Nutrition and oral health

NUTRITION AND DENTAL HEALTH PRESENTED BY

SUJANA ADHIKARIROLL NO :4BDS 1ST BATCH

CONTENTS INTRODUCTION CLASSIFICATION OF FOOD NUTRIENTS CARBOHYDRATES PROTEINS FATS VITAMINS AND MINERALS BALANCED DIET EFFECTS OF NUTRITION ON ORAL TISSUES: NUTRITION AND DENTAL CARIES. EFFECTS OF MALNUTRITION ON MALOCCLUSION. NUTRITION AND PERIODONTAL DISEASES. NUTRITION AND ORAL CANCER. NUTRITION IN CHILDRENS NUTRITION IN ADULTS PREVENTION AND SOCIAL MEASURES CONCLUSION REFERENCE

INTRODUCTION

NUTRITION : The sum of processes concerned in the growth maintenance and repair of living body as a whole or its constituents parts

DIET: Is defined as the types and amount of food

eaten daily by an individual.

FOOD : Any substance which when undertaken into the body of an organ may be used either to supply energy or to build a tissue

MALNUTRITION: A pathological state

resulting from a relative or absolute deficiency or excess of one or more essential nutrients.

CLASSIFICATION OF FOOD:BY ORIGIN: -Foods of animal origin. -Foods of vegetables origin.

BY CHEMICAL COMPOSITION: -Proteins, fats, carbohydrates, vitamins.

BY PREDOMINANT FUNCTION: -Body building food:-milk, meat. -Energy giving food:-cereals, sugars. -Protective food:-vegetables, fruits.

BY NUTRITIVE VALUE: -Cereals, pulses, nuts.

NUTRIENTS:

Are organic and inorganic complexes contained in food.

MACRONUTRIENTS

• Protein, fat ,carbohydrate

MICRONUTRIENTS

• Vitamins, minerals

CARBOHYDRATES:

Third major component of food. 3- main sources are:- STARCH, SUGAR AND CELLULOSE.

SOURCES: Cereals, fruits and vegetables in form

of cellulose and glucose as major source of energy.

FUNCTION:

1. Supply energy.2. Essential for oxidation of fats.3. Required for synthesis of certain non

essential amino-acids.

PROTEINS:

Are complex inorganic nitrogenous compound composed of Carbon, H2, N2, O2 and sulphur.

Proteins are composed of amino acid.1. Essential amino acids2. Non essential amino acids.

SOURCES:.

FUNCTION:

Body building. Repair and maintenance of body

tissues Maintenance of osmotic pressure. Synthesis of certain substances like-

Abs., plasma proteins, enzymes and coagulation factors.

FATS AND OIL:

Are concentrated source of energy. Classified as: 1.Simple lipid:- triglycerides. 2.Compound lipid:- phospholipids. 3.Derived lipid:- cholestrol.

FATTY- ACIDS:- Fats yeilds fatty acid and glycerol on

hydrolysis.

FUNCTIONS:

Energy foods. Serves as vehicles for fat soluble

vitamins. Supports viscera like heart, kidney. Provides insulation against cold.

SOURCES: Ghee , butter, cheese, meat, fish,

coconut, mustard.

VITAMINS: Is a substance which must be obtained

by dietary means Vitamins are divided into two groups: -Fat soluble:- vitamin A, E, D, K -Water soluble:-vitamin B and C.

VITAMIN-A:

Found in:-liver, eggs cheese, spinach, papaya.

FUNCTION: 1.Required for normal vision.2.Production of retinal pigment.3.Maintains the integrity and function of glandular and

epithelial tissues.4.Anti-infective. DAILY INTAKE:- 600 microgram for adults.Its deficiency causes:- night blindness, conjuntivis.In oral cavity : delayed healing

VITAMIN-D:

. Nutritionally important form:- Calceferol(vit.D2), Cholecalciferol(vit.D3).

Recently regarded as “kidney hormone”. Synthesize by action of UV- rays on 7-

dehydrocholestrol. SOURCES:-

FUNCTIONS:

Deficiency :In oral cavity : risk of jaw fracture, periodontal

diseases, affect formation of teeth

Daily intake:- 2.5 microgram(100IU)FOR ADULTS.

