This document discusses nutrition and diet. It begins with a brief history of the study of nutrition dating back to ancient Egyptians and Greeks. It then defines key terms like diet, nutrition, and types of nutrients. The document outlines Recommended Daily Allowances and discusses assessments of nutritional status. It also covers calcium metabolism and the role of fluoride. The document provides an overview of topics related to ensuring optimal nutrition and diet.

1. By
Dr.sinu jayapraksh
DIET & NUTRITION

2.  Introduction
 Definitions
 Type
 RDA
 Assessments of nutritional status
 Ca metabolism
 Role of F
 Referances
CONTENTS

3. THE BEGINNING OF THE STUDY OF
NUTRITION…..
 1st century BC – Egyptians believed that
excessive eating was the cause of many
diseases
 Hippocrates ( 460-359 BC)
“ Growing bodies have the most innate heat.
They require the most food; for otherwise
their bodies are wasted”
 Leonardo Da vinci ( 1452-1519)
3

4.  Francois Magendie ( 1783 -1855)
protein important
 Baron Justus von Liebig ( 1803-1873)
Fats and carbohydrate as fuel foods
 Claude Bernard( 1813- 1873)- glycogen
 Karl von Voit ( 1831- 1908)-
Protein–organised mass of tissue,
Fat & carbohydrate – mechanical work
 20th century
4

5.  Edentulousness remains prevalent in many industrialised
countries, despite progress made in reducing dental disease.
 Loss of teeth increases with age, and since the number of
people aged >65 years is increasing globally, it will continue
to affect a huge population for the foreseeable future.
 There is substantial evidence that edentulousness is
associated with a sub-optimum diet low in fruits and
vegetables and fibre and high in fat but whether this is a
direct causal effect in all instances remains unclear.

6.  There is growing interest in the associations between oral and
systemic health and recognition of a significant role of
nutrition as a factor that bridges oral and systemic disease.
 To advance research in this field, an understanding of basic
nutritional methodologies is required.
 Assessment of nutritional status encompasses measuring
food and nutrient intake, body composition, body levels of
nutrients, and investigating functional markers of nutritional
status.
 More than one of these categories is required for accuracy
due to lack of sensitivity and specificity of single nutritional
indicators.
 The chosen approach should be determined by the purpose of
the study and the underlying hypothesis.

7.  Diet
• The food that is taken into the mouth.
• Child diet is 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.
(DCNA 2003)
DEFINITION

8.  Nutrition
• The science of how the body utilizes food to meet
requirements for development, growth, repair, and
maintenance.(DCNA 2003)
• Deals not only with food intake but also with systemic
(physical or medical conditions) and the environmental
(Cultural, social, economic, and behavioral) factors
influencing food choices and food utilization that contribute
to achievement of optimal health and performance. (Nizel)

9.  CARBOHYDRATES
 FATS
 PROTEINS
 VITAMINS
 MINERALS
 WATER.
TYPES

10.  Recommended Daily Allowance
 Is the nutrient amount required in excess for 98% of the
population to maintain health
 Food and nutritional board incorporated RDA within Dietary
Reference Intake
 That is
• RDA -the average daily dietary intake of nutrient
that is sufficient to meet the requirement of nearly all healthy
people
• Adequate intake –a level of nutrient based on observation
intakes of groups of healthy people when RDA cannot be
established
RDA

11. • Tolerable upper intake level –the highest daily intake of nutrient
that is likely to pose no risk of toxicity for most healthy people
• Estimated average requirement – the amount of nutrient
estimated to meet the requirement for half of all healthy
people in a population

18.  In 2005 the U.S Department of Agriculture (USDA) released a
food pyramid called MyPyramid, which was designed to
educate people about the 2005 Dietary Guidelines for
Americans.
 It replaced the previous food guide pyramid that was
introduced in 1992. These guidelines were developed jointly
by the USDA and the Department of Health and Human
services (HHS).
 The dietary guidelines are revised every five years by both
departments. (Currently, there are new guidelines in place,
and the government have decided to drop the pyramid shaped
illustration to replace it with a plate model called MyPlate.)

