Indian Dental Academy Leader in Continuing Dental Education

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

NUTRITION AND ORAL
HEALTH
Presenters
Dr. Prathima Sreenivasan
Dr. Giridhar Naidu S
Under the able guidance of
Prof Dr. Gopakumar R
Dept. Oral Medicine & Maxillofacial Radiology
A.B.Shetty Memorial Institute Of Dental Sciences
Deralakatte, Mangalorewww.indiandentalacademy.com

Om Bramhmarpanam bramha havi
Bramhagna bramhanahutam
Bramhaiva tena gantavyam
Bramha karma samadhinaa

YOU ARE
WHAT YOU
EAT !

Food:
Food is what is taken to supply the necessary
nutritive elements.
Diet:
Diet is a prescribed course of eating and drinking
in which the amount of food as well as the times at
which it has to be taken are regulated by the
physician for therapeutic uses.
Nutrient:
It is a constituent of food or a diet that must be
supplied in suitable amounts.

Nutrition:
It is the science of foods, the nutrients and other
substances therein; their action,interaction and
balance in relationship to health and disease.,the
process by which the organism ingests, digests,
absorbs, transports and utilizes.
Malnutrition:
Impairment of health resulting from a deficiency
excess or imbalance of nutrients.

NUTRIENTS
MACRONUTRIENTS MICRONUTRIENTS
Carbohydrates
Fats
Proteins
Water
Dietary Fibers
Minerals
(Micro &Macro)
Vitamins

PROTEINS
Structure
Catalysts
Regulation
Transportation
Clotting of blood
Antibodies
Contractile proteins
Osmotic balance
Chemical messengers

CARBOHYDRATES
Energy source
Regulate protein metabolism
Derivatives like glucoronic acid
glycerol & glycogen
Pentose sugars form nucleic
acids

LIPIDS
Energy source
Cell membrane constituent
Biologic metabolites
Glycolipids and lipoproteins
Precursors of cholesterol,steroids, hormones,
Flavor and satiety

Protein Calorie Malnutrition
Growth phase (Rat experiments)
Shaw & Griffith - smaller molars, delayed eruption
Di Orio – Increased caries susceptibility
Menaker & Navia – Atrophy of salivary glands
Nakamoto & Muller – Retarded mandibular development
Post growth phase (Primate experiments)
Decreased amylase, sIgA
Atrophy of human parotid
Necrotizing Ulcerative Gingivitis
Delayed wound healing
Cytologic defects www.indiandentalacademy.com

VITAMINS (Vital Amine)
Vitamin A Cellular differentiation,
integrity,growth,
antikeratinizing, vision
Xerostomia, Enamel
Hypoplasia, Tooth
eruption,cancer
Vitamin D Calcium & Phosphorous
metabolism
Cementum & dentin
Vitamin E Antioxidant
Vitamin K Clotting factors Bleeding in surgery

VITAMINS
Vitamin C Collagen synthesis,
adrenal cortical hormones
Scurvy,
Enamel & dentin
defects
Vitamin B
complex
Coenzyme in many
biological reactions,
DNA synthesis
Glossitis, angular
cheilitis, RAS,
Ulceration, Infection,
keratinocyte
maturation

MINERALS
Calcium Bone, tooth formation
, blood clotting,
muscle, nerve.
Bone density,
hypoplasia
Phosphorous Bone tooth formation rare
Iron Hemoglobin Anemia glossitis,
chelitis
Zinc Wound healing, Taste, smell,wound
healing,
Fluorine Bone, tooth formation Susceptibility to
dental caries

MINERALS
Copper Antioxidant, iron
absorption
anemia
Selenium antioxidant Predisposition Cardiac
disease

DIETARY FIBERS
They are complex polysaccharides
Components cellulose, lignin & non cellulosic
polysaccharides
Physical Properties
Water binding
Bile acid binding
Cation binding
Sources
Cereals & millets, Gums, fenugreek, pulses, fruits
vegetables

Physiologic effects
Increase fecal bulk
Decreases nutrient digestion and absorption
Reduce glycemic response
Hypocholestrolemic effect

WATER
Constitutes 50-60% of body weight
Universal solvent/ medium for all metabolic reaction
Temperature regulation
Dissociates into H & OH
Lubrication between cells

NUTRITIONAL VALUE
Energy requirement:
The level of energy intake in relation to expenditure
which is most likely to prolong active life.
Energy for basal metabolism
Energy for physical activity
Energy expended during digestion and absorption of
nutrients
Basal Metabolism:
Minimum amount of energy needed to regulate and
maintain the involuntary essential processes.
BMR:
Number of kilocalories expended by the organism per hourwww.indiandentalacademy.com

SDA:
Specific dynamic action is the expenditure
of calories during the digestion and absorption
of food.
Calories:
Quantity of energy required to raise the
temperature of 1kg of water by 1 C

Recommended Daily Allowance
Carbohydrate 50-70%
Protein 1gm/kg/day
Fat 20%
Vitamin A
Beta carotene
750mcg
3000mcg
Vitamin D 2.5mcg
5 mcg
Vitamin E 10mg
Vitamin K 45mcg
Vitamin C 40mcg
Thiamine 0.5mg/1000 Cwww.indiandentalacademy.com

Recommended Daily Allowance
Riboflavin 0.6mg/1000 kcal
Naicin 6.6mg/1000 kcal
Pyridoxine 2mg
Pantothenic acid 10mg
Folate 100mcg
Cyanacobolamine 1mcg
Iron 0.9mg
2.8mg
Iodine 150mcg
Calcium 400-500mg
Fluorine 0.5 – 0.8mg/lt
Zinc 15mgwww.indiandentalacademy.com

BALANCED DIET
A balanced diet is one which includes all the
essential food groups and allows the body to
function at an optimal level free from disease and
malaise.

