NUTRITION - PROXIMAL CARIES- Caries between tooth TYPES OF NUTRIENTS

- TOOTH ENAMEL- White part

 A science which deals with the study of food - SALIVA can neutralize acids  Carbohydrates- are composed of mainly
and its nutrients and their relation to health. - The worst offenders in terms of promoting elements such as carbon, hydrogen and
 A multidisciplinary integrated science that dental caries are the sticky and gummy oxygen. Provide the major source of
deals with food and how the body uses it in foods high in sugars, such as caramel, nutrients in the body.
order to survive. because they stick to the teeth and supply  Lipids/fats
 The science of food, nutrients and other the bacteria with a long-lived carbohydrate  Protein- repair factor
substance therein, their action, interaction source.  Minerals-
and balance in relation to health and - Frequent consumption of liquid sugar  Vitamins
disease, and the processes by which an sources (e.g., fruit juices) can also cause  Water- human body is 60%
organism ingests, digests, absorbs, dental caries.
transports, utilizes and excretes food Average man- 3 liters of water
substances. FOOD
 Broader definition includes social, CLASSIFICATION OF NUTRIENTS
economic, cultural, psychological  Edible substances made up of a
implication of food and eating. variety of nutrients that nourish the  According to function
body. Body building
- Science is based on facts  Is a product derived from plants or - Water, protein, fat, carbohydrate, minerals
animals that can be taken into the Furnish energy
body - Carbohydrate, fats, protein
PRACTICE OF NUTRITION:  We yield energy and nutrients for Regulate body processes
the maintenance of life and growth - All major groups
 Nutritional education and repair tissues.  According to chemical nature
 Giving of nutritional counselling Organic – has a carbon and its source is
 Prescribing of diets for group or IDEAL QUALITIES OF FOOD from a living
individuals in health and in sickness Inorganic- doesn’t have carbon and its
 Nourishing source is not from a living
 Has satiety value  According to essentiality
WHY DO WE STUDY NUTRITION?  Prepared under sanitary condition All major nutrients
(esthetically & scientifically)  According to concentration
 Individuals/personal  Free from toxic agents, or does not contain Macronutrients
 Health/sickness substances deemed deleterious to health Micronutrients- vitamins and minerals are
 Dentistry???  Offers variety & planned within socio- micronutrients
economic context
- Nutrition- is a lifestyle factor that is a key  Palatability factors (Color, aroma, flavour, DIETETICS
for maintaining and developing an optimal texture, etc)
state of health.   The art of food planning, food preparation,
- Poor diet- are known to be risk factor for and food service.
life threatening diseases. NUTRIENT
- During pregnancy, OSTEOPOROSIS is DIET
prominent in pregnant women but  Substances found in food and needed by the
TEMPORARY. SO THEY NEED CALCIUM. body for life & health.  A regimen of food intake made up of a sum
- RICE is considered SUGAR if fermented in of meals and in between snacks.
oral cavity.
CRUZ
  Prepared in such a way to prevent disease  Management program For every gram of carbohydrates , there are 4
and maintain the health of an individual. Treatement of gastric ulcer calories
 A diet is the food and the beverage a person
eats and drinks. NOTE: “RED MEAT MIGHT CAUSE CHRONIC For every gram of FAT, there are 9 calories
DISEASES”
DIET is for For every gram of protein, there are 4 calories

 Weight reduction COMPUTATION

 Caries control
 4 GRAMS OF SUGAR
 Diabetic diet
ENERGY VALUES OF FOOD & NUTRIENTS 4 grams of sugar x 4 calories/ 1 gram
 High fiber diet
= 16 calories
ADEQUATE DIET ENERGY METABOLISM
 4 GRAMS OF FATS
 Normal diet  The exchange of the energy derived from 4 grams of fats x 9 calories/1 gram
the oxidation of ingested food into energy =36 calories
DIET THERAPHY that moves and heats the body.
 Refers to all the reaction involved by  6 GRAMS OF PROTEIN
 Is a biological base practice which uses generating ATP 6 grams of protein x 4 calories/ 1 gram
specialized dietary regimens such as =24 calories
microbiotic, meditteranean and low carb ENERGY
diet.  ½ pint of milk contain:
 Use of food as a factor in aiding recovery  Measured in terms of heat & calories. CHO- 12 gm x 4 calories/gm= 48 calories
from illness. FAT- 10 gm x 9 calories/gm= 90 calories
CALORIES PROTEIN- 8 gm x 4 calories/gm = 32
calories
CLASSIFICATION OF DIET  In chemistry, represented as small “c”
TOTAL CALORIES= 170 Calories
o Amount of heat required to raise
 Nutrients the temperature of 1 gram of water
- High protein diet to 1°C MAJOR CATEGORIES TO BE CONSIDERED TO
- High vitamin diet  In nutrition, represented as Large Calorie © DETERMINE ENERGY NEEDS OF THE BODY
- Low fat diet o 1000x of c
 Fiber o The amount of heat required to  Basal metabolism
- Low residue- it limits high fiber food like raise the temperature of 1 kilogram  Energy expenditure
whole grain, breads, cereals, nuts, raw and (2.2 lbs) of water to 1 °C.
dried foods and vegetables BASAL METABOLISM
- High residue- BODY TEMPERATURE IS EXPRESSED AS A HEAT
- RESIDUE- Is undigestive food EQUIVALENT.  The minimum amount of energy needed to
 Texture & consistency regulate & maintain essential life processes:
 CHO  Breathing
- Soft diet
- 4 Calories / 1 gram  Beating of the heart
- Liquid diet
 FAT  Circulation of blood
 Restricted or quantitative diet
- 9 calories/1 gram  Maintenance of body temperature
DIABETIC
 PROTEIN
- 1000 calories diet  Excretion, etc
- 4 calories/1 gram
- 500 mg sodium diet
CRUZ
  Basal metabolism is expressed as basal Adult’s BMR= Lower - Activities of an individual may be classified
metabolic rate (BMR). After 6 years old, male BMR is as:
 Amount of energy spent for the body to approximately 5 % greater than the female  SEDENTARY
perform its basic function. BMR because of the muscular tissues.  MODERATE
 Thyroid Activity  HEAVY
Thyroid activity  VERY HEAVY
HOW RO ESTIMATE YOUR BASAL METABOLIC  Thyroxine- iodine-containing - People who are chronically ill have poor
RATE (BMR) secretion of the thyroid gland appetite & lower metabolism
 Important single factor that
- Nasa internet influences tissue oxidation Other important points:
 The activity of the thyroid gland is
used as a measure of basal  estimation of energy requirements
metabolism  the best guide to the adequacy of caloric
 HYPERTHYROIDISM- Increased allowances lies in maintaining the desirable
BMR weight, based on heaight, age, physica
 HYPOTHYROIDISM- Decreased activity & physiological state.
BMR  Excess calories= stored as fats= obesity
 lesser calories= stored fats are utilized=
 Pregnancy & lactation loses weight
 Pregnant women need 10-20%
more calories than non-pregnant
women
BODY MASS INDEX (BMI)
 Nursing mother requires 1000
calories to produce milk  Is a measure of body size, It combines a
BMR person’s weight with their height. The
ENERGY EXPENDITURE
results of a BMI measurement can give an
Factors that influence the BMR
3 major factors that affect energy expenditure idea about whether a person has the correct
 Body size weight for their height.
-Basal heat production is directly  Environmental temperature  BMI= Kg/m²
proportional to skin surface area because An important factor in heat production  BMI=lbs x 703/in²
heat is continuously lost through the skin by - When the body is exposed to a lower
irradiation. environmental temperature, it must
- increased skin surface- increased BMR produce more heat in order to maintain
 Amount of muscle tissue normal body temperature.
- An athlete has a higher BMR than a regular - During winter you tend to use more energy
person compare to summer
 Rate of growth  Specific dynamic action of food
Period of spurt or rapid growth -increased in metabolic begins soon after
- Infancy adolescence the food has been ingested
- Last trimester of pregnancy - the process of eating & digesting food
Increased BMR increase the bodily heat production
 Age & Sex  Muscular activity
Infant’s BMR= Higher - Affects energy requirements & heat
production
CRUZ
OBESITY  Calories taken must be equal to calories
expended otherwise will result to obesity
 Overweight  Balanced diet
 Weights 10% above the patient ideal weight  Regular activity & exercise
 May be a symptom of disease which causes
fluid accumulation FOR LOSING WEIGHT
- Kidney dysfunction
- Heart failure  Select nutritious low-caloric food
 Result of too much fat accumulation in the  Reduce fat consumption
body and/or excess body fluid in the tissues,  Cut sugar intake
which will lead to disease.  Eat smaller portions
- Refuse second helpings
ETIOLOGIC FACTOR (MULTI-FACTORAL)  Cut down on alcoholic drinks

 Hereditary – genetic factors

- Obesity runs in the family
- If both parents are obese, 80% chance that
the child will be obese
- If one parent is obese, 40% chance of
obesity to the offspring
- If both parents are not obese, less than 10%
risk
 Eating pattern early in infancy
- Number of fat cells can increased when
newborns are fed excessively
- If an obese adult loses weight, he or she
always has a more than normal number of
fat cells to store fat and thus may easily
become obese again.
 Eating habits of obese adults
- Obese persons ingest an excess of calories
because they nibble continuously.
- They do not refuse food, regardless of their
physiological need.
 Psychological factors
- Unhappiness
- Stress
 Physical activity/exercises
- Beside dietary management
- Regular physical activity is considered vital
aid for weight control

PREVENTION & CONTROL

CRUZ
CARBOHYDRATES 2/1/2021 - found in glucose from lactose - meaning DIETARY FIBERS
after the lactose has been digest and Insoluble fibers
- The chief and cheapest source of energy absorbed, galactose arrives in the liver - cellulose, hemicellulose, lignins- cabbage,
 Glucose- sole source of energy for brain 2. Disaccharides- formed when two cereals, wholegrains breads
and nerve tissue monosaccharides combine
 Kotse ka ghorl a. Sucrose Soluble fibers
 Glycogen-stored form of energy in liver b. Lactose Pectins- apples, citrus fruits, strawberries,
and muscles c. Maltose carrots
- Glycogen stores are depleted in about 18 hours Sucrose- glucose + fructose Gum and mucilages - oats, dried beans,
- found naturally in sugarcane, sugar beets, legumes
CLASSIFICATIONS OF CHO honey, and maple sugar
Simple carbohydrates Lactose- glucose + galactose during synthesis of milk
1. Monosaccharides- glucose, fructose, and - improves the absorption of calcium and
galactose other minerals in the body
2. Disaccharides- sucrose, lactose, and maltose - lactose intolerance
Maltose- glucose + glucose
Complex carbohydrates - does not occur naturally, formed from the
3. Polysaccharides- starches (amylose and enzymatic breakdown of starch
amylopectin), glycogen, complex most fibers - plays an important role in the beer and
liquor industry
SIMPLE CARBOHYDRATES
1. Monosaccharide - simple sugar units COMPLEX CARBOHYDRATES
- five and six carbon atom monosaccharde - single unit sugars that are bonded together to form
units a chain FUNCTIONAL FIBERS AND TOTAL FIBERS
- pentose 5 carbon atoms componenrs of - may contain 1000 or more glucose unit Functional fiber- added to foods that has been shown
nucleic acids (ribose, deoxyribose) - “ starch” to provide health benefits
- hexose 6 carbon atoms - two forms of starch digestible by humans Total fiber- combination of dietary foods and
Glucose- 6 Carbon Amylose- long, straight chain of glucose units, functional fiber in food.
- major monosaccharide found in the body comprise about 20% of the digestible starch found in
- “dextrose” vegetables, beans, breads, pasta, etc.
-Common source- from digestion of starches Amylopectin- digested more rapidly and raises
and sucrose ( common table sugar) from blood glucose much more rapidly than amylase.
our food
- source of fuel for cells Fibers- non-starch polysaccharides
Fructose - fruit sugar - group of substances with similar
- 6 carbon monosaccharide that usually characteristics
exists in a ring form -cellulose
- absorbed by the small intestine and then - hemicellulose
transported to the liver - pectins
- sweetest among monosaccharides - gums
- soft drinks, candies, jams, jellies, fruit - mucilages
Galactose - lignin (non- CHO)
- nearly the same structure of glucose - “dietary fibers” found in back of pack

