This document discusses the relationship between nutrition and dental caries and periodontal diseases. It covers how carbohydrates, proteins, fats, vitamins, minerals, and other nutrients can impact the development of dental caries and periodontal diseases. Carbohydrates like sugars are the main dietary factor that promotes dental caries by feeding cariogenic bacteria, while proteins, fats, calcium, phosphate, and fluoride can help prevent dental caries. Nutritional deficiencies can also weaken periodontal tissues and impair the body's defenses against periodontal infections. The document provides details on the mechanisms and evidence from studies on how different nutrients influence oral health.
Diet and dental caries - Diet charts and Diet counsellingKarishma Sirimulla
This seminar includes a brief introduction to Diet and Dental caries along with Role of carbohydrates,Proteins and Fats with Dental caries along with diet charts, diet modifications, Diet counselling,Food log and sugar substitutes
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Diet and dental caries - Diet charts and Diet counsellingKarishma Sirimulla
This seminar includes a brief introduction to Diet and Dental caries along with Role of carbohydrates,Proteins and Fats with Dental caries along with diet charts, diet modifications, Diet counselling,Food log and sugar substitutes
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope a presentation on DIET AND DENTAL CARIES will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
Food exerts a nutritional i.e systemic effect on the formation of the dental matrix and its mineralization during the pre-eruptive periods of development of both deciduous and permanent teeth.
Biofilms on the teeth are the root cause of inflammation on the gums and periodontium. Understanding the formation of biofilms will make improve our treatment modalities towards disruption of biofilms hence provide better periodontal health to our patients at large.
This presentation features the various measures which can be undertaken to prevent pit and fissure caries to develop i an otherwise healthy oral environment. The use of pit and fissure sealants is emphasised in case of deep pits and fissures.
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope you a presentation on ANALGESICS IN PEDIATRIC DENTISTRY will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
this presentation is on the relationship and effect of nutrition on general and oral health
management of few cases and pictures of the same are also included
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope a presentation on DIET AND DENTAL CARIES will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
Food exerts a nutritional i.e systemic effect on the formation of the dental matrix and its mineralization during the pre-eruptive periods of development of both deciduous and permanent teeth.
Biofilms on the teeth are the root cause of inflammation on the gums and periodontium. Understanding the formation of biofilms will make improve our treatment modalities towards disruption of biofilms hence provide better periodontal health to our patients at large.
This presentation features the various measures which can be undertaken to prevent pit and fissure caries to develop i an otherwise healthy oral environment. The use of pit and fissure sealants is emphasised in case of deep pits and fissures.
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope you a presentation on ANALGESICS IN PEDIATRIC DENTISTRY will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
this presentation is on the relationship and effect of nutrition on general and oral health
management of few cases and pictures of the same are also included
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Oral microflora / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
A very catchy, picture-filled power point for lecturing to children. The aim is to give little information but in an interesting way for kids to understand and remember while having fun. :)
As’salaam O Alaikum,
1000 Sunnah per Day & Night.
A very useful booklet shows 1000 acts of Sunnah of the Prophet Muhammad (Sall-Allaahu ‘Alayhi Wa Sallam) Per Day & Night. It contains different situations i.e. waking up, going to the bathroom, performing ablutions, using sewak, wearing shoes, wearing clothes, going out and coming back home, going to the mosque, athan, iqama, praying at night and post-prayer sunnahs. Insha'Allah keep act on these Sunnah and share these treasures with your family and friends as well.
Jazakallah khayran
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Diet and dental caries /orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Nutrition and dental caries. Promotion of sound dietary practices is an essential component of caries management, along with fluoride exposure and oral hygiene practices. ... Fermentable carbohydrates interact dynamically with oral bacteria and saliva, and these foods will continue to be a major part of a healthful diet.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Introduction
Carbohydrate and dental caries
Protein and dental caries
Fat and dental caries
Calcium phosphate and dental caries
Vitamins and dental caries
Trace elements and dental caries
Diet in the etiology of dental caries
Diet and periodontal disease
Protein and periodontal disease
Fat and periodontal disease
Vitamins and periodontal disease
Diet in the etiology of periodontal disease
Diet counselling for periodontal diseases
Recent studies
Conclusion
References
CONTENTS
4. The science which deals with the study of nutrient and foods
and their effects on the nature & function or organism under
different condition of age, health & disease.
