This document provides an overview of diet, nutrition, and their importance in pediatric dentistry. It defines key terms like diet, food, and nutrition. It discusses the major nutrients including carbohydrates, proteins, lipids, vitamins, and minerals. It outlines the recommended dietary allowances and food sources for various nutrients. The document also discusses balanced diets, nutritional requirements by age, common nutritional disorders in pediatrics, and the role of dietary counseling.

2. Presented By:
Dr. Milind Rajan 1st year mds
Dept. of Pediatric dentistry

3. CONTENTS :
 Definition – Diet, Food, Nutrition.
Components of diet
o Major nutrients
o Micro nutrients
Recommended dietary allowances(RDA
 Balanced diet.
 Nutrients.
 Food group guides.
 Nutritional requirements.
 Diet and oral health.
 Diet and Common oral diseases.
contd..

4.  Diet & Nutrition in Pediatric Dentistry.
 Pediatric Dietary Guidelines by Age.
 Pediatric Dietary Guidelines.
 Nutrition related Pediatric Disorders.
 Dietary habits.
 Dietary counselling in Pediatrics.
 Diet Counselling.

5. DEFINITION :
DIET
 Finn- Referred to as food & drink regularly
consumed.
 Nizel (1989): Total oral intake of a substance that
provides nourishment .

6. DEFINITION :
FOOD
 Finn : Any substance which when taken into the
body or an organ may be used either to supply
energy or build a tissue.
 Nizel 1989 : Any thing that is eaten , drunk or
absorbed for maintenance of life, growth & repair of
the tissue.

7. DEFINITION :
 NUTRITION :
 Finn: The sum process in the growth, maintenance and repair of living
body as a whole or its constituent parts.
 W.H.O(1971): Science of food and its relationship to health. It is
concerned primarily with the part played by the nutrient in body
growth, development & maintenance
 NIZEL 1989: 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.
Good nutrition – an adequate, well Balanced Diet combined with regular
physical activity – a cornerstone of good health.
Poor nutrition can lead to reduced immunity, increased susceptibility to
disease, impaired physical and mental development, and reduced
productivity.

9. BALANCED DIET
It is one which contains varieties of foods in such quantities and
proportion that the need for energy, aminoacids, vitamins, fats,
carbohydrates and other nutrients is adequately met for
maintaining health , vitality and general well being and also make
provision for a short duration of leanness (CHAULIAC 1984)

10. The overall energy needs of the body are calculated to be the sum
of three factors –
1) BASAL METABOLISM
Is the minimum amount of energy needed to regulate and
maintain the involuntary essential life processes, such as
breathing , circulation of the blood , cellular activity, keeping
muscles in good tone, and maintaing body temperature.
 Healthy man requires 1600-1800kcal daily
 Healthy woman requires 1200-1450kcal daily
BASAL METABOLIC RATE (BMR)
Is defined as the number of kilocalories expended
by the organism per square meter of body surface
per hour (kcal/m2/hour)

11. 2) ENERGY FOR PHYSICALACTIVITY
 Muscular activity affects both energy expenditure & heat production.
 Energy expenditure increases with musclar activity
3) SPECIFIC DYNAMIC ACTION OF FOOD
 SDA is the term used to describe the expenditure of
calories during the digestion & absorption of food.
 Fats – 2%
 Carbohydrates – 6%
 Proteins – 29%

12. COMPONENTS OF DIET

13. MACRO NUTRIENTS
 CARBOHYDRATES
Complex carbohydrates:
•supply energy
•maintain blood glucose
•spare protein
•burn fat for fuel
•provide bulk in the form of fiber
in the diet
Refined carbohydrates:
•only white flour or sugars
•lack other important
nutrients

14.  PROTEINS
 word protein means “of prime
importance”, because it mediates
most of the actions of life.
 essential for all body tissues: skin,
tendons, bone matrix, cartilage,
and connective tissue.
 also forms hormones, enzymes,
antibodies and acts as a chemical
messenger within the body.
 Requirements for protein vary
between 40-65 g/day depending
on physical activity, stress, and
growth cycles.

