Nutrition and dental disease Flashcards
What is dental erosion?
1) Dental erosion is the loss of enamel, it can be the result of excessive consumption of acidic foods and drinks.
2) Unlike dental caries, it does not directly involve mouth bacteria. When enamel wears away the dentine underneath is exposed. This can lead to pain and sensitivity
3) When acidic foods and drinks like fruit juices,soft drinks,and pickles are consumed the enamel on the teeth may temporarily lose some mineral content and therefore its strength
4) Commonly seen together with tooth decay
Explain what the stephan curve is?
1) The stephan curve shows the fluctuation of PH value when exposed to dietary sugars
2) Commonly used to measure the acidogenic potential of a range of foods
3) Other factors which may have an impact include: Protective factors in food, resistance of enamel, salivary factors
Explain the idea behind the stephan graph?
1940’s work by Stephan who pioneered work on the pH of dental plaque using microelectrodes
Resting pH of plaque was 6.5 – 7 but reduces to 5.5 (critical pH) on exposure to sugars (rapid drop within a few minutes)
He plotted the pH value against time which is commonly referred to as the Stephan curve
TheStephan Curveshows the effect of eating and drinking in your mouth clearly in a graphical form and is crucial in helping you understand dental decay
What dental care advise is given?
1) Limit sugar consumption at meal times
2) Stickiness of carbohydrate-containing foods
3) Chewing sugar-free gum has been shown to reduce dental caries by increasing saliva production
Teeth brushing using a fluoride-containing toothpaste twice a day is the most important strategy with flossing
Visit the dentist regularly for a thorough check-up
How does fluoride help prevent caries?
Strengthens enamel by reinforcing the integrity of the crystal structure and replace the hydroxyl groups in hydroxyapatite to form fluoroapatite, which is more stable and resistant to demineralisation
Re-mineralisation of enamel is improved with fluoroapatite
Fluoride inhibits bacterial sugars metabolism which leads to less acid production
The removal of fluoridation of drinking water has led to an increase in dental caries in different regions in the UK, e.g. Scotland (Stephan et al., 1987).
How does gum with xylitol reduce dental plaque?
Xylitol is a sugar alcohol – minimally metabolised in the body and not cariogenic
Approved health claim which should include information to the consumer that the beneficial effect is obtained with a consumption of 2-3g of chewing gum sweetened with 100% xylitol at least 3 times per day after the meals
Based on well documented evidence (EFSA 2008, also demonstrated in SACN 2015)
what is xylitol?
Xylitol is a 5-carbon sugar alcohol (polyol) with a flavour similar to sucrose. It is a normal sugar in human metabolism (found in the pentose shunt of Kreb’s cycle) and of many plants, e.g. berries, fruit, vegetables and the woody fibres of birch tree bark (main manufactured source) and corn cobs.
Xylan is extracted from the birch wood pulp and extracted liquid sugar is converted to crystalline xylitol.
What causes dental erosion?
Sugars and other fermentable carbohydrates (e.g. starches) are fermented by bacteria on the tooth surface. This results in localised acid production (and fall in pH, e.g. during meal times as shown in the graph below), which can lead to progressive damage (demineralisation) to teeth, particularly if pH remains low owing to frequent ingestion of fermentable carbohydrates.
Although all fermentable carbohydrates have the potential to cause decay, frequency (rather than amount) of sugar consumption is thought to be the main dietary factor related to dental caries.
Saliva (being slightly alkaline) slowly cancels out the acidity at the tooth surface (caused by plaque acids and acidic foods and drinks) and restores the natural balance. However, if acid attacks happen too often, the teeth do not have a chance to repair themselves and over time the enamel becomes thinner and thinner. This is made worse if teeth are brushed soon after consuming acidic foods and drinks, whilst the enamel is still weakened.
What are key things for good dental health?
Enamel is composed of crystals of hydroxyapatite, a crystalline compound made of calcium and phosphate, arranged in a characteristic way in a thinly dispersed organic matrix.
Calcium, magnesium, phosphorus and vitamin D all contribute to the maintenance of normal teeth
Vitamin C contributes to normal collagen formation for the normal function of teeth
