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Dr. Abdelmonem Altarhony Foods habits and implication in oral health (Oral health education and Health promotion) Objective Students should be able to explain and discuss: • Diet assessment and counseling in dental care • The role of dental provider in diet counseling- primary, secondary and tertiary prevention • Dietary guidelines • Recommendations for specific population groups • Nutritional factors affecting the oral cavity • Diet and enamel demineralization • Effects of eating Patterns and physical form of foods • Diet suggestion for patients with special conditions The role of dental provider in diet counseling primary, secondary and tertiary prevention Primary prevention : 1. Preventing oral diseases before they occur. 2. Guidelines for a healthy diet and information on dietary implications in dental caries and periodontal disease. 3. Targets: patients and groups at increased risk for developing oral problems. Type of patients who might be at increase risk of oral diseases related to their diet and nutrition status. 1. Patients with cariogenic diet pattern, 2. Patients with xerostomia, 3. Adolescents with high intake of soft drinks, sports drinks, and snack foods 4. New denture wearers or those having jaw fixation, 5. Patients under radiation or chemotherapy Secondary prevention It is intervention to arrest a disease condition that has already occurred and prevent further disease and occurrence. Tertiary prevention • Supportive and rehabilitative services to maximize the quality of life • Discuss methods of preparing foods to facilitate consumption of a healthy diet when chewing can be compromised by tooth loss or dentures. Dietary guidelines Are designed to recommend a pattern of eating to promote health and prevent chronic disease. Nutritional factors affecting the oral cavity 1.Tetracycline staining of teeth 2.Dental fluorosis 3.Enamel defects in children born prematurely 4.Fever induced hypoplasia seen in primary teeth 5.Protein energy malnutrition in early childhood can result in an increased caries risk. Protein deficiency may leads to: 1. 2. 3. 4. 5. Decrease in the ratio of gingival healing. Delays in tooth eruption, Enamel structural deficiencies, Decreased salivary flow and buffering capacity, Impaired salivary antimicrobial effect ( higher caries susceptibility) 6. Impact immune response tissue regeneration and response to insult and infection. Minerals deficiency Calcium, vitamin D, and phosphorus are essential for proper development and maintenance of mineralized tissues, especially teeth alveolar bone. Deficiency can results in: • Hypomineralization of developing teeth and possible delayed eruption. Why premature children are more predisposed to those conditions? What is the most common nutrient deficient in almost all world countries? Iron Vegas diet should be complemented with Vitamin C for enhancement of Iron absorption from vegetables. Zinc deficiency 1. Inhibit collagen formation, 2. Retard osteogenesis and bone matrix mineralization, 3. Delayed wound healing, 4. Defective keratinization of epithelial cells, 5. Atrophic oral mucosa, and xerostomia, 6. Declines in taste experience Food rich in Zn Vitamin A • Essential for the development and continued integrity of all body organs and tissues, including the epithelial mucosa of the oral cavity. • *Vitamin A deficiency impairs cells differentiation. • Vitamin A toxicity can show similar effects with impaired healing response being the most direct affect in the oral cavity. Vitamin C • Synthesis of hydroxyproline, an essential component of collagen, requires ascorbic acid. • Defects in collagen synthesis are responsible for the many manifestations of vitamin C deficiency called SCURVY. Scurvy – signals in the oral cavity: • Scurvy Detachment of oral epithelial tissue. • Impaired wound healing. • The odds of having periodontal disease are higher in those with low dietary vitamin C and smokers with low Vit. C intake are at 1.6 times higher risk of having periodontal disease. • Ascorbic acid is essential to resistance to oral infection. Complex B vitamins Oral signs and symptoms of vitamin B complex deficiency: 1. Cracks in the corner of the mouth – cheilosis and inflammation, 2. Burning sensation, 3. Redness, 4. Pain, 5. Swelling of the tongue. Sources of vitamin B complex Effects of eating Patterns and physical form of foods Dietary factors that affect risk of caries development: 1. Frequency of eating ( Vipeholm study) sugar between meals intake lead to increase of dental caries 2. Physical form of the carbohydrate (liquid X solid, hard, sticky) • Starchy foods as soft bread and potato chips are retained on tooth surface for longer time results in lower pH for longer time. 3. Sequence in which food are consumed • Sugared coffee in the end of a meal will cause the plaque pH to remain low longer than when an unsweetened food is eaten following sugared coffee. • If peanuts are eaten before or after sugarcontaining foods, • the plaque pH is less depressed. 4. Presence of minerals in a food Caries-protective food: • Protein, fat, phosphorus, and calcium. • Fluoride • Aged natural cheeses have been shown to be cariostatic. • Lipids accelerate oral clearance of food particles Thank you