15. AMINO ACIDS:
Building blocks of proteins.

16.  Quality of protein:
 That provides amino acid pattern close to that of tissue
protein
 Breast milk and egg protein satisfy this criteria.
 Egg called reference protein: provides all essential amino
acids, easy availability & storage convinience.
 Excess is stored as fat.
 The specific dynamic action (SDA) or the thermic effect of
food (TEF) for protein (29%) is much higher than that of
carbohydrate and fat (5%).
Deficiency state: Protein energy malnutrition
(PEM) :
Kwashiorkar, Marasmus and Marasmic
Kwashiorkar

17. KWASHIORKAR
 First recognized by Prof Cicely Williams in 1933 from Gold
Coast.
 She observed that this was the disease of the first child when
the second was on the way displacing the first child from
breast feeding.
 She named it Kwashiorkar, word taken from Ga language of
Ghana, which means the ‘red boy’ due to characteristic
pigmentary changes.
 Later on, the term was interpreted as “deposed child”.

18.  Classic signs:
 Stunted growth
 Hepatomegaly
 Anaemia
 Oedema
 Grading
Grade I: pedal oedema
Grade II: I + facial oedema
Grade III : II + paraspinal and chest oedema
Grade IV: III + ascites

19. MARASMUS
 Word Marasmus is derived from Greek word Marasmos,
which means “wasting”.
 Affected children exhibit extreme wasting.
 Old man appearance to jaws and skin and bones.

20.  Grading:
 Grade I: wasting starting in axilla and groin.
 Grade II: I + wasting in thigh and buttock region
 Grade III: II+ chest and abdomen
 Grade IV: buccal pad of fat
 Wasting of brown fat occurs first because it is more
metabolically active.
 Marasmic Kwashiorkar: when marasmic children
develop oedema.

21. ORAL MANIFESTATIONS
 Bright reddening of tongue
 Loss of papillae: erythematous and smooth dorsum of tongue
 Kwashiorkar:
 Edema of tongue with scalloping around the lateral margins due
to indentation of the teeth.
 Bilateral angular cheilosis
 Fissuring of lip
 Loss of circumoral pigmentation
 Dry mouth
 Reduced caries activity due to lack of substrate carbohydrate.
 Decreased overall growth of jaws
 Delayed eruption
 Deciduous teeth may show linear hypoplasia

22.  LIPIDS
 Fats insulate against the cold, cushion organs, slow
digestion, carry fat-soluble vitamins A, D, E, K, and
make foods taste good.
 Types :
 Deficiency symptoms:
eczema
low growth rate in infants
lowered resistance to infections
Saturated fats
•mainly from animal foods, such as
meat, poultry, butter, and whole
milk.
•They increase the risk of
cardiovascular disease, cancer, and
obesity.
Unsaturated fats:
•Mono and polyunsaturated fats
are heart healthy fats.
• EFA: “essential fatty acids” are
Polyunsaturated fatty acids, used
to be called “queen of vitamins”
and then it was designated as
vitamin F.

23. RECOMMENDED DIETARY ALOWANCE
(RDA)
 1943, Food and Nutritional Board
 The RDA are the set of values for levels of intake of nutrients
currently considered essential and which meet the physiological
needs of nearly of all individuals .
 The RDA are primarily designed
 If the food consumed contain the amounts of nutrients that met the
RDA, the probability of developing nutrional deficiencies is
negligible.
 The RDA also serves as the basis for :
- Food guides
- The development of diets and products for therapeutic uses
- The formulation of new food products
- A guide for food provided

