This document discusses the relationship between diet, nutrition, and oral health. It begins by defining diet and nutrition, and explaining the importance of a balanced diet for overall health and well-being. It then covers the effects of major nutrients like carbohydrates, fats, proteins, vitamins, and minerals on oral tissues and dental health. Carbohydrates are identified as the main dietary factor that promotes dental caries, with sugars and frequent snacking increasing risk. However, studies also suggest proteins, fats, and fiber-rich foods may help prevent caries. The document reviews evidence from dietary intervention and observational studies on this topic.

1. DIET AND NUTRITION IN
ORAL HEALTH
By
Nitya Krishna.N
3rd Year postgraduate
Department of Public health Dentistry

2. CONTENTS
 Introduction
 Definition
 Nutritional Aspects In Oral Tissue Growth And Development
 Classification of foods
 Components of diet
 Carbohydrates and its effect on Oral health
 Fats and its effect on Oral health
 Proteins and its effect on Oral health
 Vitamins and its effect on Oral health
 Minerals and its effect on Oral health
 Dietary goals
 Conclusion
 References

3. INTRODUCTION
 Diet and nutrition are often used interchangeably.
 The main way of getting nutrition is by having a proper diet.
 Poor diet - poor metabolic efficiency - nutrient disorders or unbalance
nutritional conditions

5. DEFINITION
Diet
Total oral intake of a substance that provides nourishment .
Nizel (1989)
Nutrition
Nutrition is the science of food and its relationship to health.
WHO 1971
 The science which deals with the study of nutrient and foods and
their effects on the nature & function of organism under different
condition of age, health & disease.
Nizel(1989)

6. Balanced diet is defined as one which contains a variety of foods in such
quantities and proportions that the need for energy, aminoacids, 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. –
Park

7. NUTRITIONAL ASPECTS IN ORAL TISSUE GROWTH AND
DEVELOPMENT
 Before tooth eruption, nutritional status can influence tooth enamel
maturation , chemical composition, tooth morphology and size.
 After tooth eruption, diet affects the dentition topically rather than
systemically.
 Early malnutrition increases a child's susceptibility to dental caries in the
primary teeth.
 Throughout life, nutritional deficiencies can affect host resistance,
healing, oral function, and oral-tissue integrity.

8. CLASSIFICATION OF FOODS
Classification of foods
origin
Animal
origin
Vegetable
origin
Chemical
Composition
Function Nutritive Value
Cereals
Pulses (legumes)
Vegetables
Nuts and oil
seeds
Fruits
Animal food
Fats and oils
Sugar and jaggery
Body
building
foods
Energy
giving foods
Protective
foods
Protiens
Fats
Carbohydrates
Vitamins
minerals

9. COMPONENTS OF DIET
MAJOR NUTRIENTS
Carbohydrates-65-80%
Proteins- 7-15%
Fats/lipids-10-30%
MICRO NUTRIENTS
Vitamins
Minerals

10. CARBOHYDRATES

11. Functions Excess/Deficiency RDA and sources
Provide energy for
organism to live and work
(4 cal/g)
Oxidation of fatty acids
Important in the formation
of nucleic acids
Participate in the
structure of cell membrane
and cellular function such
as cell growth, adhesion
and fertilization.
Furnish fiber for normal
peristalsis
Diabetis mellitus
Hereditary fructose
intolerance: due to the
absence of enzyme –
aldolase.
Oral manifestation: caries
For an adult man,
weighing 70 kg-
400gms.
Sources:
99% - table sugar
60-80%- cereals
50-60%- pulses
50-60% - bread
20-30% - roots and
tubers

12. CARBOHYDRATES AND ORAL HEALTH

13. PATHOGENESIS OF DC
Enamel pellicle + bacteria
Plaque formation
Plaque bacteria + fermentable carbohydrate
Acid production
demineralisation of inorganic and
Dissolution of organic structures of tooth
Dental caries

14. EARLY THEORIES
The concept of “Noble savage” developed during later part of 18th century.
An understandable development from this ideal was the belief that
apparent freedom from caries enjoyed by so-called primitive races could be
attributed to the natural diet on which they existed.
 Eating hard, fibrous and unprocessed food led to better development of
the jaws and teeth and helped to clear food debris from the teeth.
 Humans started eating soft processed food, highly fermentable
carbohydrate, which did not properly exercise the masticatory apparatus
and lead to dental decay.

