Indian Dental Academy Nutrition and Oral Health Presentation

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


NUTRITION AND ORAL
HEALTH
Presenters
Dr. Prathima Sreenivasan
Dr. Giridhar Naidu S
Under the able guidance of
Prof Dr. Gopakumar R
Dept. Oral Medicine & Maxillofacial Radiology
A.B.Shetty Memorial Institute Of Dental Sciences
Deralakatte, Mangalore

Om Bramhmarpanam bramha havi
Bramhagna bramhanahutam
Bramhaiva tena gantavyam
Bramha karma samadhinaa


YOU ARE
WHAT YOU
EAT !

Food:
Food is what is taken to supply the necessary
nutritive elements.
Diet:
Diet is a prescribed course of eating and drinking
in which the amount of food as well as the times at
which it has to be taken are regulated by the
physician for therapeutic uses.
Nutrient:
It is a constituent of food or a diet that must be
supplied in suitable amounts.

Nutrition:
It is the science of foods, the nutrients and other
substances therein; their action,interaction and
balance in relationship to health and disease.,the
process by which the organism ingests, digests,
absorbs, transports and utilizes.
Malnutrition:
Impairment of health resulting from a deficiency
excess or imbalance of nutrients.

NUTRIENTS
MACRONUTRIENTS

Carbohydrates
Fats
Proteins
Water
Dietary Fibers

MICRONUTRIENTS

Minerals
(Micro &Macro)
Vitamins


PROTEINS

Structure
Catalysts
Regulation
Transportation
Clotting of blood
Antibodies
Contractile proteins
Osmotic balance
Chemical messengers

CARBOHYDRATES
 Energy source
 Regulate protein metabolism
 Derivatives like glucoronic acid
glycerol & glycogen
 Pentose sugars form nucleic
acids


LIPIDS
Energy source
Cell membrane constituent
Biologic metabolites
Glycolipids and lipoproteins
Precursors of cholesterol,steroids, hormones,
Flavor and satiety


Protein Calorie Malnutrition
Growth phase (Rat experiments)
Shaw & Griffith - smaller molars, delayed eruption
Di Orio – Increased caries susceptibility
Menaker & Navia – Atrophy of salivary glands
Nakamoto & Muller – Retarded mandibular development
Post growth phase (Primate experiments)
Decreased amylase, sIgA
Atrophy of human parotid
Necrotizing Ulcerative Gingivitis
Delayed wound healing
Cytologic defects www.indiandentalacademy.com

VITAMINS (Vital Amine)
Vitamin A

Cellular differentiation,
integrity,growth,
antikeratinizing, vision

Vitamin D

Calcium & Phosphorous Cementum & dentin
metabolism

Vitamin E

Antioxidant

Vitamin K

Clotting factors


Xerostomia, Enamel
Hypoplasia, Tooth
eruption,cancer

Bleeding in surgery

VITAMINS
Vitamin C

Collagen synthesis,
Scurvy,
adrenal cortical hormones Enamel & dentin
defects

Vitamin B
complex

Coenzyme in many
biological reactions,
DNA synthesis


Glossitis, angular
cheilitis, RAS,
Ulceration, Infection,
keratinocyte
maturation

MINERALS
Calcium

Bone, tooth formation Bone density,
, blood clotting,
hypoplasia
muscle, nerve.

Phosphorous

Bone tooth formation rare

Iron

Hemoglobin

Anemia glossitis,
chelitis

Zinc

Wound healing,

Taste, smell,wound
healing,

Fluorine

Bone, tooth formation Susceptibility to
dental caries

MINERALS
Copper

Antioxidant, iron
absorption

anemia

Selenium

antioxidant

Predisposition Cardiac
disease


DIETARY FIBERS
They are complex polysaccharides
Components cellulose, lignin & non cellulosic
polysaccharides
Physical Properties
Water binding
Bile acid binding
Cation binding
Sources
Cereals & millets, Gums, fenugreek, pulses, fruits
vegetables

Physiologic effects
Increase fecal bulk
Decreases nutrient digestion and absorption
Reduce glycemic response
Hypocholestrolemic effect


WATER
Constitutes 50-60% of body weight
Universal solvent/ medium for all metabolic reaction
Temperature regulation
Dissociates into H & OH
Lubrication between cells


NUTRITIONAL VALUE
Energy requirement:
The level of energy intake in relation to expenditure
which is most likely to prolong active life.
 Energy

for basal metabolism
 Energy for physical activity
 Energy expended during digestion and absorption of
nutrients

Basal Metabolism:
Minimum amount of energy needed to regulate and
maintain the involuntary essential processes.
BMR:
Number of kilocalories expended by the organism per hour

SDA:
Specific dynamic action is the expenditure
of calories during the digestion and absorption
of food.

Calories:
Quantity of energy required to raise the
temperature of 1kg of water by 1 C

Recommended Daily Allowance
Carbohydrate

50-70%

Protein

1gm/kg/day

Fat
Vitamin A
Beta carotene
Vitamin D
Vitamin E
Vitamin K
Vitamin C

20%
750mcg
3000mcg
2.5mcg
5 mcg
10mg
45mcg
40mcg

Thiamine
0.5mg/1000 C

Recommended Daily Allowance
Riboflavin
Naicin
Pyridoxine
Pantothenic acid
Folate
Cyanacobolamine
Iron
Iodine
Calcium
Fluorine
Zinc

0.6mg/1000 kcal
6.6mg/1000 kcal
2mg
10mg
100mcg
1mcg
0.9mg
2.8mg

150mcg
400-500mg
0.5 – 0.8mg/lt
15mg

BALANCED DIET
A balanced diet is one which includes all the
essential food groups and allows the body to
function at an optimal level free from disease and
malaise.


