Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS stage 2 > Nutrition and diet > Flashcards

Nutrition and diet Flashcards

1
Q

How can nutrition affect tooth development ?

A

affect in utero tooth development
affect posteruptive tooth development
affect caries and periodontal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the macronutrients ?

A

fat
carbohydrate
protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the purpose of the macronutrients ?

A

provide energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the micronutrients ?

A

vitamins minerals and trace elemnts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can energy be measured in ?

A

kJ or kcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many kcal per fat gram ?

A

9 kcal per gram of fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How many kcal per carbohydrate ?

A

4 kcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How many kcal per protein gram ?

A

4 kcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many kcal per gram of alcohol ?

A

7 kcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How many kJ in one kcal ?

A

i kcal-4.18 kJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is EAR ?

A

estimated average requirment

total dietary intake prediced to maintain energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens to excess energy ?

A

stored as fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is EAR required for ?

A

temperature maintenance
breathing
heartbeat
brain function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does EAR maintain ?

A

BMR

basic metabolic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is BMR altered ?

A

body builders

pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a healthy BMI ?

A

18.5 and 24.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is EAR based on ?

A

body size and composition
gender
age
activity level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What 2 things link EAR in an equation ?

A

EAR= BMR x PAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the EAR of adult men ?

A

2772 kcL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the EAR of 1 year old girls ?

A

646 kcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the EAR of 1 year boys ?

A

718

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the EAR of adult women ?

A

2079 kcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are fats composed of ?

A

glycerol and fatty acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are types of fatty acids ?

A

saturated and monounsaturated and polyunsaturated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are saturated fatty acids ?

A

no double bonds

only single carbon carbon bond

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where can you find saturated fatty acids ?

A

animal and dairy fats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where can you find MUFA ?

A

seeds and nuts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where can you find PUFA ?

A

oils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the functions of dietary fats ?

A 
make lipid bilayer
energy release
precursors of prostaglandins 
precursor of cholesterol 
absorption of ADEK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are essential fatty acids ?

A

not made in the body

must come from diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is cholesterol needed for ?

A

fat absorption via chylomicrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the essential fatty acids ?

A

alpha lionlenic

linoleic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Where can you find lionleic and linolenic fatty acids ?

A

plant oils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are omega 3 fatty acids ?

A

3 carbon double bonds before the methyl end of the chain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Give an example of an omega 3 fatty acid ?

A

lionoleic fatty acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What odes alpha linolenic acid do ?

A

converts into EPA and DHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is EPA ?

A

EICOSAPENTANOIC ACID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is DHA ?

A

docosahexanoic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the purpose of DHA and EPA ?

A

form prostaglandins
decrease cardiovascular risk
prevent periodontal disease
reduce platelet aggregation and hence thromboembolic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is a cis fatty acid ?

A

hydrogen atoms orinetated in one direaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is a trans fatty acid ?

A

hydrogen atoms orientated in different direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What do hydrogenated oils contain ?

A

trans fatty acids

cheaper than animal fats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is trans fat intake strongly associated with ?

A

colon cancer

cardiovascualr disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What does accumulation of cholesterol rich lipid lead to an increase in ?

A

increase cardiovascular disease risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which is the bad type of cholesterol ?

A

LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What can saturated fat increase ?

A

LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What do trans fatty acids to ?

A

increase LDL

decrease HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What does dietary cholesterol increase ?

A

increases LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How can we substitute saturated fat ?

A

with PUFA- secreases cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What do plant stanols and sterols do ?

A

prevent cholesterol absorption

lower LDL cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is a commercial plant stanol ?

A

benecol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What can also lower cholesterol ?

A

oat fibre

soya protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How do oat fibres reduce cholesterol absorption ?

A

beta glucans in oat fibres bind to cholesterol and sequester it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is obesity associated with ?

A

cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is high animal fat intake associated with ?

A

bowel
pancreas
prostate
cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

How much of the total dietary intake should come from fat ?

A

less than 35%

less than 5% from saturated fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the types of carbohydrates ?

A

starch
sugars
fibre
oligosaccharides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is starch ?

A

amylose and amylopectin

bread, pasta. potatoes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the types of sugars ?

A

monosaccharidea

disaccharides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are sugar alcohols ?

A

xylitol

sugar substitutes and sweetners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

How much kcal do sugars produce ?

A

4 kcal per gra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is excess energy from sugar stored as ?

A

glycogen and fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are sugars used for in the body ?

A

glycoproteins - albulin
GAGs- hyaluronic acid
proteoglycans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What can high sugar intake lead to ?

A

obesity
cardiovascular disease
diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are oligosaccharides ?

A

2 or more sugar molecules bonded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is fibre?

A

non glycaemic carbohydrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the classifications of fibre ?

A

NSP
resistant starch
resistant oligosaccharide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is NSP ?

A

cellulose
pectine
mucilages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

How is NSP digested ?

A

not in the digestive tract
passes to the colon and undergoes microbial anaeroic fementation
adds to stool bulk and stimulate peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is insoluble NSP ?

A

adds to stool mass

increases satiety- good for weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is resistant starch ?

A

starch not digested because enclosed in cells

green bananas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is resistant oligosaccharide ?

A

encourage growth of bifodobacterium and lactobacillus so can increase caries risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What are maltodextrins and glucose syrups ?

A

made from starch hydrolysis
can be found in soya infant formula
increase cariogenic risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the recommended intake of free sugars ?

A

5% of all dietary intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

How much sugar intake in children 11+ ?

A

30 g sugar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What are the functions of dietary proteins ?

A

muscle and tissue maintenance

hormones and enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are animal sources of proteins ?

A

meat dairy and fish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What are the vegetable protein sources ?

A

pulses

nutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the nitrogen balance ?

A

the balance determines requirements for proteins

amount of nitrogen we intake should equal amount excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is a positive nitrogen balance ?

A

amount excreted in less than amount taken in

growth and pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is a negative nitrogen balance ?

A

amount excreted is more than amount uptaken

in starvation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

How much nitrogen is in 6.25g of protein ?

A

1 g of N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

How much protein do people require ?

A

0.75 kg to 1.g kg per kg of weight

bascially 1 g for every kilo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

How much of total dietary intake is protein ?

A

12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What are the 3 types of protein deficiency syndromes ?

A

marasmus
kwashiorkor
NOMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is marasmus ?

A

protein-energy malnutrition
severe muscle wasting
decreased insulin:glucagon
muscle proteins used in liver to make albumin - prevents oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What is kwashikor ?

A

protein deficiecny
high insulin: glucagon
reduced amino acids for albumin synthesis causes oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is NOMA ?

