Diet, nutrition and oral health

Question 1

Describe the factors other than activity levels that impact on your need for energy now and in the future

Answer 1

Genetics, metabolic rate, sex, age

Question 2

How much energy do YOU need per day – what nutrients will provide this energy?

Answer 2

The average adult needs about 8,700 kJ - carbs, protein, fats

Question 3

What are the major functions of dietary fat?

Answer 3

Energy, precursor of cholesterol and prostagladin, absorption of fat-soluble vitamins, essential fatty acids are used to synthesise components important for bodily function

Question 4

What is meant by ‘essential fatty acid’ and where do we get this from?

Answer 4

Fatty acids that cannot be synthesised by the body and must be obtained from diet. Comprises comega 3 and omega 6

Question 5

List the 3 categories of fats, the 2 subcategories for the last one
And where they are found in diet

Answer 5

List 3 foods that are high in saturated (fatty meats, dairy, coconut and palm oil), monounsaturated fat (avocados, olive oil, sesame oil), polyunsaturated fat (means omega 3 and omega 6), and omega 3 fatty acid (fish, flaxseed, canola oils, walnuts) omega 6 fatty acid (peanut oil, corn oil, sunflower seeds)

Question 6

What are the 4 fat soluble vitamins

Answer 6

ADEK

Question 7

What advice on dietary fat would you give to your patient and how would you explain to you patient the difference between omega 3 and omega 6 fats

Answer 7

Omega 3 is more anti-inflammatory while omega 6 is pro-inflammatory, the ratio should be kept 1:1

Question 8

What are the major functions of protein in the body?

Answer 8

Catalyse almost all reactions
structural function
regulatory factors
dietary protein are supply of amino acids

Question 9

Sources of protein

Answer 9

Meat, fish, dairy, eggs
Pulses, tofu, nuts, beans and legumes

Question 10

What can increase a person’s protein requirement?

Answer 10

activity level

Question 11

What are the main categories of carbohydrates in the diet?

Answer 11

Saccharides, starch, dietary fibre

Question 12

Your client asks is a low carbohydrate diet is healthy - what do you say and why?

Answer 12

No - advise cutting down on sugars and replacing with less processed carbs - you need carbs for energy

Question 13

List the 3 categories of dietary fibre, where each may be found, and what they do

Answer 13

Dietary ‘fibre’ includes soluble fibre (oatmeal, beans and lentils, apples, chia seeds, nuts) (regulates blood glucose and cholesterol levels), insoluble fibre (whole wheat, brown rice, quinoa, legumes, leafy vegetables, nuts) (helps bowel movements, removes toxins, increases satiety) and resistant starch (cereal foods, bananas) (supports microbiome in large intestine - does not get digested in upper GIT, provides food for fermentation). Describe each of these where they might be found and what they do.

Question 14

What is meant by the term ‘estimated average requirement’ and how does this
differ from the term ‘recommended daily intake?

Answer 14

EAR = the amount of a given nutrient needed to meet the daily needs of 50% of healthy individuals of a given age and sex. (= the median intake of the population) RDI = amount of given nutrient needed to meet the daily needs of almost all healthy individuals of a given age and sex

Question 15

2) With respect to vegetables, what do the Australian Dietary Guidelines recommend
and how many serves should you aim for each day? As well as number of serves,
what else should you aim for?

Answer 15

5 servings per day, you should also aim for balanced variety of vegetables for the different nutrients

Question 16

3) Your patient asks ‘are there any particular foods I should avoid?’ Keeping in mind what you know about the Australian Dietary Guidelines, what simple advice would you give? Write down what you would say to the patient.

Answer 16

Foods with added sugars, added salt, trans and saturated fat, alcohol. Such as processed foods

Question 17

4) Your patient is a nursing mother and she ask you if breastfeeding is damaging her
baby’s teeth. With reference to the Australian Infant feeding guidelines, what would
you advise. Write down what you would say to the mother.

Answer 17

Breastfeeding is perfectly safe for teeth; the milk sugars in milk, lactose, do not cause tooth decay (unlike formula milk which contains sucrose). In fact breast milk is good for the teeth since 1) contains calcium and phosphate ions, which strengthen teeth against decay, and 2) contains antibodies that reduce growth of harmful bacteria in the mouth. It is important to keep breastfeeding the baby as breast milk is a key source of essential nutrients for the baby’s development.

