List 5 purposes of government standards of nutrition.
facilitate education for individuals about dietary needs and goals: for health promotion
healp achieve diet adequacy for the public
make recommendations relative to poor food habits: missed meals, omission of essential foods and nutrients, and illogical dieting
make specific recommendations for oral health
motivate for behavioral modification
What are 2 guidelines for government standards of nutrition?
provide guidelines through printed and web-based educational materials
guidelines reflect health concerns of the general public
List 5 different specific dietary standards.
Dietary reference intakes: DRIs
estimated average requirements: EARs
recommended dietary allowances: RDAs
adequate intakes: AIs
tolerable upper intake levels, or upper levels: ULs
Which dietary standard is established for vitamins and minerals, and is established by the institute of medicine for the healthy general population to avoid overeating and to prevent chronic disease?
dietary reference intakes (DRIs)
Which dietary standard relfects adequate nutrient intake of essential nutrients for healthy individuals to prevent deficiency; and is based on gender and age but does no include special needs such as an illness.
recommended dietary allowances (RDAs)
What was developed by the united states department of agriculture in 1991 and the newest version established in 2005? It was designed as an educational tool for the general public and as educational framework of variety, proportionality, moderation, and activity?
food pyramid
How many colored bands are included on the food pyramid, and what do they illustrate?
six color bands
represent: 5 food groups and oils
the caloric recommendations of the food pyramid are based on what?
gender
age
activity level from age 2-76 years
What was coordinated wiht mypyramid food guidance system established by USDA and USDHHS as a basis for a federal nutritional policy that consists of nine major categories since 2005?
dietary guidelines for Americans, 2005
in regards to the dietary guidelines for americans, 2005; application of standards state that food intake varies with what 3 things in promoting healthy weight and lifestyle?
age
gender
activity level
Nutritional needs _________ with activity and ___________ with increasing age and sedentary lifestyle
increase
decrease
The dietary guidelines:
emphasize______________
promote______________-
reduce ___________________
emphasize: physical activity and caloric control
promote: a healthier lifestyle
reduce: the risk of chronic disease more than any previous version
name the 5 different food groups in the food pyramid.
grains
vegetables
fruits
mild
meat and beans
for a 2,000 calorie diet, what amount of each section of the food pyramid do you need every day?
grains: 6 oz
vegetables: 2 1/2 cups
fruits: 2 cups
milk: 3 cups
meat and beans: 5 1/2 oz
true or false. Nutrition, diet, and oral health are closely related.
true
What is the gateway to the health of the entire body?
the oral cavity
vitamin A, B complex and ascorbic acid are relevant vitamins and zinc and iron are relvant minerals to what part of the oral cavity?
skin and mucous membrane
true or false. Periodontal diseases are not caused by nutritional deficiencies, but malnutrition may contribute to the progression of periodontal disease symptoms and influence how tx can succeed in bringing the tissues back to health
both are true
do nutritional deficiencies cause periodontal disease? What does?
NO
bacteria
without local factors including what 3 things; periodontal infections cannot occur.
true or false. Severe nutritional deficiencies are rare in developed contries.
true
symptoms of deficiencies may be seen in cases of what 3 things?
severe deprivation
starvation
long-term pts with alcoholism or other drug addictions
true or false. As a part of total body health, the daily diet nourishes the oral tissue. recommended dietary allowances are essetial to the health of the periodontal tissue
both are true
What type of diet encourages biofilm buildup and proliferation of bacteria, including the periodontal pathogens? (physical character of the diet contributes to it)
a soft sticky diet that stays on the tooth surfaces, especially cervical third and proximal areas
Malnutrition suppresses the ______________ and so impairs the host's reaction to _______________-
immune system
infections
increased activity of pathogenic microorganisms may resutl in ____________ periodontal disease
increased
The elements vitamin B complex, vitamin C, and dietary calcium are all strongly associated with what?
wound helaing and tissue repair
What nutritional element refers to all the water-soluble vitamins except vitamin C. They are thiamin, riboflavin, niacin, pyridoxine, cobalamin, biotin, folic acid, and pahtothenic acid? Each different member has different functions.