24. VITAMINS
VITAM
IN
NAME FUNCTION DEFICIEN
CY
RDA
FOOD
SOURCE
S
ORAL
MANIFESTATI
ONS
B1 THIAMINE •COENZYME
•HELPS IN DNA ,
RNA FORMATION
•METABOLISM OF
FATS AND
PROTEINS
•ROLE IN
NEUROPHYSIOLOG
Y
WET , DRY
NAD
INFATILE
BERIBERI
1mg /day CEREALS,
MEAT
,LIVER,PEA
S, BEEF
,NUTS
,MILK,
LEAFY
LEGUMES,P
ORK,VEGET
ABLES
NO ORAL
MANIFESTATIONS
B2 RIBOFLAV
IN
•CO-ENZYME
•ATP GENERATION
•METABOLISM
DERMATITIS,
GLOSSITIS,
ANGULAR
STOMATITIS
1.5mg/da
y
MILK,LIVER
,CHEESE
,EGGS,CERE
ALS,WHOLE
GRAINS,VE
GETABLES
ANGULAR
CHEILOSIS,
ATROPHY OF
FILLIFORM
PAPILLAE,ENLARG
ED FUNGIFORM
PAPILLAE,SHINY
RED LIPS,, SORE
TONGUE
B4 NIACIN •CO-ENZYME
•TISSUE
RESPIRATION
•CNS FUNCTIONING
PELLAGRA 16-33
NIACIN
EQUIVA
LENTS
LIVER
,YEAST,
MEAT
CERALS
ANGULAR
CHEILOSIS,MUCOSI
TIS,STOMATITIS,UL
CERATIVE
GINGIVITIS

25. B5 PANTHOT
HENIC
ACID
•INVOLVED IN
KREB’S CYCLE
•COMPONENT
OF STEROLS
PARASTHESIA ,
ABDOMINAL
STRESS,FATIGUE
4-7 mg/day EGGS , CEREALS
, LEGUMES
_
_ BIOTIN •STIMULATES
GROWTH OF
YEAST
•CONSTITUENT
OF DNA
DERMATITIS,
GLOSSITIS AND
PARASTHESIS
100-
200Mg/day
LIVER, MILK ,
EGG YOLK ,
YEAST
_
B6 PYRIDOXI
NE
•CO-FACTOR
FOE ENZYMES
•SYNTHESIS OF
AMINOACIDS
DERMATITIS ,
GLOSSITIS AND
CONVULSIONS
0.3-2 mg /day MEAT , LIVE
YEAST ,
CEREALS
ANGULAR
CHEILIOSIS,
SORE OR
BURNING
MOUTH,GLO
SSITIS
B12 CYANOCO
BALAMIN
•CO-ENZYME
•MAINTENANC
E OF MYELIN
SHEALTH
ATROPHIC
GLOSSITIS,
COMBINED
SYSTEM DISEASE
3M/day MEAT, EGG
,MILK, CHEESE,
FISH
ANGULAR
CHEILOSIS,M
UCOSITIS,ST
OMATISTIS,H
ALITOSIS,
XEROSTOMI
A,
APHTHOUS
ULCER
_ FOLIC
ACID
•MATURATION
OF BLOOD
CELLS, CO-
ENZYME
MALABSORPION ,
ANEMIA,
ANGULAR
CHEILOSIS
0.4 mg/day LIVER, ORANGE,
DARK GREEN
LEAFY
VEGETABLES,SO
YA
_

26. C ASCORBI
C ACID
•FORMATION OF
COLLAGEN
•WOUND HEALING
•ROLE IN
HEMATOLOGY
•ROLE IN
PHAGOCYTOSIS
•METABOLISM OF
AMINO ACIDS
SCURVY,
HEMORRHAGIC
SKIN
,FOLLICLES,SW
OLLEN AND
BLEEDING
GUMS
60mg/
DAY
PEPPER,
CITRUS
RFRUITS,
CABBAG
E,BEANS,
TOMATO,
CARROT
SCURVY-RED SWOLLEN
GINGIVAE,GINGIVAL
FRIABILITY,PERIODONTAL
DESTRUCTION,SORE
BURNING MOUTH, sed
RISK OF
CANDIDIASIS,MALFORME
D TEETH( INADEQUATE
DENTINE)
A RETINOL •FORMATION OF
VISUAL PURPLE
•DIFFERENTIATION
OF EPITHELIUM
•PROMOTION OF
BONE
REMODELLING
•ACTIVATION OF
CELL MEMRANE
NIHGHT
BLINDNESS,
KERATOMALA
CIA,XEROPHTH
ALMIAHYPERK
ERATOSIS,HYP
OPLASIA
5000IU CARROT,
CABBAG
E,
SPINACH,
POTATOE
S
INADEQUATE CELL
DIFFERENTIATION-
IMPAIRED, HEALING AND
TISSUE REGENERATION,
DESQUAMMATION OF
ORALMUCOSA,KERATOSIS
, INCREASED RISK OF
CANDIDIASIS,XEROSTOMI
A,DISTURBED OR
ARRESTEDENAMEL
DEVELOPMENT,IRREGULA
R TUBULAR DENTINE
FORMATION AND
INCREASED CARIES RISK
D CHOLEC
ALCIFER
OL
•CALCIUM AND
PHOSPHORUS
ABSORPTION
RICKETS AND
OSTEOMALACI
A
400IU FISH,EGG
,LIVER,B
UTTER,M
ILK
INCOMPLETE
MINERALIZATION OF
TEETHAND ALVEOLAR
BONE EXCESS-PULP
CALCIFICATION,ENAMEL
HYPOPLASIA

