LO 2 - Part 1 Flashcards

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1
Q

Describe the importance of collagen in tooth formation

A
  1. Calcified structures in the teeth – dentin, cementum and bone - depend on proper collagen deposition.
  2. Immediately after collagen formation, mineralization begins.
  3. Adequate nutrients are necessary during both collagen formation & mineral deposition in order to prevent structural imperfections.
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2
Q

Describe collagen

A
  1. Tough bundles of fibre
    with great tensile strength
  2. Collagen is a fibrous structural protein that is the main protein of connective tissue
  3. Is the main component of teeth and bone - 90-95% of bone matrix is made up of collagen
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3
Q

___________ is the deposition of inorganic materials (no carbon) on an organic matrix (protein & lipids)

A

Mineralization

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4
Q

Describe the importance of minerals in the body

A
  1. Minerals account for only 4% of total body weight but are essential to human health
  2. Minerals provide compression strength over the tensile strength of collagen
  3. Resembles reinforced concrete
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5
Q

How are minerals classified?

A
  1. Major (“Macro” Minerals) – body needs larger amounts > 100 mg/day – calcium, phosphorus, sodium, potassium, magnesium, chlorine, sulfur.
  2. Trace Elements (“Micro” Minerals) – body needs in smaller amounts <100 mg/day – iron, copper, zinc, manganese, iodine, fluorine, etc.
  3. 100 mg is dividing line between Macro and Micro Minerals
  4. Ultra-Trace Elements (Minerals) –No DRI - required, if at all, in minute amounts: boron, nickel, silicon, tin, aluminum, lead, lithium, & mercury
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6
Q

Describe where calcium is found in the body

A
  1. Calcium is the most abundant mineral in the human body
  2. More than 99% of total body calcium is stored in the bones and teeth where it functions to support their structure
  3. The remaining 1% is found throughout the body in blood, muscle, and the fluid between cells.
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7
Q

What is the ideal calcium-to-phosphorus ratio for adults required for proper mineralization of bone?

A

1:1

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8
Q

Phosphorous levels go ___________ calcium levels go ___________ –contributing to potential loss of bone mass.

A

up; down

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9
Q

How much calcium is required by adults? Children?

A
  1. Most adults require in the range of 1,000 mg/day (1,200 if over 50)
  2. For growing children aged 9 -18 1,300 mg/day
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10
Q

How is calcium absorbed?

A
  1. Calcium is principally absorbed in the small intestine
  2. Under normal conditions, less than 1/3 calcium consumed is absorbed – best absorbed in small amounts throughout the day
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11
Q

List some good sources of calcium

A
  1. Milk and Dairy products
  2. Salmon, Sardines, Oysters
  3. Almonds
  4. Seeds – poppy, sesame, chia
  5. Beans & legumes
  6. Dark Green leafy vegetables: spinach, all the Chinese cabbages: kale, bok choy, collard greens, broccoli
  7. Calcium & Vitamin D Fortified Beverages: soy, rice and almond beverages; orange juice
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12
Q

From which sources are calcium best absorbed?

A

Calcium from dairy is absorbed better than calcium from dark leafy vegetables because oxalates in vegetables (ex: spinach) bind the calcium and interfere with absorption

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13
Q

___________ is the excess levels of calcium in blood seen most frequently in infants 5-8 months old due to inappropriate use of vitamin D preparations (ie: supplements)

A

Hypercalcemia

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14
Q

What can hypocalcemia lead to?

A

Hypothyroidism as well as bone diseases

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15
Q

Describe osteoporosis

A

Refers to the degeneration of already constructed bone (brittle bones) seen in adults/seniors

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16
Q

Describe Osteomalacia (Rickets in children)

A
  1. Is an abnormality in the building process of bone (defective bone mineralization), making them soft - attributed to vitamin D deficiency
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17
Q

What are the oral consequences of calcium deficiency?

A
  1. During tooth formation deficiency could result in incomplete calcification of teeth, failure of dentin formation, delayed dentition; small molars
  2. After tooth eruption: deficiency could result in Weakened alveolar bone; The breakdown of healthy periodontal tissue (alveolar bone; cementum, gingiva); Increased risk of decay
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18
Q

What may calcium deficiency result from?