A

malnorushment
ulceration and stomatitis
of upper gum. maxilla and cheeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What is beta carotene ?

A

a yellow pigment antioxidant that is converted to vitamin A

found in yellow vegetables

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What are sources of vitamin A ?

A 
cheese
eggs
milk 
eggs
yoghurt
leafy vegetables
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What are the fucntions of the vitamin A ?

A 
sight- retinol production 
T cell differentiation
Maintenance of healthy skin 
regulates gene expression 
anti oxidant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is the recommended intake for vitamin A ?

A

750 micrograms for men

650 micrograms for women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are signs of vit A deficiency ?

A

eczema
night blindness
infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What are oral healthy symptoms in deficiency ?

A

increased keratin formation- blocks saliva ducts leading to xerostomia
enamel hypoplasia
delayed tooth eruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What are sources of thiamine ?

A

meat

bread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is thiamine (B1) used for ?

A

metabolic pathways to convert carbohydrates to ATP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are signs of thiamine deficiency ?

A

weight loss
anorexia
muscle weakness
beri beri disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What are sources of riboflavin (B2) ?

A

animal products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the function of B2 ?

A

metabolism of fats
conezymes
conversion of carbs to ATP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What are signs of deficiecny of riboflavin ?

A

anaemia
cataracts
skin disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What are oral symptoms of thiamine deficnecny ?

A

thiamine deficinecy cna cause vomiting effecting enamel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What are oral symptoms of riboflavin deficiency ?

A

ulceration
angular cheilitis
mucosal inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What are sources of folate ?

A

green veg
nuts
beans and dairy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What is the fucntion of folic acid ?

A

neural tube closuure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What can happen with folic acid deficiency ?

A

failure of neural tube to close

leads to anencephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What are sources of B12 ?

A

animal products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What are the fucntions of B12 ?

A

coenzyme

DNA and RNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What does folic acid and B12 deficinecy lead to ?

A

megaloblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What are the oral symptoms of B12 and folate deficinecy ?

A

lack of keratinisation
pale mucosa
angular cheilitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What are sources of vitamin C ?

A

oranges
red peppers
brocolli
supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What are functions of vitamin C ?

A

collagen synthesis
cartialge and bone
wound healing and scar formation
antioxidant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What are symptoms of vitamin C deficiency ?

A

painful joints
osteoporosis
scurvy
dry skin and hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What are the oral symptoms of vitamin C deficiency ?

A

swollen , erethematous gingiva
PDL breakdown as it made of collagen
antioxidant- reduce ROS in inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What are the fat soluble vitamins ?

A

A D E K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What are sources of vitamin K ?

A 
green leafy veg 
nuts 
seeds
meat
dairy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What are the fucntions of vitamin K ?

A

needed in acitivation of vitamin K dependent clotting factors
2,7, 9 and 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Which medication should you not prescribe to someone with folic acid deficiency ?

A

sulfonamides

trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What can vitamin K deficiency lead to ?

A

haemorhage
excessive bleeding
easy bruising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What are oral symptoms of vitamin K deficiency ?

A

osteocalcin regulates mineralisation and is vit K dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

What are the sources of nicotinic acid (B3) ?

A

meat
fish
wheat
fortified cereals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What are the functions of vitamin B3 ?

A

protein and fat metabolism
inhibit LDL production
precursor of enzymes- NAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

What are signs of nicotinic acid deficinency ?

A

pellagra- thick scaly rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

What are oral symptoms of nicotnic acid deficinecy ?

A

atrophic glossitis
atrophy of filliform anf fungifomr papillae
angular stomatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What are sources of vitamin D ?

A

oily fish
red meat
sunlight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What is the function of vitamin d ?

A

increeases blood calcium via absorption

1,25 DHCC converted from D to allow bone resorption and GIT abosrbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

What are the signs of vitamin D deficiency ?

A

rickets

weak immune system- innate immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What are the oral symptoms needs of vitamin D ?

A

allows calcium absorption

hydroxyapatite formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

What are sources of calcium ?

A

dairy
green veg
tofu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

What are the functions of calcium ?

A

muscle contraction
blood clotting
nerve signalling
bone and tooth formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

What are the signs of calcium deficiency ?

A

muscle cramps
brittle fingernails
osteoporosis
insufficinet blood clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

What are sources of magnesium ?

A

dark chocolate
avocado
legumes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What are the functions of magnesium ?

A

co factor for muscle contraction
glycaemic control
ionic transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

What are the symptoms of magnesium deficiency ?

A

muscle cramps
nausea
seizures
decreased apatite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

What are the oral symptoms of magnesium deficiency ?

A

anti inflammatory- lack of can lead to gingival inflammation

can lead to reduced calcium absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

What are the sources of iron ?

A

liver
beans
fortified cerelas
dark green veg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

What is the function of iron ?

A

haemoglobin formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What are the symptoms of iron deficiency ?

A

tiredness
paleness
shortness of breath
dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

What are the oral symptoms of iron deficiency ?

A

pale tongue

angular cheilitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

What are sources of zinc ?

A

oysters
red meat
phyates can bind to zinc and prevent absorption- soak beans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

What are the functions of zinc ?

A

cell division
cell growth
wound healing
T cell development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

What are the signs of zinc deficiency ?

A

immune problems
loss of smell and taste
lethargy
acne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

What is the oral significance of zinc ?

A

found in saliva to inhibit plaque growth

inhibits bacterial metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

What are dietary reference values ?

A

given for food, energy and nutrients in the UK

amount of nutrient needed for different groups like age and gender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

What are dietary reference values given for ?

A

carbohydrates- free sugars and fibre
protein -
fat- saturated and trans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

What are DRVs based on ?

A

popualtions not individulas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

What is the RNI ?

A

reference nutrient intake

amount of nutrient enough to satisfy 97.5% of population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Where is RNI on a normal distribution graph ?

A

near the end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

What is the estimated average requirement ?

A

EAR
estimate of the average requirement of energy or a specific nutrient
approximately 50% of population will need less energy and 50% will need more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

What is RNI used for ?

A

reference amount for population groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

What is EAR used for ?

A

energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

What is LRNI used for ?

A

nutritional inadequacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

What is the LRNI ?

A

lower reference nutrient intake
amount of nutrient enough for only a small number of people
they have low requirements- 2.5%
majority of population will need more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

How much should fat constitute of total energy intake ?

A

35%
less than 10% saturated
less than 2% trans fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

How much should free sugars constitute total energy intake ?

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

How much should protein constitute total energy intake ?

A

12-15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

How much sugar should 11+ have ?

A

no more than 30g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

How much sugar should 7-10 years ?

A

no more than 24g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

How much sugar should 4-6 years have ?

