Nutrition and oral health Flashcards
(46 cards)
The dentition
Diet and nutrition may have an effect with respect to
- developmental defects
- caries
- erosion
Developmental defects
Nutritional deficiencies -calcium and phosphates -vitamin A -vitamin D -malnutrition Nutritional excess -fluoride tetracycline
Nutritional fluoride in caries prevention
Water supplies (1ppm, 10% of UK
pop)
Salt (2nd most important dietary vehicle. Has
been used in Switzerland since1955)
Occurs naturally in tea (200mg F/Kg) and
some oily fish
Added to children’s school milk (2.65 ppm)
Fluoride
At the right amount, 15-50% reduction in caries
With an excess, will cause dental fluorosis (GIT upset, respiratory arrest and death)
Tetracycline
Broad spectrum antibiotic used for periodontal disease, acne, chest infections (cystic fibrosis patients) If given during enamel formation stage will cause severe intrinsic staining of enamel
Vitamin D - evidence for role in dental development
Historically, May Mellanby (early 1900s) found that dogs fed on diets deficient in vit D had:
- delayed dental development
- deficient (hypoplastic) enamel
Patients with Vit D resistant rickets (Hereditary hypophophatasia) may present with
Large pulp chambers
Large/ prominent pulp horns
Enamel hypoplasia
Clefts and tubular defects in dentine
Vitamin D resistant rickets - clinical significance
Due to thin enamel, prominent pulp horns and clefts in dentine - pxs may present may present with ‘spontaneous’ dental abscesses
Study (1991) found 25% of children with VDRR had experienced spontaneous abscesses of one or more of their primary teeth
Calcium and phosphates - evidence for role in dental development
There was a significant < in prevalence of enamel hypoplasia in children (1929-1943) following introduction of: -Cheap milk -Cod liver oil for pregnant women and young children -Bread fortified with calcium Pxs with disorders of calcium & phosphate metabolism (x-linked hypophosphatasia, hypoparathyroidism) show significant > in enamel defects (hypoplasias)
Vitamin A - evidence for role in dental development
Severe changes in ameloblasts occurs in rats fed with diet deficient in vit A – with resultant defective enamel and dentine formation No evidence for role of vit A in human tooth formation
Malnutrition - role in dental development
Nigerian study (1973) found following
dental defects in malnourished children (severe lack of protein)
-enamel hypoplasia (linear grooves) involving
primary incisors
-generalised enamel hypoplasias in 20% of
children
-delayed dental eruption
Hypoplasia
Enamel missing
Caries
Established role of non-milk extrinsic sugars in aetiology of dental decay - frequency rather than quantity
Erosion
Loss of dental hard tissues by chemical process that does not involve bacteria
Loss of tooth tissue into dentine in 25% of British 5 year olds (2013 child dental health survey)
Extrinsic causes of erosion
Acidic drinks - most fruit-flavoured or carbonated drinks
Acidic food - citrus fruits, yogurts
Vit C tablets
Pickled foods and vinegar
Erosion - dietary risk factors
> 2 citrus fruits daily
“Odd diets”
Vegetarianism?
4 carbonated drinks daily: 252% increased risk
Food consistency and periodontal health
In (some) animals there is evidence that fibrous diet will help < incidence of
plaque-related gingivitis &
perio disease
Food consistency
No real evidence that eating fibrous foods < plaque-related disease in humans - however
Eating fibrous foods may help to maintain supporting tissues of periodontium, and > salivary flow from eating fibrous foods may have some beneficial effects on oral health generally
PEG
Percutaneous endoscopic gastrostomy feeding tube
Children who are PEG-fed
Seem to readily develop excessive calculus deposits on all tooth surfaces
Food type and periodontal health
Food type does have effect on amount of plaque formed – > when there is higher sugar content However no real evidence that there will then be > perio disease
Vit C and periodontal health
Clear evidence that vitamin C deficiency has detrimental effect on perio health
Vit C deficiency associated with
Disturbed collagen formation Bleeding & swollen gums, loose teeth First seen in sailors (now seen in people with very deficient diets: homeless, fussy teenagers!)
Folic acid and periodontal health
Most deficient nutrient in adults Primarily concerned with DNA synthesis & cell turnover Probably plays role in perio health by maintaining epithelial integrity & attachment Folate mouthwashes & supplements have been shown to < pregnancy-related gingivitis
