Dental Hygiene Considerations

 

• Although fat intake may have a positive effect on dental
  health, the medical history of the patient needs to be consid-
  ered when providing nutritional counseling.
• Lipids provide a source of energy, 9 kcal/g, whereas carbo-
  hydrates and proteins provide 4 kcal/g.
• Fish consumption may have a favorable effect on blood
  platelets and other blood clotting mechanisms, reducing the
  risk of clot formation.
• Evaluate your total fat intake. Everyone
  needs adequate amounts of fat to allow protein to perform
  its functions of building and repairing. If total energy intake
  is inadequate, healing is slower. Also, inadequate fat intake
  could lead to secondary deficiencies of fat-soluble
  vitamins.
• Foods such as nuts and certain cheeses (cheddar, Monterey
  Jack, Swiss) may protect teeth against acid attack, especially
  when consumed after fermentable carbohydrates. Even
  though they are generally considered nutritious foods, they
  have a relatively high fat content.
   
• Because omega-3 fatty acids may be beneficial to health,
  determine your frequency of fish consumption. An
  increase in fish consumption is recommended for most
  patients, but some fish, especially mackerel and tuna, should
  be consumed in moderation because of their mercury
  content.
   
• Do not advocate indiscriminate use of omega-3 fatty acid
  supplements. Fish oils may have a negative effect on blood
  glucose levels in people with diabetes mellitus.
  Intakes of more than 3g should be under a healthcare provider’s supervision.
• If you are taking anticoagulants or aspirin, you should be
  careful with use of omega-3 fatty acids. You may be prone to
  bleeding problems or poor wound healing.
   
• Structural differences among the various trans fatty
  acids result in different health effects.

Nutritional Directions

• Although the digestion of fried foods takes longer, the
  process is as complete as that of other foods in most indi-
  viduals if food is fried at the proper temperature.
• Fats act as a lubricant  in  the  intestines, decreasing
  constipation.
   
• Foods containing trans fats include stick margarine, vegeta-
  ble shortening, peanut butter, commercially baked goods
  (cookies, crackers, biscuits, cake, and breads), potato chips,
  salad dressing, and fast foods (French fries, doughnuts, and
  other fried foods). The use of products containing hydroge-
  nated or partially hydrogenated (or trans) fats should be
  limited because trans fats behave like saturated fat in the
  body.
• People should consult their health care provider or a
  registered dietitian before taking an omega-3 fatty acid
  supplement.
• People should read labels of omega-3 fatty acid supple-
  ments. Supplements made from liver should be avoided
  because high levels of pesticides or heavy metals may be
  present.
• The potential relationship between periodontal disease and
  heart disease emphasizes important health reasons for good
  dental hygiene.
• Partially hydrogenated oils are trans fats, but fully hydroge-
  nated fats do not contain trans fats.
• Avoid choosing a product with less trans fats but more satu-
  rated fat because both have undesirable effects on blood
  lipids.

 

WISE CHOICES OF DIETARY FATS

Purchasing and Planning

• Read nutrition labels on foods to determine the amount of fat and saturated fat in a serving. Low fat is less than 3 g fat per serving.
• Choose fats and oils with 2 g or less saturated fat per tablespoon, such as liquid and tub margarines and canola and olive oil. Liquid vegetable oil should be listed as the first ingredient. Avoid saturated fats such as butter, lard and palm and coconut oils.
• Avoid foods containing hydrogenated or partially hydrogenated fats because they contain trans fatty acids. Such foods include shortening, chips, doughnuts, cookies, snack crackers, cakes, fried foods, and some processed and convenience foods.
• Foods containing partially hydrogenated fats may have some redeeming factors if they contain canola or soybean oil that contain trace amounts of partially hydrogenated oil.
• Watch for reformulated products with lower trans fats.
• Substitute plain low-fat yogurt for mayonnaise or sour cream or purchase light sour cream (compare fat content on labels).
• Choose two or three servings of lean meat, skinless poultry, or fich, with a daily total of about 6oz.
• Choose a vegetarian entree (dry beans and peas) at least once a week.
• Include fish (not fried) at least twice a week.
• Include all types of meat; producers breed animals to produce leaner beef and pork.
• Choose beef graded “select” because it contains fewer kilocalories as a result of less fat marbling. The fat content of the meat also depends on the type of cut; leaner cuts include flank steak, sirloin or tenderloin, loin pork chops, and 85% or grater lean ground beef.
• Use low-fat ground turkey or extra-lean ground beef in casseroles, spaghetti, and chili.
• Moderate the use of egg yolks (maximum of four egg yolks weekly) and organ meats (liver, brains, and kidney).
• Choose tuna packed in water, not in oil (compare fat content on labels).
• Choose cheeses with 6 g or less of fat per ounce (90% of the kilocalories in cream cheese are from fat).

