontal disease is affected by the host's immune response.

True

T/F The primary form of fat in the body is triglyceride, not cholesterol

True

T/F The relatively small amounts of trans fatty acids that occur naturally in meat and dairy products do not appear to be harmful

True

T/F Vitamin B12 should be taken with vitamin C-rich foods to enhance absorption.

True

The making of a disaccharide from two monosaccharides is an example of

condensation.

T/F Patients with hyperparathyroidism may exhibit extensive alveolar bone resorption.

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T/F Physical inactivity results in bone depletion.

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T/F Riboflavin is known to be toxic.

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T/F Studies have found no association between fluoride supplementation and cancer in humans.

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T/F Supplemental phosphate may be helpful in preventing dental caries.

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T/F The ultratrace mineral, arsenic, may be physiologically essential.

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T/F Vitamin deficiencies occur in isolation.

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T/F Weight-bearing exercise has a positive effect on calcium deposition in bone.

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Test 1 Biochemistry

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Vitamin B12 is important! You will see it again in Oral Pathology, Pharmacology, etc.

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What are trace minerals?

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What is one of the first signs of vitamin C deficiency?

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What role does magnesium play in the body?

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What should the dental hygienist do if a patient reports an adverse reaction to a prescribed osteoporosis-related therapy?

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When considering the elements that make up lipids, how are lipids like carbohydrates? How do lipids differ from carbohydrates?

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Which dietary supplement can cause flushing (redness) of the skin?

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Which populations are more likely to develop a phosphorus deficiency?

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Which type of diet provides the most dietary magnesium?

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Which vitamin deficiencies are associated with parotid gland enlargement? (and yes, you will see this again in oral pathology!)

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Your nutrition final is not a pathology final. Specific pathologies will be discussed in Fall 2016.

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Hyperlipidemia:

Recommend noncariogenic snacks relatively low in fat; Low-fat or nonfat cheese or skim milk

Which are disaccharides?

sucrose, maltose, lactose

Describe oral conditions that may be present in a child is born with or develops hypothyroidism at a young age. How do these oral conditions affect nutritional/dietary directions? Dental considerations?

(Poor muscle tone > macroglossia tongue > tendency to choke Delayed eruption of teeth > severe malocclusion > makes eating/chewing difficult; hinders proper oral hygiene > increased risk of dental caries/periodontal disease)

The different types of anemia are important to know. Make a study-table comparing iron-deficiency anemia and megaloblastic (pernicious) anemia. Include: typical physical symptoms, oral changes, cause of, treatment for, examples of dietary suggestions/interventions.

*Iron-Deficiency Anemia- caused by a deficiency of dietary iron or by excessive bleeding. Likely to occur during infancy or pregnancy. Lethargy and fatigue in addition to glossitis, apthous ulcers, and xerostomia associated with iron-deficiency anemia can lead to changes in appetite and food intake. Clinical symptoms in the oral cavity include gingival and mucosal pallor, angular cheilosis, and atrophic glossitis. Iron supplements help symptoms to resolve in 48 hours, and filiform papillae regenerate in 3 to 4 weeks. *Megaloblastic (Pernicious) Anemia occurs when Vitamin B12 is deficient in the diet, absorption is inadequate, or requirements are incrust. Vitamin B12 deficiency is most common among vegans who consume no animal products. Symptoms include: angular cheilosis, recurrent pathos ulcers, erythematous mucositis, and pale or yellowish oral mucosa. Patients may also complain of a painful, sore, burning tongue with signs of atrophic glossitis associated with a beefy red color. Replacement therapy with vitamin B12 supplements or injections relieves symptoms within 36 to 48 hours with evidence of regeneration of tongue papillae within 4 to 7 days, and the tongue may be normal in 3 to 4 weeks. *Another type of megablastic anemia, caused by folic acid deficiency is frequently associated with poor diets or medications that interfere with folate absorption or metabolism. Oral manifestations are similar to symptoms present in pernicious anemia: glossitis, atrophy of the papillae, ulcerations, and glossodynia (pain of the tongue). Folate replacement is necessary because diet alone is inadequate to replace lost stores.

T/F Patients who use excessive alcohol or caffeine, or smoke cigarettes, are at risk of calcium loss.

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When counseling a patient who presents with periodontal disease, what nutritional directions should you provide?

-encourage nutrient-dense foods that are not retentive. Soft foods are followed by appropriate oral hygiene. -Encourage vitamin C-rich foods and a well-balanced diet using MyPlate as a guide.

For the patient who has undergone periodontal surgery, what dental interventions should occur?

-oral prophylaxis to debride and deplaque teeth to eliminate or suppress infectious microorganisms. -recommend an antimicrobial -encourage appropriate techniques for optimal self-care. -provide smoking cessation counseling, if needed -control of systemic disease, such as diabetes -identify and recommend modification of open margins, overhangs, inadequate restorations. -recommend or provide fluoride therapy for desensitization, if needed.