-NIZEL 1989
Nutrients are defined as the constituents of food, which
perform important functions in our body
Macro and Mirco nutrients
NUTRITION
5. Nizel (1989): Total oral intake of a substance that provides
nourishment & supply.
BALANCED DIET :
One providing each nutrient in the (neither deficient nor
excess) needed to maintain optimum health.
- Stewart
DIET
6. EFFECT OF DIET ON ORAL HEALTH
Systemic mechanism
Absorption and circulation
of nutritents to cells and
tissues
These effects are
mediated locally
Local mechanism
Development of teeth,
quality and quantity of
salivary secretion
Influence the metabolism
of oral flora
10. CLASSES OF NUTRIENTS
Carbohydrates – Body
fuel
Lipids – body cushion
Proteins – body
builder
Vitamins – director of
cell processes
Minerals – regulators
of body fluids
Water – vital for life
13. 1. Frequency of eating:
Vipeholm study showed that frequency of consumption of sugars and the oral
clearance time for sugars are important factors affecting cariogenicity.
In a study of more than 1000 children in USA, indicated that the
frequency or between meal snacks of candies, cookies, chewing gum or
carbonated beverages correlated with the DMF rates (Weiss et al 1960)
When sucrose is ingested frequently even a relatively low concentration of
1.25% will cause a pH drop between 4 and 5.
FACTORS INFLUENCING CARIOGENICITY OF
SUCROSE IN DIETS
14. • A significant correlation was found between a high sugar concentration in
saliva with a prolonged clearance time and caries activity (Lundquist, 1952).
• This finding implies that retentive, sticky, sweet foods with little
detergency or self cleaning properties may be potentially more cariogenic
than foods that detergent and rapidly clear the oral cavity.
ORAL CLEARANCE RATE
15. The availability of sucrose for support of bacterial metabolism in plaque
which is influenced by the texture, consistency of food, the stimulation of
saliva by chewing and the rapidity of clearance of the substrate.
With the advent of highly concentrated processed canned sugar the level of
sucrose consumption as well as concentration of sucrose in food item
increased dramatically.
EFFECTIVE CONCENTRATION OF SUCROSE
16. • Many oral bacteria utilize sucrose, glucose, fructose and other simple
sugars to produce organic acids (Lactic, acetic, propionic)
• It is only from sucrose that most bacteria are able to synthesize both
soluble and insoluble extracellular polymers (dextrans and mutans) which
increase the bulk of plaque and facilitate the attachment of bacteria,
especially streptococcus mutans.
Sucrose a Unique Substrate for
Cariogenic Flora
17. The concentrated and complex mixture of bacteria and plaque give
rise to a wide variety of glycolytic products which cause pH to drop.
STEPHAN (1940) using many microelectrodes, recorded the pH values
of dental plaque in situ before, during, after a glucose rinse.
pH CHANGES IN PLAQUE FROM FOODS
20. A protein deficient diet fed to
experimental animals during
the preeruptive tooth
development period increases
their caries susceptibility
(Navia J. et al 1970). The
caries may be caused either by
a quality defect in the matrix
of the tooth enamel or equally
important by alteration in the
salivary gland.
PROTEIN AND DENTAL CARIES
21. Caries in rodents have been reduced significantly by adding
casein to an otherwise cariogenic diet. Since casein is a
phospho-protein, it is possible that phosphate in this protein
compound may have exerted some anti cariogenic effect.
Several animal studies show that the aminoacids such as
lysine and glycine help prevent caries (Nizel et al 1970 ;
McClure et al 1955; Harris et al 1967).
PROTEIN AND DENTAL CARIES
22. There is indirect evidence that dietary
fats may help prevent caries in
humans. For example those Eskimos
whose diets are almost solely of
animal origin and furnish about 70-
80% of their total calories as fat
experience less decay. It is only when
the fat content of the diet is reduced
to 25% or less that decay starts to
appear.
