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CHAPTER 34 Diet and Dietary Analysis KNOWLEDGE EXERCISES 1. ■ Fruits ■ Grains ■ Vegetables ■ Protein ■ dairy 2. ■ Oils ■ Discretionary calorie allowances 3. calorie 4. ■ Age level ■ Activity level ■ Gender 5. Answer is individualized for each student. Example: For a 21-year-old female with a moderately active lifestyle, a 2,200-calorie intake per day is recommended. 6. Answer is individualized for each student. Example: For a 2,200-calorie diet, 3 cups per week of dark green vegetables are recommended. 7. INFOMAP 34-1 Answer Key ORAL MANIFESTATIONS OF NUTRIENT DEFICIENCY FOOD SOURCES Vitamin A Intraoral lesions and delayed wound healing, incomplete mineralization of teeth, xerostomia, altered taste, increased risk for candidiasis Intraoral lesions and delayed wound healing, modified gingival tissue permeability, susceptibility to dental biofilm, glossitis, glossodynia, angular cheilosis, inflamed bleeding gingiva, stomatitis, mucositis, xerostomia, sore or burning tongue, altered taste Table 32-1 in the textbook identifies Thiamin (Vitamin B1) food sources for each of the nutrients listed in the infomap. Intraoral lesions and delayed wound healing, modified gingival tissue permeability, susceptibility to dental biofilm, red inflamed friable bleeding gingival tissue, diffuse petechiae, and overall sore mouth Incomplete calcification of Riboflavin (Vitamin B2) alveolar bone, osteoporosis, osteomalacia, postmenopausal bone alterations, decreased mineralization Pyridoxine (Vitamin B6) Incomplete calcification of alveolar bone, osteoporosis, osteomalacia, postmenopausal bone alterations, incomplete mineralization of teeth Cobalamin (Vitamin B12) Incomplete mineralization of teeth, prevention of dental caries Intraoral lesions and Ascorbic Acid (Vitamin delayed wound healing, angular cheilosis, sore or C) burning tongue, increased risk for candidiasis Incomplete calcification of Vitamin D alveolar bone, osteoporosis, osteomalacia, postmenopausal bone alterations, incomplete mineralization of teeth Incomplete calcification of Calcium alveolar bone, osteoporosis, osteomalacia, postmenopausal bone alterations, incomplete mineralization of teeth Niacin (Vitamin B3) Fluoride Folate Iron Magnesium Phosphorus Zinc Intraoral lesions and delayed wound healing, modified gingival tissue permeability, susceptibility to dental biofilm, altered taste, increased risk for candidiasis Modified gingival tissue permeability, susceptibility to dental biofilm Intraoral lesions and delayed wound healing, incomplete mineralization of teeth, xerostomia, altered taste, increased risk for candidiasis Intraoral lesions and delayed wound healing, modified gingival tissue permeability, susceptibility to dental biofilm, glossitis, glossodynia, angular cheilosis, inflamed bleeding gingiva, stomatitis, mucositis, xerostomia, sore or burning tongue, altered taste Intraoral lesions and delayed wound healing, modified gingival tissue permeability, susceptibility to dental biofilm, red inflamed friable bleeding gingival tissue, diffuse petechiae, and overall sore mouth Incomplete calcification of alveolar bone, osteoporosis, osteomalacia, postmenopausal bone alterations, decreased mineralization Protein Incomplete calcification of alveolar bone, osteoporosis, osteomalacia, postmenopausal bone alterations, incomplete mineralization of teeth 8. ■ Vitamin A, B complex vitamins ■ Ascorbic acid (vitamin C) ■ Zinc ■ Iron 9. ■ B complex vitamins ■ Vitamin C ■ Calcium 10. ■ Vitamin A ■ Calcium ■ Phosphorus ■ Magnesium ■ Fluoride 11. cariogenic (or high sucrose) 12. ■ Microorganisms ■ Cariogenic diet ■ Salivary factors ■ Tooth resistance 13. ■ Consistency (stickiness) of the cariogenic food ■ Frequency of intake 14. The purposes include identifying patients at risk and determining dietary factors associated with increased risk for compromised oral health. It is important to refer the patient to a registered dietitian if intervention beyond scope of dental hygiene practice is necessary. 15. Explain the purpose and the form used (and illustrate it with current day’s intake) and provide general directions—complete soon after eating, use of typical day, details of recording combination dishes, record all types of intake, designating where meal is consumed, and using consecutive days + one weekend. 16. Garnishes, beverages, snacks, gum, syrup from canned fruit, seasonings, cereal, and type of potato Using the information from a patient’s 24-hour diet recall, total up the frequency of 17. exposure to each of the types of reference foods listed in the Sweet Score form. Calculate the total points in each category by multiplying the number of exposures by the weighted score that is listed for each category. Add the total points and compare to the risk for dental caries score to determine the level of risk. 18. Listed in Figure 34-6: ■ Cut down on frequency of sweets and sweet beverages. ■ Avoid slowly dissolving sweets such as hard candies. ■ Suggest including more non–decay-promoting foods in diet. ■ Patient willingness and ability to cooperate ■ Resistance to change of habits and loss of favorite foods ■ Limited knowledge and misconceptions ■ Cultural patterns of eating ■ Attitude toward sugar 19. 20. ■ Providing too much information (overwhelming) ■ Not providing appropriate information to increase the patient’s knowledge of how diet affects oral health ■ Not considering cultural, lifestyle, financial, and emotional issues ■ Not using many of the pointers included in the Pointers for Success of a Conference that are listed in the text 21. Xylitol COMPETENCY EXERCISES Click here to access the Evaluation Rubric for Competency Exercises template, which can be used to grade all competency exercises including Everyday Ethics and Factors To Teach The Patient. 