 Hello everyone, welcome back to a new session on dentistry and work. So today's topic is diet, nutrition and its association with oral health. So oral health, general health and diet is always interconnected. So let's see how the diet influences oral health and dental caries and diet. In epremology of dental caries, we have seen the connection between diet and dental caries. This chapter highlights the diet, nutrition and its effect on the nutritional deficiency on the oral health and other factors. So the basic difference between diet and nutrition is that is what you eat and drink, but nutrition is an internal processing from that food stuffs, how much your body consumes, that is nutrition. It is an internal processing of foods and beverages such as nutrition, digestion, absorption and assimilation, distribution and elimination. So the whole process is nutrition and diet is nothing but the food stuffs you eat or drink. So this is a very basic chapter of this we have seen in our early years like maybe first years and even our early school life also we have seen this, the major nutrients, micronutrients and trace elements, carbohydrate, proteins, fats, vitamins, minerals and trace elements. So proteins we know it is very important. So I am not going very detail about proteins because it is very simple topic, this is not much explanation required. So it is required for body tissue, skin, stent and spatulages and it also forms hormones and enzymes. So we need to stress on the deficiency, protein energy deficiency that is PEM, quashioca malasmas. So quashioca is nothing but, were taken from the weak language and which means red boy due to the characteristic pigmentary changes, later on the term was interpreted as deposed child. So it was first recognized by Prof. C. C. Williams in 1933. So it was the disease of first child when the second was on the way, displacing the first child from breastfeeding. So malasmas is known as wasting, it is a greek word malasmas and it affects children exhibiting extreme wasting and old man appearance to jaws and skin and bones. So these type of appearance will be seen in children. So this is oral manifestation of protein deficiency, there will be right reddening of tongue, loss of papillae and edema of tongue, bilateral chelosis, bushering of lip, loss of circum, oral pigmentation and dry mouth. So the basic thing is most of the oral manifestations are same for most of the vitamin deficiency and there is slight variations in color appearance but 60 to 70% is the same. So delayed eruptions as it is teeth measure, linear dysplasia. So lipids we know it is fats basically saturated and unsaturated fats and fat soluble vitamins ADEK which carries these lipids. So nutritional factors affecting oral cavity, there should be optimal nutrition created for hard and soft tissue development. So malnutrition or nutrition will create problems such as a tetracycline staining of teeth, tender fluorescence, enamel defects in premature born children and fever induced enamel hypoplasia. So nutrients, deficiencies or excess have been directly associated with conditions like protein, calcium, phosphorus, vitamin C, AD, iodine and fluorine. So let's see the classification of vitamins, fats soluble ADEK and water soluble B complex and C. So B, there are various category B1, B2, B3, B6, B7, pantothenic acid, B9, B12, Cyanocobalamin. So vitamin A sources we know it meat and diet products, beta-carotene also is a precursor of vitamin A. So these are the deficiencies, nipeline, conjunctival, cirrhosis, pitot sports, corneal cirrhosis and keratomalacia. So oral health, this is what we are emphasizing upon. Vitamin A helps in synthesis of proteoglycans, fibronectin and typhon procollagen, it is also helps in epithelial tissue differentiation, axon cells with high turnover rate and helps in formation of aminoblasts and orondoblasts. So what happens if there is a deficiency, it affects salivary gland, there will be decreased salivary flow, it causes increased caries, oral mucus membrane, there will be hyper keratosis and gingeral hyperplasia. In teeth, during pre-araptive stage deficiency, it causes enamel hyperplasia and defective dentine formation. So normal teeth spacing and osteoblast function of albular bone also will be impaired in case of vitamin A deficiency. And in periodontium there is tendency to periodontal pocket formation. So as a result of this pocket formation proliferation of basal cells of gingeral epithelium and a decreased cellular infiltrate on the lamina propria. And there will be cleft lip and pallet chances during early development of both deficiency and high doses reported to induced cleft lip and pallet. Vitamin D we know it is known as unscented vitamin, there are D1 to D5 category, D2 D3 are nutritional importance. So these are the required daily allowance upper level. So only the fat