19.  MyPyramid recommends that at least 50% of the grains should
be whole grain.
 Eat at least 3 ounces of whole grain breads, crackers, cereals,
crackers, rice or pasta everyday.
 1 ounce= 1 slice of bread, or 1 cup of breakfast cereal
 1 ounce= 1/2 cup of cooked rice, or cereal, or pasta.
 There are two types of grains: whole grains and refined grains.
Refined grains have been milled to gain finer texture and
improve their shelf life. The problem with this process is that all
fibre, iron and most of the vitamin B, have been removed. After
this process the iron and vitamin B are often added back
(enriched). The fibre is not added back though, and fibre is very
important for the health of the digestive system and for lowering
cholesterol.
MYPYRAMID – GRAINS

20.  MyPyramid recommends that you should vary your veggies.
 Eat more of the dark green and orange veggies and more of the dry
beans and peas.
 The amount of vegetables you need to eat depends on your age, sex
and level of physical activity. For adults 2 1/2 cups of vegetables and
2 cups of fruit per day is recommended for a reference of 2000 calorie
intake, with higher or lower amounts depending on the calorie level.
 1 cup=1 cup of raw/cooked vegetables, or vegetable juice.
 1 cup=2 cups of raw leafy greens.
 Your body has the capability to store some vitamins, but this is not the
case with vitamin B and C. Vitamin B and C can not be stored in your
body. Therefore, it is very important to get these vitamins everyday
from food. The best source for vitamin B and C is vegetables.
MYPYRAMID – VEGETABLES

21.  MyPyramid recommends that you should eat a variety of fruits,
but go easy on the fruit juice. Chose fresh, frozen, canned or
dried fruit.
 The amount of fruits you need to eat depends on you age, sex
and level of physical activity. For adults 2 cups of fruit and 2 1/2
cups of vegetables per day is recommended for a reference of
2000 calorie intake, with higher or lower amounts depending on
the calorie level.
 1 cup= 1 cup of fruit, or 100% fruit juice, or 1/2 cup of dried
fruit
 Fruit contains many important vitamins and minerals that most
people don’t generally get in their regular diet. Fruit is a good
source of fibre and contains very little fat. Eat at least two-three
fruits a day, and don’t forget the vegetables.
MYPYRAMID – FRUITS

22.  MyPyramid recommends that most of your fat should come
from fish, nuts and vegetable oils.
 Keep total fat intake between 20-35% of calories with most
fats from polyunsaturated and monounsaturated fatty acids.
 Oils from plant sources (vegetable and nut oils) are better for
your health since they do not contain any cholesterol. You
should limit solid fats like butter and margarine. Solid fats
come from animals and are solid at room temperature. Solid
fats are considered a contributor to cardiovascular disease, a
leading cause of death in the U.S.
MYPYRAMID – OILS

23.  MyPyramid recommends 3 cups per day of fat-free or low-fat
milk, or milk products for adults.
 Children 2-8 years old should consume 2 cups per day of fat-
free or low-fat milk.
 Milk, yogurt and cheese are all rich in calcium.
 Choose lactose-free product or other calcium sources if you
can’t consume milk.
MYPYRAMID – MILK, YOGURT AND
CHEESE

24.  MyPyramid recommends that you should choose low-fat or
lean meats and poultry.
 Bake it, broil it or grill it.
 Eat more fish, beans, peas, nuts and seeds. They contain
healthier unsaturated fats.
.
MYPYRAMID – MEAT, POULTRY, FISH,
DRY BEANS, EGGS AND NUTS

25.  The figure on the stairs is there to remind you of the
importance of physical activity.
 MyPyramid recommends that adults should engage in physical
activity (above usual activity) for at least 30 minutes every
day, or most days.
 Children and teenagers should be physically active for at least
60 minutes every day, or most days.
MYPYRAMID – PHYSICAL ACTIVITY

27.  It is a icon and multimodal communication plan developed for
the 2010 Dietary Guidelines for Americans (DGA), provides an
opportunity to consider new approaches to evaluating the
effectiveness of communication initiatives.
 The plate model was chosen as it is easier for individuals to
understand
 A review of indicators used in assessments for previous DGA
communication initiatives finds gaps in accounting for
important intermediate and long-term outcomes.
MY PLATE

28.  The goal of Choose MyPlate is not to provide a specified
dietary program to address any particular physical or health
related condition. Rather, the goal of ChooseMyPlate is to
help Americans make smarter food choices from every food
group represented, strike a balance between food and
physical activity that helps to use the food for energy, stay
within suggested daily calorie needs, and to get more
nutrition from the calories that are consumed.

