Diet and nutrition/endodontic courses

Diet and Nutrition
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

Introduction
 Importance of nutrition
 Dietary nutrients
- carbohydrates
- lipids
- proteins
- vitamins
- minerals and water

 This seminar relates to these nutrients, their
functions and sources and how they relate to
oral health and diseases.
 Various factors which have an impact on the
nutritional status of the elderly are also
discussed.
 Current nutritional requirements of various
age groups.

Definitions :
 Diet :
- Defined as the kinds of food on which a
person or group lives.
 Nutrition :
- the science of how the body utilizes food
to meet requirements for development
growth, repair and maintenance.

 Balanced diet :
- defined as one which contains a variety f 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 small provision for extra nutrients
to withstand short duration of leanness.

 RDA’s :
- the average daily dietary intake of a
nutrient that is sufficient to meet the
requirement of nearly all healthy people.
 BMR :
- measured as the heat output under
physical and mental rest in an adult male in
post absorptive condition (12 hrs after food
intake ), is 35kcl/hr/sq.mt body surface area.

Various nutrients :
1. Carbohydrates
2. Lipids
3. Proteins
4. Vitamins
5. Minerals
6. Water

Carbohydrates :
1. Basics
2. Functions
3. Classification

Basics :
 Poly hydroxy carbon compounds with an
actual or potential carbonyl function.
 Hydrophilic substances
 Simpler forms known as sugars.

Carbohydrates
mono oligo poly
homo hetro
polyglucans polfructants hemi cellulose mucoolysaccharides
cellulose starch
amylose
Amylo-pectin
inulin
Classification

Functions :
 55% - 60 % of daily energy requirement
 As a “ spare protein ”
 Aid in fat metabolism.
 Formation of structural elements.
( cartilage, nervous tissue and bone )
 Formation of non-essential amino acids.

Lipids :
1. Basics
2. Functions
3. Classification

Basics :
 Concentrated sources of energy.
 Provide more than twice the amount of
energy generated by carbohydrates or
proteins. ( 9 Kcal/gm )

Classification :
lipids
simple compound derived
triglycerides phospholipids cholesterol

Fatty acids
saturated unsaturated
mono poly
Omega 3 fats
Omega 6 fats
lauric
palmetic
sterric
• Essential fatty acids : Linoleic, Linolenic, Aracheidonic

Functions :
1. Excellent source of energy. ( 9 Kcal/gm )
2. As adipose tissue protects internal organs,
regulates body temperature and acts as a
store for energy.
3. Vehicle for fat soluble vitamins.
4. Palatability and satiety.
5. Decreases serum cholesterol.
6. Essential component of membranes and
nervous tissue.

Protiens :
1. Basics
2. Classification
3. Essential amino acids.
4. Deficiencies
5. Functions

Basics :
 Linear polymers of amino acids.
 20 different alpha-aminoacids serve as
building blocks of protiens.
 AA -Basic structure : -- amino group
-- carboxyl group

Amino acids
Acidic Basic neutral
aspertic
glutamic
lysine
argenine
histadine
others

 Proteins are large polypeptides or their
associates .
 Most important bio-molecules functionally.
 A typical cell consists of nearly 20% of its
weight as proteins.

Based on overall structure :
protiens
globular fibrous
Hb albumin Ig collagen keratin

Depending upon sub-groups :
protiens
simple conjugated
Plasma albumin
Growth hormone
Enzyme trypsin
Phospho proteins
glycoproteins
nucleoproteins

Essetial aminoacids :
 Determines protein quality
 Should be provided in the diet as not
synthesized by the body.
 Examples :
1. Leucine
2. Iso leucine
3. trytophan

Deficiencies :
 Particularly seen in age group of 1-5 yrs.
 2 types of protein energy malnutrition
1. Kwashiorkar
-- inadequate protein
2. Marasamus
-- inadequate protein + calorie

Functions of proteins :
 Major structural component of cellular membranes.
 Help in body immunity.
 Influence and control osmotic pressure of body
fluids.
 Help in movement of muscle fibers.
 As carrier proteins.
 As molecular receptors and nucleoproteins …

Vitamins :
1. Basics
2. Functions
3. Classification

Basics :
 Vitamin deficiencies in adults are subclinical
and their symptoms are usually stress
induced.
 Individuals prone to HYPOVITAMINOSIS :
1. Under drug therapy
2. Diseased state
3. Low calorie intake

Classification :
vitamins
Fat soluble Water soluble
A, D, E, K B complex
Vitamin C

Balanced diet :
 A balanced diet has become an accepted means to
safeguard a population from nutritional deficiencies.
 Principles governing a balanced diet
1. Daily requirement of protein must be met –
amounts to 15-20% of the daily energy intake.
2. Fat requirement – 20-30% of daily energy intake
3. Carbohydrates rich in natural fiber and micro-
nutrients should constitute the remaining food
energy.

