1
Q
What 4 things are involved in the importance of oral health?
A
- eating the food you like
- self-confidence
- positive self-image
- can help lower risks of oral disease
2
Q
What 6 things happen when your mouth isn’t healthy?
A
- dental caries
- tooth decay
- sugar
- tooth loss
- calcium
- vitamin D
3
Q
One of the oldest observations on nutrition and periodontal health is James Lind’s account of ___ in the first controlled therapeutic trial conducted in 1747.
A
scurvy
4
Q
Deficiencies in these 4 vitamins have detrimental effects on periodontal health
A
- vitamin A
- vitamin C
- vitamin E
- folate
5
Q
What can the use of tobacco alter?
A
distribution of antioxidants
6
Q
What is the function of antioxidants
A
protection of cells
7
Q
Which 4 vitamins have antioxidant properties?
A
- vitamin A
- vitamin E
- vitamin C
- beta carotene
8
Q
What are the 4 functions of vitamin A, E, C and beta carotene?
A
- neutralize metabolic products
- interfere with activation of pro-carcinogens
- inhibit chromosomal aberrations
- inhibit the growth of malignant lesions
9
Q
complex nitrogenous compounds
A
proteins
10
Q
These are amde up of smaller units called amino acids
A
proteins
11
Q
What are the 3 functions of proteins?
A
- body building
- repair and maintenance of tissues
- synthesis of antibodies, hemoglobin, enzymes
12
Q
What does the word protein mean?
A
prime of importance
**because it mediates most of the actions of life
13
Q
What are proteins essential for?
A
all body tissues
14
Q
What 4 things can proteins form?
A
- hormones
- enzymes
- antibodies
- chemical messengers
15
Q
What is the range which protein requirements vary?
A
40-65 g/day
16
Q
What 3 things cause protein requirements to vary?
A
- physical activity
- stress
- growth cycles
17
Q
How is excess protein stored?
A
as fat
18
Q
What is the specific dynamic action (SDA) or thermic effect of food (TEF) for protein?
A
29%
19
Q
What is the specific dynamic action (SDA) or thermic effect of food (TEF) for carbohydrates and fats?
A
5%
20
Q
What are two types of protein deficiency?
A
- kwashiorkar
- marasmus
21
Q
What are the 7 oral symptoms of protein deficiency?
A
- formation, eruption, alignment
- adverse effects for
- periodontium cells
- fibroblast
- osteoblast
- cementoblast - caries prone teeth
- retarded cementum deposition
- degenerative changes in gingiva
- poor calcification of dentin and matrix
- reddening of tongue with loss of papilla
22
Q
Fats are solid at what temperature?
A
20 degrees celcius
23
Q
When are fats called oils?
A
liquid @ 20 degrees celcius
24
Q
these are concentrated sources of energy
A
fats/lipids
25
What are the 3 ways lipids can be classified?
1. simple lipids --> triglycerides
2. compound lipids --> phospholipids
3. derived lipids --> cholesterol
26
Almost 99% of body fats are in the form of
triglycerides
27
What are the 5 functions of fats?
1. flavour
2. fat soluble vitamins (A,D,E,K)
3. insulation
4. supports viscera of heart, kidneys, intestines
5. omega 3 fatty acids/linolenic acid decreases cholesterol and cardiac risk by reducing BP and preventing blood clots
28
What are the 3 effects of fats on oral health?
1. phospholipids = structural component of cell membrane, tooth enamel, and dentin
2. high fat = inhibitory to dental caries
3. small quantities of nuts and cheese good between meals for pt's concerned with dental caries
29
These provide the body's primary source of fuel for heat and energy. They also maintain body's back up store of quick energy as glycogen (animal starch)
carbohydrates
30
What are the 3 main sources of carbohydrates?
1. starches
2. sugars
3. cellulose
31
What is the carbohydrate reserve of a human adult?
500 mg
32
True or false: The carbohydrate reserve is rapidly exhausted when a person is fasting
True
33
What are the 4 functions of carbohydrates?
1. fat metabolism
2. synthesis of ground substance of connective tissues
3. synthesis of certain non-essential amino acids
4. glucose essential for erythrocyte and brain function
34
What are the 3 effects of carbohydrates on oral health?
1. dental caries caused by carbohydrates
2. sucrose is used by bacteria to produce polysaccharides
3. causation of caries depend on
- type
- consistency
- time
- frequency
of carbohydrates
35
These make up 4% of body weight
minerals
36
Minerals are divided into how many groups?
3
37
What are the 5 major minerals?
1. calcium
2. phosphate
3. sodium
4. potassium
5. magnesium
38
These are required from dietary sources in amounts greater than 100 mg per day
major minerals
39
These elements are required by the body in quantities of less than a few mgs per day
trace elements
40
What are the 14 trace elements?
1. iron
2. iodine
3. fluorine
4. zinc
5. copper
6. cobalt
7. chromium
8. manganese
9. molybdenum
10. selenium
11. tin
12. silicon
13. vanadium
14. nickel
41
What are the 4 effects of minerals on oral health?