Food Preparation

• Use fats and oils sparingly in cooking (roast, bake, grill, or broil when possible). Baste meats with broth or stock.
• Use nonstick cookware and an aerosol cooking spray.
• Use the paste method for making gravy or sauces:add flour or cornstarch to cold liquids slowly and blend well.
• Season with herbs, lemon juice, or stock rather than lard, bacon, ham, margarine, or fatty sauces.
• Remove skin from poultry and visible fat from beef and pork products.
• Skim fat from homemade soups or stews by chilling and removing the fat layer that rises to the top.
• Include healthful fats, such as olive, canola, soybean, and flaxseed oils; nuts; avocados; and olives.
• Use jam, jelly, or marmalade instead of butter or margarine.
• Rely on mustard and salad greens to add moisture to sandwiches rather than fat-laden spreads.
• Marinate leaner cuts of meat in lemon juice, flavored vinegars, or fruit juices.
• Saute with olive oil instead of butter. Substitute olive oil for vegetable oil in salad dressings and marinades. Use canola oil for baking.
• Sprinkle slivered nuts or flaxseed or sunflower seeds on salads instead of bacon bits.
• Choose a handful of nuts rather than chips or crackers.
• Place meat or poultry on a rack to allow the fat to drain.
•  Steam, simmer or boil, broil, bake, or microwave foods rather than fry.
• Use smaller servings of oil-based or low-fat salad dressings.
• Use whole-grain flours to enhance flavors of baked goods made with less fat.
• Choose nonhydrogenated peanut butter or other nut-butter spread on celery, banana, or rice or popcorn cakes.
• Add avocado slices rather than cheese to a salad or sandwich.

Federation of American Societies for Experimental Biology.

Fish oil could be therapy for periodontal disease.

San Diego, CA — Periodontitis, inflammation of the tissue surrounding
the teeth, affects more than half of adults and is linked to an
increased risk of stroke and other heart problems. To evaluate whether
fish oil supplementation could be an adjunct therapy for periodontitis,
Dr. Alison Coates from the University of South Australia and colleagues
from the School of Dentistry at University of Adelaide in Australia
reviewed evidence from eight unique studies that involved humans.

Their review of these studies showed that improvements in clinical
measures were common in all studies, but were scientifically significant
in two that used a combination of fish oil and aspirin. Although this is
not conclusive evidence, intake of fish oil is recommended for health
benefits beyond the teeth.

“I would recommend that people ensure they have a sufficient intake of
long chain omega-3 fatty acids in their diet for general health,” said
Coates. “In Australia, these types of fatty acids are considered to be
essential with ~500 mg recommended as the suggested dietary target. This
equates to approximately 2 fatty fish meals per week.”

There are no serious dangers to consuming fish oil. At high levels of
fish oil above the GRAS limit, people may experience a delayed clotting
time and at very high doses potential gastric upset. If people are
taking blood thinning medication, then they should consult with a doctor.

