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

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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.

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3
Q

Provide structural components for growth,

development, and maintenance of oral tissues

A

– Mainly from protein (collagen), minerals (calcium and

phosphorus), fat, water.

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4
Q

Regulate metabolic processes

A

– Carbohydrate, protein, fat, vitamins, minerals, water

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5
Q

Maintain a constant internal environment

A

– By controlling the fluid balance & temperature.

– Mainly from water, protein, fat, mineral

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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.

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7
Q

• Diet

A

– Amount & type of food consumed to meet specific

requirements of individual.

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8
Q

Macronutrients

A
• Nutrients required
by the body in large
amounts (gram)
– Carbohydrates
– Proteins
– Fats
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9
Q

Micronutrients

A
Nutrients required
by the body in small
amounts
– Vitamins
– minerals
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10
Q

The Importance of Nutrients in the Oral

Cavity

A
  1. Development & growth of oral tissues

2. The continued maintenance of oral tissues

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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

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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

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13
Q

Nutrient requirement during this phase is

influence by systemic factor

A

• during prenatal development, nutrients are obtained

from the mother’s blood

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14
Q

Any interferences occurred during growth

development could lead to :

A

hypoplasia

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15
Q

hypoplasia

A

Disturbances of ameloblasts activity which will affect the
function of the ameloblasts and lead to disturbances during
the mineralisation stage

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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

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17
Q

Hypoplasia chronological

A

Hypoplasia chronological

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18
Q

Colorado stain/Fluorosis (opaque enamel)

A

Colorado stain/Fluorosis (opaque enamel)

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19
Q

During the continued maintenance of oral

tissues

A

Nutrient requirement during this phase is

influence by environmental factors

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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

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21
Q

protein fx

A
  1. Source of amino acids for protein
    synthesis in tissues development
  2. Synthesis of protein conjugates
  3. Structural components & regeneration of the tissues
  4. Protection by synthesizing defense proteins
  5. Regulates the metabolism process
  6. Transporter & binding protein
  7. Regulates the pH in saliva
  8. As an energy production (insufficient of carbohydrate)
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22
Q
  1. Source of amino acids for protein

synthesis in tissues development

A

animal protein, plant protein

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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
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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

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25
Q
  1. Synthesis of protein conjugates
A

– Amylases

– Glycoproteins: Mucin

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26
Q
  1. • Structural components & regeneration of the tissues. pro
A

Collagen: matrix protein of dentin, cementum, bones & PDL.

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27
Q
  1. Protection by synthesizing defense proteins
A

– IgA: neutralize the foreign substance

– Histatins: salivary antifungal proteins

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28
Q
  1. Regulates the metabolism process.. pro
A

Calmodulin regulates the calcium-mediated process

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29
Q
  1. Calmodulin regulates the calcium-mediated process.. pro
A

– Hemoglobin: oxygen transport

– Albumin: major protein transporter

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30
Q
  1. Regulates the pH in saliva.. pro
A

– Sialin: salivary pH buffering protein

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31
Q
  1. As an energy production (insufficient of carbohydrate)
A

– Protein is metabolised to be used for energy.

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32
Q

Protein digestion

A

Plant protein is poorly digestibility

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33
Q

Plant protein is poorly digestibility due to

A

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

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34
Q

• Deficiency of protein

A

– Defects in teeth composition, eruption pattern &
resistance to decay
– Increase susceptibility to infection in soft tissues
– Poor healing & tissue regeneration

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35
Q

fx carb

A

as source and storage of energy, main constituent of connective tissues, combines with protein to form glycoprotein, dietary sources

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36
Q

(cho) As source & storage of energy

A

– Most of the process needs ATP to be
function
– Store in liver & muscle as glycogen

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37
Q

(cho) main constituent of connective tissues

A

glycosaminoglycan

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38
Q

cho : Combines with protein to form

glycoprotein.

