nutrition in dev of oral tissues Flashcards
1
Q
Function of Food (Nutrients)
A
provide energy source of body work, provide structural component, and maintenance of oral tissues. Regulate metabolic processes, maintain a constant internal environment
2
Q
Provide energy source of body work
A
– Energy is stored as ATP in cells, glycogen in liver, fat in
adipose tissue.
– Mainly from carbohydrate and fat.
3
Q
Provide structural components for growth,
development, and maintenance of oral tissues
A
– Mainly from protein (collagen), minerals (calcium and
phosphorus), fat, water.
4
Q
Regulate metabolic processes
A
– Carbohydrate, protein, fat, vitamins, minerals, water
5
Q
Maintain a constant internal environment
A
– By controlling the fluid balance & temperature.
– Mainly from water, protein, fat, mineral
6
Q
Nutrition
A
– Is the intake of nutrients such as proteins, fats and
carbohydrates, vitamins, essential minerals and
trace elements for development, growth, repair
and maintenance.
7
Q
• Diet
A
– Amount & type of food consumed to meet specific
requirements of individual.
8
Q
Macronutrients
A
• Nutrients required by the body in large amounts (gram) – Carbohydrates – Proteins – Fats
9
Q
Micronutrients
A
Nutrients required by the body in small amounts – Vitamins – minerals
10
Q
The Importance of Nutrients in the Oral
Cavity
A
- Development & growth of oral tissues
2. The continued maintenance of oral tissues
11
Q
During the development & growth of oral
tissues
A
– Nutrient requirement during this phase is
influence by systemic factor
– Defects/abnormalities acquired during this stage
12
Q
– Defects/abnormalities acquired during this stage
A
• is highly influenced by the nutrients supply in the
mother’s blood
• is also contributed by genetic factors
– eg. Amelogenesis imperfecta
13
Q
Nutrient requirement during this phase is
influence by systemic factor
A
• during prenatal development, nutrients are obtained
from the mother’s blood
14
Q
Any interferences occurred during growth
development could lead to :
A
hypoplasia
15
Q
hypoplasia
A
Disturbances of ameloblasts activity which will affect the
function of the ameloblasts and lead to disturbances during
the mineralisation stage
16
Q
cause of hyppoplasia
A
» Hypoplasia chronological – caused by prolonged fever
(measles)
» Colorado stain/Fluorosis (opaque enamel)
• caused by exposure to high fluoride level during
mineralisation phase
17
Q
Hypoplasia chronological
A
Hypoplasia chronological
18
Q
Colorado stain/Fluorosis (opaque enamel)
A
Colorado stain/Fluorosis (opaque enamel)
19
Q
During the continued maintenance of oral
tissues
A
Nutrient requirement during this phase is
influence by environmental factors
20
Q
Nutrient requirement during this phase is
influence by environmental factors
A
• interaction between oral tissues & environment
components within the oral cavity
• eg. Caries, Gingivitis, Periodontal diseases
21
Q
protein fx
A
- Source of amino acids for protein
synthesis in tissues development - Synthesis of protein conjugates
- Structural components & regeneration of the tissues
- Protection by synthesizing defense proteins
- Regulates the metabolism process
- Transporter & binding protein
- Regulates the pH in saliva
- As an energy production (insufficient of carbohydrate)
22
Q
- Source of amino acids for protein
synthesis in tissues development
A
animal protein, plant protein
23
Q
animal protein
A
• Rich in essential a/a • Must be obtained from diet • Cannot synthesized by human e.g. Phe, Leu, Val, Met, His, Arg, etc • More desirable than plant
24
Q
– Plant proteins
A
Deficient in some a/a
• e.g. Trp, Lys & Sulfur-containing a/a
• but may contain other a/a in excess
25
2. Synthesis of protein conjugates
– Amylases
| – Glycoproteins: Mucin
26
3. • Structural components & regeneration of the tissues. pro
Collagen: matrix protein of dentin, cementum, bones & PDL.
27
4. Protection by synthesizing defense proteins
– IgA: neutralize the foreign substance
| – Histatins: salivary antifungal proteins
28
5. Regulates the metabolism process.. pro
Calmodulin regulates the calcium-mediated process
29
6. Calmodulin regulates the calcium-mediated process.. pro
– Hemoglobin: oxygen transport
| – Albumin: major protein transporter
30
7. Regulates the pH in saliva.. pro
– Sialin: salivary pH buffering protein
31
8. As an energy production (insufficient of carbohydrate)
– Protein is metabolised to be used for energy.
