DAT 123 Nutrition & Oral Health: Eating Well for a Healthy Mouth Dentalcare.com PDF

Recognize specific nutrient requirements during the human lifecycle. adults

30 - 40 year olds may begin to feel effects of reduced basal metabolic rate (BMR): weight gain & bone resorption puts adults at risk for more serious health problems later in life More at risk for root caries which is often associated with development of dry mouth & use of hard candies/mints to increase salivary flow Goal of nutrition in adulthood: health promotion Maintain oral tissue & supporting structures, immune support, physical activity, follow Dietary Guidelines for Americans

Vitamin C:

Aka: ascorbic acid Function: necessary for clotting & collagen formation, antioxidant, aids with calcium & iron absorption Sources: citrus fruits, kiwi, strawberries, cruciferous vegetables, tomatoes, leafy greens Deficiency: scurvy, anemia, capillary fragility, easy bruising & slow healing, bleeding tissue

Vitamin A:

Aka: beta carotene Function: protects from infections; keeps skin, oral tissues, stomach & intestines healthy; antioxidant Sources: yellow/orange vegetables & fruits, dairy products Deficiency: atrophy of oral mucosa, xerostomia, oral leukoplakia, night blindness

Vitamin B12:

Aka: cobalamine Function: works with folate to make RBC's; needs intrinsic factor from stomach for absorption Sources: animal products exclusively (vegans must supplement) Deficiency: pernicious anemia

Folate:

Aka: folic acid Function: manufacture RBC's, may protect against heart disease Sources: liver, green leafy vegetables, fruits Deficiency: megaloblastic anemia, spina bifida

Vitamin B3:

Aka: niacin Function: helps body use sugars & fatty acids; can be synthesize in body from tryptophan Sources: animal products, grains, green leafy vegetables Deficiency: Pellegra (dermatitis, diarrhea, dementia)

Vitamin B6:

Aka: pyridoxine Function: metabolism of carbohydrates, fats & proteins; formation of blood cells Sources: animal products, fish, fruits & vegetables Deficiency: microcytic anemia; depressed immunity, irritability, glossitis

Vitamin B2:

Aka: riboflavin Function: helps produce energy within your cells Sources: milk products, meat, poultry, fish, whole grains Deficiency: Arboflavinosis (angular cheilosis, glossitis)

Vitamin B1:

Aka: thiamin or thiamine Function: helps produce energy from carbohydrates Sources: meats, organ products, grains, yeast Deficiency: Beriberi (loss of appetite, muscle weakness, burning tongue

Vitamin E:

Aka: tocopherol Function: antioxidant; protects RBC's Sources: vegetable oils, leafy greens, nuts & seeds Deficiency: anemia (breakdown of RBC)

Identify the function of vitamins, minerals, and antioxidants and symptoms of excesses or deficits.

Antioxidants Protectors from damaging free radicals Incorporate more colorful fruits & vegetables, especially purple, red, orange & yellow Includes beta-carotene, Vit. C & Vit. E (3 superstar antioxidants)

Infants & Toddlers:

Breast milk or formula provide necessary nourishment during first 6 months of development Gradual introduction of solid food generally occurs around 6 months of age Children should be off the bottle or breast by age 1 Offer healthy snack options & limit fast foods Prevent early childhood caries by cleaning teeth with gauze/toothbrush after meals; drink water instead of juice or mild before naps & bedtime Calcium, phosphorus & vitamin D are essential for calcification of permanent crowns

Iron (Fe):

Function: 20% stored in bone marrow; carries oxygen to cells; absorption aided by Vit. C Sources: Heme iron; meat, fish, poultry; non-heme iron: plants & legumes Deficiency: anemia, decreased immunity; angular cheilosis, pallor of lips/mucosa, glossitis, candidiasis, dysphagia

Potassium (K):

Function: 2nd most abundant mineral; acid-base balance, sodium potassium pump, water balance Sources: bananas, potatoes, yams, dried fruits, legumes, meat, dairy Deficiency: nausea, vomiting, muscle cramps, heart arrhythmia, cardiac arrest

Magnesium (Mg):

Function: 60% in bones & teeth; responsible for homeostasis Sources: green leafy vegetables, nuts, whole grains Deficiency: muscle tremors, convulsions, gingival hypertrophy

Phosphorus (P):

Function: 80-90% in bones & teeth; favors Vit. D absorption; formation of bone & teeth, acid-balance Sources: dairy products, poultry, whole grains, nuts, legumes Deficiency: demineralization of bone, calcium loss, incomplete calcification of teeth; susceptibility to dental caries, periodontal disease

Zinc (Zn):

Function: Normal growth & development, taste & smell receptors Sources: non-heme iron: plants; protein rich foods Deficiency: loss of taste & smell, delayed wound healing, xerostomia, increased candidiasis, periodontal disease & caries

Vitamin D:

Function: aids in absorption of calcium, phosphorus & deposition of these minerals in bones & teeth; made by body from cholesterol in skin & ultraviolet light Sources: sunlight, cod liver oil, fortified dairy products Deficiency: Adults: osteomalacia; kids: rickets; delayed dentition, enamel hypocalcification

Calcium (Ca):

Function: most abundant mineral in body; 99% stored in teeth & bones; responsible for muscle contraction, nerve transmission, requires Vit. D for absorption Sources: dairy products, broccoli, dark leafy green vegetables, fortified orange juice & soy milk Deficiency: osteopenia/osteoporosis, rickets, incomplete calcification of teeth, susceptible to dental caries, increased tooth mobility, convulsions

Fluorine (F):

