BALANCED DIET and DENTAL EROSION RELATED TO DIET

Presented by:Dr.Ayesha TahaJR IDepartment of Pedodontics and Preventive DentistrySPPGIDMS, Lucknow

CONTENTS

•Diet definition•Balanced Diet definition•Basal Metabolism•Basal Metabolism Rate•Specific Dynamic Action (SDA) of food•Recommended Dietary Allowance (RDA)•Food Group Guides•Food Guide pyramid•Dietary Goals•Weight loss for Kids and Teenagers•Dental Erosion•Acids Involved•Dental Erosion References•Dental Erosion and its Management•Conclusion

Total oral intake of substance that provide nourishment and energy. (Nizel,1989)

It is referred to as food and dink regularly consumed (Oxford Dental Dictionary).

DIETDefinition

Diet definition contd…

Diet is defined as types and amount of food eaten daily by an individual. (FDI,1994)

It is one which contains varieties of foods in such quantities and proportion that the need for energy,

amino acid, vitamins, fats, carbohydrate and other nutrients is adequately

met for maintaining health, vitality and

general well being and also makes provision for a short duration of leanness.

(Chauliac, 1984)

BALANCED DIET

BASAL METABOLISM

It is the minimum amount of energy needed to regulate

and maintain the involuntary essential life process, such as breathing, circulation of the

blood, cellular activity, keeping muscles in good tone

and maintaining body temperature.

BASAL METABOLISM RATE (BMR)

It is defined as the number of kilocalories expended

by the organism per square meter of body

surface per hour. (kcal/m2/hour)

MEN: 1600-1800 kcal/dayWOMEN: 1200-1450

kcal/day

SPECIFIC DYNAMIC ACTION (SDA) OF FOOD

It is the term used to describe the expenditure of calories

during digestion and absorption of food.

FAT= 2%CARBOHYDRATE= 6%

PROTEIN= 12%

RECOMMENDED DIETARY ALLOWANCE (RDA)

These are set of values for level of intake of the nutrients currently considered essential

and which meet the physiological needs of nearly

all individuals.

The Food and Nutrition Board, since 1943. (revised every 5 year)

RDA for Women

RDA for Men

FOOD GROUP GUIDES

The objective of national food guides has been to translate dietary standards into

simple and reliable devices for the nutrition education of a layman person.

FACTORS: Customary food patterns

Availability of foodFood economics

Nutritive value of food in a particular location.

The USDA daily food

guide divides

commonly eaten foods

into five groups

according to their

respective nutritional

contributions

• It is a Pyramid shaped guide of healthy foods divided into sections to show the

recommended intake for each food group.

• First dietary guidelines were published in 1894 by

Dr Wilbur Olin Atwater.

Commonly used tool for planning a healthful diet.

FOOD GUIDE PYRAMID

Oranges,

Tomatoes,

Grapefruit Potatoes

and other

Vegetables and fruits

Milk and milk

productsMeat,

poultry, fish or eggs

Bread, flour and

cereals

Butter and

fortified margarin

e

Green & Yellow

Vegetables

BASIC SEVEN

First food guide proposed in 1943

BASIC FOUR

Vegetables, and Fruits

Meat Milk

Cereals and Bread

BASIC FOURBasic seven upgraded in 1957 to the four food group.

FIVE GROUP GUIDE

Fats, Sweet and Alcohol

Five Group Guide

In 1979, the USDA (United States Department of Agriculture) recommended a five-food groups.

FOOD WHEEL APPROACH

•Total diet approach included goals for both nutrient adequacy and moderation.

•Five food groups and amounts formed the basis.

FOOD WHEEL APPROACH

•The pyramid shows a range of servings for each food group.

•The number of servings that are right for you depends on how many calories you need, which in turn depends on your age, sex, size, and activity level. •Almost everyone should have at least the lowest number of servings in the ranges.

VEGETABLES (1-2 cups every day)

MEAT & BEANS (2-5 oz everyday)

GRAINS (3-5 oz Every day)

MILK GROUP (2 cups every day)

FRUITS (1-1½ Cups every day)

FOOD GUIDE PYRAMID FOR CHILDREN BETWEEN 2-5 YEARS OF AGE

MILK GROUP (2-3 cups every day)

VEGETABLES (2-2½ cups every day)

GRAINS (5-6 oz Every day)

MEAT & BEANS (4-5½ oz everyday)

FRUITS (1½-2 Cups every day)

FOOD GUIDE PYRAMID FOR CHILDREN BETWEEN 4-11 YEARS OF AGE

The following calorie level suggestions are based on recommendations of the National Academy of Sciences and on calorie intakes reported by people in national food consumption surveys.