15. Wallace 1902 was a firm proponent of cleansing foods. Stated that
accumulations of fermentable carbohydrate, were the cause of caries and that
such deposits could be removed by eating hard and fibrous foods (Cleansing /
detersive foods).
Pickerill 1923
Stated that if a meal was finished with a salivary stimulant like apple, the
mouth would be kept free of fermentation both by physical cleansing effect of
fibrous food and also because of induced salivary flow.

16. DIETARY FACTORS
Increased Susceptibility
 Fermentable Carbohydrates
– Sugars
– Sugar/Starch Combination
Decreased Susceptibility
 Proteins
 Fats: Cheese, Nuts
 Foods with Sugar Alcohols
 “Healthy” Snacks
Fermentable carbohydrates are carbohydrates (sugars and starch)
that begin digestion in the oral cavity via salivary amylase.

17. WHAT ARE SUGARS?
• Sugars are a form of fermentable carbohydrate.
• Sugar - combination of mono &disaccharide, - highest % of carbohydrate
on a dry weight basis.
 Sugars enter the diet in 2 forms: those found naturally in foods (eg, fruit,
honey, and dairy products) and those that are added to foods during
processing to alter the flavor, taste, or texture of the food

18. Classifications of Sugars –
Total Sugars
Intrinsic Sugars Extrinsic Sugars
Milk Sugars Non Milk Extrinsic Sugars
( NMES)
No Harm to Teeth Harm to Teeth
Classifications of Sugars

19. saliva Plaque micro organisms
starches
Maltose
Glucose
Lactose
fructose
sucrose
sucrose
Energy +
Organic
acids
glycogen
Sucrose
phosphate
Glucose
fructose
Sucrose
phosphateSoluble
polysaccharides
Glucan/fructan
Insoluble
polysaccharides
extracellular intracellular
polysaccharides
Bacterial
capsule

20. DIETARY STUDIES
INTERVENTIONAL STUDIES
 VIPEHOLM STUDY
 HOPEHOOD HOUSE STUDY
 TURKU SUGAR STUDY
EXPERIMENTAL CARIES STUDY
NON INTERVENTIONAL STUDIES
 CROSS- SECTIONAL STUDIES
 OBSERVATIONAL STUDIES

21. Study Authors Purpose Method Findings
Vipeholm
study
Gustaffson
et 1954
Summarized
-Davies 1955
Does an
increase in
carbohydrate
intake cause
an increase in
dental caries
Seven groups
Control group,
sucrose group, bread
group, choclate
group, caremel group,
8 toffee group, 24
toffee group
Increase in
carbohydrate –
increases the caries.
Greater caries- sugar
consumed-that it will
be retained on the
tooth surfaces, sugar
consumed between
meals
Hopewood
house
study
Sullivan
Harris-1958,
Harris-1963
Absence of
meat and
rigid
restriction of
refined
carbohydrate
-2 principles
80 children, 7-14 yrs
(10yr period),
meals supplemented
by-vitamin
concentrates
,occasional serving of
nuts and sweetening
agent as honey.
53% were caries free
0.4%-13 years-had
caries

22. Study Authors Purpose Method Findings
Turku sugar
study
Scheinin and
Makinen -
1975
To compare
the
cariogenicity
of sucrose,
fructose and
Xylitol
125 subjects (115),
27.6yrs (15-45yr) for
24 months
3 groups – sucrose
(S), fructose (F) and
xylitol (X)
1 year-sucrose
and fructose
had equal
cariogenicity
2 year-caries
increased in
sucrose group
Experimental
caries study
Vonder fehr et
al 1970
23 days, dental
students rinsing nine
times daily with
10ml of a 50%
sucrose, fluoride
rinses
sucrose solution
developed a
higher caries

23. NON INTERVENTIONAL HUMAN STUDIES
 Subjects are free to choose whatever diet they please, correlation
between caries increment and dietary factor is low.
 Based on dietary recall
 No control over amount/ frequency of sugar intake

24. CROSS SECTIONAL STUDIES
Rugg Gunn 1993, summarized published results
 21 studies: Weight of sugar consumed and caries increment
 9 - Positive association
 12 – No association
 37 studies: Frequency of sugar consumed and caries increment
 23 - Positive association
 14 – No association

25. Granath et al 1978, compared the level of dental caries in over 500
four year Swedish children to sugar consumption, fluoride
supplements and oral hygiene practices.
Intake of sugar was the most important factor
Adjusted for fluoride supplements and oral hygiene practices. Children
with low intake of sugar between meals
 86% less buccolingual caries
 68% less approximal caries

26. OBSERVATIONAL STUDIES
Sreenby 1982
Correlated dmft of primary
dentition of 5 and 6 year olds
with sugar supplies data of 23
countries
Correlated DMFT of
permanent dentition of 12
year olds with sugar supplies
data of 47 countries0.31 0.7
 For every 25g sugar/day 1 dmft/child
 Countries where Intake < 18 kg/person/year < DMFT 3.