FATS AND DENTAL CARIES
23. Coating
fatty protective layer
interfere with the growth
decrease the amount
MECHANISM OF ACTION OF FAT
24. It has been observed that cheese and butter reduce
the cariogenicity in rats. Ingestion of cheddar
cheese caused the pH raise of buccal plaque (Rugg-
Gunn et al 1975).
The mechanism of the effect of cheese in raising the
plaque pH is still uncertain but one possibility is that
the bicarbonates in the alkaline saliva secreted in
response to cheese ingestion diffuses into plaque
and neutralizes the acids.
An additional anticaries action of cheese is that
calcium and phosphate ions are extracted from it
during mastication and enter plaque thus reducing
demineralization and favoring remineralization
CHEESE AND DENTAL CARIES
25. In Vitamin A deficient animals, atrophic
changes in the ameloblasts, subsequent
abnormalities in tooth morphology has been
observed.
In man severe Vitamin A deficiency during
tooth formation does not necessarily lead to
defective enamel.
The only member of the Vitamin B complex
which has been associated with caries is
pyridoxine (Vitamin B6) very high doses (10
times > than normal) have been reported in two
small scale experiments in human subjects
(pregnant and school children) to reduce
caries. (Cole et al 1980).
VITAMINS AND DENTAL CARIES
26. TRACE ELEMENTS AND DENTAL CARIES
Caries promoting elements : Selenium, magnesium, Cadmium, Platinum,
Lead, Silicon.
Elements that are mildly cariostatic : Molybdenum, Vanadium, Strontium,
Calcium, Boron, Lithium, Gold.
Elements with doubtful effect on caries : Beryllium, Cobalt, Manganese, Tin,
Zinc, Bromine, Iodine.
Caries inert elements : Barium, aluminium, nickel, iron, palladium, titanium.
Elements that are strongly cariostatic : Fluorine, phosphorous.
27. Fluoride :
Water borne fluorides which originally were observed to cause
an unattractive discolouration and deformity to tooth enamel,
when ingested at level above 2 ppm, later were proved to be
essential of dental health because they reduced the incidence
of dental decay when ingested daily at optimum levels of 1
ppm.
Fluoride acts to reduce dental decay
TRACE ELEMENTS AND DENTAL CARIES
28. Diet chart
A diet history concerning food intake patterns, diet adequacy,
consumption of fermentable carbohydrates (including
naturally occurring and added sugars), and the use of
fluoridated toothpaste is a strategy for health professionals to
use to determine the diet related caries risk habits of
persons.
DIETARY MANAGEMENT
29. What food was eaten?
How much was eaten?
How was it prepared?
How was it served?
DIET RECALL
30. EDUARDO BERNABÉ ET AL. JOURNAL OF DENTISTRY 2014
Data from 939 dentate adults who participated in the Health 2000
Survey and the Follow-Up Study of Finnish Adults’ Oral Health
showed a
Adults drinking 1–2 and 3+ sweetened beverages
daily had, respectively, 31% and 33% greater net DMFT
increments than those not drinking any sugar sweetened
beverages.
Clinical significance:
in adults.
31. Exploring the relation between body mass index, diet, and dental caries among 6-12-year-old
children
Elangovan A, Mungara J, Joseph E Department of Pedodontics and Preventive Dentistry,
RagasDental College and Hospital, Chennai, Tamilnadu, India
Background and Aim: Childhood overweight and obesity are becoming a major public health concern all over the
world. Change in lifestyles and economic growth have led to sedentary lifestyle and altered dietary patterns. There
are conflicting reports in the literature regarding the association between body mass index (BMI) and dental
caries from various parts of the world. The aim of the present study was to determine if there is an association
between BMI-for-age and dental caries in children and to find out the role of diet with respect to BMI-for-age and
dental caries. Materials and Methods: Demographics and anthropometric measurements were obtained for 600
children and BMI-for-age was calculated. Clinical examination for dental caries was carried out following WHO
criteria. A diet recording sheet was prepared and children/parents were asked to record the dietary intake for 3
days. Data obtained were statistically analyzed using Chi-square, analysis of variance (ANOVA), and multiple linear
regression. Results: After excluding improperly filled diet recording sheets, 510 children were included in the
study. Caries prevalence was more in obese children than in other BMI groups. Caries scores increased as
BMI-for-age increased, though this was not statistically significant. Consumption of fatty foods and snacks was
more with obese children compared to other groups. A correlation was found between caries and snacks.