Ch. 10 Study guide

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Ch. 11 Study guide

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Ch. 9 study guide

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Chapter 19 Study Guide

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Describe oral conditions that may be present in an adult who presents with developmental disabilities. How do these oral conditions affect nutritional/dietary directions? Dental considerations?

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Describe oral conditions that may be present in an adult who presents with epilepsy. How do these oral conditions affect nutritional/dietary directions? Dental considerations?

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Discuss the role of water fluoridation in the prevention of dental caries.

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Explain to a patient who is a vegan, why vitamin B12 is important.

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For your National Boards, know diabetes mellitus forward, backward, & up-side down! Dental considerations, Interventions, Nutritional Directions.

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How do oral conditions associated with Parkinson disease affect nutritional/dietary directions? Dental considerations?

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How do oral conditions associated with renal disease affect nutritional/dietary directions? Dental considerations?

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In order to provide maximum benefits, at which time of development is systemic fluoride most important or most effective?

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Know dental considerations, assessment, interventions, evaluations, and nutritional directions for the patient experiencing anorexia nervosa and bulimia nervosa.

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Know dental considerations, assessment, interventions, evaluations, and nutritional directions for the patient undergoing cancer treatments.

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List the minerals found in collagen, bones, and teeth.

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Name 2 interventions/recommendations that serve to prevent further bone loss.

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Name 4 actions to take in order to maintain your brain.

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Name some fat-soluble vitamins.

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Name some foods that are considered a good source of dietary riboflavin.

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Name some foods that are good sources of vitamin B12.

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Name some known risk factors for developing Alzheimer disease.

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Name some water-soluble vitamins.

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Neoplasia: What role do physiological factors play in nutritional/dietary directions? Dental considerations?

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On page 183 of your text, it mentions molybdenum. In what other course have your discussed molybdenum?

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Read Buyer Beware! Your patients will bring this information to you, wanting you to praise them for their efforts. How will you handle a patient who is singing the praises of a testimonial/endorsement that all the celebrities are supporting? Just food for thought.

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Review and know the answers to the Test Your NQ.

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T/F After menopause, calcium and vitamin D supplements slow bone loss and reduce fractures.

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T/F An excessive consumption of soft drinks in place of milk can interrupt the calcium-to-phosphorus ratio.

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T/F Congenital facial abnormalities may occur if the mother is deficient in riboflavin at the time of conception. (I do not believe that this fact was discussed in our woman, pregnancy chapters.)

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T/F Enriched products provide more riboflavin than their whole-grain counterparts. (I didn't know this!)

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T/F Excessive manganese can produce iron-deficiency anemia.

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T/F High levels of calcium can interfere with the absorption of fluoride.

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T/F Low phosphate intake may lead to an increased rate of caries formation.

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T/F More than 500 mg of calcium per tablet may cause constipation.

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T/F Patients should be advised to take high doses of riboflavin.

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What are 2 advantages of partial hydrogenation?

1. Longer shelf life 2.flavors are stable

Identify the 2 targets for Healthy People 2020.

1. to reduce the prevalence of moderate or severe periodontitis from nearly 13% to 11% in people ages 45-74 years 2. to reduce the prevalence of tooth loss from periodontal involvement

How many kcal/g does lipids supply?

9

What is hydrogenation?

A commercial process in which vegetable oil is converted to a solid margarine or shortening by adding hydrogen to the oil.

Describe a full liquid diet.

A full liquid diet provides food in a liquid form for patients who are unable to chew. It should consist of high-protein, high-kilocalorie fluids and semi-solid foods to promote optimal healing. A full liquid diet is used only temporarily because nutrient and caloric value is usually inadequate.

Describe a mechanically altered diet.

A mechanically altered diet is a regular diet altered in consistency and texture for ease in mastication when chewing may be compromised. The diet includes soft, ripened, chopped, ground, mashed, and pureed foods. Foods are generally moist. This diet is recommended for 3-7 days until the patient can tolerate regular foods.

Name factors that influence the properties of plaque biofilm and saliva.

A patients health, medications, and food choices influence the properties of plaque biofilm and saliva. The buffering and antimicrobial effects of saliva are significant factors in periodontal disease. A change in composition or amount of saliva can influence development and maturation of plaque biofilm.

Define trans fatty acid

An unsaturated fatty acid of a type occurring in margarines and manufactured cooking oils as a result of the hydrogenation process, having a trans arrangement of the hydrogen atoms so that they are on opposite sides of the bond.

How can the nutritional directions for a patient with GI problems affect dental health and/or dental treatment?

Anticholinergic medications prescribed for gastroesophageal reflux disease may interfere with absorption of vitamin B12 and folic acid. These medications may also cause xerostomia.