32
Protein digestion
Plant protein is poorly digestibility
33
Plant protein is poorly digestibility due to
Presence of peptide bonds which are resistant to
digestive enzymes
– Presence of enzyme inhibitors e.g. trypsin inhibitor
– Presence of fibres which hinders the access of
proteolytic enzymes
34
• Deficiency of protein
– Defects in teeth composition, eruption pattern &
resistance to decay
– Increase susceptibility to infection in soft tissues
– Poor healing & tissue regeneration
35
fx carb
as source and storage of energy, main constituent of connective tissues, combines with protein to form glycoprotein, dietary sources
36
(cho) As source & storage of energy
– Most of the process needs ATP to be
function
– Store in liver & muscle as glycogen
37
(cho) main constituent of connective tissues
glycosaminoglycan
38
cho : Combines with protein to form
| glycoprotein.
mucin
39
dietary sources of cho
– Starch & fibres (Polysaccharide)
– Sucrose (Disaccharide): Cariogenic
– Glucose, fructose, lactose
(Monosaccharide)
40
fx fibres
Is the supporting structures of plant cell
walls.
Retains H2O & binds acidic materials &
metals by its cation exchange capacity
41
fibre eg supporting structure
cellulose, hemicellulose, pectin substances,
| lignin
42
digestibility
-Cannot be digested by mammalian enzymes
– But extensive degradation may occur as a
result of microbial action in the colon
43
The main products of the anaerobic
| fermentation of fibre:
```
• Volatile fatty acids (acetate, propianate, butyrate)
• Gas (CO2
, H2
, methane)
• Energy
```
44
Physiological effects of dietary fibre in the
| mouth:
– Fibre rich food require more mastication – thus
lead to reduction of food eaten – help in control of
obesity
– Chewing promotes a greater flow of saliva –
prevent stagnation of food – reduce dental caries
45
lipid fx
Major source of energy after
carbohydrate.
• Facilitates lipid-soluble vitamin absorption.
• Precursor for cholesterol synthesis
• Provides EFAs (linolenic acid & linoleic
acid
-Some lipids essential for calcification.
46
lipid as precursor for cholestrol
– Cholesterol is the precursor for vitamin D &
| steroid hormones synthesis
47
EFAs
important for synthesis of lipid
| molecules (DHA/EPA) in the body
48
• Some lipids essential for calcification.
Associated vit D: vit D is essential for
| mineralization of hard tissues.
49
excess lipid
stored in adipose tissue and is
burnt when the body has run out of
carbohydrates.
50
Vitamins
Organic compounds; contain carbon & nitrogen
51
vit can be classified as
– lipid-soluble (vit A, D, E & K)
| – water-soluble (vit B & C)
52
general fx of vit
– Essential for normal metabolism, growth and development
and regulation of cell function.
– As coenzyme in energy & protein synthesis
53
deficiency of vits
affects the oral tissues
54
excess of vit
– Water-soluble: readily excreted to the urine
– Lipid-soluble: accumulated in liver & fatty tissues in the
body (harmful)
55
vit A fx
– Essential for growth, development &
maintenance of epithelial tissues.
– Involves in immune function.
– Involves in the formation of ameloblasts &
odontoblasts.
– Stimulates osteoclasts activity
56
vit A deficiency
– Abnormal of epithelial tissues
– Affect tooth development
Suppresses osteoclasts activity
57
vit A deficiency ::
| – Abnormal of epithelial tissues
* Inadequate differentiation of cells
* Desquamation of oral mucosa
* Hyperkeratosis of keratinised tissues
* keratinised of non-keratinised tissues
58
• Hyperkeratosis of keratinised tissues
– Decrease in differentiation of cells lining tissue surface
| produce flatten & accumulate keratin
59
• keratinised of non-keratinised tissues
– keratinised of salivary glands - reduces saliva secretion
-candidiasis, leukoplakia, decreased taste sensitivity,
xerostomia
60
vit A deficiency– Affect tooth development
Degeneration of ameloblasts – causing
enamel hypoplasia.
• Affect odontoblast – causing atrophy –
poor dentine formation
61
vit A deficiency - supresses osteoclast activity
• failure of bone remodeling & no check
| on osteoblast bone deposition
62
excess vit a
```
– impairs cell differentiation and
epithelialization, resulting in
delayed and impaired healing of
oral tissues (mimicking signs and
symptoms of deficiency)
– congenital defect: cleft palate &
lip
```
63
vit D fx
```
– Facilitates the absorption of Ca2+ &
PO4
2-
for mineralization of bones and
teeth.
– Involves in formation of red blood
cells, skin, cardio
```
64
vit d deficiency
```
– incomplete calcification of teeth and
alveolar bone
– abnormal bone regeneration
– cause Rickets (children),
osteomalacia (adult) & osteoporosis
```
65
excess of vit d
Hypercalcaemia and
ectopic calcification (pulp
calcification).