29.  My Plate is made of four sections with the colours orange,
green, blue and red, plus a side order in blue.
 Each colour represent a specific food group and provides
certain nutritional benefits.
 This plate model illustrates the importance of a varied diet
with foods from each food group.
 The purpose with this design is to help people make healthier
and smarter food choices.
THE COLORS IN MYPLATE

30. • Orange represents the grain group – “Make at least half your
grains whole.”
• Green represents the vegetable group – “Vary your
vegetables.”
• Red represents the fruit group – “Focus on fruits.”
• Purple represents the protein foods group – “Go lean with
protein.”
• Blue represents the dairy group – “Get your calcium rich
foods.”

31.  Balance Calories: Determine how many calories you need per
day as a first step in diet management. Physical activity also
helps to balance caloric intake.
 Enjoy your Food, But Eat less: There’s nothing wrong with
enjoying your food as you eat it. When your attention is
somewhere else or when you eat too fast, there is a greater
possibility of consuming too many calories and overeating.
Pay attention to fullness and hunger cues before, during and
after you have eaten. Use these cues to recognize when to eat
and when you have had enough.
 Avoid Oversized Portions: Use a smaller glass, bowl and plate.
Determine portion size before you eat and when eating out,
choose a smaller size option such as the lunch portion for
dinner. Share your dish with those you eat with and take home
a portion of your meal.
10 TIPS FOR A GREAT PLATE

32.  Foods to Eat Often: Increase the number and amount fruits,
vegetables, whole grains and low and fat free dairy and milk
products. These foods tend to be nutritionally packed and
include specific healthful nutrients including fiber, vitamin D,
calcium, and potassium. Make these food stuffs the basis not
just of meals but of snacks as well.
 Make Half your Plate Vegetables and Fruit: Choose colorful
vegetables such as sweet potatoes, butternut squash,
tomatoes, and broccoli in addition to other vegetables. Make
fruit a part of side dishes as well as dessert.
 Switch to fat free or low fat milk: The same amount of
calcium is available in these options as you would find in
whole milk, but there are fewer saturated fats and fewer
calories.

33.  Make Half Your Grains Whole Grains: Substitute refined grain
products for whole grain products; for example, substitute
wheat for white bread, and brown for white rice.
 Reduce foods that are high in added sugars, salts and solid
fats. These foods include ice cream, candies, sweetened
drinks, pizza, cakes and pies and fatty meats such as hot
dogs, bacon sausage, and ribs. It’s okay to have them every
now and then, on occasion, but not as a part of everyday
meals.
 Compare Sodium in Foods: Review the nutrition facts label
available on every food product with the exception of fresh
vegetables and fruits. Select canned items that are “no salt
added”, “low sodium”, and “reduced sodium”.

34.  Drink Water instead of Sugary Drinks: Reduce calories by
changing what you drink. Calories can be significantly reduced
with unsweetened beverages or water. Soda, sports and
energy drinks are a significant source of calories and added
sugar in many Americans diets.

35. 35
NUTRITIONAL ASSESSMENT
“ Health condition of individual as influenced by his
intake & utilization of nutrients determined from the
correlation of informed from physical, biochemical,
clinical & dietary studies.”
a) Pts complaints &medical & social histories.
b) Dietary history & evaluations
c) Physical examination- anthropometric measurements
d) Pertinent lab test.

36. 36
COMPLAINTS:
•general weakness
•Chronic fatigue
•Loss of appetite
•Painful bleeding gums
•Loss of wt
•Sore lips, OMM, tongue
•Irritability
•Loss of ability to concentrate.
•Loss of manual dexterity

37. 37
Medical and social histories:
•Chronic debilitating diseases
•Alcoholism
•Digestive disturbances
•Ulcerative colitis
•Diarrhea
Emotional problems:
•Excessive wt loss – anorexia nervosa
•Food fads
• medically unsupervised quick wt reduction diets

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DIETARY HISTORY & EVALUTION:
•24 hr recall
•3day record
•5 day record
•7 day record
•Adequacy of food = Nutrients consumed (nutritive values of food)
RDA

40. 40
Physical signs of malnutrition

41. 41
Effects of nutrition on oral cavity:
3 MAJOR CHANGES ;
•Functional
•Anatomical
•Color
•Functional changes- burning sensation of mouth
nonspecific*
resolve within weeks
Anatomic changes: chronic disturbances
weeks – months
Color changes-

42. 42

43. 43
Anthropometric measurements:
•Valuable index for measurements for nutritional status’
•Weight
•Weight for height
•Mid upper arm circumference
•Dugdale index
•QUAC- stick method
•Shakir tape method
•Bangle method
Weight:
Simplest, most widely accepted, most reliable, provided recorded
correctly to the corrected age.
Difficult- underprivileged, ignored sections of the society.