B complex
What nutritional element is needed for collagen formation and intercellular material, and healing tissues after procedures including scaling and root planing?
vitamin C
What nutritional element is essential for cell metabolism, muscle contraction, and nerve impulse transmission?
dietary calcium
What percent of dietary calcium in the body is in the bones and teeth? What percent is in the body tissues and fluids?
bones and teeth: 99%
body tissues and fluid: 1%
What nutritional element is necessary for the continuous exchange of calcium between the blood, skeletal bones, and other cells?
Vitamin D
Low dietary intake of calcium can be a risk factor for what disease?
periodontal disease
What are 2 typical periodontal disease symptoms?
loss of alveolar bone
loss of soft tissue attachment
current and former smokers show increased severity of periodontal disease, when smokers have low dietary vitamin ____ intake, their periodontal disease is more sever.
vitamin C
Is there any research to show that the intake of vitamin C can improve periodontal health?
no
true or false. obesity is a significant predictor of periodontal disease.
true
a younger population with overall and abdominal obesity shows __________ periodontal disease. underweight individuals have __________ periodontal disease
increase
decrease
recommendations of firm fibrous foods such as what 2 types may stimulate the oral tissue and improve circulation?
raw carrots
apples
chewing firm foods increases what? Which acts as a buffer and aids in oral clearance
salivary flow
a soft diet of high quality protein is indicated for adequate wound healing. What are 5 examples of soft food that have a high quality of protein to promote healing?
puddings
scrambled eggs
milkshakes
yogurt
cottage cheese
What nutrient functions as: fat soluble, antioxidant, bone and tooth development, skin and mucous membrane integrity, cell differentiation; essential for reproduction, vision in dim light, immune system integrity?
Vitamin A
What vitamin is defficient with the following:
night blindness, xerophthalmia, poor growth, keratinizatino of epithelium, dry, scaly skin, toxic in large doses (double vision, hair loss, dry mucous membrane, joint pain, liver damage)
vitamin A
What vitamin is in egg yolk, liver, fish liver oils, fortified milk, cream cheeses; green leafy vegetables, orange, red, yellow pigmented fruits and vegetables
Vitamin A
What vitamin functions as: fat soluble, aids in the absorption of calcium and phosphorous, and mineralization of bone?
Vitamin D
What vitamin is defficient in the following:
rickets in kids, osteomalacia in adults, osteoporosis, toxic in large doses (calcification of soft tissues, growth retardation)
Vitamin D
Which vitamin can be attained by exposure to UV sunlight, fortified milk, and fish oils?
Vitamin D
Which vitamin functions as fat soluble and antioxidant?
Vitamin E
What vitamin is defficient in the following: low incidenc of deficiency and has low toxicity in high amounts
Vitamin E
What vitamin can be attained in whole grains, wheat germ, plant oils, margarines, legumes, seeds, nuts, greens?
Vitamin E
Which vitamin functions as fat soluble, and synthesis of prothrombin in blood clotting and bone protein?
Vitamin K
What vitamin is defficient with the following:
prolonged clotting time, hemorrhage, toxic in large doses (pts on blood thinners need to limit the use in their diet)
Vitamin K
What vitamin is synthesized by intestinal bacterial flora and can be found in dark leafy green vegetables and in the liver?
Vitamin K
What nutrient functions and acts as a coenzyme in carbohydrate and amino acid metabolism?
Thiamin (B1)
Which vitamin deficiency would result in: essential for synthesis of acetylcholine for healthy nerves, beriberi: weight loss, fatigue, edema, depression, toxicity: is not seen with this vitamin?
thiamin (B1)
What nutrient can be found in enriched whole grains and cereals, pork, meats, poultry, nuts, seeds, legumes?
Thiamin (B1)
Which 2 vitamins are coenzymes in energy metabolism of fat, carbohydrate, and protein?
Riboflaven (B2)
Niacin (B3)
A deficiency in which vitamin would result in:
ariboflavinosis, angular cheilosis, growth failure, eye disorders, and toxicity is not seen with this vitamin?
Riboflavin (B2)
Which vitamin can be found in milk, cheese, enriched and whole grains and cereals, rice, mushrooms, and liver?
riboflavin (B2)
Which vitamin deficiency would cause the following:
pellagra: diarrhea, dermatitis, dementia, and death; toxicity is not seen in food sources, but toxicity is seen with large doses of supplements for treatment of hypercholesterolemia (skin redness and flushing, gastric ulcers)?
niacin (B3)
Which vitamin can be found in enriched whole grains and cereals, rice, meat, poultry, fish, and green leafy vegetables?
niacin (B3)
Which vitamin is a coenzyme in amino acid and lipid metabolsim; aids in hemoblobin synthesis and homocysteine metabolism?