Which recommendation is consistent with the Dietary Guidelines for Americans?

Balance the food you eat with physical activity.

Name some common food sources of saturated fatty acids

Beef, chicken, cheese, milk

Name some common food sources of monounsaturated fatty acids.

Beef, pork, salmon, and avocados.

What are bisphosphonates? What is the growing concern for patients receiving bisphosphonates?

Bisphosphonates are medications primarily prescribed for postmenopausal and glucocorticoid-induced osteoporosis, multiple myeloma, and intravenous use is sometimes prescribed during chemotherapy for cancer. A growing concern for patients receiving bisphosphonates is the risk for osteonecrosis (bone death of the jaw) after invasive dental procedures.

When a monosaccharide is reduced, it is changed to a sugar alcohol because it has undergone an oxidation-reduction reaction.

Both the statement and the reason are correct and related.

Which are energy-yielding nutrients?

Carbohydrates, fats, and proteins.

How does the consistency of food affect periodontal health?

Chewing firm, coarse, and fibrous foods, such as raw fruits and vegetables, stimulates salivary flow. Plaque biofilm is not physically removed by eating firm foods, however, soft, sticky foods increase accumulation of foods, which enhances dental biofilm growth.

People choose their food patterns based on all factors EXCEPT one. Which one is the EXCEPTION? A. Habits. B. Availability. C. Ethnic heritage. D. Nutritional value. E. Regional cuisines.

D. Nutritional value

Which is the correct order for ingredients listed on food labels?

Descending order of predominance by weight.

Glucose is also known as

Dextrose

Which directive was written for health people with the purpose of helping to reduce the risk of development of chronic diseases?

Dietary Guidelines for Americans.

What is the difference between "causing" and "predisposing" gingival inflammation?

Ex: a lack of nutrients does not CAUSE gingival inflammation but may be a PREDISPOSING factor by disrupting the process of tissue repair. Bacteria or infection due to bacteria is the cause of inflammation.

T/F A lack of nutrients causes gingival inflammation.

False. A lack of nutrients does NOT cause gingival inflammation, but may be a predisposing factor by disrupting the process of tissue repair.

T/F The role of nutrition in periodontal disease is clearly defined.

False. It is not clearly defined.

T/F Neutropenia refers to a smaller size of white blood cells.

False. It refers to a low number of white blood cells (neutrophils)

T/F Gingivitis is the leading reason for tooth loss for individuals older than age 45 years.

False. Periodontal disease

T/F Plaque biofilm is physically removed by eating firm foods.

False. Plaque biofilm is NOT physically removed by eating firm foods.

T/F Subgingival plaque biofilm adhesion and formation is influenced by frequent dietary consumption of glucose

False. Supragingival plaque biofilm

T/F Nutritional deficiencies, which may occur in adolescence, do not modify the body's response to periodontal disease.

False. They can modify

T/F Megadoses of vitamin-mineral supplements are used to cure or prevent periodontal disease.

False. They do not cure or prevent periodontal disease.

T/F Nutritional deficiencies initiate periodontal disease.

False. They do not initiate periodontal disease

What is satiety?

Feeling of fullness

All organs secrete digestive juices EXCEPT one. Which one is the EXCEPTION?

Gallbladder.

Which is the storage form of glucose in the body?

Glycogen.

What instructions should the dental hygienist provide to the patient after periodontal surgery?

Instruct the patient avoid hard, sticky, and brittle foods, and to follow the guidelines for a mechanically altered diet for 1-2 days. Also, encourage cool liquids and foods for the first 24 hours to allow the periodontal dressing to harden and prevent swelling. Discourage smoking and the use of straws because sucking pressure could dislodge a blood clot.

Which conditions or problems are associated with delayed wound healing?

Iron deficiency, Plummer-Vinson, Malabsorptive conditions, diabetes mellitus, diminished kidney function

Fat fragments combine to form which entity when there is insufficient glucose in metabolism?

Ketone bodies.

What is the principal oral problem associated with hypopituitarism? (decreased skeletal growth)

Malocclusion

Name some frequently occurring oral complications associated with neutropenia.

Mucositis and viral and fungal infections (candidiasis)

Identify some conditions associated with neutropenia. Should dental hygiene treatment be performed when a patient is experiencing an episode of neutropenia?

Neutropenia results from dysfunctional bone marrow: cancer (leukemia), drugs (chemotherapeutic agents or antibiotics), radiation therapy, autoimmune disease (rheumatoid arthritis or systemic lupus erythematosus), bone marrow transplant, nutritional deficiencies (severe vitamin B12 or folate deficiency), or certain bacterial or viral infections (HIV, malaria, tuberculosis, or Epstein-Barr virus). When neutropenia is present, invasive dental treatment is usually contraindicated until WBC counts increase. If treatment is indicated, a consultation with the healthcare provider is necessary to determine if antibiotic prophylaxis is needed.