Conclusion: Dental caries scores showed no relationship between BMI-for-age in children. Both snacks and fatty
food items were consumed more by obese children, which seeks attention.
33. Glucose and other carbohydrates are also used to produce
extracellular polysaccharides and, therefore, diets containing
sucrose, glucose and other disaccharides can increase the
plaque mass and facilitate the retention and colonization of
the plaque biofilm which forms a substrate for bacteria to
grow leading to periodontal diseases.
-Boyd (2003)
EFFECT OF DIET ON PERIODONTAL HEALTH
34. By interfering with the
A) integrity of gingival epithelial barrier.
B) tissue repair processes.
C) resistance mechanisms of the body.
NUTRITIONAL DEFICIENCIES CONTRIBUTES TO
PERIODONTAL DISEASE
35. The rapid rate of turnover of epithelium cells of the gingival sulcus
indicates need for continuous synthesis of DNA and RNA and tissue
protein.
This means that the sulcular epithelium has a high requirement for
nutrient such as folic acid, and protein, which are involved in cell form. To
maintain the integrity of the epithelium vitamin A is also needed.
At the base of the sulcular epithelium is a narrow basement membrane
made up of collagen….acts as a barrier against the entrance of toxic
meterials into the underlying connective tissue.
NUTRITION AND EPITHELIUM BARRIER
36. Protein and ascorbic acid are intimately involved in connective tissue
formation .
Zinc seems to have the property of accelerating wound healing, of
which may be due to anti infective action. Since epithelium tissue
contains 20% of the body's zinc and since zinc is involved in the
healing process, it follows an adequate intake of foods that are good
zinc sources can be helpful.
Calcium : Phosphorus are important nutrients for promoting density of
alveolar bone.
NUTRITION AND THE REPAIR PROCESS
37. Protein deficiency impair the body's immune mechanism, they
interfere with antibody formation, activity of the cell that ingest
bacteria, and nonspecific resist factors.
Protein deficiency diets interfere with body's formation of
immunoglobulin that act as antibodies to toxins. Consequently,
infections will not be readily controllable.
NUTRITION AND IMMUNE MECHANISM
39. Glucose and other carbohydrates are also used
to produce extracellular polysaccharides and,
therefore, diets containing sucrose, glucose
and other disaccharides can increase the
plaque mass and facilitate the retention and
colonization of the plaque biofilm which forms
a substrate for bacteria to grow leading to
periodontal diseases. -Boyd (2003)
Research studies using an experimental gingivitis
model have shown increased levels of bleeding on
probing when participants were fed with a diet
high in carbohydrates when compared to those on
a low sugar diet
Carbohydrates and periodontal health
40. The epithelium of the gingival crevice or pocket
adheres to the tooth surface by physiochemical
forces mediated by the proteins and glycoproteins
in the gingival fluid.
When a foreign body is introduced into the
periodontal pocket in a protein – deficient animal,
the resorption of alveolar crest, the down growth
of the epithelial attachment, and the
inflammatory exudate are increased.
Role of protein on periodontal tissue
41. Periodontal tissues of the gingival crevice or
pocket adheres to the tooth surface mucoproteins
are essential for the maintenance of a regular
distribution of water and electrolytes in the tissues.
Collagen deficiencies in connective tissue may be
due to any of three factors:
1) An inability of fibroblasts to synthesize collagen
(owing to a deficiency in amino acids, such as in
proline and lysine)
2)Failure of soluble collagen to form insoluble
fibers
3)Degeneration of collagen by collagen-liquifying
enzyme derived from Bacteroides melaninogenicus,
an anaerobic organism associated with periodontal
disease
Protein in the biochemistry periodontal tissues
42. Vitamin A deficiency produces
hyperkeratosis and hyperplasia of
gingival tissue. There is a tendency to
periodontal pocket formation.
