Post on 10-Aug-2020
Nutrition Instruction in Community Dentistry
for Health Promotion of Children
MASAFUMI MOTOHASHIAssociate Professor, Department of Oral Health,Nihon University, School of Dentistry
1. An Introduction to Nutrition Instruction
OCTOBER 30, 2008
1. Basic concept of nutritional instruction
2. Nutrients needs for normal development of
teeth and periodontal tissue.
Topics
Human being and food –stuffs are constructed from
nutrients. Human being must continue to take nutrients
to maintain its life.
Lack of nourishment and excess of nourishment
may cause certain diseases.
Nutrition instruction for expecting mother,
mother and children is very important to promote
systemic health and oral health.
Purpose of nutrition instruction
Composition of
human body
60 Kg Adults water
62.6 %
proteins
16.4 %
fats
15.3 %
minerals,5 .7 %
carbohydrates
1.0 %
Nutritional and energy balance is basic principlein nutritional instruction
Carbohydrates
Proteins Energy
Lipid Source
Vitamins
Minerals
waters
Maintenance
Work
Child Growth
Fetus growth
Appropriate intakeof all the nutrients
Nutrients, Nutrition and health
Nutrition
Foodstuffs ⇒Health
Disease
Disorder
Digestion
Absorption
metabolism
Nutrients
WHO’s statementNutrition is an input to and foundation for health and
development. Better nutrition means stronger immunesystems, less illness and better health.
Nutrients Deficiency and Oral Manifestation
in Children
Protein deficiency in children
Systemic manifestationPoor growthPoor wound healingIncreased susceptibility to infectionAnemiaOthers
Oral manifestationDelay of eruptionHypoplasia and hypocalcification
Periodontal tissueAtrophic and degenerative changes in the periodontaltissue.
Vitamin A deficiency
Systemic manifestation
Dryness in the skin (hyperkeratinization) and eye
Night-blindness
Oral manifestation
Enamel Hypoplasia
Periodontal tissue
Gingival hyperplasia and hyperkeratosis
Vitamin D Deficiency
Systemic manifestation
Rickets in children
Osteomalacia in adults
Oral manifestation
Delay of eruption
Enamel hypoplasia
Dentine hypoplasia
Vitamin C Deficiency
Systemic manifestation
Scurvy
Greater Susceptibility to infection
Oral manifestation
Gingivitis: Swollen and bleeding gingiva
Dentine hypoplasia
A Case of Enamel Decalcification 1
Deficiency of Vitamin A, Vitamin D or Proteincan be suspected
A Case of Enamel Decalcification 2
A white spot of enamel 10 years old boy
A Case of Enamel Hypoplasia
Nursing Bottle Syndrome
Photo library
A case of Nursing Bottle Syndrome
Rampant caries caused by the use of nursingbottle to feed sweet beverage
中国新聞医療サイト
Sex Age Height Weight DMFT dft
F 12 129 26 9 0
A Case seems to have some problem in eating habitin addition to some problems in brushing habit.
A case with severe dental caries
Steps of Nutrition Instruction in Community Medicine
Estimation of problem in target community↓
Analysis of the problem related to malnutrition↓
Planning of the of nutrition instruction↓
Evaluation of potential effect of the instruction↓
Practice of nutrition guidance↓
Evaluation of the intervention
1. Children with many carious teeth have a
tendency of unbalanced diet.
2. Too much sugar or carbohydrates leads to
unbalanced nutrients intake
Oral health and nutrition instruction
Dental caries incidence in one of the good indicatorsof appropriateness of food eating habit
A
A Case seems to have some problem in eating habitin addition to some problems in brushing habit.
