nutrition symposium / orthodontic courses by indian dental academy

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INDIAN DENTAL ACADEMY

Leader in continuing dental education www.indiandentalacademy.com


NUTRITION AND ORAL HEALTH

PresentersDr. Prathima Sreenivasan

Dr. Giridhar Naidu S

Under the able guidance of Prof Dr. Gopakumar R

Dept. Oral Medicine & Maxillofacial RadiologyA.B.Shetty Memorial Institute Of Dental Sciences

Deralakatte, Mangalore


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

CarbohydratesFats

ProteinsWater

Dietary Fibers

Minerals(Micro &Macro)

Vitamins


PROTEINSStructureCatalystsRegulationTransportationClotting of bloodAntibodiesContractile proteinsOsmotic balanceChemical messengers


CARBOHYDRATESEnergy sourceRegulate protein metabolismDerivatives like glucoronic acid

glycerol & glycogenPentose sugars form nucleic acids


LIPIDSEnergy sourceCell membrane constituentBiologic metabolitesGlycolipids and lipoproteinsPrecursors of cholesterol,steroids, hormones, Flavor and satiety


Protein Calorie MalnutritionGrowth phase (Rat experiments)

Shaw & Griffith - smaller molars, delayed eruptionDi Orio – Increased caries susceptibilityMenaker & Navia – Atrophy of salivary glandsNakamoto & Muller – Retarded mandibular development

Post growth phase (Primate experiments)Decreased amylase, sIgAAtrophy of human parotidNecrotizing Ulcerative GingivitisDelayed wound healingCytologic defects www.indiandentalacademy.com

VITAMINS (Vital Amine)

Vitamin A Cellular differentiation, integrity,growth, antikeratinizing, vision

Xerostomia, EnamelHypoplasia, 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


MINERALSCalcium 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 FIBERSThey are complex polysaccharidesComponents cellulose, lignin & non cellulosic polysaccharidesPhysical PropertiesWater bindingBile acid bindingCation bindingSourcesCereals & millets, Gums, fenugreek, pulses, fruits vegetables


Physiologic effectsIncrease fecal bulkDecreases nutrient digestion and absorptionReduce glycemic responseHypocholestrolemic effect


WATER

Constitutes 50-60% of body weightUniversal solvent/ medium for all metabolic reactionTemperature regulationDissociates into H & OH Lubrication between cells


NUTRITIONAL VALUEEnergy 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 activityEnergy 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 hour


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 Cwww.indiandentalacademy.com

Recommended Daily Allowance

Carbohydrate 50-70%

Protein 1gm/kg/day

Fat 20%Vitamin A

Beta carotene 750mcg

3000mcgVitamin D 2.5mcg

5 mcgVitamin E 10mgVitamin K 45mcgVitamin C 40mcgThiamine 0.5mg/1000 Cwww.indiandentalacademy.com

Recommended Daily AllowanceRiboflavin 0.6mg/1000 kcalNaicin 6.6mg/1000 kcalPyridoxine 2mgPantothenic acid 10mgFolate 100mcgCyanacobolamine 1mcgIron 0.9mg

2.8mgIodine 150mcgCalcium 400-500mgFluorine 0.5 – 0.8mg/ltZinc 15mgwww.indiandentalacademy.com

BALANCED DIETA 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 DIETCereals: 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

HistoryAnthropometryClinical examinationBiochemical evaluationAssessment of dietary intakeVital and health statisticsEcological studies


Excess nutrition

Normal nutrition

Primary DEFICIENCY Secondary

Tissue Depletion

Biochemical Lesion

Clinical Signswww.indiandentalacademy.com

HISTORYWeight changeImmunologic disordersTMJ painXerostomiaSteroid therapyHead and neck cancerOsteoporosisHerbal medication – eichinacea, ephedra


ANTHROPOMETRICWeightHeight and lengthSkin fold measurementsOther body measurementsBMI and Dentate statusBody Mass Index : body weight in kg

height in mts< 21 natural teeth - obese< 11 natural teeth – underweight


DIETARY SUPPLEMENTSDietary 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 & FRUITSIndolesCaroteneLycopene


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 peroxidasewww.indiandentalacademy.com

Free radical Chain reaction

PUFA-OO PUFA-OOH

TOCOH TOCOPUFA-H

Vit Cox Vit cred PUFA-OOH GS-SG GSH H2O2 GSH

Superoxide catalase Dismutase

H2O GS-SGSuperoxide PUFA-OHwww.indiandentalacademy.com

DISEASE AND NUTRITIONAnemiaDiabetes MellitusCardiac DiseaseCancer Liver diseaseRenal DiseaseAIDSAcid Peptic Disease


NUTRITION IN ANEMIASupplements

IronVitamin B complexProtein, red meatVitamin C

Avoid:High fat Spicy food


OBESITYOverweight:

10- 20 % above desired weightObese :

Excessive amount of adiposeHypercellularHypertrophied

Risk for Cardiac DiseasesDiabetes Melitus


NUTRITION IN DIABETES MELLITUS

Risk factorsHigh cholesterolSedentary life style

SupplementsRegular meal patternProteinAdequate carbohydrateFibers


NUTRITION IN CARDIAC DISEASERisk factors:

High salt intakeLow potassium, calcium, High cholesterolAlcohol

SupplementOmega 3 FASoybeansFruits and VegetablesDietary fiber


DIETARY MODIFICATIONS

DASH – Dietary Approaches to Stop HypertensionControl diet- reduced fruits and vegetablesFruit and vegetable dietCombination dietBP- 11.4/5.5mm of Hg

Cholesterol loweringHydrogenated oils, sugar- reduceFish, soluble fiber - increase

Sodium Controlled – 2gms/daywww.indiandentalacademy.com

NUTRITION IN CANCERRisk Factors:

AlcoholFatPickled & smoked foodArsenical, lead, cadmiumAdditives like saccharin, flavonoids

SupplementFruits and vegetableDietary FiberWaterVit E and seleniumPhytoestrogen


NUTRITION IN RENAL DISEASERisk factors

High proteinHigh sodiumExcess fluid intakeHigh cholesterol

SupplementsKilocalories – carbohydratesPotassium, calcium, phosphorousVitamins


NUTRITION IN LIVER DISEASERisk factors

High proteinHigh fatAlcohol

SupplementsAdequate proteinReduced fatHigher carbohydrateMicronutrients


NUTRITION IN AIDS

CachexiaHormonal imbalanceImmunologic changes

SupplementsHigh calorie dietFrequent mealsVitamins and minerals


NUTRITION IN ACID PEPTIC DISEASE

Risk factorsHigh food quantityMilkSeasoningsCoffeeCitric acid fruitsAlcohol


Thank you all !www.indiandentalacademy.com

nutrition symposium / orthodontic courses by indian dental academy

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