Non fluoride prevention methods Flashcards
What is the classification of total dietary sugars?
- Intrinsic sugars (inside the cell e.g. raw fruit)
- Extrinsic sugars (not inside the cell)
What are some non fluoride prevention methods?
- diet modification
- oral hygiene and dental health education
- fissure sealants
- sugar free medicines
- chewing gum
- chlorhexadine
What is the classification of extrinsic sugars?
- Milk sugars
- Non-milk extrinsic sugars
What is the classification of non-milk extrinsic sugars?
- Fruit juices, pulps, puree, honey
- Recipe sugar (added by cook or manufacturer)
- Table sugar (discretionary sugar)
What did the Committee on Medical Aspects of Food Policy (COMA) report of 1989 conclude?
Caries is positively related to frequency and amount of non-milk extrinsic sugar consumption. They recommended that consumption of non-milk extrinsic sugars should be decreased and replaced by fruit, vegetables and starchy foods
What is the dietary advice to prevent dental caries provided in the Delivering Better Oral Health toolkit?
- frequency of sugars should be reduced
- consumption of sugary foods should be restricted to mealtimes
- limit consumption of foods and drinks with added sugars to a maximum of 4 times a day
- sugars (EXCLUDING those naturally present in whole fruit) should provide less than 10% of total energy in the diet
Give some examples of potentially cariogenic foods and drinks.
Sugar and chocolate confectionary; cakes and biscuits; buns, pastries, fruit pies; sponge and other puddings; table sugar; sugared breakfast cereals; jams, preserves, honey; ice cream; fruit in syrup; fresh fruit juices; sugared soft, alcoholic and milk-based drinks; dried fruits
What was the Vipeholm Study of Diet and Dental Caries? (1954)
Conducted in an institute for the mentally deficient, its aim was to determine the relationship between diet, frequency of sugar intake and dental caries.
Variables: type of sugar ingested (sticky or non-sticky) and frequency of sugar intake (at meals or in between meals)
What was the Hopewood House study? (1953)
Conducted in a children’s home, it was a study performed to determine is the significantly different diet of the children living at the home (as compared to that of the children in the average Australian family household) would affect dental caries activity.
What were the key messages about caries gleaned from the Vipeholm and Hopewood House studies?
- restrict sugar in food and drinks to no more than 4 times a day
- drink only water and milk
- snack on sugar free snacks e.g. fresh fruit and cheese
- avoid fruit juice, pop or sweetened milk in feeding bottles
- nothing to eat or drink after brushing
Why is selection of non-cariogenic food difficult?
- sugar content labelling is not always clear
- access to healthy food is difficult in socially deprived areas
- marketing by the sugar industry is better funded that prevention methods by the government
- few families stick to solid three-meals-a-day regimes and graze
- school tuck shops are tempting
- not everyone can cook
What are the principles behind a diet diary?
- both dental decay and erosion require investigation of dietary habits
- 3 day diaries are useful (especially including Sat or Sun)
- clear instruction to record everything and amount
- 24hr recall used if desperate
How do you analyse a diet diary?
- amount of sugar intakes (non-milk extrinsic sugars <10%!)
- frequency of sugar intakes
- frequency of snack intakes
- how food and drink are consumed
How do you review a diet diary after analysis?
- remember its inaccuracies
- ask the parent/patient to identify problem areas
- offer alternative non-cariogenic foods
- recommend alternatives that fit with family lifestyle
What are some examples of non-cariogenic, non-sugar sweeteners?
sorbitol, xylitol, mannitol