A balanced diet constitutes the following
-

Protein

15 %

Carbohydrates

60%

Fats

25-30%

Dietary Fiber


FOOD PYRAMID


Cereals:

NORMAL INDIAN DIET
Rice, wheat

Millets

Jowar, bajra, ragi

Animal Foods

Eggs, milk , fish , meat

Vegetables and
pulses

Roots and tubers, green leaves

Fruits

Banana, mango, musambi, grapes, apples,
oranges, dates

Beverages

Coffee,tea,cocoa,alcohol

Fats and oils

Butter, ghee, dalda

Condiments

Cardamom, garlic, chilies, turmeric pepper

ASSESSMENT OF NUTRITIONAL STATUS
History
Anthropometry
Clinical examination
Biochemical evaluation
Assessment of dietary intake
Vital and health statistics
Ecological studies

Excess nutrition
Normal nutrition
Primary

DEFICIENCY

Tissue Depletion
Biochemical Lesion
Clinical Signs

Secondary

HISTORY
Weight change
Immunologic disorders
TMJ pain
Xerostomia
Steroid therapy
Head and neck cancer
Osteoporosis
Herbal medication – eichinacea, ephedra


ANTHROPOMETRIC
Weight
Height and length
Skin fold measurements
Other body measurements
BMI and Dentate status
Body Mass Index : body weight in kg
height in mts
< 21 natural teeth - obese
< 11 natural teeth – underweight

DIETARY SUPPLEMENTS
Dietary supplement Act,1994
• Products intended to supplement the diet
• contains a vitamin,mineral,amino acid or other

botanicals.
• Does not represent conventional food.
• Ingested in the form of capsule,
powder,softgel etc


FOOD FORTIFICATION
Fortification is a public health measure aimed at
reinforcing dietary intake of nutrients with additional
supplies to prevent or control nutritional disorders in a
given area.
Example
• fortification of salt with iodine.

•

fortification of wheat with vitamins.


Supplement

Oral use

Forms

Caffeine

Ergogenic aid

Beverage

Capsaicin

Pain relief for
tooth ache and
trigeminal
neuralgia

Chillies, topical
ointments

Garlic

Treatment and
prevention of
oral candidiasis

Supplement

Oral use

Forms

Green tea

Decreases risk
of dental caries,
cancer
prevention

Beverage

Lysine

Vitamin C

Prevents
Tablets, Topical
recurrence of
applications
aphthous ulcers,
herpes labialis
Integrity of
gingiva,
improved
healing

Citrus fruits,
tablets

ANTOXIDANTS IN VEGETABLES & FRUITS
Indoles
Carotene
Lycopene


Reactive species

Antioxidant

Singlet oxygen

Vit A, E , beta carotene

Superoxide free radical

Vit E, Beta carotene

Peroxyl free radical

Vit E, C.

Hydrogen peroxide

Catalase, Glutathione
peroxidase

Lipid peroxides

Glutathione peroxidase


Free radical Chain reaction
PUFA-OO

PUFA-OOH
TOCOH

TOCO

PUFA-H
Vit Cox
GS-SG
Superoxide
Dismutase

Superoxide

Vit cred
GSH

PUFA-OOH
H2O2

GSH

catalase

H2O
PUFA-OH

GS-SG

DISEASE AND NUTRITION
Anemia
Diabetes Mellitus
Cardiac Disease
Cancer
Liver disease
Renal Disease
AIDS
Acid Peptic Disease


NUTRITION IN ANEMIA
Supplements
Iron
Vitamin B complex
Protein, red meat
Vitamin C
Avoid:
High fat
Spicy food


OBESITY
Overweight:
10- 20 % above desired weight
Obese :
Excessive amount of adipose
Hypercellular
Hypertrophied
Risk for
Cardiac Diseases
Diabetes Melitus

NUTRITION IN DIABETES MELLITUS
Risk factors
High cholesterol
Sedentary life style
Supplements
Regular meal pattern
Protein
Adequate carbohydrate
Fibers

NUTRITION IN CARDIAC DISEASE
Risk factors:
High salt intake
Low potassium, calcium,
High cholesterol
Alcohol
Supplement
Omega 3 FA
Soybeans
Fruits and Vegetables
Dietary fiber

DIETARY MODIFICATIONS
DASH – Dietary Approaches to Stop Hypertension
Control diet- reduced fruits and vegetables
Fruit and vegetable diet
Combination diet
BP- 11.4/5.5mm of Hg
Cholesterol lowering
Hydrogenated oils, sugar- reduce
Fish, soluble fiber - increase

Sodium Controlled – 2gms/day

NUTRITION IN CANCER
Risk Factors:
Alcohol
Fat
Pickled & smoked food
Arsenical, lead, cadmium
Additives like saccharin, flavonoids
Supplement
Fruits and vegetable
Dietary Fiber
Water
Vit E and selenium
Phytoestrogen

NUTRITION IN RENAL DISEASE
Risk factors
High protein
High sodium
Excess fluid intake
High cholesterol
Supplements
Kilocalories – carbohydrates
Potassium, calcium, phosphorous
Vitamins

NUTRITION IN LIVER DISEASE
Risk factors
High protein
High fat
Alcohol
Supplements
Adequate protein
Reduced fat
Higher carbohydrate
Micronutrients

NUTRITION IN AIDS
Cachexia
Hormonal imbalance
Immunologic changes
Supplements
High calorie diet
Frequent meals
Vitamins and minerals


NUTRITION IN ACID PEPTIC DISEASE
Risk factors
High food quantity
Milk
Seasonings
Coffee
Citric acid fruits
Alcohol


Thank you all !

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