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Factors that decrease calcium absorption
- High fiber diet
- high-protein diet
Some foods rank higher in absorbability of calcium, rank these in order from excellent to poor:
Milk Almonds Cauliflower spinach
- Excellent: Caulilower, brussels sprouts, broccoli
- Good: Milk, Soy milk tofu
- Fair: Almonds, sesame seeds, pinto beans
- Poor: Spinach
In osteoporosis, the bone mineral density (BMD) is reduced, bone microarchitecture deteriorates, and the amount and variety of proteins in bone are altered.
what are some of the risk factors for osteoporosis?
- Caucasian or Asian
- Thinness (small bones)
- overectomy before 45
- physical inactivity
- deficient vitamin D intake
- high animal protein intake
T/F distorted body shape occurs in osteoporosis
is osteoporosis preventable?
This mineral is a common multipurpose food additive...
______________ is to chlorophyl in plants as iron is to hemoglobin in humans
name some food sources for magnesium:
- Dried Figs
- Black eyed peas
- baked potato
- sunflower seeds
T/F Sulfur is an important mineral in the human body
What mineral deficiency causes "Old Rose" colored tongue with depapillation evident at periphery?
(oral mucosa is also darker red)
Pellagra (niacine deficiency) is manifested in the oral cavity through these three symptoms:
- Enlarged Tongue
- Smooth atrophic surface on dorsum of tongue
- Glossopyrosis (burining tongue)
What are the oral manifestations of riboflavin deficiency?
- Glossitis (inflamation of the tongue) affects teh lateral marins of the tip of tongue
- Fiery red color of tongue due to atrophy of filiform papillae
- angular cheilosis (fissuring and dry scaling of the vermilion surface of the lips and angles of the mouth, a characteristic of riboflavin deficiency)
- lips may become red and smooth
- mucous membranes bleed easily
Name the Oral Manifestations of Scurvy (Vitamin C Deficiency)
- Gingival changes: friability, deep red color, raggedness, hemorrhages, swelling.
- The eventual result of untreated scurvy is involvement of the supporting structures of the teeth, with marked mobility of the teeth and spontaneous exfoliation.
Name the Oral Manifestations of Folic Acid Deficiency
- Fiery red tongue, completely devoid of papillae.
- Marked chronic periodontitis with loosening of the teeth.
- Oral Manifestations of Folic Acid Deficiency
Name the characteristics of Anorexia Nervosa:
Psychological disorder. Refusal to maintain a minimally normal body weight. Intense fear of gaining weight. Significant disturbance in the perception of the shape or size of his/her body. Amenorrhea.
T/F 0.5-1.0% prevalence among females in late adolescence and early adulthood. with Bimodal peaks at ages 16 and 21.
False, the bimodal peaks are at ages 14 and 18. b/t/w Long-term mortality is 10% (from starvation, suicide, electrolyte imbalance).
Describe the Characteristics of Patients with Anorexia:
- Abnormal fear of weight gain; Distorted body image. Loss of 25% or more of normal body weight. Self-induced starvation.
- Dry skin, brittle fingernails, fine downy hair over entire body (lanugo), loss of hair. Characteristics of Patients with Anorexia Amenorrhea. Hypothermia. Often shy and introverted. High achiever, rigid compliance. Feelings of inadequacy and unworthiness. Referred for treatment by concerned individual.
Name the Systemic Complications of Anorexia:
Impaired renal function (associated with chronic dehydration and hypokalemia). CV problems (severe hypotension, arrhythmias). Osteoporosis (from low calcium intake & absorption, reduced estrogen secretion & increased cortisol secretion). Normochromic normocytic anemia. Dental problems.
Describe Bulimia Nervosa:
Psychological disorder. Repeated episodes of binge eating (in a discrete period of time) followed by inappropriate compensatory behaviors (purging), at least twice a week for 3 months. Excessive emphasis on body shape and weight – these are most important factors in determining the patient’s self-esteem.
What behavior qualifies as Purging?
Self-induced vomiting ; Misuse of laxatives; Misuse of diuretics; Misuse of other medications; Fasting; Excessive exercise
- T/F 1-3% prevalence among females in adolescence and adulthood. Usually begins in late adolescence or early adulthood.
- Prevalence in males is one-tenth that in females. 90% of bulimic individuals are female.
