Ch. 14

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Kymberli
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82770
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Ch. 14
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2011-05-01 18:38:10
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Nutrition Periodontium
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Nutrition Exam 3
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  1. Nutritional status affects the development, growth, & maintenance of the ________________.
    periodontal tissues (gingiva, PDL, alveolar bone, cementum, & oral mucosa)
  2. Nutritional status is important in ___________ & resistance to __________.
    immunity; infection
  3. T/F: Nutritional deficiencies, excesses, & imbalances do NOT initiate Periodontal Disease, but they complicate it.
    TRUE.

    *POOR NUTRITION does NOT initiate Periodontal Disease.

    *Nutritional status MAY modify the progression Periodontal Disease & the healing of Periodontal tissues.
  4. What is the MAIN initiating agent of Periodontal Disease?
    PLAQUE!
  5. T/F: Periodontal disease advances MORE RAPIDLY when a patient has a POOR immune system; immune system function is DIRECTLY related to nutrition.
    TRUE; TRUE
  6. 3 things Nutrition may alter in the Periodontium:
    • 1.) development
    • 2.) resistance
    • 3.) repair

    • Nutrition effects the severity & extent of periodontal disease
    • Thus, resistance to infection depends on one's health (& their health depends on their nutrition)
  7. What is the LEADING cause of TOOTH LOSS for people > 35 yrs old?
    PERIODONTAL DISEASE!
  8. DECREASED immunity/immune system INCREASES the RISK & EXTENT of?
    infectious diseases (ex: periodontal disease)
  9. Nutritional deficiencies can do 3 things:
    • 1.) ALTER immunity/immune system/immunocompetence
    • 2.) INCREASE risk of oral infection
    • 3.) INCREASE extent of oral infection
  10. Effects of Protein Malnutrition:
    • 1.) IMPAIRS the Acute Phase Response to infection, which leads to a REDUCED ability to mount an EFFECTIVE inflammatory response
    • 2.) REDUCES White Blood Cell (Neutrophil) function
  11. 3 HIGH RISK GROUPS for PROTEIN MALNUTRITION:
    • 1.) Poorly controlled Diabetics
    • 2.) Cancer pts.
    • 3.) AIDS pts.
  12. 3 Functions of Vitamin C in the Immune System:
    is present in HIGH amounts in Neutrophils

    • 1.) ENHANCES the migration of Neutrophils to the site of the infection
    • 2.) PRESERVES Neutrophil cell structure
    • 2.) makes Oxidative destruction of microorganisms EASIER
  13. *2 Effects of Vitamin C Deficiency:
    • 1.) Oxidation of Collagen (increases permeability of blood vessels & sulcular epithelium)
    • 2.) Scurvy
  14. *T/F: Scurvy symptoms FIRST appear in the oral cavity.
    TRUE.
  15. *9 Scurvy symptoms:
    • 1.) swollen/inflammed gingiva
    • 2.) LOOSE teeth
    • 3.) follicular hyperkeratosis
    • 4.) hemorrhage
    • 5.) weakness
    • 6.) malaise
    • 7.) sore joints
    • 8.) ecchymosis
    • 9.) weight loss
  16. 4 ROLES of SALIVA:
    • 1.) SIGNIFICANT player in Periodontal Disease
    • 2.) Buffering
    • 3.) Antimicrobial
    • 4.) Saliva AMOUNT or COMPOSITION changes influence plaque growth
  17. * 2 Effects of Food on Supragingival Biofilm:
    • 1.) Food serves as the SOURCE of NUTRIENTS for bacterial biofilm
    • 2.) Sucrose intake is NEEDED for the SYNTHESIS of Glucan (Glucan promotes bacterial adherence to the dental pellicle)
  18. * Are nutrients REQUIRED for healthy tissue growth, maintenance, & repair?
    YES!
  19. * 13 Nutrients Needed for Tissue Integrity & Immune Response:
    • 1.) Vitamin A (oral mucosa tissue)
    • 2.) Vitamin B Complex (epithelial & connective tissue)
    • 3.) Vitamin C (collagen & connective tissue)
    • 4.) Vitamin D (immune response, alveolar bone & cementum)
    • 5.) Protein (host immune & repair functions)
    • 6.) Carbohydrates/CHO (host immune & repair functions)
    • 7.) Calcium (host immune & repair functions; alveolar bone & cementum)
    • 8.) Iron (host immune & repair functions)
    • 9.) Zinc (host immune & repair functions)
    • 10.) Folate/Folic Acid (host immune & repair functions)
    • 11.) Amino Acids (alveolar bone & cementum)
    • 12.) Phosphorus (alveolar bone & cementum)
    • 13.) Magnesium (alveolar bone & cementum)
  20. Fibrous Foods & Perio: (3)
    • 1.) Fibrous foods are NOT very retentive (IS a good alternative to more cariogenic foods)
    • 2.) Chew firm, coarse, & fibrous foods to STIMULATE salivary flow for better food clearance & to decrease debris (DOES increase food clearance by increasing salivary flow)
    • 3.) STIMULATES & STRENGTHENS PDL & density of alveolar bone (MAY help maintain supporting tissues of teeth)
    • 4.) does NOT remove plaque from areas adjacent to the gingiva
  21. 3 Causes of Periodontal Disease:
    • 1.) Stress
    • 2.) Tissue Catabolism
    • 3.) Infection
  22. 5 Symptoms of Prescription (Rx) Vitamin C:
    • 1.) Gingivitis
    • 2.) Hemorrhage
    • 3.) Blue-red gingiva
    • 4.) Widened PDL spaces
    • 5.) Tooth mobility
  23. * 5 Goals of Dietary Counseling for Periodontal Patients:
    • 1.) FACILITATE tissue repair & wound healing
    • 2.) IMPROVE resistance to infection
    • 3.) REDUCE complications
    • 4.) SHORTER recovery
    • 5.) FASTER return to health
  24. 4 Types of Periodontal Disease:
    • 1.) Gingivitis
    • 2.) Chronic Gingivitis
    • 3.) Chronic Periodontitis
    • 4.) NUG/NUP
  25. Gingivitis & Vitamin C:
    Vitamin C therapy may HELP in the EARLY stages of Gingivitis by REDUCING crevicular bleeding

