Dietary advice - Dr Al-Ani Flashcards
What are the important factors in caries control
- Plaque control
- Use of fluoride
- Dietary modification
What factors may place a patient at high risk for caries
- High sugar intake
- Inadequate brushing habits
- No fluoride exposure
- Irregular dental attendee
- Medically compromised
- Xerostomia
What investigations should be caried out for a patient with xerostomia
- Diet analysis
- Investigation on fluoride intake
- Medical history
- Oral hygiene practices
- Bitewing radiographs
What dietary factors are associated with caries
- Amount of fermentable carbohydrate eaten
- Sugar concentration of food
- Physical form of carbohydrate
- Oral retentiveness
- Frequency of eating meals and snacks
- Length of interval between eating
- Sequence of food consumption
What is the Vipeholm study
- The consumption of sugary foods is
associated with a higher caries incidence - Increasing the frequency of sugar intake
also increases caries incidence - Lowering sugar intake reduces caries
incidence - Consumption of sticky sugar-containing
between meal products can be associated
with high caries risk
What sugars are investigated in the Turku study
Sucrose
Xylitol
What did the Turku study show
The results show a profound
difference in caries rate
between the two groups
The findings clearly indicate a
therapeutic, caries inhibitory
effect of xylitol
What is the Stephan Curve
The Stephan Curve is a graph that shows what happens after the
consumption of sugar in relation to dental caries
How much pf our total energy consuption should consist of free sugars according to WHO
No more than 10%
50g per day
What are some carbohydrates can cause caries
- Sucrose
- Fructose
- Glucose
- Maltose
What are some foods with a very high hidden sigar content
baked beans
breakfast cereals
tomato ketchup
plain biscuits
What should dietary advice be
Acceptable, Practical
and Affordable
What advice could you give to someone to reduce the risk of caries
- Reduce snacks containing sugar; replace it with healthy snacks
- Avoid adding sugar (consider using sugar substitutes); look for ‘hidden
sugars’ on food labels - Best time to do have fruit drinks when saliva flow is highest at meal-times
- Save sweets to as special time of the week, eg Saturday morning
- Eat sweet all in one rather than spreading them out
- Only drink plain milk or plain water between meals
- Don’t eat or drink after brushing at night
- Increase the amount of fresh fruit and vegetable
- Avoid food within 20 minutes of bedtime
How long does damage to teeth occur after eating sugary food
Up to one hour after intake
What does the prevention and management of dental caries on children programme state
- Give dietary advice at least
once a year - Advise or remind the
child/parent/carer about how a
healthy diet can help prevent
caries - Limit consumption of sugar
containing food and drink - Snack on healthier foods which
are low in sugar, such as fresh
fruit, carrots, peppers,
breadsticks, oatcakes and
occasionally a small amount of
lower fat cheese - Do not place sugary
drinks, fruit juices,
sweetened milk or soy
formula milk in feeding
bottles or pacifiers - Do not eat or drink, apart
from tap water, after
brushing at night - Be aware of hidden sugars
in food and of the acid
content of drinks
What causes dental erosion
Chronic exposure of dental hard tissues to acidic substances which can be extrinsic or intrinsic
What causes extrinsic erosion
Extrinsic erosion is caused by acid
originating outside the body (for example
in drinks). Generally the acid strength
will be pH 2.5 or weaker
What causes intrinsic erosion
Intrinsic erosion is due to stomach acid
reaching the teeth, with a pH of 1. This
acid is typically 100 times stronger than
in extrinsic erosion, and so much more
destructive
What is titratable acidity
Reflects the number of hydrogen ions available for erosive attack, rather than pH
Which has a more erosive potential
-Coke
-Grapefruit juice
Grapefruit juice as it’s TA (titratable acidity is much hight (9) than coke (2)
What is the worst acid for teeth
Citric acid
How can simulation salivary flow after meals be beneficial
Saliva acts as buffer and removes harmful acids after eating
What should you finish a meal with
Milk or cheese
What teeth are exceptions to the erosion in order of eruption
Lower primary incisors
* the position of the submandibular ducts
that open adjacent to these teeth
* the position of the tongue in suckling,
which covers the lower incisors
What is the patern of teeth erosion
Teeth become carious in the order in which they erupt
What should the advice be to parents about night time feeding
Only water should be given during the night after 12 months of age
What additional factors make the upper
primary incisors more predisposed to caries?
- High bow-shaped upper lip in infants which does not cover the upper incisors
and results in an increased evaporation of any saliva on these teeth - Gravity, which keeps submandibular saliva pooled around the lower incisors and
less likely to reach the upper incisors - Any liquid with sugar that is allowed to bathe the teeth on a frequent basis will
cause caries. This is especially so at night when the protective function of saliva
reduces as less saliva is produced - Even breast milk, formula milk or cows’ milk with their lowered natural sugars
can still be cariogenic on this basis - In some situations maxillary incisors may erupt with hypoplastic or
hypomineralized defects, thus making the teeth less resistant to the development
of dental caries