T/F Bulimia can be either Chronic or intermittent behavior.
Name the Physical Characteristics of Patients with Bulimia:
Weight usually within normal range. Dry lips. Blotched, dry skin from dehydration. May have scars or calluses on dorsum of hand. (from putting hand down throat.)
Describe the Psychological Characteristics of Patients with Bulimia:
Socially extroverted and gregarious. Alternate between self-control and impulsiveness. Low self-esteem, depression, guilt feelings following purging. Often seek assistance in gaining control of behavior.
List the Systemic Complications of Bulimia
- Protein malnutrition. Weight loss. Dehydration and electrolyte disturbance. Cardiovascular or renal failure (due to hypokalelmia).
- Cardiac arrest. Trauma to esophagus & stomach lining. Chemical erosion of the teeth.
What are the Dental Manifestations of the Bulimic Patient
Perimolysis. Increase in cervical caries. Impairment of mucous membranes and periodontal tissue. Chronic swelling of the parotid glands. (overstimulation) Xerostomia. Perimolysis. THE EROSION OF ENAMELon the lingual, occlusal and incisal surfaces of the teeth.(It may be recognized by loss of enamel with rounded margins, a notched appearance on the incisal surfaces of the anterior teeth, amalgam restorations appearing as raised islands, or loss of occlusal contours on unrestored teeth).
What are the possible Causes of Enamel Erosion?
Vomiting as a result of bulimia. Vomiting as a result of gastric disturbance. Intake of high citric acid fruit juice. Habitual eating or sucking on chewable Vitamin C tablets. Antabuse therapy for alcoholism. Medication containing hydrochloric acid. Exposure to industrial acids.
What is the recommended dental Treatment of the Bulimic Patient?
Maintenance of good oral hygiene. Rinsing with sodium bicarbonate or magnesium hydroxide solution. Neutral pH sodium fluoride rinses(0.5-2.0%). 0.4% stannous fluoride gels. Composite resins. Full crown coverage.
Describe the effects of Bulimia on the Dentition
Pronounced lingual erosion of anterior teeth. Rounded appearance of cusps on posterior teeth. Both features are due to erosion.
Caries is a multifactorial disease caused by:
Bacteria; A supporting host diet of refined carbohydrates; Decreased host resistance; and time for the cavity to develop
What is the Chemo-Parasitic Theory of Caries Development?
Acids produced by bacteria in plaque dissolve the enamel mineral.
what does the term Exposure Time refer to?
Exposure time refers to exposure of the teeth to acid production when you eat a cariogenic food.
describe the timing of acid production in "Exposure Time"
Upon exposure to the cariogenic food, the cariogenic bacteria begin producing acid within 30 seconds. Acid production continues for about 30 minutes. The pH of the plaque, which is normally 6.2 – 7.0, drops rapidly.
What is the Critical pH?
a pH = 5.5; If the pH of the plaque falls below 5.5, the enamel will begin to decalcify.
describe the battle of Demineralization vs. remineralization.
- Repeated exposures (more than 4 x 30-minute exposures) throughout the day prevent remineralization of the tooth structure.
- The bacteria must be organized to produce acid.
- Exposure Time
When calculating exposure time, remember the three F’s:
1. Food type (fermentable carbohydrate); 2. Form of food (retentive vs non-retentive); 3. Frequency of eating
what are intrinsic sugars?
Naturally occurring in fruits and vegetables. Not readily fermentable by the bacteria. (note Dried fruits ARE fermentable).
Extrinsic sugars are:
Sugars that are added to the food.
T/F Fresh fruit, dried fruit & fruit juices are capable of causing dental caries.
True: but Fresh fruit is of low cariogenicity. Citrus fruits have not been associated with the development of caries at all.
T/F There is no evidence that milk and cheese have a protective effect against development of caries.
False, there is some evidence of this.
T/F Regarding cariogenicity, frequency of eating a food is less important than the form of the food.
False, the frequency is more important than the form of the food
List the Sugars in Order of Cariogenicity:
- Sucrose (table sugar) – preferred by bacteria.
- Glucose (dextrose)
- Lactose (milk sugar)
- Fructose (fruit sugar)
- Sorbitol (gastro-intestinal problems)
- Xylitol (gastro-intestinal problems)