Nutritional Counselling in Oral Health

 

M. Vaishali¹, Pradeep Kumar.R²

¹Student Saveetha Dental College and Hospitals, Saveetha University

²Reader, Department of Public Health Dentistry Saveetha Dental College and Hospitals, Saveetha University

 

ABSTRACT:

Nutrition counselling has an important place in the dental care setting given the clear relationship between dietary factors and dental caries and the association between obesity, diabetes and periodontitis. Moreover, it is an important step in determining whether nutritional deficiencies/imbalances exist and assessing the need for necessary referrals. Limited resources, lack of financial incentive, inadequate skills in nutrition counselling and time constraints may restrict many dental care professionals from providing nutritional counselling as part of their routine preventive oral disease strategy. This review will provide evidence to suggest that nutritional counselling can be well received by patients and their families and they can induce meaningful changes.

 

 

 

INTRODUCTION:

Nutrition counseling has an important role in the dental care setting given the clear relationship between dietary factors and dental caries and the association between obesity, diabetes and periodontitis.1-3

 

Nutritional counseling can be defined as a cooperative mode of interaction between the patient and health care provider aimed at assisting patients in adopting healthy dietary behaviors associated with improved health outcomes.4  Moreover, it is an major step in decide whether nutritional deficiencies/imbalances exist and assessing the need for necessary referrals.5  Personalized and tailored nutritional counseling such as the guidance provided by dental care professionals should be altered based on age, socio-cultural background and health literacy.1

 

A well-balanced, nutritious diet is important for good oral health and general health. The food we eat supplies the nutrients that the body, bones,

 

teeth and gums need to renew tissues and help fight infection and disease, including periodontal (gum) disease. Dental hygienists work with their clients to promote good overall health by keeping the mouth and body healthy with preventive oral care treatment and nutrition counselling.

 

The Impact On Oral And Overall Health:

Hectic lifestyles, fast food, fad diets, large amounts of sugar and trendy supplements can have health repercussions. A poor diet can contribute to gum disease and tooth decay. Food high in sugars and starches increase the production of acids that can erode and weaken the tooth’s outer layer (enamel). Eventually, these acids can cause tooth decay. Lack of proper nutrition can lead to other diseases and conditions in the body such as obesity, hypertension, high cholesterol, type 2 diabetes, cardiovascular disease, osteoporosis and some cancers, including oral cancer.

 

Risk factors:

There are a number of factors that can put individuals at risk for poor oral and overall health such as an unhealthy diet, age, medication, allergies, restrictive diets, chronic disease, lack of vitamins (supplements), as well as socioeconomic conditions.

 

Children and teens Children need a balanced nutritious diet so that their teeth develop properly and are strong and decay-resistant. Eating patterns and food choices are important factors that affect how quickly tooth decay develops and could put them at risk for serious ailments, such as diabetes and osteoporosis, later in life.

 

Often the elderly are at high risk for poor nutrition. Those on restrictive diets or undergoing medical treatment may be too isolated, weak or lack the appetite, time, resources or money to eat nutritionally balanced meals. This could result in tooth loss, gum disease, pain or a joint dysfunction such as temporomandibular joint (TMJ) disorder, which can impair an individual’s ability to taste, bite, chew and swallow food. Medication.

 

Some medications can cause dry mouth, making it difficult to chew and swallow food. This can result in a poor nutritional state that could have a negative impact on oral health.

 

Many herbal supplements contain active ingredients that may not safely mix with prescription or over-the-counter drugs. Some food can also interact negatively with prescription drugs. Restrictive diets/allergies Those with food allergies or on restrictive diets, e.g., gluten free, as well as vegetarians, particularly vegans (consuming no food or drink of animal origin) may experience vitamin and protein deficiencies. This could put them at greater risk for tooth decay and gum disease. Choosing the right food and quantities can supply the nutrients they need. Taking a multi vitamin daily is also recommended.

 

The 5A’s approach to nutritional counselling:

Prior information regarding the patient’s dietary exposures, including meals, snacks, frequency, structure of meals and intake of sugared beverages, is key to providing successful behavior modification.

 

The 5A’s approach to nutritional counseling incorporates these key counseling components and can provide an effective and structured system easily implementable in the dental practice to increase compliance to nutritional recommendations.These steps outlined by Eaton et al. 10 include

 

1 Address:

the agenda, “What you eat is very important for your health and to decrease your further risk of dental caries. I recommend we review your dietary intake.”;

 

2 Assess:

the patient’s current and past dietary history and sources of motivation;

 

 

3 Advise:

patients based on their current dietary intake and oral and systemic health risks to move forward with focused areas of recommended modification; 4) Assist in preparing reasonable goals using anticipatory guidance, identifying potential barriers, sources of support, refer to dietitian if needed; and

 

4 Arrange

frequent follow-up which can be conducted through phone, email or dental office visit.

 

CONCLUSION:

As professional health-care providers, dentist are primarily concerned with promoting good oral health.  Nutritional counseling should be incorporated into each dental visit, which has been shown to be acceptable by dental personnel. Nutritional counseling must include elements to increase effectiveness and improve compliance. Specific nutritional recommendations can lead to improvements in patient nutritional status but require follow-up to provide support goals. Recommendations to improve oral health should be consistent with messages regarding systemic health and emphasize positive messages rather than restrictive messages.

 

REFERENCES:

1.       Marshall TA. Chairside diet assessment of caries risk. J Am Dent Assoc. Jun 2009; 140(6):670-674.

2.       Kading CL, Wilder RS, Vann WF, Jr., Curran AE. Factors affecting North Carolina dental hygienists' confidence in providing obesity education and counseling. J Dent Hyg. 2010; 84(2): 94-102.

3.       Ritchie CS, Joshipura K, Hung HC, Douglass CW. Nutrition as a mediator in the relation between oral and systemic disease: associations between specific measures of adult oral health and nutrition outcomes. Crit Rev Oral Biol Med. 2002; 13(3): 291-300.

4.       Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. May 2002; 22(4): 267-284.

5.       Touger-Decker R. Role of nutrition in the dental practice. Quintessence Int. Jan 2004; 35(1): 67-70.

6.       Hornick B. Diet and nutrition implications for oral health. J Dent Hyg. Winter 2002; 76(1): 67-78; quiz 79-81.

7.       Eaton CB, McBride PE, Gans KA, Underbakke GL. Teaching nutrition skills to primary care practitioners. J Nutr. Feb 2003; 133(2): 563S-566S.

 

 

 

 

Accepted on 13.11.2017        © RJPT All right reserved

Research J. Pharm. and Tech 2018; 11(10): 4749-4750.