A

no more than 19g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

What is the eatwell guide ?

A

guide to proportion of each nutrient needed daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What does eatwell guide recommend for fruit and veg ?

A

5 a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

What are the portions of fish required from the eatwell guide ?

A

2 portions a weel

1 should be oily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

What are portions of red meat needed according to EP ?

A

limit to less than 70g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

How much fluid should be taken according to EP ?

A

6/8 glasses a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

Which starchy foods are needed in EP ?

A 
bread
rice potatoes
pasta
wholegrain 
provide fibre, protein, B vtamins and vitamin E
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

What is the recommendend milk and dairy intake ?

A

moderately

choose low fat varieties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

What are the protein requirements according to EP ?

A

eat moderate amounts
choose low fat- remove skin from chicken
eggs and fish in this group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

What is enamel hypoplasia ?

A

structural defect in enamel

enamel is present and well mineralised but deficient in amount

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

What are the manifestations of enamel hypoplasia ?

A

alteration of shape

pits and grooves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

What is enamel hypomineralisation ?

A

defects in which enamel matrix is present
reduced mineral content
enamel opacities and chips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

What are some of the manifestations of hypomineralisation ?

A

enamel chips

white and brown marks softer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

What is one cause of developmental enamel defects ?

A

nutritional deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

What is the problem with enamel defects ?

A

can get stained

carious risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

What is manifestations of enamel hypoplasia ?

A

pits and grooves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

What are some of the nutrient deficiencies that can lead to enamel hypoplasia ?

A 
vitamin A 
vitamin D
hypocalcaemia 
PEM 
LBW
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

What are the causes of LBW ?

A

placental insufficinecy

maternal undernutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

What are the conclusions in the guatemalen rats study ?

A

providing a protein supplement does not reduce the caries incidence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

What is the effect of protein insufficiency in mothers diet ?

A

poor quality milk
increased dental caries
provide the protein in utero nd differneces are abolished
differences not abolished when given post birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

What does protein deficiency cause ?

A

salivary gland atrophy

xerostomia leads to rampant caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

What does vitamin D dependent caries lead to ?

A

low calcium
low phosphate
hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

What does hypophosphataemia lead to ?

A

normal calcium
low phosphate
no hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

What does hypoparathyroidism lead to ?

A

low calcium
high phosphate
hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

Why is hypocalcaemia common in undernourished children ?

A

diarrhoea induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

What is vitamin A deficiency linked to ?

A

PEM

linked to defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

What is the rat vitamin A deficiency experiment ?

A

vitamin A deficient rates given a highly cariogenic diet had higher caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

What does vitamin A deficinecy lead to ?

A

salivary gland hypotrophy

poor quality saliva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

What happened to dogs on a vitamin D deficient diet ?

A

poorly aligned teeth
delayed eruption
delayed development
enamel and dentine defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

What can be concluded from the may mellanby experiment ?

A

all teeth with hypoplasia has caries

vitamin D is a factor responsible for caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

What happened when children were given a vitamin D supplement ?

A

reduced inititiation and spread of caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

What happened in world war II ?

A 
improvement in childrens teeth due to reduction in sugar
cheap milk (calcium and vitamin d)
Cod liver oil 
vitamin A and D added to margarine 
calcium carbontae added to flour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

What do the vitamin D studies in india conclude ?

A

gross enamel hypoplasia due to diarrhoea indiced hypocalcaemia

mild enamel hypolasia is same as UK as the sunshine compensates for it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

What does vitamin D do with caries ?

A

may lead to developmental defects
which can lead to more dental caries
low certainty conclusions that it may decrease dental caries incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

What is the PHE advice for vitamin D ?

A

adults and children over the age of 1 should hvae 10 mcg

equivalent of 5 sardines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

What can lead to high caries rates in developing countries ?

A

poor diet

high sugars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

What does under nutrition lead to ?

A

lack of PE results in developmental defects
making tooth caries prone
salivary gland atrophy
delays eruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

What does dental fluorosis lead to ?

A

opacities
mottling
hypomineralisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

What does excess fluoride ingestion lead to ?

A

alters the rate at which amelogenins are removed enzymatically

alter the action of protease- decrease availability of free calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

What are the manifestations of fluorosis ?

A

hypomineralised
alteresd optical properties
opaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

What does the dean research tell us ?

A

continued use of water- 1 ppm - 10%

continued use of water at 1.7 ppm- 40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

What does excess fluoride lead to ?

A

enamel mottling

hypomineralisation

200
Q

What are the sources of fluorid exposure ?

A

diet- natural sources like tea, seafood
added- water and food
dental products- topical fluoride varnish, mouthwash, toothpaste
Fluoride supplement s

201
Q

What are the methods of fluoride absorption ?

A

90% of fluoride is absorbed mainly in stoamch as HF (uncharged)- rapid absoroption

202
Q

What happens to fluoride in the body ?

A

99% goes to calcified tissues like bones and teeth

203
Q

How is fluoride excreted ?

A

10% urine and faeces

204
Q

What happens to fluoride metabolism in high fat diet ?

A

slows down digestion and rate of gastric emptying decreases
increased absorption- positive fluoride balance
leads to fluorosis

205
Q

What happens to fluoride metabolism with a vegetarian diet ?

A

increased pH of renal tubules
increases urine excretion
more elimination of fluoride leaving in negative fluoride balance

206
Q

What does fluoride do with divalent, trivalent cations ?

A

forms complexes in the GIT
dont get absorbed and excreted in faces
faecal excretion increases
negative fluoride balance

207
Q

What happens in fluorosis ?

A

dental fluorosis mottling of enamel, opacities

skeletal fluorosis- brittle bones and teeth

208
Q

How does fluoride act ?

A

topically- aids remineralisation

also inhibits anaerobic glycolysis and sunsequent acd production by oral bacteria

209
Q

What are the methods for arresting primary caries ?

A

eliminate dietary abd microbial factors

enhance protecitve factros- fluoride, selaant and salivary stimulation

210
Q

What is acute fluoride toxicity ?

A

acute fluoride sudden poiaoning
sudden ingestion of a lethal dose
nausea, vomiting, diarrhoea and abdominal pain

211
Q

What is a safe fluoridated dose ?

A

8-16 mg F/kg

212
Q

What is chronic fluoride ingestion ?

A

smaller dose over long time
affects teeth while still forming
increases risk of dental fluorosis in primary and permenant dentition
affects bone continually

213
Q

What is the optimum safe dose for fluoride ?

A

0.05-0.07 mg/Kg body weight

214
Q

What are the methods for fluoride therapy ?

