NUTRITION IN
PROSTHODONTIC
PATIENTS
presented by
Dr.V.Anusha
1st year P.G
Department of
CONTENTS
• Introduction • Assessing nutritional status
• Utilization of energy in • Risk factors for malnutrition in
man patients with dentures
• Balanced diet • Nutritional guidelines for the
patient undergoing
• Malnutrition prosthodontics
• Age factors that affect • Dietary recommends for new
nutrition denture wearers
• Nutritional needs of • Dietary management when
elderly teeth are extracted
o carbohydrates ,prot • Nutrition in maxillofacial
eins , fats , fibres prosthesis
o minerals and • Conclusion
vitamins • References 2
INTRODUCTION
WHAT IS NUTRITION ?
WHY NUTRITION IS IMPORTANT?
3
NUTRITION: Nutrition is defined as the science that
interprets the interaction of nutrients and other
substances in food in relation to maintenance ,growth
reproduction, health and diseases of an organism.
it includes food intake, adsorption ,
assimilation ,biosynthesis , catabolism , excretion.
DIET: The total oral intake of substances that furnish
nourishment and calories.
NUTRIENTS: are the constituents of food necessary to
sustain the normal function of the body.
ESSENTIAL NUTRIENTS INCLUDE:
Proteins ,carbohydrates, fats , vitamins , minerals , and4
electrolytes
NUTRITION AND ENERGY SUPPLY:
• The ingested food undergoes metabolism to liberate
energy required for vital activities of the body.
• The calorific value of a food is calculated from heat
released by the total combustion of food in
calorimeter.
calorific value of food stuff
food stuff energy value [ Cal/g]
carbohydrates 4
fat 9
proteins 4
5
UTILIZATION OF ENERGY IN MAN
Man consumes energy to meet the fuel demands of
the three on going processes in the body
1.Basal metabolic rate
2.Specific dynamic action
3.Physical activity
RECOMMENDED DIETARY ALLOWANCES[RDA]:
• RDA represents the quantities of the nutrients to be
provided in the diet for maintaining good health and
physical efficiency of the body.
6
• Factors affecting RDA – age and sex
BALANCED DIET:
It is defined as diet which contain a variety of food in
such quantities and proportions that the need for
energy, amino acids, vitamins, minerals, fats,
carbohydrates and other nutrients is adequately met for
maintaining healthy, vitality and general well being and
also make a small provision for extra nutrients to
withstand short duration of leanness.
It is attained by incorporating the
following groups of food items
into daily diet:
1. Cereals , grains
2. Pulses and legumes
3. Milk, nuts and meat products
4. Fruits , vegetables
5. Fats and sugars
7
[Concise medical physiology- chaudhari]
MALNUTRITION:
It is a generic term given to pathophysiological
consequences of ingestion of inadequate, excessive or
unbalanced amounts of essential nutrients [primary
malnutrition]as well as the impaired utilization of these
nutrients brought about by factors such as diseases
[secondary malnutrition].
NUTRITIONAL DISORDERS:
Important nutritional disorders are:
Nutritional anemias , protein energy malnutrition
anemias reduced concentration of haemoglobin O2 TRASPORT
1. MICROCYTIC ANEMIAS –deficiency of iron, copper and
pyridoxine
Importance of
nutrition
in
prosthodontics
Careful inspection of oral tissues and oral environment
done before final diagnosis and prognosis for the
prosthesis.
People who are above the age of 65 years are termed
as geriatric persons.
GERIATRICS: The branch of medicine or dentistry
that treats the problems peculiar to the aging
patient, including the clinical problems of senescence
and senility.
GERODONTICS: The treatment of dental problems of
aging persons or problems peculiar to advanced age.
GERODONTOLOGY: The study of the dentition and
1
dental problems in aged or aging persons
GPT -9
0
AGE FACTORS THAT EFFECT NUTRITIONAL
STATUS
1.PHYSIOLOGICAL FACTORS
2.PSYCOLOGICAL FACTORS
3.FUNCTIONAL FACTORS
4.PHARMOCOLOGICAL FACTORS
5.ORAL FACTORS
11
.