The group reports that the evidence for fish oil being effective in
reducing periodontal symptoms is building but there is a need for more
well designed studies that evaluate the supplement both alone and in
combination with aspirin to be able to tease out whether fish oil by
itself is effective. It is important that compliance to treatment is
considered and that the dose and length of supplementation is
appropriate. A clinical trial is underway in Australia that is
investigating the effects of fish oil as adjunct therapy for periodontitis.

Results from this study will be presented April 24, 2012 at the
Experimental Biology 2012 meeting in San Diego, CA.

About Experimental Biology 2012

Experimental Biology’s mission is to share the newest scientific
concepts and research findings shaping future and current clinical
advances – and to give scientists and clinicians an unparalleled
opportunity to hear from colleagues working on similar biomedical
problems using different disciplines. With six sponsoring societies and
another 20 U.S. and international guest societies, the annual meeting
brings together scientists from throughout the United States and the
world, representing dozens of scientific areas, from laboratory to
translational to clinical research. The meeting also offers a wide
spectrum of professional development sessions.

About the American Society for Nutrition

The American Society for Nutrition (ASN) is the preeminent professional
organization for nutrition research scientists and clinicians around the
world. ASN is dedicated to bringing together the top nutrition
researchers, medical practitioners, policy makers and industry leaders
to advance our knowledge and application of nutrition. Founded in 1928,
ASN publishes The American Journal of Clinical Nutrition (AJCN), The
Journal of Nutrition (JN), and Advances in Nutrition and provides a wide
range of education and professional development opportunities to advance
nutrition research, practice, and education. Visit ASN online at
www.nutrition.org.

http://www.eurekalert.org/pub_releases/2012-04/foas-foc041812.php

 

What can happen when diabetes isn’t well maintained. The good news is that there are things you can do to arm yourself against the complications associated with the disease. On the program to tell us more about ways to properly manage diabetes was pharmacist David Wilpula and clinical dietitian Ghida Bilani.

or click on the link blow to listen to the interview
 http://www.oakwood.org//Video/view.aspx?videoID=1621

FAT STORAGE

Adipose tissue, or body fat, has several roles:

1. it provides a concentrated energy source
2. it protects internal organs
3. it maintains body temperature

Energy
Excess dietary carbohydrates and protein are converted to fat and stored in adipose tissue. Fatty acids can be used as an energy source by all cells except red blood cells and central nervous system cells. People have been known to survive total starvation for 30 to 40 days with only water to drink.

Protection of Organs
Fatty tissue surrounds vital organs and provides a cushion, protecting them from traumatic injury and shock.

Insulation
The subcutaneous layer of fat functions as an insulator that preserves body heat and maintains body temperature. Excessive layers of fat can also deter heat loss during hot weather.

DIETARY FATS AND DENTAL HEALTH

Dietary fats are essential for oral health because they are
incorporated into the tooth structure. There is some evidence
from epidemiological and laboratory studies that fats may
have a cariostatic effect. Eskimos, whose diet may contain
80% fat from animal and seafood sources, have a very low
incidence of dental caries. Another factor that may affect
caries rate in Eskimos is a low carbohydrate intake. Dietary
fats probably have local rather than systemic influence
because fats added to foods protect the teeth more than foods
naturally high in fat. Precisely how fats reduce the caries
rate is unknown; however, several hypotheses have been
explored, as follows:

1. Some fatty acids, specifically oleic acid, are growth
factors for lactic acid bacteria, whereas streptococcal
organisms are inhibited by lauric acid  (Lauricidin).

2. Long-chain fatty acids may reduce dissolution of
hydroxyapatite by acids.

3. Oral food retention is reduced by increasing fat intake.

4. Fats may lubricate the tooth surface and prevent penetra-
tion of acid to the enamel (i.e., the “greased” tooth is
impervious to acid, protecting caries-susceptible areas).

5. Fats may produce a film on the food particles and prevent
partial digestion of food particles in the mouth.

6.Dietary fat delays gastric emptying, enhancing fluoride
absorption and increasing tissue fluoride concentration.

