Nutrition in dentistry

1. Nutrition in dentistry

2. Vitamins

3. Vitamin B1 • thiamine • function – coenzyme (oxidative decarboxylation...) Symptoms • Deficiency: beri-beri • exudative (wet) form – heart insufficiency, oedema • dry form – polyneuritis, Wernicke-Korsakoff syndrome • B1 deficiency – chronic alcoholism

4. Beri-beri

5. Vitamin B2 • riboflavin • function – coenzyme (redox reactions... ) Oral signs and symptoms • Deficiency: angular cheilosis, atrophy of filliform papilae, shiny red lips, sore tongue Other symptoms • conjuctivitis, dermatitis, anaemia, mental retardation

6. Vitamin B2 angular cheilosis conjuctivitis atrophy of filliform papilae

7. Vitamin B3 • niacin, nicotinic acid • function – coenzyme (redox reactions...) Oral signs and symptoms • Deficiency: angular cheilosis, mucositis, stomatitis, oral pain, ulceration, denuded tongue, glositis, glossodynia, red and swollen tip or borders of tongue, dorsum is dry and smooth Other symptoms • Deficiency: Pelagra (3D) – dermatitis, diarhea, dementia

8. cheilosis mucositisglositis glossodynia Pelagra - dermatitis

9. Folic acid • Tetrahydrofolic acid • function – biosynthesis of purins → DNA Oral signs and symptoms • Deficiency: angular cheilosis, mucositis, stomatitis, oral pain, sore or burning mouth, increased risk of candidiasis, inflamed gingiva, glossitis, glossodynia, red and swollen tips or borders of tongue, aphtous ulcers Other symptoms • Deficiency: macrocytic anaemia, diarhea, weight loss

10. candidiasis inflamed gingiva aphtous ulcers macrocytic anaemia macrocytes normal RBC

11. Vitamin B6 • pyridoxine • function – coenzyme (amino acid metabolism...) Oral signs and symptoms • Deficiency: angular cheilosis, sore or burning mouth, glossitis, glossodynia Other symptoms • Deficiency: neuritis, diarhea, dermatitis, anaemia, seizures

12. Vitamin B12 • cyanocobalamine • function – coenzyme, folate metabolism... Oral signs and symptoms • Deficiency: angular cheilosis, mucositis, stomatitis, sore or burning mouth, haemorrhage gingiva, halitosis, dysplasia of oral mucosa, loss of taste, oral pain, ulceration, glossitis, glossodynia, red tongue, xerostomia, aphtous ulcers Other symptoms • Deficiency: pernicious anaemia, neurological signs

13. halitosis xerostomia

14. Vitamin C • ascorbic acid • function – reducing agent, antioxidant, collagen biosynthesis, iron absorption, immunity... Oral signs and symptoms • Deficiency: Scurvy – red swollen gingiva, gingival friability, periodontal destruction, increased tooth mobility and exfoliation, sore burning mouth, soft tissue ulceration, increased risk of candidiasis, malformed teeth (inadequate dentine) Other symptoms • Deficiency: fragility of vessel wall, impaired development of bones

15. Scurvy

16. Vitamin A • retinol • function – vision, growth and differentiation of epitels Oral signs and symptoms • Deficiency: impaired tissue healing and regeneration, desquamation of oral mucosa, keratosis, increases risk of candidiasis, gingival hypertrophy and inflammation, leukoplakia, decreased taste sensitivity, xerostomia, disturbed enamel development, increased caries risk • Excess: impaired wound healing Other symptoms • Deficiency: night blindness, xerophtalmia, mucosa dryness • Excess: hepatosplenomegalia, anaemia, hair loss

17. desquamation of oral mucosakeratosis gingival hypertrophy and inflammationm

18. leukoplakiaxerostomia disturbed enamel developmentcaries

19. Vitamin D • calcitriol • function – hormone, Ca metabolism Oral signs and symptoms • Deficiency: osteoporosis, osteomalacia, rickets, incomplete mineralisation of teeth • Excess: pulp calcification, enamel hypoplasia Other symptoms • Deficiency: osteoporosis, osteomalacia, rickets • Excess: Ca mobilisation from bones, kidney stones

20. pulp calcification enamel hypoplasia osteoporosis rickets

21. Vitamin K • function – blood clotting Oral signs and symptoms • Deficiency: increased risk of bleeding • tocopherol • function – antioxidant Vitamin E

22. Minerals

23. Fluoride Oral signs and symptoms • Deficiency: decreased resistance to caries • Excess: enamel hypoplasia (fluorosis)

24. Iron Oral signs and symptoms • Deficiency: angular cheilosis, pallor of lips and oral mucosa, sore, burning tongue, glossitis Other symptoms • Deficiency: anaemia

25. Calcium Oral signs and symptoms • Deficiency: incomplete mineralisation of teeth, rickets, osteomalacia, osteoporosis, bone fragility, increased tooth mobility and premature loss Other symptoms • Deficiency: rickets, osteomalacia, osteoporosis

26. Zinc Oral signs and symptoms • Deficiency: loss of taste and tongue sensation, delayed wound healing, increased susceptibility to periodontal disease, candidiasis, xerostomia, caries Other symptoms • Deficiency: impaired immune function

27. Magnesium Oral signs and symptoms • Deficiency: alveolar bone fragility, gingival hypertrophy Oral signs and symptoms • Deficiency: incomplete mineralisation of teeth, increased susceptibility to caries if deficient during tooth formation, increased susceptibility to periodontal disease Phosphorus

28. Other nutrients

29. Carbohydrate Oral signs and symptoms • Deficiency: decreased risk of caries • Excess (except fibre): caries

30. Fats Oral signs and symptoms • Deficiency: angular cheilosis, pallor of lips and oral mucosa, sore burning tongue, atrophy of filliform papillae, increased risk of candidiasis, glossitis • Excess: no effect (teeth) but

31. Proteins Oral signs and symptoms • Deficiency: defect of tooth composition, eruption pattern, resistance to decay, increased susceptibility to soft tissue infraction, poor tissue healing and regeneration • Excess: no effect

32. Water Oral signs and symptoms • Deficiency: dehydratation and fragility of epitelial tissue, decreased muscle strength for chewing, xerostomia, burning tongue