44. 44
Weight eight for height ratio:
Partially age independent,
%weight for height = actual weightX100
expected weight for actual height
Mid-upper- arm-circumference:
•Mid-way between the point of the shoulder (acromian) &
olecranon process
•Left arm with hanging down by the side of the body
•2-3 yrs-----16.25-16.75cm.
< 80%i,e12.5—malnutrition

45.  Carbohydrates
• Major source of energy in human diet
• Average adult stores 300g
• Functions
oFuel
oSpare proteins
oRequired for fat metabolism
oFormation of Structural component
NUTRIENTS

46.  Classified
o Simple
o Complex
 RDA – 55-60% of total energy intake
 Deficiency
o Affect proper development
o Wound healing
o Immune response

47.  Refined sugars can contribute to dental caries and plaque
formation
 Alternative- Xylitol
DENTAL POINT OF VIEW

48.  Lipids
• Are great source of energy – 9kcal/g
• Stored – adipose tissue
• Protect internal organs
• Regulate temperature
• Stores energy for times of famine
• Source of fat soluble vit and 2 vital fatty acids
• Two forms in diet – oils and fat
• Chemically – triglyceride, phospholipids and sterols

49.  Fatty acid
o Saturated
o Unsaturated
 At lest 3%-30% of dietary calories – not more than 80g of fat
• Omega 3 –have health benefits
• Cholesterol, cardiac diseases
 Substitute – simplesse (milk and protein based)
- olestra (sucrose based )

50.  Component of cell membrane, tooth enamel , dentin
 Initiation of calcification and mineralisation of teeth and bone
 High fat food have inhibitory effect on caries
DENTAL POINT OF VIEW

51.  Dietary proteins are composed of amino acids, all of which
have the same basic structure that includes a central carbon
atom with hydrogen, an amino group, an acid group, and a
side group.
 The uniqueness of the side group gives each amino acid
different characteristics. The body can synthesize most amino
acids, but there are some that the body cannot manufacture
and these are termed essential amino acids.
 The essential amino acids are histidine, leucine, isoleucine,
lysine, methionine, phenylalanine, threonine, tryptophan, and
valine. These essential amino acids must be obtained through
dietary means.
PROTEINS

52.  Dietary proteins are ultimately degraded to their component
amino acids that enter an amino acid pool from which the
body can obtain building materials.
 One of the main functions of proteins is in the building,
repair, and replacement of body tissues.
 Proteins also function as enzymes, hormones, regulators of
fluid and acid-base balance, transport molecules (eg,
hemoglobin), and antibodies.
 Like carbohydrates, proteins provide 4 kcal/g; however, this is
not their primary function

53.  The RDA for protein is 0.8 g/kg; thus, an adult 150 lb man
would meet the RDA with about 54 g of protein per day. This
amount can be obtained by consuming, for example, two 3 oz
roasted chicken wings.
 In addition, it is recommended that protein not account for
more than 15% to 20% of daily calories (kcal). An estimate for
a serving size of protein is roughly the size of a deck of cards.
 Proteins of poor quality provide an unbalanced supply of
amino acids so the body cannot completely utilize all of them.
 Complete proteins contain all the essential amino acids; these
are the highest quality. Generally, animal products contain
complete proteins; plant foods may be limited in one or more
amino acids.

54.  Inadequate dietary protein may predispose to decreased
immune function, impaired wound healing, and oral infections
 Effect of protein deficiency on the jaw and teeth:
• consumption of too little EAA during critical period of active
growth – permanent structural damage.
• PEM- rotated teeth, crowded, retarded growth of jaw bone.
• Nigerian children with kwashiorkor –delayed eruption,
hypoplasia of deciduous teeth.