Sex Age Height Weight DMFT dft
F 12 129 26 9 0
A case with severe dental caries
STANDARD TABLES OF FOOD COMPOSITION IN JAPANFifth Revised and Enlarged Edition - 2005 –
Food Composition Databaseby Japan Science and Technology Agency
01031 French bread (in Japan)(per 100 g edible portion)
Energy:279 kcal
Protein:9.4 g Vitamin B1:0.08 mgLipids:1.3 g Vitamin B2:0.05 mgCarbohydrate:57.5 g Vitamin C:0 mg
Vitamin D:0 mg
Calcium:16 mgIron:0.9 mg
STANDARD TABLES OF FOOD COMPOSITION IN JAPANFifth Revised and Enlarged Edition - 2005 –
01215 Chicken Thigh Without skin, raw(per 100 g edible portion)
Energy:138 kcal
Water:72.3
Protein:22.0 g Vitamin B1:0.10 mgLipids:4.8 g Vitamin B2:0.31 mgCarbohydrate:0 g Vitamin C:1 mg
Vitamin D:0 mg
Calcium:9 mgFe:2.1 mg
STANDARD TABLES OF FOOD COMPOSITION IN JAPANFifth Revised and Enlarged Edition - 2005 –
07107 Banana Raw(per 100 g edible portion)
Energy:86 kcal
Water:75.4
Protein:1.1 g Vitamin B1:0.05 mgLipids:0.2 g Vitamin B2:0.04 mgCarbohydrate:22.5 g Vitamin C:16 mg
Vitamin D:0 mg
Calcium:6 mgIron:0.3mg
STANDARD TABLES OF FOOD COMPOSITION IN JAPANFifth Revised and Enlarged Edition - 2005 –
Dietary Reference Intakes in Japan
Japanese “Dietary Reference Intakes” shows the standard ofcaloric intake and amount of nutrients. The aim is to promotehealth of people and to prevent diseases caused by malnutrition
Indicators for each nutrient
Estimated Energy Requirement: EER
Estimated Average Requirement: EAR
Recommended Dietary Allowance: RDA
Adequate Intake: AI
Dietary Goal for preventing life-style related diseases: DG
tolerable Upper intake Level: UL
Example of Dietary Reference Intakes 1
Dietary Reference Intakes of Energy:Estimated energy requirement (kcal/day)
Sex
Activity level Low Ordinary High Low Ordinary High
0~5(months)Breast feeding - 600 - - 550 -
0~5(months)Bottle feeding - 650 - - 600 -
6~11(months) - 700 - - 650 -
1~2(years) - 1,050 - - 950 -
3~5years) - 1,400 - - 1,250 -
6~7(years) - 1,650 - - 1,450 -
8~9(years) - 1,950 2,200 - 1,800 2,000
10~11(years) - 2,300 2,550 - 2,150 2,400
12~14(years) 2,350 2,650 2,950 2,050 2,300 2,600
15~17(years) 2,350 2,750 3,150 1,900 2,200 2,550
18~29(years) 2,300 2,650 3,050 1,750 2,050 2,350
male female
Dietary Reference Intakes of Energy
sex
EAR RDA AI DG EAR RDA AI DG(g/day
)
(g/day
)
(g/day
)(% Energy)1 (g/day
)
(g/day
)
(g/day
)(% Energy)1
6~11 (months)
Breast feeding)- - 15 - - - 15 -
6~11 (months)
Bottle feeding- - 20 - - - 20 -
1~2 (years) 15 20 - - 15 20 - -
3~5 (years) 20 25 - - 20 25 - -
6~7 (years) 30 35 - - 25 30 - -
8~9 (years) 30 40 - - 30 40 - -
10~11 (years) 40 50 - - 40 50 - -
12~14 (Aears) 50 60 - - 45 55 - -
15~17 (years) 50 65 - - 40 50 - -
18~29 (years) 50 60 - Lower than 20 40 50 - Lower than 201 Protein energy rate
Age
Male Female
Example of Dietary Reference Intakes 2
Japanese– Food Guide Spinning Top
Do you have a well-balanced diet?
Two essential component in nutritional guidance
for health promotion for children and mother
1. Appropriate amount of nutrients taken in everyday life
・ Eating habit considering dietary reference Intakes
・ Balanced nutrients intake
2. Regular eating habit and care for characteristics of foodstuffs
・ Well-regulated dinner and between meal taking
・ Care for development of oral function
・ Care for prevention of oral diseases