Vitamins And Mineral

Front 1

Why is Nutrition Important to the RDH?

Back 1

Oral Health
General / Systemic Health
Diet / Nutrition

Front 2

What are Dietary Reference Intakes (DRIs)

Back 2

- formally the RDAs
- provide guidelines for determining nutritional needs of healthy individual, and detail

Front 3

List the fat soluble vitamins

Back 3

A
D
E
K

Front 4

Benefits of Vitamin A

Back 4

1) maintains health of retina
2) growth & health of skin & mucous membrane
3) development of teeth, soft tissue and skeletal tissue

Front 5

Hyperstate of Vit A

Back 5

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

Front 6

Hypostate of Vit A

Back 6

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)

Front 7

Benifits of Vitamin D

Back 7

1) Promotes the body's absorption of calcium, essential to development of bones and teeth

Front 8

Hyperstate of Vit D

Back 8

Toxic effects occur in adults receiving 2500 µg (100,000 IU)/day for several months

Front 9

Who is at risk for Hyperstate of Vitamin D?

Back 9

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

Front 10

Hypostate of Vitamin D

Back 10

1) Osteoporosis
2) Vitamin D may be protective against some cancers
3) Low levels may increase risk for heart attack
4) Rickets
5) Osteomalacia

Front 11

Benefits of Vitamin E

Back 11

1) Protects cell membranes & tissues from oxidation
2) Formation of red blood cells & use of vitamin K
3) Function of a healthy circulatory system

Front 12

Hyperstate of Vit E

Back 12

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

Front 13

Hypostate of Vit E

Back 13

1) Mild hemolytic anemia associated with increased erythrocyte hemolysis
2) Peripheral neuropathy
3) Subsequent decline in physical function

Front 14

Groups at risk for Vit E Hypostate

Back 14

1) Sickle cell anemia
2) Smokers
3) Those on an extremely low-fat diets

Front 15

Benefit of Vitamin K

Back 15

Blood clotting

Front 16

Hypostate of Vit K

Back 16

1) Results from risk factors
2) No specific oral manifestations except for possible excess bleeding

Front 17

Those at risk for Vit K Hypostate

Back 17

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

Front 18

Hyperstate of Vit K

Back 18

No noted reports

Front 19

List the water soluble vitamins

Back 19

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

Front 20

Benefits of B1 (Thiamine)

Back 20

1) helps the body convert food to energy
2) aid in function of heart, cardiovascular, brain and nervous system

Front 21

Hyperstate of B1 (Thiamine)

Back 21

Excess no apparent adverse side effects

Front 22

Deficiency of B1 (Thiamine)

Back 22

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

Front 23

Benefits of B2 (Riboflavin)

Back 23

1) promotes healthy growth and tissue repair
2) helps release energy from carbohydrates
3) healthy skin
4) healthy red blood cell production

Front 24

Hyperstate of B2 (Riboflavin)

Back 24

Not reported

Front 25

People at risk for B2 (Riboflavin) deficiencies

Back 25

1) Congenital facial deformities due to mom’s deficiency
2) Watch phenothiazines and antibiotics
3) Watch vegans
4) Added stress, alcoholism, surgery, malabsorption

Front 26

Deficiencies for B2 Riboflavin

Back 26

1) Uncommon unless at risk
2) Needed for B6 and Niacin so similar secondary symptoms
3) Angular cheilosis
4) Dermatitis
5) Anemia

Front 27

Benefits of B3 (Nicotinic Acid/ Niacin)

Back 27

1) helps release energy from carbohydrates
2) healthy nerves
3) healthy digestive system

Front 28

Hyperstate of B3 (Nicotinic Acid/ Niacin)

Back 28

1) Abnormal liver function
2) Gout

Front 29

Those at risk for B3 (Nicotinic Acid/ Niacin) deficiencies

Back 29

1) Alcoholics
2) Dependent on corn/maize
3) Prolonged treatment with Isoniazids

Front 30

Deficiencies for B3 (Nicotinic Acid/ Niacin)

Back 30

1) Pellegra (3D’s dermatitis, diarrhea, & dementia/depression)
2) Stomatitis
3) Red, painful, edematous tongue, loss of papilla

Front 31

Benefits of B6 (Pyroxidine)

Back 31

1) healthy brain function
2) formation of red blood cells
3) breakdown of protein
4) synthesis of antibodies that support the immune system

Front 32

Hyperstate of B6 (Pyroxidine)

Back 32

1) Uncommon
2) Megadose - ataxia & neuropathy

Front 33

Those at rist for B6 (Pyroxidine) deficiencies

Back 33

1) Alcoholics
2) Elderly
3) Medications that reduce absorption: TB drugs, penicilliamine, theophylline, and oral contraceptives

Front 34

Deficiencies of B6 (Pyroxidine)

Back 34

1) With other B Vitamins
2) CNS Abnormalities
3) Cheilosis
4) Dermatitis
5) Glossitis
6) Impaired immune response
7) Anemia