CADA
Maltose- maltase - Role of microorganisms - Inadequate volume of saliva would decrease
Sucrose- sucrase - streptococcus sanguis the amount of natural buffers in the oral
Lactose- lactase - streptococcus mutans environment
Lactose intolerance- insufficient production of lactase - actinomycoses viscoses - may buffer substance sa saliva,
kaya na poop ng malambot, yurmie - lactobacillus acidophilus (pangalan palang
acidic na) Dental Plaque Bacteria:
RECOMMENDED DAILY INTAKE FOR CARBOHYRATES - Dental plaque is a sticky, jelly-like mass that
130 grams per day for adults - Role of acids may cover the enamel on all the surfaces
- many of the microorganisms in the oral
PROBLEMS WITH HIGH- SUGAR DIETS cavity were capable of producing acids Fermentable Carbohydrates:
- Caries - leptothrix buccalis - Concentration of sugar in a food- Key Factor

DENTAL CAREIS - Role of dental plaque Time for Caries Lesion to develop & Frequency of
- Erosion in the surface of a tooth caused by acids “ Gelatinous plaque of the caries fungus in a Between - Meal Snack:
made by bacteria as they metabolize sugars thin, transparent film that usually escapes - 18 months +/- 6 months- incipient attack to
- Worst offenders: sticky and gummy foods rich on observation, and which is revealed only bu clinically detectable caries
sugars careful search” - Patients with xerostomia - 3 months
- The pH is about 7.1 in caries free individuals - Between meal snack = caries
and approximately 5.5 in individuals with high susceptibility
DENTAL CARIES 2/08/2021 caries activity. Decrease saliva higher chance of caries bc of pH

Miller’s Chemicoparasitic Theory/Acidogenic Theory FACTORS IN THE DENTAL CARIES PROCESS CARIOGENIC POTENTIAL OF FOOD
- Willoughby Miller in 1882 - Tooth Chemistry/ Structures - A food is classified as potential potential cariogenic if,
Dental caries is a two (2) stage process - Amount of Salivary flow when it comes in contact with the plaque bacteria, the
Demineralization of inorganic - Types of Dental Plaque Bacteria plaque pH falls below 5.5
structures bacteria or “parasitic” - Types of Fermentable CHO eaten - Non- cariogenic food, with pH of 6 & above
phase-dissolution of albuminous - Frequency of Daily Food intake -cheeses, high protein
substances & digestive action of
bacteria Tooth Structures: RELATIONSHIP OF SUGAR ALCOHOL TO DENTAL
- Role of carbohydrates - Internal structures of the enamel - fluoride CARIES
- Role of microorganisms to make the enamel stronger for kidz onli - Have little or no effect on plaque pH
- Role of acids - Susceptible surfaces - pits & fissures , buccal - E.g. sorbitol-containing chewing gum may not
- Roles of dental plaque pits & grooves, proximal surfaces, lingual pits- contribute significantly to tooth decay
-Role of Carbohydraes food gets stuck here easily - Xylitol is very popular today as the sweetener for
- Slow clearance rate from the oral cavity are - Alignment of teeth - crowding ad sugar-free chewing gum (slenda sugar, etc)
more carcinogenc overlapping teeth , rotated teeth
- Polysaccharides are less easily fermented by (orthodontics lower the case of caries RELATIONSHIP OF SUGAR-RICH FOOD TO DENTAL
plaque bacteria than monosaccharides and production) CARIES
disaccharides - Sucrose “most-cariogenic”
- Sucrose is readily fermented by mainly Saliva: - Fructose & glucose are also cariogenic
Streptococcus mutans - Inadequate salivary flow can interfere with - Physical form of the sugar in which they are ingested
- The pH of plaque falls to 4.5-5 in about 1-3 proper oral clearance of carcinogenic influences its cariogenicity.
minutes of sugar intake. substrates
CADA
NURSING BOTTLE CARIES
- Falling asleep with the feeding bottle in the mouth of
children over long period of time
- Milk, Juices, sweetened drinks
Sealant repair para di maging catch basin for food
debris

CADA
LIPIDS the serving is 30 g or less or 2 - increases the risk of heart diseases
- group of compounds that are not uniform in tablespoons or less, 5 g of the food E.g. margarines, chips, doughnuts, cookies,
composition - Reduced or less cholesterol: at least crackers cakes, fries, and fried foods
- 9kcal/gram 25% less cholesterol and 2 g or less of
1. True fats saturated fat per serving than
2. Substances whose molecular structure reference food
includes fatty acids or fatty acid derivatives
3. Compounds present in minor amounts LIPIDS “FATTY ACID”
associated in nature - Basic structural unit
Further categorized as: * classifications according to degree of
1. Visible fats- butter, lard, margarine saturation
2. Invisible fats- marbleized fat in roast beef, butterfat, 1. Fully saturated (stearic acid)
milk, oil in avocado, potato chips, ice cream 2. Monosaturated (oleic acid -9)
3. Polyunsaturated (alpha-linolenic
Triacylglycerol acid -3 & linoleic acid -6)
- Carbon
- Hydrogen KULANG NEED SC 1. Fully saturated
- Oxygen - carbon atoms connected to hydrogen
atoms by a single bond CLASSES OF LIPIDS: TRIACYGLYCERIDS
DEFINITIONS FOR NUTRITIONAL CLAIMS ABOUT FAT A. Stearic acid - beef and lard - 18 - glycerol + 3 fatty acids
AND CHOLESTEROL OF FOOD LABELS carbons - most common fat that is present in animal or
FAT B. Palmitic acids - animal fat and palm protein food
- Fat free: less than 0.5 g of fat per serving oil - 16 carbons - primary form of fat in the body
- Saturated fat free: less than 0.5 g per serving, C. Lauric acid - milk and coconut oil - -> storage of energy, protects certain
and the level of trans fatty acids does not 12 carbons organs, transport fat-soluble vitamins,
exceed 0.5 g per serving and helps insulate the body
- Low fat: 3 g or less per serving and, if the 2. Monosaturated
serving is 30 g or less or 2 tablespoons or less, - one or more free bonds CLASSES OF LIPIDS: PHOSPHOLIPIDS
per 50 g of the food, 2% milk can no longer be - “not fully saturated” - contains phosphorus and nitrogenous base in
labeled low fat, as it exceeds 3 g per serving. - has one reactive unsaturated linkage addition to glycerol and fatty acids
Reduced fat will be the term used instead or one double bond and no hydrogen - allows fat-soluble substances (including
- Low saturated fat: 1 g or less per serving and atom vitamins and hormones) to easily pass in and
not more than 15% of local from saturated A. Palmitoleic acid out of the cell
fatty acids B. Oleic acid - olive oil, shortenings, - keep fats suspended in the blood and body
- Reduced or less fat: at least 25% less per lard, peanut oil, lamb, and poultry fat fluids since they are uniquely water soluble
serving than reference food
- Reduced or less saturated fat: at least 25% less 3. Polyunsaturated Sub-groups:
per serving than reference food - 2 or more double bonds per molecule 1. Phosphatides - part of cell walls and mitochondria
A. Linoleic acid - essential fatty acid A. Lecithin - composed of glycerol, fatty acid,
CHOLESTEROL (EFA) found in soybean, cottonseed, and choline
- Cholesterol free: less than 2 milligrams (mg) and other vegetable oils B. Cephalin - present in thromboplastin
of cholesterol and 2 g or less of saturated fat
per serving TRANS-FATTY ACIDS
- Low cholesterol: 20 mg or less cholesterol - unsaturated fatty acid that have
and 2 g less of saturated fat per serving and , if become hydrogenated
DNU MIDTERM
2. Plasmalogens - are commonly found in cell CHYLOMICRONS
membranes in the nervous, immune and cardiovascular Arachidonic Acid - Formed in the absorptive cells of the small
system - Not naturally found in humans intestine after fat absorption and travel
through the lymphatic system to the blood
3. Sphingomyelins - a component of fat-like sheath DEFICIENCY OF LINOLEIC ACID SIGNS AND stream
substance SYMPTOMS: - Chylomicrons enter the lymphatic system then
- Scaly skin into the bloodstream
CLASSES OF LIPIDS: CHOLESTEROL - Sparse hair growth - It is surrounded by large droplets of lipid
- fat-like, waxy substance classified as sterol - Poor wound healing surrounded by thin, water-soluble shell
- most of the time, intake of cholesterol is not - Thrombocytopenia
needed Good sources of linoleic acid – corn, cottonseed,
- constituent of brain and nerve tissue, bile peanut, soybean, safflower oils
salts, precursors of Vitamin D
- risk factor : atherosclerosis LIPIDS: DIGESTION AND ABSORPTION
- only 1.5 to 2 g of cholesterol in the body is - Fatty foods stimulates
synthesized per day “enterogastrone”
- high intake of cholesterol raises the total - It inhibits gastric motility and retards
plasma cholesterol level the discharge of food from the
stomach
ATHEROSCLEROSIS “GOOD” and “BAD” cholesterol in the bloodstream
- refers to the buildup of fats, cholesterol and other LIPIDS: METABOLISM AND STORAGE LDL – bad
substances in and on your artery walls (plaque), which *Liver plays an important role in fat HDL - good
can restrict blood flow metabolism by: All fats are not cariogenic but in fact it protects tooth
- Atheromata - deposits of lipids “plaque” - Synthesizing triglycerides from CHO from dental caries bec it forms a protective layer
- Synthesizing cholesterol from
LIPOPROTEINS triglycerides PROTEIN
- carriers of cholesterol and other fatty substances in - Synthesizing phospholipids and - Form important structures of the body
the bloodstream lipoprotein from proteins - Building blocks of the body
1. LDL - low - density lipoprotein - Clearing phospholipid, cholesterol, - Daily protein intake comes from animal
2. HDL - high-density lipoprotein and lipoprotein form plasma sources (milk, meat, egg)
*storage – adipose tissue under the skin - Can also come from vegetables like nuts
ESSENTIAL FATTY ACIDS (EFA) - Large complex molecules basically contain
Functions: CARRYING LIPIDS IN THE BLOODSTREAM CARBON, HYDROGEN, OXYGEN, and
1. Maintain the function and integrity of cell - Lipoproteins - serves as vehicle for NITROGEN arranged into amino acids
membranes transport of lipids from the small - Can also come from phosphorus, sulfur, copper,
2. Used to esterify cholesterol in plasma intestine and liver to the body tissue manganese
3. Required for the metabolism of cholesterol and - Precursor of antibodies and are also essential
other lipids components of enzymes and hormones
- Half of the body weight is protein
Linoleic Acid → 1/3 body protein is found in muscles
- Precursors for a group of hormone like → 1/5 is found in bone and cartilage
compounds “Prostaglandins” → 1/10 skin
- (Prostaglandins: for contraction of certain - Crucial to the regulation and maintenance of
muscles) the body

DNU MIDTERM
PROTEIN: AMINO ACIDS - Nonessential amino acids do not need
- Building block of protein to be supplied from the diet
- Each amino acid has an “acid” group, “amino”
group, and “side” group
- Branch chain amino acids: Leucine, Isoleucine,
and Valine (these three are found in WHEY)

Types of protein (according to the number of AA)

1. Peptide 3. Contributing to acid-base balance
2. Tripeptide - Blood proteins are especially good buffer for
3. Peptose the body
4. peptone - Buffer makes acidic environment into alkaline
Proteins environment
PUTTING PROTEINS TO WORK IN THE BODY
- building body structures 4. Forming hormones and enzymes
1. Producing vital body structures
- about 300g of the 10kg body protein is - Required for the synthesis of many hormones
- “Protein Turnover”: is a process by
replaced daily - Examples: thyroid hormones – TYROSINE
which a cell can respond to its
Insulin – composed of 51 AA
PROTEIN DIGESTION AND ABSORPTION changing environment by producing
5. Contributing to immune function
1. Stomach – presence of hydrochloric acid from proteins that are needed and
- Proteins are key component of the cells within
gastric glands disassembling proteins that are not
the immune system
• Renin – an enzyme that slows down needed
- ANTIBODIES: a protein produced by one type
the passage of milk and acts on casein - During any day, an adult makes and
of WBC; these antibodies can bind to foreign
(protein in milk substance) to form a degrades about 250 grams of protein,
proteins in the body, an important step in
more easily digested curd recycling many of the amino acids
removing invaders from the body
2. Small intestine – enzyme for digestion are: 2. Maintaining fluid balance
6. Forming glucose
• Pancreatic (Trypsin) - Not balance causes edema or
- If there is no sufficient carbohydrate to supply
• Intestinal (Erepsin) namamaga
the glucose, your liver (and kidneys, to a lesser
PROTEIN METABOLISM extent) will be forces to make glucose from
Liver – main site for metabolism; amino acids present in body tissues
- responsible for breakdown into simpler 7. Providing energy
compounds with release of energy of most of - Proteins are a costly source of calories,
the essential amino acids considering the amount of processing the liver
- Nitrogen-end containing products of protein and kidneys must perform to use this calorie
metabolism that are excreted in the urine source
consists mainly of UREA, ammonia, uric acid, 8. Contributing to satiety
creatinine for muscle protein - feeling of being full
- Nitrogen is excreted through urine and feces
PROTEIN NEEDS
AMINO ACIDS ESSENTIAL AND NONESSENTIAL
protein need = protein breakdown
- 22 essential amino acids
DNU MIDTERM
PROTEIN BREAKDOWN → Changes in hair color,
- The amount of breakdown can be determined potassium deficiency, flaky
by measuring the amount of urea and other skin, fatty liver, reduced
nitrogen-containing compounds in the urine muscle mass, and massive
- Balance the protein intake with the losses to edema in the abdomen and
maintain a state of protein equilibrium, also legs. The presence of edema
called protein balance in a child who has some
subcutaneous fat (ie directly
Positive protein balance
under the skin) is the
⚫ Growth
hallmark of kwashiorkor
⚫ Pregnancy
Marasmus
⚫ Recovery stage after illness and injury
- “An infant slowly starves to death”
⚫ Athletic training
- It is caused by diets containing
Protein equilibrium minimal amounts of calories as well as
⚫ Healthy adult meeting nutrient needs notably too the portion and other nutrients
protein and calorie needs. - Commonly represented by a shrunken,
Negative protein balance wasted appearance, loss of muscle
⚫ inadequate protein intake (e. fasting, intestinal mass and subcutaneous fat mass
tract disease)
⚫ inadequate calorie intake
⚫ fevers, burns infections
⚫ increased protein loss (e.g kidney disease)
RDA FOR PROTEIN INTAKE
0.8 grams of protein per kilogram of healthy body
weight
***4 kcal per gram of food
TOO MUCH PROTEIN IN DIET
- Studies shows that high-protein diets can
increase calcium losses in urine
- Colon cancer
- Some researchers have expressed concern that
a high-protein intake may overburden the
kidneys by forcing them to excrete the extra
nitrogen as urea
- Kidney stones

