dietary analysis and education

Question 1

Why might a diet diary not be accurate?

Answer 1

Forget to return it or loses it
Change their eating habits (sub/consciously)
Maybe observing religious festival or special diet at the time
Write what they think you want to see
Forget details
Literacy/language difficulties

Question 2

Who do we give diet diaries to?

Answer 2

Target at-risk patients (caries/erosion)
Ask them (/guardian) for a written record for 3 days inc. one weekend day
Return for feedback

Question 3

What evidence is there for diet interventions?

Answer 3

Cochrane review 2012
5 studies
2 about diet and general health (alcohol and fruit/veg) and there was a change to behaviour following advice
3 about sugar consumption and tooth decay + toothbrushing so can’t tell whether other message affected outcome- poor evidence

Dietary advice and dental erosion, 2015- no conclusive studies identified

Question 4

How do you do a diet diary?

Answer 4

1. Thank person for returning sheet and show genuine interest, say that you’ll take some time to look at it before next visit
2. Gain general idea of completion (eg. drinks inc?)? For follow up qs
3. Find some positive feedback
4. Highlight cariogenic/erosive snacks outside of mealtime and count episodes
5. Identify hidden sugars in meals if not snacking
6. Personal written/verbal feedback
7. Repeat at recall, habits can change and caries risk

Question 5

What kind of feedback should be given?

Answer 5

1. Positive comment
2. Explain freq of attacks need to be reduced
3. Offer safe and realistic alternatives
4. Advise against drinks for infants in bottle
5. Recommend healthy eating guidelines (5 a day)
6. Reinforce tooth brushing

Simple, don’t be judgemental, be encouraging, be practical, medical reasons may override diet advice, reinforce

Question 6

What feedback can be given regarding erosion?

Answer 6

1. Discourage freq and amount
2. Promote chilling of drinks (reduces erosive potential) and limit to mealtimes
3. Use straw
4. Eat neutralising food eg. Cheese
5. Don’t brush straight after- acid rubbed in

Question 7

What are safe snacks/drinks?

Answer 7

Water/milk/tea w/o sugar
Fresh fruit/veg
Cheese/meat
Bread/breadstick
Rice crackers
Plain crisps (careful w salt)
Nuts (only for adults)