27. • Before world war II estimated sugar consumption rate
15 kg/person/ year-reduced to less than 0.2 kg/person/year
• Dental caries rate dropped during war time and rose when sugar
restriction were lifted -England, Norway and Japan

28. TRISTAN DA CUNHA STUDY
YEAR
PREVALENCE OF CARIES IN FIRST
PERMANENT MOLARS OF 6-19 YEAR OLD
1932
0%
1937
0%
1962
50%
1966
80%

29. • Most of the symptoms due to secondary hypoglycemia
• Comfortable with other foods containing glucose, galactose, and lactose
• HFI will have reduced levels of hepatic fructose-1-phosphate aldolase.
• Newbrun in 1969 found very low dental caries among 31 persons suffering
from HFI.
• Masthaler 1967
Persons with HFI show a strikingly reduced dental caries experience when
compared to a control population of the same age.
About 50% of the population with HFI are caries free. If caries lesion are
present they are limited to the most susceptible pit and fissure surfaces .

30. ENAMEL SLAB EXPERIMENTS
 Use oral appliance that hold slabs of bovine or human enamel.
 Plaque forms on enamel slabs
 Slabs are exposed to dietary factors being tested,
 Either Insitu
 Or removing the appliance several times a day and dipping into the vessels.
 Advantages over invitro
 They measure demineralization and not just acidogenic potential and also
account for the protective role of saliva.
 Findings
 Sugars : Demineralization
 Non sugar sweetners: Remineralization
 Increasing concentration and frequency : Demineralization

31. PLAQUE PH STUDIES
Stephan [1940, 1944]
Demonstrated the relationship between sugar exposure resulting in the
acidification of dental plaque and caries experience.
Plaque pH studies that have been used to rank the acidogencity of snack
foods,
 Boiled sweets: low pH
 Sweetened tea and coffee: low pH
 Salivary stimulants (Peanuts): High pH

32. SNACK FOODS, MEAL PATTERN, AND PLAQUE PH
 Eating a hard cheese following a sugar snack (syrup) :- abolished the fall in pH
 Sugared coffee in place of hard cheese: Fall in pH
 Hard cheese
 Stimulate saliva
 Less carbohydrate(lactose content)
 Recommended: Consumption of sugar rich foods at meal times rather than alone in
between meals.
 Dilution effect
 Increases salivary flow

33. STARCHES AND DENTAL CARIES
Rugg-Gunn 1993 extensively reviewed and concluded that:
 Cooked staple starchy foods such as rice, potatoes and bread are of low
cariogenicity in humans.
 Cariogenicity of uncooked starch is very low.
 Finely ground and heat-treated starch can induce dental caries but the amount of
caries is less than that caused by sugars.
However, mixtures of starch and sucrose would seem to be potentially more
cariogenic than starch alone and the level of caries that developed was related to
the sucrose concentration in the mix.
Bowen WH 1980

34. FRUIT AND DENTAL CARIES
 According to Imfeld TN in 1991, Stephan RM in 1996 who conducted studies in
animals have shown that, when fruit is consumed in high frequencies (e.g. 17
times a day) it may induce caries.
 Epidemiological studies have shown that, as habitually consumed, fruit is of low
cariogenicity.
 Only epidemiological study in which an association between fruit
consumption and dental caries was reported was that of Grobler and Blignaut
1989 who compared the dental caries experience of workers on apple and
grape farms with workers on grain farms having high caries.

35. CARBOHYDRATES AND EARLY CHILDHOOD
CARIES
Socioeconomic factors
Dietary factors
Cariogenic bacteria
Multifactorial in nature

36. FATS
 Fats are concentrated sources of energy. They are solids at 20 degree C and oils at room
temperature
 Classification:
simple lipids compound lipids derived lipids
eg: triglycerides eg: phospholipids eg: cholesterol
SOURCES:
1. ANIMAL FATS: ghee, milk, cheese, eggs, fat of meats and fish. Animal fats with few
exceptions like cod liver oil and sardine oil are mostly saturated fats.
2.VEGETABLE FATS: groundnut, mustard, sesame, coconut,etc.