PHYSIOLOGICAL FACTORS:
These changes These
Gradual .
are slow and changes
loss of influenced by take place
function in genetics, at different
most socioeconomic rates, not
organs and status only
tissues of illness between
the body life events individuals,
with accessibility of but within
AGING health care individuals
environment
As age advances there is
steady decrease in lean body
mass and calorie needs 1
decreased 2
.
• Usually between 30 to 40 years of age bone loss
begin to occur , as bone resorption exceeds bone
formation. .
• Many nutrient deficiencies common in elder's ,
including zinc and Vitamin B - reduce or modify
immune response.
GASTRO INTESTINAL FUNCTIONING:
decreased peristalsis
decreased hydrochloric acid secretion
altered oesophageal mobility
reduction in digestive enzymes
• Neurological and behavioral impairment –
deficiency of B2 , niacin , B6, B12, foliate,
13
panthotenic acid ,vitamin c and
.
psychological Functional factors
factors
PHARMOCOLOGICAL FACTORS:
14
.
ORAL FACTORS:
Oral mucosa- Loss of elasticity with dryness and atrophy.
.
Gingiva - Loss of stippling. Edematous appearance.
Keratinized layer thin or absent, Tissue friable and
easily injured.
Impact of dental status on food intake
Effect of dentures on chewing ability
Hardness and texture of food
15
SENSE OF TASTE:
• As age increases there is decrease in taste and smell
acuity , number of .papilla , taste buds decreases with
age.
• Tongue more sensitive to - salt and
sweet
• Palate more sensitive to - sour
and bitter
• taste for salt and sweet food -
disappear early
This is because
• taste of hyperkeratinisation
for bitter - persist for longer of epithelium that
may occlude taste bud ducts .
• When dentures are first inserted - sensation to taste
is absent.
• As patient adapts to denture - ability to taste is 16
improved
XEROSTOMIA: also called dry mouth caused due to
diminished salivary flow.
Causes: fear and. anxiety,
• drug therapy- antihypertensive ,
anticonvulsants, anti depressants ,
tranquilisers and antiparkinsonian
drugs
• Therapeutic radiation for head and
neck cancer
• Infections – like mumps
• Autoimmune deficiencies – sjogren’s
syndrome
• Diabetes, alcoholism, vitamin A and
vitamin B complex deficiencies,
pernicious anemia
• HIV infections 17
• Lack of salivation effect 70% of
Lack saliva can affect the nutritional status in
number of ways:
.
1.It hinders chewing of food and prevents the
formation of bolus
2. It makes mouth sore and chewing painful
3. Swallowing becomes difficult due to loss of
saliva‘s lubricant effect.
4. Cause changes in taste perception that
decrease adequate food intake, burning tissues
and tongue.
5. In denture patients – affect denture retention,
18
mastication, deglutition difficult.
PROSTHODONTIC CONSIDERATION :
Before prosthesis fabrication – xerostomia condition is
corrected .
Drug is has
• Milk the cause – alter theas
been proposed drug and modification
a saliva substitute, itof
dosage schedule and buffering action.
has lubricating
• Use of artificial saliva and frequent mouth rinses
• Hydrophilic fruits are advised
• Mashed potatoes , rice , soups are good option
• Choose soft foods like scrambled eggs ,
puddings
19
20
• Cut food in to small pieces , so it is easy to chew
• Coating the tissue surface with
petrolatum, lubricating jelly's will
increase the flow .rate.
• Sialogues, stimulate the flow of saliva
• Pylocarpine hydrochloride 5mg before
meals will cause flow for 2 to 5 hours.
• Primary impression is taken with –
impression compound.
• Secondary impression with light body
elastomeric material
• Xerostomic patients are successfully
20
treated by providing reservoir dentures
NUTRITIONAL NEEDS OF ELDERLY :
ENERGY:
• With aging , lean. body mass decreases leads to
decrease in metabolic rate and physical activity.