27. E TOCOPHERO
L
•ANTIOXIDA
NT
•STABILIZES
CELL
MEMBRANE
•PREVENTS
FAT FROM
DECCAY
ANEMIA 10-20 IU CEREALS,SO
YABEAN,CO
RN,MEAT,EG
G
NO ORAL
MANIFESTAT
IONS
K MENADIONE •SYNTHESIS
OF
PROTHROMB
IN AND
OTHER
CLOTTING
FACTORS
CLOTTING
DISORDERS
70-
140Mg/DAY
LETTUCE,SPI
NACH,
CAULIFLOW
ER,CABBAGE
INCREASED
RISK OF
BLEEDING
AND
CANDIDIASI
S

28. MINERALS
MINERAL
FUNCTIONS SOURCES DEFICIENCY
CALCIUM •GIVES RIGIDITY TO BONES AND
TEETH
•AIDS IN TRANSMISSION OF IMPULSES
ACROSS NEUROMUSCULAR
JUNCTION
•ACTS AS QA CHEMICAL TRIGGER IN
THE CONTRACTION OF MUSCLES
•ESSENTIAL FACTOR IN CLOTTING OF
BLOOD
•MILK ANA MILK
PRODUCTS
•LEAFY GREEN
VEGETABLES-MUSTARD
GREEN
,BROCCOLI(SPINACH
CONTAINS OXALIC ACID
WHICH BINDS WITH
CALCIUM SO THAT IT
CANNOT BE ABSORBED)
HYPOCALCEMIA
,TETANY
PHOSPHOR
US
•DEVELOPMENT AND MAINTENANCE
OF SKELETAL STRUCTURE
•INVOLVED IN THE STORAGE AND
RELEASE OF ENERGY IN
CARBOHYDRATE METABOLISM
•COMPONENET OF RNAAND DNA
•COMPONENETS OF CELL
MEMBRANES
•MEAT,POULTRY,FISH,EG
GS
•MILK,DRIESPEAS AND
BEANS
•WHOLE GRAIN
BREADSAND CEREALS
ARE RICH SOURCES,BUT
MUCH OF
PHOSPHOROUS IS
BOUND BY PHYTIC ACID
IRRITABILTY
,WEAKNESS,BLOOD
CELL DISORDERS,GIT
DYSFUNCTION
SODIUM
AND
CHLORINE
•MAJOR COMPONENTS OF
EXTRACELLULAR FLUID-HELPS
MAINTAIN OSMOTIC PRESSURE
•HELPS REGULATE ACID-BASE
BALANCE
•SALT USED IN
PROCESSING FOOD,
COOKING AND AT THE
TABLE
SODIUM-
HYPONATREMIA,COMA,
CONFUSION
CHLORINE-
ALKALOSIS,FAILURE TO