1. calcium --> vitamin D and phosphorous --> development and maintenance of teeth and bones
2. fluorides --> anticaries
3. iron deficiency anemia manifests in oral cavity by oral tissues (i.e., tongue)
4. zinc deficiency can inhibit collagen formation and reduces cell-mediated immunity
42
When are trace elements in human dental enamel derived from during?
mineralization and during and after maturation of the tooth
43
What are the 2 cariostatic elements?
1. F
2. P
44
What are the 7 mild cariostatic elements?
1. Mo
2. V
3. Cu
4. Sr
5. B
6. Li
7. Au
45
What are the 7 doubtful elements?
1. Be
2. Co
3. Mn
4. Sn
5. Zn
6. Br
7. I
46
What are the 6 caries inert elements?
1. Ba
2. Al
3. Ni
4. Fe
5. Pd
6. Ti
47
What are the 6 caries promoting elements?
1. Se
2. Mg
3. Cd
4. Pt
5. Pb
6. Si
48
Organic compounds which are required in minute amounts to maintain normal health of organisms
vitamins
49
Vitamins are a part of what type of system?
enzyme system
50
What are the 2 classifications of vitamins?
1. fat soluble (A,D,E,K)
2. water soluble (B,C)
51
Re-draw this chart of vitamin classifications
52
This vitamin is widely distributed in animal and plant foods
vitamin A
53
How is vitamin A in animals formed?
pre-formed
54
What is an example of pre-formed vitamin A in animals?
retinol
55
How is vitamin A in plants formed?
pro-formed
56
What is an example of pro-formed vitamin A in plants?
carotene
57
How and where is vitamin A stored?
- in form of retinol palmitate
- liver
58
Under normal conditions, a well-fed person has sufficient Vitamin A reserves to meet his need for how long?
6-9 months or more
59
Free retinol is highly active and toxic, so what must happen?
transport to the blood stream in combination with retinol binding protein from the liver
60
What are the 6 physiological functions of vitamin A?
1. vision
2. epithelial cell "integrity"
3. reproduction
4. resistance to infectious disease
5. bone remodelling
6. growth
61
In teeth, what does vitamin A deficiency lead to?
defective enamel formation
62
Regarding the hypoplasia of teeth, what does vitamin A deficiency lead to?
disturbance of enamel forming cells
63
Regarding the dentin, what does deficiency of vitamin A lead to?
lack of normal tubular structure
64
Regarding caries, what does deficiency of vitamin A lead to?
increased risk for caries
65
Regarding eruption, what does vitamin A deficiency lead to?
delayed in prolonged deficiency
66
Regarding alveolar bone, what does vitamin A deficiency lead to?
retarded in rate of formation
67
Regarding the gingiva, what does vitamin A deficiency lead to?
- gingival epithelium becoming hyperplastic
- prolonged deficiency = keratinization
68
Regarding periodontal disease, what does vitamin A deficiency lead to?
tissue easily invaded by bacteria that may cause periodontal disease
69
Regarding salivary gland, what does vitamin A deficiency lead to?
keratinizing metaplasia
70
What are the 2 forms vitamin D is available in?
D3 - cholecalciferol
D2 - calciferol
71
Where are precursors of vitamin D found?
1. yeast
2. animal tissues
72
In yeast, what is the sterol precursor ergsterol converted to?
vitamin D2 (ergocalciferol)
73
This compound is most commonly found as the additive to fortify milk
ercocalciferol
74
Describe the chemical origins of vitamin D in the dermal tissues of animals
precursor is 7-dehydrocholesterol which is converted first to pre-vitamin D 3 and then to vitamin D3 (cholecalciferol)
75
What are Vitamin D2 and D3 converted to in the liver and kidney?
calcidiol and calcitriol
76
D2 and D3 are sometimes referred to as
vitamers
77
Describe the absorption and storage of vitamin D that is taken into the gut
absorbed --> by intestinal mucosal cells in the duodenum and jejunum and packaged into chylomicrons
storage --> chylomicrons carry vitamin to liver or adipose for storage and use
78
Describe the absorption and storage of vitamin D that is synthesized through the skin
sunlight binds to a blood protein called vitamin D binding protein (DBP) which transports it to the liver
79
**QUIZ ENDED ON THIS SLIDE**Redraw this diagram on how the skin takes in sunlight to make and store vitamin D
80
What are the 4 biochemical functions of vitamin D?
1. regulates plasma levels of calcium
2. calcitriol --> intestine
3. calcitriol --> bone
4. calcitriol --> kidney
81
How many levels does calcitrol act on to maintain plasma calcium?
3
82
What is the normal plasma calcium level?
9-11 mg/dl
83
What is vitamin D deficiency in children?
rickets
84
What is vitamin D deficiency in adults?
osteomalacia
85
True or false: Vitamin D deficiency leads to increased risk of osteoporosis.
True
86
Where did the term rickets come from?
old english word "twist" or "wrick"
87
During growth, human bone is made and maintained by the interaction of ____, ____ and ____.
calcium
phosphorous
vitamin D
88
Calcium is deposited in immature bone (osteoid) in a process called _____ which transforms immature bone into mature bone
calcification
89
Also known as adult rickets
osteomalacia
90
What two bones are affected in osteomalacia?