1. 2. Key Considerations: ■ Analysis of factors in patient case ■ Application of nutritional assessment techniques Key Considerations: ■ Application of nutritional assessment techniques ■ Analysis of factors in patient case for clinical decision making ■ Application of patient-appropriate language and patient-centered approach 3. 4. 5. 6. Key Considerations: ■ Application of nutritional assessment techniques ■ Application of use of technology in patient assessment and clinical decision making ■ Application of patient-appropriate language and patient-centered approach Key Considerations: ■ Application of nutritional assessment techniques ■ Application of use of technology in patient assessment and clinical decision making ■ Application of patient-appropriate language and patient-centered approach Key Considerations: ■ Application of nutritional assessment techniques ■ Application of use of technology in patient assessment and clinical decision making ■ Application of patient-appropriate language and patient-centered approach ■ Respect/cultural competence Key Considerations: ■ Analysis of patient factors for clinical decision making ■ Application of care-planning process CROSSWORD PUZZLE A PRIMER AND TEMPLATE FOR THE USE OF EVALUATION RUBRICS Competence is the ability to apply knowledge and skills in a relevant way to solve problems, answer questions, or make decisions. Objectively evaluating a learner’s ability to recall factual information is relatively easy. Evaluation of student responses to exercises/learning activities that are intended to assess competence is often significantly more difficult. Competence is a complex interaction of skills that begins with an understanding of basic facts (KNOWLEDGE) and incorporates the ANALYSIS of all relevant factors in a specific situation, and SYNTHESIS of information in order to answer questions or solve problems. Competence also includes being able to SUPPORT or clearly explain the rationale for decisions and as well as effectively COMMUNICATE the plan for action. An academic grading rubric provides objective criteria useful for evaluating student work that has been submitted to demonstrate competence. The assignment of points for each of the criteria stated in the rubric will aid the faculty member in providing an objective grade or score. When the evaluation rubric is provided along with instructions for the assignment, students receive a guide to faculty expectations. When the finished assignment is graded, focused feedback will help the student understand errors or omissions that result in a lower score or grade for the assignment. The example evaluation rubric below, which is also included as Appendix E in the workbook, can be used as a template for grading all of the competency exercises, including those related to Factors To Teach The Patient and Everyday Ethics, in each chapter of the Student Workbook. The point range as well as the list of criteria in this sample rubric can be revised as needed by the evaluator. The revised rubric can then be downloaded or printed to provide a guide for evaluation of student work. EVALUATION RUBRIC FOR COMPETENCY EXERCISES CATEGORIES KNOWLEDGE Familiarity with and understanding of concepts and information. Points _________ ANALYSIS Breaking down a complex topic into its component parts. EXCELLENT 3 points Student includes relevant and accurate information from the main chapter. AND Student includes relevant information from related chapters in the textbook (based on what is reasonable to expect at the student’s current level in the dental hygiene curriculum). All components of the question, case scenario, or patient assessment data are considered in the student’s answer. ACCEPTABLE 2 points Student includes relevant and accurate information from the main chapter. UNSATISFACTORY 0–1 points Significant relevant information from the main chapter is missing OR Misunderstanding of one or more basic concepts is evident. Only minor details or components of the question, case scenario, or patient assessment data have not been addressed in the student’s answer. At least one major component has not been addressed. Connection or comparisons made between factors, concepts Connection or comparisons between factors, concepts, and Important or obvious connections are missing from the students answer. Points _________ SYNTHESIS Combining ideas to form a complex, cohesive whole using logical reasoning and deduction. and facts/knowledge from the textbook chapter is very clear. facts/knowledge from the chapter textbook is apparent, but not completely explained. Student provides clear explanations that support conclusions, statements, or connections made. Examples: Linking basic information and intended actions or conclusions drawn Explaining personal perspective Defining controversy that requires further investigation Meets professional writing standards for: Grammar Spelling Appropriate use of either a formal or “patient-friendly” writing style (based on the focus of the exercise). Explanations are provided that support conclusions, statements, or connections, but could be more completely or clearly explained. Little evidence is provided to support conclusions, statements or connections Meets professional writing standards for: Grammar Spelling Appropriate use of either a formal or “patient-friendly” writing style (based on the focus of the exercise). Errors in spelling or grammar. OR Writing style is too casual/conversational for professional writing. OR Inappropriate professional jargon is used for a patient discussion. . Points _________ SUPPORT Providing rationale for statements Points _________ COMMUNICATION Conveying information Points _________ Total points ______________ / 15 possible points FACULTY FEEDBACK: