CE Course 7 - Tables

Table I. Dietary guidelines for Americans

Aim for Fitness
• Aim for a healthy weight
• Be physically active each day

Build a Healthy Base
• Let the pyramid guide your food choices
• Choose a variety of grains daily, especially whole grains
• Choose a variety of fruits and vegetables daily
• Keep foods safe to eat

Choose Sensibly
• Choose a diet that is low in saturated fat and cholesterol and moderate in total fat
• Choose beverages and foods to moderate your intake of sugars
• Choose and prepare foods with less salt
• If you drink alcoholic beverages, do so in moderation

Source: Nutrition and Your Health: Dietary Guidelines for Americans. 5th edition. United States Department of Agriculture, United States Department of Health and Human Services. Home and Garden Bulletin No. 232, 2000.

Table II. Effects of nutrient deficiencies on tooth development
Deficient Nutrient Effect on Teeth
Protein/calorie malnutrition Delayed tooth eruption
Reduced tooth size
Decreased enamel solubility
Salivary gland dysfunction
Vitamin A Vitamin A Decreased epithelial tissue development
Impaired tooth formation
Enamel hypoplasia
Craniofacial and oral clefts (excess vitamin A)
Vitamin D/calcium/phosphorus Lowered plasma calcium
Hypomineralization
Compromised tooth integrity
Delayed eruption patterns
Vitamin C Irregular dentin formation
Dental pulpal alterations
Fluoride Impairs enamel remineralization
Increased demineralization in presence of
organic acids
Iron Slowed growth
Salivary gland dysfunction

Table III. Dietary fluoride supplement schedule
Approved by the American Dental Association, American Academy of Pediatrics, American Academy of Pediatric Dentistry
Age Fluoride ion level in drinking water (ppm)*
  Less than 0.3ppm 0.3-0.6 ppm Greater than 0.6 ppm
Birth-6 months None None None
6 months-3 years 0.25 mg/day** None None
3-6 years 0.50 mg/day** 0.25 mg/day None
6-16 years 1.0 mg/day 0.50 mg/day None
*0.1 part per million (ppm) = 1 milligram/liter (mg/L)
**2.2 mg sodium fluoride contains 1 mg fluoride ion

Table IV. Characteristics of high and low cariogenic potential foods
High Cariogenicity Low Cariogenicity
High fermentable carbohydrate content
(starch, sugars, or a mixture)
Sticky consistency
Breaks into small particles in the mouth
Causes pH to fall below 5.5
Highly processed
Relatively high protein
Moderate amounts of fat
Minimal amounts of carbohydrate
High concentration of calcium and phosphorus
pH greater than 6
Stimulates saliva secretion
Examples: Examples:
Crackers
Pre-sweetened cereals
Breads
Muffins
Dried fruits
Cookies
Potato chips
Cheese
Peanuts
Meat
Milk
Eggs
Some vegetables

Table V. Oral signs and symptoms of nutritional deficiencies*
Symptom Possible Deficiency
niacin, folic acid, vitamin B6, vitamin B12
Glossodynia B vitamins (riboflavin, niacin, folic acid,vitamin B6, and vitamin B12), zinc, iron
Stomatitis niacin, folic acid, vitamin B12
Xerostomia vitamin A, vitamin B12
Bleeding gingiva vitamin C, vitamin K
Angular cheilosis iron, B vitamins
* Other causes of these signs and symptoms may include medication, radiation therapy for oral cancer, and other disease states.

Table VI. Activities for effective integration of nutrition in oral health promotion and disease prevention

Clinical Setting

  • Include diet counseling for caries prevention and control as a component of comprehensive dental care.
  • Request a nutritional consult and confer with dietetics professional for patients at nutrition risk because of compromised oral health (e.g., caries, diabetes, xerostomia, immunosuppressive disorders).
  • Be familiar with nontraditional diet interventions and provide patients with guidelines to maximize oral intake.
  • Collaborate with dietetics professionals in delivery of medical nutrition therapy and provision of oral health care in long-term care settings.

Community Setting

  • Develop oral health messages that include nutrition education.
  • Offer advisory assistance to school and community nutrition programs.
  • Include nutrition screening initiatives in oral health programs in schools, worksites, and health maintenance organizations.
  • Develop partnerships with dietetics professionals to promote nutrition screening, assessment, and counseling in private practice.

Research Setting

  • Identify and support nutrition topics in appropriate clinical oral health research.

Oral Health and Nutrition: Position of the American Dietetic Association. Copyright by the American Dietetic Association. Adapted with permission from the Journal of the American Dietetic Association 1996;96:184-189.