Tissues of the oral cavity which include the teeth as well as the soft tissue known as the gums or the gingival have nutritional requirements in much the same way as the rest of the body. We often neglect this aspect, and our ignorance of certain very basic issues, may lead onto severe oral problems such as caries (Kumar & Clarke, 2002), which is a very painful condition, which may eventually require tooth extraction. In addition, there may be other gingival problems which lead to halitosis, making the patient a social outcast, and bleeding, which can result in anemia.
Teeth may be affected by nutritional deficiencies, nutritional excesses, and also the absence of oral hygiene following any eating process (Gussy, 2006) . Scurvy is an important example of the first condition, while in heavily industrialized states the dental region is badly affected by repeated high calorie food, which is injurious to teeth, as well as the ill effects of diabetes. The diet affects not only the development of caries, but is a significant contributor to development of periodontal disease (gum disease). Undernutrition and Oral Health
The lack of specific nutrients in the diet (vitamin C, niacin, etc. ) produces characteristic oral manifestations, which are often diagnostic signs for their deficiency. A typical example is the presence of glossitis in typical B-vitamin deficiency, ( tongue is red and swollen which “burns”), with other features in that the taste of food has changed, with development of ulcers at the lip commisures and labial margins (angular cheilosis) (Kumar and Clarke, 2002, Gussy, 2006). A second typical example is that of vitamin C deficiency.
Here petechiae (small, hemorrhaging red spots) are seen in the oral cavity, apart from easy bruisability in other areas of the party due to poor collagen. In addition, the gums bleed upon brushing or by examination by dental instrument (Bruno, 2006). Nutritional deficiencies as a cause for dental problems is not the only problem, that affects teeth. Oral lesions are common in women and children with HIV/AIDS and may decrease the overall quality of life in these patients because of pain, dry mouth, and difficulty in eating.
With advent of new diseases like HIV (Gennaro, 2008), but post cancer radiation affects dental hygiene adversely also, by reducing the saliva production which is a reason for caries also (Scrimger, 2006) Nutritional excesses Sugar-containing foods and beverages promote dental caries which is even worse when fluoride is provided in reduced quantity (like non usage of fluoridated toothpaste). On the other hand these foods also promotes dental erosion by not allowing restoration of dental ph.
The reason for this problem can be clearly defined by understanding what a dental plaque is. This is a sticky substance containing bacteria, present on the surface of teeth. Its presence can be minimised by regular brushing with fluoride containing toothpaste Gussy, 2006) Plaque bacteria produce acids by fermentation of sugars ( from the diet which we have consumed, hence the role of excess sugars), decreasing the pH at the tooth surface. The production of these acids dissolve minerals in the enamel (calcium and phosphorus) by a process called demineralization (Gussy, 2006).
But these acids produced by bacteria in the mouth nearly completely neutralised by saliva, which allows the ph in this region to become more than the critical pH. This increase in pH causes a return of the dissolved calcium and phosphate back to the tooth enamel (remineralisation). Therefore foods or drinks containing carbohydrate give hardly any time for the process of remineralisation to occur (Gussy, 2006). However, even if 2-3 hours of time is available between carbohydrate meals, the reparative capacity of the teeth allows self repair.
Some foods protect against caries. Milk and dairy products, especially cheese raises the pH values in the mouth. They are both rich in calcium and phosphate and promote remineralisation. They are also rich in protein which buffers the acid produced. Their consumption allows an increase saliva production which increases the pH level in the mouth, and encourages remineralisation (American Dental Association). Fibre rich foods also increase the flow of saliva as does sugar-free chewing gum, helping to clean the surface of the tooth (American Dental Association).
Fluoride is a known protectant against tooth decay. Fluoride makes the enamel surface of the tooth more resistant to acid; it also allows a reduction in the production of acids by bacteria in the mouth, which thereby hastens the remineralisation process (Gussy, 2006, Boggess, 2008). In summary, dental hygiene is affected by both nutritional excess, nutritional deficiencies as well as general ignorance. Most of these problems are easily preventable by proper knowledge.