• average energy consumption of
65-74 years – 1300kcal ( old women)
1800kcal (old men)
51 years - 1900kcal (women)
2300kcal(men)
• Deficiency causes dull , dry hair , salivary gland
enlargement , muscle wasting, pallor , pale atrophic
tongue , spoon nails and paleconjuctiva
21
CALORIES:
• With advancing age, energy expenditure decreases -
calorie requirement also decreases .
.
• When calorie intake is low- consumption of food with
high nutrient density such as legumes , vegetables
soups, fruit desserts , low food dairy foods , whole
grain breads , cereals .
• To reduce calories , food high in
fats and simple sugars are
replaced with complex
carbohydrates
• Mean RDA is 1600kcal for women and
2400kcal for men
22
Recommended calorie intake for Indian population
Group particulars kcalories
.
Male sedentary work 2350
moderate work 2700
heavy work 3200
Female sedentary work 1800
moderate work 2100
heavy work 2450
handbook of food and nutrition - M.Swaminathan 23
NUTRITIONAL IMPORTANCE OF CARBOHYDRATES:
• - provide fuel
USES . to body, absolute
requirement of brain, protein
sparing action, synthesis of fats.
• RDA – 400gms
• recommended range of intake- 50
to60% of total calories
• Sources – sugars ,starches , fiber’s ,
found in grains , fruits and
vegetables , and cereals
Elderly people consume more amount of
carbohydrates because of their low cost , ease to
preparation
24
Systemic considerations:
• Increased intake causes weight gain, diabetes,
.
poor metabolic health and increased risk of heart
diseases.
• Decreased intake causes diabetic ketoacidosis,
hypoglycemia, hyperosmolar coma.
prosthodontics considerations:
• Reduced tolerance during treatment
• Systemic diseases affects the healing and
functioning of soft tissue
• Increases caries suseptibility
25
NUTRITIONAL IMPORTANCE OF PROTEIS
They support the .growth of the tissues when given in
high concentration.
RDA average = 0.8 g/kg/day, 10 to 30% of total calories
Proteins from animal sources- chopped meat ,
poultry ,boiled fish , eggs , powdered milk
Have higher value than vegetable sources
Proteins from plant sources - lentils
peas ,nuts etc.
26
Systemic considerations-
physiological stresses are associated with age
.
related degenerative diseases, protein needs of
older adults higher than younger adults.
Decreased intake causes skin, hair and nail
problems, loss of muscle mass, increased risk of
bone fractures, inhibit growth in children
Prosthodontic considerations
• hypo functioning of salivary glands
• demineralisation
• abutment teeth failure due to periodontitis 27
NUTRITIONAL IMPORTANCE OF FATS:
.
uses : structural components of biological members
transport and utilization of cholesterol
maintain proper growth and reproduction
15 -50% of the body energy requirements
RDA- 44-78 grams a day
SOURCES: saturated fats- cause atherosclerosis
e.g ghee, pork , butter, in fish and fowl [low
saturated fats]
poly unsaturated fats are recommended – salads ,
walnuts, sunflower, flaxseed oils
28
Systemic considerations-
• Increased intake causes weight gain,
.
diabetes, heart problems, cancer
• Decreased intake causes dry eyes,
skin, hair, hormonal problems, deficiency
in fat soluble vitamins, mental fatigue
Prosthodontics considerations
increased body fat worsens periodontal status of
teeth
29
NUTRITIONAL IMPORTANCE OF FIBERS:
1. Important component of complex carbohydrates is
fiber .
2. fibers promote bowel function , reduce serum
cholesterol, prevent diverticular diseases.
3.Reduce selection of foods rich in fibres which are hard
to chew , provoke gastrointestinal disturbances due to
deficient masticatory performance in elderly people
4.A study concluded that even 1gm of difference in
dietary fiber intake
between dentate and edentulous, lead to 2% increase
5. Fibres
risk in the form
of myocardial of bran. is
infration
frequently added to dry cereals and 30
breads , vegetable fibres are more
WATER:
• Water is the most important and essential nutrients.
.