soluble vitamins have upper level because it is getting stored, not like BMC which is water soluble. So vitamin D if deficiency causes enamel hyperplasia, there will be uncalcified dentine matrix, physical roughness of enamel surfaces causes, adherence of plaque and caries. So vitamin E, it increases resistance to inflammatory mediated tissue destruction and which improves gingeral health. So in case of deficiency, there will be decreased inflammatory response and gingeral health also will be impaired. So vitamin K which is helping for the coagulation if deficiency is there, there will be hemorrhage. Secondary deficiency also causes with antibiotics, newborn infarms receives a single dose of vitamin K at birth because of the sterile intestine and tract. So gingeral bleeding and post extraction hemorrhages are the problems associated with vitamin K and which is also known as anti-caries agent because it has an inactivity of enzyme inhibiting in the carbohydrate degradation cycle. Vitamin A and vitamin E have no non-effect on anti-caries activity. So let's move on to vitamin B that is water soluble vitamin B1, venothiamine. So it is all these structures. Deficiency causes beriberi, dry beriberi and infantile beriberi. Wet means it has cardiac manifestations. This is CNS manifestation and infantile beriberi because it is seen in infants born to mothers suffering from thiamine deficiency. So what are the dental considerations? There will be tongue changes in form of enlarged flabby, red and edematous appearance with engorgement of bunchiform papillate. Ginger becomes inflamed and present with an old rose color. So these type of features we need to keep in mind because always study link thiamine old rose color because most of the manifestations are the same like I told. So the old rose seen in thiamine deficiency, hepatical like vesicles, palate, buccal mucosa and tongue. So vitamin B2, riboflavin, it is a first week complex component to be isolated. And deficiency angloaculitis, pyloroflipsan, anglofemod, glossitis, magenta color tongue causes. So this magenta color tongue, keep in mind, cause you to atrophy of papilla and increase to vascularization, seborrheic dermatitis and proliferation of bilboa congenital capillaries. Tongue changes. Tongue changes, initial stages, reddish appearance of tip and lateral margins of tongue with caustric granular due to atrophy of philiform papillae and engorgement of bunchiform papillae will happen. So in CVO cases which leads to atrophy of all papillae causing tongue to appear very smooth and glazed. So also deficiency leads to increased vascularization which causes tongue to appear, magenta and color. So always remember, riboflavin deficiency, seborrheic dermatitis and magenta color tongue. So vitamin B3, niacin. So we know basic functions of now impulses and recirculatory free fatty acids. So let's see what other dental consideration it causes, dermatitis, angloaculitis, atrophy glausitis and CVO gene jamal, inflammation with neck crosses. So tongue changes are epithelium of tongue appears, discommitate, philiform papillae disappears, first hand engorgement of bunchiform papillae. So early stages same as other deficiency, tip and lateral borders are involved. It becomes swollen and at advanced cases there will be severe redness and becomes all the papillae losing. Pandothenic acid derived from Greek good pantoins means everywhere. So formerly known as anti-dermatitis factor which is a coenzyme A metabolic role is coenzyme A. So dental consideration, ulceration and hyperkeratosis, gene jamal necrosis and resorption of alveolar crest. So barotin is anti-aqua white injury factor. So it's high consumption of raw egg which contains evident is which tightly binds to barotin and reduces intestinal absorption. So there will be destruction of intestinal fiora due to prolonged administration. So vitamin B6 is also known as spirodoxin, it's a lentil deficiency that really changes the most common thing is angloarchelitis. It initially presents as a pallor of the lip and the angle of the mouth. Then it is followed by reddening of lips due to disformation of epithelium at the angles. These visuals develop a yellow crest which can be removed without bleeding. So tongue changes are closer it is with pain, edema and papillary changes. Tongue has scaled sensation followed by reddening and hypertrophy of the filiform papillae. The tip margins are in dosage. So citric acid which means leaf of vegetable, what happens is deficiency passes process of folate deficiency. There will be defective absorption, hemolytic anemia and true deficiency. So folate deficiency causes these problems that is macrosetting anemia, there will be increased risk of atherosclerosis, hyperchromosistrinuria. So vitamin B12, you know cyanocobalamin which is nutritional vitamin B2 deficiency, it's seen in elderly people and