NUTRITIONAL DISORDERS

Dr.linda Maher

NUTRITION: is the supply of materials - food -

required by organisms and cells to stay alive.

 NUTRITIONAL DISORDER:  is a disease that results from

excessive or inadequate intake of food and nutrients which leads to conditions

 

CAUSES OF NUTRITIONAL DEFICIENCIES (LACK OF NUTRIENTS):

1\inadequate intake 2\malabsorption (defect of

absorption) 3\high secretion rate

Body requirementsTHE BASIC NUTRITONAL

REQUIREMENT OF BODY GROWTH:1\carbohydrates2\ proteins3\fats4\vitamins(A, B complex ,C,D,E and

K)5\ minerals6\water

The integrity of the oral mucous membrane is maintained by a wide-ranging complex of factors, including those dependent on adequate nutrition

The mouth is a uniquely sensitive indicator of nutritional information reflecting past and present nutritional insults to a degree unmatched by almost any other body site

Oral healthDiet and nutrition play a key role in

—Tooth development—Gingival and oral tissue

integrity—Bone strength

__salivary production—Prevention and management

of diseases of the oral cavity

TEETH:Teeth are made from organic protein

matrix that is mineralized with collagen (requiring vitamin C), calcium, and phosphorus (requiring vitamins D and A)

Changes in the structural integrity of the teeth provide a history of exposure to deficiencies of vitamin A, vitamin C, vitamin D and iodine and to an excess of fluorides during the years of tooth formation

ORAL MUCOSAOral mucosa composed of epithelial cell

layer and basal layer that are in continuous turnover and proliferation processes (requiring different vitamins and mineral supplements)

Changes in the structural integrity of the oral mucosa may signal ongoing deficiencies of riboflavin, niacin, folic acid, vitamin B6, vitamin B12, biotin, vitamin C, vitamin K, iron and protein calories

VITAMIN DEFICIENCIESVitamins help to regulate chemical

reactions in the body. There are 13 vitamins, including

vitamins A, B complex, C, D, E, and K.

Because most vitamins cannot be made in the body, we must obtain them through the diet.

Several oral conditions of doubtful causes such as glossitis and periodontal diseases have been ascribed to vitamin deficiencies.

Vitamin deficiencies are not contributory cause of dental caries.

 

1\VITAMIN (A)DEFICIENCY:Vitamin Ait is important for growth and

development, for the maintenance of the immune system and good vision

SYSTEMIC EFFECT of vit A deficiency:

Night blindness , xerophthalmia(dry eye)ORAL EFFECT of vit A deficiency:Unconfirmed contribution to cancer

VITAMIN B B vitamins are a group of water-soluble

vitamins that play important roles in cell metabolism

They are 8 vitamins , B1,B2,B3,B5,B6,B7,B9 and B12

These vitamins are found in whole unprocessed food ,meets and nutritional yeasts

2\RIBOFLAVIN(B2)DEFICIENCYMainly results from malabsorption syndromeSYSTEMIC EFFECT: cause dermatitis(inflammation of the

skin)ORAL EFFECT: 1\angular stomatitis, with painful red fissures

at the angles of the mouth , and shiny redness of the mucous membranes.

2\glossitis: the tongue become magenta in color and granular or pebbly in appearance

*Gingiva is not usually affected

Treatment: Riboflavin 5 mg tds

3\VIT (B12) DEFICIENCYCAUSE:Caused by malabsorption of

B12 vitaminORAL MANIFISTATIONS:1\ Glossitis 2\ Aphthus ulcerTREATMENT: 1\Vit B12 supplements 2\Topical covering agents

for ulcers(orabase)

APHTHUS ULCER:common type of ulcer found in the

mouth, gums, sometimes the upper throat region.

It usually involves the breaking down of mucosal surface, and this exposes the underlying tissue, leading to severe pain especially with

contact or movement.TYPES : 1\major Aphthus ulcer >1 cm 2\minor Aphthus ulcers <1 cm

MORPHOLOGY OF THE LESION: yellow or whitish base where the tissue is

exposed and a fiery red border is found around the ulcer

AETIOLOGY OF APHTHUS ULCER: The true underlying cause  is not fully

established but there are numerous factors which can contribute to development of such ulcers in the mouth

Vit B 12 deficiency ,iron deficiency ,folic acid deficiency ,local trauma , stress ,infections ,hormonal imbalance and food allergy.

Treatment of Aphthus ulcer 1\ Mostly are recurrent self –healing ulcers 2\ blood investigation to find out and treat the

underlying cause if any.(vit b12 deficiency-folate deficiency ….etc)

3\corticosteroid pellets allowed to dissolve in the mouth . Tds (it does not fasten healing of existing ulcer but reduces inflammatory pain)

4\covering agent (e.g. orabase) 5\clorhexidine 0.2% mouth wash tds. (reduces

duration and discomfort of ulcers)

4\VITAMIN(C) DEFICIENCY(SCURVEY)WAS common among crews of sailing

ships and now is exceedingly rare.Vitamin c is important in collagen

synthesis , hence, it’s deficiency will lead to defective production of normal collagen fibers

This will lead to production of fragile blood capillaries causing abnormal bleeding and delayed wound healing

Collagen is an important part of bone, so bone formation is affected

SYSTEMIC MANIFISTATIONS: 1\Purpura ( appearance of red or

purple discolorations on the skin ) 2\Delayed wound healing 3\Bone lesion in childrenORAL MANIFISTATIONS:Gingival swelling and bleedingTREATMENT: 1\ eating food containing vit

C (such as oranges, papaya, strawberries, lemon),

2\ vit c tablets

5\VITAMIN (D)DEFICIENCYDeficiency of vitamin

D during skeletal development causes rickets(disease in which the bone tissue doesn't properly mineralize, leading to soft bones and skeletal deformities)

CAUSES: 1\inadequate intake 2\lack of sunlight(in strong

sunlight vit D can be synthesized in the skin)

ORAL MANIFISTATIONS: Dental defects occur only in

exceptionally sever rickets

5\FOLIC ACID DEFICIENCYCAUSES: 1\inadequate intake

(malnutrition) 2\pregnancy 3\mal absorptionSYSTEMIC

MANIFISTATIONS: Macrocytic anemia(folic acid is

important in DNA synthesis and production of red blood cells)

ORAL MANIFISTATIONS: 1\glossitis 2\Aphthus ulcer

6\IRON DEFICIENCYIron deficiency causes IRON DEFICIENCY

ANAEMIAANAEMIA: low red blood cell or hemoglobin levelCAUSES: Usually results from chronic blood loss

(menstrual blood loss-sever peptic ulcer….etc)CLINICAL FEATURES: 1\Pallor 2\Fatigue 3\Breathlessness 4\Tachycardia and palpitation

ORAL MANIFISTATIONS: 1\Glossitis 2\Aphthuas ulcerTREATMENT: 1\eating more iron-rich foods,

such as beans, lentils or red meat,

2\ taking iron supplements 3\topical covering for ulcers

(orabase)

THANK YOU.