Nutrition And Oral Health Public Health Dentistry Question And Answers

Nutrition And Oral Health

Question 1. Discuss the role of nutrition in the oral and dental health.
Or
Describe briefly role of nutrition in oral health and disease.
Answer.

Nutrition and Dental Caries

Pre-eruptive effects: Physical and chemical properties of enamel could be altered in direction of increase dental caries susceptibility. Malnutrition can predispose teeth to dental caries. Maturation of enamel, its physical and chemical composition, time of eruption of teeth and various other factors are influenced by pre-eruptive nutrient intake.

• Mineral malnutrition occurs due to inadequate quantities of calcium and phosphorus.
• Dental dysplasias associated with malnutrition are:
  • Odontoclasia in deciduous dentition
  • Yellow teeth condition in permanent teeth
  • Infantile melanodontia in permanent teeth.
    The above hypoplastic defects are seen in malnourished population and are caused by interaction between nutrition deficiencies and processes that occur along tooth development.

Posteruptive effects: Posteruptive effects of malnutrition lead to decrease salivary lysozyme and secretory IgA levels. Alteration in salivary protein has negative effects on susceptibility of caries. Changes in salivary peroxidase, lactoferrin, lysozyme and other proteins can reduce the host defense mechanism to cariogenic organisms.

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Nutrition and Periodontal Disease

Periodontal diseases involve episodic, progressive disruption of several tissues. Different host factors are susceptible to nutritional influences acting systemically on structure, repair and defense.

Main targets in nutritional deficiency are epithelial barrier and attachment, periodontal ligament, gingival connective tissue, alveolar bone, cellular and humoral immune mechanisms, inflammatory response, etc.

Following are the nutrients and their deficiencies:

Iron

• It is an obligate factor in collagen metabolism. Since it plays role in movement of oxygen to cells and its role in cytochrome enzymes, it provides innate and adaptive immunity.
• Deficiency causes reduced thickness of oral epithelium, reduced size of progenitor cells and delayed malnutrition of epithelial barrier.

Protein

• Alveolar bone is sensitive to changes in protein metabolism.
• Protein deficiency leads to increased susceptibility to periodontal infection while supplementation reduces inflammation and tooth mobility.

Vitamin C

• It provides tensile strength to tissues and determines morphology.
• Deficiency causes scurvy in which there is gingivitis with hemorrhage and presence of bluish red gingiva.
• In severe vitamin C deficiency, tooth exfoliate and there is also presence of xerostomia.

Vitamin A

• Vitamin A plays role in the synthesis of proteoglycans, fibronectin and Type I procollagen and in epithelial tissue differentiation.
• Deficiency of vitamin A leads to decreased salivary flow, hyperkeratosis and gingival hyperplasia.

Vitamin B Complex

• It plays an important role in division and growth of cells mainly in those with rapid renewal rate.
• Its deficiency affects epithelium of mouth and lips.
• Niacin deficiency predisposes gingiva to Vincent’s infection and acute necrotizing ulcerative gingivitis (ANUG).

Vitamin K

Its deficiency leads to gingival bleeding and post extraction hemorrhage.

Vitamin E

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

Calcium and Phosphorous

• Calcium decreases gingival inflammation, calculus formation, pocket depth and tooth mobility.
• Low calcium phosphate ratio leads to severe alveolar ridge resorption.

Nutrition and Oral Cancer

• Malnutrition increases the susceptibility of head and neck cancer.
• There are various chemical carcinogens which require enzyme activation. Specific nutritional deficiencies may depress these enzymes by reducing body’s defense against chemical carcinogens.
• Nutritional factors protect against tumorigenesis by
  • Acting as blocking agents
  • Altering metabolism of carcinogen through decreasedactivation.
  • Increasing detoxification
  • By competitive inhibition.

Vitamin A and Retinoids

• Inhibit chemically-induced tumors in various tissues.
• Affect tumor latency by retarding growth of tumors.
• Retinoids are successful in treatment of oral leukoplakia.

Vitamin C

• Act as antioxidant and free radical scavenger.
• Enhances immune responses by acting on phagocytes.
• It is an effector of oxidases involved in detoxification of carcinogens by acting on.

Vitamin E

• It is an anti-oxidant.
• Act as free radical scavenger.
• Inhibit nitrosamine formation.
• It influences hormonal and cell-mediated immunity.
• It increases cell repair capacity.

Foods

• Fruit consumption provides protective effect.
• Fish, buttermilk, milk, dairy products, citrus fruits, cabbage and sea food are protective against oral cancer.

Question 2. Write in brief on importance of balanced diet.
Answer. A balanced diet is defined as one which contains a variety of foods in such quantities and proportions that the need for energy, amino acids, vitamins, minerals, fats, carbohydrates and other nutrients is adequately met for maintaining health, vitality and general well being and also makes a small provision for extra nutrients to withstand short duration of leanness.

Importance of Balanced Diet

• It prevents diseases and infections: A well-balanced diet helps your body fight many diseases and infections. When the body receives enough nutrients, the immune system functions well, which prevents infection, reduces the risk of chronic diseases like cancer, high blood pressure, diabetes, and heart disease, as well as prevents seasonal allergies.
• It helps control weight: Eating a balanced diet helps people to maintain proper weight, which includes reducing the risk for either obesity or undernutrition. This reduces fats and carbohydrates from the diet.
• It promotes healthy body growth: Obtaining the essential nutrients does not only promote fitness and prevent disease; but also helps the body to grow and maintain proper function. A balanced diet is therefore important especially for growing children and adolescents.
• It helps promote mental health: Eating a well-balanced diet helps promote good mental function, boosts energy, enhances memory, and reduces the risk of mental disorders.
• It helps enhance your beauty: Getting the proper nutrients does not only promote health inside the body; but also shows in the way an individual look externally. The youthful glow seen on people’s hair and skin does not only result from using various beauty products, but also reflects the healthy state of the body inside and out from a balanced diet.
• Growth of children: A healthy, balanced diet for children provides essential vitamins, minerals and other nutritional goodies that kids need for healthy growth and development.

Question 3. Write short note on oral manifestations associated with malnutrition.
Answer. Following are the oral manifestation which occurs due to malnutrition:

• Tongue becomes glistening red along with loss of papillae.
• Angular cheilosis is seen bilaterally.
• Circumoral pigmentation becomes lost.
• Xerostomia is present.
• Activity of dental caries subsides.
• Detachment of epithelium occurs easily from the base and leaves raw bleeding surface.
• Growth of the jaws gets decreased.
• Delayed eruption of dentition is present.
• Incisors and molars present retarded growth.
• Degeneration of gingiva and periodontal ligament occur.
• Hypoplasia of primary teeth is present.
• At times necrotizing ulcerative gingivitis occur in oral cavity.