A

public water fluoridation
school water fluoridation
fluoridises, salt and mil
topical mouth rinse, varnish and toothpaste

215
Q

What did H trendley deans graph result in ?

A

J shaped curve

216
Q

What did H trendly conclude ?

A

water fluoridation at 1 ppm wa best balance between caries prevention and fluorosis risk

217
Q

What is the effect of water fluoridation on social class ?

A 
lower social class have greater caries rates
water fluoridation ahs the biggest caries reduction rate on them
218
Q

Why is fluoride beneficial for adults too ?

A

caries is progressice- fluoride cant protect exposed roots

219
Q

Have studies linked cancer and fluoride ?

A

no association between water fluoridation and mortality frm any cancer

220
Q

What can happen if water fluoridation is decreased ?

A

increased caries rate- higher than those of water unfluoridated areas

221
Q

What are the benefits of fluoridated salts ?

A

decreases caries
gives consumer choice
better if milk/water fluoridation not available

222
Q

What can happen to fluoride in milk ?

A

F binds to calcium and protein- reduces the topical effect- not free

223
Q

What do trials show about F milk ?

A

it has preventative effects

especially if given whilst teeth are developing

224
Q

What do systematic reviews say about milk fluoridation?

A

milk fluoridation is beneficial
less good evidence than for water fluoridation
cessation associated with worsening dental health
can lead to mild fluorosis but not of concern

225
Q

What are the doses used in fluoridated milk school schemes ?

A

doses between 0.5-1.5 mg F per drink

doses used above/below that of water F levels

226
Q

What is the reduction in dental caries rates due to water fluridation ?

A

20-50 %

227
Q

Why is water fluoridation more effective ?

A

hits everyone

228
Q

What are the advantages and disadvantages of public water supply ?

A

advantages- hits everyone

disadvantages- no chocie

229
Q

What are the advantages and disadvantages of milk fluoridation ?

A

advantage- children- high ECC risk

disadvantage- not everyone taking milk

230
Q

What are advantages of salt and disadvantages of salt fluoridation ?

A

advantage- gives choice

disadvanteg- hypertesnion if excess

231
Q

What are the classifications of carbohydrates ?

A

sugars (monsaccharides and disaccharides)
polyols
oligosaccharides (malto and non digestivle)
polysacchrides

232
Q

What are types of polysaccharides ?

A

starch

non starch polysaccharides

233
Q

Where are digestible carbohydrates absorbed and digested ?

A

in the small intestine

234
Q

What happens to non-digestible polysaccharides ?

A

resistant to hydrolysis in small intestine
reach large intestine
partially fermented by commensal bacteria in colon

235
Q

What is dietary fibre ?

A

constituents of non digetible carbohydrates

associated with plant cell walls

236
Q

What is the classification of sugars ?

A

total sugars split into
free sugars
intrinsic sugars
milk sugars

237
Q

What are intrisnsic sugars ?

A

in whole fruits, veg and grains

238
Q

What are milk sugars ?

A

naturally present in milk and milk products

239
Q

What are free sugars ?

A

free sugars,added sugars and sugars in honey, syrups, fruit and juices and fruit juice concentrates
monsaccharides and disaccharides

240
Q

What do you need to be careful about with fruit ?

A

blending can change composition

241
Q

Why do we care about sugars ?

A

high levels of sugar intkae- tooth decay

greater higher energy intake
weight gain and increases BMI- hard to GA

too many high sugar beverages increases type 2 diabetes

242
Q

What is the impact of dental diseases ?

A 
cost to health services
multiple extractions under GA 
self esteem 
pain and anxiety
time lost from school/work
243
Q

What is children dental health in UK like ?

A

DMFT has decreased over time, decay experience has decreased

however inequality is increasing- the actual amount of decay is increasing - repeat GA is high

244
Q

What percentage of 5 year old children have decay experience ?

A

31%- this is obvious decay as well

mean number of teeth efffected-0.7

245
Q

How many dentate adults have decay ?

A

30%

hard to manage

246
Q

What percentage of 55-66 year olds have root caries ?

A

11%

247
Q

What percentage of 75-84 year olds have root caries ?

A

20%
ageing population
polypharmacy- xerostomia and increased caries

248
Q

What are problems of root caries ?

A

hard to manage
hard to control diet
endentulous end up
affects all teeth usually

249
Q

What are the SACN free sugar recommendations ?

A

no more than 5% of daily dietary intake

250
Q

What are the WHO guidelines for free sugar intake ?

A

do not exceed 10% intake

251
Q

What is the problem with diluting juice ?

A

says no added sugar
not actually sugar free
high frequency of attacks

252
Q

What does the WHO say about limiting free sugars ?

A

get down to less than 5% of energy intkae

dental caries tracks from childhood to adulthood

253
Q

What is the recommended dietary reference value for carbohydrate intake ?

A

50% of total dietary intake

254
Q

By reducing the free sugar intake which is part of carbohydrate intake what can we replace the deficient sugar with ?

A

starches
sugars contained in cellular structure of foods
lactose naturally present in milk and milk products

255
Q

What is helpful for parents and sugar intake ?

A

sugar cubes

256
Q

How much sugar should 11 year olds have ?

A

no more than 30g
7 cubes
6-7 teaspoons

257
Q

How much sugar ahould 7-10 year olds have ?

A

no more than 24g
6 cubes
5-6 teaspoons

258
Q

How much sugar should 4-6 year olds have ?

A

5 cubes

4-5 teaspoons

259
Q

How much sugar is one sugar cube ?

A

4g

260
Q

What is significant about honey ?

A

protects agaisnt dental caries

propolis bee glue contains flavanoids and esters that decrease enamel dissolution

261
Q

How can we transition from a high sugar to low sugar cereals ?

A

sprinke on top

262
Q

What are RCTs ?

A

preferred- gold standard
doesnt work for dental caries
wouldnt be ethical- giving a high sugar diet

263
Q

What are non randomised intervention studies ?

A

open to bias

264
Q

What is the strongest data after RCT ?

A

cohort studies

265
Q

What are cohort studies ?

A

look at the effect of specific risk factors

266
Q

What are population ecological studies ?

A

use per capita sugars data- people in popualtion

267
Q

What are cross sectional studies ?

A

measure one point in time only

268
Q

What are case studies ?

A

weak evidence and only suggestive

269
Q

What are the weaker forms of evidence ?

A 
animal expriments 
enamel slab- in vivo
plaque pH studies-
lab experiments- in vitro 
weak unless there is evidene from epidemiological studies
270
Q

What is the problem with cross sectional studies ?

A 
dental caries takes several years to develop 
diet several years earlier leads to it 
those with decay may have changed habits
habits change all the time 
be careful with data
271
Q

What is a cross sectional study ?

