Outcome 3: Describe diet modifications required by dental patients. Flashcards
What is inflammation the result of?
The release of inflammatory chemicals that cause the five cardinal signs; redness, swelling, heat, pain and impaired function
What is redness caused by?
The chemicals cause vasodilation. As blood vessels expand in diameter, more blood runs through the vessels and to the injured site, and hence the wound looks a deeper red color.
What is swelling caused by?
The chemicals make the blood vessels more permeable and hence they exude more fluid out of the blood and into the tissue. This not only causes swelling but allows helpful plasma chemicals and blood cells to get to the tissue (eg. antibodies)
What is heat caused by?
Hyperemia (increased blood flow) accounts for the heat of the inflamed tissue. Heat increases the metabolic rate in the injured area, thus promiting cell replication and healing.
What is the Pain and Impaired function caused by?
This is due to injured nerve endings and the pressure caused by the swelling. Pain is an important alarm signal that calls attention to tissue injury, makes one favor the injured part of the body, and makes the body keep still so it gets the rest it need for recovery.
What nutrients are required for wound healing?
Wound healing is a priority after any major surgery, injury or trauma. The healing process is comoplex and requires a variety of nutrients for support. These include energy, protein, zinc, as well as antioxidant nutrients: Vitamins A, C, E and selenium.
The need for nutritional supplements depends on the:
-the nutritional status prior to the injury
-the length of time the patient will be on a restricted diet
-the patient’s ability to meet all nutritional requirments through diet during the recovery period
What is the purpose of a special clear liquid diet?
For post-operative use (up to 24 hours). Easily digested
What does a special clear liquid diet consist of?
This diet consists of clear fluids or foods that are liquid at body temperature. No residue. Not spicy. This diet should not be used for greater than 3 days without other nutrition support.
Foods allowed in a clear liquid diet?
-Clear fruit juices (apple, cran, grape)
-Pulp free juices
-Bouillon, consomme, clear broth
-Clear fruit flavoured / unflavoured gelatin
-Sugar, honey, frozen pop and fruit ice (made from clear fruit juices)
-low-residue (no pulp) lactose-free nutrional supplements (Ensure, Boost, Resource)
-Herbs and mild seasoning, salt & flavoured extract
-Tea & Coffee
What foods are NOT allowed in a clear liquid diet?
Milk, cream, fruit juices with pulp, cocoa, prune juice, vegetable juices.
Creamed soups, soups with meat and veggie pieces
-Pepper and other spices (cumin, coriander)
What is the purpose of a Full Fluids Diet?
Easily digest
What is the Full Fluids Diet?
Part of the diet progression (from clear fluids to mechanically altered). Transition to mechanically altered, blenderized, or regular diet
Foods allowed in a full fluid diet?
All fluids, including milk, eggnog, milkshakes (without pieces of fruit)
Plain yogurt
Hot cereals ie cream of wheat
Fruit & vegetable juices
Strained soups
Tea & coffee
Nutritional supplements
What foods are not allowed in a full fluid diet?
Chunky Soups
Mashed solids foods (apple sauces, pureed peaches)
What is the normal diet progessional after surgery/oral trauma?
The normal diet progression after surgery or oral trauma is from clear fluids to full fluids to a soft/mechanically altered (pureed, minced, cut-up) or regular diet.
What is the purpse of a Mechanically Altered Diet?
Texture-modified foods that require less chewing or biting. Prevents further damage or irritation to diseased or post-operated gums and teeth
What is a Mechanically Altered diet?
All foods that are modified in texture to promote ease of mastication. Chopped, ground, mashed, pureed foods. Emphasis should be placed on getting adequate fibre and fluids in this diet.
What foods are allowed in a Mechanically Altered diet?
All beverages. Soft bread, pancakes, and muffins without nuts, seeds, or dried fruits.
Plain-cooked cereal.
Plain puddings and custards. Mashed or cut-up or pureed ripe fruits (applesauce, mashed bananas, peaches). Soft, cooked, and moist meats. Mashed, baked, creamed potatoes. Blended and strained soups. Well-cooked soft vegetables without tough skin and seeds.
What food are not allowed in a Mechanically Altered diet?
Most raw fruits and vegetable seeds, nuts, dried fruits, crunchy candy, granola, caramel, taffy
Large chunks of meat and vegetables
Cereals that remain crunchy in milk (ie: granola, shredded wheat).
Berries, pineapple, crisp apple. tough cuts of meat, sausages, and hard cheeses.
French fries, potato skins.
N.B.: a food processor is recommended, as blenders tend to liquefy foods.
Cautions for Veeners on Anterior Teeth
Caution against biting on foods that might fracture or damage this dental work.
Ex:
-Avoid chewing ice or other hard substances, and
avoid biting into hard foods like apples and carrots.
These foods should be cut into bite-sized pieces first
Cautions for Injured Anterior Teeth
They must be protected from additional stress while they heal, therefore biting hard foods must be avoided. If there is an accompanying lip or tongue injury, a liquid or soft diet may be required for a few days.
