diet and nutrition

1. Diet and nutrition
in relation to
Dental caries
By : Ammar Mohammed Moham
Moshtaq
Kashea Ali
Heavy Duty Team

2. The Diet & Nutrition
• The Diet, in a easy way it is the sum of food that we
consumed .
• The word diet often implies the use of specific intake
of nutrition for health or weight-management or
lose, reasons .

3. The Nutrition
• In easy way too , Nutrition is what enters your
bloodstream after your digestion system is finished
digesting the food consumed .
• So , Your diet is what you eat, and nutrition is what
you get from it.

4. Dental Caries
• Dental Caries, also known as Tooth decay or cavities, it is a
breakdown of teeth due to acids made by bacteria.
• The cavities may be a number of different colors from yellow
to black.
• Symptoms may include pain and difficulty with eating.
• Complications may include inflammation of the tissue around
the tooth, tooth loss, and infection or abscess formation.

5. Relation between Diet
and Caries
• Caries is caused by the dissolution of the teeth by
acid produced by the metabolism of dietary
carbohydrates by oral bacteria.
• The 2 primary bacteria involved in caries formation
are mutans streptococci and lactobacilli .

6. In the 1960s the caries theory was depicted
as 3 parts of a circle representing the 3
prerequisites for dental caries :
Host
Bacteria
Food
Time

7. Modifying Factors
• Since then, many modifying factors have been recognized ,
resulting in a more complex model that includes saliva, the
immune system , time , socioeconomic status , level of
education, lifestyle behaviors, and the use of fluorides .
• sugars and dental caries The caries process can be described
as loss of mineral (demineralization) when the pH of plaque
drops below the critical pH value of 5.5 .
• The critical value for enamel dissolution is 5–6, and an
average pH of 5.5 is the generally accepted value.

8. Re-mineralization
and role of fluoride
• Re-disposition of mineral (re-mineralization) occurs
when the pH of plaque rises.
• The presence of fluoride reduces the critical pH by
0.5 pH units, thus exerting its protective effect.

9. The Bacteria
• The most common bacteria associated with dental cavities are the
mutans streptococci , Streptococcus sobrinus , and lactobacilli .
• cariogenic bacteria (the ones that can cause the disease) are
present in dental plaque, but they are usually in too low
concentrations to cause problems unless there is a shift in the
balance.
• This is driven by local environmental change, such as frequent
sugar, no biofilm removal (a lack of tooth brushing).
• If left untreated, the disease can lead to pain, tooth loss and
infection.

11. Important note
• You are not born with the bacteria that cause
cavities.
• These bacteria are usually transferred to you at a
young age by your primary care taker, most often
your mother.
• To reduce the chances of passing the bacteria to your
children, avoid sharing utensils, straws or other items
that may have saliva on them.

12. Diet and nutrition
• Diet and nutrition may interfere with the balance of tooth
demineralization and re-mineralization in several ways .
• The diet provides sugars and other fermentable carbohydrates,
which are metabolized to acids by plaque bacteria .
• The resultant low pH favors the growth of the acidogenic and
aciduric bacteria (mutans streptococci).
• In contrast, a diet lower in added sugars and fermentable
carbohydrates and high in calcium-rich cheese may favor
remineralization.

13. Dental decay process
• This photo shows the bacteria role in decay process

14. End Of Part 1

15. What do we mean by sugar?
• When we say “sugar”, we usually mean
granulated Table sugar.
• However there are so many kinds of sugars
these days, we need to be very clear the word “
sugar ” includes these things ending in “ose”

16. Types of sugar :
• 1- Sucrose (Table sugar) a simple sugar made from cane sugar or
beets.
• 2- Fructose, a simple sugar in fruits, plants and honey.
• 3- Maltose, a complex sugar in barley and malt syrups .
• 4 - Lactose, a complex sugar in milk.
• 5- Dextrose, a refined simple sugar from corn, sugar cane or beets.
• 6- Glucose, a simple sugar in fruits, vegetables and grains.