A

snapshot of time

272
Q

What do world wide ecological studies do ?

A

compare sugar availability and dental data from dental surverys and per-capita data on sugar availability
eg. From food and agricultural organisation

273
Q

What is the relationship between sugar avaialability and DMFT ?

A

more sugar availabiltiy and higher DMFT

274
Q

What is tristan de cuhna ?

A

island
low free sugar diet
transport links icnreased- decay increased as sugar access increases

275
Q

What is the relationship between sugar availability and caries ?

A

reduced sugar availability
reduced caries
ww2 and iraq

276
Q

What can happen with the transition from primary to secondary school ?

A

increased access to sugar

277
Q

What happened in iraq ?

A

reduced sugar intake after UN sanctions

reduced DMFT after sanctions

278
Q

What are intervention studies ?

A

change diet in one group
and monitor dental caries increment compared with a control group
randomised into intervention and control groups
assessor should be blind

hard to do but could be medically have to reduce sugar diet

279
Q

What conclusions can be drawn from the turku study ?

A

substituting sucrose in the diet with xylitol (0) leads to a lower caries increment compared with a sucrose diet (4)
starch ewas freely taken as well showing it has no effect on caries

280
Q

Can dental caries still occur in children when free sugar intake is less than 10% ?

A

yes

281
Q

What do cohort studies tell us about the effect of reducing sugar intake to 5% from 10% ?

A

japan ww2
lower levels of dental caries when sugar availability was less than 5% than 10%
however not reliable

282
Q

What can we conclude from animal experiments about frequency of food intakes and dental caries ?

A

increased frequency of intake increases development of caries
same quantity of food

283
Q

What have cohort studies shown about caries and freqency and amount of sugar ?

A

amount is more important

284
Q

Which type of studies can measure if frequency or amount is more important ?

A

measure frequency and amount

285
Q

What is the cariogenicity of mono and disaccharides ?

A

exception of lactose

cariogenicity of mon/di saccharides is similar

286
Q

What is the cariogenicity of lactose ?

A

lactose is less carigenic than other mono.disaccharides

287
Q

What do some animal studies say about sucrose ?

A

more cariogenic

288
Q

What does turku say about fructose and sucrose ?

A

pre cavity lesions more with sucrose than fructose

289
Q

What is the role of sucrose ?

A

substrate for extracellualr glucan synthesis

sucrose has high energy bond

290
Q

What is the evidence about glucan and strep mutans ?

A

glucans enhance strep mutans in plaque by increasing plaque porosity- acid accumulation at enamel surface

291
Q

How much does fluoride reduce careis by ?

A

50%

292
Q

Is there still careis in fluoridated areas ?

A

still a relationship between sugar and careis in fluoridated area
sugar is a moderate risk factor in fluoridaed areas

293
Q

Why are low levels of caries in childhood significant ?

A

dental caries is progressive and effects of sugars on dentition are lifelong

294
Q

What type of evidence is lacking to show a relationship between frequency of sugar and caries ?

A

epidemiological evidence is lacking

295
Q

What is the evidence for an association between free sugars and dental caries in intervention studies ?

A

turku showed that removing sugar from diet and replacing it with xylitol leads to an 85% caries reduction in adults

vipeholm study showed that consumption of sugars inbetween meals increased caries

sugars up to 4 times with meals only had lesser effect

withdrawal of sugars dropped carious activity

296
Q

What is the evidence for cohort studies linking sugar and caries ?

A

8 cohort studies show higher caries with higher sugars

5 cohort studies show lower caries intake of free sugar is less than 10%

some show low levels of dental caries occur at less than 10%

297
Q

What is the evidence for ecological studies showing a relationship between free sugars and dental caries ?

A

lower caries when < 5% and lower than when 10%

298
Q

What are the limitations of plaque pH studies ?

A

indirect measure of dental caries as they only measure acidogenicity

299
Q

What are the limitations of animal experiments ?

A

differneces in tooth morphology and salivary composition

caution when extrapolating findings to humans

300
Q

What are the limitations of cross sectional epidemiological studies ?

A

current diet may be differnet from diet several years ago when caries was initiated
only measure disease and diet at one point

301
Q

What happens in cross sectional studies ?

A

look at data from a specific population at a specific time

302
Q

What happens in population based ecological studies ?

A

do not account for confounding factors that use per capita sugars data
eg. assumes sugar consumption is equal across all population groups

303
Q

What happens in cohort studies ?

A

do not provide such strong data as RCT

dont control for compounding factors like fluoride

304
Q

What are highly processed starchy foods ?

A 
sweetened breakfast cereals
biscuits
cakes
processed corn and potato snacks 
sweetened popcorn
305
Q

What have aninal studies shown about starch ?

A

raw starch is not cariogenic
cooked starch can cause caries but less than sucrose
mixes of sugar and starch can increase caries to levels with sugars alone

306
Q

What has lab incubation concluded about processed starchy foods ?

A

crisps. pretzels, breadksticks and crackers - hydrolysed to glucose - metabolised to lactic acid

307
Q

What do enamel slab experiments show about processed starchy foods ?

A

cause 1/4 of the demineralisation seen with sugars

308
Q

What happens when total starch intake is unaltered/increases and sugar decreases ?

A

caries declines

309
Q

What happened in japan and norway ?

A

sugar decreased
starch increased
dental caries decreased

310
Q

What do children with HFI compared with controls have ?

A

low caries
low intake of sucrose and fructose
normal/higher intake of starch

311
Q

What does WHO say about starch rich staple foods and caries relationship ?

A

evidence that starch rich food showed no relationship with caries

312
Q

What did the iowa fluoride study say ?

A

significant associations between consumption of highly processed starch foods and development of caries

313
Q

What are the conclusiosns regarding cooked staple starchy foods ?

A

low cariogenicity in man

314
Q

What happens if starchy food are eaten frequently, heat treated and ground ?

A

can cause caries- less than sugars

315
Q

What are conclusions about cariogenicity about cooked starch foods ?

A

adding sugar increases cariogenicity

baked starch- same levels of cariogenivity as sucrose

316
Q

What are recommendations to patients on starch ?

A

consume starchy staples

avoid highly processed starchy foods

317
Q

What do plaque pH studies show about fruit consumption ?

A

fruit consumption decreaes pH but not to below critical

318
Q

What do epidemiological studies show about fruit consumption ?

A

associted wih low levels fo caries

319
Q

What is the advice to parents about frehs fruit ?

A

fresh whole fruit is a healthy snack

fruot juices are high in free sugars- limit to one portion a day

320
Q

What is the problem with dried fruits ?