1. flat bones
2. diaphysis of long bones
91
What group of people does osteomalacia most commonly affect?
post menopause female with a history of low dietary calcium intake
92
What are the two most common symptoms of osteomalacia?
1. bone pain
2. muscle weakness
93
What are 9 oral manifestations?
94
What is the oral manifestation of teeth as a result of vitamin D?
development abnormalities of dentin and enamel
95
What is the oral manifestation of caries as a result of vitamin D?
higher risk of caries
96
What is the oral manifestation of enamel as a result of vitamin D?
hypoplasia, mottled, yellow grey
97
What is the oral manifestation of the pulp as a result of vitamin D?
high pulp horns
large pulp chamber
delayed closure of root apices
98
This is a naturally occurring antioxidant that is essential for normal reproduction in many animals
vitamin E
99
anti sterility vitamin
vitamin E
100
What are the 6 biochemical functions of vitamin E?
1. membrane structure and integrity
2. prevents perioxidation of fatty acids
3. preserves and maintain germinal epithelial gonads
4. protects liver from damage
5. works with vitamins A, C, and betacarotene to delay onset of cataract
6. prevents oxidation of LDL
101
A deficiency of vitamin E is related to what 4 things?
1. sterility
2. degenerative changes in muscle
3. megaloblastic anaemia
4. changes in CNS
102
What are the two oral manifestations of vitamin E deficiency?
1. loss of pigmentation
2. atrophic degenerative changes in enamel
103
Vitamin C is also called
ascorbic acid
104
What is the most active reducing agent?
vitamin C
105
True or false: Vitamin C is a powerful antioxidant
True
106
What are the 10 biochemical functions of vitamin C?
bone formation and metabolism
107
What is vitamin C deficiency?
scurvy
108
What 8 things characterize scurvy?
1. spongy and sore gums
2. loose teeth
3. anemia
4. swollen joints
5. decreased immunocompetence
6. delayed wound healing
7. haemorrhage
8. osteoporosis
109
Scorbutic gingivitis is characterized by what 3 things?
1. ulcerative gingivitis
2. rapid periodontal pocket development
3. tooth exfoliation
110
Most of these vitamins occurs in nature in the bound form within the cells of vegetables or animals
b complex
111
The digestion for the liberation of B complex vitamins and its absorption is a result of what?
breakdown of cellular structures in the gut
112
Where does excretion of B complex vitamins occur?
kidney
113
What is thiamine (vitamin B1) called?
anti beri-beri factor
anti neuritic factor
aneurin
114
Thiamine, vitamin B1, also has a specific coenzyme called _____, which is associated with carbohydrate metabolism.
thiamine pyrophosphate (TTP)
115
A colourless, basic organic compound that is composed of a sulfated pyramidine ring
thiamine (vitamin B1)
116
What are the biochemical functions of thiamine?
energy and nerve impulse
117
What are 7 deficiencies of thiamine?
1. nervous disorders --> cells cannot metabolize glucose
- mental depression
2. digestive symptoms --> defective HCL
- no appetite
- poor digestion
- weight loss
3. BERI BERI
- dry beri beri
- wet beri beri
- infantile beri beri
4. wernickes encephalopathy
5. peripheral neuritis
6. korsakoffs
7. psychosis
118
What are the two thiamine (vitamin B1) oral manifestations?
1. hypersensitivity of oral mucosa
2. pain in tongue, teeth, jaw, face
119
riboflavin
vitamin B2
120
What are the two coenzyme forms of riboflavin?
1. FMN - flavin mononucleotide
2. FAD - flavin adenine dinucleotide (FAD)
121
What are the biochemical functions of riboflavin?
redox reactions and metabolism
122
What are the two deficiencies of riboflavin?
1. cheiolosis
2. glossitis
123
chapping and fissuring of lips
cheilosis
124
inflammed, red beefy tongue
glossitis
125
What is the daily requirement of B3 (niacin)?
5-15 mg
126
"nature's valium
niacin
127
What is the precursor for vitamin B3?
tryptophan
128
"nature's sleeping pill"
tryptophan
129
70 mg of protein intake provides ___ mg of niacin
12
130
What is vitamin B3 deficiency called?
pellagra
131
This deficiency state leads to photosensitive dermatitis, diarrhoea, and dementia
pellagra
132
What are the two types of dermatitis caused by vitamin D3 deficiency?
1. casal's necklaces
2. glove and stocking
133
Most of the therapeutic preparations contain this which is sensitive to light and heat liable
cyanocobalamine (vitamin B12)
134
vitamin B12
cyanocobalamine
135
What are the biochemical functions of vitamin b12?
136
What is vitamin b12 deficiency called?
perinicious anemia
137
This deficiency is characterized by low hemoglobin levels, decreased number of erythrocytes and neurological manifestations.
perinicious anemia
138
What two things are used to assess B12 deficiency?
1. excretion of methylmalonic acid
2. serum B12
139
What are the 4 oral manifestations of vitamin B12 deficiency?
1. burning sensation
2. trouble swallowing
3. swollen tongue
4. pale mucosal tissues that could break off
