Much of the emphasis in dental programs concerning nutritional counselling is placed on preventing caries. The link between “sugars” and decay is greatly discussed.
In more recent years, the link between an acidic diet, with a surge in healthy eating including salad dressings and energy or sports drinks, a connection was emphasized between tooth erosion and diet.
Less attention was given to oral mucosal pathologies. Dr. Anthony M. Iacopino DMD, PhD notes in a 2008 article in JCDA, that:
“Poor nutrition and diet may affect the development of the oral cavity and the progression of oral diseases through altered tissue homeostasis, reduced resistance to microbial biofilms and reduced tissue repair capacity”.
He also mentions Iron, vitamin B12 and folate deficiencies could contribute to recurrent aphthous ulcers, atrophic glossitis, and Candida albicans infections.
Another diet and oral health link which does not receive enough significance is the one related to edentulous people. In a 2002 article in JCDA, by Brian Hutton, BSc, Jocelyne Feine, DDS, HDR, and Jose Morais, MD, FRCPC, CSPG, it is stated:
“Edentulous people have difficulty chewing foods that are hard or tough in texture, even when wearing well-made dentures. These individuals typically modify their diets to compensate for loss of oral function. This practice leads to the question of whether the diet of edentulous individuals is adequate to maintain good general health.
…changes in diet associated with edentulism… include reductions of fruits, vegetables, meats and other hard-to-chew foods are associated with compromised nutrition……the lack of specific nutrients may place them at risk for various health disorders.”
In his 2008 article in JADA, Anthony M. Iacopino, PhD, also discusses the detrimental effects poor oral health can have on systemic health.
“Poor oral function due to edentulism, ill-fitting prostheses and oral disease compromises overall nutrition through altered food choices and food preparation.”
“The impact of masticatory efficiency on food selection is likely to be compounded by food preparation……overcooking or overpreparing fresh foods. affects a wide range of nutrients.”
Dr. Anthony M. Iacopino, PhD further states:
“As we learn more about the links between oral health and nutrition, practitioners from all health professions must learn to provide screening, basic patient education and referral to each other as part of comprehensive patient care….Collaboration between dietetics and dentistry is recommended for oral health promotion and disease prevention and intervention.”
Part of the scope of practice for Intra Oral Dental Assistants is to provide nutritional counselling relative to oral health. (Domain Description 8.2). We must delve beyond dental caries and erosion by assessing the client’s oral health and not limit it to dental health. Including the health history, intra-oral and extra-oral, gingival, and hard tissue assessments are essential. It is also important to understand the cultural beliefs and habits our patients may follow. It is only with all this information that can we provide comprehensive recommendations.