A suitable antimetabolite of vitamin K
might interfere with the growth of
Bacteroides Melaninogenicus and
consequently, prevent the occurrence
of periodontal disease.
The characteristic oral sign of Vitamin
C deficiency is scurvy which results in
enlargement of the marginal gingivae
that envelopes and almost completely
conceals the teeth.
EFFECTS OF VITAMIN DEFICIENCY ON
PERIODONTIUM
43. Animal studies show that ascorbic
acid may be involved in both the
pathogenesis and severity of NUG
through its act on collagen synthesis
and its effect on neutrophils of the
immune system
Thus, nutritional factors do not
cause periodontal disease directly,
but can play an important role in
healing. In turn, periodontal
conditions and their treatment may
impair the desire and ability to eat
and contribute to poor nutrition.
Necrotizing Ulcerative Gingivitis /Periodontitis
44. 1)History- includes general and oral hygiene habits, socioeconomic status,
and food likes and dislikes is necessary to understand the reasons for tood
choices and dietary practices.
2)Dietary screening – screening the adequacy of the diet is to use the dental
health diet score.
3)Dietary prescription - a)Daily food pattern
Dietary management of ANUG/NUP
45. Dietary management of ANUG/NUP
b)Frequency of meals:
c) Menu plan:
Vegetable-fruit group
Bread-cereal group
Milk-cheese group
Meat-poultry,fish and bean group
4)Vitamin supplementation- multivitamin combination (vitamin c and B-complex)
46. Step 1 :Ascertain the dental health diet score and if necessary,
demonstrate the method for keeping a food intake diary
Step 2 :explain the nutrition-periodontal relationship
Step 3 : Assess nutritional status
Step 4 : Prescribe a diet –improve adequacy of diet
Emphasize foods that are particularly beneficial to periodontal tissue-
proteins,vit C,A,folic acid,calcium,iron and zinc
Encourage the elimination of plaque forming sweets and substitution of
fibrous foods
Allow the patient to prescribe meal.
Step 5 :Follow up
NUTRITION COUNSELLING FOR A PATIENT WITH
CHRONIC PERIODONTITIS
47. The National Health and Nutrition Examination Survey (NHANES) is a
program of studies designed to assess the health and nutritional status of
adults and children in the United States.
NCHS (national centre for health statistics) is part of the Centers for
Disease Control and Prevention (CDC) and has the responsibility for
producing vital and health statistics for the Nation.
The NHANES interview includes demographic, socioeconomic, dietary, and
health-related questions.
The examination component consists of medical, dental, and physiological
measurements, as well as laboratory tests.
EPIDEMIOLOGICAL SURVEYS
49. REFERENCES
Park K. Park’s Textbook of Preventive and Social Medicine, 21st Edition, Banarsidas Bhanot,
2007, Pg: 438 – 487.
Abraham E. Nizel. The science of nutrition and its application in clinical dentistry 2nd edition, W,
B Saunders Company, Philadelphia 1966.
Paula J. Moynihan. The role of diet and nutrition in the etiology and prevention of oral diseases
.Bulletin of the World Health Organization (BLT). Volume 83, Number 9, September 2005, 641-
720
Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental diseases. Public Health
Nutrition. 7(1A): 201–26
Elangovan A, Mungara J, Joseph . Exploring the relation between body mass index, diet, and
dental caries among 6-12-year-old children .J Indian Soc Pedod Prev Dent. 2012 Oct-
Dec;30(4):293-300
50. Eduardo Bernabé et al. Sugar-sweetened beverages and dental caries in
adults: A 4-year prospective study . Journal of dentistry 2014.
Kum Sun Lee, Nam-Joong Kim, Eun-Hee Lee, Ja-Won Cho. Cariogenic
Potential Index of Fruits according to Their Viscosity and Sugar Content. Int
J Clin Prev Dent 2014;10(4):255-258
Paula J. Moynihan. The role of diet and nutrition in the etiology and
prevention of oral diseases . Bulletin of the World Health Organization
(BLT). Volume 83, Number 9, September 2005, 641-720
REFERENCES