1 - Nutrition: Introduction to Nutrition and Oral Health

The science of how the body uses food to meet its requirement for growth, development, repair, maintenance, and disease prevention

What is nutrition?

Consumption

Digestion

Absorption

Metabolism

Storage

Excretion

Nutrition encompasses the following aspects of food:

The pattern of individual food intake, eating habits, kind and amount of food eaten

What is diet?

Diet

What can affect general health, is a major risk for dental caries, and is impacted by a host of factors?

All necessary nutrients in amounts needed to meet individual needs

What does a healthy diet contain?

Nutrition contributes to wellness

Why is nutrition important?

Disease (Physical, emotional, and spiritual health)

Wellness is the absence of...

Nutrition

Physical activity

Sleep

Stress management (& attitude)

Social Network

Environment

What are the critical components of wellness?

5

1 in _____ deaths have poor diet as a major component

Almost all states double the percentage of self-reported obesity

How has obesity changed in the US between 2011 and 2020?

Malnutrition

What was the goal of nutrition 50 years ago (1970s)?

Chronic illness

What was the goal of nutrition 20 years ago (early 2000s)?

Obesity/Fads

What was the goal of nutrition 3 years ago (~2021)?

- Biological/health

- Ethnic

- Cultural

- Religious

- Social

- Lifestyle

- Socio-economic

- Environment/geographic

- Psychological/emotional

- Educational

All these factors are important when giving patients advise

Why do people eat the way they do?

Educational factors

What type of factors are these for why people eat the way they do?

Budgeting skills, nutritional labels and packaging, knowledge about healthy eating

Environmental factors

What type of factors are these for why people eat the way they do?

Access to Food, transportation to shops

Economic factors

What type of factors are these for why people eat the way they do?

Cost of food, income, time

Social factors

What type of factors are these for why people eat the way they do?

Experience, marketing, media, branding

dietitian

Dietitian or nutritionist?

Expert in dietetics

dietitian

Dietitian or nutritionist?

Human nutrition and the regulation of diet

dietitian

Dietitian or nutritionist?

Alters their patient's nutrition based upon their medical condition and individual needs

dietitian

Dietitian or nutritionist?

Are regulated healthcare professionals licensed to assess, diagnose, and treat nutritional problems

nutritionist

Dietitian or nutritionist?

A person who advises on matters of food and nutrition impacts on health

nutritionist

Dietitian or nutritionist?

Different professional terms are used in different countries

nutritionist

Dietitian or nutritionist?

Some examples include nutrition scientist, public health nutritionist, dietitian-nutritionist, clinical nutritionist, and sports nutritionist

nutritionist

Dietitian or nutritionist?

Can be someone to help you with your diet

True

T/F The mouth reflects general health and well-being

high cell turnover rate in mouth compared to rest of the body (3-7 days)

why is the oral cavity considered the gatekeeper specifically

Oral cavity mirror of systemic health -> medical/nutritional problems are seen FIRST in the oral cavity -> high cell turnover rate

(Reasons for a healthy mouth: Affects digestion, sensory, structural, systemic defense, speech/communication, facial expressions, self-image/self-esteem, social barrier)

Why is nutrition important in oral cavity?

- Tooth development

- Gingival and oral tissue integrity

- Bone strength

- Oral microbiome

- Prevention and management of diseases of the oral cavity

Where does Nutrition play a role in Dentistry?

- Periodontal Health/Disease

- Oral Microbiome

- Tooth Retention/Loss

- Ability to Chew/Nutrition

- Muscle Strength

- Salivary Flow (Decreased)

- Oral Health Literacy Importance/Acknowledgement

Relationship between oral health and diet

- Fluorosis - enamel stains and streaks

- Vit D toxicity - developmental defects

- Vit A toxicity - tissue regeneration

Overnutrition

- Decreased resistance to oral infections

- Decrease immune response

- Ultimately may result in increased tooth loss/enamel defects

Undernutrition

Diet induced

Nutrition implications of common oral problems: dental caries are....

WORSENED by malnutrition (not caused)

Nutrition implications of common oral problems: Periodontal disease can be....

Synergistic/oral microbiome

Nutrition implications of common oral problems: oral infections can occur by..

Nutrition implications of common oral problems: tooth loss...

WORSENS malnutrition (no food to eat), not a cause!