A

mucin

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39
Q

dietary sources of cho

A

– Starch & fibres (Polysaccharide)
– Sucrose (Disaccharide): Cariogenic
– Glucose, fructose, lactose
(Monosaccharide)

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40
Q

fx fibres

A

Is the supporting structures of plant cell
walls.
Retains H2O & binds acidic materials &
metals by its cation exchange capacity

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41
Q

fibre eg supporting structure

A

cellulose, hemicellulose, pectin substances,

lignin

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42
Q

digestibility

A

-Cannot be digested by mammalian enzymes
– But extensive degradation may occur as a
result of microbial action in the colon

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43
Q

The main products of the anaerobic

fermentation of fibre:

A
• Volatile fatty acids (acetate, propianate, butyrate)
• Gas (CO2
, H2
, methane)
• Energy
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44
Q

Physiological effects of dietary fibre in the

mouth:

A

– 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

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45
Q

lipid fx

A

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.

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46
Q

lipid as precursor for cholestrol

A

– Cholesterol is the precursor for vitamin D &

steroid hormones synthesis

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47
Q

EFAs

A

important for synthesis of lipid

molecules (DHA/EPA) in the body

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48
Q

• Some lipids essential for calcification.

A

Associated vit D: vit D is essential for

mineralization of hard tissues.

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49
Q

excess lipid

A

stored in adipose tissue and is
burnt when the body has run out of
carbohydrates.

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50
Q

Vitamins

A

Organic compounds; contain carbon & nitrogen

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51
Q

vit can be classified as

A

– lipid-soluble (vit A, D, E & K)

– water-soluble (vit B & C)

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52
Q

general fx of vit

A

– Essential for normal metabolism, growth and development
and regulation of cell function.
– As coenzyme in energy & protein synthesis

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53
Q

deficiency of vits

A

affects the oral tissues

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54
Q

excess of vit

A

– Water-soluble: readily excreted to the urine
– Lipid-soluble: accumulated in liver & fatty tissues in the
body (harmful)

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55
Q

vit A fx

A

– Essential for growth, development &
maintenance of epithelial tissues.
– Involves in immune function.
– Involves in the formation of ameloblasts &
odontoblasts.
– Stimulates osteoclasts activity

56
Q

vit A deficiency

A

– Abnormal of epithelial tissues
– Affect tooth development
Suppresses osteoclasts activity

57
Q

vit A deficiency ::

– Abnormal of epithelial tissues

A
  • Inadequate differentiation of cells
  • Desquamation of oral mucosa
  • Hyperkeratosis of keratinised tissues
  • keratinised of non-keratinised tissues
58
Q

• Hyperkeratosis of keratinised tissues

A

– Decrease in differentiation of cells lining tissue surface

 produce flatten & accumulate keratin

59
Q

• keratinised of non-keratinised tissues

A

– keratinised of salivary glands - reduces saliva secretion
-candidiasis, leukoplakia, decreased taste sensitivity,
xerostomia

60
Q

vit A deficiency– Affect tooth development

A

Degeneration of ameloblasts – causing
enamel hypoplasia.
• Affect odontoblast – causing atrophy –
poor dentine formation

61
Q

vit A deficiency - supresses osteoclast activity

A

• failure of bone remodeling & no check

on osteoblast bone deposition

62
Q

excess vit a

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
Q

vit D fx

A
– Facilitates the absorption of Ca2+ &
PO4
2-
for mineralization of bones and
teeth.
– Involves in formation of red blood
cells, skin, cardio
64
Q

vit d deficiency

A
– incomplete calcification of teeth and
alveolar bone
– abnormal bone regeneration
– cause Rickets (children),
osteomalacia (adult) & osteoporosis
65
Q

excess of vit d

A

Hypercalcaemia and
ectopic calcification (pulp
calcification).

66
Q

vit e fx

A

– Maintain the integrity of enamel
– An antioxidant & a scavenger
– Stimulates immune response &
acts as an anti-inflammatory

67
Q

vit e deficiency

A

– In rats: enamel defects, resulting

in chalky white incisors

68
Q

vit e excess

A

-Interfere vit. K clotting
mechanism
– Impairs white blood cells activity

69
Q

other name of vit e

A

tocopherol

70
Q

vit k fx

A

– Vit. K dependent proteins bind Ca2+ & involve
in crystallization of bone.
– Catalyst for synthesis of blood clotting factors.

