Nutrition 1 Flashcards
What are the immediate causes of major dental diseases (caries and periodontal disease)?
diet, plaque, smoking
What approach is used to improve multiple health aspects simultaneously?
common risk factor approach e.g. smoking is a risk factor for heart disease, respiratory disease, cancer, periodontal disease
What aspects of oral health are influenced by diet and nutrition?
tooth development, gingival and oral tissue integrity, bone strength, oral diseases
Why are deficiencies spotted earlier in the mouth?
oral epithelia grow and are replaced rapidly, healthy epithelium acts as a barrier against toxic substances
Which nutrients are required for oral health?
calcium, phosphorous, fluoride, protein, vitamin A, C and D
Define cariogenic
contains fermentable carbohydrates that are metabolised by microorganisms in plaque to cause a decrease in pH <5.5 and demineralisation
Define cariostatic
not metabolised by microorganism so there is no decrease in salivary pH
Examples of cariogenic foods
CHO (bread, cereals), sweet and sticky foods, sugars, carbonated drinks, fruit juices, fruits
Examples of cariostatic foods
proteins, vegetables, fats, sugarless gum
Define anticariogenic foods
foods that prevent plaque recognising an acidogenic food, may increase salivation or antimicrobial activity
Examples of anticariogenic foods
xylitol and cheeses
What factors apart from the cariogenic nature of foods affect diet cariogenicity?
food consistency (e.g. stickiness), frequency, food form (e.g. slowly dissolving), sequency of eating (cheese or milk at the end of a meal)
Effect of protein/calorie malnutrition on oral structures
delayed tooth eruption, reduced tooth size, decreased enamel solubility, salivary gland dysfunction
Effect of vitamin A deficiency on oral structures
decreased epithelium development, impaired tooth formation, enamel hypoplasia
Effect of vitamin D / calcium / phosphorous malnutrition on oral structures
lowered plasma calcium, hypomineralisation, compromised tooth integrity, delayed eruption, absence of lamina dura (compact bone connecting PDL to alveolar bone), abnormal alveolar bone patterns
Effect of vitamin C malnutrition on oral structures
irregular dentin formation, dental pulpal alterations, bleeding gums, delayed wound healing, defective collagen formation
Effect of vitamin B1 (thiamine) deficiency on oral structures
cracked lips, angular cheilitis
Effect of vitamin B2 (riboflavin) and vitamin B3 (niacin) deficiencies on oral structures
inflammation of tongue, angular cheilitis, ulcerative gingivitis
Effect of vitamin B6 deficiency on oral structures
periodontal disease, anaemia, sore tongue, burning sensation
Effect of vitamin B12 deficiency on oral structures
angular cheilitis, halitosis, bone loss, haemorrhagic gingivitis, detachment of periodontal fibres, painful ulcers
Effect of iron deficiency on oral structures
salivary gland dysfunction, very red, painful tongue with burning sensation, dysphagia, angular cheilitis
Effect of fluoride deficiency on oral strutures
less stable enamel more prone to demineralisation and therefore caries
Define nutrition
organelles, cells, tissues, organs and the body obtaining and using necessary substances from foods to maintain structural and functional integrity
How can nutrients be classed?
macronutrients (carbohydrates, fats, proteins) and micronutrients (vitamins, minerals) and water
What are dietary allowances (DRVs)?
Dietary Reference Values - quantitative estimates of energy and nutritional requirements of healthy population subgroups to prevent deficiencies
What are dietary goals?
quantitative national targets for selected macronutrients and micronutrients aimed at preventing long-term chronic disease
Examples of dietary goals
reduction in calorie intake by 120 kcal/day, 5 fruit/vegetable portions a day, one portion of oily fish per week
What are dietary guidelines?
broad quantitative or qualitative targets to promote overall nutrient wellbeing
Why were 1991 DRVs ground breaking?
- covered a wide range of nutrients (40)
- terminology of Dietary Reference rather than Recommended Daily Amounts
- Range of values
Which committee provides nutritional advice / surveillance to government departments?
SACN (Scientific Advisory Committee on Nutrition)
What criteria are Dietary Reference Values (DRVs) established by?
the optimal nutrient intake (instead of just preventing deficiency)
What is should a nutritional requirement achieve?
prevent clinical signs of deficiency and allow degree of storage
How are Dietary Reference Values (DRVs) derived?
committee of experts review scientific evidence from research studies and decide on average amount required to meet adequacy and the variation in requirement between individuals
Which criteria are used to define adequacy?
level needed to maintain circulating level, enzyme saturation, tissue concentration, prevent deficiency signs, maintain balance, cure deficiency
Which deficiency disease results from a lack of vitamin C?
scurvy
What do Dietary Reference Values (DRVs) assume / limitations?
- energy and other nutrient requirements are being met
- healthy individual
- intake varies day to day
- not individual recommendations
- normal distribution of requirements
What is the Estimated Average Requirement (EAR)?
mean nutritional requirement that will meet the needs of half the population (middle of normal distribution)
What is the Reference Nutrient Intake (RNI)?
intake calculated as 2SD above EAR - meets the needs of 97.5% of the population. Intake above RNI almost certainly adequate.
What is Lower Reference Nutrient Intake (LRNI)?
intake calculated as 2SD below EAR. Only meets the needs of 2.5% of population. Intakes below LRNI are almost certainly inadequate.
What is safe intake?
a level that has no risk of deficiency that is below the level of risk of undesirable effects
Examples of inconsistencies of recommendations of different countries
different terminology, different values, different age bands, different units