people with gastrectomy, fish tapeworm, infection people. So dental consideration, benign and B12 causes pernicious anemia. In dental consideration, initial oral symptoms is presented with glosoparia and followed by swelling and pallor with disappearance of filiform and fensiform papillae. Then bright red diffuse excruciating painful ulcers will be seen. So vitamin C, we know that the James Lind experiment I have mentioned it in the ophthalmology side RCT section, James Lind was one of the pioneers in epidemiology or randomized control trial. So we used lime water for treating this curvy. So what happens if we stop taking vitamin C, there will be hemorrhagic signs, defective synthesis of steward, impaired wound healing and very follicular hemorrhages. So vitamin C is very important role in our peroncium because low levels of vitamin C influences metabolism of collagen within the peroncium. It interferes with bone formation leading to alveolar bone loss which increases levels of ascorbic acid enhances chemotactic and migratory action of leukocytes. These are the roles of vitamin C and depletion causes which interferes with ecological equilibrium of bacteria in plaque and increases its pathogenicity. An optimal level of vitamin C is required to maintain the integrity of peronyl microvascular vasculature and wound healing. So vitamin C has a very crucial role in maintaining a proper peronyl health. So let's see what are the basic dental concentration as we discussed. The earliest manifestation of scurvy in gingivitis which leads to peronylitis and tooth mobility and loss of teeth. So deficiency aggravate in gingivitis wants to bleed and worsen the edema, enlargement and bleeding. Vitamin C influences we have seen in the previous slide collagen metabolism of peroncium and affecting the ability of tissue to regenerate and repair itself. So scurvy is very severe disease causing the gums which leads to changes in the teeth in form of hypoblastic, it's atrophy of aminoblast and odendoblast and dentin form which lacks parallel arrangement of dentin to build. So this is affecting both soft tissues and heart tissues. So let's see what are the minerals affected calcium, vitamin D and phosphorus which are essential for proper development and maintenance of mineralized tissues especially teeth and alveoli. So deficiency of these nutrients is a critical phase of tooth development causing hyper mineralization of teeth and it might lead to delayed eruption. Iron deficiency anemia which manifests in the oral cavity has parallel oral tissues which we have seen with venous anemia, tongue will be shiny and planted filiform papillae. Suminolized tissues are less clear than deficiency associated effect and serves basically as a cofactor with ascorbic acid so it has a role in vitamin C and its synthesis. So zinc regulates the function of inflammation by inhibiting release of lysosimilar enzymes, zinc deficiency can inhibit collagen formation and reduce cell mediated immunity. This is important because sometimes question might come as trace elements and oral health. So zinc deficiency can also result in delayed wound healing, effective caratination and epithelial thickening and atrophy of oral mucosa also essential for taste and other sensitivity. So diet and enamel enolization. So dental demenolization can result from excessive tooth brushing, regurgitation of stomach acid as in eating disorders like bulimia nervosa or excessive consumption of acid containing foods or beverages and also the effect of acid from diet is magnified in presence of zero stromium because salivar helps to neutralize acid. So dietary sources of acids are citrus fruits, juices, acero-genic, sports drink, snacks with citrus acid, the carbonated beverages, vitamin C chewable tablets and the gastric regurgitation products. The role of carbohydrate we know we have discussed in detail in eprimulogy of tendril caries. You know, structococcus is a bacteria which needs a susceptible tooth, bacteria and fermentable carbohydrate at appropriate time which becomes eprimulogy tritra. So other dietary factors counteract the damaging effect of carbohydrates. So there will be always a balance between protective and destructive factors. So protective factors are fluoride, calcium, phosphorus in plaque and saliva which promotes remuneration of early lesions. So that's all about diet and oral health or tendril caries and oral health. So this is a very common question that's been repeatedly asked. The diet and oral health or diet and nutrition and its effect on oral health, diet and tendril caries, trace elements and tendril caries. So all these are very simple to study. Only thing, the same thing which we studied in first year or early school life, the same thing which a little bit of oral manifestation make a good essay. So I'll come up with a new session on dentistry and all.