Bacterial inflammation and the systemic immune response
are believed to play a central role in the initiation and propa-
gation of atherosclerosis. When bacteria are allowed to
grow rampantly in the mouth, inflammation may occur
throughout the body, including in plaque forming on the
lining of the arteries. This inflammation may serve as a base
for development of arterial atherosclerotic plaques. Research
is ongoing to determine how these conditions are related,
but some researchers believe gingivitis is a risk factor for
coronary artery disease.

DIETARY REQUIREMENTS

A certain amount of fat is needed to provide adequate
amounts of fat-soluble vitamins and EFAs. The acceptable
macronutrient distribution range (AMDR) for fat is esti-
mated to be 20% to 35% of energy intake for adults.
The lower limit for fat intake was established to mini-
mize the increase in blood triglyceride levels and decreases
in HDL cholesterol levels that occur with higher intakes of
carbohydrates. The upper limit of 35% kcal from fat was
based on information indicating higher fat intake is associ-
ated with a greater intake of energy and SFA, which may be
detrimental to health.
   Between 1971-2000, the percentage of kilocalories from
total fat decreased to about 33%. This decrease was because
of an increase in total kilocalories consumed; actually, the
total fat consumed increased. The World Health Organiza-
tion (WHO) recommends a range of 15% to 30% of total
kilocalories from fats.
   The dietary reference intake (DRI) also recommends SFA
and trans fatty acid be as low as possible while consuming
a diet providing an adequate intake of all essential nutrients.
The percentage of saturated fat in a 2000-kcal diet is cur-
rently about 11%.
   The adequate intake (AI) established for linoleic acid is
17 g per day for men and 12 g per day for women 19 to 50
years old, and 14 g per day for men and 11 g per day for
women older than 51 years. When dietary intake is high,
liloleic acid is stored in the tissues.

SOURCES

Of the food groups, animal products contribute the largest pro-
portion of fat, although their share has been declining. The
most important sources of saturated fats are the meat and
milk groups; cocoa butter and coconut and palm oils also
are high in saturated fat. SFAs are found in animal fats,
butter fat, coconut oil, cocoa butter, coffee creamers and
fully hydrogenated vegetable oils.
Animal products and canola and olive oils supply approximately
50% of MUFAs. Oleic acid, the most prevalent MUFA, is
present in most fats, oils, nuts, seeds, and avocados.
   PUFAs from the n-6 series are derived from land plants,
especially foods from the grain group, and additional fats
and oils. Linoleic acid is the most prevalent PUFA in the
food supply. Safflower, soybean, and corn oils provide the
most linoleic acid; food sources are nuts and seeds. Approxi-
mately 80% of all vegetable oil consumed in the United
States is soybean oil. CLAs are natural components of
beef, lamb, and dairy products. Linolenic acid is present in
flaxseed, canola, and soybean oils; soybeans; walnuts; flax-
seed; and wheat germ. The long-chain n-3 fatty acids (EPA
and doxosahexaenoic acid [DHA]) are provided from
seafood, including fatty fish such as mackerel, Atlantic
salmon, and albacore tuna (presented in order of highest to
lowest), and fish oils. These foods are also low in saturated
fat. The American Heart Association (AHA) Guidelines rec-
ommend consumption of fish at least two times a week.
   Approximately 52% of the soybean oil used in the United
States was partially hydrogenated in 2003-2004. Trans fats
are present in shortening; stick margarine; deep-fried fast
foods such as French fries and commercially baked pastries
and desserts such as doughnuts, cookies, and crackers.
   Only animal products contain cholesterol;
it is not found in egg whites or plant foods (i.e., vegetable
oils). It is highest in egg yolks, liver, and other organ
meats.

The Encarta World English Dictionary defines a habit as a “regularly repeated behavior pattern; an action or pattern of behavior that is repeated so often that it becomes typical of somebody, although he or she may be unaware of it.” Some habits are good, but others are detrimental to our health. These tips can help you break unhealthy habits.

