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3. Nutrition
The science of food, nutrients and other substances
and balance in relation to health and disease and
process by which the organism ingest, digest,
absorbs, transports, utilizes and excretes the food
substances.
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4. Nutrient
Food consists of certain chemical substances, which are called as
nutrients.
Function of nutrients may be one of following
Regulation of different body process
Provide materials for development repairing and maintaining of
different body tissues.
Serves as fuel to provide energy.
Malnutrition and under-nutrition constitute globally the most
important category of environmental disease.
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5. Types of Nutrients
Macronutrients – greater part of food
Carbohydrates
Fats
Proteins
Micronutrients - required in small quantities
Vitamins
Minerals
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6. Defined as one which contains different types of foods in
such quantities and proportions that need for energy,
amino acids, vitamins, minerals, fats, carbohydrates ,and
other nutrients is adequately met for maintaining health,
vitality ,and general well being and also makes small
provisions for extra nutrients to withstand short
durations of leanness.
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7. Malnutrition
It is a pathological state, resulting from ,a
relative or absolute deficiency or excess of
one or more essential nutrients.
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9.
Increased requirements
Trauma
Burns
Rapid growth in infancy, in childhood, of puberty,
pregnancy,
Excessive loss of in protein losing enteropathies and
nephropathies.
Special Category
Total parenteral nutrition
Drug induced interference with absorption
Genetic disorders interfering with conversion or utilization
of nutrients
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10. Malnutrition – Occlusion
Loss of teeth
Severe caries
Periodontal disease
Retarded Jaw development
There is a special need for Calcium, Phosphorus,
Vitamin C & Vitamin D, in relation to occlusion
and dentofacial development
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11. Over Consumption
Obesity
Diabetes type 2
Obstructive sleep apnea
Hypertension
Coronary heart disease
Some cancers
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14. Any form of carbohydrate gets converted to glucose
after ingestion and then gets absorbed in to the blood
R.D.A. is 440gms
Excess amount which is present in blood is converted
to the glycogen and stored into the liver
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15. Carbohydrates
Glucose enter the circulation to supply requirement to
the other parts of body.
Certain amount of glucose is converted to glycogen
for storage in other parts of body like muscle
Blood sugar level is maintained with in the
physiologic limits, i.e. (60-90 mg/100ml).
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19. Proteins
Functions
Building, repair & replacement
Enzymes & hormones
Regulators of fluid & acid-base balance
Transport of molecules & Ab
4kcal/g
RDA: 0.8 g/kg
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20. Proteins
Sources:
Animal proteins - eggs, meat, fish, milk
Plant proteins – soya beans, wheat, corn & rice
Effect on formation, eruption, alignment:
During pregnant
During active period of growth & development
Protein calorie malnutrition
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21.
Co-enzyme + Apoenzyme - Holoenzyme
2 forms - active & inactive (provitamin)
Classification
Water soluble : Vit B-complex & C
Fat soluble : Vit A, D, E, K
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42. 4% body wt
Macro minerals (>100mg/day) Ca, P, Na, K, Mg, Cl,
S
Micro minerals (.004 - .00004%)
Fl, Fe, I, Cu, Co, Mn, Mo, Se, Cr, Zn
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43. Distribution
1) Bones and Teeth (99%)
- amorphous form – young teeth
- crystalline form – mature teeth
2) ECF, soft tissues & membrane structures
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44. Function:
Bone and teeth
Blood coagulation, muscle contraction…
Irritability of nervous tissue - tetany
Release of neurotransmitter
Transport of ions across membrane
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46.
80-90% + Ca - bone & teeth
Functions…
Formation of bone & tooth
Absorption & transport of nutrients
Regulation of acid - base balance
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48. Distribution.. 60% - PO4 ions & CO3
40% - cells, soft tissue, body fluids
Functions:
Cellular respiration, energy production
Metabolism of CHO and protein
Regulation of acid-base balance
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53. Fe deficiency Anemia
- Inadequate intake & increase loss
- Infants & children… low content of
Fe in milk & less Fe reserve at birth
- Pregnant women
- Pathological blood loss
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55. 2-3 mg
Functions…
- Integral part of metallo-enzymes
- Synth of RNA, DNA & Protein
- Wound healing & growth of all tissues
- Production of hormones
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56. C/F:
- Poor appetite, slow healing of wounds
- Loss of taste sensation & co-ordination
- Pregnancy-abnormal taste sensation, high risk to
fetus
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62. Nutritional factors & orofacial
skeleton development
All tissues in human organism develop in sequential phase like.