• Under normal conditions , fluid intake should be at
least 30ml per kg body weight per day
DUE TO DEHYDRATION -PRODUCTION OF ALL SECRECTIONS
DECREASED
31
TREATMENT FOR DEHYDRATION:
• Xerostomia treated to restore normal
.
health of oral tissues .
• Acute dehydration – intravenous and
subcutaneous fluids are given
• Chronic dehydration – decreased by
hydrophilic foods.
• Soups- provide water and nutrients to
dehydrated tissues
• Vegetable soups are highly desirable for
elderly
32
• Vegetable soups enriched by meat or fish
NUTRITIONAL IMPORTANCE OF MINERALS:
• In organic elements in food that are essential to life
.
processes
Classified as :
Macro minerals requirement > 100mg/dl
e.g: Ca , P , Na , K , Cl , Mg
Micro mineral requirement < 100mg/dl
e.g:Cr, Co , Cu , Fe , I , Mn , Mo , Se , Si , Zn
A study conducted by J. Crystal Braxter illustrated
deficiencies in magnesium , fluoride , folic acid , zinc
and calcium in the geriatric population.
33
CALCIUM:
Daily requirement of calcium- 800mg/dl
Calcium needs in elderly
. persons –
1000mg per day
Functions – development of bone and
teeth,
transmission of nerve
impulses,
Food sources: milk and milk products
cell membrane
dried beans and integrity,
leafy vegetables
blood coagulation
Deficiency:
poor tooth formation , retarded growth , increase
clotting time, osteoporosis
Bone serves on internal sources of calcium when 3
exogenous sources are deficient. 4
OSTEOPOROSIS:
A medical condition. characterized by a decrease in bone
mass with diminished density and concurrent
enlargement of bone spaces which produces porosities
and fragility of bone
Seen in weight bearing parts of skeleton i.e. vertebral
column, epiphyses of long bone, the pelvis , the maxilla ,
fingers.
Causes of osteoporosis:
lack of calcium intake
Lake of calcium adsorption,
Lactase deficiency,
Low estrogen – levels are seen in
postmenopausal women
3
5
NUTRITION FOR OSTEOPOROSIS
PATIENT:
.
• Milk , yogurt , cheese and other dairy products
have high levels of calcium
• lactose intolerance – calcium fortified orange
juices, plant based milks[ soy and almond milk]
and cereals , green leafy vegetables , sea foods
are advised .
• vitamin D and fluoride supplements are given
• Calcium citrate and calcium carbonate advised
3
6
FLOURIDE:
RDA – 1 to 2 mg , in drinking water – 1ppm
.
Functions: bone and tooth formation
increased resistance to decay
important in remineralised process of
demineralised bone
fluoride along with vitamin D and calcium
reduce osteoporosis
Food sources : potatoes , grapes , spinach , shellfish
Deficiency: increased dental caries
3
7
ZINC:
RDA – 15mg per day
.
Functions: required for digestion, wound healing , tissue
growth,
reproduction.
Food sources: animal products , wholegrain , dried
beans
IRON:
Deficiency: taste alteration, delayed wound healing ,
RDA – 10mg
retarded per day
growth
Functions: growth , hb formation
Food sources: meat, fish , leafy vegetables, dried
beans and peas
Deficiency: burning tongue , dry mouth , anemias ,
CLASSIFICATION OF VITAMINS:
.
3
9
VITAMIN A:
.
• It is widely distributed in plants as provitamin
BETA CAROTENE and animals as RETINOIDS.
• In plant sources- yellow, green and red vegetables
and fruits
• In animals- meat , liver , milk and milk products
Recommended dietary
allowance:
• Men and women – 750mg per day
• Pregnancy and lactation – 1000 mg per day
• Infants – 350 mg per day 40
• Children – 600 mg per day.
ORAL MANIFESATIONS OF DEFICIENCY
• Enamel hypoplasia
.
• Dentin lacks normal tubercular structure
• Increased risk of caries
• Delayed eruption
• Decreased bone formation
• Hyperplastic gingiva with keratinization
• Periodontal infection
• Keratinizing metaplasia of salivary gland causes
XEROSTOMIA 41
Prosthodontics consideration
.