A
  1. Lack of education & false belief that adults do not require calcium
  2. The fact that it may be difficult to achieve required intake from diet alone
  3. Acidifying influences in the diet & insufficient vitamin D
  4. Lactose intolerance coupled with food allergies/aversions
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19
Q

Describe phosphorus in the body

A
  1. Phosphorous is the second most abundant mineral in the body
  2. It makes up 1% of a person’s total body weight.
  3. It is present in every cell of the body, but most – 85% - is found in the bones and teeth.
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20
Q

What is phosphorus needed for?

A
  1. The metabolism of macronutrients
  2. The composition of phospholipids
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21
Q

How much phosphorus do adults require? Where is it absorbed?

A
  1. Adults (over 18) 700mg/day
  2. Phosphorous is absorbed in the small intestine like calcium
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22
Q

List the food sources of phosphorus

A
  1. Primary sources include milk products and meats – it is also used widely as a food additive in baked goods, cheese, processed meats & soft drinks
  2. A diet adequate in calcium and protein will contain sufficient phosphorous
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23
Q

___________ may be seen in cases of persons with thyroid disease (hypo) or renal insufficiency – body is not able to clear excess

A

Hyperphosphatemia

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24
Q

___________ may result from long term ingestion of antacids which binds to phosphorous interfering with absorption

A

Hypophosphatemia

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25
Q

__________ can also result in phosphorous malabsorption deficiencies. Insufficient dietary sources may also be at play. Principal clinical symptom = muscle weakness.

A

Intestinal conditions (notably IBS)

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26
Q

During tooth formation deficiency of phosphorus could result in ___________

A

incomplete calcification of teeth, failure of dentin formation and increased susceptibility to caries.

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27
Q

Describe the physiology of magnesium

A
  1. Almost 2/3 of total body magnesium is found in bone, the other 1/3 is found predominantly inside cells of body tissues and organs.
  2. Like calcium, 1% of magnesium is found in blood
  3. It is vitally important to the structural integrity of heart muscles as well as all muscles and nerves (magnesium is a natural muscle relaxant).
28
Q

How much magnesium do adults require per day?

A

For adults DRI in the range of 420 mg/day

29
Q

What are good sources of magnesium?

A
  1. Whole grains, nuts/seeds, beans and leafy greens
30
Q

Describe magnesium deficiency

A
  1. In certain disease states deficiencies may occur – GI issues; malnutrition; alcoholism and meds
  2. Symptoms of deficiency include: neuromuscular dysfunction, muscle spasm and convulsions.
31
Q

How is the body impacted by too much or too little magnesium?

A
  1. Teeth and periodontium may be affected by deficiencies (hypoplasia of enamel and dentin, widening of periodontal ligament space, gingival hyperplasia)
  2. Alveolar bone formation may be reduced
  3. Excess magnesium (in supplement form) at toxic levels is associated with kidney failure (kidneys regulate plasma magnesium levels) not from diet
32
Q

What trace elements are found in calcified structures?

A
  1. Copper
  2. Selenium
  3. Manganese
  4. Fluorine
33
Q

Describe copper

A
  1. Essential for the formation of red blood cells and connective tissue
  2. Readily absorbed in tooth enamel.
  3. Found in shellfish, organ meats nuts and seeds.
34
Q

Describe selenium

A
  1. Cofactor present in tooth enamel & dentin
  2. Found in animal products – meats & dairy.
35
Q

Describe Manganese

A
  1. Essential for enzyme systems, optimal bone matrix & macronutrient metabolism.
  2. Found in whole grains, legumes, nuts and leafy greens.
36
Q

What is the importance of fluorine?

A
  1. Element from which fluoride is derived
37
Q

Describe the physiology of fluoride

A
  1. Technically not an essential nutrient for health – (no known metabolic function) but is advantageous to dental health
  2. Primary sources include: Fluoridated water, marine fish & fluoridated dental products
  3. Our municipal water contains approximately 1 mg/L of fluoride.
38
Q

How much fluoride should adults have per day?