    this is an influence of Vitamin C in maintaining the integrity of the micro-vasculature of the sulcus
  26. Chronic Gingivitis:
    • begins at the inter-dental papillae & then advances to the attached gingiva
    • caused by LARGE QUANTITIES of plaque
  27. 3 things Chronic Gingivitis can be an INDICATOR of:
    • 1.) Metabolic disease: Diabetics, AIDS
    • 2.) Hormonal changes: Pregnancy, Puberty
    • 3.) Vitamin C deficiency: Scurvy
  28. Nutritional intervention for Chronic Gingivitis:
    • promote adequate intake of ALL food groups
    • REDUCE fermentable CHO's
  29. Chronic Periodontitis
    • involves clinical attachment loss (CAL)
    • is from length of time of plaque & disease resistance
    • generalized or localized
  30. * T/F: nutrient imbalance or deficiencies are SECONDARY causative factors.
    TRUE!

    host resistance to infection is effected by nutrient stores = poor nutrition> decreased immunity> perio disease
  31. Nutritional intervention for Chronic Periodontitis:
    • promote adequate intake of ALL food groups
    • REDUCE fermentable Carbohydrates (CHO's)
  32. 6 Predisposing Factors of NUG/NUP:
    • 1.) poor oral hygiene
    • 2.) preexisting Gingivitis
    • 3.) mental stress
    • 4.) smoking
    • 5.) physical stress
    • 6.) Caucasian race
  33. T/F: Poor nutrition has NOT been well documented as a PREDISPOSING FACTOR to NUG/NUP.
    TRUE.
  34. Nutritional Factors & Lowered Host Resistance:
    • Protein, Vitamin C, Vitamin B Complex deficiencies
    • Poor eating habits: LOW nutrient intake
    • Obtain health, dental, & social histories = IMPORTANT for nutritional management
    • No alcohol, smoking, caffeine
    • Liquid nutritional supplements
  35. Pre/Post-Surgical Nutrition:
    • Pt should be provided with list of nutrient-dense foods & beverages BEFORE treatment
    • A multivitamin supplement with 100% RDA levels may be recommended
  36. 4 Reasons Post-Operative Nutrient Requirements Increase:
    • 1.) Blood loss
    • 2.) Increased Catabolism
    • 3.) Tissue regeneration
    • 4.) Host defense activities
  37. After Periodontal Surgery:
    • Full liquid diet : 1-3 days; high protein & high kcal fluids
    • Mechanical soft diet: 3-7 days; soft, ripened, chopped, ground, mashed, & pureed moist foods
    • Bland diet: to avoid tissue irritation
    • Hard, sticky, brittle foods are CONTRAINDICATED
    • Cool liquids, NO sucking through straws
  38. Osteoporosis
    • = REDUCED bone mass
    • possible correlation between systemic Osteoporosis, Alveolar Bone, & Tooth Loss in Postmenopausal Women
  39. * T/F: The REDUCTION in total skeletal mass is DIRECTLY RELATED to REDUCTION in mandibular bone density in WOMEN with OSTEOPOROSIS.
    TRUE!
  40. 6 Risk Factors of Osteoporosis:
    • 1.) Low lifetime Calcium intake
    • 2.) Smoking
    • 3.) Genetics
    • 4.) Medications
    • 5.) Physical Inactivity
    • 6.) Low Estrogen status

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