IN REMOVABLE PROSTHESIS
Xerostomia is a feature of vit A deficiency causing
mucosa dry and irritation and tissue damage during
denture wear
IN FIXED PROSTHESIS
Periodontal infection is more common in vit A def
patients causing early abutment tooth loss in fpd and
peri-implantitis and decreased osseointegration in
case of implants.
42
VITAMIN D:
It is also called SUNSHINE VITAMIN, ANTI RACHITIC
VITAMIN .
It is available in 2 forms
- D3 - Cholecalciferol
- D2 – Ergocalciferol
Good sources of vitamin D include fatty fish , fish liver
oils , egg yolk etc
Natural source - exposure of skin to sunlight synthesizes
vitamin D.
RDA– 5ug per day
43
• calcitrol - Circulates as hormone in blood regulating
the concentration of calcium and phosphate.
.
• Causes mineralisation of bone, coordinates the
remodelling of bone
• Low calcitrol levels – increased production of
parthhormone
GENERAL MANIFESTATION OF DEFICIENCY
• Rickets in children -
• Osteomalacia in adults
• renal rickets
• Increased risk of osteoporosis
4
4
ORAL MANIFESTATIONS OF DEFICIENCIES
.
• Developmental anomalies of dentin and enamel, teeth
shows wide prezone dentin with interglobular dentin.
• Delayed eruption of primary and permanent dentin
• High pulp horns and large pulp chamber , risk of
caries.
PROSTHODONTIC CONSIDERATION
Vit D deficiency - affect wound healing and
osseointegration of implant.
Bone loss and weakness of the ridges that resulting in
poor fitting dentures, mobility of abutment tooth
resulting in failure of prosthesis.
VITAMIN E:
• Vitamin E is a . natural occurring antioxidant. It is
essential for normal reproduction in many animals
hence known as antisterility vitamin.
• - tochopherol – active form
• RDA: 10 ug per day
• It is given to pregnant and lactating
women
• Available from vegetable oils , nuts ,
margarines
46
IMPORTANCE:
• It has antioxidant property
.
• Prevents oxidation of LDL – prevent heart diseases
• Protects RBC from haemolysis by oxidising agent
• Protects liver from toxic compounds
ORAL MANIFESTATIONS OF DEFICIENCY
• Loss of pigmentation
• Atrophic degenerative changes in enamel
4
7
VITAMIN K:
• also called coagulation vitamin
• . forms
It is available in 3
• K1 – phylloquinone, present in plants
• K2 – menaguinone, synthesised by intestinal
bacteria
• K3 - menadione is a synthetic form
• RDA - 70ug per day
48
IMPORTANCE:
• Post translation modification of 2, 7, 9,10 blood clotting
factors .
• Particularly prothrombin.
• deficiency of vitamin k result in prolonged clotting time
• Prothrombin level below 35% - bleeding after tooth
brushing
• Prothrombin levels below 20% - spontaneous gingival
haemorrhages
49
VITAMIN B1 [THAMINE]:
Also called as anti beriberi or anti - neuriti vitamin.
.
thiamine pyrophosphate – coenzyme of thiamine
associated with carbohydrate metabolism.
Plays important role in transmission of nerve impulse.
Food sources – meat [pork and chicken], peas, fortified
grains, yeast
Deficiency of B1- seen in population consuming polished
rice,
dryberi beri - peripheral neuritis
wet beriberi - cardiac manifestation
VITAMIN B2 : RIBOFLAVIN
Takes part in cellular. oxidation reduction reactions
Coenzyme –FAD and FMN
Sources: milk products, meat, eggs, liver, kidney, cereal,
fruits , vegetables
RDA – 2 mg/day
Importance - redox reaction responsible for energy
production
Deficiency- glossitis[ magenta colour tongue]
cheilosis , ocular lesions , nasolabial
seborrhoea 51
VITAMINB3 NIACIN: RDA-15 - 20mg/day
Known as pellagra preventing factor
.
