Dietary advice - Dr Al-Ani Flashcards

1
Q

What are the important factors in caries control

A
  • Plaque control
  • Use of fluoride
  • Dietary modification
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2
Q

What factors may place a patient at high risk for caries

A
  • High sugar intake
  • Inadequate brushing habits
  • No fluoride exposure
  • Irregular dental attendee
  • Medically compromised
  • Xerostomia
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3
Q

What investigations should be caried out for a patient with xerostomia

A
  • Diet analysis
  • Investigation on fluoride intake
  • Medical history
  • Oral hygiene practices
  • Bitewing radiographs
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4
Q

What dietary factors are associated with caries

A
  • Amount of fermentable carbohydrate eaten
  • Sugar concentration of food
  • Physical form of carbohydrate
  • Oral retentiveness
  • Frequency of eating meals and snacks
  • Length of interval between eating
  • Sequence of food consumption
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5
Q

What is the Vipeholm study

A
  • The consumption of sugary foods is
    associated with a higher caries incidence
  • Increasing the frequency of sugar intake
    also increases caries incidence
  • Lowering sugar intake reduces caries
    incidence
  • Consumption of sticky sugar-containing
    between meal products can be associated
    with high caries risk
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6
Q

What sugars are investigated in the Turku study

A

Sucrose
Xylitol

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7
Q

What did the Turku study show

A

The results show a profound
difference in caries rate
between the two groups
The findings clearly indicate a
therapeutic, caries inhibitory
effect of xylitol

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8
Q

What is the Stephan Curve

A

The Stephan Curve is a graph that shows what happens after the
consumption of sugar in relation to dental caries

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9
Q

How much pf our total energy consuption should consist of free sugars according to WHO

A

No more than 10%
50g per day

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10
Q

What are some carbohydrates can cause caries

A
  • Sucrose
  • Fructose
  • Glucose
  • Maltose
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11
Q

What are some foods with a very high hidden sigar content

A

baked beans
breakfast cereals
tomato ketchup
plain biscuits

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12
Q

What should dietary advice be

A

Acceptable, Practical
and Affordable

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13
Q

What advice could you give to someone to reduce the risk of caries

A
  • Reduce snacks containing sugar; replace it with healthy snacks
  • Avoid adding sugar (consider using sugar substitutes); look for ‘hidden
    sugars’ on food labels
  • Best time to do have fruit drinks when saliva flow is highest at meal-times
  • Save sweets to as special time of the week, eg Saturday morning
  • Eat sweet all in one rather than spreading them out
  • Only drink plain milk or plain water between meals
  • Don’t eat or drink after brushing at night
  • Increase the amount of fresh fruit and vegetable
  • Avoid food within 20 minutes of bedtime
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14
Q

How long does damage to teeth occur after eating sugary food

A

Up to one hour after intake

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15
Q

What does the prevention and management of dental caries on children programme state

A
  • Give dietary advice at least
    once a year
  • Advise or remind the
    child/parent/carer about how a
    healthy diet can help prevent
    caries
  • Limit consumption of sugar
    containing food and drink
  • Snack on healthier foods which
    are low in sugar, such as fresh
    fruit, carrots, peppers,
    breadsticks, oatcakes and
    occasionally a small amount of
    lower fat cheese
  • Do not place sugary
    drinks, fruit juices,
    sweetened milk or soy
    formula milk in feeding
    bottles or pacifiers
  • Do not eat or drink, apart
    from tap water, after
    brushing at night
  • Be aware of hidden sugars
    in food and of the acid
    content of drinks
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16
Q

What causes dental erosion

A

Chronic exposure of dental hard tissues to acidic substances which can be extrinsic or intrinsic

17
Q

What causes extrinsic erosion

A

Extrinsic erosion is caused by acid
originating outside the body (for example
in drinks). Generally the acid strength
will be pH 2.5 or weaker

18
Q

What causes intrinsic erosion

A

Intrinsic erosion is due to stomach acid
reaching the teeth, with a pH of 1. This
acid is typically 100 times stronger than
in extrinsic erosion, and so much more
destructive

19
Q

What is titratable acidity

A

Reflects the number of hydrogen ions available for erosive attack, rather than pH

20
Q

Which has a more erosive potential
-Coke
-Grapefruit juice

A

Grapefruit juice as it’s TA (titratable acidity is much hight (9) than coke (2)

21
Q

What is the worst acid for teeth

A

Citric acid

22
Q

How can simulation salivary flow after meals be beneficial

A

Saliva acts as buffer and removes harmful acids after eating

23
Q

What should you finish a meal with

A

Milk or cheese

24
Q

What teeth are exceptions to the erosion in order of eruption

A

Lower primary incisors
* the position of the submandibular ducts
that open adjacent to these teeth
* the position of the tongue in suckling,
which covers the lower incisors

25
Q

What is the patern of teeth erosion

A

Teeth become carious in the order in which they erupt

26
Q

What should the advice be to parents about night time feeding

A

Only water should be given during the night after 12 months of age

27
Q

What additional factors make the upper
primary incisors more predisposed to caries?

A
  • High bow-shaped upper lip in infants which does not cover the upper incisors
    and results in an increased evaporation of any saliva on these teeth
  • Gravity, which keeps submandibular saliva pooled around the lower incisors and
    less likely to reach the upper incisors
  • Any liquid with sugar that is allowed to bathe the teeth on a frequent basis will
    cause caries. This is especially so at night when the protective function of saliva
    reduces as less saliva is produced
  • Even breast milk, formula milk or cows’ milk with their lowered natural sugars
    can still be cariogenic on this basis
  • In some situations maxillary incisors may erupt with hypoplastic or
    hypomineralized defects, thus making the teeth less resistant to the development
    of dental caries