Change multiple bad habits

Changing more than one habit at a time traditionally is thought to cause too much stress for a person, leading to greater rates of relapse. However, a new study from the Baylor College of Medicine shows that many people do better when they break multiple habits at the same time. This is believed to hold true, because bad habits love company and tend to cluster together. A good example of this is people who say, “I only smoke when I am drinking alcohol.”

Have a good reason to break a bad habit

You need a good, well-thought-out reason for wanting to break a bad habit. “I want to stop smoking cigarettes” is not going to cut it. Instead, try, “I want to stop smoking cigarettes to reduce my risk of developing heart disease and cancer, to feel more comfortable in social situations, to save money for a vacation next summer, and to stop allowing an externality to control how I spend my time.”

Find a new way of spending your time

A habit is often a way of spending time. You will need to find a new way to fill that time before you can successfully break the habit. What if you worked on an art or craft project that you used to enjoy doing instead of watching television and snacking on work nights, or what if you started to read through that stack of books and magazines you set aside for a “later time” instead of shopping every Saturday?

Do not go it alone

You do not need to call a meeting of all of your coworkers and announce that you are giving up your 4 pm candy bar habit, but it is helpful to let a few supportive people know what you are doing, so that they can help to hold you accountable and motivate you during tough times.

Do not anticipate failure

Do not expect to fail, but accept that it might happen. Many people say, “I am sure that I am going to screw this up, but when I do, I will just try again.” This is a mistake. Why are you “sure” that you are going to fail at something until you try not to? You often hear these remarks from people who are making a change that they are not personally invested in and are instead changing something about themselves for another person or group of people. Instead, it is healthier to say, “I might slip up, although I am going to try really hard not to because (list of reasons). If I do slip up, I am going to (list of actions).”

Set ‘want to’ goals

Studies have shown that “want to” goals are much more likely to succeed than “have to” goals. Saying, “I have to start eating better” probably is not going to help. Saying, “I want to replace my potato chip and ice cream habits with more fruits and vegetables to lose weight and increase my energy” is more likely to lead to sustained lifestyle changes.

Know why you are doing something

You need to know why you are doing something in order to find an effective way to stop it. Why are you digging into the candy jar, lighting up, pouring yourself another glass of wine, or spending too much money? These habits may form because of either chronic stress or chronic boredom, among many other reasons. What the reason is will greatly impact how to best go about breaking the habit.

Pick a date to break that habit

Sometimes, you just have to jump. Some people spend so much time researching why to stop doing something, strategizing how to stop doing something, and coming up with ways to make stopping easier that they never actually get around to stopping. If this sounds familiar, you have to just specify a date to break a bad habit and do it.

 

References and recommended readings

Bouchez C. How to drop pound-packing habits. Available at: http://www.webmd.com/diet/guide/how-to-drop-pound-packing-habits. Accessed September 26, 2009.

Martha Stewart Living Omnimedia, Inc. How to break a habit. Available at: http://www.wholeliving.com/photogallery/how-to-break-a-habit?autonomy_kw=breaking%20habits. Accessed on September 26, 2009.

Van Dusen A. Best ways to break unhealthy habits. Available at: http://www.forbes.com/2008/04/30/breaking-bad-habits-forbeslife-cx_avd_0430health.html. Accessed on September 26, 2009.

 Review Date 12/09

G-1194

Besides the link between tobacco and heart disease, stroke, emphysema, and cancer (especially lung and throat cancers), smoking leads to the following oral health consequences:

• Bad breath
• Tooth discoloration
• Inflammation of the salivary gland openings on the roof of the mouth
• Increased build up of plaque and tartar on the teeth
• Increased loss of bone within the jaw
• Increased risk of leukoplakia, white patches inside the mouth
• Increased risk of developing gum disease, a leading cause of tooth loss
• Delayed healing process following tooth extraction, periodontal treatment, or oral surgery
• Lower success rate of dental implant procedures
• Increased risk of developing oral cancer

How Does Smoking Lead to Gum Disease?