Pyridoxine (B6)
Which vitamin deficiency can cause dermatitis, depression, convulsions, peripheral neuritis, toxicity is not seen in food, but toxicity from supplements can result in neuropathy or irreversible nerve damage?
pyridoxine (B6)
Which vitamin is found in a widespread of food sources with the exception of fat and sugar?
pyridoxine (B6)
Which vitamin functions in the maturation of RBCs, requires intrinsic factors from parietal cells for absorption, and is a cofactor in folate and homocysteine metabolism?
Cobalamin (B12)
Which vitamin is deficient in the following:
pernicious enemia, secondary to lack of intrinsic factor and total vegan diet, and toxicity is not seen with this vitamin?
cobalamin (B12)
Which vitamin can be found in all animal foods, and fortified cereals?
cobalamin (B12)
Which nutrient functions in the maturation fo RBCs, DNA synthesis, and nomocysteine metabolism?
folate (folic acid)
Which vitamin deficiency results in the following:
megaloblastic anemia, neural tube defects (spina bifida), masks B12 deficiency and toxicity is not seen?
folate (folic acid)
What nutrient can be found in green leafy vegetables, fruits, legumes, and fortified grains?
folate (folic acid)
What nutrient functions as an antioxidant, in collagen synthesis, wound healing, and aids in absorption of iron?
ascorbic acid (Vitamin C)
What nutrient deficiency will result in the following:
scurvy, poor wound healing, petechial hemorrhages, increased periodontal symptoms, toxicity may result in rebound scurvy
Ascorbic acid (Vitamin C)
Which nutrient can be found in citrus fruits, broccoli, strawberries, peppers, tomatoes, and canteloupe?
ascorbic acid (Vitamin C)
Which nutrient functions in muscle contraction, blood clotting, nerve impulse transmission, calcification of bone and tooth structure?
calcium
What nutrient deficiency may result in the following:
osteoporosis, incomplete clacification of teeth, compromised alveolar integrity, and toxicity is not seen?
calcium
Which nutrient is found in dairy products, tofu, fortified organge juice and soy milk, green leafy vegetables, canned salmon and sardine bones?
calcium
Which nutrient functions and is required for bone and teeth strength, acid-base balance, and muscle contraction?
phosphorus
a deficiency of what nutrient may result in:
poor bone maintenance, incomplete calcification of teeth, compromised alveolar integrity; and toxicity may cause skeletal porosity?
phosphorus
What nutrient can be found in dairy products, meat, poultry, processed foods, soft drinks, nuts, legumes, and whole grain cereals?
phosphorus
What nutrient functions in bone strength an rigidity, hydroxyapatite crystal formation, nerve impulse, and muscle contraction?
magnesium
Which nutrient deficiency may result in:
muscle weakness, alveolar bone fragility, toxicity is seen in medications containing this?
magnesium
What nutrient can be found in wheat bran, whole grains, green leafy vegetables, legumes, nuts, and chocolate?
magnesium
What nutrient functions in the prevention of dental caries and remineralization?
fluoride
What nutrient deficiency may result in:
increased incidence of caries; and toxicity can cause tooth mottling and enamel hypoplasia
fluoride
What nutrient is found in fluoridated water, tea, seawee, and toothpaste?
fluoride
What nutrient functions as a component in hemoglobin, carries oxygen to cells, immune function, and cognitive development?
iron
a deficiency in what nutrient may cause:
aneamia: pallor of face, conjunctiva, lips, mucosa, and gingiva; shortness of breath, fatigue, decreased immunity; and toxicity can cause GI upset, pigmentation; seen in persons with hemochromatosis?
iron
What nutrient can be found in meat, poultry, fish, whole grains, dried fruit, and enriched grains?
iron
What nutrient functions and is required for over 100 enzymes, normal growth and development, taste and smell sensitivity, sexual development and reproduction, immune integrity, wound healing?
zinc
What nutritional deficiency may result in: altered taste, growth retardation, decreased wound healing, impaired immunity; and toxicity is rare, but may cause stomach irritation, cramps, diarrhea, and vomiting
zinc
What nutrient can be found in seafood, meats, whole grains, and greens?
zinc
What nutrient functions to aid in iron metabolism and collagen formation?