1600 calories• Right for many sedentary

women and some older adults.

2200 calories

• Right for most children, teenage girls, active women, and many sedentary men. Women who are pregnant or breastfeeding may need somewhat more.

2800 calories• Right for teenage boys,

many active men, and some very active women.

MY PLATE

The food guide pyramid were discontinued and a new alternative program named MY PLATE was initiated in June 2nd 2011.

•The plate is divided into four slightly different sized quadrants, with fruits and vegetables taking up half the space and grains and protein making up the other half.

•The guideline also recommended portion control while still enjoying food, as well as reduction in sodium and sugar intake.

MY PLATE

DIETARY GOALSThe following dietary goals are

recommended to provide adequate nutritionIncrease the consumption of complex carbohydrate and naturally occurring sugars from about 28% to about 48%.Reduce the consumption of refined and processed sugars by about 45%.Reduce overall fat consumption.Reduce Cholesterol consumption to about 300mg/day.Reduce saturated fat consumption.Limit sodium intake by reducing salt to about 5g/day.

                                                       • Diet and nutrition for kids is a challenge. Most children are bombarded with persuasive and attractive advertising from a very young age.

• Most foods advertised tend to be high in sugar or salt and are often sponsored by colorful cartoon characters.

• Children need to be given a choice and must be allowed to eat little.

Diets and Kids

Children who are overweight should never go on restrictive diets or even have foods restricted.

Any approach should include the entire family and result in improving the diet of the parents as well as the children.

The program must address behavioral issues as well as nutritional issues.

Weight Loss for Kids and Teenagers

Stephen Mitchell, pediatric dentist at the University of Alabama, Birmingham

Sweetened drinks can prevent the development of strong teeth, which are essential for chewing, speech development and healthy smiles.

To prevent decay, Mitchell suggested wiping the infant’s gums with a clean gauze pad after each feeding.

A CHILD ON A DIET• Putting a child on a diet is a tricky thing to do. It is not just cruel, but could also affect the psychology of the child to watch the rest of the family enjoying the food that the child is asked to avoid.

•Instead, opt for making healthy meals for the whole family. The best approach to helping a child is to lead by example. Making healthy choices for the whole family, rather than setting out a different meal and exercise routine for the child is the best approach.

•Outdoor sports or activities that the whole family can enjoy. Avoiding snacking or having meals in front of the Television. This way the child will not feel singled out and in the bargain, the whole family will be on the path to good health.

Dental Erosion

related to Diet

Diet and Dental Erosion

The clinical term Dental Erosion is used to describe the physical results of a pathologic, chronic, and localized loss of dental hard tissue that is chemically etched away from the tooth surface by acid and/or chelation withoutbacterial involvement.

The acids responsible for erosion are not the products of the oral flora; but dietary, occupational, or intrinsic sources.

Mild erosion may be symptomless, but the first sign of erosion

may be sensitivity to hot, cold or sweet

foods. The tooth may become increasingly painful as the pulp at the centre

is affected, and gradually, as the

enamel wears away, the teeth may become

shorter and darker.

Dental Erosion

Diet and dental erosion: what acids are involved ?

• Strong acids - pH < 4.5 (regurgitated stomach acid)

• Citric acid -pH 2.5 - 3.5 (lemon juice)

Diet and dental erosion

Severe erosion requires

frequent short contacts or less frequent prolonged contacts of erosive substances (enhanced if there is lowered buffering capacity).

Extrinsic Acid

• Fruit juices• Beer• Wine• Sports drink• Carbonated drinks

Intrinsic Acid

• Gastric Acid

ACID SOURCES

Other causes of Dental Erosion

People with diseases such

as Anorexia Nervosa,Bulimia and Gastroesophageal reflux disease (GERD) often suffer from Dental Erosion.

ReferencesPurnita Goyel (2013)“Comparative evaluation of erosive potential of different beverages on enamel and tooth coloured restorative materials: An in vitro study”

It was concluded that that erosion of enamel was significantly higher than tooth- colored restorative materials. The erosive potential of orange juice was highest followed by tomato soup and apple juice.

Goyel P, Singh MG, Bansal R. Comparative evaluation of erosive potential of different beverages on enamel and tooth colored restorative materials: An in vitro study . Journal of Pediatric Dentistry;2013:1:58-62

References

Deshpande (2004)“Dental erosion in children: An increasing clinical problem”

It was concluded that out of 100 children examined, percentage of children with dental erosion for 5 years age group was found to be 28.57% while for the age group of 6 years 30.70%. The increase of higher percentage that is 30.70% was seen due to the exposure of carbonated drinks or soft drinks.

