nutritional problems,National nutritional Programs Nutrition & oral health

1. Nutrition And
Oral health
Dr Bindu V Bhaskar
Dept. of Public Health Dentistry
1

2. Oral health General
Health
Nutrition /Diet
2

3. Elements of primary health care
 Education about health problems and
solutions
 Prevention and control of Locally
endemic diseases
 Provision of Essential drugs
 Maternal and child care
 Expanded Immunization of infectious
diseases
 Food supply and proper Nutrition3

4. Impact of nutrition
in
public health
Health Disease
4

5. Impact of nutrition in Public health
Nutritional Requirement
Nutritional Status Assessment
Nutritional Problems in Public
Health
Nutritional Programs in India
5

6. Nutritional epidemiology
6

7. Nutritional Epidemiology
Nutritional status of
community
Diet Survey
Nutrition and Growth
Monitoring
Nutritional indicators
Nutritional
Intervention
Nutritional
Rehabilitation
Nutritional
Surveillance
7

8. Nutritional deficiency disorders
 Increased Food Production
 Social Issue
8

9. Nutrition
Social
issue
9

10. The types
and
amount of
food
eaten
daily by
an
individual10

11. Nutrition
11

12. nutrition
“The science which deals with
study of nutrients and foods
and their effect on the nature
and function of the organism
under different condition of
age, health and diseases.”
NIZEL
12

13. Nutritional problems
 LBW
 PEM
 Xerophthalmia
 Nutritional Anemia
 Iodine Deficiency disorders
 Fluorosis
 Lathyrisim
 Obesity
13

14. Malnutrition
 It is a pathological state resulting from
a relative or absolute deficiency or
excess of one or more essential
nutrients.
14

15. Nutrition and chronic disease
 Coronary Artery
Diseases
 Diabetes Mellitus
 Cancer
Oral Diseases
15

16. 16

17. 17

18. National nutrition policy
 1993
 Dept. of Women and Children
 (Ministry of Human Resource and
Development)
 Control of micronutrient deficiency
 Food fortification
18

19. National Nutritional programs
 High Prevalence of Malnutrition
Five year Plans Focus
First And Second Increase in Food
Production
Third Applied Nutrition
Programs
Fourth Prophylaxis for
Nutritional Anemia,
Nutritional Blindness
19

20. Nutritional problems
 LBW
 PEM
 Xerophthalmia
 Nutritional Anemia
 Iodine Deficiency disorders
 Fluorosis
 Lathyrisim
 Obesity
20

21. Protein Energy Malnutrition
(PEM)
21

22. 22

23. Low Birth Weight (LBW)
23

24. Xerophthalmia
24

25. Nutritional Anemia
25

26. Nutritional Anemia
26

27. Iodine Deficiency disorders
27

28. Fluorosis
28

29. Lathyrisim
29

30. Lathyrisim
30

31. NUTRITIONAL PROGRAMMES IN INDIA
1. Vitamin A prophylaxis program
2. Prophylaxis Against Nutritional Anemia
3. Control of Iodine Deficiency Disorders
4. Special Nutrition Program
5. Balwadi Nutrition Program
6. ICDS program
7. Mid Day Meal Program
8. Mid day Meal Scheme
31

32. Vitamin A prophylaxis program
Oral administration
Vitamin A
(2,00,000 IU )
Preschool children
Every 6 months
32

33. Prophylaxis Against Nutritional Anemia
 Distribution of Iron and Folic acid
tablets
 MCH, PHC, ICDS
 Iron fortification of common salt
33

34. Control of Iodine Deficiency Disorders
34

35. Control of Iodine Deficiency Disorders
 National Goitre Control Program
(1962)
35

36. Control of Iodine Deficiency Disorders
 Goitre endemic Areas
 IDD control Program 1986
 Edible salt to iodide salt
36

37. Special Nutrition Program (1970)
 Target Groups
 Children below 6 years
 Pregnant and nursing mothers
 300 Kcal + 10-12 g of protein /child
 500 Kcal + 25 g of protein to mothers
 Ministry of Social Welfare
37