Function: stored in bones & teeth Sources: fluoridated water, tea, seafood Deficiency: decreased resistance to dental caries

Vitamin K:

Function: used in prothrombin formation for clotting; absorption inhibited by excessive Vitamin E Sources: intestinal microflora, leafy greens, liver Deficiency: hemolytic anemia; failure of wounds to stop bleeding

Sodium (Na):

Function: works with chloride & potassium; water balance, acid-base balance; nerve function Sources: table salt, soups, cured meats, processed foods Deficiency: muscle cramping, mental apathy

Chloride (Cl):

Function: works with sodium; regulated acid-base, water balance & digestion (hydrochloric acid) Sources: table salt, eggs, fish, meat Deficiency: muscle cramping, digestive problems, mental apathy

Recognize specific nutrient requirements during the human lifecycle. Eldery

Good nutrition important to keep body free from disease & keep the dentition intact Xerostomia, dysphagia, tooth loss & economics may pose dietary restrictions Incorporate fiber rich foods for GI health, decrease fat intake for weight control, supplement with senior multivitamin for osteoporosis prevention & maintain hydration Older adults who exercise regularly have reduced risk of chronic disease & can improve quality of life

Guide the patient to clarify and understand his or her own diet-dental relationship.

Have patient keep food diary for 3 - 7 days Return for dietary counseling to reduce oral risks from diet & promote good nutrition for health Keep diet changes simple (1 - 2 goals to practice between dental appointments) Be aware of patient's cultural influence, education, current health status & financial restrictions that may inhibit food selection

Recognize specific nutrient requirements during the human lifecycle. Pregnancy

Most serious damage to oral structures from exposure to toxins & nutritional deficiencies occur beginning at 6 - 9 weeks gestation Before conception: prenatal vitamin with 400 mcg folic acid & folate rich foods (cleft lip & palate most common birth defects-related to severe folic acid deficiency during pregnancy) Additional 300 calories per day from 4th month of pregnancy to delivery Additional protein (fetal tissue development), calcium, phosphorus, & vitamin D (bone remineralization & calcification of deciduous teeth) & 25% fluid intake (maternal blood volume) Avoid raw eggs, meat, soft cheese & unpasteurized juice that could cause food-borne illness & harm baby Avoid stimulants (caffeine, alcohol, tobacco) & medications (Rx, OTC) that can pass through placental barrier & affect growth & development

School-age children

Need frequent meals to maintain healthy blood glucose levels for optimum academic performance Eating takes on social, psychological & emotional implications & children develop lifelong relationship with food Involve children in meal preparation & never use food as a reward or punishment to teach healthy eating strategies Calcium, phosphorus & vitamin D requirements increase due to growth spurts in long bones Primary teeth are exfoliating & permanent teeth are erupting; Place sealants on first permanent molars to prevent caries

Fats

No more than 30% of calories/day should come from fat Trans fat: silent killer because it damages arteries & raises cholesterol levels 2 essential fatty acids body is unable to make so we must get from foods in our diet Omega-3 & Omega-6 (fish, nuts, oils, olives & avocado) Total cholesterol should be below 200 HDL should be 50-75 mg/dl; LDL should be below 130 mg/dl Help coat tooth surface when consumed in a meal; protects teeth from sugars

Recognize specific nutrient requirements during the human lifecycle Teenagers:.

Often have worst diets & most difficult age to counsel Appeal to body image & encourage healthy snacks (nuts, popcorn, cereal, cheese, fruit) Use visual aids about negative effects of soda & energy drink consumption on tooth & bone health) Advise drinking flavored sparkling & fitness waters, 100% fruit juice & low-fat milk Peer pressure, weight control, rapid growth, hormones & stress challenge the body & mind both psychologically & physically Look for signs of eating disorders Females: reached maximum linear growth & begin increasing percentage of body fat Males: still building muscle & bone mass so caloric intake needs to be higher

Proteins

Requirements vary between 40-65 g/day depending on physical activity, stress & growth cycles Excess is stored in the body as fat Help coat tooth surface when consumed in a meal; protects teeth from sugars

Carbohydrates:

Simple sugars/refined carbs, complex carbs, dietary fiber Fermentable carbohydrates are part of the dental caries equation Susceptible tooth, cariogenic bacteria in dental plaque (streptococcus mutans & lactobacilllus) & a fermentable carbohydrate

Pantothenic acid:

Sources: animal foods, whole-grain cereal, digestive tract Deficiency: N/A

Selenium

Sources: animal products Deficiency: N/A

Biotin:

Sources: egg yolk, liver, cereals Deficiency: pallor of tongue, atrophy of lingual papillae

Copper:

Sources: shellfish, liver, nuts, legumes Deficiency: osteoporosis, arthritis, lesions within connective tissue

Manganese

Sources: whole grains, legumes, nuts, tea, leafy greens Deficiency: growth retardation, congenital malformations, poor reproduction

Fermentable carbohydrate:

carbohydrates that can be broken down into acid by the plaque in the mouth

Cariostatic:

caries-inhibiting

Anticariogenic:

food that contributes favorably to dental health by discouraging acid production

Cariogenic:

fermentable carbohydrate that causes a reduction of salivary & plaque pH to less than 5.5, thus promoting tooth decalcification

Dysphagia:

difficulty swallowing

Remineralization:

process in which minerals are returned to the molecular structure of the tooth itself

Demineralization:

removal or loss of calcium, phosphate & other minerals from tooth enamel

Xylitol:

sugar alcohol which has the ability to reduce streptococcus mutans in the mouth