37. Functions Excess/Deficiency RDA and sources
Concentrated fuel reserve
of the body.
Energy yield- 9 kcal per one
gram
Lipids are the constituents
of membrane structure and
regulate the membrane
permeability.
They serve as a source of fat
soluble vitamins (A, D, E and
K).
Lipids are important as
cellular metabolic regulators
(steroid hormones and
prostaglandins
Increases the risk for
atherosclerosis, coronary heart
disease and cancer.
Oral health:
prevents caries
 Parotid enlargement
70gms per kg body
weight
WHO expert
committee-20-30%
Indian Council of
Medical Research-
< 20%
Sources
vegetable and fish
oils. The rich
vegetable sources
are – sunflower oil,
cotton seed oil,
corn oil, soyabeen
oil

38. FATS AND ORAL HEALTH:
 There is indirect evidence that dietary fats may help prevent caries.
 It has been observed that Eskimos whose diet are almost solely of animal fat (70-
80%) experience little decay.
 It is only when the fat content is reduced to 25% or less decay starts.
 The mechanism whereby fat reduces dental caries are probably as follows-
 Coating of the tooth surface with an oily substance would mean that food particles
will not be readily retained.
 A fatty protective layer over plaque would prevent fermentable sugar from being
reduced to acids.
 High concentration of fatty acids may interfere with the growth of cariogenic
bacteria
 Increased dietary fat will decrease the amount of dietary fermentable
carbohydrates necessary for organic acid formation.

39. Periodontal disease
 hyperlipidemia –increases white blood cell (WBC) activity - progression of
periodontal disease in adults
Oral cancer
 Peroxidation of the lipids is caused by exposure to oxygen, which is
responsible for the damage to the tissue
Jade RE et al J Dent Res. 2014; 67: 12-19

40. PROTEINS

41. Functions Excess/Deficiency RDA and sources
Body building
Repair and maintenance of
body tissues
Maintenance of osmotic
pressure
Synthesis of certain
substances like antibodies,
plasma proteins, hemoglobin,
enzymes, hormones and
coagulation factors
Proteins can also supply
energy (4 kcal per one gram)
when the calorie intake is
inadequate, but this is not
their primary function
Excess-
High intake of protein - increases
the phosphorous level- alters the
calcium phosphorous level to 1:3
or more- osteoporosis
Cause kidney problems – retains
nitrogen and excessive loss of
calcium in urine
Deficiency –
Phenylketonuria
Hunger edema
Protein energy malnutrition –
kwashiokar and Marasmus
Sources:
Milk, Meat, Eggs,
Cheese, Fish And
Fowl
Pulses (Legumes) ,
Cereals, Beans,
Nuts , Oil Seed
Cakes

42. EFFECTS OF PROTEIN ON ORAL HEALTH
1. Effect on salivary gland
The normal functioning of the salivary gland is necessary for the maintenance of a
healthy oral cavity.
 Psoter WJ et al has showed that hypofunctioning of the salivary glands has
been reported with PEM, which results in a decreased salivary flow rate, a
decreased buffering capacity, and decreased salivary constituents, particularly
proteins.
 PEM and vitamin A deficiency are associated with salivary gland atrophy, which
subsequently reduces the defence capacity of the oral cavity against infection
and its ability to buffer the plaque acids

43. 2. Effect on dental caries
 PEM can be correlated with the host factors which are associated with the
development of caries, especially tooth defects and the salivary system.
 The tooth defects of interest are the external structural defects (hypoplasia) that
can provide a more cariogenic environmental niche and less protective enamel
and defects that include hypomineralization, which might increase the
susceptibility to demineralization
 Navia et al 1970 showed that a protein-deficient diet fed to experimental
animals during the pre-eruptive tooth development period increases their caries
susceptibility.

44. 3.Delayed eruption
Gebrian B et al conducted aretrospective cohort study which was to determine the
effects of Early Childhood Protein-Energy Malnutrition (EC-PEM) and the eruption
patterns of teeth among adolescents, concluded that a delayed exfoliation of the
primary teeth and a delayed eruption of the permanent teeth were associated with
EC-PEM.