- Ability to eat (desire)

- Diet quality (soft foods)

- Taste and swallowing

- Malnutrition (restrictive eating)

What factors are affected by pain and discomfort in oral conditions?

Use of dentures/dental status

What is a major risk factor for malnutrition in the elderly?

Dentures

What is cited as the main cause of death from choking in the elderly?

Tooth decay

Tooth + Bacteria in plaque + sugar in food + time -->

Infant: early childhood caries

Ex: milk bottle, juice

Teens: caries

Ex: soda

Adults: Root caries

- medications, xerostomia, tobacco use=increased sugar consumption, coffee, candies/lozenges

Geriatric: oral cavity concerns

- Ex: Infrequent dental visits

Lifecycle Nutrition

- Conventional foods consumed in the regular diet.

- Any food, modified food, or food ingredient

- Have demonstrated some physiological BENEFIT beyond its nutritional value

- And/or reduce the RISK of chronic illness over and beyond the nutritional function

Functional foods

1. Prolonging life and wellbeing

2. Preventing disease and disability

3. Personalization of nutrition to individual needs/desires

What are the goals of good nutrition?

how many food groups are there?

6

biochemicals

smallest compounds in the body:

water

protein

carbs

fats

vitamins

minerals

name the 6 essential nutrients:

carbs

fats

proteins

which 3 essential nutrients can provide energy?

fats

proteins

which 2 essential nutrients have subdivisions of essential and non-essential?

vitamins A, B, C, D, E, K

name the 6 vitamins obtained from food:

vitamin B

which of the vitamins is complex with 7 components

calcium

phosphorus

magnesium

sulfur

sodium

potassium

chloride

name the 7 minerals in diet:

Sodium, chloride, potassium

Which minerals provide electrolytes?

Diabetes

Heart Disease

Blood pressure

After smoking, highest deaths from (3):

Heart disease

Cancer

Covid-19

* Important to note: Alzheimer disease, Diabetes, Kidney disease

On the graph, leading causes of death in 2020

Medical/nutrition problems are seen FIRST in the:

oral cavity

nutrition can affect bone as tissue health _____

systemically

demineralization

acidic foods/beverages can affect dentition directly via:

True

T/F: vitamin C can affect dentition directly via demineralization

Increase in cell size, affected by malnutrition -> reversible

Define hypertrophy. Is it reversible?

Increase in cell numbers, affected by malnutrition, irreversible

Define hyperplasia. Is it reversible?

Delayed tooth eruption

Decreased Tooth size

Delayed eruption patterns

Altered growth patterns

Effect of Nutrient Deficiencies on Tooth Development:

Delayed tooth eruption

Decreased tooth size

Effect on tissue of protein/calorie malnutrition?

Delayed eruption patterns

Effect on tissue of vitamin D/calcium/phosphate?

Delayed tooth eruption

Altered growth patterns

Effect on tissue of iodine?

- Bottle sipping - constantly exposure

- Juices - non-nutritious

- Contributes to childhood obesity

Causes of Early childhood caries:

Soda

- Single largest source of refined sugars consumption in American Diet

27% of all drinks for teens are what?

Xerostomia

In adults, multiple medication led to...

Sugar consumption

Smoking cessation leads to increase in...

Root caries

Hard candies, breath lozenges, and sipping on coffee/beverage all day can cause...

All of the new trends in nutrition

What does this image tell us about nutrition?

Component: Probiotics

Benefit: Improved GI health

Function component and benefit of functional food: yogurt/fermented foods

Component: Insoluble fiber

Benefit: Healthy GI

Functional component and benefit of functional food: wheat bran

Component: Tomato

Benefit: Prostate health

Function component and benefit of functional food: Lycopene

Component: soluble fiber

Benefit: heart health

Function component and benefit of functional food: apples and blueberries

Component: monounsatured fats (MUFA)

Benefit: heart health

Function component and benefit of functional food: tree nuts

Component: Omega-3

Benefit: Heart health

Function component and benefit of functional food: fish oils

Component: Xylitol, Sorbitol

Benefit: Reduce dental caries

Function component and benefit of functional food: chewing gum

1. Routine diet screening and assessment

2. Identification of risky diet patterns for general and oral health

3. Diet counseling related to oral health when indicated

4. Referral to nutrition professionals when indicated

What is the responsibility of a dentist?