Nutrition and Oral health

Nutrition and Oral health

What is meant by Nutrition?

Nutrition is the raw material obtained from the foods as the result of digestion process, which is later used by our body for living. It includes carbohydrates, proteins, fats, vitamins, minerals.

Balanced Diet

A balanced diet contains a variety of foods with various nutrition in correct proportions which is needed for maintaining good health. It consist of

• Protein 10%- 15%
• Fat 15% - 30% 
• Carbohydrates 60%- 70%

Food guide pyramid

The food guide pyramid helps to choose a variety of food that helps to achieve a balanced diet.

 The WHO recommended daily dietary goal (prudent diet) is, 

• Dietary fat  <15%–30%.
• Saturated fat <10% total energy.
• Salt <5gm/day.
• Protein 10%–15%.
• Excessive consumption of refined carbohydrates should be avoided.
• Reduced consumption of bottles of ketchup, coals, and other food that supply empty calories should be avoided.

NUTRITION AND DENTAL CARIES

Pre-eruptive Effects

Malnutrition can cause irreversible changes that may lead to caries development. Malnutrition is due to inadequate quantities of calcium and phosphorous. The dentine dysplasia associated with malnutrition are, 

1. Odontoclasia in deciduous teeth.

2. ‘Yellow teeth’ seen in permanent teeth.

3. Infantile melanodontia has been seen in deciduous teeth.

4. Lesion caique – linear hypoplasia of deciduous teeth due to lack of vitamin C and A or neonatal infection.

5. L –ascorbic acid deficiency leads to deficiency of dentin formation (Dentinogenesis Imperfecta).

6. Vitamin D deficiency leads to the hypoplastic lesion of the leads to extensive development of dental caries.

Post-eruptive Effects

Children with protein deficiency may lead to high susceptibility to caries. Major cariostatic elements are Fluoride(F), Phosphorous (Ph)

NUTRITION AND MALOCCLUSION

Chronic postnatal malnutrition results in a stunted jaw this may cause Class-I Malocculusion. This may result in poor tooth alignment and crowding may cause caries and periodontal disease. 

NUTRITION AND PERIODONTAL DISEASES

Nutritional deficiency may lead to loss of attachment and epithelial barrier, periodontal gingival connective tissue, and alveolar bone. 

IRON

It is an important factor in collagen metabolism. Iron deficiency may lead to impaired reduced lymphocytes, and antigenic response may lead to severity of infection. Iron deficiency may also cause reduced thickness of the oral reduced size of its progenitor cells, and delayed maturation of the epithelial in the gingiva, it is characterized by pale color. 

PROTEIN

Protein deficiency leads to periodontal infection while supplementation reduces inflammation and tooth mobility. 

VITAMIN C

Vitamin C gives tensile strength that determines the morphology. Deficiency of vitamin C causes scurvy the signs of gingivitis with hemorrhagic, enlarged bluish red gingiva, bleeding of exfoliation of teeth (collagen regeneration with the shedding of teeth and resorption of bone Scurvy may also cause a reduction in salivary flow. 

VITAMIN A

Vitamin A plays a vital role in the synthesis of proteoglycan, fibronectin, and type I procollagen and epithelial tissue differentiation. The deficiency of vitamin A may affect the rapid turnover potential of cells and also reduced salivary flow, hyperkeratosis, and gingival hyperplasia. 

VITAMIN B COMPLEX

The deficiency of vitamin B complex affects the epithelium of the mouth and lips. It also predisposes to Acute Necrotizing Ulcerative Gingivitis (ANUG) or Vincent’s infection.

VITAMIN K

Deficiency causes gingival bleeding and post-extraction hemorrhage.

VITAMIN E

It increases periodontal resistance to inflammatory mediated tissue destruction and improves gingival health. 

CALCIUM AND PHOSPHOROUS

Subjects with low calcium result in severe alveolar bone loss following tooth mobility.  Calcium supplements decrease the gingival calculus and pocket depth occurence.

The benefits of good nutritions are, 

It helps to resist infection. It strengthens and maintains the epithelial barrier. It promotes repair of damaged periodontal tissues. It acclerates the wound healing.

NUTRITION AND ORAL CANCER

Nutrition plays an important role in the etiology of oral and pharyngeal cancer. Malnutrition increases the risk of cancer in the head and neck. Our diet contains both initiators and modifiers for carcinogenesis. A high protein diet consists of a large number of animals and saturated fats and calories are both associated with an increased risk of cancer of mouth and pharynx. Malnutrition or anemia reduces the ability of the immune system to counteract neoplastic cells. Nutritional factors protect against tumors by, 

• Acting as a blocking agent.
• Increases detoxification.
• Altering metabolism of carcinogen through decreased activation.
• Competitive inhibition.
• By scavenging the active molecular species of carcinogen to prevent reaching their target cells.

VITAMIN A & RETINOIDS (DERIVATIVES OF VITAMIN A)

Vitamin A inhibits chemically induced tumors in various tissue. Consumption of vitamin A lowers the risk of many cancer in humans. It affects the tumor latency by retarding the down growth of the tumor. Vitamin A has effects on protein kinase C that influences the epidermal growth factor receptor and DNA synthesis inhibition. Retinoids and analogs used topically and

systematically used as a successful treatment of oral leukoplakia. 

BETA CAROTENE (METABOLIZED TO VITAMIN A)

It is an antioxidant and free radical scavenger, and also has an inverse relationship with oral cancer and dietary availability of beta carotene or retinoids. Patients with oral cancer are treated with all-trans-retinoic acid, 13- cis-retinoic acid, or beta carotene used to reduce the size of the lesion and its effects on leukoplakia. 

VITAMIN C

It is an antioxidant which reduces the risk of oral cancer and also inhibits the carcinogen N –nitroso (nitrosamine) and mutagen (beta propiolactone and methylnitrosoguanidine). It enhances the effect on immune response

VITAMIN E

It is an antioxidant vitamin. It reduces half the risk of developing oral cancer. It is a free radicle scavenger and protects the cell membrane from oxidative damage. Increases humoral and cell-mediated immunity. Increases cell repair capacity. It blocks nitrosamine formation.

VITAMIN B COMPLEX

Patients with cancer or precancerous lesion in the mouth show the signs of vitamin B complex deficiency.

FOODS THAT REDUCE THE RISK OF ORAL CANCER

The risk of cancer is reduced to half for the subjects who consume fruits and vegetables daily especially more carrots, citrus fruits, green buttermilk, milk,  dairy products, oranges, cabbages, and citrus fruits. Frequent consumption of meat, and fish reduces the risk of oral carcinogens in smokers and betelnut chewers. More risk of oral cancer is observed in a patient who consumes excess vegetable oil and animal fat. 

NUTRITION IN ELDERLY PEOPLE

Elderly persons who are not able to chew the food thoroughly because of a lack of good dentition and appetite is reduced. Metabolism is also reduced and all together constitute a lack of nutritional balance. Some of the subjects may have   blood  cardiovascular disease, osteoporosis, and cancer) those who have some medical conditions should have a special diet chart maintained by a team of specialists in dietetics, sociology, and psychology. 

ALVEOLAR OSTEOPOROSIS

Body calcium imbalance may susceptible to osteoporosis. There is an increased risk of bone resorption than deposition. With the loss of the alveolar bone has lost its function to support the tooth and its resorbed. so it is necessary, particularly elder women need supplements of calcium and vitamin D and  B along with their diet with iron and folic acid for adequate maintenance of alveolar bone loss and increases the resistance of bone to mechanical and nutritional biochemical stresses.