What is palatability?

Pleasing to the "palate", or taste, due to texture.

Which is the major reason to maintain a healthy weight?

Reduce likelihood of developing chronic disease.

Successful weight loss depends on which factor?

Reducing energy intake and increasing physical activity.

Name some common food sources of polyunsaturated fatty acids

Salad dressing, nuts and seeds

Which conditions or problems are associated with xerostomia?

Sjogren disease and therapies (radiation)

Before surgery, what considerations should the dental hygienist consider before making dietary suggestions?

The hygienist should consider the extent of surgery, its potential discomfort, and the patient's ability to eat after the periodontal procedure, and encourage the patient to make food choices that avoid tissue trauma.The patients food preferences and dislikes are other factors to be taken into consideration.

All disease processes result from a combination of which factors?

The presence of an etiologic agent (plaque biofilm), the susceptibility or resistance of the host (or activation of immune response), and environmental factors. One of the most important factors in one's ability to combat hostile agents is availability of nutrients acquired from food.

Enzymes catalyze all biochemical reactions because they are nonprotein organic substances that assist in converting a substrate into a product.

The statement is correct, but the reason is NOT.

Define fatty acid

The structural component of lipids

What is the definition of anorexia? Name some reasons that a person may experience anorexia.

The term anorexia nervosa refers to a disease associated with a distorted body image, but anorexia may also refer to a condition in which a patient has a poor appetite for a variety of reasons including: cancer treatment, pain, apathy, anorexia, drugs, inactivity, or many other reasons.

Name some oral problems associated with diabetes mellitus.

Type 2 diabetes and risk of periodontitis are correlated. Periodontal disease, neuropathy or nephropathy are also considered long-term complications associated with diabetes.

Which are essential nutrients required in the diet because they cannot be synthesized by the organism itself?

Vitamins.

Which group of medications can be negatively affected by large doses of folate?

anticonvulsants

Which 3 groups of medications are associated with xerostomia?

antidepressants, antihistamines, antihypersensitives, diuretics, and gastrointestinal drugs. More than one-third of older adults experience xerostomia primarily as a result of anticholinergic medications.

The semiliquid, partially digested food that travels through the intestinal tract is called

chyme

A person who chooses a chicken leg that provides 0.5 milligram of iron and 95 kcalories instead of 2 tablespoons of peanut butter that also provides 0.5 milligram of ion but 188 kcalories is using the principle of nutrient

density

Food labels list ingredients in

descending order of predominance by weight.

What is the principal oral problem associated with Cushing syndrome? (weakness in muscles of mastication & the tongue)

diabetes and associated bone loss?

What is the dental hygienists' purpose for providing dietary education to all periodontal patients?

dietary education of all periodontal patients by the dental hygienist facilitates tissue repair and wound healing, improves resistance to infection, and reduces the number and severity of complications. Optimally, good nutritional status results in a shorter recovery and more rapid return to health.

Name some foods that a patient with acid reflux should avoid.

fatty foods (gravy, pastries, chocolate, fatty meats, cheese, nuts, chips, salad dressing, and mayonnaise), peppermint, caffeinated foods (coffee, tea, chocolate, and some carbonated beverages), alcohol, and onions. Other foods to avoid are those directly irritating to the esophagus, such as citrus juices, tomato products, and red peppers.

Which nutrient passes through the GI tract mostly undigested and unabsorbed?

fiber

Sucrose is hydrolyzed into

glucose and fructose.

When people eat the foods typical of their families or geographic region, their choices are influenced by

heritage or tradition.

What factors do periodontal disease-causing-bacteria affect?

increase the risk of cardiovascular disease, stroke, premature births, respiratory infections, and uncontrolled diabetes.

Which enzyme breaks a disaccharide into glucose and galactose?

lactase

Absorption occurs primarily in the

small intestine

Which type of food can enhance food retention and affect severity of gingival inflammation?

soft, retentive, or fermentable carbohydrates. In addition to retentive carbohydrates, excess glucose and sucrose have been shown to increase rate of bacterial growth in the early stages of biofilm development.

After a patient has undergone periodontal surgery, why is the use of straws discouraged?

sucking pressure could dislodge a blood clot.

Disaccharides include

sucrose, maltose, and lactose.

If periodontal surgery is indicated, what is important for optimal healing and preventing or minimizing infections?

the body's immunological competency is important for optimal healing and preventing or minimizing infections.

Do know these nutritional considerations/directions when counseling a patient who has a malabsorptive condition: Diarrhea & malabsorption create deficiencies of nutrients. Nutritional considerations:

• Diet high in kilocalories & protein • Limited fat & fiber • Possible lactose or gluten restriction • Small, frequent feedings are better tolerated & increase adequacy of intake • Extremely hot & cold foods, & high-fiber foods are avoided due to increase peristalsis