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Diet and caries

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  • 1. Diet and Caries Dr. Kauser Sadia Fakhruddin
  • 2. CLASSIFICATION OF SUGARS FOR DENTAL HEALTH PURPOSES
  • 3.  INTRINSIC SUGARS: sugars integrated into the cellular structure of food (e.g., in fruits) are called intrinsic sugars. EXTRINSIC SUGARS: sugars present in a free form (e.g., table sugar) or added to food(e.g., sweets biscuits) are called extrinsic sugars. They are more readily available for metabolism by the oral bacteria and therefore potentially more cariogenic.
  • 4.  Milk contains lactose but is not generally regarded as cariogenic. Cheese and yoghurts, without added sugars, may also be considered safe for teeth. Thus the most damaging sugars for dental health are non-milk extrinsic sugars (NMES)
  • 5. Recommended and current levels of sugar intake The recomended intake of non-milk extrinsic sugars is a maximum of 60g/day, which is about 10% of daily energy intake.
  • 6. Starch, fruits and fruits sugars Raw starch (e.g., raw vegetables) is of low cariogenicity. However, cooked and highly refined starch (e.g., crisps) can cause decay. And a combinations of cooked starch and sucrose (e.g., cakes, biscuits, sugared breakfast cereals) can be highly cariogenic.
  • 7.  Fruit contains sugars (fructose, sucrose and glucose) but fresh fruits appear to be low cariogenicity. However, the same cannot be said for fruit juices. The juicing process releases the sugars from the whole fruit, and these drinks are potentially cariogenic.
  • 8.  Dried fruit is also cariogenic. These products are sticky, tending to adhere to teeth and the drying process release some of the intrinsic sugars.
  • 9. Groups at particular risk of caries in relation to diet
  • 10.  Infants and toddlers with prolonged breast-feeding on demand Infants and toddlers provided with a feeding bottle at bedtime, or bottle suspended in the cot for use during the night, with sugar containing liquid.
  • 11.  People with increased frequency of eating because of a medical problem, e.g., gastrointestinal disease, eating disorders, uncontrolled diabetes. Those with an increased carbohydrate intake due to a medical problem e.g., Crohn’s disease, chronic renal failure, or other chronic illness, malnutrition or failure to thrive.
  • 12.  Those with reduced salivary secretion. Sjogren’s syndrome, irradiation in the region of the salivary glands. Athletes taking sugar-containing sport supplement drinks.
  • 13.  Workers subject to occupational hazards such as food sampling and those on a monotonous job such as a night shift. Drug abusers who have a craving for sugar and a prolonged clearance rate as a result of reduced salivary secretion People of any age, on long term and/or multiple medications. Are these sugar-based and/or do they cause a dry mouth?
  • 14. Diet Analysis
  • 15.  There are two principal techniques for determining food intake. One is to record the dietary intake during the preceding 24 hours, the so called 24- hour recall. The other method is to obtain a 3-4 day written diet record.
  • 16. How to analyze the diet record The main meals, to see whether they are sufficiently substantial-this is important to prevent the patient craving food between meals The between-meal snacks. Are they cariogenic? Any medication, particularly if it is based on sucrose syrup or it is likely to cause dry mouth or thirst.
  • 17.  The number and type of between-meal drinks. Are these cariogenic? The consistency of any between-meal snacks. Are they sticky and therefore take a long time to clear from the mouth?
  • 18.  The use of sucrose-containing chewing gum or any sweet that takes a long time to dissolve in the mouth Any sugary bedtime snacks or drinks.
  • 19. It would not be unreasonable to suggestthat after a sugar attack the plaque is likely to remain acid for 1 hour , thus 8 attacks would equal 8 hours of acid plaque.

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