W2: Perio- Nutrition, Inflammation and PD Flashcards
What is the release of O2 species in response to biofilm called?
free radicals
Discuss the link between obesity and periodontal disease
a) what pro-inflammatory cytokines are thought to be involved in pathogenesis?
b) what is decreased in adipose tissues?
c) how are osteoclasts involved?
d) fat cell increase could trigger which protein to break down what?
- significant link
- obesity is rampant, healthy BMI is 25. almost half of males, and 1/3 of females are obese (costs AUS $87.7billion)
A pro-inflammatory diet and poor micronutrient intake have been linked to an increased risk of periodontal disease. In contrast, adherence to an anti-inflammatory dietary pattern “high micronutrient and fibre” has been linked to a lower risk of periodontitis and tooth loss
free radicals
- any molecule independant, unpaired electron= more reactive (unstable)
- reductants or oxidants in body
- ROS= subspecies, has N
-antioxidant= scavenge and neutralise free radicals
oxidative stress
Oxidation
imbalance in species -> DNA damage/ inflammatory condition
- Describe the proposed roles of micronutrients and macronutrients in periodontal disease
produce energy
C/P/F= add calories to diet (nutritive)
micronutrients
trace elements such as ions, vitamins, min for growth
micronutrients
trace elements such as ions, vitamins, min for growth
Average BMI in AUS
27.6 (over 25)
27% AUS over 18 are obese.
Average BMI in AUS
27.6 (over 25)
27% AUS over 18 are obese.
Explain the role of oral health therapists in addressing obesity and nutritional management of periodontal disease
yes
How is Obesity linked to PD?
study 13 k ppl found link. study finds correlation (not causation)
- link coming from increase in biofilm, l=deep pockets, inflammatory type foods will contribute
Biological link to Obesity
-poor understand
- release of pro inflammatory cytokine
leptin
found in healthy normal individual, its increased in obesity
IL-6
stimulates bone break down
PAI-1
elevated in perio disease. increase with increade in plaque.
ROS causes
low levels
vit C and v E
- betacarotene
selenium
fluric acid gluthathione
what increases ROR
fast food, fats, proteins,
Apple like our cells, how so?
expose to o2= breakdown (oxidative effect)
Discuss the role of PMN leukocytes in the production of reactive oxygen species in
response to plaque biofilm
leukocytes//neurtaphil
inflammatory response
DNA damage in tissue
in perio= increase in neurtrol
neutrophil= 1st defense buddy, higher level of ROS species release causing dmage to PDL, bin
- Discuss how antioxidants may influence periodontal disease onset and progression
protect boy from
halt progression
help wound healing
Vit C
mid 19th century. scurvy.
lack: severe lethargy, spongey gum, die.
study 15 yrs ago? showed alot of uni students had scurvy. keep in mind for pt, they msy not have ac. water solution.
do smokers require smae amount of Vit C?
* List some oral symptoms associated with ascorbic acid deficiency gingivitis
no, higher.
Vitamin D MOA
ab proteins
Vit A/ Bcarotene
A: store in out body, skin remodeling, reduction in A = less good saliva
Vit D
assist Ca and P absorption (maintain bone levels and enamel)
secrete molecule with strong AB except,
- 3 yr study for Vit D and osteolosis, 30% loss in s
too mudh saliva
aids demin
Vit E
protect cell mambrane
good for elderly
Vit B9/Folic accid/Folay
involed in DNA synthesis, high turn over in mouth so need high B9
B12/B complex
risk of periodontal lesion
vegetarian pt. need supp
B12 in animal sources like red meat with best bioavailability.
- flap remove, clean
- some surg recc vit B after, helps with clinical attachment and wound healing
Vitamin B12 helps to form red blood cells, which carry oxygen to the tissues in your mouth. It also helps to break down homocysteine, an amino acid that can damage tooth enamel. A lack of Vitamin B12 can lead to bad breath, mouth ulcers, and the detachment of the connective tissues supporting your teeth.