Examples:
cut hard foods into bite-sized pieces so they can be chewed, not bitten
avoid sandwiches since they cannot easily be cut into bite-sized pieces
avoid toast, crusty rolls, and pretzels
What is the purpose of a Blenderized Liquid / “Jaw” Diet?
For use 3-8 weeks after oral or facial surgery. To provide food in a liquid form for patietns who are unable to chew, swallow, or tolerate solid foods. To be used for syringe, straw, and spoon feeding.
What is the Blenderized Liquid Diet?
This diet consists of liquid formed foods: fluids and blenderized foods. Blended foods can range from the thickness of fruit juice to that of cream soups. Is like a “meal” replacement. Should include all food groups.
Foods allowed in a Blenderized Liquid diet?
In general, all foods are well blenderized. Guidelines: blenderize nutrient-dense foods ad liquids. Use mild flavours and seasonings. Include foods/liquids in all food groups.
What Foods are NOT allowed in a Blenderized Liquid Diet?
Foods that do not blend well: Yogurt products with nuts and seeds. Coarse whole grains. Baked goods with coconut, chocolate and peanut butter chips. Fruits with seeds and membranes. Fried meats, sausages. Raw or fried veggies. Popcorn
Required amount of food for a patient on the blenderized liquid diet?
The patient needs to eat five to six times a day and will consume 2 - 3 litres of liquid per day.
Nutritional adequacy is a risk with a blenderized diet. Because the nourishment must be watery in texture, it is challenging to achieve caloric density (ample calories in a small volume of fluid).
Dietary challenges for ortho appliances?
Food and plaque can easily get trapped on tissues. This situation makes it more difficult for patient to maintain hygiene increasing the risk of decay and periodontal diseases.
Additionally, hard or sticky foods can break wires or brackets.
Foods to Avoid if you have orthodontic appliances:
Grains - corn chips, crisp tacos, large pieces of hard bread such as bagels, french bread and pizza crust, pretzels
Fruits/Veg - lemons, corn on the cob, cut raw fruits, and vegetables into thin slices which require minimal chewing force
Proteins - nuts
Scacks - hard candy, popcorn, peanut brittle, highly retentive and sticky foods, such as caramels, taffy and bubble gums
What is Ulcerative?
Formation of an ulcer on the surface of a tissue
What is Necrotizing?
Causing cell death
Dietary challenges if you have Necrotizing Ulcerative Gingivits?
The result is a sore mouth with anorexia (loss of appetite). This requires dietary intervention. Typically start with a clear fluid diet - move to a full fluid - then to a soft diet.
Food to avoid if you have Necrotizing Ulcerative Gingivitis?
Avoid spicy foods
Foods to eat for Necrotizing Ulcerative Gingivitis?
-Soothing foods like jello, ice cream, smoothies
-eating frequent small meals
-drink plenty of fluids
-supplements are often required
Nutritional problems for periodontal surgery
- the mouth is sore, but nutrition is essential for healing
- the periodontal dressing must be protected so food does not lodge under it
Dietary recommendations for patients who had periodontal surgery:
-no alcohol, no spicy foods
-cold liquids for the first 24 hours asa this limits swelling and allows the dressing to harden properly
-soft diet for the next one to two days, or until the soreness subsides
-Avoid hard foods until the dressing is removed
-no popcorn, hard foods, or sticky foods
Nutritional problems for oral surgery
- poor appetite
- the wound must be protected
- the patient cannot chew in the area of the surgery
Dietary recommendations for patients who had oral surgery
-progress from liquid to soft to regular diet
-protect the surgical area
-chew on the opposite side of the surgery
-no alcohol, spicy foods, or hot drinks
Most common reason for xerostomia?
Medications
Approximately 50% of elders take medications that can result in xerostomia.
Consequences of Xerostomia and gingival recession?
The combination of gingival recession and xerostomia increases the risk of root caries. This problem can ultimately lead to loss of teeth.
Nutritional deficiencies causing xerostomia?
Persons who experience xerostomia have significantly lower caloric intake, fibre intake, potassium, B6, iron, calcium, and zinc.
What are the nutritional implications of dentures?
-Diet quality declines as the number of missing teeth increases.
-Dentures may not always improve the quality of the diet
-Denture wearers have higher body weight, cholesterol, sugar, and CHO intake, and incidence of Type 2 Diabetes.
-Upper dentures can impair taste and swallowing function.
-Denture wearers have a lower calcium intake and accelerated alveolar bone resorption.
Advice for patient with new dentures?
-there is an adjustment period for the patient to learn to speak, bite, and chew.
- cut food into small pieces
- take small bites and chew slowly
- avoid sticky and hard foods at first
-chew on both sides to prevent tipping of the denture
-be careful as with dentures the mouth is less sensitive to very hot temperatures