A

DRI is 3 mg/day for women and 4 mg/day for men

39
Q

Describe what happens when too much fluoride is consumed

A
  1. Mottling of tooth enamel can result from overexposure (approximately 3 to 4 times the amount necessary to prevent caries) during tooth formation.
  2. Dental fluorosis (the hypomineralization of enamel) may result from overexposure during tooth development.
40
Q

Describe ultra-trace elements

A
  1. Elements are required, if at all, in minute amounts - less than one microgram.
  2. (microgram is 1/1000 milligram or 1/1,000,000 of a gram ).
  3. These dietary requirements are easily met through common foods
  4. Ultra-trace elements include: boron, nickel, silicon, tin, aluminum, lead, lithium, vanadium & mercury
  5. Deficiencies in ultra-trace minerals have not been established nor have fixed human requirements.
41
Q

Describe vitamins

A
  1. Vitamins are considered organic substances (contain carbon) that are essential to life (metabolism) in small quantities
  2. They are required in all metabolic reactions using proteins, fats and carbohydrates for energy, growth and cell maintenance.
  3. They do not provide energy and cannot be used without adequate supply of macronutrients, enzymes & minerals
  4. They must come from outside sources (diet or the sun) because they cannot be produced by the body or synthesized in adequate amounts
  5. Absorption is highest when stores are depleted
42
Q

What are the 2 types of minerals?

A
  1. Water-soluble (C&B)
  2. Fat-soluble A, D, E, K
43
Q

Describe the characteristics of fat-soluble vitamins (FSVs)

A
  1. They are soluble (ie: dissolve) in fat
  2. Bile assists in the absorption of FSV
  3. They are not lost to heat (ie: cooking)
  4. FSV are absorbed in the small intestine along with fats in foods
  5. They are stored in the fat tissues in the body & liver until the body needs them.
44
Q

Describe the characteristics of water-soluble vitamins (WSVs)

A
  1. They are soluble (ie: dissolve) in water
  2. They are lost to heat (cooking)
  3. Unlike fat soluble vitamins, water soluble vitamins don’t get stored in the body.
  4. WSV have vital role as coenzymes (necessary for cellular reaction in the body)
  5. WSV are absorbed in the small intestine like FSV
45
Q

What factors influence vitamin requirements?

A
  1. Smoking
  2. Use of alcohol
  3. Medication (the contraceptive pill diminishes B vitamins)
  4. Caffeine or drugs
  5. Stress - As our stress levels increase so do our nutritional needs
46
Q

Describe nutritional deficiencies

A
  1. Arise when inadequate amounts of nutrients are available to sustain biological functions.
  2. Primary deficiency: insufficient intake from diet or environment
  3. Secondary deficiency: intake may be sufficient, but the body is unable to adequately absorb or utilize the nutrients.
47
Q

Describe vitamin A (retinol)

A
  1. From animal sources & plant sources in the form of beta-carotene - The liver stores 90% of vitamin A
  2. In addition to helping eyes adjust to light changes, vitamin A plays an important role in bone growth and tooth development
  3. Skin, eyes and mucous membranes of the mouth, nose, throat and lungs depend on vitamin A to remain moist.
  4. Development of teeth –formation of ameloblast (enamel) and odontoblasts (in dentin)
  5. Normal teeth spacing and promotes osteoblast (bone) function of alveolar bone
  6. Antioxidant (potential cancer-fighting properties)
48
Q

List the food sources of vitamin A

A
  1. Milk fortified with vitamin A
  2. Liver & fish oils
  3. Orange fruits and vegetables (like cantaloupe, peaches, apricots, carrots, sweet potatoes)
  4. Dark green leafy vegetables (like kale, collards, spinach)
  5. Supplementation outside the diet is not normally advisable for healthy individuals (potentially toxic at high doses)
49
Q

What can vitamin A excess cause?

A
  1. Excess can cause hypercarotenemia- yellowing of the palms of the hands and soles of the feet (too much carotene in the fat stores)
  2. Vitamin A supplements are not advisable during pregnancy can cause birth defect (no more than 5000 IU per day in pregnancy– some multies have more)
50
Q

What can vitamin A deficiency cause?

A
  1. Night blindness and very dry, rough skin decreased resistance to infections, faulty tooth development, and slower bone growth.
51
Q

Describe vitamin D (Calciferol)

A
  1. Vitamin D plays a critical role in the mineralization of bones and the body’s use of calcium and phosphorous.
  2. It increases the amount of calcium absorbed from the small intestine and helps form and maintain bones.
  3. Children and adults both need adequate amounts
52
Q

What are the sources of vitamin D?

