Chapter 18: Nutritional Aspects of Dental Caries: Causes, Prevention, and Treatment
Nutritional status and oral health have a strong interrelationship
countless research studies have shown the importance of diet in the development, maintenance, and repair of hard and soft oral tissues
Major Factors in the Dental Caries Process
Diet and nutrients play a role in dental caries
There is not a single parameter responsible for the formation of dental caries. Combination of factors are involved.
Tooth Structure
Host Factors
Saliva
Plaque biofilms and its Bacterial components
Cariogenic Foods
Increasing resistance of tooth against demineralization begins in the pre=eruptive phase. An adequate intake of nutrients during growth and development of enamel and dentin is essential.
food selection, dietary patterns, oral hygiene habits, race or ethnicity, age , and income are factors that determine susceptibility to caries
availability of essential nutrients during hte development of salivary glands, which begins during the fourth week in utero, has a significant impact on the amount of saliva and its composition
protection provided by an adequate salivary flow and buffering capacity of saliva ultimately reduce the destructive capabilities of fermentable carbohydrates on teeth
Physical Form
complex environment of bacteria, polysaccharides, proteins, and lipids . Forms a local barrier on enamel and may interfere with demineralization
Fermentable carbohydrates that can be metabolized by oral bacteria and reduce salivary pH below 5.5
Cariostatic/Noncariogenic Properties of Food
do not cause a reduction in salivary pH below 5.5
Nonnutritive sweetners
aspartame, saccharin, sucralose, neotame, and acesulfame are a few examples of nonnutritive sweetners
Protein and Fat
two nutrient classes that may be considered cariostatic because they do not lower plaque pH
Anticariogenic Properties of Food
Anticarcinogenic foods or beverages do not cause a reduction in pH below 5.5 and may protect teeth from cariogenic activity
Sugar Alcohols
mannitol and sorbitol are often used as substitute sweeteners. They are viable alternatives to sugar because of their sweet teste but have the added benefit of being noncariogenic
Phosphorus and Calcium
Other Foods and Protective Factors
a constituent in chocolate, known as cocoa factor, has shown anticariogenic properties
glycyrrhiza, the active ingredient in licorice, can also be considered anticariogenic due to the potential to reduce S. mutans in saliva
provide qualities protecting against caries . Dispersion of these minerals throughout plaque biofilm may provide a buffering effect, increasing plaque pH
Ingestion of hard candy results in prolonged exposure. A sticky and retentive carbohydrate remains in contact with the enamel surface for a longer period than sweetener fluids
Fermentable carbohydrates that are chewy, such as caramels, adhere to teeth
Frequency of Intake
longer periods of oral exposure to a fermentable carbohydrate lead to a greater risk of demineralization and less opportunity for teeth to remineralize
Timing and Sequence in a Meal
another consideration to be made is whether the cariogenic food is eaten with meals or snacks
Frequent consumption of soft drinks, sports drinks, energy drinks, and flavored coffees and teas compounded with a a decline in dairy products can also influence caries risk and erosion despite the rapid oral clearance of these fluids
location of acidogenic food within a meal presents another consideration for caries potential
Dental Hygiene Care Plan
providing nutrition information is an essential component of the preventive programs
review for pattern of fermentable carbohydrates consumption, frequency, form , and time consumed
fermentable carbohydrates alone do note cause dental decay. it is one factor in the decay process
further questioning can reveal dietary habits that the patient failed to recognize as being relevant to oral health
CAMBRA- Caries Management by Risk Assessment
a popular tool used by dental professionals to identify risk of caries and to determine preventive and therapeutic goals for both children and adult patients