38. Balwadi Nutrition Program
 3- 6 year old children, Ministry of Social
Welfare
38

39. ICDS program
National Policy for Children
 Preschool children below 6 years
 Adolescent girls 11-18 years
 Pregnant and lactating mothers
 Anganwadi workers (1000 population),
Mukyasevikas
 Child Development Project Officer
39

40. ICDS program
40

41. Mid Day Meal Program (1961)
41

42. MID day meal scheme (1995)
 Centrally sponsored scheme
 Nutritional support to primary Education
42

43. 43

44. National Nutritional programs
 High Prevalence of Malnutrition
Five year Plans Focus
First And Second Increase in Food
Production
Third Applied Nutrition
Programs
Fourth Prophylaxis for
Nutritional Anemia,
Nutritional Blindness
44

45. Food Guide Pyramid
 A food guide help to choose a variety of foods to
help achieve a balenced diet
45

46. Balanced diet
 A balanced diet is one which contains
a variety of foods in such quantities
and proportions 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 provision
for extra nutrients to withstand short
46

47. Balenced Diet

 Protein 10-15 %
 Fat -15-30 %
 Carbohydrate- remaining
47

48. The dietary Goals (WHO)
 Limit Dietary fat – 15-30% of total daily
intake
 Saturated fats – not more than 10 % of
total energy intake
 Avoid excessive consumption of Refined
carbohydrates
 Salt intake- not more than 5 g per day
 Protein-10-15 % of daily intake
 Avoid Colas, ketchups, empty calories
48

49. Recommended Dietary allowance (RDA)
 Amount of nutrients sufficient for the
maintanence of health in nearly all people
1. Minimal physiological Requirement (lack-
deficiency disease)
2. A margin of safety of 30-50% of above actual
physiological requirement to allow for individual
variation and to provide body stores in times of
stress.
49

50. RDA
RDA = Minimum requirement +
Safety Margin
Doesn’t apply to sick people
50

51. Trace elements (14) (SIM Card)
 Selenium
 Silicon
 Iron
 Iodine
 Molybdenu
m
 Manganese
 Copper
 Cobalt
 Chromium
 Fluorine
 Vanadium
 Nickel
 Zinc
51

52. Nutrition And oral health
1. Nutriton and Dental Caries
2. Nutrition and Malocclusion
3. Nutrition and Periodontal
disease
4. Nutrition and Oral Cancer
52

53. Nutrition
and
Dental caries
53

54. Nutrition and Dental caries
Pre - eruptive Effect
Post - eruptive Effect
54

55. Nutrient deficiencies
During tooth Development
55

56. Pre- eruptive effect
Malnutrition before the eruption
of tooth
Irreversible changes in the
tooth
Increased caries
suseptibility
56

57. pre -eruptive effects
Enamel maturation
Physical and chemical
composition
Time of eruption
Tooth morphology
Tooth size
57

58. Mineral Malnutrition
 Calcium, P,hosphorous ,
Iron
 Hypoplasia
 Odontoclasia
 Infantile Melanodontia
 Yellow teeth
58

59. Lesion Cauque
Ascorbic acid
deficiency
Vitamin A
deficiency
59

60. Pulpal Stone
 L-Ascorbic acid
deficiency
Deficent Dentine
formation
Ectopic calcification
60

61. Vitamin-D
Hypoplastic lesion of the
enamel
Dental caries
61

62. Post- eruptive effect
Protien
deficiency
Reduce host
defence
Increased caries
suseptibility62

63. Post eruptive effect
 Salaivary
Lysosome
 Secretry IgA
 Salaivary
peroxidase
 Lactoferrin
 Lysozyme63

64. Nutrition and periodontal
disease
64

65. Local factors are
conductive to
periodontal disease in
man
Rapidity of the
destructive process is
determined by65

66. 66

67. 67

68. Nutritional Deficiency
 Epithelial barrier
 Epithelieal
attachement
 Periodontal
ligament
 Gingival
connective tissue
 Alveolar bone
 Immune
mechanism
 Inflamatory
response
 Composition of
gingival fluid
68

69. Iron deficiency
 Role of Iron
 Obligate factor in collagen metabolism
 Movement of oxygen to cells
 Cytochrome enzyme
 Innate and acquired immunity
69

70. Iron deficiency
 Impared neutrophil function
 Reduced response to antigens
 Reduced lymphocyte proliferation
 Risk and severity of infection
70