Front 35

Benefits of B12 (Cobalamin)

Back 35

1) Metabolism
2) formation of RBC
3) maintenance of central nervous system (brain & spinal cord)

Front 36

Hyperstate of B12 (Cobalamin)

Back 36

1) NO benefit/ may mask
2) Too much Folic acid masks a deficiency

Front 37

Those at risk for B12 (Cobalamin) deficiencies

Back 37

1) 5-20% Elderly
2) Vegans
3) Xerostomia
4) Excessive Vitamin C
5) Gastric bypass
6) Tummy meds

Front 38

Hypostate of B12 (Cobalamin)

Back 38

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

Front 39

Benefits of B9 (Folate/Folic Acid)

Back 39

1) RBC production
2) Synthesis of DNA
3) helps digest & use proteins

Front 40

Hyperstate of B9 (Folate/Folic Acid)

Back 40

1) May mask vitamin B12 deficiency
2) Kidney damage
3) Risk of cognitive decline reported in elderly persons

Front 41

Those at risk for B9 (Folate/Folic Acid) deficiencies

Back 41

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

Front 42

Deficiencies of B9 (Folate/Folic Acid)

Back 42

1) Neural tube defects
2) Megaloblastic anemia
3) Elevated blood homocysteine levels
4) Glossitis (fiery red, denuded of papillae)
5) Impairs immune response

Front 43

Benefits of Biotin & Pantothenic Acid

Back 43

1) Energy
2) Metabolism
3) Hair & nail growth

Front 44

Hyperstate of Biotin

Back 44

None reported

Front 45

At risk for Biotin Deficiencies

Back 45

Antibiotic use

Front 46

Hypostate of Biotin

Back 46

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

Front 47

Hyperstate of Pantothenic Acid

Back 47

None reported

Front 48

Hypostate of Pantothenic Acid

Back 48

None reported

Front 49

Benefits of Vitamin C

Back 49

1) healthy immune system
2) helps wounds heal
3) maintains connective tissue
4) aid in absorption of iron

Front 50

Hypostate of Vitamin C

Back 50

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

Front 51

Iron Deficiency Anemia
Related to?
Who is an advocated by?

Back 51

-- Vitamin C aids absorption of iron so Vitamin C is combined with or recommend take Iron with Vitamin C
-- Linus Pauling

Front 52

Hyperstate of B6 (Pyroxidine)

Back 52

1) Uncommon
2) Megadose - ataxia & neuropathy

Front 53

Those at rist for B6 (Pyroxidine) deficiencies

Back 53

1) Alcoholics
2) Elderly
3) Medications that reduce absorption: TB drugs, penicilliamine, theophylline, and oral contraceptives

Front 54

Deficiencies of B6 (Pyroxidine)

Back 54

1) With other B Vitamins
2) CNS Abnormalities
3) Cheilosis
4) Dermatitis
5) Glossitis
6) Impaired immune response
7) Anemia

Front 55

Benefits of B12 (Cobalamin)

Back 55

1) Metabolism
2) formation of RBC
3) maintenance of central nervous system (brain & spinal cord)

Front 56

Hyperstate of Iron

Back 56

1) Hemochromatosis
2) Poison for children

Front 57

Those at risk for Iron deficiencies

Back 57

alcoholics

Front 58

Hypostate of Iron

Back 58

1) Plummer-Vinson Syndrome
--- Dysphagia due to anomalies in the esophagus (such as cervical esophageal webs)
--- Iron deficiency anemia
--- Glossitis/Burning Tongue/Angular Chelitis

Front 59

Zinc deficiencies

Back 59

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

Front 60

Hyperstate of Selenium

Back 60

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

Front 61

Hyperstate of fluoride

Back 61

Fluorosis

Front 62

Magnesium effects

Back 62

1) Helps absorb calcium
2) Helps hydroxyapatite crystal formation and growth
3) Hypocalcification
4) Hypercalcification

Front 63

Hypercalcemia

Back 63

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

Front 64

At risk for Hypercalcemia

Back 64

1) Hyperparathryoidism
2) Overdoses of cholecalciferol
3) Vitamin D poisoning

Front 65

Hypocalcemia

Back 65

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

Front 66

Hyperstate of Phosphorous

Back 66

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

Front 67

Those at risk for deficiencies

Back 67

1) Long-term ingestion of aluminum hydroxide antacids
2) Malabsorption conditions (sprue and celiac disease)

Front 68

Hypostate of Phosphorous

Back 68

1) During tooth development, deficiency results in:
--- Incomplete calcification of teeth
--- Failure of dentin formation
--- Increased susceptibility to caries

Front 69

Bisphosphonate Medications

Back 69

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

Front 70

Why are Vitamins Required for Oral Soft Tissues and Salivary Glands

Back 70

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

Front 71

The Role of the Dental Hygienist when it comes to vitamins & minerals.

Back 71

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.