A
  1. Sunlight is our primary source of vitamin D. Our skin makes vitamin D in response to the sun’s light.
  2. Vitamin D occurs naturally in animal foods such as fatty fish, eggs, liver, some cereals and butter but in small and insignificant amounts. Vitamin D fortified foods can be helpful.
53
Q

What can an excess of vitamin D cause?

A
  1. As is the case with most vits & mins, Vitamin D excess rarely occurs from diet – it is almost always the result of supplementation
54
Q

What can a deficiency of vitamin D cause?

A
  1. Vitamin D deficiency can lead to osteomalacia and Osteoporosis
  2. Dentally, delayed dentition and small molars are observed.
55
Q

Describe vitamin E

A
  1. Vitamin E acts as an antioxidant
  2. Protects vitamins A,C, red blood cells and unsaturated fatty acids from oxidation.
  3. Promotes resistance of periodontium to inflammation
56
Q

List the dietary sources of vitamin E

A
  1. Vegetable oils, sunflower, canola, corn, soybean, and olive oil
  2. Nuts, seeds & wheat germ
57
Q

What can an excess of vitamin E cause?

A

Large doses of vitamin E may pose a hazard to people who take blood-thinning medications. People taking statin (cholesterol lowering) drugs are also not advised to take supplemental vitamin E because it may interfere with how the medication works.

58
Q

What can a deficiency of vitamin E cause?

A

Vitamin E deficiency is rare and generally only occurs in premature infants and people unable to absorb fats.

59
Q

Describe vitamin K

A
  1. found in bones, kidneys and other tissues
  2. K is from the German word for “coagulation” or clotting of the blood
  3. Naturally produced by the bacteria in the intestines
  4. vitamin K plays an essential role in normal blood clotting & helps promote bone health (it binds with calcium and is involved in bone formation).
60
Q

List the dietary sources of vitamin K

A

Vitamin K is mostly found in vegetables especially greens – cruciferous vegetables (broccoli, Brussels sprouts and cabbage), kale and Swiss chard.

61
Q

What can an excess of vitamin K cause?

A
  1. Although a tolerable upper intake level has not been established for vitamin K, excessive amounts can cause the breakdown of red blood cells and liver damage.
  2. No toxicity symptoms have been documented.
62
Q

What can a deficiency of vitamin K cause?

A
  1. Deficiency is uncommon but disease or drug therapy may cause deficiencies)
  2. A deficiency may cause a delay in blood clotting times
63
Q

Describe vitamin C (ascorbic acid)

A
  1. Functions as an antioxidant and works with vitamin E as a free-radical scavenger.
  2. Acts as a coenzyme and is vital in the production of collagen
  3. Important in wound healing by strengthening tissues and promoting capillary integrity
  4. Helps development of RBC
  5. Dentally it is important in the development of connective tissue, teeth and bones in the formation of fibroblasts (collagen forming cells) osteoblasts and odontoblasts.
  6. Vitamin C is quickly depleted during times of stress, healing and infections – it is also negatively affected by tobacco, alcohol, oral contraceptives and aspirin.
64
Q

List the dietary sources of vitamin C

A

Red bell pepper, broccoli, papaya, strawberry, orange, kiwi, grapefruit, cantaloupe & peach

65
Q

What can an excess of vitamin C cause?

A
  1. Excess amounts of ascorbic acid can cause gastrointestinal upset and may affect the absorption of B12.
66
Q

What can a deficiency of vitamin C cause?

A
  1. The scientific name of vitamin C, ascorbic acid, is derived from the Latin name of “scurvy”.
  2. A deficiency in vitamin C can lead to scurvy which manifests in the formation of spots on the skin, spongy gums, bleeding from mucous membranes, fatigue, depression and cessation of bone growth.
  3. Inadequate vitamin C during tooth development can lead to ameloblasts and odontoblasts atrophy and affect the integrity of the hard tissue.
  4. Gingivitis caused by ascorbic acid deficiency can affect the periodontium resulting in tooth mobility