Smoking and other tobacco products can lead to gum disease by affecting the attachment of bone and soft tissue to your teeth. More specifically, it appears that smoking interferes with the normal function of gum tissue cells. This interference makes smokers more susceptible to infections, such as periodontal disease, and also seems to impair blood flow to the gums – which may affect wound healing.

Do Pipe and Cigar Smokers Experience Fewer Oral Health Risks Than Cigarette Smokers?

No, like cigarettes, pipes and cigars do lead to oral health problems. According to results of a 23-year long study published in the Journal of the American Dental Association, cigar smokers experience tooth loss and alveolar bone loss (bone loss within the jawbone that anchors teeth) at rates equivalent to those of cigarette smokers. Pipe smokers also have a similar risk of tooth loss as cigarette smokers. Beyond these risks, pipe and cigar smokers are still at risk for oral and pharyngeal (throat) cancers – even if you don’t inhale – as well as face the other oral health downsides of smoking – bad breath, stained teeth, and increased risk of periodontal (gum) disease.

Are Smokeless Tobacco Products Safer?

No. Like cigars and cigarettes, smokeless tobacco products (for example, snuff and chewing tobacco) contain at least 28 chemicals that have been shown to increase the risk of oral cancer and cancer of the throat and esophagus. In fact, chewing tobacco contains higher levels of nicotine than cigarettes, making it harder to quit than cigarettes. And one can of snuff delivers more nicotine than over 60 cigarettes.

Smokeless tobacco can irritate your gum tissue, causing it to recede or pull away from your teeth. Once the gum tissue recedes, your teeth roots become exposed, creating an increased risk of tooth decay. Exposed roots are also more sensitive to hot and cold or other irritants, making eating and drinking uncomfortable.

In addition, sugars, which are often added to enhance the flavor of smokeless tobacco, can increase your risk for tooth decay. A study published in the Journal of the American Dental Association showed that chewing tobacco users were four times more likely than nonusers to develop tooth decay.

Smokeless tobacco also typically contains sand and grit, which can wear down your teeth. 

Kick the Tobacco Habit

Regardless of how long you have used tobacco products, quitting now can greatly reduce serious risks to your health. Eleven years after quitting, former smokers’ likelihood of having periodontal (gum) disease was not significantly different from people who never smoked.

Even reducing the amount you smoke appears to help. One study found that smokers who reduced their smoking habit to less than half a pack a day had only three times the risk of developing gum disease compared with nonsmokers, which was significantly lower than the six times higher risk seen in those who smoked more than a pack and a half per day. Another study publishedin the Journal of the American Dental Association found that the mouth lesion leukoplakia completely resolved within 6 weeks of quitting in 97.5% of patients with these lesions who used smokeless tobacco products.

Some statistics from the American Cancer Society present some other sobering reasons to quit smoking. They state that:

• About 90% of people with cancer of the mouth, lips, tongue, and throat use tobacco, and the risk of developing these cancers increases with the amount smoked or chewed and the duration of the habit. Smokers are six times more likely than nonsmokers to develop these cancers.
• About 37% of patients who persist in smoking after apparent cure of their cancer will develop second cancers of the mouth, lips, tongue, and throat compared with only 6% of those who stop smoking.

How Can I Quit Tobacco?

To stop using tobacco, your dentist or doctor may be able to help you calm nicotine cravings with medications, such as nicotine gum and patches. Some of these products can be purchased over-the-counter; others require a prescription. Other medications (such as Zyban) require a prescription.

Smoking cessation classes and support groups are often used in tandem with drug therapy. These programs are offered through local hospitals in your community and sometimes through your employer or health insurance company. Ask your doctor or dentist for information on similar programs they may be familiar with.

Herbal remedies as well as hypnosis and acupuncture are other treatments that may help you kick the habit.