45. 4.Effect on periodontal status
Epithelium of the gingival crevice or pocket adheres to tooth surface by forces
mediated by proteins and glycoproteins in the gingival fluid
Connective tissue of ground substance are composed of serum proteins,
glycoproteins and mucoproteins – required for maintenance of regular distribution of
water and electrolytes
Negatively affects the activity of fibroblasts, oseoblasts and cementoblasts.
Alveolar bone is sensitive to proteins and mineral metabolism.

46.  Periodontal disease is due to proteolysis of proteinacious material
found both in the ground substance as mucoprotein and in fibers as
collagen.
 Russell SL et al conducted a retrospective cohort study to examine
whether an exposure to Early Childhood Protein-Energy
Malnutrition (ECPEM) was related to a worsened periodontal status
in the permanent dentition during adolescence.
 This study revealed that ECPEM was related to a poorer periodontal
status.

47. 5.Effect on jaws and teeth
 An adequate protein diet during pregnancy has been shown to benefit
significantly the bone and dental development of children.
 Teeth of children who suffer from protein caloric malnutrition tend to be
crowded and rotated, possibly caused by inadequate development or retarded
growth of the jaw bone.
 Newly forming bone tissue is extremely sensitive to protein deprivation.
 Infante PF et al has showed that 71% of infants whose mothers had a poor
protein diet during pregnancy had retarded development of bone and teeth

49. Vitamins and its effect on oral health
Vitamin A
Structure Symptoms
Oral Mucous
Membranes
Epithelial metaplasia and hyperkeratinization
Salivary glands Atrophy reduced salivary flow increased caries
Teeth •A deficiency during pre-eruptive stages of tooth
development leads to enamel hypoplasia and
defectivedentin formation.
•Odontoblasts lose their ability to arrange themselves
in normal parallel linear formation.
Periodontium Hyperkeratosis and hyperplasia of gingival tissue.
 Proliferation of basal cells of gingival epithelium and a
decreased cellular infiltrate of lamina Propria-
periodontal pocket formation.
Decreased repair activity.
Cleft lip and palate During early development, both deficiency and high doses
reported to induce cleft lip and palate

50. Symptoms
Oral Cancer •Inhibits chemically-induced tumors in various tissues
•People with highest total carotenoid concentrations are 1/3 rd at risk
for oral and pharyngeal cancer
•Affects tumor latency by retarding growth of tumor
RDA  Males:1000RE
5000IU
Females:800 RE
4000 IU
Rathee M et al. Ind J App Res. 2017; 37: 35-38

51. Vitamin D
Delayed eruption
Enamel hypoplasia Dental caries
In cross-sectional studies, low vitamin D level in the body has been associated
with increased gingival inflammation, tooth loss, and maternal periodontal
diseases during pregnancy
Uwitonze AM et al J Steroid Biochem Mol Biol. 2018;175:190-194.
RDA adults:2.5mcg
Infants: 5mcg
Pregnant: 10mcg

52.  Vitamin C

53. Leggott et al
Gingival bleeding increased significantly after ascorbic acid depletion and
returned to baseline after ascorbic acid repletion.
.
Leggott et al. J Dent Res.1991;21:75-85
Maserejian, et al
Reported the positive effects of vitaminC-rich fruits and vegetables in decreasing
the risk of oral premalignant lesions.
Maserejian et al. Am J Epidemiol 2006; 35:77

54. WATER SOLUBLE VITAMINS

56. MINERALS
CLASSIFICATION
Major minerals
• Calcium
• Phosphorus
• Sodium
• Potassium
• Magnesium
Trace elements
• Iron, iodine, fluorine, zinc, copper, cobalt, chromium, manganese, molybdenum,
selenium, nickel, tin, silicon and vanadium
Trace with no known function: lead, mercury, barium, boron, and aluminium

57.  2.1. WHO Classification, 1973
(1) Essential elements: zinc (Zn), copper (Cu), selenium (Se), chromium (Cr),
cobalt (Co), iodine (I), manganese (Mn), and molybdenum (Mo).
(2) Probably essential elements.
(3) Potentially toxic elements.
 2.2. Frieden’s Classification of Elements.
(1) Essential trace elements: boron, cobalt, copper, iodine, iron, manganese,
molybdenum, and zinc.
(2) Probably essential trace elements: chromium, fluorine, nickel, selenium, and
vanadium.
(3) Physically promotive trace elements: bromine, lithium, silicon, tin, and
titanium.

