Chapter 16

Question 1

Dental nutritional counseling was developed to do what?

Answer 1

Prevent or minimize dental disease.

Question 2

What do patients know?

Answer 2

• Most pt. fail to recognize the relationship between overall nutritional status and eating habits and their dental health.
• They don’t understand the connection between what, when, and how they eat and their health.
• They do have a vague understanding that sugar causes cavities, but how diet relates to the health of the soft tissues and periodontium is not common knowledge.

Question 3

Who can benefit from counseling?

Answer 3

• Almost everyone
• Certain groups are more at risk: Elderly, teenagers, single and independents, infants, toddlers, and school-aged children, adults that diet or take multiple medications, and pt. who have had a change in dental status.

Question 4

When do you determine the need to counsel a patient?

Answer 4

during the data collection phase

Question 5

What are clues to look for to determine if a patient needs counseling

Answer 5

• New or recurrent caries
• Tooth loss
• Skin lesions
• Atrophied lingual papilla
• Burning tongue
• Pale or gray mucosa
• Angular Cheilitis
• Greasy, scaly skin around nose
• Inadequately functioning salivary glands
• Difficulty chewing or swallowing
• ill-fitting dentures
• Sores under appliance
• Loss of lamina dura
• Polypharmacy
• Marginal erythema

Question 6

Gain Consent

Answer 6

• If any of the clues are found during assessment, explain the need for counseling.
• Explain relationship between finding and diet
• Patient has to be ready to make a change.

Question 7

Collecting dietary Information

Answer 7

• 24-hour recall
• 3-day food record
• 7-day food diary
• computerized diet assessment

Question 8

24-hour food recall

Answer 8

• Best for quick inquiry
• Ask patient to list all foods consumed in a 24-hour period
• Ask the patient if this is typical
• Easy to accomplish while waiting for a doctor check.

Question 9

3- and 7-Day Diet Diaries

Answer 9

• More in-depth studies
• Should include at least one day of the weekend.
• Patient keeps track of foods eaten on a daily basis.
• After analysis, counsel one-on-one

Question 10

Computerized Diet Assessment

Answer 10

• More general than dental related
• Analyzes nutrient content of food.
• Online programs.

Question 11

Barriers to eating well

Answer 11

• Jobs dictate odd hours of eating
• Eating alone
• Fixed income
• Convenience

Question 12

Counseling technique

Answer 12

• Direct Approach

- Nondirect Approach

Question 13

Direct Approach

Answer 13

Clinician is dictator and patient is passive

-Ineffective

Question 14

Nondirect Approach

Answer 14

Patient is in control and clinician is facilitator

• Also called Patient-centered technique
• Most effective

Question 15

Tips for effective counseling

Answer 15

• Be nonjudgemental
• Use eye contact and nod head
• Provide feedback as to your understanding
• Use open body language
• Offer encouragement
• Sandwich criticism between two positive statements

Question 16

Counseling in the Dental Office

Answer 16

• Seat patients at eye level
• Have a good working space
• Enhance learning space with visual aids
• Counsel in a place that does not invoke anxious feelings
• Use redireference card or other visual aids

Question 17

When diet change is indicated you want to

Answer 17

• Keep it simple
• Make small changes
• No more than two suggestions at a time
• Let the patient decide on diet changes to be made

Question 18

Considerations

Answer 18

• Be consistent with cultural influences and regional preferences
• Consider foods in season
• Consider cost of food and patient’s ability to purchase
• Encourage healthy choices at restaurants
• Suggest changes to reduce potential acid production

Question 19

Suggestions

Answer 19

• Stimulate salivary production
• -Raw Vegetables
• -Sugar-free candy
• -Sugar free gum
• -apples

Question 20

Foods that raise the PH

Answer 20

• Cheese
• Chicken, pork, beef and fish
• Dairy products
• Gum with xylitol

Question 21

Soft Drinks

Answer 21

• Diet soft drinks have a pH around 2.5 and demineralize enamel independent of bacteria
• Regular sodas have acidic additives that also demineralize enamel
• Root beer, tea, and black coffee are the least detrimental
• light-colored sodas are the most detrimental

Question 22

When to refer

Answer 22

• when the patient’s nutritional counseling needs are beyond the scope of your practice
• Never counsel for medical reasons
• -Improving heart health
• -Suspected diabetes
• -Dysphagia
• -Eating disorders
• Never counsel for medical
• -HIV/AIDS
• -Malnutrition
• -Osteoporosis