Question 18

5) Considering the classification of sugars for health purposes, what are the main categories of dietary sugars

Answer 18

Free sugars (juices, honey, added sugar), intrinsic sugars (in whole fruit, veg and grains), milk sugars

Question 19

What does the World Health Organization recommend with respect to dietary sugars?

Answer 19

intake of free sugars should not exceed 10% of total daily energy intake

Question 20

Human epidemiological evidence of the association between sugars and caries
includes data from different types of studies including a) cohort studies b) cross
sectional studies and 2) ecological (population) studies

What is meant by each, what has each type show and what are the limitations of each study design?

Answer 20

Human epidemiological evidence of the association between sugars and caries
includes data from different types of studies including a) cohort studies (measure changes in dental caries in a study cohort over time - strongest data after RCT) b) cross
sectional studies (measure and comparison of two variables at a given time, eg caries and sugar intake, limitation - caries takes years to develop, current diet may not be influencing factor of current caries) and 2) ecological (population) studies (look at dental data and sugar availability data across the whole population, limitation - conclusion may not apply to each individual). What is meant by each, what has each type show and what are the limitations of each study design?

Question 21

Why should your advice to a patient around dietary sugars NOT be a simple message to eat sugars less frequently?

Answer 21

Limiting advice to frequency can cause patients to simply eat more sugars in a single sitting, which is still unhealthy for both teeth and systemic health, which can lead to many non-communicable diseases (diabetes and obesity)

Question 22

5) Will substituting sucrose in the diet with lactose impact on dental caries? Would you advice your patient to do this?

Answer 22

Lactose is a much less cariogenic sugar than sucrose since sucrose is taken up by cariogenic bacteria to make extracellular glucans which make biofilm stickier and adhere better to tooth surface making them more resistant to removal. Lactose is also not as readily broken down as sucrose by S. mutans. I would advise the patient do this substitution if it helps them to reduce their consumption of sucrose, but be aware that lactose is still a sugar n still cariogenic even if less so. It is better to cut down on the amount of added sugars in the long run.

Question 23

Which sub-groups of the population are at increased risk of getting dental erosion and why?

Answer 23

Industry exposure, swimmers, gastric reflux, regular alcohol consumption

Question 24

2) Your patient tells you that they have seen an advert on TV where the dentist is saying that fruit is bad for the teeth causing erosion and they have decided to stop eating fruit as erosion is horrible! What would you day to this patient? What advice would you give them to help them minimise their risk of erosive tooth wear?

Answer 24

Thats wrong lol its fruit juice that is the problem
10x less erosive than juices and sodas
Fruit is ok as long as ur not eating like, Bucketloads of fruit
If you are worried you can drink water after eating fruit, or eating cheese/drinking milk afterwards to restore pH in your mouth quicker
PLEASE eat fruit it’s important part of a balanced diet

Question 25

3) What factors other than acids in the diet can contribute to erosive tooth wear? Are there any particular groups of the population who are particularly at risk of erosive tooth wear that is not caused by dietary acids?

Answer 25

Caffeine - reduces salivary flow. Chelating agents - locks away calcium

Question 26

4) Your fellow student is on the oenology course and has asked you about how their career might impact on their dental health. What would you say and what would you advise them to do to mitigate risk?

Answer 26

Wait 30min before brushing. Rinse with water after drinking alcohol. Can drink milk or eat cheese

Question 27

1) Are polyols bad for the teeth? What would prevent you from recommending them as a substitute for sugars?

Answer 27

No, can’t be metabolised by bacteria. Does not discourage a sweet taste, can cause issues if consumed in excess - ferment in large intestine - bloating, diarrhoea

Question 28

2) What is meant by the term ‘non-nutritive sweetener’? Give some examples of these sweeteners.

Answer 28

Artificial sweeteners that provide negligible levels of energy

Aspartame, , sucralose, saccharin, Stevia

Question 29

4) How would you explain to your patient the benefits to the teeth of eating cheese while addressing any concerns that they have about its fat content?

Answer 29

Cheese has calcium and phosphate ions
Chewing the cheese helps produce saliva
Saturated fat yeah but consume it in moderate amts

Question 30

5) Your patient is a vegan (with a ‘sweet tooth’) and they ask you to suggest some foods that they can eat that will help prevent tooth decay. What would you day to this patient?

Answer 30

fruit and veg, a balanced diet rich in fibre in general

calcium-fortified soy milk

apples

cranberries - polyphenols