copper
What nutritional deficiency may result in:
anemia, poor growth, low WBC, bone demineralization, tissue fragility, decreased trabeculae of alveolar bone; and toxicity causes vomiting and diarrhea?
copper
What nutrient can be found in whole grains, nuts, dried fruits, meats, legumes, shell fish, and organs?
copper
List 4 oral symptoms of nutrient deficiencies associated with the tongue:
altered taste sensation
glossitis
glossodynia
sore or burning tongue
List 4 oral symptoms associated with mucosal tissue from nutrient defficiencies:
angular cheilosis
candidiasis
delayed wound healing
mucositis/stomatitis
List 4 oral symptoms associated with periodontal tissue and tooth development from nutrient deficiencies:
decreased alveolar bone integrity
inflammed, bleeding gingiva
mineralization of teeth
altered enamel development
Name 4 minerals and 1 vitamin that are relevant and essential for healthy tooth structure:
minerals: calcium, phosphorus, magnesium, and fluoride
vitamin: Vitamin A
What is the essential mineral for dental caries prevention?
fluoride
What are 4 factors involved in the development of dental caries that act together and caries result?
microorganisms
cariogenic diet
salivary factors
tooth resistance
What is a result of excess cariogenic foods, not a nutrient deficiency?
caries
fermentable carbohydrates produce what when acted on by specific biofilm microorganisms?
acids
What are 2 types of microorganisms that use fermentable carbohydrate from the diet to produce acids?
streptococcus mutans
lactobacilli
What type of consistency of food encourage biofilm accumulation, and aids in leading to increased acid formation, and how?
soft sticky foods: cling to the teeth and gingiva
microorganisms are protected and nourished in dental biofilm of the tooth
What are 4 factors of prevention and control in the counseling for dental caries control?
control of dental biofilm
modification of intake of sugars and cariogenic food
strengthening the tooth surface to resist caries activity
presence of saliva is essential: xerostomia increases the risk for demineralization
What are 3 preventive measures that support dietary control in the counseling for dental caries control?
pit and fissure sealants
restoration of existing carious lesions
implementation of fluoride therapy
What are 2 purposes of dietary assessment?
identify the pt who may be at nutritional and oral health risk
plan with the pt for necessary changes to improve the health of the oral mucosa and periodontium, and prevent dental caries
Information obtained from medical, dental, and social histories is essential in assessing oral health and nutritional status what are 6 things to look for in these histories?
disease states
medications
disabilities
learning limitations
significant unintentional changes in body weight
factors influencing food use and food intake
Dietary influences can be identified by ______________ examination which may reveal oral tissue that is suggestive of nutritional deficiencies.
intra and extraoral exams
What type of form used for dietary assessment is described?
diary of pts intake over previous 24 hrs; obtained by interview w/pt; assesses nutrients, food groups, diet inadequacy, form and frequency of the carb intake, and snacking patterns; results are reveiwed; it is quick and easy and done chairside, but it is not necessarily representative of pts normal diet
food diary
What type of form used for dietary assessment is described?
more accurate account of a pts intake; pt completes food diary for 3-7 days inclusive of 1 weekend day; affords pt a more active role in the assessmeht; provide pt with 3-7 copies of food diary and have pt return it; it is evaluated for eating patterns, consumption and frequency of fermentable carbohydrates, and nutritional adequacy?
dietary analysis recording form
There are 3 principle parts of the food diary to analyze, what are they?
number of servings in each food group
frequency of cariongenci food
consistency of diet
Is frequency or quantity of carbohydrate intake more relevant in caries incidence?
frequency
What is a common misconception about conentrated sugar?
as an indespensable energy source
The sucrose from cariogenic food on the tooth surface can be changed to acid within ____________.
minutes
What is the critical pH level for demineralization of enamel?
below 5.5
How long will it take for acid left undisturbed to be cleared from the mouth by salivary flow?
40 minutes to 2 hrs
Why are cariogenic foods taken after brushing and flossing before retiring are not cleared readily?
because salivary flow decreases during sleep
are cariogenic liquids or solids removed from the teeth in less time?
liquids
What type of food are not metabolized by bacteria and are recommended bo be eaten at the end of a meal?
protein and fat
What type of food can be eaten after sweets of at the end of a meal to prevent the decrease in pH and production of acids in the oral cavity?
cheese
true or false. natural sugars are just as detrimental as refined sugars.