29. POTASSIUM •HELPS TO MAINTAIN OSMOTIC
PRESSURE AND ACID-BASE
BALANCE
DRIED PEAS, BEANS,
ORANGES BREWER’S
YEAST
HYPOKALCEMIA,PARAL
YSIS,CARDIAC
PROBLEMS
MAGNESIUM •ROLE IN BODY’S ANABOLIC AND
CATABOLIC PROCESSES
•LEAFY GREEN
VEGETABLES,
NUTS,SOYABEAN
NEUROMUSCULAR
IRRITABILITY
SULFUR •COMPONENTS OF SULFUR-
CONTAINING AMINOACIDS, THE
VITAMINS,THALAMINE NAD
BIOTIN,ENZYMES(COENZYME A)
AND HORMONES(INSULIN)
•LENTILS,PEANUTS,CHE
ESE
•MAJOR SOURCE IS THE
AMINOACID CYSTINE
IRON •COMPONENT OF HEMOGLOBIN
(CARRIES OXYGEN FROM LUNGS TO
TISSUES)
•COMPONENT OF
MYOGLOBIN(STORES OXYGEN
TEMPORARILY IN MUSCLE)
•COMPONENT OF CATALYSTS IN THE
METABOLISM OF GLUCOSE
•MEAT, EGG
YOLKS,OYSTER,LEAFY
GREEN VEGETABLES
ANEMIA,ENTEROPATHY,
DECREASED WORK
PERFORMANCE,IMPAIRE
D LEARNING ABILITY
IODINE •ESSENTIAL COMPONENT OF
THYROXINEAND
TRIIODOTHYRONINE(REGULATES
THE RATE OF OXIDATION –
REDUCTION REACTIONS)
•IODIZED SALT
•SEA FOOD
•SEAWEED
CRETINISM,IMPAIRED
FETAL
GROWTH,RETARDED
BRAIN DEVELOPMENT
MANGANES
E
•COFACTOR IN ENZYME SYSTEMS •DRY TEA,INSTANT
COFFEE,WHOLE
GRAINS,PEANUT
BUTTER
ANTHRALGIA,NEURALG
AI

30. COPPER •PRESENT IN SEVERAL ENZYMES
ESSENTIAL FOR DEVELOPMENT
OF YOUNG BLOOD CELLS
COCOA POWDER,DRY
TEA,BEEF,PEANUT
BUTTER
ANEMIA,MENKES
SYNDROME
ZINC •COMPONENTS OF SEVERAL
METALLOENZYMES
MEAT, POULTRY,SE
FOOD ,EGGS
GROWTH
RETARDATION,HYPOGO
NADISM
COBALT •CONSTITUENT OF VITAMIN B12 _
MOLYBDENUM •NOT ESSENTIAL IN MAN LEGUMES,CEREAL
GRAINS,LIVER
TACHYCARDIA,NAUSEA,
HEADACHE
FLUORINE •INCORPORATED INTO TOOTH
STRUCTURE, AIDS IN
RESISTANCE TO CARIES
•FLUORIDATED
WATER,SEAFOOD,DRY
TEA
•OSTEOPOROSIS,DENTAL
CRIES
CHROMIUM •ROLE IN GLUCOSE TOLERANCE
IN HUMANS
•AMERICAN
CHEESE,DRY BEANS,
MEAT,WHOLE GRAINS
•IMPAIRED GLUCOSE
TOLERANCE
SELENIUM •NON SPECIFIC ANTIOXIDANT
CATALYST
•MEAT,EGGS,MILK,SEAF
OOD,WHOLE GRAINS
•MUSCLE WEAKNESS

31. Proteins -
Fats -
-
7 to 15 per cent
10 to 30 per cent
Carbohydrates - 65 to 80 per cent
NUTRIENTS : NUTRIENTS ARE ORGANIC AND INORGANIC
COMPLEXES CONTAINED IN FOOD. THERE ARE ABOUT 50
DIFFERENT NUTRIENTS WHICH ARE NORMALLY SUPPLIED
THROUGH THE FOODS WE EAT. EACH NUTRIENT HAS SPECIFIC
FUNCTIONS IN THE BODY. MOST NATURAL FOODS CONTAIN
MORE THAN ONE NUTRIENT. THESE MAY BE DIVIDED INTO :
1.Macronutrients : Are proteins, fats, and carbohydrates,
which are often called ‘proximate principles’ because
they form the main bulk of food.
In the Indian dietary practices, they contribute to the total
energy intake in the following proportions:

32. In constructing balanced diet, following principles
has to be followed---
•Protein - should be 15-20 % of daily energy intake.
•Fat requirement – limited to 20-30 % of daily
energy intake.
•Carbohydrates rich in natural fibers should
constitute remaining energy intake.
•Requirements of micronutrients should be met.
2. Micronutrients: - vitamins and minerals.
- required in small amounts
(mg to several grams).