PROTEIN-CALORIE MALNUTRITION
Kwashiorkor
Common symptoms:
→ Apathy
→ Diarrhea
→ Failure to grow and gain weight
→ Withdrawal from environment
Further symptoms:
DNU MIDTERM
WATER & ELECTROLYTES  Major electrolytes as long as 10 weeks, but without H2O, life would be
Drink Ur Water Bhie
- Na. K. cl over in a matter of days”
- Mg, ca “second to O2 in importance to the body”
* Pag mineral water lang
 Non electrolytes WATER RDA
- Glucose & urea in small amount  6-8 8oz glasses of H2o daily
- universal solvent
 2 liters or 2 quarts daily
- w/o water it will not take place
WATER FUNCTION  Depend on the following:
- cant live w/o u (water)
 Promote body processes by acting as solvent - Age
- Digestion, absorption, circulatory, - Body size - determined per kg = 1 ml/kg
WATER
excretion etc for adult
 component of the fluid tissues of the body
 Build tissues- part of tissue structures - Infant 1.5ml/kg
-blood plasma
- Bone - /13 H2O - Activity level
- lymph
- muscle - 2/3 H2O - Diet
- interstitial fluids surrounding cells
- whole body- 4/5 H2O  Additional for infant because of the
 carries dissolved proteins & inorganic salts
 Regulate body temperature high protein formulas
 65-70% total body weight
- Evaporation from the skin & elimination  Additional for patients who are/ have
- Higher in infants, male & athletes
from the lungs coma, fever, polyuria, vomiting,
 Play an important role in cushioning the joint & diarrhea & taking
WATER DISTRIBUTION
internal organ  Climate in which you live
 60% intracellular fluid
 Lubricate body tissues - warm or hot environment
 40 extracellular fluid
- Eyes, lungs & air passages
Interstitial fluid- water that surrounds the
 Protects fetus during pregnancy WATER SOURCES
cells of the tissues
 Helps kidney to function normally  Liquid
Blood plasma & lymph of the circulatory
 Helps maintain electrolyte balance - Water hot tea, coffee, juices, soups
system
 Play an active role in the hydrolysis of nutrient  Solid
- Fruits & vegetables 80 - 95% H2O
ELECTROLYTES
“of all the essential nutrients, H2O is the most - cooked pasta- 60% H2O
 mineral or compounds in water
critical, we can survive on our body’s stored food for - meat- 50% water
 Conduct electricity by means of their ions
- Bread - 30 % H2O by weight
DNU MT
 Water sources resulting from the oxidation of SALIVA ELECTROLYTE
dietary CHO, CHON & fats  Clear, alkaline, somewhat viscid secretion from  Electrolytes are minerls in your blood and
te parotid, submandibular, sublingual & other other body fluids that carry an electrical charge
WATER BALANCE smaller mucous glands of the mouth  Electrolytes exist in the blood as acids, bases,
 The maintenance of a normal fluid environment SALIVA FUNCTIONS and slats (such as sodium, calcium, potassium,
within the body  maintains proper bodily H2O balance chlorine, magnesium, and bicarbonate). they
 Depends on a balance between intake & output  aids in lubrication & swallowing of food can be measured by laboratory studies of the
 acts as buffer and neutralize acid in the oral blood.
WATER INTAKE cavity after eating
 Performed in H2O in liquids (main source)  affects the dental caries formation ELECTROLYTES
- H2O & other beverages 1. Sodium (NA-)
- 1,200 ml -1, 500 ml/day SALIVARY COMPOSITION 2. Potassium (K+)
 Performed H2O in food One liter of saliva consists of: 3. Chloride (Cl)
- 700-100ml/ day - fruits & vegetables  994 g of H2O
 Product of oxidation  3 g of organic materials 1. SODIUM
- 200-300ml/day Mucin, serum albumins, globulin, lysozyme  essential nutrient
- 100g of fat produces 107 g of H2O  2 g inorganic materials  Maintains extracellular fluid volumes cellular
Na, K, P, CA, Cl, CO2, etc osmotic pressures
WATER OUTPUT  1 g of suspended material  Aids in the transmission of nerve impulses
 Leaves the body through: Epithelial cells, disintegrated leukocytes, permeability of cell membrane & muscle
Kidney - 1-2 liters oral bacteria, yeast contraction
Skin - 350 ml  requirements vary from one person to another
Lungs - 350 ml SALIVARY FLOW RATE - Age
Feces- 150-200 ml  Buffering capacity - environmental temperature
 2,600 ml  As flow rate increases, electrolytes, protein - Humidity
Urine 1500 ml concentration & pH increases - amount of physical activity
Stool- 100ml  Proteins & vegetables increases the buffering  Minimum dietary intake of sodium of
Insensible H20- 900ml capacity 200mg/day is necessary to maintain
 CHO decreases the buffering capacity physiological balance in adults
- 0.5 g NaCl or salt = 39% NA
DNU MT
 Safe & adequate daily dietary intake  Low sodium - 140 mg or less per serving  Manifested by:
- 1100-3000 mg of NA  Reduce sodium - 75% reduction in sodium - Muscle weakness
- Food & nutrition board content - Paralysis, reduced or absence if reflexes
 Unsalted, no salt added & without salt - no salt - Mental confusion
SODIUM BALANCE was used in food preservation - Cardiovascular signs :ECG changes, poor
 Maintained by renal and hormonal mechanisms pulse & weak heart sounds
in the kidney & adrenal glands 2. POTASSIUM
 Sources:  Principal cation in intracellular fluid POTASSIUM EXCESS
- Table salt  Present in very small amounts in the  Result from sudden increases in intake of about
- Condiments like soy sauce, fish extracellular fluid 18 g of potassium by an adult
sauce(patis) , seasoning etc  Present in meat, milk & many fruits such as  This can cause fatal cardiac arrest
- Foods that are cured : ham, sausages, banana apples, pears
corned beef  Intracellular potassium is essential in many 3. CHLORIDE
- Preserved food cellular enzymatic function:  Predominantly anion in the extracellular fluid
- Pre-mixed sauces, canned goods, etc - Glycogen synthesis  Is almost entirely absent within the cells
 Uses: - Glucose degradation  Appears in combination with sodium &
- Flavoring agents - Amino acid uptake potassium cations
- Raises the boiling point of water  Chief function of extracellular potassium is to  The highest concentrations:
- Lower the freezing point of water when control cardiac function & muscle and nerve - Found in the secretion of the git
making ice cream irritability - Found in the cerebrospinal fluid
- used as preservatives  Component if HCL in gastric juice
Kosher foods POTASSIUM RDA - HCL=important in initiating protein
Suppressing growth of bacteria - Least 3500 mg per day through food digestion
- can dehydrate some vegetables  Low concentrations
- Help to cure meat POTASSIUM DEFICIENCY - muscle
- Control texture of foods: cheese  Unlikely to occur, because of many sources - nerve tissues
- Regulates fermentation of yeast in bakery  Occur from prolong potassium-free diet or from  Functions:
products excessive losses resulting from diarrhea, - To regulate the osmotic pressure and
 Sodium free - less tha 5 mg per serving diabetic acidosis or use of rugs such as diuretics, water balance in the body
 Very low sodium - 35 mg or less per serving steroid or purgatives
DNU MT
 - Acts as a coenzyme in the digestive - Low CHO, high protein or high fat diet will
process lose large amount of water from excessive
- To maintain the acid-base balance of the oxidation of body fat
blood - Denture wearer= looseness of dentures
- Also aids in the preservation of the - Decrease salivary flow = xerostomia (dry
potassium mouth)
- Burning sensation of the mouth
CHLORIDE DEFICIENCY - Dental caries & gingival irritation
ENERGY-RELEASING: do not provide the body with
 Causes:  Edema
fuel for energy, but without it, the body lacks energy.
- Starvation, fever, diarrhea, excessive - Retain water
B-group vitamins are needed to help the body to use
vomiting & excessive sweating - Denture wearer will tend to have pressure-
the energy-yielding nutrients (such as
 Marked loss, together with potassium induced sore spots on the underlying
carbohydrates, fat and protein) for fuel.
 Result to hypokalemic alkalosis swollen tissue
HEMATOPOIETIC: needed to help cells to multiply
 Decrease in chloride concentration in the
extracellular fluid, increasing the bicarbonate B COMPLEX VITAMINS
concentration, will lead to a state of alkalosis RECALL: VITAMIN B1 (Thiamine)
(accumulation of base) Vitamins naturally occur in food and are needed in
1) Provides energy for the brain
 Cl & K supplements to correct the deficiency very small amounts for various bodily functions.
2) Improvement of neurotransmitters
DEPARTMENT OF HEALTH & HUMAN SERVICES,
3) Proper function of the heart muscles
CHLORIDE RDA STATE GOVERNMENT OF VICTORIA, AUSTRALIA
4) Maintenance of smooth skeletal muscle
 Daily chloride intake is about 2-3 g
 Food sources: Thiamin ( B 1 )
VITAMIN B2 (RIBOFLAVIN)
- Table salts=sodium Riboflavin ( B 2 )
1) Aids in healthy fetal development
- Dairy & meat products Niacin ( B 3 )
2) Boosts mineral absorption in the body
- Fruits & vegetables Pantothenic acid ( B 5 )
3) Strengthens immune and digestive system
Pyridoxine ( B 6 )
EFFECTS OF ATER & ELECTROLYTE ON ORAL Biotin ( B 7 )
VITAMIN B3 (NIACIN)
HEALTH Folate or ‘folic acid’ when included in supplements
1) Supports nervous and digestive system
 Dehydration (B9)
2) For normal growth and healthy skin
Cyanocobalamin ( B 1 2)
3) Vital for energy release in tissues and cells
DNU MT
VITAMIN B5 (PANTOTHENIC ACID) - Pork - Fortified Cereals
1) Contributes to a reduction in tiredness and - Fish - Banana
fatigue - Green Peas
2) Helps release energy from food - Yogurt VITAMIN B7 (BIOTIN)
3) Helps to increase hemoglobin level Beef Liver
VITAMIN B2 (RIBOFLAVIN) - Avocado
VITAMIN B6 (PYRIDOXINE) - Dairy Milk - Pork
1) Assist the body in protein metabolism - Yogurt - Sweet Potato
2) Helps to produce red blood cells - Cheese
vitamin b7 (Biotin)) Lowering blood glucose - Eggs VITAMIN B9 (FOLIC ACID)
2) Maintains healthy hair, skin, and nails - Lean Beef and Pork - Beans
3) Lowers cholesterol - Peanuts
VITAMIN B3 (NIACIN) - Whole Grain
VITAMIN B9 (FOLIC ACID) Red Meat - Beef, Beef Liver and Pork - Seafood
1) Prevention of birth defects and pregnancy - Poultry - Egg
complications - Fish
2) Promotion of brain health - Brown Rice VITAMIN B12
3) Adjunctive treatment of mental health disorders - Fortified Cereals and Bread - Fish
4) Reduction of health risk factors - Red Meat
VITAMIN B5 (PANTOTHENIC ACID) - Egg
VITAMIN B12 - Fortified Cereals - Poultry
1) DNA synthesis - Organ Meat - Milk
2) Energy metabolism - Beef - Cheese
3) Lipid metabolism - Chicken Breast - Yogurt
4) Messenger substances - Mushrooms
5) Detoxification Conditions Associated with Vitamin B Deficiency
VITAMIN B6 (PYRIDOXINE) Beriberi
FOOD SOURCES AND DEFICIENCY - Beef Liver - Caused by Vitamin B1 (Thiamine deficiency)
VITAMIN B1 (Thiamine) - Tuna - Has 2 types: Dry Beriberi and Wet Beriberi
- Fortified Breakfast Cereals - Poultry Overall Symptoms Include:
DNU MT
 - Shortness of breath - Nausea Adolesce Men 14 years and older – { HYPERLINK
- Rapid Heart Rate - Vomiting nts and "https://medlineplus.gov/druginfo/natu
- Decreased Muscle Function in the lower - Thinning Hair adults ral/965.html" }
leg - Brittle Nails Females 14-18 years – 1mg/daily
- Fatigue Pregnant women – 1.4mg/daily
ARIBOFLAVINOSIS - Muscle Pain Breastfeeding women – 1.5mg/daily
- People with kidney disease and undergoing dialysis
has great risk of developing this condition RECOMMENDED DAILY
Symptoms Include: ALLOWANCE
- Sore Lips / Throat RDAs, or recommended dietary allowances, are Riboflavin (Vitamin B2)

