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71 Cards in this Set

  • Front
  • Back
Why is Nutrition Important to the RDH?
Oral Health
General / Systemic Health
Diet / Nutrition
What are Dietary Reference Intakes (DRIs)
- formally the RDAs
- provide guidelines for determining nutritional needs of healthy individual, and detail
List the fat soluble vitamins
A
D
E
K
Benefits of Vitamin A
1) maintains health of retina
2) growth & health of skin & mucous membrane
3) development of teeth, soft tissue and skeletal tissue
Hyperstate of Vit A
1) More common—fatal
2) Related to birth defects in the head and neck regions
3) Healing of epithelial and periodontal tissues
4) Manifest as a yellow or orange color in tissues
Hypostate of Vit A
1) Rare in USA
2) Inability to heal
3) Xerosis (drying of eye)
4) Xeropthalmia ( drying and opaqueness of cornea)
5) Changes in taste due to xerostomia
6) High rate of co morbidity and mortality with infectious diseases (respiratory and diarrhea)
Benifits of Vitamin D
1) Promotes the body's absorption of calcium, essential to development of bones and teeth
Hyperstate of Vit D
Toxic effects occur in adults receiving 2500 µg (100,000 IU)/day for several months
Who is at risk for Hyperstate of Vitamin D?
1) Vitamin D deficiency a pandemic problem in 40%-60% of adults and teens
2) Insufficient Sun Exposure
3) Elderly
4) Malabsorption
5) Kidney failure
Hypostate of Vitamin D
1) Osteoporosis
2) Vitamin D may be protective against some cancers
3) Low levels may increase risk for heart attack
4) Rickets
5) Osteomalacia
Benefits of Vitamin E
1) Protects cell membranes & tissues from oxidation
2) Formation of red blood cells & use of vitamin K
3) Function of a healthy circulatory system
Hyperstate of Vit E
1) Research suggests an increase in mortality with supplementation
2) Occasionally, muscle weakness, fatigue, nausea, and diarrhea have occurred in persons taking 800 to 3200 mg/day
3) Most significant effect at >1000 mg/day is antagonism to vitamin K action and enhancement of the effect of oral anticoagulants
Hypostate of Vit E
1) Mild hemolytic anemia associated with increased erythrocyte hemolysis
2) Peripheral neuropathy
3) Subsequent decline in physical function
Groups at risk for Vit E Hypostate
1) Sickle cell anemia
2) Smokers
3) Those on an extremely low-fat diets
Benefit of Vitamin K
Blood clotting
Hypostate of Vit K
1) Results from risk factors
2) No specific oral manifestations except for possible excess bleeding
Those at risk for Vit K Hypostate
1) Celiac disease, sprue
2) Diarrheal diseases
3) Hemorrhagic disease of the newborn
4) Marginal dietary intake due to trauma, extensive surgery, or long-term parenteral nutrition
5) Anticonvulsants, anticoagulants, certain antibiotics (particularly cephalosporins), salicylates, and megadoses of vitamin A or E
Hyperstate of Vit K
No noted reports
List the water soluble vitamins
1) B1 - Thiamine
2) B2 - Riboflavin
3) B3 - Nicotinic Acid/ Niacin
4) B6 - Pyroxidine
5) B12 - Cobalamin
6) B9 - Folate/ Folic Acid
7) Biotin & Pantothenic Acid
8) Vitamin C
Benefits of B1 (Thiamine)
1) helps the body convert food to energy
2) aid in function of heart, cardiovascular, brain and nervous system
Hyperstate of B1 (Thiamine)
Excess no apparent adverse side effects
Deficiency of B1 (Thiamine)
1) Rare in developing countries
2) Classic Beriberi ( I cannot) related to alcoholism
3) Wernicke-Korsakoff Syndrome
4) Burning Tongue
5) Sensitive and Burning Mucosa
6) Loss of Taste
7) Loss of Appetite
Benefits of B2 (Riboflavin)
1) promotes healthy growth and tissue repair
2) helps release energy from carbohydrates
3) healthy skin
4) healthy red blood cell production
Hyperstate of B2 (Riboflavin)