71
Q

vit k deficiency

A

– Reduce bone mass density- increase hip
fractures risk
– Lower prothrombin level  failure of blood to
clot or increased clotting times

72
Q

– Reduce bone mass density increase hip

fractures risk

A

• Vit K helps osteocalcin undergo carboxylation
strengthen bones. Lack of carboxyl groups attach
to bone protein, weakened the skeletal system.

73
Q

– Lower prothrombin level  failure of blood to

clot or increased clotting times

A

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
Q

types of vitamin b

A

thiamine(B1), Riboflavin (B2), Niacin (B3), Panthotenic acid B5, Biotin (B7), Pyridoxine (B6), Folic acid (B9), Cobalamin (B12)

75
Q

fx of b1, b2,b3

A
As coenzyme
in CHO,
protein &amp; fat
metabolism
for energy
production
• As
component
for synthesis
of niacin
76
Q

deficiency of b1

A

Glossitis – flabby, red

& swollen tongue

77
Q

sources of b1

A

Breads &
cereals
• Fish & meat
• Milk

78
Q

deficiency of b2

A
Angular cheilitis –
cracking of the skin at
the corner of the lips
• Magenta tongue –
purple red &amp; swollen
tongue
• Anemia &amp; dermatitits
79
Q

sources of b2

A
-Lean meat
• Eggs
• Milk
• Cereals &amp; nuts
• Green leafy
vegetable
80
Q

deficiency of b3

A

• Angular cheilitis &
Angular stomatitis
• Glossitis & Stomatitis
• Ulcerative gingivitis

81
Q

sources of b3

A

• Poultry
• Same with
riboflavin
sources

82
Q

fx of b5

A
• Essential part of
coenzyme A in
energy metabolism
• Involve in synthesis
of Vit D, cholesterol
&amp; other steroids
• Involve in synthesis
of porphyrin in Hb
83
Q

sources of b5

A
• Abundant in
animal foods &amp;
whole grain
cereals
• Broccoli,
cauliflower,
tomato,
mushroom
• Avocado
• Honey
84
Q

fx of b7

A

• As coenzyme in
CHO, protein & fat
metabolism

85
Q

deficiency of b7

A

• Glossitis
• Painful tongue
• Magenta
tongue

86
Q

sources of b7

A
• Eggs
• Cauliflower,
tomato
• Banana
• Yogurt
• Almond
87
Q

fx of b12

A
• Coenzyme in nucleic
acid synthesis; in
catabolism of amino
acids &amp; fatty acids
• Essential for RBC
synthesis &amp; myelin
88
Q

deficiency of b12

A
• Cheilitis
• Stomatitis &amp; Glossitis
• Pale &amp; yellowish
mucosa
• Hemorrhagic gingiva
89
Q

sources of b12

A
• Eggs
• Meat &amp; Poultry
• Milk &amp; milk
products
• Shellfish
90
Q

fx of vit C

A

– Essential for collagen formation
– Involve in wound healing.
– Act as antioxidant

91
Q

fx of vit C : – Essential for collagen formation

A

• 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
Q

fx of vit C – Involve in wound healing.

A

• Involve in synthesis of leukocytes & other immune

system components.

93
Q

fx of vit C – Act as antioxidant.

A

• Quench the free radicals.
• Protect Vit A, Vit E & polyunsaturated fatty acids from
oxidation.

94
Q

deficiency of vitamin C

A

– Increase rate of ageing & carcinogenesis process
– Scurvy
– Poor collagen formation

95
Q

Minerals

A

inorganic, no carbon. supplied by diet

96
Q

classifiication of minerals

A

macrominerals, microminerals

97
Q

macrominerals

A

needed in large amounts (>100mg/day)

98
Q

eg of macromineral

A

calcium, phosphorous, magnesium, sodium, potassium, chloride &
sulfur

99
Q

properties of minerals

A

– Stable to heat.
– Soluble in water, acid & alkaline; solubility of minerals
affected by pH.

