Transcript Nutrition and Oral Health: Making the Connection Wahida Karmally

NUTRI-BITES®
Webinar Series
Nutrition and Oral Health:
What Dietitians Should Know
January 16, 2014
Presenter:
Wahida Karmally, DrPH, RD, CDE, CLS, FNLA
Associate Research Scientist, Lecturer in Dentistry
Director of Nutrition Irving Institute for Clinical and Translational Research
Columbia University
Moderator:
James M. Rippe, MD – Leading cardiologist, Founder and Director,
Rippe Lifestyle Institute
Approved for 1 CPE (Level 2) by the Commission on Dietetic Registration, credentialing agency for the Academy of
Nutrition and Dietetics.
Original recording of the January 16, 2014 webinar and PDF download of presentation available at:
www.ConAgraFoodsScienceInstitute.com
Nutrition and Oral Health
NUTRI-BITES®
Webinar Series
Based on this webinar, learners should be able to:
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Discuss the lifelong synergy between nutrition and oral
health status in health and disease
Outline the role of nutrition in the development and
integrity of the oral cavity and the progression of oral
disease
Describe practical strategies dietitians can use to integrate
oral health information with lifestyle/nutrition counseling
Academy of Nutrition and Dietetics's Position
Paper "Oral Health and Nutrition - 2013”
• Nutrition is an integral component of oral health
• Oral infectious diseases, as well as acute, chronic, and
systemic diseases with oral manifestations, impact an
individual's functional ability to eat and their nutrition status
• Nutrition and diet can affect the development and integrity
of the oral cavity and progression of oral diseases.
Journal of the Academy of Nutrition and Dietetics. (2013) 113:693-701.
Nutritional Deficiencies and Oral Problems
• Stomatitis : Niacin, folic acid &vitamin B12
• Glossitis: Niacin, folic acid, B6 and B12
• Xerostomia: Vitamins A* and B12
• Cheilosis: Iron, B vitamins
• Gingival bleeding: Vitamins C and K
• Glossodynia: B vitamins, Zinc, Iron
*Excessive intakes of vitamin A intake can impact soft
and hard tissues
Vitamin A toxicity can impair oral mucosal
epithelium development.
Children's Oral Health
Although dental caries (tooth decay) is largely
preventable, it remains the most common chronic
disease of children aged 6 to 11 years (25%), and
adolescents aged 12 to 19 years (59%).
Tooth decay is four times more common than
asthma among adolescents aged 14 to 17 years (15%).
Factors Affecting Food Cariogenicity
• Frequency of consumption of fermentable
carbohydrates
• Food form: liquid, solid, slowly dissolving
• Sequence of eating foods
• Combination of foods
• Nutrient composition of foods and beverages
Be Fit to Be’ne’FitSM
NewYork-Presbyterian Hospital
2006
Oral Health and Children
Teeth decay is the #1 chronic disease in childhood!
3 Tips To Prevent Tooth Decay:
1. Provide bottles and sippy cups at mealtimes only
- Avoid bottles at bedtime - bacteria feed on the sugars in milk
2. Encourage children to drink from a regular cup by 12-15
months of age - prevents liquid from sitting around teeth
3. Brush teeth after breakfast and before bed
Schedule regular dental visits!
Adult Oral Health
Chronic disabling diseases such as jaw joint
diseases (TMD), diabetes, and osteoporosis
affect millions of Americans and
compromise oral health and functioning.
Temporomandibular disorders TMD
The mouth is the telltale of diseases
such as:
Nutritional anemias
Uncontrolled diabetes mellitus
Eating disorders
HIV infection
Oral Cancer
Periodontal Disease
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Diabetes - types 1 and 2
Heart disease
Stroke
Pulmonary disease
Obesity
Osteoporosis
Calcium and vitamin D
Dietitians can use Oral Health information
to integrate
with lifestyle/nutrition counseling
• The International and Dietetic Nutritional
Terminology
. includes diagnostic terms related to oral
health.
• Proficiency and competency in examining the mouth
to identify nutrient-deficiencies highly recommended
• Assess impact of chronic diseases and risk factors on
oral health. Oral health screening should be a
component of nutrition assessment.
Clinical , Community and Research Settings
References:
Position of the Academy of Nutrition and Dietetics:
The impact of fluoride on health.
Palmer CA, Gilbert JA; Academy of Nutrition and Dietetics.
J Acad Nutr Diet. 2012 Sep;112(9):1443-53
Position of the Academy of Nutrition and Dietetics:
Oral health and nutrition.
Touger-Decker R, Mobley C; Academy of Nutrition and
Dietetics. J Acad Nutr Diet. 2013 May;113(5):693-701
Diet, cardiovascular disease and oral health: promoting
health and reducing risk.
Touger-Decker R. J Am Dent Assoc. 2010 Feb;141(2):167-70.
Review.