A 
syrup / sugar added in drying process 
not classified as free suugars
cocnentrated natural sugar
source of micronutrients and fibre 
consume at mealtimes
321
Q

What is lactose content in human milk ?

A

7g per 100g

322
Q

What is lactose content in cows milk ?

A

5g per 100g

323
Q

Is milk classified as cariogenic ?

A

could be
lactose is least cariogneic of the sugars
calcium and phosphprous help against enamel dissolution

324
Q

Which breastfed children have an increased risk of caries ?

A

breastfed for more than 12 months

frequentyl fed and nocurnally fed

325
Q

What are the types of artificial sweetners ?

A

intense and bulk

326
Q

What are bulk sweeteners ?

A 
composed by polyols 
derivatives of normal sigars with a carbohydrate strucutre 
mild
have to be added in bulk 
virtually non cariogenic
327
Q

What are some examples of bulk sweeteners ?

A

xylitol
sorbitol
mannitol

328
Q

What are intense sweeteners ?

A

range of structures like dipeptides

much more sweeter than sugar

329
Q

What are some examples of intense sweeteners ?

A

acesulfame potassium
thaumatin
aspartame
stevia

330
Q

What are plaque pH studies ?

A

in vitro

plaque in test tube and look at pH drop

331
Q

What are animal studies ?

A

comapre sugar and sweetneers and look at incidence of caries
rodents have a different tooth anatomy

332
Q

What are intervention studies ?

A

clincial trials

333
Q

What are enamel slabs ?

A

bovine enamel

attached to tooth and observed

334
Q

What type of sweeteners are sorbitol and mannitol ?

A

bulk

335
Q

How sweet are sorbitol and mannitol ?

A

sorbitol- 0.5 times as sweet

mannitol- 0.7 times a sweet

336
Q

What do incubation studies show about sorbitol and mannitol ?

A

sweeteners are fermented much slower than sugar

337
Q

What do plaque pH studies show about sorbitol and mannitol ?

A

slight decrease

338
Q

What do animal studues dhow about sorbitol and mannitol ?

A

happens but at a lesser extent than curose

339
Q

What do clinical trials show about sorbitol and mannitol ?

A

non cariogenic

340
Q

What is the risk of using chewing gum in studies and comapring it with no gum ?

A

gum stimulates salivar production

341
Q

Are there any long term effects of sorbitol and mannitol ?

A

no

likely to increase caries in normal people

342
Q

What type of sweetener is xyltoll ?

A

bulk

343
Q

How sweet is xylitol ?

A

as sweet as sucrose

344
Q

Is xylitol cariogenic ?

A

no- it is non cariogenic

345
Q

What did the turku study show about xylitol ?

A

total sub of sucorse with xylitol- 85% less caries development

346
Q

What does xylitol do ?

A

increases salivary flow

347
Q

What is sucralose ?

A

splenda
bulk
chlorinated derivative of sucrose

348
Q

What is aspartame ?

A

canderel
intense- 200x sweeter
non cariogenic
used in frozen foods

349
Q

What is the problem with aspartame ?

A

contains phenylalanine

cant be used by PKU patients

350
Q

What happens in PKU ?

A

mutations in phenylalanine hydroxylase
cant convert phenyalalanine to tyrosine
leads to irreversable brain damage

351
Q

What is saccharin ?

A

intense
500 x times as sweet as sucrose
inhibits bacterial growth/metabolism by enzyme inhibition

352
Q

What is acesulfame potassium ?

A

130 x as sweet as sucrose
non cariogenic but doesnt inhibit caries
used in boiled sweets as it withstands high temperatures

353
Q

What is stevia ?

A 
intense
from the leaves of the plant 
active comounds are stevoil glycosides 
heat stable/pH stable 
non fermentable
354
Q

What are the types of tooth wear ?

A

attrition
erosion
abrasion

355
Q

What is erosion ?

A

chemical dissolution of enamel by acids of non bacterial origin

356
Q

How is the BEWE carried out ?

A

mouth divided into sextants
all surfaces measured
no 8s
cumulative scores given - only record highest score for the sextant

357
Q

What is a BEWE score 1 ?

A

initial surface texture loss
shiny enamel surface
loss of mamelons
incisal translucency

358
Q

What is BEWE score 0 ?

A

no erosive tooth wear

359
Q

What is a BEWE score 2 ?

A

distinct defect

hard tisseu loss is lessthan 50% of surface area

360
Q

What is a BEWE score 3 ?

A

Hard tissue loss is more than 50% of surface area
dentine is exposed- hypersensitivity
possible pathological

361
Q

What is the highest BEWE score ?

A

3

362
Q

Is erosive tooth wear reversible ?

A

no

363
Q

What happens in pathological wear ?

A

pulpal exposure

364
Q

What are the consequences of pathological wear ?

A 
loss of function 
pain 
aesthetics 
destructuion 
psychological 
costly
365
Q

What is the aetiology of erosion ?

A

intrinsci

extrinsic

366
Q

What is the intrinsic aetiology of erosion ?

A

GERD
frequent vomiting
Hcl

367
Q

What are the extrinsic aetiology of erosion ?

A

medicine

dietary acids

368
Q

What are some examples of dietary acids ?

A 
acetic 
ascorbic 
citrus
carbonic 
phosphoric
369
Q

What re some acidic foods and drinks ?

A 
carboanted 
alcohol 
fresh fruit juices
fruit
tomato and chilli foods
370
Q

How do hydrogen ions erode enamel ?

A

hydrogen ions are dissociated in water
combine with phosphate/carbonate ions
release all ions from that part of the crystal

371
Q

What is the appearance of eroded enamel ?

A

honeycomb

372
Q

How does Hcl work in erosion ?

A

hydrogen ions directly dissolve mineral surface

no effect from chloride ions

373
Q

How does citric acid dissolve ?

A

hydrogen ions directly dissolve

citrate anion interacts with calcium removing it from crystal surface

374
Q

Which acid has a higher erosive potential ?

A

citric

375
Q

What determines the erosive potential ?

A 
pH
titratable acidity 
buffering capacity 
mineral content 
calcium chelation
376
Q

What is the titratable acidity ?

A

total amount of acid in solution as pH changes

377
Q

What is buffering capacity ?

A

maintain pH at neutral

offset the effects of the acid

378
Q

How does quantity influence erosive potential ?

A

increased acidic drinks and fruit intake - higher erosio prevalence

379
Q

How does frequency affect erosive potential ?

A

dietary acids more than 4 times a day- tooth wear
fruit between meals- higher risk of erosion
drinks with meals- reduced prevalence by 50%

380
Q

How do habits affect erosive potential ?

A

spending longer eating druit/acidic drinks means more tooth weast
longer time drinking- less time for the acid to buffer away
swishing and sipping

381
Q

How does temperature affect erosive potential ?