A balanced diet constitutes the following
-
Protein 15 %
Carbohydrates 60%
Fats 25-30%
Dietary Fiber

FOOD PYRAMID

NORMAL INDIAN DIET
Cereals: Rice, wheat
Millets Jowar, bajra, ragi
Animal Foods Eggs, milk , fish , meat
Vegetables and
pulses
Roots and tubers, green leaves
Fruits Banana, mango, musambi, grapes, apples,
oranges, dates
Beverages Coffee,tea,cocoa,alcohol
Fats and oils Butter, ghee, dalda
Condiments Cardamom, garlic, chilies, turmeric pepperwww.indiandentalacademy.com

ASSESSMENT OF NUTRITIONAL STATUS
History
Anthropometry
Clinical examination
Biochemical evaluation
Assessment of dietary intake
Vital and health statistics
Ecological studies

Excess nutrition
Normal nutrition
Primary DEFICIENCY Secondary
Tissue Depletion
Biochemical Lesion
Clinical Signs

HISTORY
Weight change
Immunologic disorders
TMJ pain
Xerostomia
Steroid therapy
Head and neck cancer
Osteoporosis
Herbal medication – eichinacea, ephedra

ANTHROPOMETRIC
Weight
Height and length
Skin fold measurements
Other body measurements
BMI and Dentate status
Body Mass Index : body weight in kg
height in mts
< 21 natural teeth - obese
< 11 natural teeth – underweight

DIETARY SUPPLEMENTS
Dietary supplement Act,1994
• Products intended to supplement the diet
• contains a vitamin,mineral,amino acid or other
botanicals.
• Does not represent conventional food.
• Ingested in the form of capsule,
powder,softgel etc

FOOD FORTIFICATION
Fortification is a public health measure aimed at
reinforcing dietary intake of nutrients with additional
supplies to prevent or control nutritional disorders in a
given area.
Example
• fortification of salt with iodine.
• fortification of wheat with vitamins.

Supplement Oral use Forms
Caffeine Ergogenic aid Beverage
Capsaicin Pain relief for
tooth ache and
trigeminal
neuralgia
Chillies, topical
ointments
Garlic Treatment and
prevention of
oral candidiasis

Supplement Oral use Forms
Green tea Decreases risk
of dental caries,
cancer
prevention
Beverage
Lysine Prevents
recurrence of
aphthous ulcers,
herpes labialis
Tablets, Topical
applications
Vitamin C Integrity of
gingiva,
improved
healing
Citrus fruits,
tablets

ANTOXIDANTS IN VEGETABLES & FRUITS
Indoles
Carotene
Lycopene

Reactive species Antioxidant
Singlet oxygen Vit A, E , beta carotene
Superoxide free radical Vit E, Beta carotene
Peroxyl free radical Vit E, C.
Hydrogen peroxide Catalase, Glutathione
peroxidase
Lipid peroxides Glutathione peroxidase

Free radical Chain reaction
PUFA-OO PUFA-OOH
TOCOH TOCO
PUFA-H
Vit Cox Vit cred PUFA-OOH
GS-SG GSH H2O2 GSH
Superoxide catalase
Dismutase
H2O GS-SG
Superoxide PUFA-OHwww.indiandentalacademy.com

DISEASE AND NUTRITION
Anemia
Diabetes Mellitus
Cardiac Disease
Cancer
Liver disease
Renal Disease
AIDS
Acid Peptic Disease

NUTRITION IN ANEMIA
Supplements
Iron
Vitamin B complex
Protein, red meat
Vitamin C
Avoid:
High fat
Spicy food

OBESITY
Overweight:
10- 20 % above desired weight
Obese :
Excessive amount of adipose
Hypercellular
Hypertrophied
Risk for
Cardiac Diseases
Diabetes Melitus

NUTRITION IN DIABETES MELLITUS
Risk factors
High cholesterol
Sedentary life style
Supplements
Regular meal pattern
Protein
Adequate carbohydrate
Fibers

NUTRITION IN CARDIAC DISEASE
Risk factors:
High salt intake
Low potassium, calcium,
High cholesterol
Alcohol
Supplement
Omega 3 FA
Soybeans
Fruits and Vegetables
Dietary fiber

DIETARY MODIFICATIONS
DASH – Dietary Approaches to Stop Hypertension
Control diet- reduced fruits and vegetables
Fruit and vegetable diet
Combination diet
BP- 11.4/5.5mm of Hg
Cholesterol lowering
Hydrogenated oils, sugar- reduce
Fish, soluble fiber - increase
Sodium Controlled – 2gms/day

NUTRITION IN CANCER
Risk Factors:
Alcohol
Fat
Pickled & smoked food
Arsenical, lead, cadmium
Additives like saccharin, flavonoids
Supplement
Fruits and vegetable
Dietary Fiber
Water
Vit E and selenium
Phytoestrogen www.indiandentalacademy.com

NUTRITION IN RENAL DISEASE
Risk factors
High protein
High sodium
Excess fluid intake
High cholesterol
Supplements
Kilocalories – carbohydrates
Potassium, calcium, phosphorous
Vitamins

NUTRITION IN LIVER DISEASE
Risk factors
High protein
High fat
Alcohol
Supplements
Adequate protein
Reduced fat
Higher carbohydrate
Micronutrients

NUTRITION IN AIDS
Cachexia
Hormonal imbalance
Immunologic changes
Supplements
High calorie diet
Frequent meals
Vitamins and minerals

NUTRITION IN ACID PEPTIC DISEASE
Risk factors
High food quantity
Milk
Seasonings
Coffee
Citric acid fruits
Alcohol

Thank you all !
For more details please visit

Indian Dental Academy Leader in Continuing Dental Education

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