55.  ROLE OF PROTEIN IN BIOCHEMISTRY OF PERIDONTAL TISSUE:
 Collagen deficiency in CT is due to
1. Inability of fibroblasts to synthesize collagen due to lack of
proline & lysine
2. Failure of soluble collagen to form insoluble fibers.
3. Degeneration of collagen.
 Effect of protein on periodontal disease:
 Experimental animal studies - ↓ dietary protein intake affects
fibroblasts, osteoblasts, cementoblasts.
 Histological- atrophic degenerative changes in CT of gingiva, pdl

56. 56
ROLE OF PROTEIN IN BIOCHEMISTRY OF PERIDONTAL TISSUE
Collagen deficiency in CT is due to
1. Inability of fibroblasts to synthesize collagen due to lack of proline
& lysine
2. Failure of soluble collagen to form insoluble fibers.
3. Degeneration of collagen.
Effect of protein on periodontal disease:
• Experimental animal studies - ↓ dietary protein intake affects
fibroblasts, osteoblasts, cementoblasts.
• Histological- atrophic degenerative changes of gingiva, pdl.
• Human studies – inconclusive and controversial.

57.  Water is an essential nutrient for life through which all body
processes occur. Nutrients and waste products are
transported throughout the body by water. Water serves the
body as a solvent, lubricant, shock absorber, temperature
regulator, blood volume regulator, and structural component
of numerous molecules, and participates in a variety of
chemical reactions within the body. About 60% of an adult
human body and an even greater percentage of a child’s is
composed of water. Water within the body is basically
intracellular or extracellular. Intracellular fluid accounts for
two thirds of body water and is high in phosphate and
potassium. The remainder is extracellular fluid that includes
interstitial fluid (high in sodium and chloride), plasma, and
structural water such as in bones and skin.
WATER

58.  The average adult requires 2000 ml to 3000 ml of water daily
(7-12 cups). Pregnancy and lactation further increase fluid
needs. The main sources of water include beverages and
foods. Many meats and cheeses are composed of up to 50%
water, whereas fruits and vegetables may be up to 95% water.
Water is also produced by the body during metabolism. Losses
of water can occur from urination, defecation, perspiration,
and respiration. The body tightly controls water balance such
that homeostasis needed for life is maintained. Thirst is the
primary regulator of water, intake in response to changes
sensed by the mouth, hypothalamus, and nerves.

59.  Fluid volume excess can result in body water moving into
interstitial compartments, which can produce peripheral
edema. Congestive heart failure, renal failure, liver disease,
and steroid use can predispose a person to sodium retention
and ultimately fluid volume excess. Prolonged dehydration
and excessive vomiting, diarrhea, perspiration, and polyuria
may result in fluid volume deficit. People may experience
light-headedness, disorientation, extreme thirst, nausea,
unusual drowsiness,

60. 60
Age in yrs Water
(ml/kg
body wt
Infants Birth- 1yr 100-120
Children 1-10 60-80
Adolescents 11-18 41-55
Adults 19-51 20-30
WATER REQURIMENT:
•Based on body size
•Determined by- per kg body wt.

61.  The oral mucosa is very sensitive to fluid volume. Xerostomia,
dry, shrunken, fissured tongue or mucous membranes, and dry
skin may be noted in patients presenting with fluid volume
deficit. In addition, a patient who has experienced rapid
weight loss or whose denture suddenly feels loose may be
experiencing a fluid volume deficit. The dentist should inquire
about medications being taken and dietary and fluid intake in
such patients. Patients experiencing edema may note their
denture fits tightly and may present with mucosal irritations
related to changes in fit of the prosthesis.

62.  Patients on high- protein diets require a much higher daily
water intake to eliminate the waste products associated with
protein metabolism

63. 63
VITAMINS
An organic substance that occurs in foods in small
amounts & is necessary for the normal metabolic
functioning of the body.
FUNCTIONS:
• Acts as co- enzyme
• Regulate the metabolism by releasing energy from fats,
carbohydrates
• Involved in AA metabolism, by releasing energy from
fats, carbohydrates
• Acts as catalysts

64. 64
Classification :
• Fat soluble-
1. Vit A,
2. Vit D
3. Vit E
4. Vit K
• water soluble:
1. Vit B
2. Vit C

65. 65

66. 66

67. 67

68. 68

69. 69
MINERALS
FUNCTIONS:
 Structural components for the body .
 Nerve, muscle function
 Blood clotting
 Tissue growth & repair
 Acid- base balance of body fluids
 Cofactors for enzymes in chemical reaction within the
body

70. 70
Classification:
• Major minerals: 100mg/ day.
• Trace minerals: lesser amounts
• Major minerals:
1.Ca 4. K 7.S
2.Mg 5. Na
3.P 6. Cl
• Trace elements:
1.F 5.Ch 9.Mn
2.Fe 6. Cu
3.Zn 7. I
4. Se 8. Mb

71. 71

72. 72

73. 73

74. 74
CALCIUM METABOLISM
Body content, distribution :
 Avg sized man – 1kg of Ca in his body.
 99% of body – bone
 Rest – cells, ECF.
Functions:
2 major functions.
 Functions due to Ca in bone & ECF.
 Functions due to presence of Ca++ in the cytosol.

75. 75
Functions due to the Ca in the bone & ECF:
•Gives strength to the bone
•Takes part in the homeostasis
•Required in regulating neuromuscular activity
•Required in regulations of hormones-PTH, thyroid hormones,
Functions within the cell wall: ,
•For Muscular contraction- cardiac muscle contraction
skeletal muscle contraction
•Act as secondary messenger
•Responsible for release of Ach as neurotransmitter

76. 76
Sources:
•Milk & milk products
•Eggs
Absorption:
principally – upper part jejunum
Other parts of the intestine as well.

77. 77
Mechanism of absorption of Ca:
1. Chiefly by a carrier mediated mechanism.
2. Simple diffusion
• Carrier mediated molecules – brush border of jejunal mucosa
• Derivative of Vit D- 1,25 dihydrocholecalciferol-facilitates
carrier mediated transport
Ca absorption in GIT--
• Presence of calcitriol
• Need of Ca in the body
• Both are interdependent

78. 78
NUTRITION IN GROWTH AND DEVELOPMENT OF
ORAL STRUCTURES
ENAMEL:
• clinical studies – rickets during the time of tooth
formation cause enamel hypoplasia
• Shelling & Anderson –in series of richatic children 43%
of teeth –
enamel hypoplasia.
• Hypoplasia - pitting variety. Pits tend to stain.
• Involve those teeth that form within the 1st yr of birth.
• Central ,lateral incisors, 1st molars.
• Premolars, 2nd , 3rd molars – seldom affected .

79. 79
•Vit A- primarily concerned with the process of differentiation
of epithelial cells
•Def of Vit A, epithelial cells fail to proliferate.
•Studies – in developing tooth of a rat with def Vit A,
odontogenic epithelium
fails
normal histodifferentiation & morphodifferentiation
increased cell proliferation.

80. 80
• Young rats whose mothers are maintained on a diet def Vit A- 5
months ---
a) severe changes in enamel,
b) Distortion of shape of incisors, molars
• Harris& Navia --- ↑ caries susceptibility of rats molars of pups
which were fed by Vit A def diet, indicating the pre-eruptive role
for Vit A tooth development.
• Post eruptive Vit A def - ↑caries scores
• Sally co workers – ↑caries scores , due to salivary gland function
than to dental changes.

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DENTINE:
• Studies – Def Vit A causes changes in dentine
a) Tubular arrangement is disturbed
b) Contains cellular & vascular inclusions.
• Vit C def in guinea pigs – atrophy & disorganization of the
odontoblasts --- irregularly laid down dentine with irregularly
arranged tubules
• Dentin formation ceases,
• Predentin becomes hypercalcified producing heavy basophilic
staining line b/ n dentin & pulp

82. 82
PERIODONTAL LIGAMENT & ALVEOLAR BONE:
Goldman --Vit C def in scorbutic monkeys
•hypertrophy of the gingiva covering the entire crowns.
•Subperiosteal hemorrhages from the underlying bone.
•Focal areas of necrosis have bee reported
•alveolar bone showed atrophic changes,
•Marrow space were replaced by fibroblasts growing in an
edematous space

83. 83
Protein calorie malnutrition –gestation neonatal period-
a)enamel hypoplasia
b)dental caries- primary dentition.
ORAL EPITHELIUM:**
Nutritional stress-critical period– impair the renewal of
sulcular epithelium & compromise an important component
of its defense mechanisms

84. 84
BONY ORAL TISSUE:
•Bone development is similar to that of soft tissues
•Animal models-increased bone growth- period of weaning
(period of low to high protein diet).
•Nutrient def, environmental factors- irreversible effect
on growth.
•Prolonged Vit A def + PEM –
a) inadequate bone growth pattern
b) malalignment & malocclusion