A

higher temperature increaes erosive potnetial

382
Q

What are some groups at risk of erosion ?

A 
sports people 
eating disorders
alcoholics
drug addicts
dieters
wine tasters
pregnant women
383
Q

What do you need to ask patients when you suspect erosiove tooth wear ?

A

how often are you having dietary acids ?
how many between meals
how long
are these hot ?

384
Q

What is essential for management of dental erosion ?

A

good records
early diagnosos
control aetiological factors
ongoing monitoring

385
Q

Which aspects of MH can effect erosion ?

A

salivary gland hypofucntion
radiotherapy
gastric disturbances
oral hygeine habits

386
Q

What is dietary advice to be given for erosion pateitns ?

A

drink water/milk with meals
consume quickly/straw
chilled beverages

387
Q

What should be used after an acid attack ?

A

remineralising agent- fluoride

neutralising agent - sugar free

388
Q

What are some protective factors for erosion ?

A

dairy milk - lactose is least cariogenic

cheese

389
Q

Why are dairy milk and cheese used as protective factors ?

A 
calcium 
phosphate 
casein 
all anti cariogenic 
increases concnetration to locally reduce conc gradient
390
Q

What does cheese do in erosive protection ?

A

increases saliva flow

391
Q

What is the effect of tooth loss on chewing ?

A

bite strength

closing force

392
Q

What types of foods do edentuolous people avoid ?

A

raw fruit and veg

food with pips

393
Q

Which nutrients are lower in edentulous ?

A 
protein 
iron
vitamin B1
vitamin B2
vitamin C
394
Q

What leads to a low intake of dietary fibre in edentulous ?

A 
tooth loss
reduced tooth function 
selective food avoidance 
low intake of fruit and veg
 low intake of fibre
395
Q

What do edentulous tend to substitute fibre with ?

A

saturated fat

396
Q

What does a low BMI in older people ?

A

low functional status
low protein intake
low energy intake

397
Q

What does being edentuolous put you at risk of ?

A

undernutrition

398
Q

What does prosthetic rehabilitation due to chewing function ?

A

prosthetic rehabilitation improve chewing fucntion

399
Q

What does prosthetic rehabilitation not do ?

A

give people the drive to change theri nutrition now they can eat

400
Q

What is needed to improve nutritional status of denture wearing patients ?

A

dietary advice

401
Q

What can dietary advice lead to in denture patients ?

A

sustained reduction in saturated fat

increased fibre intake

402
Q

What needs to be done to improve nutritional status of denture patients ?

A

dietary adive

optimised denture

403
Q

How could you increase fruit and veg fro edentuolous ?

A

smoothies
mushy peas
grate
soup

404
Q

How can you increase fibre in edentulous aptients ?

A

wetabix
porridege
lentil soup
dhal

405
Q

What are the interacting factors in the disease process of periodontitis ?

A

exaggerated host response
patient risk factros
microbial dysbiosis

406
Q

What are some risk factors for periodontal disease ?

A 
tobacco 
environmental
oral hygiene 
medication 
microbial 
obesity 
genetics
407
Q

What is the main overriding factor in aetiology of periodontal disease ?

A

plaque

408
Q

What does nutrition do in periodontitis ?

A

poor nutriton impairs the host defence

409
Q

Which sugar affects plaque volume ?

A

sucrose leads to higher volumes of plque

410
Q

Why does sucrose impact on plaque ?

A

sucrose leads to glucan formation

411
Q

What does malnutrition due to immune systems ?

A

impairs innate immunity- phagocyte production,

impairs adaptive immunity- cell mediated, antibody

412
Q

Why does malnutrition affect oral disease ?

A

more glucocortoicoids

impaired host defence of saliva

413
Q

What are some diseases that are a result of poor nutrition ?

A

poor nutrition leads to necrotising periodontal diseases

ANUG- seen with poor OH and stress
Cancrum oris

414
Q

What is cancrum oris ?

A

gangrenous disease

rapid necotising destruction of soft and hard tisseu

415
Q

What are some risk factors for necrotising diseases ?

A

malnutrition
poor OH
compromised immune system
HIV

416
Q

What have calcium and vitamin D deficiencies lead to in animals ?

A

resorption of bone

exacerbates bone loss

417
Q

What is vitamin D needed for ?

A

cell development
bone development
neuromuscualr functioning
inflammation control

418
Q

What is a major source of vitamin D ?

A

from the conversion of 7-dehyrocholesterol to D3

419
Q

What are the sources of vitamin D ?

A

oily fish
egg yolks
cheese
fortified foods

420
Q

What is folic acid needed for ?

A

needed for cells with high turonver - gingiva

low serum folate independently associated with periodontla disease

421
Q

What is vitamin C ?

A

ascorbic acid

antioxidant

422
Q

What does severe vitamin C deficiency lead to ?

A

scurvy

swollen bleeding gums and tooth loss

423
Q

What is vitamin C needed for ?

A

collagen synthesis
PDL
bone matrix
blood vessel wallls

424
Q

What is the immune fucntion of vitamin C ?

A

phagocytosis and wound healing

425
Q

What is the link between vitamin C and periodontitis ?

A

weak association with vitamin C and periodontitis

426
Q

What are low B12 levels associated with ?

A

worsening of periodontal status and tooth loss

427
Q

What are ROS and when are they produced ?

A

ROS are released from PMNs in response to antigens

leads to phagocytosis and oxidative burst

428
Q

What can a prolonged period of ROS lead to ?

A

tissue damage

429
Q

What is oxidative stress ?

A

balance between ROS and antioxidants

in pathogenesis of diseases

430
Q

Which diseases does oxidative stress feature in ?

A

type 2 diabetes
cardiovascualr sisease
rheumatoid arthritis

431
Q

Which type of diet provides oxidants ?

A

refined sugars
carbs
saturated fats

432
Q

What does a disbalance in ROS lead to ?

A

local tissue damage

affects epithelial cells, connectove tiises, bone and neutrophils- in periodontitis

433
Q

What do antioxidants do ?

A

prevent oxidation of other molecules
influence periodontal onset, progressiona dn wound healing
buffer agaisnt ROS tissue damage

434
Q

Which tissues are damaged by ROS in peridontitis ?

A

gingival tissue
PDL
alveolar bone

435
Q

What do ROS do ?

A

lipid peroxidation
protein degradation
DNA mutations
bone resorption

436
Q

Give some examples of antioxidants ?

A

glucathione
coper
IRon
vitamin AEC

437
Q

Give some antioxidant rich foods ?

A 
sweet potato
apricots
almonds
sunflower 
sesame
chicken
438
Q

Which antiocidants are compromised in periodontitis ?