- Redness / Swelling of mouth and throat recommendations established by the National Infants 0-6 months – 0.3mg/daily

- Angular Stomatitis Academy of Sciences' Institute of Medicine's Food 7-12 months – 0.4mg/daily

and Nutrition Board. RDAs refer to vitamins and Children 1-3 years – 0.5mg/daily
Pellagra minerals derived from food and supplements taken 4-8 years – 0.6mg/daily
Caused by the inability of body to absorb Niacin on a regular basis. The aim of these 9-13 years – 0.9mg/daily
Most Common Symptoms Include: recommendations is to show you how much of a
- Diarrhea particular nutrient your body requires on a daily Adolesce Males 14-18 years – 1.3mg/daily
- Dermatitis basis. nts and Females 14-18 years – 1mg/daily
- Dementia adults Women 18 years and over – 1.1mg/daily
Thiamine (Vitamin B1) Pregnant women – 1.4mg/daily
Peripheral Neuropathy Infants 0-6 months – 0.2mg/daily Breastfeeding women – { HYPERLINK
- Similar to Pellagra 7-12 months – 0.3mg/daily "https://medlineplus.gov/druginfo/natu
- accompanied by anemia and seizures ral/957.html" }
Children 1-3 years – 0.5mg/daily
- Focused on nerve damage
4-8 years – 0.6mg/daily
- Can impair Muscle movement
Boys 9-13 years – 0.9mg/daily
Girls 9-13 years – 0.9mg/daily
Other Vitamin B Deficiency Symptoms
- Headache
Niacin (Vitamin B3)
- Irritability
- Disturbed Sleep
DNU MT
Infants 0-6 months – 2mg/daily ral/313.html" } Infants 0-12 months – 7mcg/daily
7-12 months – 4mg/daily Children 1-3 years – 8mcg/daily
4-8 years – 12mcg/daily
Children 1-3 years – 6mg/daily
9-13 years – 20mcg/daily
4-8 years – 8mg/daily
9-13 years – 12mg/daily
Adults and Males and females 14-18 years –
Pyridoxine (Vitamin B6) adolescents 25mcg/daily
Adolesce Males 14-18 years and over –
Infants 0-6 months – 0.1mg/daily Men and women over 18 and
nts and 16mg/daily
7-12 months – 0.3mg/daily pregnant women – 30mcg/daily
adults Females 14-18 years and over –
Children 1-3 years – 0.5mg/daily Breastfeeding women –
14mg/daily
4-8 years – 0.6mg/daily 35mcg/daily
Pregnant women – 18mg/daily
9-13 years – 1mg/daily Folate and Folic Acid (Vitamin B9)
Breastfeeding women – { HYPERLINK
"https://medlineplus.gov/druginfo/natu Infants (there is 0-6 months – 65mcg/daily

ral/924.html" } Adolesce Males 14-50 years – 1.3mg/daily no RDA for 7-12 months – 80mcg/daily
nts and Females 14-18 years – { HYPERLINK infants)
adults "https://medlineplus.gov/druginfo/natu Children (RDA) 1-3 years – 150mcg/daily
Pantothenic Acid (Vitamin B5)
ral/853.html" } 4-8 years – 200mcg/daily
Infants 0-6 months – 1.7mg/daily
Men 50 years and over – 1.7mg/daily 9-13 years – 300mcg/daily
7-12 months – 1.8mg/daily
Women 50 years and over – 1.5mg/daily
Pregnant women – 1.9mg/daily
Breastfeeding women – 2mg/daily
Children 1-3 years – 2mg/daily
4-8 years – 3mg/daily
9-13 years – 4mg/daily Biotin (Vitamin B7)
Biotin is made in the body and there is insufficient
Adolesce Men and women 14 years and older – amount in food like red meat, eggs, nuts, etc and it
nts and 5mg/daily has no Recommended daily intake/allowances, but
adults Pregnant women – 6mg/daily an adequate intake (AI) is made. It is similar to the
Breastfeeding women – { HYPERLINK RDA for the vitamin B complex, it is set due to the
"https://medlineplus.gov/druginfo/natu lack of evidence to make a RDA.

DNU MT
Adolescents and Males and females 14-18 years Adolesce Males and females over the age of 14 – { (thiamine pyrophosphate) has been reported by one
adults – 400mcg/daily nts and HYPERLINK study to have a major role in dental caries due to
Men and women 18 years and adults "https://medlineplus.gov/ency/article/ accumulation of pyruvic acid in tissue.
over – 400mcg DFE/daily 002403.htm" }
Pregnant women – 600mcg Pregnant teens and women – Pyridoxine (Vitamin B6)
DFE/daily 2.6mcg/daily Pyridoxine deficiency leads to
Breastfeeding women – Breastfeeding teens and women – increased caries incidence.
500mcg DFE/daily 2.8mcg/daily
Women capable of becoming Other B vitamins
pregnant – 400mcg/daily VITAMIN B COMPLEX OVERDOSE Other B vitamins that have a role in caries formation
Pregnant women with a Niacin flush are biotin, pantothenic acid, folic acid, and inositol.
previous history of neural tube ‒ hot, burning sensation in the face High saliva folic acid level promotes the
defects – 4mg/daily ‒ Caused by too much vitamin B3 (niacin) development of caries and increased levels of
‒ Liver can become damaged inositol
Vitamin B6. acts as cariostatic
Peripheral neuropathy - loss of feeling in the arms
and legs, as well as muscle weakness, can occur as a
result of nerve damage

ORAL RELEVANCE OF B COMPLEX VITAMINS

Cobalamin (Vitamin B12)
B COMPLEX VITAMINS
Infants 0-6 months – 0.4mcg/daily
Vitamin B complex can help prevent irritation of the
(AI) 7-12 months – 0.5mcg/daily
inside and outside of the mouth, These vitamins are
Children 1-3 years – 0.9mcg/daily helpful in preventing cracked lips, inflammation of
4-8 years – 1.2mcg/daily the tongue and irritation inside the mouth and gums.
9-13 years – 1.8mcg/daily The vitamin B complex also helps against gum
disease.

Thiamine (Vitamin B1)

Deficiency of cocarboxylase
DNU MT
VITAMIN C ‒ Fresh fruits (strawberries, tomato) ‒ Antioxdant
a.k.a. Ascorbic acid
“ vitamin C has received a great deal of attention, ‒ Reduce blood uric acid levels
‒ One of the safest and most effective nutrient
and with good reason. Higher blood levels of Vitamin
‒ An essential vitamin
C may be the ideal nutrition marker for overall DEFICIENCY IN VITAMIN C
‒ Water soluble
health.” Mark Moyad, MD, MPH of the University of ‒ Scurvy
‒ To maintain adequate levels of Vitamin C,
Michigan Symptoms:
people need to consume food that contains it,
‒ Generally feeling unwell
everyday.
FUNCTIONS ‒ Fatigue
‒ May reduce risk in chronic disease ‒ Loss of appetite
RECOMMENDED DAILY INTAKE
‒ Antioxidants = molecules that boost ‒ Nausea
Males: 90 mg
immune system, they protect cell from ‒ Diarrhea
Females: 75 mg
harmful cells called FREE RADICALS ‒ Fever
‒ Additional Vitamin C is necessary during and
‒ May help manage high blood pressure ‒ Painful joints and muscles
while breastfeeding
- Systolic= upper value ‒ Small ‘pinpoint’ bleeding around hair
‒ The safe upper limit for Vitamin C is 2,000 mg a
- Diastolic = lower value follicle visible in the skin
day, and there is a great track record with
‒ May lower risk of heart disease
strong evidence that taking 500 mg daily is safe.
- LDL - bad cholesterol levels
‒ While it’s commonly advised to get your
- HDL - good cholesterol levels
Vitamin C intake from foods, many people turn
‒ Protect memory and thinking as you age
to supplements to meet their needs.
- Dementia - term used to describe
symptoms of poor thinking and memory
‒ Helps prevent iron deficiency
- Iron - essential for making red blood cells
and transporting oxygen throughout the
body
‒ Boosts immunity (white blood cells)
‒ Boost eye health
SOURCES OF VITAMIN C ‒ Required for growth and repair of tissue
‒ Citrus fruits (lemon, orange) ‒ Necessary to form collagen
‒ Vegetables (spinach, leafy greens) ‒ Bone formation
DNU MT
 RESULT OF EXCESIVE VITAMIN C ORAL RELEVANCE
‒ Kidney stones An essential antioxidant which maintains and
Consuming too much vitamin C has the repairs gum tissues, reducing the risk of:
potential to increase the amount of oxalate ‒ Gum recession, gum inflammation
in the urine, thus increasing the risk of ‒ Cavities, sensitivity, enamel erosion
developing kidney stones
‒ Digestive symptoms Role in periodontal health
Diarrhea Vitamin C support periodontal health through
‒ Scorbutic gums and pinpoint Nausea maintenance of :
Vomiting ‒ Gingiva
Heartburn ‒ Periodontal ligament
Abdominal cramps ‒ Cementum
Headache ‒ Alveolar bone
Bloating Aids in the collagen synthesis which is a significant
factor in having healthy gums
WHAT ARE THE LIMITATIONS?
‒ People with kidney diseases should avoid
‒ Hemorrhages
taking vitamin C in large doses
‒ Pregnant women should not take large doses of
vitamin C supplements that may increase the
risk of pre-term birth

PREVENTIONS
‒ Drinking more water should also help to flush
out your body and help you recover from an
overdose
‒ The key is to learn how much vitamin C you
TREATMENT
really need.
Vitamin C supplements & citrus fruits