VITAMIN-E(

Alpha- tocoferol is biologically potent. SOURCES:- Vegetables oils, egg yolk, butter. DAILY INTAKE:- 0.8 mg/gm essential fatty acid.

SOURCES:- K1-- Green vegetables, cow’s milk. K2—synthesized by intestinal bacteria.

ROLE:-- Stimulate release of coagulation factors.DEFFICIENCY : excessive bleeding after tooth extraction

DAILY INTAKE:--0.03mg/kg for adults.

VITAMIN- B COMPLEX:

VITAMIN- B1:--Essential for utilization of carbohydrates.

SOURCES:-Whole grains, wheat, gram, groundnut.

DAILY INTAKE:-- 0.5mg/1000 k cal.ITS DEFICIENCY causes:--Beriberi and

Wernicke’s encephalopathy.

VITAMIN-B2(RIBOFLAVIN):

Fundamental role in cellular oxidation. SOURCES:--Milk, egg,liver, kidney, green vegetables. DAILY INTAKE:--0.6mg/1000kcal. DEFICIENCY:--Angular stomatitis, Glossitis.

VITAMIN-B6(PYRIDOXINE):

Exists in 3 forms: pyridoxine, pyridoxal, pyridoxamine.ROLE:-- Metabolism of amino acid, fat.DAILY INTAKE:--2 mgDEFICIENCY:--Peripheral neuritis.

VITAMIN-B7(NIACIN): Metabolism of carbohydrates, proteins,fats. SOURCES:--Legumes, groundnut, meat ,fish. Daily intake:--6.6mg/1000kcal. DEFICIENCY:-- FOLATE:-

Occurs in 2 form:- free folate and bound folate.ROLE:--In synthesis of nucleic acid, and normal

growth of bone marrow cells.

SOURCES:--Dairy products, egg , fruits. DAILY INTAKE:--100 microgm for adults. DEFICIENCY:--Megaloblastic anaemia, glossitis, cheilosis,

diarrhoea.

VITAMIN-B12:Complex organo-metallic compoud with cobalt atom.ROLE:-- synthesis of DNA.SOURCES:--Meat, fish, cheese.DEFICENCY:--Megaloblastic anaemia, neurological lesion, infertility.DAILY INTAKE:--1 microgm/day.

VITAMIN-C:

ASCORBIC ACID. Sensitive to heat..SOURCES:--DAILY INTAKE:--60mg.DEFICIENCY:--Bleeding gums, delayed wound healing, anaemia, weakness.

MINERALS:

Required for growth, repair, maintainence of body.Classified in 3- major groups:-

1.MAJOR:--Ca, Ph, Na, K, Mg. 2.TRACE:--Fe, F, Zn, Mg, Mb. 3.TRACE CONTAMINANTS WITH KNOWN FUNCTION:--Pb, Hg,Ba,

B, Al.

Defficiency : fluorosis dental caries Osteoporosis

CALCIUM:. SOURCES:--Milk products, eggs, fish. ROLE;--Formation of bones and teeth. Coagulation of blood. Contraction of muscles. DAILY INTAKE:-- 400-500 mg. Defficiency : osteoporosis hypocalcemia Bone weak Bone fracture

PHOSPHORUS

Essential for formation of bones and teeth

SOURCE:-- Foodstuffs. DAILY INTAKE:-- 400-700 gms

Defficiency : chron’s disease

IRON:

Formation of haemoglobin, brain development,regulation of body temperature, muscle metabolism and catecholamine metabolism.

DAILY INTAKE:--0.9mg. DEFICIENCY:--Iron deficiency anaemia. -impaired cell mediated immunity.

-reduced resistance to infection.

IODINE:

FUNCTION:-- For synthesis of thyroid hormones. For normal growth and development.DAILY INTAKE:--150 microgram.DEFICIENCY:--Goiter, hypothyroidism, dwarfism, retarded physical

and mental growth.

FLOURINE: Essential for normal mineralization of bones and formation of enamel.SOURCES:--Drinking water, sea fish, tea.DAILY INTAKE:--0.5-0.8mg/liter.DEFICIENCY:--Dental caries.EXCESS:--Dental and skeletal fluorosis.

Is one which contain variety of foods in such quantities and proportion that the need for energy, amino acids, vitamins, minerals, fats, carbohydrates and other nutrients is adequately met for maintaining health,vitality, and general well being and also makes a small provision for extra nutrients to withstand short duration of leanness.