66
vit e fx
– Maintain the integrity of enamel
– An antioxidant & a scavenger
– Stimulates immune response &
acts as an anti-inflammatory
67
vit e deficiency
– In rats: enamel defects, resulting
| in chalky white incisors
68
vit e excess
-Interfere vit. K clotting
mechanism
– Impairs white blood cells activity
69
other name of vit e
tocopherol
70
vit k fx
– Vit. K dependent proteins bind Ca2+ & involve
in crystallization of bone.
– Catalyst for synthesis of blood clotting factors.
71
vit k deficiency
– Reduce bone mass density- increase hip
fractures risk
– Lower prothrombin level failure of blood to
clot or increased clotting times
72
– Reduce bone mass density increase hip
| fractures risk
• Vit K helps osteocalcin undergo carboxylation
strengthen bones. Lack of carboxyl groups attach
to bone protein, weakened the skeletal system.
73
– Lower prothrombin level failure of blood to
| clot or increased clotting times
Vit K catalysed Glutamic acid to form
Prothrombin. Level of prothrombin reduced with
vit K deficiency.
• < 35 % of prothrombin bleeding after brushing
• Vit K prescribe for patient after extractions.
74
types of vitamin b
thiamine(B1), Riboflavin (B2), Niacin (B3), Panthotenic acid B5, Biotin (B7), Pyridoxine (B6), Folic acid (B9), Cobalamin (B12)
75
fx of b1, b2,b3
```
As coenzyme
in CHO,
protein & fat
metabolism
for energy
production
• As
component
for synthesis
of niacin
```
76
deficiency of b1
Glossitis – flabby, red
| & swollen tongue
77
sources of b1
Breads &
cereals
• Fish & meat
• Milk
78
deficiency of b2
```
Angular cheilitis –
cracking of the skin at
the corner of the lips
• Magenta tongue –
purple red & swollen
tongue
• Anemia & dermatitits
```
79
sources of b2
```
-Lean meat
• Eggs
• Milk
• Cereals & nuts
• Green leafy
vegetable
```
80
deficiency of b3
• Angular cheilitis &
Angular stomatitis
• Glossitis & Stomatitis
• Ulcerative gingivitis
81
sources of b3
• Poultry
• Same with
riboflavin
sources
82
fx of b5
```
• Essential part of
coenzyme A in
energy metabolism
• Involve in synthesis
of Vit D, cholesterol
& other steroids
• Involve in synthesis
of porphyrin in Hb
```
83
sources of b5
```
• Abundant in
animal foods &
whole grain
cereals
• Broccoli,
cauliflower,
tomato,
mushroom
• Avocado
• Honey
```
84
fx of b7
• As coenzyme in
CHO, protein & fat
metabolism
85
deficiency of b7
• Glossitis
• Painful tongue
• Magenta
tongue
86
sources of b7
```
• Eggs
• Cauliflower,
tomato
• Banana
• Yogurt
• Almond
```
87
fx of b12
```
• Coenzyme in nucleic
acid synthesis; in
catabolism of amino
acids & fatty acids
• Essential for RBC
synthesis & myelin
```
88
deficiency of b12
```
• Cheilitis
• Stomatitis & Glossitis
• Pale & yellowish
mucosa
• Hemorrhagic gingiva
```
89
sources of b12
```
• Eggs
• Meat & Poultry
• Milk & milk
products
• Shellfish
```
90
fx of vit C
– Essential for collagen formation
– Involve in wound healing.
– Act as antioxidant
91
fx of vit C : – Essential for collagen formation
• As coenzyme for proline hydroxylase & lysyl hydroxylase
for the hydroxylation of proline & lysine to form
hydroxylproline & hydroxylysine by regenerating ferric
(Fe3+) to ferrous (Fe2+)
92
fx of vit C – Involve in wound healing.
• Involve in synthesis of leukocytes & other immune
| system components.
93
fx of vit C – Act as antioxidant.
• Quench the free radicals.
• Protect Vit A, Vit E & polyunsaturated fatty acids from
oxidation.
94
deficiency of vitamin C
– Increase rate of ageing & carcinogenesis process
– Scurvy
– Poor collagen formation
95
Minerals
inorganic, no carbon. supplied by diet
96
classifiication of minerals
macrominerals, microminerals
97
macrominerals
needed in large amounts (>100mg/day)
98
eg of macromineral
calcium, phosphorous, magnesium, sodium, potassium, chloride &
sulfur
99
properties of minerals
– Stable to heat.
– Soluble in water, acid & alkaline; solubility of minerals
affected by pH.
