Nutrition

Lecturer 9
Oral Consequences of Compromised Nutritional
Well-Being

nutritionist Clinical /Dr. Hamas Swiaed

Oral Consequences of Compromised Nutritional
Well-Being
 Compromised Nutritional Status and Enamel Developmental Defects

Developmental defects may be broadly classified into opacities (fluorosis or white or yellow
areas of opaque enamel) that are caused largely by excess fluoride ingestion, or
‘‘hypoplasia,’’ a term that describes surface defects of enamel There are many causes of
enamel developmental defects including congenital defects, effects of drugs, trauma,
infection, and metabolic disturbances compromised nutritional status is just one cause.
 Protein Energy Malnutrition and Enamel Developmental Defects

The most common enamel abnormality in severely malnourished children is

linear enamel hypoplasia.
 The Effect of Compromised Nutritional Status on Dental Caries

Protein Energy Malnutrition

There are three potential mechanisms to explain how deficiency of

protein, energy, or both increase caries susceptibility. First, malnutrition
results in defectively formed enamel that is poorly Calcified and
therefore susceptible to dental decay.
Vitamin Deficiencies and Dental Caries

that vitamin D deficiency was the cause of dental caries in children

because deficiency of this vitamin resulted in hypoplasia that rendered the
teeth susceptible to dental decay.
 Vitamin A

that deficiency of vitamin A causes gross structural changes in

teeth, and this increases risk of dental caries Vitamin A deficiency is often
associated with diarrhea and may increase susceptibility to dental caries by
causing hypoplasia and also by affecting normal salivary function.
The Effect of Compromised Nutritional Status on Salivary Secretion
and Composition

Moderate and severe protein malnutrition results in alterations salivary

gland growth and function When protein deficiency takes place at an
early stage of development, the submandibular gland has been found to
be smaller.
 Effects of Childhood Malnutrition on Saliva
In 8–12 year-old Indian children with moderate to severe PEM, extensive analyses of
their salivary production and composition found the following
-decreased stimulated salivary secretion rate elated to the severity of PEM, but no
difference in the unstimulated salivary secretion rate;
-owner content of calcium and chloride ions and total protein secretion in stimulated
saliva
-impaired immunological and agglutinating defense factors noted in unstimulated saliva
The magnitude of decrease in salivary protein concentration and arginase activity
increased with increased severity of PEM .
Effects of Moderate Malnutrition in Adults on
Saliva

In one of the few studies carried out on human adults where a low energy (300
kcal/d) liquid diet was given for 7 days, a reduction in stimulated salivary secretion
rate, phosphate, and calcium ion concentrations were found This observation
occurred even when controlled for the absence of chewing. In a previous study by
the same investigators, a significant decrease in secretion rate, phosphate, and sialic
acid concentration of stimulated whole saliva was observed.
 Compromised Nutritional Well-Being and Disorders of the
Oral Mucosa
Nutritional deficiencies have a profound effect on the integrity of the oral
cavity. Malnutrition can contribute to atrophy of the oral mucosa and the
thinning, inflammation, and ulceration of the oral mucosa, and the loss of
filiform papillae on the lingual mucosa, resulting in glossitis (inflammation
of the tongue).
Nutritional deficiencies also cause atrophy, inflammation, and fissures to
the labial mucosa of the lips, and a common feature of compromised
nutritional well-being is angular cheilitis
(sores at the corners of the mouth), largely because of the high turnover of
cells in the labial
commissures.