oral health and prevention - unit 6

diet in relation to enamel erosion and the caries process

Define enamel erosion

Dental erosion is the breakdown of tooth structure caused by the weakening or loss of the tooth’s outer layer of enamel

Discuss the causes of enamel erosion

• Consuming acidic foods excessively

• Vegetarian diets

• Eating disorders (bulimia/anorexia nervosa)

• Gastro-esophageal reflux disease (GERD)

• Aggressive brushing

• Xerostomia (lack of saliva)

Discuss the signs and symptoms of enamel erosion

• Sensitivity (cold/hot)

• Transparency

• Discoloration (yellowish)

• Rounded edges of teeth

• Cracks or cupping (indents on chewing surfaces)

Discuss some ways of how to prevent enamel erosion

• Healthy diet (low acidic food and drinks)

• Visit dental office regularly

• Soft bristle toothbrush

• Non-abrasive toothpaste

• Use a straw to drink

• Rinse mouth with water after acidic food/drink

• Brush teeth at least after 30 mins after consuming acidic food/drinks

How does a high protein diet influence the risk of caries?

May provide protection against caries due to presence of alkaline

• Can cause halitosis

• e.g. meat, nuts, legumes

How does a high carbohydrates diet influence the risk of caries?

Results in secretion of acid. Higher risk of decay.

• Lactic acid and formic acid (strong)

• Acetic, propionic, butyric (weaker)

How do fat and proteins in milk and cheeses help with reducing caries activity?

They have some protection against the harmful effects of acid

How does the frequency of sugar you eat affect caries activity?

Frequency of intake matters more than the amount eaten. A little sugar can start acid formation just as easily.

• More sugar intake = more acid produced and increased risk of caries

How does faster solubility of foods affect caries activity?

The faster food dissolves = reduces risk of demineralization

Describe how chewing sugar-free gum affect saliva production and composition

• Increase flow of saliva 12x more

• Increase remineralization

• Increase pH of plaque, diluting acids

• Clears sugar and food from mouth

• Increases salivary bicarbonates, for buffering acids

What is the definition of cariogenic food?

Food that causes the pH of plaque to fall below 5.5, promoting tooth decay

What are some examples of foods that produce little or no plaque acid?

• Cheese and yogurt

• Meat, fish, and poultry

• Popcorn and legumes

• Chocolate, cocoa products

• Raw vegetables, nuts, and sugarless gum

Why do cocoa products produce little or no plaque acid?

They may reduce enamel solubility and the growth of bacteria.

Which natural sugar is consumed the most?

Sucrose

How much lactose (%) is turned into acid?

50% is turned into acid

Why is Xylitol highly beneficial in preventive dentistry?

It is non-cariogenic and actively prevents certain strains of bacteria, like Strep. mutans.

What are 2 ways to satisfy sweet tooths?

1. Eat meals rich in protein and fiber so you get full, preventing temptation of having a sweet treat after

2. Use spices like cinnamon instead to add flavor instead of sugar

What is the definition of Early Childhood Tooth Decay?

One or more cavities in the upper six front teeth of a child 3 years old or younger.

What are other common names for Early Childhood Tooth Decay (ECTD)?

• Nursing Bottle Mouth

• Baby Bottle Syndrome

• Nursing Bottles Caries

• Early Childhood Caries

What term does the Ontario Association of Public Health Dentistry prefer to use?

Early Childhood Tooth Decay (ECTD)

What primary dietary exposure causes ECTD?

Prolonged exposure of teeth to fermentable carbohydrates (like sucrose, fructose, and lactose).

What feeding behaviors increase the risk of ECTD?

• Overusing a bottle, breast, or sippy cup

• Sleeping with a bottle containing anything except plain water

• Nursing without cleaning the child's teeth afterward

• Prolonged bottle use past one year of age

What maternal and infant health factors lead to poor enamel development?

• Malnutrition

• Poor pre-birth health

• Poor pre-birth nutritional status of both mother and child

When should you start cleaning a child's teeth?

As soon as the first tooth appears

How often should a child's teeth be cleaned?

Thoroughly at least once a day, but best after every feeding

What should be done after extended or repetitive breast/bottle feeding?

Wipe the child's teeth and gums

What type and amount of toothpaste should be used for children under age 3?

A light smear of non-fluoridated toothpaste (unless they are at high risk for caries)

How can caregivers prevent the spread of dental disease via objects?

Do not share objects that have been in the caregiver's mouth

When should a baby be transitioned to a cup?

When they can sit unassisted

By what age should a baby stop drinking from the bottle?

By 13 months of age

By what age should a child start regular dental visits?

By age 1

Who should you contact if you cannot afford dental care?

Your local public health unit

What organization is concerned about high sugar levels in medications?

The Canadian Dental Association.

What is the typical sugar content range (%) in formulation drugs?

20% to 80%

Which two patient groups are particularly at risk for dental caries from medication?

• Patients with special needs

• Infants on long-term medications

^^ Have not established proper oral hygiene

What three healthcare groups should be aware of high sugar content in oral elixirs and suspensions?

Physicians, dentists, and pharmacists

What should be included on labels for high-sugar medications?

Warnings regarding the increased risk of dental caries from chronic use