100
microminerals
needed in small amounts (<23 mg/day);
| trace elements
101
eg of microminerals
iron, zinc, copper, fluoride, manganese, iodine, chromium,
| molybdenum, selenium, cobalt, nickel, tin, vanadium & silicon
102
ca and phosphate
Required for mineralisation of hard tissues
103
Magnesium (Mg)
Essential for calcification of dentine
104
Minerals- Trace elements
The absorption is greatly influenced by other
dietary components both organic (phytates) and
inorganic components (metals)
105
eg of trace elements
zinc, iron , copper, fluoride, manganese,, iodine`
106
• Iron (Fe)
– Responsible for O2 uptake
– Deficiency may cause the pale colour of gingiva &
other oral tissues
107
• Zinc
– Essential body constituent for the normal cell growth
| & differentiation
108
• Copper (Cu)
– Required for the production of blood and nerve fibers
109
• Iodine
– Essential constituent of thyroxine (T4) & tri-iodothyronine
(T3)
– Most dietary iodine is converted to iodide in the
gastrointestinal tract & being absorbed by the body
110
• Fluoride
– Important during tooth development
– Ingestion of excess F- during development of enamel organ
adversely affects both the organic & inorganic phases of
enamel, resulting in hypoplasia of teeth
111
• Manganese
– As component of many enzymes in collagen formation,
| protein synthesis & energy metabolism
112
Effects of Dietary Sugars
– Dental Caries
| – Alternative sweetener
113
– Alternative sweetener
• Is a substitutes to the normal dietary sugars (eg. glucose,
sucrose, etc.)
• Used for diabetics & slimming purposes
• Examples of various sweeteners – saccharin, aspartame,
sorbitol, xylitol, etc.
• Xylitol is as sweet as sucrose helps in the prevention of
caries
114
– Dental Caries
• Dietary sugars (sucrose) contribute to the prevalence of
caries
• Sucrose (major cariogenic foodstuff):
– used by saccharolytic dental plaque bacteria to form acids
– acids could cause the demineralisation of enamel surfaces
– (However, it is not harmful to oral health if taken moderately of a
balance diet)
115
Effects of Coarse & Granular Food:
Periodontal Disease
116
Periodontal Disease
• may cause inflammation through over-use or
injury to the periodontal tissue
• However, diet that requires to be chewed
promotes the formation of dense strong
periodontal ligaments
117
Effect of Acidic Diet :
– Enamel erosion
118
– Enamel erosion
• Acid foods or liquid (acidic beverages) may
be harmful to enamel as the acids may
dissolve the apatite surface and cause
enamel erosion
• Enamel erosion can occurs on the palatal
surface of the anterior teeth, and dentine is
exposed
119
The Role of Nutrients in the
| Maintenance of Oral Health
Nutrients taken in an adequate amount &
having a balance diet will lead to a healthy oral
health
120
Malnutrition
– is the condition that develops when the body does not
get the right amount of the vitamins, minerals, and
other nutrients needed to maintain healthy tissues
and organ function
121
Malnutrition occurs in people who are
undernourished or overnourished
122
undernourished
consuming too few essential nutrients
or using/excreting them more rapidly than they can
be replaced
123
overnourished
consuming too much essential
| nutrients
124
Effect of malnutrition on oral tissues can involve
both the hard and soft tissues.
125
– Effect on Hard Tissues:
* Teeth
| * Bone
126
– Effect on Soft Tissues:
* oral epithelium
* tongue
* gingiva
* salivary glands
* pulp
* periodontal ligaments
127
Effect of Malnutrition on the Tooth
| During pre-eruptive phase is influenced by systemic effect
```
– Deficiency of protein
– Deficiency of ascorbic acid (Vitamin C)
– Deficiency of Vitamin A
– Deficiency of Vitamin D
– excess of vit D
```
128
– Deficiency of Vitamin A
* Enamel hypoplasia
* Odontoblast abnormality
* Suppress osteoclast activity
129
Deficiency of ascorbic acid (Vitamin C):
Dentine formation is defective (weak collagen)
130
– Deficiency of protein
Developed teeth is abnormal, size is small & teeth prone to have
caries
131
• Effect of Malnutrition on the Tooth
| During post-eruptive phase
• Effect of Malnutrition on the Tooth
| During post-eruptive phase
132
• Effect of Malnutrition on the Bone
– Deficiency of protein & vitamin C will affect the
| formation of organic matrix of bone
133
• Effect of Malnutrition on the Oral Epithelium
Deficiency of Vitamin A: hyperkeratosis
– Excess of Vitamin A: cleft palate and lip
– Deficiency of Riboflavin (B2) : cheilitis, sores in the mouth
– Deficiency of Cobalamine (B12) : megaloblastic anaemia (pale
appearance of mucosa)
134
• Effect of Malnutrition on the Tongue
```
– Deficiency of Riboflavin (B2) : inflammation of tongue/reddish
purple tongue (magenta tongue)
```
135
• Effect of Malnutrition on the Gingiva
Deficiency of Vitamin C : Scurvy
136
Effect of Malnutrition on the Salivary Glands
Deficiency of protein : Lower DNA, RNA and protein content