DNU MT
FAT SOLUBLE VITAMINS A,D,E,K ‒ Tocotrienols: alpha-tocotrienol, beta- ‒ A person can obtain some vitamin D from the
‒ Fat soluble vitamins tocotrienol, gamma-tocotrienol and delta- sun
‒ Are similar to oil and do not dissolve in water tocotrienol
‒ Most abundant in high-fat food and are much Alpha-tocopherol is the most common form of Vitamin E
better absorbed into your bloodstream when Vitamin E ‒ Found in plant-based oils,nuts, seeds, fruits, and
you eat them with fat vegetables
‒ Stored in the body’s fatty tissue and in the liver Vitamin K ‒ Wheat germ oil, sunflower (sunflower
‒ Helps to form blood clots seeds),safflower, and soybean oil, almonds,
Vitamins: ‒ Vitamin K1(phylloquinone): found in plant- peanuts(peanut butter), beef greens, collard
Vitamin A sourced foods; it is the main form of Vitamin K greens, spinach
‒ Known as retinol in the diet
‒ Associated with vision and eye health ‒ Vitamin K2(menaquinone) found in animal- Vitamin K
‒ Studied in the prevention and treatment of sourced foods and fermented soy products, like ‒ Vitamin K1 - found in leafy green vegetables
some types of cancers natto; also produced by gut bacteria in the (spinach, broccoli, brussels sprouts, cabbage,
colon lettuces, soybeans and canola oil)
Vitamin D ‒ Synthetic forms: K3 (menadione), vitamin K4 ‒ Vitamin K2 - animal-sourced foods, such as
‒ Sunshine vitamin (menadiol diacetate) and vitamin K5 liver, butter and egg yolks
‒ D2 (ergocalciferol): in mushrooms and some
plants FOOD SOURCES FUNCTIONS OF EACH VITAMINS
‒ D3 (cholecalciferol): in eggs and fish oil, and Vitamin A Vitamin A
produced by your skin when exposed to ‒ Cheese, carrots, yellow and orange vegetables, ‒ Maintenance if normal vision (Retinal + Opsin
sunlight. some leafty, dark-green vegetables(spinach), =RHODOPSIN)
potat, eggs, oily fish, fortified low-fat spreads, ‒ Protect and maintain the cornea and
Vitamin E milk and yogurt, liver and liver products conjunctiva
‒ Type of antioxidant ‒ Maintain surface tissues such as skin, intestine,
‒ Tocopherols: alpha-tecopherol, beta- Vitamin D lungs, bladder and inner ear
tecopherol, gamma-tecopherol and delta- ‒ Oily fish and fish oils - (such as salmon, ‒ Supporting the growth and distribution of T-
tecopherol sardines, mackarel), fortified diary products cells
(plant-based milks and cereals),beef liver, eggs, ‒ Supports healthy skin cells, male and female
mushroom reproduction and fetal development
DNU FINALS
Vitamin D ‒ Plays and integral part in promoting bone Following the consumption of Vitamin D2-
‒ Sunshine vitamin health containing food, about 80% of Vitamin D2 is
‒ Regulating the absorption of calcium and ‒ Ensures calcium-binding action required for the incorporated into micelles in the small intestine and
phosphorus, and facilitating normal immune healthy function of the bones and gums then absorbed and transported to the liver by
system function ‒ Strengthens the skeletal structure chylomicrons through lymphatic system. Patients
‒ Fights diseases (reducing the risk of multiple ‒ Treats osteoporosis and bone loss with chronic fat-malabsorption syndromes (e.g.
sclerosis, decrease the chance of developing ‒ Highly essential in improving dental health cystic fibrosis, Crohn’s disease and celiac disease)
heart disease, reduce the likelihood of have trouble absorbing Vitamin D2 and may develop
developing flu) DIGESTION, ABSORPTION AND METABOLISM a deficiency.
‒ Reduces depression Overview:
‒ Boosts weight loss ‒ Fat soluble vitamins are absorbed along with
dietary fats. Needs adequate absorption
Vitamin E ‒ Utilizes bile salts, pancreatic lipase, healthy,
‒ Protects body tissue from damage caused by intestinal wall
substances called free radicals( free radicals are ‒ Packaged and delivered to target cells in a
increased by: cigarette smoking, exposure to air similar manner to dietary fats- chylomicrons
pollution, high exposure to ultraviolet rays and other blood lipoprotein
from sunlight Vitamin E (alpha-tocopherol)

‒ Help keep the immune system strong against Vitamin A

viruses and bacteria ‒ Absorbed in small intestine
‒ Important in the formation of red blood cells ‒ B-carotene converted into retinol with retinol
‒ Vitamin E can prevent (cancer, heart disease binding protein
dementia, liver disease) ‒ 90% of vitamin A (Retinyl palmitate) is stored
in liver
Vitamin K ‒ It is released into the plasma whenever
‒ Natural remedy for coagulating the blood required
‒ Healing of wounds and reversing the harmful
effects of blood thinning medicines Vitamin D (calcified)
‒ Preventing bleeding disorders in the newborn Absorption of vitamin D2 from food
(Haemorrhagic diseases)
DNU FINALS
Vitamin K (phylloquinone) VITAMIN D Excessive Intake
Deficiency ‒ Vitamin E toxicity - high supplemental doses
‒ Osteoporosis - is a bone disease that occurs of vitamin E may be harmful for certain
when the body loses too much bone, makes too individuals. Side effects: nausea, intestinal
little bone, or both. As a result, bones become distress, and diarrhea. Long-term use may
weak and may break from a fall or, in serious cause hemorrhagic stroke.
cases, from sneezing or minor bumps.
‒ Rickets - is the softening and weakening of VITAMIN K
CONDITIONS RESULTING FROM DEFICIENCY AND bones in children, usually because of an Deficiency
EXCESSIVE INTAKE OF EACH VITAMINS extreme and prolonged vitamin D deficiency. ‒ Vitamin K deficiency bleeding or VKDB -
VITAMIN A occurs when babies cannot stop bleeding
Deficiency Excessive Intake because their blood does not have enough
‒ Xerophthalmia-abnormal dryness of the ‒ Hypercalcemia - is a condition in which the Vitamin K. Vitamin K is essential for normal
conjunctiva and cornea of the eye, with calcium level in your blood is above normal. blood clotting or coagulation, it prevents
inflammation and ridge formation. Too much calcium in your blood can weaken excessive bleeding internally and externally.
‒ Nyctalopia (Night blindness)-the inability to your bones, create kidney stones, and interfere
see well at night or in poor light such as in a with how your heart and brain work. Excessive Intake
restaurant or movie theater. It is often ‒ Vitamin K toxicity - occurs only as a result of
associated with an inability to quickly adapt VITAMIN E supplement overuse. This can lead to excessive
from a well-illuminated to a poorly illuminated Deficiency clotting which could cause a heart attack or
environment ‒ Crohn's disease - is a type of inflammatory stroke. However, this can be reverse by
bowel disease (IBD). It causes inflammation of Warfarin-- a blood thinner used to slow blood
Excessive Intake your digestive tract, which can lead to clotting. Vitamin K toxicity can also cause a
‒ Hypervitaminosis A - condition that occurs abdominal pain, severe diarrhea, fatigue, from of anemia in which red blood cells rupture
when a person has too much vitamin A in their weight loss and malnutrition. (hemolytic anemia).
body. This can happen if a person takes too ‒ Ataxia - is a degenerative disease of the
many supplements or uses certain creams for nervous system. Many symptoms of Ataxia
acne over a prolonged period. Symptoms of mimic those of being drunk, such as slurred
hypervitaminosis A include vision problems, speech, stumbling, falling, and incoordination
changes in the skin, and bone pain.
DNU FINALS
CLINICAL DENTAL SIGNIFICANCE VITAMIN K
VITAMIN A Vitamin K, or potassium, facilitates blood clotting
This vitamin helps keep mucous membranes healthy. and also promotes teeth and bone health
It prevents dry mouth and helps your mouth heal ‒ Broccoli
quickly. VITAMIN A ‒ Collards
Foods that have it: ‒ Spinach and other green, leafy vegetables
‒ Carrots ‒ Bananas
‒ Citrus fruits ‒ Avocados
‒ Dark leafy greens ‒ Mushrooms
‒ Egg yolks ‒ Milk
‒ Fish ‒ Cheese
‒ Yogurt
VITAMIN D ‒ Legume
Vitamin D helps the body absorb calcium while
boosting bone mineral density.
‒ Milk
‒ Yogurt
‒ Hard cheese
‒ Eggs
‒ Fortified cereals
‒ Kale
‒ Fortified non-diary alternatives like soy milk

VITAMIN E
Vitamin E, just like Vitamin C, helps prevent gum
disease by doing two things: reducing inflammation
and serving as an antioxidant

