nutrition, inflammation and periodontal disease - periodontitics

Question 1

discuss the link between obesity and periodontal disease

Answer 1

• study shows that invididuals who are overweight/obese are more likely to suffer form periodontal disease. but it has not necessary that obesity causing the periodontitis or periodontitis causing obesity, but It can be related to each other. obesity people secrete the same pro-inflammatory mediator cytokines which causes an increase susceptibility for bacteria infection. therefore people with obesity have greater chance of destructive periodontal disease with alveolar bone and connective tissue loss

Question 2

discuss the role of PMN leukocytes in the production of reactive oxygen species in response to plaque biofilm

Answer 2

reactive oxygen species are highly reactive oxygen and nitrogen containing molecules. so when there is imbalance between these species and antioxidants in the body, there is the development of periodontal disease due to tissue damage. so how it works, is that due to plaque biofilm there is greater production of these ROS and what it does, these ROS activate osteoclast as well as break down of DNA resulting in mutation of cancer/cell death. therefore the increase number of PMNs results in higher degree of reactive oxygen species causing damaging to the tissues

Question 3

discuss how antioxidants may influence periodontal disease onset and progression

Answer 3

antioxidants neutralise ROS and reactive nitrogen species that cause oxidative stress, which results in tissues damage and periodontal breakdown. there is the possibility that antioxidants play role in modulating gingival inflammation.

Question 4

describe the roles of micronutrients and macronutrients in periodontal disease

Answer 4

macronutrients are nutritive components of food that are required for energy and to maintain’s the body’s normal growth and function in contrast micronutritients are required in trace amounts (not as much) - if you eat too much out of recommended amount it can again lead to periodontal disease due to those ROS species

Question 5

list some oral symptoms associated with ascorbic acid deficiency gingivitis

Answer 5

it is will appear with tooth mobility
weak and immature periodontal ligament
pain
shortness of breath
gum disease
corkscrew hair
swelling or oedema
poor wound healing
red, bleeds spontaneously on slightest provocation, resulting in hemorrhages/purpuras/bruising

Question 6

explain the role of oral health therapist in addressing obesity and nutritional management of periodontal disease

Answer 6

1. be aware of significant obesity as a risk factor for oral health and education patients on this link
2. understanding the causes and management of obesity are complex
3. implementing strategies to include vitamin A. B, C,D ,E, calcium, magnesium, probiotics and polyphenols in a balance diet according to AGHE to assist with periodontal ligament
4. cooperation and collaboration of all health care professionals (GP, dietitian, physiotherapist/exercise physiologist, psychologist) to encourage counselling weight reduction and treatment

Question 7

what is vitamin C or ascorbic acid?

Answer 7

vitamin C deficiency can cause scurvy, lack of fruits or vegetables can lead to this conditions. vitamin C has effective antioxidant properties that are important for maintaining intergrity of cell membranes and protection against ROS generated during inflammatory response. smokers are require amounts of vitamin C.
vitamin C deficiency will results in a lack of activation of lysine and proline to achieve collagen maturation

Question 8

what is vitamin A and B carotene

Answer 8

fat soluble vitamin needed for epithelial cell differentiation, bone remodelling and anti-inflammatory effect.
deficiency can results in reduction in mucous containing salivary and lacrimal secretions (has lead to blindness in third world countries).
B - carotene can be converted to vitamin A . this is also anti-oxidant , vitamin A is not

Question 9

what is vitamin D ?

Answer 9

can be obtain by diet but can also be synthesised in the body following exposure to sunlight.
helps to maintains blood calcium levels, and enhance Ca and PO4 absorption and aids in the calcification of teeth.
high vitamin D levels corresponds to less gingival inflammation and less BOP.

Question 10

what is vitamin E

Answer 10

most important fat soluble anti oxidant
protects cell membranes by quenching free radicals that cause oxidative damage to the fatty acids in the membrane . reduces production of prostaglandin E2 in macrophages which has been shown to be increase in GCF in patient with periodontal disease. supplementation has positive effects on the immune response especially in the elderly

Question 11

what is vitamin B9/folic acid/folate

Answer 11

water soluble vitamin belongingness to the B complex group.
involved in DNS synthesis and deficiency may reduce the ability to act as a barrier to bacteria

Question 12

what is vitamin B12 and B complex?

Answer 12

low serum B12 levels had an increase risk of developing periodontal lesions.
vegetarians should be supplemented appropriately for B12 .
may be important for periodontal wound healing

Question 13

what is calcium?

Answer 13

micronutrient imperative in the calcification process and are involved in the formation and maintenance of alveolar bone. elderly adults are lower risk of tooth loss with higher intake of calcium. individuals who consumed higher levels of calcium had lower incidence of periodontal disease

Question 14

what is magnesium?

Answer 14

involved in energy transfer reactions - concentrated in the mitochondria. lower serum magnesium is associated with elevated concentration of systemic inflammatory markers.
subjects taking magnesium - containing drugs had; greater number of teeth, shallower pocket depths and less loss of periodontal attachment.