It contains:--protein: 15-20% fat: 20-30% carbohydrates:remaining part.

FOOD PYRAMID:

EFFECT OF NUTRITION ON ORAL TISSUES:

1. NUTRITION AND DENTAL CARIES: Pre-eruptive phase:- Alteration in properties of enamel. Increased risk of dental caries. Enamel immaturation. Delayed eruption time. Altered tooth morphology. Enamel hypoplasia.

POST ERUPTIVE EFFECTS:

Decreased salivary lysozymes and secretory IgA level.

Increased susceptibilityof caries. Decreased level of salivary protein,

decreases host defense mechanism to cariogenic microganisms.

NUTRITION AND MALOCCLUSION:

Teeth undergo immature growth. Stunted jaw bone development leading

to retrognathic or prognathic jaw bones.

Chronic postnatal malnutrition may laeds to class 1 malocclusion.

Poor teeth alignment and crowding results in increased risk of caries and periodontal diseases.

NUTRITION AND PERIODONTAL DISEASES:

Malnutrition leads to episodic, progressive disruption of several tissues.

Nutritional imbalance leads to hamper epithelial barrier, attachment, pdl, gingiva, alveolar bone.

IRON:- deficiency causes impaired neutrophils bacterial activity, reduced lymphocyte proliferation altogether causes reduced thickness of oral epithelium.

PROTEIN deficiency in body causes incresed risk of periodontal problems.

VITAMIN-C: Strengthens tissues and determines morphology.

Its deficiency causes:- scurvy which can further laed to exfoliation of teeth and decreased salivary flow.

CALCIUM AND PHOSPHOROUS:- Deficiency causes alveolar bone loss.

Ca decreases gingival inflammation, pocket depth, tooth mobility.

VITAMIN-A:- Deficiency causes decreased salivary flow, hyperkeratosis, and gingival hyperplasia.

VITAMIN-B COMPLEX:- Its deficiency affects epitheliun of mouth and lips and predisposes gingiva to “vincent’s infection”.

VITAMIN-K:- Deficiency causes gingival bleeding and post- extraction haemorrhage.

VITAMIN-E:- Increases periodontal resistance to inflammatory mediated tissues.

NUTRITION AND ORAL CANCER:

Specific nutrients deficit may reduce the body’s defense mechanism against chemical carcinogens.

High protein diet increases the risk of cancer, due to high amount of saturated fats.

Malnutrition reduces body’s ability to counteract with neoplastic cells.

VITAMIN-A and RETINOIDS:- Inhibits chemically induced tumors.

NUTRITION IN CHILDREN

NUTRITION IN ADULTS

ANOREXIA

Food behaviour symptoms Dieting despite

being thin Obsession with fats

calories nutrition Pretending to eat Preoccupation with

food Strange food rituals

Appearance symptoms Dramatic weight loss Felling fat despite

being underweight Fixation on body

image Harsly critical of

appearane Denial that you are

thin

PREVENTION AND SOCIAL MEASURES: Nutritional problems can be ruled out

only by coordinated approach of: FAMILY LEVEL:- Throughout nutritional

education for selection of right kind of planned diet.

Promotion of breast feeding and improvement of child’s health.

Promote kitchen gardening.

AT COMMUNITY LEVEL:-

AT NATIONAL AND INTERNATIONAL LEVEL:-by rural developmnt and stabilizing population.

Increasing agricultural products and nutritional intervention programs.

WHO, FAO, UNICEF, UNDP, are some agencies helping national government.

CONCLUSION: Nutrition is vital to human

development, growth, and health maintenance. compared with other health care workers , dentist reach a larger number of general public per year and are in position to provide clinical and behavioural assesment , information, education, motivation and follow up.

REFERENCES:

TEXT BOOK OF PREVENTIVE AND SOCIAL MEDICINE. K. PARK(22ND-EDITION)

TEXT BOOK OF PREVENTIVE AND COMMUNITY DENTISTRY. SOBEN PETER. (4TH- EDITION)

TEXT BOOK OF PEDODONTICS 2nd editionSHOVA TANDON

TEXTBOOK OF MEDICAL BIOCHEMISTRY 8TH EDITIONMN CHATTERJEA