33. National Nutrition Week :- 1st-7th September
Source: https://www.kent.co.in/blog/national-nutrition-week-2017-a-handy-guide-to-the-ideal-
balanced-diet/

34. FOCUS ON A BALANCED DIET
•Start your Day with Water
(6:30 a.m.-7:00 a.m.)
•Eat a Healthy and Filling Breakfast
(8:00 a.m.-9:00 a.m.)
•Include a Mid-Morning Snack
(10:00 a.m.- 11 a.m.)
•Eat a Balanced Lunch
(1:00 p.m.-2:00.p.m.)
•Evening Snack (3:30-4:00 pm)
•Have a Light Dinner (7:00 p.m.-
7:30 p.m.)

35. Source: Dietary Guidelines For Indians-A Manual - National Institute Of Nutrition, Hyderabad

36. FOOD GROUP GUIDE
 Objective
 Five Groups(acc. to nutritional contributions)
1) Vegetable-fruit
2) Bread-cereal
3) Milk-cheese
4) Meat, poultry, fish, and beans.
5) Fats, sweets and alcohol.

37. FOOD GUIDES
 USDAs first dietary guidelines were published in
1894 by Dr. Wilbur Olin Atwater.
 Basic Seven
 Basic Four
 Five Group guide
 Food Wheel Approach
 Food Guide Pyramid
 My Plate

38. BASIC SEVEN
•First food guide proposed in1943.

39. BASIC FOUR
 Basic seven was upgraded.
 Food groups were
1. Vegetables and fruits
2. Milk
3. Meat
4. Cereals and breads

40. FIVE GROUP GUIDE
 Called Daily Food Guide.
 Fats, sweets, and alcohol groups were added.

41. FOOD WHEEL APPROACH

42. FOOD GUIDE PYRAMID
•First food pyramid was published in Sweden in 1974.
Introduction of USDAs 1st food guide.

43.  On 15th April 2005, the USDA updated its guide with
MyPyramid.
 For adults
 For children
 For vegetarians

44. FOR ADULTS

45. FOR CHILDREN

47. FOR VEGETARIANS

48. MY PLATE
•Food guide pyramids were discontinued and a new alternative program
name My Plate was initiated in 2nd June 2011.
•Vegetables and grains portion are the largest of the four.

49. COMMON INDIAN FOOD GROUPS – FOOD
GUIDE FOR CHILDREN

50. CLASSES OF NUTRIENTS
 Energy providing Carbohydrates & Lipids.
 Tissue building Proteins.
 Regulator Vitamins & Minerals.
 Water – 55 to 65% of total body weight.

51. NUTRITIONAL REQUIREMENTS
 Knowledge of nutritional requirement is necessary in order to
assess the nutritional adequacy of diets for growth of infants,
children and adolescents and for maintenance of health in
adults of both sexes & during pregnancy and lactation in
women.
 Various terms have been used to define the amount of
nutrients needed by the body as:
• Optimum requirement.
• Minimal requirements.
• Recommended intakes/ allowances.
• Safe level of intake.
Of all these the term “recommended dietary allowance” (RDA)
has been widely accepted

52. DIET AND ORAL HEALTH.
 A shortage of vitamins and minerals in the phase before
conception influences the development of the future
embryo, influencing dental organogenesis, the growth of
the maxilla, and skull/facial development.
 An insufficient supply of proteins can lead to the
following:
(i) atrophy of the lingual papillae,
(ii) connective degeneration,
(iii) alteration in dentinogenesis,
(iv) alteration in cementogenesis,
(v) altered development of the maxilla,
(vi) malocclusion,
(vii) linear hypoplasia of the enamel.

53.  An insufficient supply of lipids can lead to the
following:
(i) inflammatory and degenerative pathologies,
(ii) parotid swelling—hyposalivation,
(iii) degeneration of glandular parenchyma,
(iv) altered mucosal trophism.

54.  An insufficient supply of carbohydrates can lead to
the following:
(i) altered organogenesis,
(ii) influence of the metabolism on the dental plaque,
(iii) caries,
(iv) periodontal disease.