DNU FINALS
MICROMINERALS: CALCIUM, PHOSPHORUS, 11. Emotional reactions The level of calcium balance in a serum is
MAGNESIUM 12. Exercise regulated by:
‒ Parathyroid hormone
CALCIUM Storage of calcium ‒ Calcitonin
Distribution of calcium ‒ Stored in the trabeculae of the long bones ‒ Vitamin D
There is about 1200g of calcium present in adult ‒ Can be withdrawn from the trabeculae from the
body body to maintain a continuous dynamic ROLE OF BONE, KIDNEY AND INTESTINE
99% (1188g) is contained in the bones and teeth equilibrium with the other minerals in the bone Bone - balance of cellular activity, osteoblast in bone
1% (12g) is found in the extracellular fluid and soft and blood production and osteoclast involve in bone
tissues and as part of various membrane structures ‒ The blood and tissue calcium act as a reserve absorption
‒ Blood within the trabeculae is responsible in Kidney - resorbs calcium, regulates the serum
Absorption of calcium transporting the calcium and phosphate salts to calcium and phosphate levels
Absorbed from the intestine by active process those tissues and structures that needs them Intestine- Helps regulate serum calcium and
requiring energy and also by passive ionic diffusion phosphate levels
in the small intestine Excretion:
Only 20-30% of calcium is absorbed and the In dietary intake of 1000g mg of calcium Role of parathyroid hormone (PTH)
remainder is excreted in the feces, urine and 700-800 mg excreted in the feces ‒ Maintains the normal level of serum calcium
perspiration. 150 mg300 mg through lactation of a mother ‒ Its secretion increases when serum calcium
15 mg daily loss through perspiration drops below 7mg/100ml
Factors influencing calcium absorption ‒ Stimulates the synthesis of 1,25-dihydroxy-
1. Needs of the body Regulation of calcium balance: cholecalciferol that causes the increased
2. Gastric acidity ‒ Calcium level is maintained at a constant absorption of calcium from the bone
3. Hormonal influences concentration of 10 mg/100ml of blood ‒ The thyroid gland releases calcitonin, if serum
4. Vitamin D ‒ 60% in ion form & is physiologically active calcium is above 10 mg/100ml, which lowers
5. Calcium to phosphate ratio ‒ 35% is bound to protein high serum calcium level.
6. Lactose ‒ 5% in complexes with citrate, bicarbonate, and ‒ Decreased in 1,25-dihydroxy-cholecalciferol
7. Citric acid phosphate leads to reduced intestinal absorption and bone
8. Dietary protein and phosphorus resorption
9. Oxalic and phytic acids
10. Fat
DNU FINAL
Role of Vitamin D ‒ 84.9% (594.3g) stored in the bone in an Absorption and Excretion
‒ For normal intestinal absorption insoluble form of calcium salt ‒ 1/3 Magnesium is absorbed and utilized by the
‒ Helps maintain bone cells, regulates serum ‒ 15% (105g) located in the cell membrane and body
calcium and serum phosphate the intracellular fluid in the soft tissues in a ‒ High intake of calcium, phosphorus, lactose
‒ Transports dietary calcium to the blood by acid form of organic phosphate interferes with absorption
mechanism ‒ 0.1% (0.7g) present in the extracellular fluid ‒ Unlike calcium, there is little excretion of Mg
through intestine
Toxicity Sources of Phosphorus ‒ Mostly stored in bone
Result to hypercalcemia: ‒ Naturally found in protein-rich foods such as ‒ Regulation of Mg in the blood depends on a
‒ Milk - alkali syndrome meats, poultry, fish, nuts, beans and diary balance between absorption and sodium
Result to high level of calcium serum and urine or products excretion
calcification of soft tissues: ‒ Lost through urine, feces, vomiting, and
‒ Idiopathic hypercalcemia of infants MAGNESIUM diarrhea
‒ Hypercalcinuria 1. One of the major cations in plant and animal
‒ Hyperthyroidism tissues Relationship of phosphate to dental caries
2. Plays an important role in the fundamental Phosphate
PHOSPHORUS enzymatic reactions and protein synthesis ‒ Chemical compound that contains phosphorus
‒ Essential mineral 3. Essential component of bone and teeth ‒ Release of energy as a result of the metabolism
‒ Components of bones, teeth, DNA, and RNA ‒ Cell protein synthesis
‒ Also a component of cell membrane and ATP Distribution of magnesium ‒ Part of the nucleic acids DNA and RNA
The body contains 20-35g of Mg ‒ Buffers
Effect of phosphorus to bone & teeth development 60% as phosphates & carbonates in bone ‒ Acid-base balance
‒ Plays an important role in how the body uses 40% other cells and soft tissues (muscles and body
carbohydrates and fats fluids) Chemistry:
‒ Phosphorus works with calcium to help build ‒ 2nd to potassium in predominant metallic cation ‒ Is a phosphate ion that is conjugate base of
bones in living cells hydrogen phosphate
‒ rd
3 most abundant mineral in teeth ‒ It is a phosphate ion and trivalent inorganic
Distribution of phosphorus ‒ Central component of chlorophyll anion
Total amount of phosphorus is 500-700g in the ‒ Anion, salt, functional group or ester derived
human body from a phosphoric acid
DNU FINAL
‒ It most commonly means orthophosphate, a Clinical trials of Phosphates added to chewing Sources and functions
derivative of orthophosphoric acid gum Calcium
Baron 1. Bone and tooth formation
DENTAL CARIES ‒ Regular gum = more dental caries 2. Nerve impulse transmission
‒ Localized demineralization ‒ Dicalcium phosphate sugar- base chewing gum 3. Muscle contraction
‒ Tooth decay is safer 4. Clotting factors
‒ Causes the breakdown of the tooth enamel
‒ Erosions of the surface of the tooth caused by Finn & Jameson Phosphorus
the combined effects of bacteria, acids, plaque ‒ Sugar gun 1. Plays a major role in structural framework of DNA
and tartar ‒ Sugarless gum and RNA
‒ Sugar gum with dicalcium phosphate additive 2. Mostly associated with calcium as a part of the
Symptoms: ‒ 20% reduction in DMFS (decayed, missing and mineral structure of bones and teeth
‒ Holes in the surface of a tooth filled surfaces) 3. It is also needed for the body to make proteins for
‒ Pain when chewing the growth, maintenance , and repair of cells and
‒ Sensitivity to hot or cold foods and beverages 3rd Clinical trial tissues.
‒ Toothache ‒ Control group not chewing any gum 4. Helps oxygen delivery in the blood
‒ Group chewing gum with dicalcium phosphate 5. Helps maintain our energy levels
Phosphate and dental caries (HISTORY) sugar
Lennox ‒ Group chewing a sugarless gum Magnesium
‒ 1931 1. Bone health
‒ White south africans Phosphate on dental caries 2. Glucose control and insulin metabolism
‒ Extensively destroyed ‒ Greatly reduces the development of 3. Cardiovascular health
‒ Phosphorus - deficient soils experimental caries 4. Migraine headaches
‒ Pit-and-fissures sealants containing amorphous
Osborn and Noriskin calcium phosphate SOURCES
‒ 1937 ‒ Repair teeth through a process known as Calcium
‒ African Bantus remineralization ‒ Cheese,seeds, yogurt, sardines and canned
‒ Unprocessed natural foods salmon, beans and lentils, leafy greens, bread,
‒ Low incidence of dental caries almonds, diary products, orange
‒ Phytates and organic phosphate
DNU FINAL
Phosphorus TYPES OF FLUORIDE Gel / foams (TOPICAL DELIVERY)
‒ Nuts, meats, fish, beans lentils, beef, squash and ‒ Systemic delivery ‒ Delivered by dentists through the use of tray
pumpkin seeds, almonds, firm tofu, diary - Water fluoridation and are seated in the mouth for a few minutes
products ‒ Topical delivery ‒ Patients should not eat/smoke for half and hour
- toothpaste for fluoride absorption
Magnesium - mouth rinse
‒ Spinach, nuts, legumes, whole grains, bananas, - gels/foams Varnish (TOPICAL DELIVERY)
leafy greens, dark chocolate, peanuts, oatmeal, - varnish ‒ Contains high fluoride concentrations applied
avocado - tablet supplements using a brush
‒ Patients are advised not to brush for the whole
FLUORIDE & THEIR ROLE IN DENTAL CARIES Water fluoridation (SYSTEMIC DELIVERY) day
PREVENTION ‒ Controlled adjustment of fluoride to a public ‒ Reapplication every 6 month is recommended
‒ Compound of fluorine with another element or water supply
radical ‒ Fluoridated water contains fluoride at a level Tablet supplements (TOPICAL DELIVERY)
‒ Fluoride containing compounds are used in effective for preventing caries ‒ Need prescription
preventing tooth decay ‒ Increases rate of remineralization in early ‒ Commonly given to those with non-fluoridated
‒ Commonly used in dentistry to strengthen stages of cavities water supply ad have high caries risk
enamel ‒ 6 month - 16 years old are carefully prescribed
‒ Mineral in the bones and teeth Toothpaste (TOPICAL DELIVERY) depending on the level of fluoride they acquire
‒ Most convenient and known delivery method
FUNCTIONS OF FLUORIDE ‒ 1,350 to 1500 ppm(PART PER MILLION) SIGNIFICANCE OF FLUORIDE IN THE
‒ Mineralization of bones and teeth (fluoride levels for adults and children no PREVENTION OF CARIES
‒ Slows down the loss of minerals from tooth younger than 3) ‒ Tooth enamel is composed of hydroxyapatite
enamel ‒ Low pH = dissolution of hydroxyapatite
‒ Reverse early signs of tooth decay Mouth rinse (TOPICAL DELIVERY) (demineralization)
‒ Protects teeth from dental caries (added in ‒ Aid in flushing out food debris and bacteria
toothpaste) ‒ Has many variants (alcohol and no alcohol) How do we prevent demineralization?
‒ Has antimicrobial effect ‒ Non-alcoholic containing are advised for ‒ One of the most effective methods of
children preventing caries is remineralization through
fluoride therapy
DNU FINAL
Remineralization ‒ It gets into the enamel through the SYSTEMIC FLUORIDE & TOPICAL FLUORIDE:
‒ Hydroxyapatite → fluorapatite (when fluoride remineralization process of the teeth SURFACE AND ACTIONS
is present in oral fluids) ‒ It forms a compound called fluorapatite Systemic Fluoride
- F⁻⁻ replace OH⁻⁻ in the formation of the ‒ Fluorapatite is Fl + Ca + PO4 ‒ It is also referred to as water fluoridation in the
apatite crystal lattice ‒ Fluorapatite is stronger and can resists decay U.S.
‒ Fluorapatite is less soluble than hydroxyapatite better than hydroxyapatite ‒ These are ingested in the body and become
even under acidic conditions incorporated into forming tooth structures.
‒ When hydroxyapatite is dissolved under ‒ It’s mechanism of action is from the topical
cariogenic conditions, fluorapatite is protection as the fluoride present in saliva
incorporated into demineralized enamel = provides a constant source that is also
demineralization is inhibited incorporated into plaque and facilitates
remineralization
‒ With fluoride treatment, a noncavitated lesion Preventive action:
can be remineralized with fluorapatite and have 1. It decreases the solubility of enamel in acid by
greater resistance to subsequent converting hydroxyapatite into less soluble
demineralization than hydroxyapatite Even fluorhydroxyapatite or fluorapatite.
when available at very low concentrations, 2. It incorporates in plaque and reduces the ability of
fluoride is effective as an anticaries agent acid production by the plaque organisms.
‒ With fluoride treatment, caries can be 3. It promotes the remineralization of enamel in
prevented. areas that have been demineralized by acids
‒ Loss of minerals can be slowed down and
reversed as well, in case of early signs of tooth ‒ Among the three mechanisms, remineralization
decay. action of fluoride is most important and
requires calcium and phosphate.
MECHANISMS OF ACTION OF FLUORIDE IN ‒ It’s cariostatic effect is attributed to the reduced
CARIES PREVENTION solubility of the enamel due to the
Fluoride mechanism incorporation of fluoride into the enamel
‒ Fluoride is easily absorbed & taken up into the minerals during tooth formation.
enamel

DNU FINAL
Sources: Fluoride mouth rinses or brush-on gels may be ‒ Hypocalcemia
 Water fluoridation recommended for school aged children with active ‒ Tetany specially of hand an feet
 Dietary supplements (tablets, drops, or caries or at high risk for caries. Indicators of ‒ Hypotension and hypersalivation
lozenges) increased caries risk may include: ‒ Mixed metabolic and respiratory acidosis due
 Fluoride present in food and beverages ‒ Orthodontic or prosthodontic appliances to failure of renal/respiratory system
 Salt and milk fluoridation ‒ Reduced salivary function ‒ Coma and convulsions leading to death
‒ Inability to clean teeth properly
Systemic fluoride such as community water ‒ Dietary risks Chronic effects
fluoridation and dietary fluoride supplements are ‒ Siblings with caries ‒ Dental fluorosis
effective in reducing tooth decay. ‒ High oral levels of cariogenic bacteria ‒ Skeletal fluorosis
‒ Hyprsenstivity reactions
TOPICAL FLUORIDE RDA & TOXICITY LEVEL ‒ Dyspepsia, gastric irritation
‒ Strengthen teeth that is already present in the ‒ Insufficiency of renal system
mouth, making them more decay resistant. ‒ Numbness, macular spasm
‒ It is applied directly to and absorbed by the ‒ Birth defects and cancer
surface of the teeth.
‒ May result in a significant reduction in caries as CONDITION RESULTING FROM
the fluoride gets integrated into the enamel EXCESSIVEFLUODE INTAKE
matrix, hardening the structure and making it Dental fluorosis
more resistant to demineralization. ‒ It is the appearance of faint white lines or
streaks on the teeth that only occurs when
Sources: younger children consume too much fluoride,
‒ Self -applied topical fluorides from any source, over long periods when teeth
- Toothpastes, mouth rinses, and gels are developing under the gums.
(contain a safe and effective concentration ‒ People with fluorosis are relatively resistant to
of fluoride to fight tooth decay) dental caries (tooth decay caused by bacteria),
‒ Professionally applied topical fluorides although there may be cosmetic concern.
- higher-strength rinses, gels, foams,
EFFECTS OF FLUORIDE TOXICTY
fluoride varnishes, and silver diamine
Acute effects
fluoride
‒ Nausea, vomiting
DNU FINAL
 T3 and T4—this is a typical feature of ‒ Secondary HPT occurs when a disease outside
hypothyroidism. of the parathyroid glands causes the
‒ With prolonged fluoride exposure, the entire parathyroid glands to become hyperactive.
function of the thyroid gland can be suppressed,
causing TSH levels to diminish.

Skeletal fluorosis
‒ It is a serious condition, resulting from chronic hyperparathyroidism
ingestion of large amounts of fluoride over
many years during periods of bone modeling Neurological problems
(growth) and/or remodeling. ‒ For years health experts have been unable to
Thyroid problems: Hyperparathyroidism
‒ In skeletal fluorosis the bones are generally agree on whether fluoride in the drinking water
‒ HPT affects one or more of the parathyroid
weaker than normal with stiffness and pain in may be toxic to the developing human brain.
glands, which help the body manage its calcium
the joints as the early symptoms. ‒ Extremely high levels of fluoride are known to
levels.
cause neurotoxicity in adults, and negative
‒ The parathyroid glands produce parathyroid
impacts on memory and learning have been
hormone (PTH), which regulates calcium in the
reported in rodent studies, but little is known
blood.
about the substance’s impact on children’s
‒ If a person is dealing with HPT, the parathyroid
neurodevelopment.
glands produce excess amounts of PTH; this
causes calcium levels in the blood to rise and
“Fluoride seems to fit in with lead, mercury, and
can result in mild to severe side effects.
other poisons that cause chemical brain drain,”

Thyroid problems: hypothyroidism Grandjean, a researcher in China, says.

Two types of HPT
‒ Fluoride increases the concentration of TSH ‒ Primary HPT occurs when the body produces
(thyroid stimulating hormone) and decreases “The effect of each toxicant may seem small, but the
an excess amount of PTH due to hyperactivity
combined damage on a population scale can be
of one or more of the parathyroid glands.
DNU FINAL
serious, especially because the brain power of the
next generation is crucial to all of us.”

Fluoride poisoning
‒ It is a condition in which there are elevated
levels of the fluoride ion in the body.
‒ Whilst fluoridated water is associated with
decreased levels of fractures in a population,
toxic levels of fluoride have been associated
with a weakening of bones and an increase in
hip and wrist fractures.

Acute, high-level exposure to fluoride can lead to:

‒ abdominal pain
‒ excessive saliva
‒ nausea and vomiting
‒ seizures and muscle spasms