100
Q

microminerals

A

needed in small amounts (<23 mg/day);

trace elements

101
Q

eg of microminerals

A

iron, zinc, copper, fluoride, manganese, iodine, chromium,

molybdenum, selenium, cobalt, nickel, tin, vanadium & silicon

102
Q

ca and phosphate

A

Required for mineralisation of hard tissues

103
Q

Magnesium (Mg)

A

Essential for calcification of dentine

104
Q

Minerals- Trace elements

A

The absorption is greatly influenced by other
dietary components both organic (phytates) and
inorganic components (metals)

105
Q

eg of trace elements

A

zinc, iron , copper, fluoride, manganese,, iodine`

106
Q

• Iron (Fe)

A

– Responsible for O2 uptake
– Deficiency may cause the pale colour of gingiva &
other oral tissues

107
Q

• Zinc

A

– Essential body constituent for the normal cell growth

& differentiation

108
Q

• Copper (Cu)

A

– Required for the production of blood and nerve fibers

109
Q

• Iodine

A

– 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
Q

• Fluoride

A

– 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
Q

• Manganese

A

– As component of many enzymes in collagen formation,

protein synthesis & energy metabolism

112
Q

Effects of Dietary Sugars

A

– Dental Caries

– Alternative sweetener

113
Q

– Alternative sweetener

A

• 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
Q

– Dental Caries

A

• 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
Q

Effects of Coarse & Granular Food:

A

Periodontal Disease

116
Q

Periodontal Disease

A

• 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
Q

Effect of Acidic Diet :

A

– Enamel erosion

118
Q

– Enamel erosion

A

• 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
Q

The Role of Nutrients in the

Maintenance of Oral Health

A

Nutrients taken in an adequate amount &
having a balance diet will lead to a healthy oral
health

120
Q

Malnutrition

A

– 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
Q

Malnutrition occurs in people who are

A

undernourished or overnourished

122
Q

undernourished

A

consuming too few essential nutrients
or using/excreting them more rapidly than they can
be replaced

123
Q

overnourished

A

consuming too much essential

nutrients

124
Q

Effect of malnutrition on oral tissues can involve

A

both the hard and soft tissues.

125
Q

– Effect on Hard Tissues:

A
  • Teeth

* Bone

126
Q

– Effect on Soft Tissues:

A
  • oral epithelium
  • tongue
  • gingiva
  • salivary glands
  • pulp
  • periodontal ligaments
127
Q

Effect of Malnutrition on the Tooth

During pre-eruptive phase is influenced by systemic effect

A
– Deficiency of protein
– Deficiency of ascorbic acid (Vitamin C) 
– Deficiency of Vitamin A
– Deficiency of Vitamin D
– excess of vit D
128
Q

– Deficiency of Vitamin A

A
  • Enamel hypoplasia
  • Odontoblast abnormality
  • Suppress osteoclast activity
129
Q

Deficiency of ascorbic acid (Vitamin C):

A

Dentine formation is defective (weak collagen)

130
Q

– Deficiency of protein

A

Developed teeth is abnormal, size is small & teeth prone to have
caries

131
Q

• Effect of Malnutrition on the Tooth

During post-eruptive phase

A

• Effect of Malnutrition on the Tooth

During post-eruptive phase

132
Q

• Effect of Malnutrition on the Bone

A

– Deficiency of protein & vitamin C will affect the

formation of organic matrix of bone

133
Q

• Effect of Malnutrition on the Oral Epithelium

A

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
Q

• Effect of Malnutrition on the Tongue

A
– Deficiency of Riboflavin (B2) : inflammation of tongue/reddish
purple tongue (magenta tongue)
135
Q

• Effect of Malnutrition on the Gingiva

A

Deficiency of Vitamin C : Scurvy

136
Q

Effect of Malnutrition on the Salivary Glands

A

Deficiency of protein : Lower DNA, RNA and protein content