Not reported
People at risk for B2 (Riboflavin) deficiencies
1) Congenital facial deformities due to mom’s deficiency
2) Watch phenothiazines and antibiotics
3) Watch vegans
4) Added stress, alcoholism, surgery, malabsorption
Deficiencies for B2 Riboflavin
1) Uncommon unless at risk
2) Needed for B6 and Niacin so similar secondary symptoms
3) Angular cheilosis
4) Dermatitis
5) Anemia
Benefits of B3 (Nicotinic Acid/ Niacin)
1) helps release energy from carbohydrates
2) healthy nerves
3) healthy digestive system
Hyperstate of B3 (Nicotinic Acid/ Niacin)
1) Abnormal liver function
2) Gout
Those at risk for B3 (Nicotinic Acid/ Niacin) deficiencies
1) Alcoholics
2) Dependent on corn/maize
3) Prolonged treatment with Isoniazids
Deficiencies for B3 (Nicotinic Acid/ Niacin)
1) Pellegra (3D’s dermatitis, diarrhea, & dementia/depression)
2) Stomatitis
3) Red, painful, edematous tongue, loss of papilla
Benefits of B6 (Pyroxidine)
1) healthy brain function
2) formation of red blood cells
3) breakdown of protein
4) synthesis of antibodies that support the immune system
Hyperstate of B6 (Pyroxidine)
1) Uncommon
2) Megadose - ataxia & neuropathy
Those at rist for B6 (Pyroxidine) deficiencies
1) Alcoholics
2) Elderly
3) Medications that reduce absorption: TB drugs, penicilliamine, theophylline, and oral contraceptives
Deficiencies of B6 (Pyroxidine)
1) With other B Vitamins
2) CNS Abnormalities
3) Cheilosis
4) Dermatitis
5) Glossitis
6) Impaired immune response
7) Anemia
Benefits of B12 (Cobalamin)
1) Metabolism
2) formation of RBC
3) maintenance of central nervous system (brain & spinal cord)
Hyperstate of B12 (Cobalamin)
1) NO benefit/ may mask
2) Too much Folic acid masks a deficiency
Those at risk for B12 (Cobalamin) deficiencies
1) 5-20% Elderly
2) Vegans
3) Xerostomia
4) Excessive Vitamin C
5) Gastric bypass
6) Tummy meds
Hypostate of B12 (Cobalamin)
1) Pernicious anemia (large RBCs)
2) Glossopyrosis (unexplained pain of the tongue)
3) Altered taste sensation
4) Glossitis
5) Cheilosis
6) Stomatitis or pale/yellowish mucosa
7) Hemorrhagic gingiva/bone loss
8) Gastrointestinal disturbances
9) Neurologic manifestations, numbness and tingling
10) Stunted growth
Benefits of B9 (Folate/Folic Acid)
1) RBC production
2) Synthesis of DNA
3) helps digest & use proteins
Hyperstate of B9 (Folate/Folic Acid)
1) May mask vitamin B12 deficiency
2) Kidney damage
3) Risk of cognitive decline reported in elderly persons
Those at risk for B9 (Folate/Folic Acid) deficiencies
1) Secondary to alcohol abuse
2) Pregnancy/lactation
3) Oral contraceptive & anticonvulsant medications
4) Kidney dialysis
5) Liver disease
6) Gastrointestinal disease
7) Bariatric surgery
Deficiencies of B9 (Folate/Folic Acid)
1) Neural tube defects
2) Megaloblastic anemia
3) Elevated blood homocysteine levels
4) Glossitis (fiery red, denuded of papillae)
5) Impairs immune response
Benefits of Biotin & Pantothenic Acid
1) Energy
2) Metabolism
3) Hair & nail growth
Hyperstate of Biotin
None reported
At risk for Biotin Deficiencies
Antibiotic use
Hypostate of Biotin
1) Can be produced by ingestion of avidin, the protein found in raw egg whites
2) Pallor of tongue
3) Patchy atrophy of lingual papillae along the lateral borders of the tongue
Hyperstate of Pantothenic Acid
None reported
Hypostate of Pantothenic Acid
None reported
Benefits of Vitamin C
1) healthy immune system
2) helps wounds heal
3) maintains connective tissue
4) aid in absorption of iron
Hypostate of Vitamin C
1) Marginal intakes
2) Deficiency does not CAUSE gingivitis or periodontal disease, but may be a contributing factor
3) Delayed wound healing
4) Poor bone and tooth development
5) Scurvy
Iron Deficiency Anemia
Related to?