DNU FINAL
FAT SOLUBLE VITAMINS A,D,E,K ‒ Tocotrienols: alpha-tocotrienol, beta- ‒ A person can obtain some vitamin D from the
‒ Fat soluble vitamins tocotrienol, gamma-tocotrienol and delta- sun
‒ Are similar to oil and do not dissolve in water tocotrienol
‒ Most abundant in high-fat food and are much Alpha-tocopherol is the most common form of Vitamin E
better absorbed into your bloodstream when Vitamin E ‒ Found in plant-based oils,nuts, seeds, fruits, and
you eat them with fat vegetables
‒ Stored in the body’s fatty tissue and in the liver Vitamin K ‒ Wheat germ oil, sunflower (sunflower
‒ Helps to form blood clots seeds),safflower, and soybean oil, almonds,
Vitamins: ‒ Vitamin K1(phylloquinone): found in plant- peanuts(peanut butter), beef greens, collard
Vitamin A sourced foods; it is the main form of Vitamin K greens, spinach
‒ Known as retinol in the diet
‒ Associated with vision and eye health ‒ Vitamin K2(menaquinone) found in animal- Vitamin K
‒ Studied in the prevention and treatment of sourced foods and fermented soy products, like ‒ Vitamin K1 - found in leafy green vegetables
some types of cancers natto; also produced by gut bacteria in the (spinach, broccoli, brussels sprouts, cabbage,
colon lettuces, soybeans and canola oil)
Vitamin D ‒ Synthetic forms: K3 (menadione), vitamin K4 ‒ Vitamin K2 - animal-sourced foods, such as
‒ Sunshine vitamin (menadiol diacetate) and vitamin K5 liver, butter and egg yolks
‒ D2 (ergocalciferol): in mushrooms and some
plants FOOD SOURCES FUNCTIONS OF EACH VITAMINS
‒ D3 (cholecalciferol): in eggs and fish oil, and Vitamin A Vitamin A
produced by your skin when exposed to ‒ Cheese, carrots, yellow and orange vegetables, ‒ Maintenance if normal vision (Retinal + Opsin
sunlight. some leafty, dark-green vegetables(spinach), =RHODOPSIN)
potat, eggs, oily fish, fortified low-fat spreads, ‒ Protect and maintain the cornea and
Vitamin E milk and yogurt, liver and liver products conjunctiva
‒ Type of antioxidant ‒ Maintain surface tissues such as skin, intestine,
‒ Tocopherols: alpha-tecopherol, beta- Vitamin D lungs, bladder and inner ear
tecopherol, gamma-tecopherol and delta- ‒ Oily fish and fish oils - (such as salmon, ‒ Supporting the growth and distribution of T-
tecopherol sardines, mackarel), fortified diary products cells
(plant-based milks and cereals),beef liver, eggs, ‒ Supports healthy skin cells, male and female
mushroom reproduction and fetal development
DNU FINALS
Vitamin D ‒ Plays and integral part in promoting bone Following the consumption of Vitamin D2-
‒ Sunshine vitamin health containing food, about 80% of Vitamin D2 is
‒ Regulating the absorption of calcium and ‒ Ensures calcium-binding action required for the incorporated into micelles in the small intestine and
phosphorus, and facilitating normal immune healthy function of the bones and gums then absorbed and transported to the liver by
system function ‒ Strengthens the skeletal structure chylomicrons through lymphatic system. Patients
‒ Fights diseases (reducing the risk of multiple ‒ Treats osteoporosis and bone loss with chronic fat-malabsorption syndromes (e.g.
sclerosis, decrease the chance of developing ‒ Highly essential in improving dental health cystic fibrosis, Crohn’s disease and celiac disease)
heart disease, reduce the likelihood of have trouble absorbing Vitamin D2 and may develop
developing flu) DIGESTION, ABSORPTION AND METABOLISM a deficiency.
‒ Reduces depression Overview:
‒ Boosts weight loss ‒ Fat soluble vitamins are absorbed along with
dietary fats. Needs adequate absorption
Vitamin E ‒ Utilizes bile salts, pancreatic lipase, healthy,
‒ Protects body tissue from damage caused by intestinal wall
substances called free radicals( free radicals are ‒ Packaged and delivered to target cells in a
increased by: cigarette smoking, exposure to air similar manner to dietary fats- chylomicrons
pollution, high exposure to ultraviolet rays and other blood lipoprotein
from sunlight Vitamin E (alpha-tocopherol)

‒ Help keep the immune system strong against Vitamin A

viruses and bacteria ‒ Absorbed in small intestine
‒ Important in the formation of red blood cells ‒ B-carotene converted into retinol with retinol
‒ Vitamin E can prevent (cancer, heart disease binding protein
dementia, liver disease) ‒ 90% of vitamin A (Retinyl palmitate) is stored
in liver
Vitamin K ‒ It is released into the plasma whenever
‒ Natural remedy for coagulating the blood required
‒ Healing of wounds and reversing the harmful
effects of blood thinning medicines Vitamin D (calcified)
‒ Preventing bleeding disorders in the newborn Absorption of vitamin D2 from food
(Haemorrhagic diseases)
DNU FINALS
Vitamin K (phylloquinone) VITAMIN D Excessive Intake
Deficiency ‒ Vitamin E toxicity - high supplemental doses
‒ Osteoporosis - is a bone disease that occurs of vitamin E may be harmful for certain
when the body loses too much bone, makes too individuals. Side effects: nausea, intestinal
little bone, or both. As a result, bones become distress, and diarrhea. Long-term use may
weak and may break from a fall or, in serious cause hemorrhagic stroke.
cases, from sneezing or minor bumps.
‒ Rickets - is the softening and weakening of VITAMIN K
CONDITIONS RESULTING FROM DEFICIENCY AND bones in children, usually because of an Deficiency
EXCESSIVE INTAKE OF EACH VITAMINS extreme and prolonged vitamin D deficiency. ‒ Vitamin K deficiency bleeding or VKDB -
VITAMIN A occurs when babies cannot stop bleeding
Deficiency Excessive Intake because their blood does not have enough
‒ Xerophthalmia-abnormal dryness of the ‒ Hypercalcemia - is a condition in which the Vitamin K. Vitamin K is essential for normal
conjunctiva and cornea of the eye, with calcium level in your blood is above normal. blood clotting or coagulation, it prevents
inflammation and ridge formation. Too much calcium in your blood can weaken excessive bleeding internally and externally.
‒ Nyctalopia (Night blindness)-the inability to your bones, create kidney stones, and interfere
see well at night or in poor light such as in a with how your heart and brain work. Excessive Intake
restaurant or movie theater. It is often ‒ Vitamin K toxicity - occurs only as a result of
associated with an inability to quickly adapt VITAMIN E supplement overuse. This can lead to excessive
from a well-illuminated to a poorly illuminated Deficiency clotting which could cause a heart attack or
environment ‒ Crohn's disease - is a type of inflammatory stroke. However, this can be reverse by
bowel disease (IBD). It causes inflammation of Warfarin-- a blood thinner used to slow blood
Excessive Intake your digestive tract, which can lead to clotting. Vitamin K toxicity can also cause a
‒ Hypervitaminosis A - condition that occurs abdominal pain, severe diarrhea, fatigue, from of anemia in which red blood cells rupture
when a person has too much vitamin A in their weight loss and malnutrition. (hemolytic anemia).
body. This can happen if a person takes too ‒ Ataxia - is a degenerative disease of the
many supplements or uses certain creams for nervous system. Many symptoms of Ataxia
acne over a prolonged period. Symptoms of mimic those of being drunk, such as slurred
hypervitaminosis A include vision problems, speech, stumbling, falling, and incoordination
changes in the skin, and bone pain.
DNU FINALS
CLINICAL DENTAL SIGNIFICANCE VITAMIN K
VITAMIN A Vitamin K, or potassium, facilitates blood clotting
This vitamin helps keep mucous membranes healthy. and also promotes teeth and bone health
It prevents dry mouth and helps your mouth heal ‒ Broccoli
quickly. VITAMIN A ‒ Collards
Foods that have it: ‒ Spinach and other green, leafy vegetables
‒ Carrots ‒ Bananas
‒ Citrus fruits ‒ Avocados
‒ Dark leafy greens ‒ Mushrooms
‒ Egg yolks ‒ Milk
‒ Fish ‒ Cheese
‒ Yogurt
VITAMIN D ‒ Legume
Vitamin D helps the body absorb calcium while
boosting bone mineral density.
‒ Milk
‒ Yogurt
‒ Hard cheese
‒ Eggs
‒ Fortified cereals
‒ Kale
‒ Fortified non-diary alternatives like soy milk

VITAMIN E
Vitamin E, just like Vitamin C, helps prevent gum
disease by doing two things: reducing inflammation
and serving as an antioxidant

DNU FINALS
TRACE MINERALS  Cobalt is a naturally occurring element in the  Boost immunity. Research shows that increased
TABLE OF CONTENTS earth's crust. It is a very small part of our selenium in the blood can speed up immune
1. DEFINITION Selenium, copper, cobalt, environment. system response
manganese  Cobalt is a component of vitamin B12, which
2. IMPORTANCE Of each trace elements to the supports the production of red blood cells. COPPER
body and functions  Very small amounts are needed for animals and  Antioxidant properties Contains antioxidants, it
3. ROLE Of each trace elements in oral health humans to stay healthy. Cobalt poisoning can may reduce the production of free radicals
4. CONDITIONS Resulting from excessive intake of occur when you are exposed to large amounts  Collagen production Help the body to replace
each elements of it. damaged connective tissues and the collagen
needed to hold bones together
1. DEFINITION Selenium, copper, cobalt, manganese MANGANESE  Boost immunity Maintaining copper levels in
SELENIUM  Manganese is a trace mineral that is present in the body may help with the production
 An essential mineral that is a component of an tiny amounts in the body. It is found mostly in  Improve cardiovascular health Helps maintain
antioxidant enzyme, glutathione reductase, that bones, the liver, kidneys, and pancreas. healthy bones, blood vessels, nerves, and
is key in tissue respiration.  Manganese helps the body form connective contributes to iron absorption
 Food sources of selenium include seafoods; tissue, bones, blood clotting factors, and sex
some meats, such as kidney and liver; and some hormones. COBALT
grains and seeds.  Found in several foods including nuts, legumes,  Production of red blood cells. Helps in the
seeds, tea, whole grains, and leafy green formation of hemoglobin; regulate and
COPPER vegetables stimulate the production of some coenzymes.
 A metallic element (atomic number 29; atomic  Multiple. Sclerosis Aids in the repair of myelin
weight 63.56) that is an essential trace mineral. 2. IMPORTANCE Of each trace elements to the body sheath; good for the treatment of sclerosis
 It is linked to key metabolic reactions, including and functions
in iron absorption and metabolism, and the SELENIUM MANGANESE
formation of red blood cells and nerve  Powerful antioxidant. Helps reduce oxidative  Controls sugar level Normalizes insulin
 It is present in mollusks, organ meats, nuts, stress, which can damage healthy cells. synthesis and secretion
legumes and seeds.  Promotes thyroid health. Plays an important  Prevents osteoporosis Essential mineral proved
role in thyroid hormone synthesis and to add to bone density and overall mineral
COBALT metabolism density

DNU FINALS
 Healthy bones Essential for the proper growth IODINE (I) - functions  Adequate supplementation of Selenium
of human bone structure  Synthesis of thyroid hormones could produce cytoprotective effects and
 Alleviates PMS Syndrome Helps to alleviate the  Regulates functions of immune cells. antiulcer activity
mood swings, headaches, depression and etc.  Has anticancer properties  It can effectively reduce the duration and
 Improves thyroid health Helps enzymes severity of oral mucositis due to its anti-
function; plays a role in the production of 4. ROLE IN ORAL HEALTH inflammatory and antioxidant effect.
thyroxine SELENIUM
COPPER
3. FUNCTIONS of trace elements; iron, chromium,  It has a significant impact on the acid
fluorine, iodine solubility of enamel, which is a basic
process in the development of dental
IRON- functions caries and erosion.
 supports healthy skin, hair and nails  Higher caries prevalence is found to be
 production of blood, hemoglobin, myoglobin, related to the existence of copper in water,
cytochromes, and other enzymes. food, soil or vegetables.
 helps convert blood sugar to energy  Deficiency of Cu in diet for a prolonged
 boosts the immune system period especially during stages of active
growth leads to anemia and defective
CHROMIUM (Cr) - functions  Decrease in the concentrations of selenium keratinisation in the oral cavity
 Plays a role in immune function and growth will result in increased oxidative stress  It is a part of vitamin B12 also referred to as
 Assists insulin as it transports glucose from the inside the body tissues with inadvertent extrinsic factor, is essential for formation
blood into the cells harmful effects. of erythrocytes.

 nutritional supplementation with this trace  Most well-known manifestation of cobalt

FLUORINE (F) - functions Element is an important rationale in the deficiency in oral cavity is pernicious
 It prevents the development of dental caries treatment of premalignant lesions like anemia which is characterized by glossitis,
 It is necessary for the proper development of leukoplakia, conditions as Oral burning sensation, beefy red tongue
bone submucous fibrosis (OSMF), and oral present in the form of patches or
 It inhibits the activities of certain enzymes cancer patients to reduce oxidative stress completely red tongue which is also

inside the body referred to as Hunters’ or Moeller’s

glossitis, and rarely shallow ulcers.
DNU FINALS
 reactions in the form of OLR. Some studies CONDITIONS CAUSED BY Excessive use of iron,
have linked OLR to risk of malignant chromium, fluorine, iodine
transformation SELENIUM
You only need
MANGANESE  - 75 μg a day for men - 60μg a day for
 The manganese concentrations in enamel women
are between 0.08 and 20 ppm, equivalent  Too much could lead to SELENOSIS A
to 0.08–20 mg/kg and dentin between 0.6 condition characterized by:
 Oral lichen planus and oral lichenoid and 1000 ppm. ‒ Loss of hair (alopecia)
reactions have been linked to their  Mn concentration is at enamel-dentin limit ‒ Loss of nails (onycholysis)
exposure to Cr, Co, Ni, and amalgam alloys at the external surface of enamel and ‒ Liver and kidney problems
that are released from metal alloys higher at permanent dentition compared
commonly used in dentistry in the oral to primary dentition COPPER
cavity.  Manganese is increasingly related to decay  You only need 1.2 mg/ day (19 - 64 years
prevalence. old)
 In places where manganese content is  Too much could lead to:
higher, dental caries incidence also ‒ Stomach pain
increased. ‒ Diarrhea
‒ Fatigue
‒ Damage to liver and kidneys (for
longer consumption)
COBALT
 You only need 1.2 mg/ day (19 - 64 years
old)
 Too much could lead to:
 These trace metals when released from the
‒ Nausea and vomiting
metal alloys come into direct contact with
‒ Long term
oral mucosa, leading to immune mediated
‒ Cardiomyopathy
damage of basal epithelial keratinocytes
‒ Polycythemia
and subsequently inducing sensitivity
‒ Goiter
DNU FINALS
MANGANESE Dietary Reference Intakes in the Adult and older  limited sun exposure
 Less than 4 mg will not cause harm for adult * 90% of older adults: Vit. D deficient
most people *corticosteroids and anticonvulsants: Vit. D & Ca
 Less than 0.5 mg for older and sensitive compromise
people *Gastric acid suppressing medications: increased
 Too much could lead to: fracture risk (altered calcium absorption)
‒ Manganism
‒ Muscle pain
‒ Nerve damage
‒ Fatigue
Energy needs
‒ Depression
 ↓energy requirement
 ↓physical activity levels
Dietary & Nutritional needs of the
Elderly
Counteractions: Resistance training routines for
Medical Changes and Disease-Related
senior citizens Dietary sources
‒ Treatment & condition -> high
 Minimal : leg press, chest press, seated row  Milk, liver, ghee (calcified butter)
nutritional risk
 Extended: overhead press, full down, leg
‒ Disease pathophysiology -> altered
extension, leg curl, low back extension, Calcium Dietary sources
absorption or utilization of nutrients
abdominal flexion, neck extension  Yogurt, cheese, fish, orange juice, green
‒ Difficulty in performing daily
leafy vegetables
activities
Calcium and Vitamin D
‒ All affect nutritional health
 ↑ Calcium &Vitamin D Vitamin B12
(omeprazole, diuretic, simvastatin)
 ↑ Vitamin D , ↑50yrs: 2x,70yrs: 3x inability to cleave protein-vitamin B12 bond = poor

*young adults: 5mcg vitamin B12 absorption (<- altered production of

Nutrition Recommendations for the Older Adult
intrinstic factor) <-> ↑ Vitamin B12 & ↑ 51yrs
‒ ↓ muscle mass & activity = ↑ Vitamins
Reasons for Vitamin D deficiencies in older adults
B12,B6, D, and Calcium (↑50 yrs)
 poor intake  2.4 mcg (synthetic)

 decreased endogenous synthesis o not bound to protein

(production inside the body)

DNU FINALS
  does not need acidic gastric The Modified MyPyramid for Older Adults Risk factors
environment  Pressure ulcers
 Wounds
Symptoms of Vitamin B12 deficiency  Trauma
 macrocytic anemia  Burns
 forgetfulness  Sepsis
 inability to concentrate  Malabsorption
 sensory disturbances
Malnutrition
Synthetic B12 Sources  Close to 60% of hospitalized or
Dehydration
 Cereal, soy milk institutionalized older persons are
Dehydration is condition caused by the loss of too
much fluid from the body. malnourished compared with close to 27%
Vitamin B6 of those living in the community
 ↑ Vitamin B6, ↑50 yrs  Malnutrition is often manifested in the form
Signs and symptoms
 female: 1.5 mg daily of unintentional weight loss in the older
 Dry mouth
 male: 1.7 mg daily person.
 Tiredness or fatigue
Sources  Factors: Poor wound healing, skeletal
 Sunken eyes
 Eggs, fish, chicken muscle loss, altered pharmacokinetics, and
 A decrease in urination
diminished immune response
 Urine that's a darker color than normal
Fluid
 Muscle cramping
Recommended daily intake of water from all sources: Why Does Malnutrition Occur in Older Adults?
 Feeling dizzy or lightheaded
 3.7 Liters - MEN  Undernutrition occurs because of three
 2.7 Liters - WOMEN primary reasons:
Protein
These contributes to fluid intake but should not be o decreased intake
 0.8 mg/kg body weight is needed for both
consumed in excess o increased losses of nutrients
younger and older adults. Some researchers
 Beer, gins, alcoholic beverages o increased nutritional needs that go
recommend 1 mg/kg body weight per day.
unmet.
 Financial constraints can lead to limitation
 In almost 25% to 40% of older adults with
of protein-containing foods because of the
unintentional weight loss, no known cause
cost of many of these foods
is found
DNU FINALS
Decreased Intake  GUSTATORY Nutritionally related oral problems in Elderly
 Changes in appetite associated with aging ➔ Mediated through the papillae, taste buds, patients: Nutritional Anemias: Painful, Burning
o Sedation and free nerve endings found in tongue and Tongue
o altered taste in hard and soft palates in the pharynx.  Pernicious anemia (Addison's anemia)
o gastrointestinal (GI) symptoms. ➔ In general, the number of these
 Pain structures appears to decreased with age.
 Physical conditions and disease ➔ A result of hyperkeratinization of the
o Symptoms: shortness of breath and epithelium that occludes taste bud ducts.
fatigue leave little energy for the ➔ Caused by Vitamin A inadequacy.
effort of eating
 Macrocytic anemia due to Vitamin B12
Xerostomia (Dry Mouth)
deficiency
Nutritionally related oral problems in Elderly  lack of saliva results to:
 Lack of intrinsic factor (atrophy of the
patients ➔ Dry and often painful mucosa.
gastric mucosa)
1. Alterations in Gustation and Olfaction ➔ Hinders chewing food because it
General Symptoms:
2. Xerostomia (Dry Mouth) prevents formation of a bolus.
 generalized weakness
3. Painful, Burning Tongue ➔ Make mouth sore and chewing
 numbness or tingling of the extremities.
4. Oral Mucous Membrane Problems painful.
 a sore, painful tongue:
5. Temporomandibular Joint Pain ➔ Make swallowing difficult
o atrophy of the papillae, dark red,
6. Alveolar Osteoporosis ➔ Causes change in taste
rather than the normal pink.
perception that decreases adequate
o oral mucosa exhibits a pale
Alteration in gustation and olfaction food intake
yellowish tinge
 OLFACTION  Prevention:
Treatment:
➔ Act of perceiving odors. ➔ chew sugar-free gums to
 Intramuscular administration of vitamin
➔ Odors of food contribute to its stimulate flow of saliva
B12
palatability. ➔ limit caffeine intake
➔ As a person gets older, olfactory function ➔ avoid mouthwash that contains
declines. alcohol
➔ Fibers in the olfactory bulb, along with ➔ stop tobacco use
olfactory receptors decrease noticeably with ➔ drink more water
age.
DNU FINALS
 Megaloblastic Anemia  Glossitis  white thickening of the palatal mucosa due
 Angular cheilitis to hyperkeratosis
 Papillary atrophy of the tongue  The glandular tissue is replaced by
Treatment/Nutritional Management: connective tissue
 ingesting iron-rich or enriched foods  Epithelial mass increases
( liver,eggs, and cereals)  Hyperkeratotic lesions on surfaces that are

 Folic Acid deficiency  iron supplements (1 g of ferrous sulfate) normally nonkeratinized

Nutritional Management:
 occurs in poorly nourished people
(e.g.malabsorption disorders).  Oral Mucous Membrane Problems  Therapeutic doses of vitamin B complex

General Symptoms: and vitamin C

 Glossodynia  Balanced, varied, adequate diet

 Glossitis  social, emotional, and economic factors

 Stomatitis
Nutritionally related oral problems in Elderly
 Diarrhea
patients: Temporomandibular Joint Pain
 General weakness Patient's chief complaints:
Temporomandibular Joint Pain
Treatment/Management:
 Burning sensation, pain, and dryness of the
 Due to the tooth wear that can produce
 5 to 15 mg of folacin tablets daily mouth
overclosure of the jaw and affect the
 Maintenance: doses of 2 to 5 mg of folacin  Cheilosis
relations of the mandibular condyle to the
tablets daily
 Chewing and swallowing become difficult
glenoid fossa
 yeast, liver, fresh green vegetables, & fruits
 Dysgeusia
 Epithelial membrane is thin, friable, and Tooth wear:
 Iron deficiency anemia
easily injured 1. Masticating very firm food: Over many
 salivary deficiency years
Changes in the blood vessels: 2. Bruxism: teeth grinding
 Atherosclerosis 3. Attrition: wearing down
 Varicosities (underside of the tongue and in

 occurs in elderly patients who live on a tea- the floor of the mouth) e.g. SLV Common cause of overclosure
and-toast diet Changes in Palatal Mucosa:  Glenoid fossa can become shallower and
General Symptoms: head of the condyle become flatter.
DNU FINALS
  Meniscus to be perforated or damaged In the elderly: Preventive Dentistry
causing pain and limitation of range of  They tend to have a relative increase in  “Actions taken prior to the onset of disease,
movement of the jaw bone disease and resorption which removes the possibility that a disease
 Partial or complete edentulism without  So, if with the loss of teeth the alveolar will ever occur”
prosthetic replacement process no longer serves its primary Objectives
 Osteoarthritis is a degenerative changes function to tooth support and therefore is  To avert initiation of disease process
that can produce articular disc changes reabsorbed.  To intercept their progress
which create the clicking of the jaw  This loss in vertical height of the bone and  To control their spread
the changing of the angel of the mandible is  To limit their complication and after effects
Temporary prevention of overclosure: manifested as a loss in face height in older  To provide rehabilitation
1. Acrylic guard people
2. Fixed bridgework or partial dentur Scope of Preventive Dentistry
3. Select foods of medium to soft BONE DISUSE aka NON FUNCTIONAL ATROPHY  Factors predisposing to disease
consistency  When occlusal forces are reduced, bone is  Factors encouraging the advancement of
Prevent excessive occlusal wear of resorbed, bone height is diminished, and disease
the intact dentition the number and thickness of the tuberculae  Complication of disease and deformity
are reduced  Factors interfering with rehabilitation
Nutritionally related oral problems in Elderly  Factors causing recurrence of disease
patients: Alveolar Osteoporosis Wical and Swoope
 Alveolar bone  “Relationship between the dietary Factors of successful prevention
 Participate in maintenance of body calcium combination of calcium and phosphorus  Knowledge of causation
balance and the resorption of alveolar bone in  Dynamics of transmission
 Calcium is constantly deposited and edentulous patient”
 Identification of risk factors
withdrawn from the alveolar bone to  Result indicate that there is a direct cause-  Availability of prophylactic or early
provide the need of other tissue and-effect relationship between low
detection
 Calcium in the cancellous trabeculae is more calcium intake or calcium-phosphorus
 Treatment measures
readily available thus more easily mobilize imbalance and severe ridge resorption
 Organization for applying these measures
 Alveolar bone acts as a reservoir of mineral  Reported that ingestion of calcium and Vit D
 Continuous evaluation of procedures
ions which makes it susceptible to dietary supplements reduced post
applied
osteoporosis extraction alveolar bone resorption by 36%
DNU FINALS
Level of prevention WHO approaches for primary prevention Modes of intervention for tertiary prevention
1. Primordial prevention  Population (mass) strategy  Disability limitation- questionable na yung
2. Primary prevention  Whole population irrespective of the ability, so nililimit yung tooth
3. Secondary prevention individual risk level  Rehabilitation: restoration of function (wala
4. Tertiary prevention  No data na teeth dito)
 Aims at socio-economic, behavioral and
Modes of intervention (preventive services) lifestyle changes Dental caries: Dental Professional Preventive
1. Health promotion  High risk strategy Dentistry services
2. Specific promotion  Individuals at special risk
3. Early diagnosis and treatment Primary Second Tertiary
 Has data
4. Disability limitation ary
5. rehabilitation Secondary prevention
Health Specific Early Disabili Rehabilitat
- “Action which halts the progress of disease
promot promot diagnos ty ion
Primordial prevention in its incipient stage and prevent
ion ion is and limitati
- Prevention of emergence or development of complication”
prompt on
risk factor in countries or population groups - Pathogenesis phase
treatm
in which they have not yet appeared
ent
- Conduct dental education Modes of intervention for secondary prevention
 early diagnosis and prompt treatment Patient Topical Comple Comple Removable
Primary prevention educati applicat te x and fixed
- “Actions taken prior to the onset of disease, Tertiary prevention on ion of exam; restorat prosthodo
which removes the possibility that a disease “All measures available to reduce or limit fluoride prompt ion ntics
will ever occur” impairments and disabilities, minimize suffering treatm dentistr
- Pre-pathogenesis phase caused by existing departures from good health ent of y
to promote patients adjustment to irremediable incipie extracti
Modes of intervention for primary prevention conditions” nt on
1. Health promotion - Late pathogenesis phase lesions
2. Specific protection

DNU FINALS