What is the recommended vitamin D intake per day?
5 micrograms/day for people 50 and below
10-15 micrograms/day for old people
What is the tolerable upper level intake of Vitamin C and Vitamin D?
Vitamin C - 2000mg/day
Vitamin D - 50 micrograms/day
What condition is a reliable predictor of protein malnutrition?
- checking for serum albumin
What levels of serum albumin would be considered a problem?
Less than 3.0 g/dL predicts mortality
Less than 3.5 g/dl suggests chronic PEM (protein energy malnutrition)
What are the two serum proteins tested for when doing a protein assessment?
Serum Transferrin - More Sensitive
What is the Nutritional Status?
A measurement of the extent to which physiological need for nutrients are being met
A Nutritional Assessment includes what tests?
A clinical observationPhysical Assessment
What test is considered to be one of the most sensitive markers of adequate nutritional status?
Whether or not the cells of the oral mucosa turn over every 3-7 days
Appropriate use of a Biochemiical/Lab assessment requires what?
○ Understanding of purpose
○ Awareness of normal values
○ Knowledge of conditions contributing to abnormal results
What things are tested in a biochemical test?
- Blood glucose
- Serum Folate
- Plasma pyridoxal 5-phosphate
What perameters are assessed when doing a Body Composition test?
What are the two other Protein assessment proteins?
What affect do you see on the immune system with malnutrition?
A decline in T cells and a decline in Thymic function
What is the role of the dentist in regards to nutrition?
- Screening with dietary assessment
- Is more in-depth assessment needed?
- Determining what available information is pertinent to dental patient treatment planning and care
Hypomineralized primary teeth can be caused by what?
Malnutrition during ANY part of pregnancy or even postnatally
What things ARE and ARE NOT associated with ECC?
-Carrying the bottle all day long
- Infant holding the bottle
- Napping and going to bed with the bottle
When is the best time to start introducing foods to your baby?
Between 4 and 6 months
-before or after this range results in a higher incidence of ECC
How much milk should a toddler and a preschooler eat?
Toddler = greater than 32 oz
Preschooler = 17-32 oz
What would be classified as Severe ECC?
○ any sign of smooth surface caries in children under 3 years of age
○ 1 or more cavitated, missing, or filled smooth surfaces in primary maxillary anterior teeth in children ages 3 and 5
As dentist, what do we want to educate the public about?
The association between the frequent consumption of carbohydrates and caries
What does the AAPD recommend?
○ That dentists provide dietary and nutritional counseling
○ People who make the food labels make the nutritional content on the label more prominent and consumer friendly
○ Health education programs in schools
○ Research, education and appropriate legislation to promote diverse and balanced diets
What is the 54321 rule for kids?
○ 5 servings of fruits and vegetables everyday
○ 4 servings of water
○ 3 servings of low-fat dairy
○ 2 hours or less of TV/Video games per day
1 hour or more of physical activity
How do you change an increase in gastric pH?
Increase intake of:
How do you change an increased level of homocysteine?
How do you change an increase in Oxidative stress?
Which two vitamins will be the most influential in not getting periodontitis and losing teeth?
Vitamin D and especially Calcium
These types of conditions are frequently associated with prosthetic dental appliances?
Digestion and GI conditions
What are the recommended amounts of the essential nutrients for people over 50?
○ Protein - 46-56 grams - 10-35%
○ CHO - greater than130 grams - 45-65%
○ FAT - - 20-35%
○ Fiber - 20-31 grams
What are the groups highest at risk for caries?
- Children with socioeconomic risk factors
- Older adults 55yrs or greater
- People that have Enamel Hypoplasia
Deficiencies in which vitamins during fetal development are associated with enamel hypoplasia?
Vitamins D and A
Also, Protein Energy Malnutrition (PEM)
What are some protective factors to caries?
○ Salivary proteins
○ Fluoride, calcium and phosphate
○ Dietary components
Which type of carbohydrates are bad for your teeth?
Fermentable Carbohydrates - leads to a steep drop in pH and an increase in the solubility of calcium hydroxyapatite (mineral disolves)
What is the critical pH when it starts to become bad for the teeth?
The next slide however says that a pH of less than 5.2 causes demineralization
What minerals in saliva help it to remineralize teeth?
It is super saturated with calcium and phosphate at a pH of 7
What mainly controls the rate of demineralization?
The concentration of hydrogen and fluoride ions at the tooth surface
What elements are put back into the tooth during remineralization?
- So fluoride replaces the Carbonate
Generally what kinds of foods are 'Cariogenic'?
Anything that contains fermentable carbohydrates (CHO) - leads to a drop in plaque pH
Does cooked starch or uncooked starch lower the pH in your mouth more?
What are the best combinations of food to eat in order to maintain a neutral oral pH?
-Combine cooked starches with fresh fruits and vegetables
-Eat high quality proteins
-Eat dairy foods when eating fermentable carbohydrates
Name a couple 'High intensity Non-Nutrative sweetners'
- aka Sweet'n low, Nutrasweet, Splenda, etc
What does Xylitol claim to do?
Inhibit bacterial glycolytic enzymes
- Impairs the ability of bacteria to stick to the tooth and form colonies
What types of diseases affect the gingiva?
Medication side effects
What are some major health problems that are associated with periodontal infections?
Name two things that are pro-inflammatory to the gingiva
-Saturated Fats (Dairy Products)
How do diets rich in refined carbohydrates and saturated fats stimulate inflammation?
Through the generation of excess ROS (whatever that is) and Oxidative Stress
What three Vitamins/minerals are the gingiva dependent on in order to stay healthy?
Which vitamins/minerals are essential to collagen formation? (important in making dentin, cementum, alveolar bone, and periodontal ligaments)
Protein and adequate Calories
What does Vitamin E help you do?
Helps with keeping the immune system health and antibody production
What does Vitamin K help?
Bone density and strength
-Lack of Vit K will be associated with gingival bleeding
The pattern of individual food intake, eating habits, and kinds and amounts of foods eaten
Chemical compounds configured by Nature or formulated by manmade processes to mimic nature
- The science and sum of dietary quality and physiological and biological activity necessary to maintain life and meet requirements for growth, development, repair and maintenance of cellular activity
Define Dietary Quality
- Agricultural or industrial sources of food, nutrient content, organoleptic appeal, variety and adequacy
Define Optimal Nutrition
- A physiological state whereby an individual is both receiving (consuming and assimilating) and using (metabolically processing) essential nutrients to maintain health and well-being at the highest level possible
- A chemical substance that is present in food and is needed by the body in adequate ratio and proportion for growth, maintenance, and repair of damaged tissues
- Chemical substances present in food that enhance, mediate or sustain optimum health status in concert with nutrients