55. DIET CAN BE A GOOD ALLY IN THE PREVENTION OF
CARIES
(i) Increase in the consumption of fibres: diminution of
the absorption of sugars contained in other food.
(ii) Diets characterized by a little sugar have very low
levels of caries.
(iii) Cheese has cariostatic properties.
(iv) Calcium, phosphorus and casein contained in
cow milk inhibit caries.

56. (v) Wholemeal foods have protective properties: they
require more mastication, thus stimulating salivary
secretion.
(vi) Peanuts, hard cheeses, and chewing gum are
good gustative/mechanical stimulators of salivary
secretion.
(vii) Black tea extract increases the concentration of
fluorine in the plaque and reduces the cariogenicity
of a diet rich in sugars.
(viii) Fluorine.

57. DIET AND COMMON ORAL DISEASES.
 Dental Caries - dietary sugars (sucrose)
- dental caries were reduced by 85%
by replacing sucrose in the diet by xylitol.
 Enamel hypoplasia - related to the nutritional
deficiencies of vitamin A, vitamin D and protein
energy malnutrition (PEM).
 Dental erosion - dietary acids are present in various
soft drinks, fruits, fruit juices, some herbal teas,
vinegar and dry wines.

58.  Periodontal diseases - Deficiencies of vitamins A,
C, E, folic acid and calcium have all been
associated with periodontal diseases.
 Vitamin A - maintenance of the epithelium
- deficiency - gingivitis, gingival
hypoplasia, proliferation of crevicular epithelium
and resorption of alveolar.
 Vitamin B complex deficiency - associated with
lower resistance to bacterial insults
 Vitamin C deficiency - scurvy - periodontitis
 PEM - affects the developing immune system-
affects respond to the periodontal pathogens.

59.  Diseases of oral mucosa - Vitamin B, iron and
folate deficiencies are linked to recurrent apthous
stomatitis (RAS), glossitis, cheilitis and angular
stomatitis.
 Oral cancer - Nutrition and diet, environmental
factors and determinants of growth and body
composition can contribute to an increased risk of
oral cancer .
- certain foods appear to offer a
protective action against oral cancer like green
vegetables, carrots, tomatoes and cruciferous
vegetables

60. DIET AND NUTRITION IN PEDIATRIC
DENTISTRY
 A child’s diet, defined as the combination of foods
consumed and the nutrients contained therein, has
the profound ability to influence cognition, behavior,
and emotional development in addition to ultimate
physical growth and development.

61. NORMAL GROWTH AND DEVELOPMENT
 Normal physical growth is defined as achievement
of gradual increments in weight, height, and head
circumference that parallel a standard growth
trajectory and as final attainment of an adult size
consistent with genetic potential.
 Normal development is defined as progressive
physical, emotional, psychologic, and cognitive
maturation ending in a mature state.
 Weight
 Stature
 Weight-for-height ratio/BMI

62.  Weight is used to monitor growth and provides an
indication of both acute and chronic nutritional status.
 A low weight-for-age value is a sensitive marker of
failure to thrive.
 Stature – Under 2 years
- Above 2 years
 Weight-for-height ratio/BMI
 Centers for Disease Control and Prevention (CDC)
guidelines define a ratio less than the fifth percentile
as underweight.
 Current CDC guidelines define the 85th to less than
the 95th per centile as at risk for overweight and
define greater than the 95th percentile as overweight.

63. INFANT AND YOUNG CHILD FEEDING GUIDELINES -
INDIAN ACADEMY OF PEDIATRICS

64. Source: Dietary Guidelines For Indians-A Manual - National Institute Of Nutrition, Hyderabad

65. PEDIATRIC DIETARY GUIDELINES
 Nutrient requirements.
 Physical development.
 Emotional development.
 Environmental influences.

66. NUTRITION-RELATED PEDIATRIC DISORDERS
Malnutrition is defined as a bad diet or nutritional
state due to excessive(eg: toxicity), inadequate (eg:
deficiency), or an unbalanced intake.
 Early childhood caries
 PEM/failure to thrive
 Obesity
 Fructose malabsorption
contd...