Prosthetic considerations :
 Geriatric nutrition :
 Since the prosthodontist works primarily with the
middle and older age groups,,he is most concerned
with the general health and well being of the older
patient.
 It is a common tendency to become so engrossed
with the technical details of the denture construction
that we loose sight of the patient as a whole.

 Nutritional problems may be difficult to
handle in older people as eating habits of a
liftime are not easily changed.
 The prosthodotist who gives some thought to
the importance of NUTRITION , can help the
older patient make the most of his limited
functional resources , and can spare the
patient many f the consequences of nutritive
deficiencies .

 The most common oral complains of this age group
results from the fact that aged mucosa is friable and
easily injured .
 There is also good evidence that prosthetic failures
are often, the result of tissue deficiencies rather then
technical deficiencies.
 It is therefore obvious, that the dentist gives
importance to the DIET AND NUTRITION of this age
group

Calorie requirement of the elderly
• With age the calorie requirements for general bodily
processes continually decreases.
• The average adult calorie requirements are :
10% less at age 60
20% less at age 70
25% less over age 90
• The dentist should therefore advise the older patients to
curtail foods with high fuel or calorie value ;because
“AN OBESE PERSON IS A SICK PERSON ,AND SICK
PEOPLE ARE POOR DENTURE PATIENTS”.

IMPORTANCE OF PROTEINS
 As the patient becomes older , the amount of
protein required per kg of body weight is
increased.
 1.4gm/k body weight is optimum.
 Too much protein never damages the health
of the elderly person.
 Milk is an ideal source of proteins for this age
group.

Importance of vitamins
 Intake should be increased for the following
reasons:
1. Provide nervous stability.
2. Provide resistance to bacterial infections.
3. Improve digestive efficiency by aiding the use of
carbohydrates and utilization of mineral elements.
4. The intake of vitamin A, B-complex, C and D
should be increased mainly .

Importance of minerals
 Minerals of of considerable importance to the
aged person.
 Ca loss contributes to bone fragility .
 They often experience a rapid and excessive
ridge resorption, under complete dentures
which may be related to negative Ca
balance; which is also one of the prime
causes o OSTEOPOROSIS.

 Thus the inclusion of Ca and PO4 in the diet is
absolutely important as the prime mineralizing
substance of bone .
 Minute quantities of trace minerals are also
important , which include: cu, mn, zn, mg, I2, K,
Na…
 Ca levels may be improved by increasing the intake
of milk and milk products plus a VIT D supplement of
400-1000units/day.
 Acidulated milk with a soft curd is especially
valuable.

Geriatric nutrition and osteoporosis
 Results from the loss of bone, especially the spongy spicules of bone
which support the weight bearing parts of the skeleton.
 Common in the- aging person
 -postmenopausal women.
 Causes:
1. Lack of Ca intake .
2. Lack of Ca absorption.
3. Lactase deficiency.
4. Lack of blood circulation.
5. Low estrogen levels.
The prosthodontists are in a strategic position to intercept
early evidence of osteoporosis and educate the patient towards good
nutrition.

APPLICATION
 The essential requirements of the daily diet having been described ,
the simplest and the most practical nutritional system to follow is the
BASIC SEVEN , which provides an excellent scheme for a daily plan
on eating and which could be used by the prosthodontist to check the
adequacy of the patients diet.
 The basic seven consists of the following 7 food groups:
 Group 1 : green and yellow vegetables.
 Group 2 : citrus fruits, tomatoes, raw cabbage or salad green .
 Group 3 : potatoes and other vegetable fruits.
 Group 4 : milk and milk products.
 Group 5 : meat , poultry , fish , eggs (if expensive increase
 group 4 ) .
 Group 6 : enriched or whole grain cereals and bread.
 Group 7 : butter or margarine ( if expensive increase group 1 and 4 )

NUTRITION FOR NEW DENTURE
WEARER
 DIET FOR THE FIRST DAY :
A liquid diet which may consist of fruit juices, milk,
etc
 DIET FOR THE SECOND AND THIRD DAY :
Soft food that requires a minimum of chewing like
milk , eggs, noodles,etc.
 DIET FOR THE FOURTH AND LATER :
As the sore spots have healed firmer foods can be
eaten.

Dietary counseling of patients
undergoing prosthodontic treatment

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