Pedodontics III Al Azhar University Palestine Gaza Upload By: Lama El Banna lama1997bana@gmail.com Faculty of oral and dental medicine

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
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2. College of Dentistry
Pedodontic III
Nutrition and Dental Health -2-
Dr. Hazem El Ajrami
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3. 2) Water soluble vitamin:
Thiamine (B1) was one of the first of the 8
vitamins discovered. The symptoms of
deficiency (beri-beri) were known long before
the vitamin was isolated.
The disorder is characterized by degenerative
changes in the nervous system. Clinically,
three different types of thiamine deficiency
may be recognized:
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4. I. "Dry-beri-beri" in which a multiple
peripheral neuritis is the main feature.
II. "Wet beri-beri" in which edema, changes in
tendon reflexes, paresthesia, and muscle
cramps are common.
III. "Cardiac" type, which rapidly progresses to
acute heart failure.
Good sources of thiamine are liver,
yeast, whole grains, enriched flour and
cereals, and fresh green vegetables.
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5.  Oral manifestation of thiamin deficiency:
1. Increase the predisposition of oral mucous
membrane to herpetic lesions.
2. Recurrent aphthae under the tongue on
mucobuccal fold and oral surface of lower
lip.
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6. • Riboflavin (B2) is the vitamin found in several
coenzymes, the flavoproteins, which are
essential in oxidation-reduction reaction in
intermediary metabolism. Cellular activity
cannot occur if the oxidation-reduction
reactions are suppressed due to a deficiency of
riboflavin.
• The clinical signs of riboflavin deficiency
include eye lesions, especially vascularisation
of the cornea, angular stomatitis glossitis and
dermatitis around the nose and scrotum
glossitis. The best sources of riboflavin are
dairy products and meat.
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7. • Niacin is known as the antipellagra vitamin.
Pellagra is a deficiency syndrome, which is
characterized in the early stages by weakness,
lassitude, anorexia, and gastric upset. Later
this is followed by the classical “three Ds”:
dermatitis, diarrhea, and dementia. In addition,
glossitis and stomatitis are common features.
• Good sources of niacin are all types of high-
quality protein such as meat, fish, eggs and
milk.
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8. Oral manifestation of niacin deficiency:
One of the earliest sign of niacin deficiency
is fiery red glossitis the tongue becomes
swollen and fissured. In acute niacin
deficiency there may be generalized stomatitis
and inflammation the gingival similar to
vincent infection.
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9. • Pyridoxine (B6) is a vitamin that functions as a
coenzyme in those reaction involving
decarboxylation and transamination of amino
acids. A deficiency results in dermatitis about
the eyes, in the eyebrows, and at the angles of
the mouth.
• Because pyridoxine is distributed widely among
various foodstuffs, a deficiency of this vitamin
is not likely to occur unless the diet is
extremely poor.
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10. • Pantothenic acid is widely distributed in
natural foodstuffs and has been found in all
forms of living things. The name of the vitamin
itself reflects this property, pantothenos means
universal occurrence.
1. Pantothenic acid is vitally important in
intermediary metabolism, where it functions
as a part of coenzyme, involved in the
release of energy from carbohydrates and is
needed for the synthesis and degradation of
fatty acid, sterols, and steroid hormones.
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11. 2. It also functions in the acetylation of choline
and sulfonamide drugs and is involved in the
synthesis of prophyrins as well as many other
compounds of prime importance to the body.
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12. • Folic acid is also known as folacin:
Megaloblastic anemia during pregnancy
occurs because of a dietary lack of folic acid.
Insufficient absorption caused by vomiting, the
increased demand for folic acid by the fetus, or
because of some unknown defect in the synthesis
of folic acid coenzymes. Persons either sprue or
with other malabsorption syndromes may exhibit
megaloblastic anemia, or an extremely poor diet
may result in megaloblastic anemia.
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13. • Vitamin B12 is about to protein in foods of animal
origin. There is little vitamin B12 vegetables. The
intrinsic factor, a microprotein enzyme secreted by
the stomach, is necessary to facilitate absorption of
vitamin B12, a deficiency of vitamin B12 results in
pernicious anemia. The deficiency can occur for
several reasons. In some persons, the intrinsic
factor may be lacking because of genetic factors or
because of total or subtotal gastrectomy. May
develop sore tongue, paresthesias, and signs of
spinal degeneration. Other causes of deficiency are
parasitic infections. Sprue and malabsorption
syndromes can cause a deficiency of vitamin Bl2.13

14. • In normal individuals, about 1.5 ug / day will
maintain and meet the biochemical needs of
the body.
• Biotin is necessary in the enzyme systems of
bacteria, animals, and probably man. It is a
required component in reaction involving the
carboxylation and decarboxylation of various
compounds associated with carbohydrate,
lipid, and protein synthesis.
• Biotin is found in a wide variety of foods, and
intestinal synthesis by bacteria is an important
source of this vitamin, a protein in raw egg
white (avidin).
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15. • Ascorbic acid (vitamin C):
Ascorbic acid is essential for tissues of
mesenchymal origin, fibrous tissue, teeth
developing bone, and blood vessels. Changes in
these tissues are the ones that explain the clinical
signs that are seen in scurvy. It may be observed
occasionally in infants whose milk formula is
unfortified and who refuse fruit juice.
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16. • Although clinical scurvy is rare, it is probable
that many cases of ascorbic acid deficiencies
exist on a subclinical basis. The term "scurvy"
refers to ascorbic acid deficiency associated
with the classical signs of the deficiency:
weakness easy fatigue, shortness of breath,
pain in bone, joints, and muscles dry rough
skin, purpura, petechial hemorrhages or
ecchymoses, swollen, spongy. Inflamed
gingiva, and extremely mobile teeth.
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17. V. Minerals:
The fifth class of nutrients is the minerals.
• Calcium: the skeletal tissues of the body
contain over 99% of the total body calcium
and 70% to 80 % of the total body
phosphorus.
• In addition to its vital role in skeletal tissues,
calcium is necessary to maintain acid-base
equilibrium and to help control muscle tone.
It is an essential well-known role in the
regulation of heart beatings. Calcium is also
necessary for the normal blood-clotting
mechanism.
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18. • Calcium is absorbed more efficiently during
times of increased need, when adequate
vitamin D is available, and when the gastric
acidity is low, Calcium absorption is
decreased or impaired by phytates, oxalate,
and fatty acid that form insoluble or poorly
soluble complexes.
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19. • Phosphorus: is extremely vital to health
because of its role in all body processes. Not
only is phosphorus an important bone mineral, it
also occupies a primary role in energy
transformations. Phosphate compound in the
form of adenosine diphosphates and
triphosphate (ADP and ATP) plus other
compound containing a high-energy phosphate
bond are essential to provide energy for
biochemical reactions. Many coenzymes have
phosphate radicals for example, thiamine
pyrophosphate.
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20. • Iron: is an essential mineral for the body. It is
present in hemoglobin, myoglobin, in several
enzymes such as catalases, peroxidases.
Absorption rate is increased during period of
increased demands such as growth in infants
and young children; however, 10% or more is
usually absorbed.
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21. • A deficiency of iron results in hypochromic
microcytic anemia. The frequency of
occurrence is greatest among infants and
children.
• Good sources of iron are meats, shellfish, egg
yolk, and legumes. Fair sources are green leafy
vegetables, whole grain and enriched cereal
products.
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22. Dental implications of dietary and medicinal
forms:
Iron tonics administered in fluid form cause
a generalized black staining of the teeth due to
deposition of iron sulphide. Iron sulphide due to
its low PH causes excessive decalcification of
the teeth .
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23. Thank You
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