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Nutrition

Lecturer 6
Relationship Between Periodontal Disease and Nutrition

nutritionist Clinical /Dr. Hamas Swiaed

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Periodontal Disease (gum disease)

Periodontal (gum) diseases, including gingivitis and periodontitis,
are infections that, left untreated, can lead to tooth loss.
Periodontal disease is a chronic infection, caused by bacteria, that
affects the gums and bone supporting the teeth. Periodontal
disease can affect one or many teeth.

Gingivitis
This is the first form of periodontal disease that affects the surface
of the gums. It causes them to become red, swollen and bleed
easily.
Complications
. It causes them to become red, swollen and bleed easily.

treatment
It is reversible with professional treatment and good oral home
care.

Periodontitis
Periodontitis is defined as “an inflammatory disease of the supportive
tissues of the teeth caused by specific microorganisms or groups of
specific microorganisms, resulting in progressive destruction.
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complications
1-the infection continues to spread. A space, known as a ‘pocket’,
develops between the gum and the tooth, as the socket bone is
gradually eroded away
2- when the disease progresses, the pockets deepen and more gum
tissue and bone are destroyed
3- if untreated, the teeth can become loose and may have to be
removed.

Causes of Periodontal Disease

-Smoking
-Genetics
-Poorly controlled diabetes
-Stress
Treatment
It is essential that you keep your mouth as clean as is necessary, to
reduce the amount of plaque to a level that your body can cope
with
necessary to provide other treatments, such as antibiotics during
this cleaning stage.

Relationship Between Periodontal Disease and Nutrition

High-sugar, high-saturated fat, low-polyols, low-fiber and low-
polyunsaturated-fat intake causes an increased risk of periodontal
diseases.
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The periodontal tissue is composed of epithelium ,collagen ,fiber

,blood vessels cementer and bon so nutritional deficiency will affect
adversely these tissue nutritional deprivation affect rate and degree
of periodontal disease rather than is initiation as nutrition
deficiency apparently do not initiate periodontal disease but may
modify the severity and extend of the lesion .over a all nutritional
deficiency affect the severity and extend of periodontal disease by
modulating the responses and repair of the tissue .
Role of Key Nutrients in Periodontal Health
Macronutrients
Macronutrients required for optimal human processes include
protein, carbohydrates, and lipids. Current recommendations allow
for more flexibility based upon individualized dietary protein. needs
and suggest that adults consume 45% to 65% of their total calories
from carbohydrates, 20% to 35% from fat, and 10% to 35% from
protein .

Carbohydrates
Carbohydrates, including glucose, are needed for adequate cellular
functioning and for normal physiological processes such as the
construction of the periodontal tissues Increased consumption of refined
sugars can inhibit tissue repair and promote oxidative stress, microbial
dysbiosis, chronic inflammation, and cellular apoptosis increase in
gingival bleeding associated with the increased consumption of
carbohydrates.
Protein

Proteins such as collagen form a major component of periodontal

connective tissue, dental hard tissue, and alveolar bone They are also
needed for the effective function of the humoral and cell-mediated
immune systems, as well as complement and other host defense
mechanisms Numerous studies have shown protein deprivation to be
associated with the degeneration of gingival and periodontal connective
tissue, osteoporosis
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of alveolar bone retardation in cemental deposition, and consequently

periodontitis and
tooth loss.
Fats

Omega-3 fatty acids are a key constituent of host cell membranes and
are essential for the maintenance
of membrane integrity. These long-chain polyunsaturated fatty acids are
also required for
the modulation of immune function and have been demonstrated to
have anti-inflammatory
property.

Micronutrients
Micronutrients consist of vitamins, minerals and trace elements.
While micronutrients do not have energy value, they are essential
for many biological processes including those that promote
periodontal health and/or disease.

Major vitamins, their dietary sources, daily requirements, deficiency

diseases, and reported importance in periodontal health
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Nutrient Importance in Dietary Sources

Periodontal Heath
Vitamin A Cod liver oil, carrots,
insignificant capsicum, liver,
improvement in sweet potato, broccoli,
periodontal leafy vegetables
health upon
supplementation.
B-vitamins Supplementation may B1—Liver, oats, pork,
accelerate post-surgical potatoes, eggs
healing. B2—Bananas, dairy,
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green beans

Vitamin c Gingival bleeding and Citrus fruits,

inflammation vegetables, liver
are hallmarks of scurvy.
Supplementation may
improve
outcomes of periodontal
therapy.
Vitamin D Deficiency may lead to Fish eggs, mushrooms,
delayed liver, milk
post-surgical healing.
Local
application may
accelerate
post-surgical
healing/osseointegration
Vitamin E Impaired gingival wound poultry, meat, fish,
healing nuts, seeds and cereals

Vitamin K Deficiency may lead to Green vegetables,

gingival bleeding. egg yolk
No known effects on
periodontal therapy if
supplementation
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Major minerals, their dietary sources, daily requirement, deficiencies,

and reported importance in periodontal health.

Nutrient Importance in Periodontal Heath Dietary Sources

Calcium Required for formation of teeth and Milk products,
bones. Supplementation improves eggs, canned bony
outcomes of non-surgical fish, leafy
periodontal vegetables, nuts,
therapy. Local application enhances seeds
osseointegration.
Magnesium Required for cell metabolism and Cocoa, soybeans,
bone formation. Supplementation nuts, spinach,
may improve outcomes of marine vegetables,
non-surgical periodontal therapy. tomatoes
Iron Possible anti-oxidant effect on Iron Red meat, tuna,
periodontium. dry beans, spinach
Zinc Possible anti-oxidant effect on Protein-rich foods,
periodontium. Reduces severity of spinach, grain
diabetes-induced periodontitis
Fluoride Supplementation and topical Grape fruits,
application prevents dental caries. cocoa, tea, dried
fruits and nuts,
fluoridated water

Antimicrobial action
Many nutrients have antimicrobial activity these may alter the
quality or quality of dental plaque and thus be associated with a
reduction in gingival inflammation.
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Anti-inflammatory effect
Nutrient that decreases that host response to injury may result in a
reduction in the severity of gingivitis and development and progression of
periodontitis these. These work by affecting the enzymes involved in the
production of the anti-inflammation compounds or by altering which compounds
are actually produced (affecting the immunological response to bacterial antigens.