Despande S, Hugar S M. Dental erosion in children: An increasing clinical problem. Journal of Indian Society of Pediatric and Preventive Dentistry;2004:22(3):118-127

References

Thomas (1957) “Further observations on the influence of citrus fruit juices on human teeth. ” showed that dental students who consumed either grapefruit juice, orange juice or cola daily for 6 weeks had signs of erosion on their labial incisors and that this was greatest with grapefruit juice.

Thomas AK. Further observations on the influence of citrus fruit juices on human teeth. New York State Dental Journal 1957; 23: 424–30.

References

Stabholz (1983)“Tooth enamel dissolution from erosion or etching and subsequent caries development.”

showed that the exfoliated deciduous teeth of children who had received orange juice at school daily for 10–18 months and found that the teeth showed slight demineralisation.

Stabholz A, Raisten J, Markitziu A. Tooth enamel dissolution from erosion or etching and subsequent caries development. Journal of Periodontology 1983; 7: 100–8.

References

Jarvinen (1991)“Risk factors in dental erosion. ”

in a case–control study, found that the dietary practices associated with erosion were consumption of citrus fruits twice or more per day, consumption of soft drinks once per day and consumption of vinegar or sports drinks more than once a week.

Jarvinen VK, Rytomaa I, Heinonen OP. Risk factors in dental erosion. Journal of Dental Research.1991; 70: 942–7.

Dental erosion and its Management

In the Initial Stage of erosive lesions only the enamel surface is involved and restoration may be inserted because of aesthetic needs and or to prevent further progression.

Dental erosion and its Management

In Advanced case dentin becomes exposed, restorative materials like glass-ionomer and composite resin should be used for re-establishing tooth structure, function and esthetics, as well as for controllingHypersensitivity.

Dental erosion and

its Management

Erosion appears to be an increasing problem in industrialised countries and is related to extrinsic and intrinsic acids.

Increases levels of erosion observed in industrialised Countries are thought to be due to increased consumption of acidic beverages (i.e. soft drinks and fruit juices).

Fruit juices are more erosive than whole fruits and consumption of the former has increased markedly over recent years in industrialised countries.

In order to reduce the prevalence of erosion the frequency of acidic beverages needs to be reduced and/or the resistance to erosion needs to be increased.

Factors such as salivary flow, fluoride, calcium and phosphate may protect against erosion although there is no consensus as to how effective these factors are in prevention.

Knowledge about Nutrition, Dietary Guidelines, Food Guides, role of diet in dental caries /erosion, counselling and motivation techniques is thus important in the prevention /management of dental caries and erosion and other oral conditions.

CONCLUSION

Diet is related to general health as well as oral health. Dentists need to understand the impact of nutrition on oral health to provide patients with appropriate advice.

References:

•Ten Cate JM, Imfeld T. Dental erosion, summary. Eur J Oral Sci1996;104:241-4.•Attin T, Wegehaupt F, Gries D, Wiegand A. The potential of deciduous and permanent bovine enamel as substitute for deciduous and permanent human enamel: Erosion- abrasion experiments. J Dent 2007;35:773-7.• Sonju Clasen AB, Ruyter IE. Quantitative determination of type A and type B carbonate in human deciduous and permanent enamel by means of Fourier transform infrared spectrometry. Adv Dent es.1997;11:523-7.•Babu GK, Rai K, Hedge AH. Pediatric liquid medicaments- Do they erode the teeth surface? An in vitro study: Part I. J Clin Pediatr Dent.2008;32:189-93.•West NX, Maxwell A, Hughes JA, Parker DM, Newcombe RG, Addy M. Method to measure clinical erosion: The effect of orange juice consumption on erosion of enamel. J Dent 1998;26:329-35.

References:

•Goyel P, Singh MG, Bansal R. Comparative evaluation of erosive potential of different beverages on enamel and tooth colored restorative materials: An in vitro study . Journal of Pediatric Dentistry;2013:1:58-62•Attin T, Wegehaupt F, Gries D, Wiegand A. The potential of deciduous and permanent bovine enamel as substitute for deciduous and permanent human enamel: Erosion- abrasion experiments. J Dent 2007;35:773-7.• Sonju Clasen AB, Ruyter IE. Quantitative determination of type A and type B carbonate in human deciduous and permanent enamel by means of Fourier transform infrared spectrometry. Adv Dent es.1997;11:523-7.•Babu GK, Rai K, Hedge AH. Pediatric liquid medicaments- Do they erode the teeth surface? An in vitro study: Part I. J Clin Pediatr Dent.2008;32:189-93.

"THE FOOD YOU EAT CAN BE EITHER SAFEST AND MOST

POWERFUL FORM OF MEDICINE, OR THE SLOWEST

FORM OF POISON"