Dietary Analysis and Advice


Diet can affect teeth:
• Pre-eruptively—fluoride is the most important. The effect of calcium,phosphate, vitamins, and sugar is unclear, but is unlikely to be great.
• Post-eruptively—again, fluoride is important, as is sugar. Acidic foods or drinks can cause erosion.


Dietary Analysis


Aim: To determine the time for which the teeth are at risk of demineralization and
increase the potential remineralization period.
Indications:

(i) high caries activity,

(ii) unusual caries pattern,

(iii) suspected dietary erosion.


Dietary advice should be tailored to the individual. This is most easily done after analysing the patient’s present eating pattern.

Method:

A consecutive 3- or 4-day analysis (including at least one weekend day) is the most widely used, with the patient recording the time, content, and quantity of food/drink consumed. In addition, toothbrushing and bed-time should be indicated. When the form is returned the entries should be checked with the patient.


Analysis:
• Ring the main meals. If in any doubt,identify those snacks that contain complex carbohydrate. Assess nutritional value of meals.
• Underline all sugar intakes in red.
• Identify between-meal snacks and note any associations, e.g. following insubstantial meals or at school.
• Decide on a maximum of three recommendations.


Dietary advice should include an explanation of the effect of between-meals eating and sugary drinks. It must also be personal, practical,and positive! The suggestion that a child should select crisps when friends
are buying sweets is more likely to be followed than total abstinence.


Some helpful hints:
• Save sweets to be eaten on a day, e.g. Saturday dinnertime, or to be eaten at the end of a meal.
• All-in-one chocolate bars are preferable to packets of individual sweets.
• Foods which increase salivary flow (e.g. cheese, sugar-free chewing gum) can help to reverse the pH drop due to sugar if eaten afterwards.

• Treacle, honey, and fruit (especially fruit juice) are cariogenic.
• Artificial sweeteners should be avoided in pre-school children.
• Fibrous foods, e.g. apples, are preferable to a sucrose snack, but they can still cause decay and there is no evidence that they can clean teeth. Where the nutritional content of meals is inadequate, considerable tact is necessary. It may be possible to suggest that larger meals would reduce the temptation to eat snacks. For children who are ‘picky’ eaters snacks and sweets saved until the end of a meal can act as an encouragement to consume more food at mealtimes.

Remember that while cheese, peanuts, and crisps may constitute a safe snack in dental terms, they are all high in fat, and peanuts can be inhaled by small children. Also, ‘diet’ cola drinks are sugar-free, but can still cause
erosion if large quantities are drunk.
Therefore, dental dietary advice should be given in the wider context of the general health of the individual, i.e. decrease consumption of sugars and fats, and increase consumption of fibre-rich starchy foods, fresh fruit, and vegetables.
Meals provide a better nutritional balance than snacks. Hence good eating/drinking at mealtimes and avoiding between meals snacking is healthy.

Dr Iswarya V

General Practitioner,

Trivandrum.

Reference : Oxford Clinical Dentistry

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