A

those in the GCF and serum

439
Q

What is the main function pf vitamin E ?

A

stabilise membrane structure by terminating free radical chain reaction

440
Q

Where can you find vitamin E ?

A

non citrus
nuts
seeds

441
Q

What did the nigata study say ?

A

higher itnake of dietary antioxidants- les teeth infected by PD
strongest for vitamin E

442
Q

What is obesity associated with ?

A

increased risk of periodontitis

443
Q

What do adipocytes do in obesity ?

A

release pro-inflamamtory adipokines like TNF aloha and IL6
up regualte acute phase proteins
promote periodontitis

444
Q

What ar the omega 3 fatty aids ?

A

EHA

DHA

445
Q

What is linoleic acid ?

A

essential fatty acid

in cell membranes

446
Q

What is the pathway for linoleic acid ?

A

linoleic acid
arachidonic acid
leukotrienes and eicosanoids

447
Q

What is the impact of EHA ?

A

stops arachidonic acid conversion into eicosanoids

promoted leukotriene B5 over B4 - less inflammatory

448
Q

What can breast feeding do ?

A

reduce child mortality

prevent 37% of deaths in

449
Q

What does the WHO recommend breast feeding for ?

A

exclusively for 6 months

450
Q

What do studies say about formula fed children and caries ?

A

formula fed children had higher caries

451
Q

What does evidence suggest about breastfeeding and its protective effect ?

A

breast feeding has a greater protective effect agaisnt dental caries that bottle feeding

452
Q

What is the link between children being breastfed for 12 months and caries ?

A

fewer dental caries if fed for 12 months

453
Q

What is the link between children being breast fed for more than 12 months and caries ?

A

fed more than 12 months then increased caries

454
Q

What increases the risk even more with breast fed children ?

A

nocturnally fed

455
Q

Why are babies breast fed after 12 months ?

A

birth control - prolonged return of meneses

reduces risk of diarrhoea
protects agaisnt respiratory infection
reduced risk of shigellosis

456
Q

What are the benefits of nocturnal breastfeeding ?

A

improves milk supply
contraceptive effect
reduced SIDS risk
ensure adequate intake as stomach volume is small
important for babies with faltering weight
promotes sleep- serotonin

457
Q

What are the benefits of baby led breastfeeding ?

A

increases milk flow and helps with nutritional adequacy
boost oxytocin
regulate body temperature and blood glucose

458
Q

When should cow mil be given ?

A

not in the first 12 months

defintiely not in first 6 months- too high risk of allergy

459
Q

What is hypoallergenic infant formula ?

A

for babies that are lactose intolerant, cow milk protein allergy or cow protein intolerant

460
Q

What does hypoallergenic infant formula contain ?

A

fully hydrolysed cow protein

can also be partially hydrolysed cow protein

maltodextrins
sucrose/fructose to camoflague taste- exceeds daily intake of sugar

461
Q

When is hypoallergenic infant formula used ?

A

under medical supervision

462
Q

What is low/lactose free formula ?

A

does not contain caesin or lactose

contains glucose syrups and sucrose so is cariogenic

463
Q

What is nutrient enriched post discharge formula ?

A

for pre term infants post discharge

464
Q

What is soya formula ?

A

use for vegan infants
higher in micronutreitns
contain glucose and syrups
not recomended because of phytooestrogens

465
Q

What is follow on formula ?

A

for infants 6 months plus
contains more proteins, micronutrients than infant formula

have a source of high iron- not needed
can contain maltodextrins and oligosaccharides

466
Q

Are follow on formulas suitable ?

A

no - they are not a repalcement for breast milk form 6 months onwards

467
Q

Why shouldnt cows milk be given before 12 months ?

A

low in iron

468
Q

Why shouldnt skimmed milk be given bedfore 5 months ?

A

loss of fat and fat soluble vitamins - ADEK

469
Q

What is bottle feeding and sugars associated with ?

A

increased dental caries

470
Q

Why do parents add sugar to infant feeds ?

A

treat constipation
aid digestion
help baby sleep and reduce pain

471
Q

When should different tastes and textures be induced ?

A

from 6-7 months

472
Q

Whens hould infants be eating family foods ?

A

from 1 year

473
Q

When are micronutrient supplements for ACD be given ?

A

from the time complementary foods are given

if they are not having infant formula

474
Q

What should be the drinks in infants ?

A

milk and juice

475
Q

When should a cup be introduced ?

A

from 6 months

476
Q

When should bottle drinking be discouraged ?

A

from 1 year

477
Q

What is the dietay proportions for children ?

A

50% of energy from fat- reduce this to 35%
5 fruot and veg
starch carbohydrate in all meals

478
Q

What increases ECC risk ?

A

sugared drinks and sweet snacks

479
Q

What are hidden sugars ?

A 
invert sugars 
glucose syrup 
corn starch 
maltodextrin 
hugh frucrose corn syrup 
fruit juice and cocnentrate
480
Q

What are some actions to reduce free sugar intake ?

A

policies
taxing foods in high sugars
advertising/marketing restrictions on food and drinks
reformulation of food products to reduce free sugars

481
Q

What are the main aims in trying to reduce free sugar intake ?

A

decrease frequnecy

decrease amount consumed

remove in between meals snacks

do not consume within bedtime

482
Q

How do you plan dietary intervention ?

A

screening- those who need to change
assessment- are they ready to change ?
desired changes- neogtiate some changes
monitor progress

483
Q

What are the 3 Ps ?

A

practical
personal
positive

484
Q

What are SMART goals ?

A 
specific 
measurable 
acheivable 
realistic 
timely
485
Q

How should goal/agenda setting be ?

A 
collaborative
patient led 
flexible 
individually tailored 
faciliated and not driven
486
Q

What are the stages of change model ?

A

pre contemplation
contemplation
planning
action maintenance

487
Q

What do you need to talk about change ?

A

change talk

rapport

488
Q

How do you assess the readiness to change ?

A

they have importance and confience

489
Q

How do you assess importance and confidence ?

A

scaling questions

490
Q

What are the aspects of change talk ?

A

rolling with resistance
scaling questions
reflections
open/closed questions

491
Q

What should you do when using scaling questions ?

A

ask why they gave a 6 and not a 1

492
Q

Which stage are people at if they are rolling with resistance ?

A

contemplation

493
Q

What should you do with rolling with resistance ?

A

acknowledge that change might not be possible now and that the relationship should be open in future

494
Q

What is important to remeber with monitroring ?

A

bring up and check nect time

495
Q

What does SMART stand for ?

A 
specific 
measurable 
acheivable 
realsitic 
timed

BDS stage 2 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions