Essential Vitamins, Minerals, and Oral Health

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4. Functions, Dietary Sources, Requirements, and Deficiencies of B-Complex Vitamins Vitamin Function Major Dietary Sources B1-thiamine Coenzyme in Pork whole and enriched carbohdrate and cereal grains, legumes, meats protein metabolism B2-riboflavin Coenzyme in Milk, green vegetables, meat, carbohydrate and fish, and eggs protein metabolism Niacin - (nicotinic acid) Coenzyme in Meat, legumes, enriched carbohydrate and or whole grain cereals protein metabolism B6-(pyridoxal, Amino acid metabolism Whole grain cereals, milk, pyridoxamine, meat, and vegetables pyridoxine) Panthothenic acid Active in coenzyme A Widely distributed in many foods B12-cyanocobalamin Nucleic metabolism Animal foods, meat and (red blood cell formation) dairy products Folic acid (folacin) Purine metabolism Green leay vegetables (red blood cell formation) organ meats Biotin Essential fr activity of Widely distributed in many enzyme systems foods

7. Some Minerals Essential to Health Mineral Best Source Important Functions Deficiency Symptoms Calcium Milk Normal development Retarded growth Cheese and maintenance of Poor tooth formation Sardines and other bone and teeth Rickets whole canned fish Clotting of the blood Slow clotting time of blood Vegetable greens Normal heart action Porous bones Normal muscle activity Iron use Phosphorus Meat, poulry, fish Formation of normal bones Retarded growth Milk and teeth Poor tooth formation Cheese Cell structure Rickets Dried beans and peas Maintenance of normal blood Porous bones Whole grain products tissue Normal muscle activity Magnesium Whole grains Production of energy Hyperexcitabbility Nuts Protein synthesis Weakness Soybeans Bone-building Depression Green, leafy vegetables Acid base balance Tremors Convulsions

8. Mineral Best Source Important Functions Deficiency Symptoms Iodine Seafoods Formation of thyroxine, Goiter Iodized salt a hormone that controls Slow metabolism metabolism rate Iron Liver, organ meat Formation of hemogolobin Anemia characterized by: Oysters of the red blood cells Weakness Vegetable greens Carrying oxygen to body tissues Dizziness Dried beans and peas Loss of weight Dried fruits Gastric disturbances Egg yolk Pallor Whole grain or enriched products Copper Liver Formation of hemogolobin Anemia (see iron) Dried beans and peas Meat Nuts Cereals

9. Nutrition-related complications of the oral cavity Nutrient Deficiency symptoms Thiamin(B1) Increased sensitivity and burning sensation of oral mucosa, burning tongue, loss of taste and appetite Riboflavin(B2) Angular cheilosis, blue-to-purple mucosa, inflamed mucosa glossitis, magenta tongue, enlarged fungiform papilla. Atrophy and inflammation of filiform papilla, burning tongue Niacin(B3) Glossitis, ulcerations of tongue, atrophy of papilla, cheilosis, thin epithelium, burning of oral mucosa, stomatitis, erythemic marginal and attached gingiva, loss of appetite Pyridoxine(B6) Cheilosis, glossitis, atrophy and burning of tongue, stomatitis Cobalamin(B12) Stomatitis, hemorrhaging, pale-to-yellow mucosa, glossitis, atrophy and burning of tongue, altered taste, loss of appetite Folic acid Glossitis with enlargement of fungiform papilla, ulcerrations along edge of tongue, gingivitis, erosion and ulcerations on buccal mucosa, pale mucosa Biotin Glossitis, patchy atrophy of papilla, gray mucosa

10. Nutrient Deficiency symptoms Vitamin C Odontoblast atrophy, porotic dentin formation, gingival inflammation with easy bleeding, deep-red-to-purple gingiva, ulceration and necrosis, delayed wound healing. muscle/joint pain, defects in collagen formation, petechia Vitamin A Ameloblast atrophy, faulty bone and tooth formation, accelerated periodontal destruction, hypoplasia, xerostomia, cleft lip, ketratinization of epithelium, drying and hardening of salivary glands, impaired taste Toxicity symptoms:Hypertrophy of bone, cracking and bleeding lips, thinning of epitelium, erythemic gingiva, cheilosis Vitamin D, Failure of bones to heal, mild calcification to enamel Calcium & hypoplasia, loss of alveolar/mandibular bone, delayed phosphorus eruption, increased caries rate, loss of lamina dura around roots of tooth Phosphorus Toxicity symptoms:Poor tooth formation and bone demineralization

11. Nutrient Deficiency symptoms Vitamin K Gingival hermorrhaging Iron Painful oral cavity; stomatitis; thinned buccal mucosa with ulcerations; pale-to-gray mucosa, lips, and tongue; angular cheilosis; burning tongue; reddening at lips and margins of tongue; atrophy of filiform papilla Zinc Thickening of epithelium, thickening of tongue with underlying muscle atrophy, impaired taste, atrophy of filiform papilla Protein Smooth, edematous tongue; angular cheilosis; fissures on lower lip; smaller teeth; delayed eruption; delayed wound healing; dental caries Selenium Toxicity symptoms: Dental caries Fluoride Dental caries Toxicity symptoms : Enamel fluorosis Magnesium Retardation in dentin formation, enamel hypoplasia, atrophy of ameloblasts and odontoblasts, enamel hyperplasia

12. Groups at Nutritional Risk Elderly Dentate status Medical Problems Polypharmacy Psychosocial issues Xerostomia Osteoporosis Low income Individuals undergoing periods of rapid growth Pregnant and lactating women Infants and children Individuals receiving inadequate calories or protein Eating disorders Long-term dieting Medically compromised individuals HIV infection Cancer Diabetes Certain medications or polypharmacy Alcoholics

13. Foods that Protect Against Dental Caries Cheese Milk Nuts Products made with xylitol Meat, fish, poultry, and eggs Fat Butter Cream Cream cheese Margarine Oils Sour cream

17. OBTAIN HEALTH EVALUATION • Identify • A dental patient who • requires nutrition intervention 2. Assess . Health history . Anthropometrics . Laboratory values . Dietary intake DENTAL TEAM 4. Implement strategies TREAT PREVENT 3. Formulate The treatment plan MAINTAIN HEALTH

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