Hyperplastic phase (proliferation)
Hypertrophic phase (cellular organization)
DNA formation
RNA formation.
Formation of proteins.
Any interference with proper development during these early phases
can lead to alteration of ultimate tissue development.
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63. Nutrition & Skeletal Maturation
Prolonged nutritive failure in growing children’s
shows a retarding influence on bone centers
Correction of dietary deficiencies of bone-forming
nutrients brings an acceleration in the over all rate
of skeletal maturation.
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64. Dietary requirements in growing children’s vary with
age and body size. Body size being more important
than age in this relation.
Dietary correction alone is not sufficient to ensure
normal calcium metabolism.
Other factor that influences the teeth by nutritional
means are abnormalities of digestion, assimilation,
endocrine disturbances and infections diseases.
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65. Co-relation of diet & orofacial
growth
Retardation of growth and morphologic
alteration of orofaical areas can occur in both
humans and animals because of deficiency of
essential nutrients.
Animals on diet deficient in folic acid,
riboflavin, and zinc have born offspring’s
with increased risk of cleft palate and lips.
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66. Short Period of Malnutrition
7-12 months
An increase in anterior open bite
A reduction in dimensions of dental arches,
with inadequate space for teeth
Insufficient dental eruption
Absence of natural diastema between front
deciduous teeth
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67. Short Period of Malnutrition
Shorter roots
Shorter mandible in antero-posterior dimensions
Marked reduction in ascending ramus, condylar
region
Changes in dentoalveolar inclination in incisor
regions
Mineral inadequacies in the diet harm bone more
than tooth
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68. Removal of CASIEN from diet of young animals has
resulted in the substantial reductions in mandibular
dimensions.
A deficiency of ESSENTIAL FATTY ACIDS has
interfered with the formation of mineralized tissues,
mostly with dentin, development.
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69. Animals
In addition with nutrition deficiency, excess intake
of vitamin A,D or K cause skeletal alterations in
animals.
Osseous damage has been observed in breast fed
animal offspring’s when maternal milk has been deficient
in micro minerals, or when hypoglycemia or folic acid
deficiency have been present.
Congenital abnormalities of dentofacial development and
occlusion are found in rats with riboflavin deficiency.
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70.
Deficiency of riboflavin has been found in
experimental
mandible,
animals to results in shortening of
cleft
palate
and
other
skeletal
malformations
Clefts of the palate and general growth
retardation and deformities of bone in rats with
acute folic acid deficiency is seen
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71. Human:
Fetus may suffer from Gregg’s viral syndrome. In
this condition a pregnant woman who has been
affected by German measles, causes the fetus to suffer
from osseous malformations. Such as microcephaly
and maxillary and mandibluar alterations
associated with poor dental alignment.
Fetal rickets can also occur when mother is
suffering from Vitamin D deficiency
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72. Inadequate intake of Vitamin. A and C has resulted in
dentin reduction, and it has caused osteoblast to turn
into fibroblast, thus preventing the periodontal
ligament from relaying tension to the bone and
causing the breakdown of dental arches.
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73. Vitamin C. is essential in formation of intercellular
substance, fibrous tissue matrices of bone, tendon and
cartilage.
In severe deficiency, the gums may become retracted,
formation of periodontal pockets. Loosening of teeth and
loss teeth.
Vitamin C deficiency produces sub-clinical scurvy which is
related with damage in development and eruption of the
teeth and formation of hypodimensional osseous bases.
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74. Vitamin B2 deficiency produces retardation of growth
of dentofacial structures.
A prenatal matarnal riboflavin (B2) deficiency
produces anomalies of jaw and teeth; which shows
shortness of mandible, and maxilla, cleft palate,
severe anomalies of incisor teeth, dentofacial
malformations resembled Angles class II malocclusion.
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75. Deficiency of Vitamin D may result to rickets, reduction
in blood calcium and phosphorus, delayed closure of
fontanelles. Disproportionate growth occurs between
face and skull. It may cause interference with bone
growth.
It causes retarded eruption of teeth early loss of deciduous
teeth due to caries.
Jaw bones become thick.
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Teeth are irregularly arranged
76. Maxilla become narrow and palate becomes high.
Mandible becomes short.
Infants with low vitamin D intakes showed delayed
eruption of teeth.
Increased susceptibility of osseous tissue to muscular
traction as undesirable oral habits.
Open bite, transverse hypodimensions and misshapen
palate are frequently observed in vitamin D deficiency.