58. MINERALS AND ITS EFFECT ON ORAL HEALTH
Mineral Function Oral health effects
Calcium Calcium is
essential for bone
growth as it is
required for
impregnation of
the bone matrix
with minerals
Pre-eruptive Effects of Calcium
imbalance in calcium nutrition will
have its major effect on tooth structure is during gestation and
childhood.
Periodontal diseases and osteoporosis
Decline in dietary intake of calcium and calcium phosphorus
ratio may enhance the appearance of both these conditions by
increasing bone resorption.
This type of bone loss affects the bones in descending order-
jaw bones (mainly alveolar bones), cranial
bones, ribs, vertebrae and long bones.
Calcium/Phosphorus ratio of the diet
implicated as contributing factors in the pathogenesis of
alveolar bone destruction and
osteoporosis.
This ratio should be approximately 1: 1.

59. Trace metals and oral lichen planus and oral lichenoid reactions
 Trace metals such as cr, co, and ni when come into contact with
oral mucosa induce sensitivity reactions in response to the
immune-mediated damage of the basal epithelial keratinocytes.

60.  Oral submucous fibrosis
Zinc levels in the tissue and serum of pre malignancies may
be used in understanding the pathogenesis
Oral pre cancer and cancer
The mean serum copper levels were significantly higher in
the sera of patients with oral premalignant and
malignant lesions and conditions.
 In other literatures- elevation of the serum copper in the
oral leukoplakia and oral squamous cell carcinoma (oscc)
group
Sachdev PK et al. Int J Dent 2018; 42: 35-45

61. Mineral elements that may inhibit or promote caries
Navia and Harris (1953)
1. Caries promoting elements: selenium, magnesium, cadmium, platinum, lead and
silicon
2. Mild cariostatic- molybdenum, vanadium, strontium, calcium, boron, lithium, gold
3. Elements with doubtful effect on caries – beryllium, cobalt, manganese, tin, zinc,
bromine, iodine
4. Caries inert elements: barium, aluminium, nickel, iron, palladium, titanium
5. Elements that are strongly cariostatic: fluorine and phosphorous
Navia R et al . J Dent Res 1953; 13: 1-4

62. Possible mechanism on dental caries
 Modify the chemical and physical composition of the teeth.
 Alter the size of the enamel crystals available to acid exposure.
 Influence the microbial ecology of plaque to either inhibit or promote
the growth of caries producing bacteria.

63. Constant et al 1954
 Found increase in dental caries in rats when fed with low level of calcium in
diet.
Lennox 1931
Noted that the teeth of the white South Africans were extensively decayed
It was due to the fact that they ate foods that were grown in phosphorus-
deficient soils.
Kulkarni N et al. J Dent Res Rev 2014;1:100-4

64. Hadjimarkos D.M 1968
Among children reared in seleniferous areas west of the Cascade Mountains in
Oregon.
Found that these children had higher incidence of caries than children reared east
of cascades, where there is no selenium in soil.
Alder 1953 in Hungary concluded
High Mo content of water was responsible for lower caries incidence among
children compared with children from area which had only traces of Mo in its water
supplies.
Kulkarni N et al. J Dent Res Rev 2014;1:100-4

65. FLUORINE
 A deficiency of fluorine -causes dental caries.
 Mottling of tooth enamel -excess fluoride ingestion.
 Dental fluorosis.

66. DIETARY GOALS - PRUDENT DIET (WHO)
1. Dietary fat should be limited to approximately 15-30% of total daily intake
2. Saturated fats should contribute no more than 10% of total energy intake
3. Excessive consumption of refined carbohydrates should be avoided: some
amount of carbohydrate rich in natural fibre should be taken.
4. Sources rich in energy such as fats and alcohol should be restricted.
5. Salt intake should be reduced to an average of not more than 5 g. per day
6. Protein should account for approximately 10-15 % of the daily intake
7. Junk foods should be reduced.