17. Sugars of these days
• TOTAL SUGARS = FREE SUGARS + ADDED SUGARS
• Added sugars are those sugars which are added to
foods and beverages, They can cause dental caries if
good oral hygiene is not maintained.
• Free sugars- Sugars present in unbound form in food
and beverages.

18. Sugars of these days

19. Recommended intake
• The recommended intake of non-milk extrinsic
sugars is a maximum of 60g/day, which is about 10%
of daily energy intake.

20. Recommended intake

21. Stephan study ( 1940 – 1944 )
• Demonstrated the relationship between sugar
exposure resulting in the acidification of dental
plaque and caries experience.

22. The influence of fluoride
on the sugars
• 1-reduces and inhibits demineralization.
• 2- remineralization of enamel .
• 3-affects plaque, by inhibiting bacterial metabolism
of sugar thus reducing acid production.

23. Vitamins
• Out of all the vitamins, Vitamin D and Vitamin K have
been proven useful in supplementing to maintenance of
oral hygiene.
• VITAMIN D- Required for normal development of teeth
and also help in reducing chances of caries occurrence in
children.
• VITAMIN K-It helps in reducing the breakdown of
carbohydrates ,so that the
bacteria present in mouth
are not able to use it.

24. End Of Part 2

25. Factors that affecting
the food cariogenicity
• 1-types of carbohydrate
• 2-physical form of food retention and oral clearance time
• 3-factor in the diet that protect against dental caries.
• 4-intake frequency
• 5-nature of diet

26. The effect of
Food physical form
• Prolonged oral retention of cariogenic components of food
may lead to extended periods of acid production and
demineralization and to shortened periods of
remineralization.
• retentiveness of foods is not the same as stickiness.
• A caramel or jellybean may be sticky, but its retentive
properties are fairly low and they are
cleared from the oral cavity faster
than are retentive foods
such as cookies or chips .

27. Oral clearance properties
• Oral clearance mean the action or process of removing or
getting rid of something and it is vary by individual person and
depend On :
• 1- metabolism by microorganisms
• 2- adsorption onto oral surfaces
• 3-degradation by plaque and salivary enzymes
• 4-saliva flow,
• 5-swallowing.
Most carbohydrates will be cleared by these
simultaneous mechanisms.

28. The Frequency
• The frequency of consumption seems to be a significant contributor to
the cariogenicity of the diet .
• although the scientist Bowen concluded that it is not the frequency of
ingestion per sec that is related to the development of caries,
• but the time that sugars are available to microorganisms in the mouth
caries is regarded as the outcome of the alternation of demineralization
and remineralization.
• Higher frequency means more demineralization and less
remineralization.
• The duration of the decrease in p
H after intake of a cariogenic food
is an important
confounder in this relation

29. Groups at particular risk
• 1- 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.
• 2-People with increased frequency of eating because
of a medical problem, e.g., gastrointestinal disease ,
eating disorders, uncontrolled diabetes.

30. Groups at particular risk
• 3-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.
• 4-Those with reduced salivary secretion. Sjogren’s
syndrome, irradiation in the region of the salivary
glands.

31. Groups at particular risk
• 5-Athletes taking sugar-containing sport supplement
drinks.
• 6-Workers subject to occupational hazards such as
food sampling and those on a monotonous job such
as a nightshift.

32. Groups at particular risk
• 7-Drug abusers who have a craving for sugar and a prolonged
clearance rate as a result of reduced salivary secretion
• 8-People of any age, on long term and/or multiple
medications. Are these sugar-based and/or do they cause a
dry mouth.
• 9-Any sugary bedtime snacks or drinks.

33. How to Prevent Decay
• Brush your teeth twice a day with fluoride
toothpaste
• Clean between teeth daily with floss
• Eat a balanced diet and limit between-meal
snacking
• Visit your CDA member dentist regularly for
professional cleanings and exams

34. • Ask your dentist about:
– dental sealants, a protective plastic coating
that can be applied to the chewing surfaces of
the back teeth where decay often starts
– xylitol gum and mints
– fluoride treatments
including varnish
How to Prevent Decay

35. The End