Calcium
bone, gingival complex, 54% increase risk of Periodisease…
- recc 1000mg per day
study high calc= low PD
Mg
300-400 mg/day
energy transfer reactions
study: lower serum Mg= elevated inflammation markers (= inflammation in body somewhere)
No matter how much calcium we take, without magnesium only soft enamel can be formed. If too soft the enamel will lack sufficient resistance to the acids and bacteria and will be prone to decay. As in the building of teeth, magnesium is required for calcium to be properly incorporated in the structure of the teeth
Macronutrients and PD
Stop oxidative stress
proteins
0.8g/kg= defensive barrers against B when JE growing
- immune response imparied with Protein def
- PD more in undernourished pt
- immune suppression in protein malnutrition
- consider protein (low fat,lean meats) avoid, frying.
Refined carbs
- more inflammation by oxidation ractive species and OMA
fermentable carbs
caries + PD + diabetes risk + cardiac condition = chronic kidney disease
.A ‘fermentable carbohydrate’ is a carbohydrate that can be broken down by the bacteria in your mouth. Any food or drink that contains ‘fermentable carbohydrates’ can be broken down by the bacteria in your mouth to produce acid. This acid can then dissolve away some of the enamel surface of your teeth leading to decay.
good vs bad fats
omega 3 = good and good for heart
Resoleomics theory
importance of Omega 3, important in res of inflamation helpe body remain in homeostatic state
Modern lifestyles have evolved in a way that contributes to chronic inflammation. Resoleomics is the resolution of the inflammation response. Chronic inflammation impedes resoleomics and impedes an effective acute inflammation response.
Changing lifestyle patterns/habits are difficult. There are several elements including sleep, nutrition, exercise, personal hygiene, stress management, and refusing or minimizing bad habits.
increase in kj from refined carbs result in?
blood glucose and lipids increase= upreg Krebs Cycle. Flow on effect= resultant increase in oxidative species.
Probiotics
- looking at AB resistant alt.
- live MO administered enough = give benefit to host,
- adjunctive therapy- i.e. make sure to give em after pt takes AB or savacol.
- reduces halitosis= bad breath
- reduce probin g deaths
polyphenols
antimicrobial, help osteoclastic effect of lowering AB loss. no evidence.
encouraged in each meal. helps periodontitis. pomonegranate, choc, grapes, bloobs, mango
What should we recc?
Aware pt.
educate. by contorlling one we control the other. get them to manage e.g. obesisty.
cause and management of obesity is complex.
What should we recc?
include all major ions. minerals
- lower refined sugars and fats
- consider counselling, dietition for pt.
Is obesity preventable
yes
Macronutrients and PD
No oxidative stress
proteins
0.8g/kg= defensive barrers against B when JE growing
- immune response imparied with Protein def
- PD more in undernourished pt
- immune suppression in protein malnutrition
- consider protein (low fat,lean meats) avoid, frying.
proteins are required in the body to help build and repair damaged or worn out tissues.
But protein (especially animal protein) contains phosphorous, a mineral that is absolutely vital in improving the strength of teeth and the jaw. In fact, when phosphorus is combined with calcium and vitamin D, healthy bones and teeth are the result!
summary
PD is not caused by nutritional def, but it can progress
- bad: high sat fat, refined carbs = increase inflammation
- council meals rich in salads, reduce refined fats
- insufficient
Average BMI in AUS
27.6 (over 25)
27% AUS over 18 are obese.
summary
PD is not caused by nutritional def, but it can progress
- bad: high sat fat, refined carbs = increase inflammation
- council meals rich in salads, reduce refined fats
- insufficient
- chew raw vegetables= less plaque buildup
- vegetarians have gum inflammation
Macronutrients and PD
oxidative stress
Average BMI in AUS
27.6 (over 25)
27% AUS over 18 are obese.
Fat soluble vitamin needed for
epithelial cell differentiation, bone
remodelling, anti-inflammatory
effect
High vitamin __________ levels corresponds to less gingival
inflammation and less BOP
Supplementation has positive effects
on the immune response especially in
the elderly
Deficiency may reduce the ability to act as a
barrier to bacteria.
levels had an increased
risk of developing periodontal lesions
Micronutrient imperative in the calcification
process and are involved in the formation
and maintenance of alveolar bone
Involved in energy transfer reactions –
concentrated in the mitochondria
Many of the pathways to inflammation are related to
Required to provide defensive barriers such as
junctional and crevicular epithelium
Excess consumption can affect immune response
Have been shown to exert anti-microbial
and antibiotic effect.
* Reduced osteoclast and alveolar bone los
