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The effect of nutrition on the state of the dentition
Rational nutrition is an integral part of a healthy lifestyle, playing a significant role in the prevention of major dental diseases (dental caries, gingivitis, periodontitis, etc.).
The manifestation of this role of good nutrition is expressed in the following aspects:
• formation of teeth resistant to adverse factors;
• reduction of cariogenic effects of simple carbohydrates;
• Improving self-cleaning of the oral cavity, overcoming chewing laziness and training the dentition.
We consider in detail each of these aspects.
One of the main conditions for the formation of caries-resistant teeth is the nutrition of a pregnant woman, sufficient in quantitative and qualitative composition, therefore, the dentist and obstetrician-gynecologist should take an active part in monitoring the nutrition of pregnant women. They should be given competent recommendations on the need for a variety of foods with the mandatory inclusion of dairy products (sources of calcium, phosphorus, vitamin D), vegetables and fruits (sources of vitamin C, other vitamins and mineral salts) in the diet. In the process of monitoring pregnant women, timely adjustments must be made to the diet and, if necessary, additionally prescribed foods, vitamins, and minerals.
In the second half of pregnancy, it is recommended to reduce the intake of easily digestible carbohydrates, which contribute to the development of caries, allergization of the body, metabolic disorders with their excessive consumption.
There are "Physiological norms of the daily requirement of the body for nutrients and energy", in which special attention is paid to normalizing the nutrition of pregnant women, as well as children and the elderly.
It is important that nutrients are introduced into the body of pregnant women as part of food products, but in some cases they also resort to prescribing drugs (calcium glycerophosphate, calcium gluconate, vitamin-mineral complexes for pregnant women).
Proper nutrition in the first year of a child's life is no less important in the formation of resistance of dental tissues, since during this period there is a laying and development of permanent teeth.
It is known that the baby’s body is little adapted to environmental influences and is not capable of assimilating a wide range of food products, so mother’s breast milk is an ideal product for a newborn. Natural feeding provides the baby with everything necessary and almost does not need correction. However, during this period, monitoring of the mother’s nutrition should continue, which, from the standpoint of the dentist, should provide the need for calcium, phosphorus, fluoride and vitamins.
When artificially feeding children, it is necessary to compensate for its shortcomings as much as possible by introducing juices, mashed potatoes and other products into the child's nutrition.
With the further growth and development of children, it is necessary to take into account their high need for calcium salts, phosphorus, vitamins D, A, proteins, fluorine, so dairy products, vegetables, fruits, meat, fish, eggs are necessarily included in the diet of children.
The prevalence and intensity of dental caries, according to numerous data from domestic and foreign scientists, is directly related to the increase in the population's consumption of simple easily digestible (refined) carbohydrates with a sweet taste: sugar (sucrose), fructose, glucose.
In this regard, information about the connection of the transition of various nationalities from traditional nutrition to modern food is very revealing, which is associated with a rapid and intensive increase in the prevalence of caries.
Carbohydrates are a normal and necessary part of the daily diet of a healthy person, since they perform the most important physiological and biological functions in the body, and in no case should people be advised to abandon them at all without harming their health. Carbohydrates are divided into simple (easily digestible), with a sweet taste, and complex (difficult to digest: starch, fiber, pectin, etc.).
A pathogenic cariesogenic diet, characterized by:
• the presence of an excess of simple carbohydrates in food;
• lack of vitamins C, B and D;
• the predominance of refined products containing few dietary fibers (fiber), phosphatides and PUFAs.
Such food can cause caries, trophic disturbances in the hard tissues of the teeth and oral mucosa, as well as scurvy.
In this case, for the prevention of these pathological changes, a milk and vegetable diet containing the required amount of missing components is recommended.
The main role in the occurrence of carious lesions of teeth is assigned primarily to simple carbohydrates, since in the human oral cavity there are necessary conditions for their glycolytic splitting:
· Temperature is about 37 ° C;
· PH close to neutral;
Microflora capable of breaking down carbohydrates to the stage of organic acids (Str: mu tans).
The metabolism of carbohydrates in the oral cavity ends with the formation of various organic acids (lactic, acetic, etc.) in concentrations that are dangerous for hard tooth tissues. The most intensive metabolic process of simple carbohydrates occurs in soft plaque, saliva.
From the foregoing, it follows that the ingestion of easily digestible carbohydrates is the trigger of the reaction, leading to a disturbance of the dynamic balance in enamel towards an increase in the intensity of the demineralization process.
The accumulated knowledge suggests that the cariogenic role of carbohydrates depends not only on the amount consumed, but also on the frequency of administration and duration of their stay in the oral cavity, as well as physical properties - stickiness, viscosity and concentration.
Promising ways to reduce the cariogenic role of carbohydrates can be:
· Consumption of simple carbohydrates within the physiological needs of the body (36% of the total amount of carbohydrates, which should be 4-6 g per I kg of normal body weight);
· A decrease in the frequency of random consumption of simple carbohydrates;
· Reducing the residence time of carbohydrates in the oral cavity.
Overcoming the prevailing food stereotype, in which the share of sweet foods is high, is a difficult task. Simple carbohydrates are relatively cheap and affordable foods with high energy value.
The decrease in the frequency of indiscriminate consumption of simple carbohydrates is pathogenetically justified, since with each intake of carbohydrates in the oral cavity, they are converted with the production of acids that cause enamel demineralization.
Reducing the residence time of carbohydrates in the oral cavity is also a pathogenetically justified measure aimed at reducing their cariogenic effect. It is based on reducing the contact time of carbohydrates with dental tissues. Studies have shown that after taking carbohydrates in the oral cavity for 20-40 minutes, an increased concentration of sucrose remains. This time is very important for the utilization of carbohydrate residues by microflora, since it is they that have a cariogenic effect.
To implement this way of caries prevention, it is necessary to regularly observe the following elementary rules:
· Do not eat sweets as the last dish when eating;
· Do not eat sweets between main meals and at night.
If any of these rules is violated, you should immediately brush your teeth or rinse your mouth with water.
These rules are included in the "culture of carbohydrate consumption" - a term proposed by V.K. Leontiev (1978), the significance of which is that this is an unconditional decrease in the cariogenic effect of carbohydrate foods with relatively small violations of traditional human habits.
Currently, methods are being developed abroad to reduce the cariogenicity of simple carbohydrates by introducing them into the body along with enzymes designed for rapid non-acidogenous sugar metabolism in the oral cavity. This method, as well as the method of including fluoride compounds in the composition of sweet foods undergo a stage of deep scientific research and clinical trials, therefore it is premature to talk about their effectiveness.
The meal itself manifests itself as a factor in self-cleaning of the oral cavity and training of its organs. This nutritional role is directly related to the chewing function of the dentition.
One of the effective ways to increase self-cleaning of the oral cavity is the intake of solid foods (raw vegetables and fruits), which requires long chewing, which means that it trains the dentition and jaw system, causing excessive salivation. It is highly recommended to eat vegetables and fruits after soft, sweet foods, as well as in between main meals.
The harmful effect of acute and very hot food on ESD is also known, which, with prolonged consumption, leads to changes in the oral mucosa in the form of leukoplakia, which is regarded as a precancerous condition.
Thus, the rational nutrition of children and adults is a powerful factor in the prevention of diseases of the teeth and periodontium.
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