67. CONCLUSION
Growth and development of tissues in organs are affected by
nutritional environment.
Nutrition is important for the body to attain full growth and
development
Professionals should a basic knowledge regarding the effects of
nutrition in health and disease

68. REFERENCES
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

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Trace elements in oral health and disease: An
updated review. J Dent Res Rev 2014;1:100-4

71. FAT SOLUBLE VITAMINS
A D E K
OTHER
NAMES
Retinal, Retinol
Retinoic acid
Ergocalciferol,
cholecalciferol
Tocopherol K1
K2
k3
SOURCE
Carrots, Sweet,
Potatoes,
Broccoli,
Spinach,Eggs,
Milk,Apricots
Eggs, Fatty fish
such as
salomon and
sardines,yogurt
Spinach
,alomonds,
avocados,
Sunflower
seeds,olive oil
Green leafy
vegetables,
sprouts,
Asaparagus,
cabbage
FUNCTIONS
 Vision
 Maintainence
of cornea,
Epithelial
cells.mucous
membranes,skin
 Bone and tooth
growth
 Reproduction
 immunity
 Mineralisation
of bones
 Collagen
maturation
 Autoregulatio
n of calcitrio
 Anti oxidant
 Inhibits PG’s
synthesis
 Protects RBC
 Synthesis of
blood clotting
proteins and
bone
proteins that
regulate
blood
calcium

72. A D E K
deficiency  Night
blindness
 Bitots spot
 Keratomalacia
 Xeropthalmia
 xerosis
 Infantile
tetany
 Rickets
 osteomalacia
 Malabsortion
disease
 Alzheimers
disease
 Sterility in
males
 Muscular
dystrophy
 Osteoporosis
 heamorrhage
Oral
manifestati
ons
 Epithelial
metaplasia
 Ameloblast
disturbances
 Irregular
atubular
dentin
 Hyperplasia of
gingival tissues
 Periodontal
pocket
 Enamel
hypoplasia
 Dental caries
 Alvelar bone
loss
Destruction of
periodontium
Boggy and
bleeding gums

73. XeropthalmiaBitot spots Keratomalacia
Tetany Rickets Alzheimers disease

74. A D E K
RDA  Males:1000RE
5000IU
Females:800 RE
4000 IU
adults:2.5mcg
Infants: 5mcg
Pregnant: 10mcg
Adults: 15mg/d 0.03mg/d
TREATMENT
Mild:30,000IU/d
Early
xeropthalmia:
2,00,000IU
or110mg of
retinol palmitate
Advanced:
5,00,000IU
Osteomalacia:
5000-
20,000IU+5g of
ca gluconate or
ca lactate TID
Rickets:1000-
5000 IU/d
Reduced to
400IU/d
< 0.5-2
mg/100ml of
plasma or
30-100mg/d
Infants: 0.1-
0.2mg of
menadione
sodium
bisulphide or
0.5 mg of vit K
Hypoprothromb
inaemia: 2-
5mg/d vit K
tablests.

75. WATER SOLUBLE VITAMINS
RDA
B1
Thiamine
Anti beri-beri
Anti neuritic
Males:
1.2mg/kg
Females:
1.1mg/kg
B2
Riboflavin
Males:
1.3mg/kg
Females:
1.1mg/kg
B3
Niacin
Males:
16mg/kg
Females:
12mg/kg
B5
Panto
Thenic acid
Adults:
5mg/d
Children:
3-4mg/d

76. RDA
B6
pyridoxine
Infants:0.3-0.6mg
Children:
0.9-1.6mg
Adults:
1.8-2mg
Pregnancy:2.5mg
B7
Vitamin H
Anti egg white injury factor
100-200mg daily
Folic acid Adults:
0.4 mg/d
Pregnancy:
0.8mg/d
B12
cyanacobalamine

77. VITAMINS AND ORAL HEALTH
 Vitamin D dependency rickets, hypoparathyroidism, studies by Mellanby
1934. Bibby 1943, Infante and Gillespsie 1977 have found higher caries in
children with Enamel hypoplasia, though the exact reason is uncertain, it is
possible that the irregularity and pits may favor the development of more
plaque compared with smooth-well formed enamel.
 Harris and Navia 1980 made rat pups vitamin A deficient specifically during
critical periods of tooth development and found that there was an increased
caries susceptibility, mainly affecting the dentinal caries scores, indicating that
the effect was more related to the integrity of the dentin rather than that of
the enamel.

78.  Vitamin B Complex: Niacin and Pyridoxine has been found to influence
dental caries in animals.
 Niacin appears to promote dental caries, perhaps mediated via stimulation
of cariogenic oral flora when the vitamin is present and inhibition of flora
when the vitamin is absent. Pyridoxine has been stated to reduce caries in
rats but the effect was not canfirmed on monkevs