DIPC 5001 - Principles of Diet Screening, Risk Assessment, and Guidance

Nutritional Assessment: Risk Score

helps us determine if someone is at nutritional risk

nutritional risk score of 0-2

good! recheck your nutritional score in 6 months

nutritional risk score of 3-5

you are at moderate nutritional risk. see what can be done to improve your eating habits and lifestyle. recheck your nutritional score in 3 months

nutritional risk score of 6 or more

you are at high nutritional risk. ask a health professional for help to improve your nutritional health

_____ can guide you in estimating portion sizes

your hands

there has been a change in ______ over the past 20 years

portion size

all dental patients should be screened for

dietary risk factors

- diet screening, assessment, and guidance should be an INTEGRAL part of the care process

- must be specific to the patients individual situation

- patient has to be committed to and actively involved in the process of diet

decisions for change in behavior must be made by ______

the patient with the dental team guidance

the two types of SOAP notes are:

clinical and nutritional

S (subjective)

chief complaint, diet history, include information collected from the assessment tools, tobacco and alcohol intake, noted signs of xerostomia, etc.

O (objective)

age, occupation, height, weight, BMI, medications, medical history

- risk assessment and clinical exam

A (assessment)

assess the patients nutritional risk. intake may be excessive or deficient per the dietary reference intake (DRI)

P (plan)

patient counseling of action with appropriate referrals noted

in the Subjective portion, you should ask about the patient's _____ history

psychosocial history

- ask about their living situation, family structure, educational status, health literacy, substance use, ability to perform daily activities, health beliefs, personal preferences, and socioeconomic status

the risk assessment is done in the _____ stage

objective

- include any medications or OTC supplements

- caries risk assessment tools

- for children: ask if they are put to bed with a bottle

- for adults: determine their nutritional health checklist

an important question indicating major risk factors for nutritional problems is:

have you gained or lost more than 10 pounds without wanting to in the past 6 months?

the clinical examination (done in objective) contains these 2 parts:

1. extraoral/ intraoral examination ( observe the patients skin, eyes, mouth, and oral soft and hard tissue for signs of nutritional problems)

2. caries and periodontal examination (if patient has significant increase in caries rate, investigate changes in salivary flow. erosion may suggest ED or GERD)

how to manually assess diet adequacy

- categorize each food item from the food record into the appropriate food group

- fill in the number of portion sizes

- compare this to recommendations based on age and gender of the person

- general adequacy of the diet can be summarized and areas needing improvement should be noted for the treatment plan

common errors during a diet guidance session

- always explain the relevance of diet and/or nutrition to the patient's specific problem

- dont begin with the assumption that changes must be made

- dont start making recommendations early in the assessment before all the needed information has been collected and assessed

- GUIDE the patient to make his/her own decisions for changes!

TEST QUESTION: cariogenicity of the diet depends on:

- physical form of sugar (can be sticky or retentive)

- frequency with which carbohydrates are consumed (at/or between meals)

- presence of acid-producing bacteria in plaque (specific mutans)

- amount and buffering capabilities of saliva (polypharmacy)

- resistance of teeth to decay (oral condition)

role of the dentist

- screening with dietary assessment

- is more in-depth assessment needed?

- determining what available information is pertinent to dental patient treatment planning and care

- promoting health and disease prevention