67.  Disordered eating[Anorexia nervosa, bulimia
nervosa, and similar disorders (eg, binge eating
disorder, female athlete triad, compulsive
overeating)]
 Psychosocial dwarfism
 Rumination
 Pica
 Osteoporosis
 Iron deficiency

68. DIETARY HABITS
 Skipping meals
 Snacking
 Drinking energy-containing beverages
 Subconscious eating

69. SKIPPING MEALS

70. SNACKING

71. DRINKING ENERGY-CONTAINING BEVERAGES

72. SUBCONSCIOUS EATING

73. DIETARY COUNSELING IN PEDIATRICS
 Objective – caries prevention
 The patient
 The problem (Pediatric nutrition-related diseases
are typically due to inappropriate dietary habits or
food offerings, caregiver-child interaction problems,
oral-motor delays, and underlying psychiatric or
systemic diseases)
 Counseling

74. DIET COUNSELLING
 First appointment – introduce diet diary forms- also
explain purpose of diet counselling.
 A 24 hour diet record is prepared to get an idea of
food the child is consuming.
 A 6 days diet diary is advised to be prepared by the
patient.
 Analyze regarding balanced and unbalanced diet.
 Isolate the sugar factors.
 Educate the patients in the role of sugar in the
decay process.
 Advice substitutes.
 Continuous positive reinforcement.

75. Sample of diet diary of the patient for a week:
•Record every food item – solid, liquid
•At mealtime, between meals, at soda fountain or while watching
television.
•Also record candies, chewing gum, cough drops or syrups.
•Kind of food & how it was prepared.
•Amount – 1 cup/ 1 tablespoon/ 1 teaspoon.
•Additions – on table.

76. SAMPLE RECORDING:

77. LIST OF FOOD CONTAINING SUGARS

78. LIST OF SUBSTITUTES

79. Few dietary recommendations:
 Excessive candy consumption - Provide miniature
candy bars at meal/snack.
- Keep out of sight.
 Refusal of new foods - Do not require consumption.
- Continue to offer.
- child can choose to taste, allow
to spit out.
- Do not provide treats for tasting.
 Requests alternative food - Provide planned meal.
- Include one preferred food.

80.  Irregular meal patterns - Provide regular meals at
similar times every day
 Poor meal appetite - Provide structured meals.
- Provide only sugar-free beverages
between meals/snacks.
 Binge eating - Provide six structured meals and snacks
at regular intervals.

81.  The oral health professional should
(1) recognize that changing dietary habits is difficult
but early intervention may be most successful;
(2) encourage small changes at one time because
multiple changes may be overwhelming, causing
the patient to revert to prior habits;
(3) reinforce the disease-risk diet-associated etiology
and complement positive behavioral changes; and
(4) present “how-to’’ rather than ‘‘don’t’’
recommendations because they are more likely to
be successful.

82. IMPLEMENTATION OF DIETARY GOALS
 Eat a variety of foods.
 Eat foods with adequate starch & fibre, such as
whole-grain bread, cereals, raw vegetables, and
fruits.
 Eat a minimum to moderate amount of sugar.
 Eat a minimum to moderate amount of salt.

84. REFERENCES :
 Textbook Of Pediatric Dentistry – Nikhil Marwah (3rd edition)
 Textbook of Dentistry for the Child and Adolescent - McDonald and Avery's (9th
edition)
 Textbook of Clinical Pedodontics – Finn (4th edition)
 Textbook of Pedodontics – Shobha Tandon (2nd edition)
 Text book of Biochemistry – Satyanarayana (3rd edition)
 Diet and nutrition in pediatric dentistry - Teresa A Marshall, PhD, RD. (article)
 Nutrition and oral health – Gondivkar et al. (article)
 The role of diet and nutrition in the etiology and prevention of oral diseases -
Paula J. Moynihan. (article)
 Good Oral Health and Diet – G. A. Scardina and P.Messina. (article)
 The interrelationship between diet and oral health - Paula Moynihan. (article)
 Infant and Young Child Feeding Guidelines: 2010 Indian Academy Of
Pediatrics.
 Dietary Guidelines For Indians-A Manual - National Institute Of Nutrition,
Hyderabad.
 Internet