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78. Vitamin A
The principal effect of vitamin A deficiency is
reduction in size of skull, changes in shape of skull distort
the face as well. The bones of face particularly mandible,
malar and zygomatic process of temporal bone are
thickened and coarse.
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79. Disturbances of differentiation and appositional
growth of developing teeth.
Disturbances in calcification of teeth, pulp stones.
Retardation of eruption.
Retardation of general dental growth and
development.
Disturbances of periodontal tissue.
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80. FOOD CONSISTANCY ON
OROFACIAL DEVLOPMENT
In Animals
It has been shown in animals that a diet that does not
supply food of a sufficiently hard consistency does not
supply adequate stimulus for proper mastication, resulting
in narrower maxillary arches.
Similar observations have also been made in humans, and
a genuine arch collapse syndrome has been described.
This type of pathologic condition was observed in
histologic studies on animals, in which alterations were
seen in the haversian system of the mandible.
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82.
There is a lower level of eruption, especially
posterior eruption.
Maxillary arches are narrower.
Mandibles are shorter, and condyles are thinner.
Temporal and massetter muscles have less tone.
The linear dimension of the skull is reduced.
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83. FOOD CONSISTANCY ON
OROFACIAL DEVLOPMENT
Soon after birth, the newborn learns that food results
from the action of sucking, as a result of the sucking
and pressing actions that are associated breast feeding,
the baby develops the earliest important functional
influences on both the thrust and physiologic growth
of the mandible.
On the other hand, the mandible may be compelled to
withdraw as a result of bottle-feeding because its
physiologic thrust effort is missing.
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84. FOOD CONSISTANCY ON
OROFACIAL DEVLOPMENT
According to anthropologic studies, the exertion of
the masticatory function has been progressively
decreasing in people from industrialized area,
probably because of the use of softer diets. But the
diets of rural populations, which usually contain an
abundance of raw vegetables, offer adequate
masticatory muscular stimulation, and orthodontic
problems in this group are at a minimum.
The consistent use of a too soft diet is a major factor
in the occurrence of dental malpositioning.
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85. Nutrition and Teeth
Diet affect teeth in two distinct ways.
LOCAL EFFECT - depends on the intraoral chemical
or physical action on the external surfaces of the teeth
and oral tissues of the products of masticatory and
bacterial action on the various foodstuffs.
SYSTEMIC NUTRITIONAL factors is important during
the period of tooth development only.
periodontium is continuously influenced by systemic
factors.
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86. Nutrition and Teeth
Critical periods exist in the development of teeth
during which time any nutritional imbalance will lead to
irreversible change in teeth.
Nutritional deficiency is also associate with
periodontal dieses deficiency of calcium, phosphate and
vitamin D produces osteoporosis of alveolar bone.
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87. Nutrition and Teeth
If mother’s diet is deficient in protein, will affect
the child’s teeth in the following ways.
Teeth will be smaller in size specially third molars.
Teeth will be more caries prone.
Late eruption of third molars.
Rotated and crowded teeth.
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88. Nutrition and Teeth
Optimal and harmonious growth and development of
maxilla and mandible are necessary to maintain a
harmonious dental arch.
Deficiency of required nutrients will results in
inadequate bone growth patterns with concomitant
malalignment and malocclusion of the teeth.
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89. Extensive epidemiologic studies show that children
calcifying their permanent teeth while using a
domestic water containing about 1 part per million of
fluoride show only about 40 to 60 per cent as much
dental caries as comparable groups of children using
fluoride-free water.
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90. Caries resistance, produced by fluorides during tooth
calcification, is due to the incorporation of the
fluoride ion in the enamel
Fluoridation of water supplies, or topical application
of fluorides, and good oral hygiene can prevent caries
in spite of the presence of sugar in the diet.
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91. Dentistry for child & adolescent - Mc Donald
Nutrition in Clinical Dentistry - Abraham E. Nizel
Craniofacial Embryology – Fourth Ed. – G.H.Sperber
Contemporary Orthodontics – Fourth Ed. – Proffit
Essentials of Facial Growth – Donald H. Enlow
Handbook of Orthodontics – Fourth Ed. – Moyers
Textbook of Orthodontics –Samir E Bishara
Orthodontics- Principles &Practice- Third Ed - T.M.Graber
Color Atlas of Dental Medicine - Orthodontic Diagnosis – ThomasRakosi, Irmtrud
Jonas, Thomas M Graber
• Textbook of Orthodontics - Salzmann
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