71. Iron deficiency
 Reduced thickness of oral epihelium
 Reduced size of pro genitor cells
 Delayed maturation of epithelial
barrier
 Increased Sulcular permeability
71

72. Iron deficiency animeia
Pale gingiva
72

73. Vitamin C
 Gives tensile strength to tissues and
determine morphology
 Scurvy
 Haemorraic, enlarged
bluish – red gingiva
 Reduced salivary flow
 Tooth exfoliate in severe deficiency
73

74. Protein Deficiency - Changes in alveolar
bone
Vitamin K deficiency
- gingival bleeding
- post extraction haemorrhage
Vitamin E
- increases resistance to infammatory
mediated tissue destruction
- Improves gingival health74

75. Vitamin B complex
 Role in cell division and growth of
cells
 Act on cells having rapid renewal rate
 Deficiency -Epithelium of lips and
mouth
 Niacin deficiency predispose to
ANUG
75

76. Vitamin a
Important in the synthesis of proteoglycan,
fibronectin and type 1 procollagen
Role in epithelial tissue differentiation
Act on cells having rapid turn over rate
Deficiency
- Decreased salivary flow
- Hyperkeratosis
- Gingival hyperplasia
76

77. Act on cells having rapid turn over rate
77

78. Calacium and phosphorous
 Alveolar ridge resorbtion
78

79. Calacium and phosphorous
 Calcium reduces
- gingival inflammation
- Calculus formation
- Pocket depth
- tooth mobility
A low calcium to phosphate ratio is positively
correlated with alveolar ridge resorption
79

80. Ammino acids
 Linoliec acid deficiency - Impaired
wound healing
 Arginine deficiency
- affect cell mediated immune
response
- T cell function
Omega 3 fatty acid deficiency
– immunological changes80

81. Benefits of good nutrition
1. Resist Infection
2. Strengthen and maintain
epithelial barrier
3. Promote repair of damaged
periodontal tissues
81

82.  The role of nutrition in the
management of gingival and
periodontal disease is primarily
that of prevention and
maintenance
82

83. Nutriti
on
and
Dental
Caries
Pre
eruptiv
e
effect
Post
eruptiv
e
Effect
Irreversible
changes
Host Defence
Hypoplastic
Lesion
Protein
Deficiency
Calciu
m
Iron
Fluori
des
Vit D
Vit C
Vit A
Sal.Lysoz
yme
Sec.IgA
Sal.peroxi
dase
Lactoferrin
83

84. Nutrition and Periodontal
disease
Iron Vit C
Prote
in Vit K
Vit B
Vit E
Amin
o
Acid
s
CaVit A P
84

85. Nutrition
and
malcclusion
85

86.  Jaw bones achieve their genetic size
potential only after the tooth have
developed
 Growth of jaw bones over a period of
time
86

87. Chronic post natal
malnutrition
Stunted jaw
development
Malocclusion
87

88. Nutrition and
oral cancer
88

89. 7 S of Oral Cancer
 Smoking
 Spirit
 Sunlight
 Stress
 Sharp teeth
 Spices
 Syphilis
89

90. 90

91. Nutrient Deficiencies
Mixed function oxidase
systems
Host Defence to carcinogens
91

92. Vitamins A, E, C,
and Beta
Carotene have
anti-oxidant
properties.
92

93. Free radicles-unstable atoms that can
damage cells,
93

94. 94

95. 95

96.  Iron Deficiency Anemia
 Plummer vinson SYNDROME
 Copper , Zinc , Manganese
 Deplete the level of anti oxidant nutrients in
tissues
96

97. 97

98. Vitamin A
 Advanced cases of oral cancer
Decreased levels of serum
retinol
 Effect on protein Kinase C
 Retinoids- synthetic Analogues
98

99. Vitamin C and E
 Anti oxidant
 Prevent conversion of amines to
nitrosamines
 Enhance immune response
– effect on phagocytes
99

100. Beta Carotene
Anti oxidant and free radicle
scavenger
Better than retinoids –low
toxicity
100

101. Vitamin B complex
 Thiamine (B1)
 Riboflavin (B2)
101

102. 102

103. 103

104. Thank you
104