Who is an advocated by?
-- Vitamin C aids absorption of iron so Vitamin C is combined with or recommend take Iron with Vitamin C
-- Linus Pauling
Hyperstate of B6 (Pyroxidine)
1) Uncommon
2) Megadose - ataxia & neuropathy
Those at rist for B6 (Pyroxidine) deficiencies
1) Alcoholics
2) Elderly
3) Medications that reduce absorption: TB drugs, penicilliamine, theophylline, and oral contraceptives
Deficiencies of B6 (Pyroxidine)
1) With other B Vitamins
2) CNS Abnormalities
3) Cheilosis
4) Dermatitis
5) Glossitis
6) Impaired immune response
7) Anemia
Benefits of B12 (Cobalamin)
1) Metabolism
2) formation of RBC
3) maintenance of central nervous system (brain & spinal cord)
Hyperstate of Iron
1) Hemochromatosis
2) Poison for children
Those at risk for Iron deficiencies
alcoholics
Hypostate of Iron
1) Plummer-Vinson Syndrome
--- Dysphagia due to anomalies in the esophagus (such as cervical esophageal webs)
--- Iron deficiency anemia
--- Glossitis/Burning Tongue/Angular Chelitis
Zinc deficiencies
1) Reduced growth
2) Increase susceptibility to infection
3) Delayed wound healing
4) Loss of taste and smell
5) Xerostomia
6) Atrophic mucosa
7) Link to Vitamin A & night blindness
8) Important for pregnant women
Hyperstate of Selenium
1) Impairs bone and cartilage growth
2) Hair loss
3) Fingernail discoloration and loss
4) Breath odor
5) Caries… DMF indices higher in areas where the soil has high concentrations of selenium
Hyperstate of fluoride
Fluorosis
Magnesium effects
1) Helps absorb calcium
2) Helps hydroxyapatite crystal formation and growth
3) Hypocalcification
4) Hypercalcification
Hypercalcemia
1) Dizziness, flushing, nausea/vomiting, severe constipation, kidney stone formation, irregular heartbeat, tingling sensations, xerostomia, fatigue and high blood pressure
2) May inhibit iron and zinc absorption
At risk for Hypercalcemia
1) Hyperparathryoidism
2) Overdoses of cholecalciferol
3) Vitamin D poisoning
Hypocalcemia
1) Rickets
--- Abnormal ossification from vitamin D, calcium deficiency
2) Osteoporosis
--- “Osteoporosis is a disease of adolescence”
>> 90% of peak bone mass is attained by age 16.9 + 1.3 yr and 99% by age 26.2 + 3.7 yr
>> Decreased BMD
>> 50% of difference in hip fracture rates in postmenopausal years
Hyperstate of Phosphorous
1) Hyperphosphatemia (serum level above 2.6 mg/dl) may occur in:
--- Hypoparathyroidism
--- Renal insufficiency
2) Excessive amounts of phosphorus bind with calcium, resulting in tetany and convulsions
Those at risk for deficiencies
1) Long-term ingestion of aluminum hydroxide antacids
2) Malabsorption conditions (sprue and celiac disease)
Hypostate of Phosphorous
1) During tooth development, deficiency results in:
--- Incomplete calcification of teeth
--- Failure of dentin formation
--- Increased susceptibility to caries
Bisphosphonate Medications
1) alendronate Fosamax
2) etidronate (not approved by FDA for osteoporosis) Didronel
3) ibandronate Boniva
4) risedronate Actonel
5) risedronate with calcium carbonate Actonel with Calcium
6) zoledronic acid Reclast
Why are Vitamins Required for Oral Soft Tissues and Salivary Glands
1) Because of the rapid turnover rate of oral tissues, the first signs of nutritional Hypostate(B-complex vitamins, vitamins C and K, iron, and protein) are frequently evident in the oral cavity
2) Angular cheilitis or cheilosis (cracks around the corners of the mouth) and glossitis (inflammation of the tongue) are commonly associated with nutrient deficiencies
The Role of the Dental Hygienist when it comes to vitamins & minerals.
1) Help evaluate the patient for vitamin deficiencies.
2) Be aware that water-soluble vitamin and mineral deficiencies have many oral manifestations.
3) Talk with the patient about the patient’s dietary intake or any health problems.
4) Encourage the patient to see his or her health care provider for appropriate therapy.