NAD and NADP coenzymes are synthesized
by tryptophan
Sources- whole grains, cereal, pulses, liver,
milk, fish, eggs, vegetables.
DEFICIENCY :
pellagra which
characterized by dermatitis, diarrhea
and dementia finally death
Bald tongue of sandwith
Raw beefy tongue
Mucosa – red and painful, salivation is 52
profuse
VITAMIN B6 : PYRIDOXINE
RDA – 1-2 mg/day, coenzyme – pyridoxal phosphate
Rich sources are eggs, fish, green leafy vegetables
and cereals
Besides it is produced by the microorganism of
intestinal tract of animal and man
DEFICIENCY:
Peripheral neuropathy , demyelination of neurons
Symptoms – cheliosis ,glossitis, hypochromic anemia ,
leucocytic
count
Vitamin B6 supplementation during isoniazid 53
therapy is necessary.
FOLIC ACID:
RDA - 150ug
Food sources- leafy green vegetables , oranges , liver
and yeast
DEFICIENCY :
Megaloblastic anaemia, altered taste
Glossitis – filliform papilla disappear first
advanced causes – fungiform papilla lost ,
tongue becomes
smooth and fiery red in colour
5
4
VITAMIN B 12 : CYNACOBOLAMIN
RDA- 2ug per day
Absorbed from GIT in presence of intrinsic factor and
stored in liver
Primary source - synthesized by intestinal microbial flora.
Food sources are liver, kidney, eggs, fish and milk
Deficiency : pernicious anemia
neurological manifestations
degeneration of myelin sheath
Beefy red tongue - glossopyrosis, glossitis,
glossodynia
high prevalence of vitamin
Hunters B12 deficiency
glossities or moellersinglossities
older people-
they receive vitamin B12 from fortified food and /or
VITAMIN C : ASCORBIC ACID
RDA – 60mg/day
man cannot synthesis ascorbic acid
Essential for collagen synthesis – helps in wound
healing
In the elderly- slow wound healing and
hypermobility of teeth increases the
need of vitamin c
56
DEFICIENCY :
Scurvy – characterised by spongy , sore gums, loose
teeth , anemia , swollen joints , delayed wound healing ,
haemorrhage , osteoporosis
Cork screw hair pattern
Woody legs
Bone formed is tender and fragile
Heavy smokers and aspirin intake have higher daily
requirement of ascorbic acid
The complete denture patients should consume more
amount of vitamin c rich food
57
58
ASSESSING NUTRITIONAL ANALYSIS:
Triphase nutritional analysis:
Phase -1 : to screen all patients
obtain information from medical , social history
screeing for clinical sings of deficiency
conducting selected anthropometrical
measurements
Qualitative dietary assessments:
To determine what an individual is eating now, what he or
she eaten in the past and recent changes in diet
Questionnaires asked to identify older individuals with
nutritional deficiency
60
Dietary counselling instituted
Phase- 2:
more information should be accumulated
• Semiquantitative dietary analysis :
nutrients in all food and beverages consumed
during 3 to 5 days are calculated using food
composition tables or computer assisted nutrient
analysis programs.
Average caloric and nutrient intake quantitated
and compared with norms
• Biochemical assessment:
Automated blood test – definitive information
Phase
about-3: nutritional status of patient.
for assessing complex nutritional problems
accomplished under the direction of physician
Biochemical analysis of blood, urine, tissues as
well as functions tests for metabolic and endocrine
systems . 61
RISK FACTORS FOR MALNUTRITION IN PATIENTS
WITH DENTURES :
Eating less than two meals/day.
Difficult chewing and swallowing
Unplanned weight gain or loss of more than 10lb in the
last 6 months
Undergoing chemotherapy or radiation therapy
Loose denture or sore spots under denture
Oral lesions(glossitis, cheliosis or burning tongue)
Severely resorbed mandible 6
2
NUTRITION AND OVER DENTURE
Cariogenic diet ca+ deficiency Vit A &C
deficiency
Caries of abutment ridge resorption poor periodontal
health
Failure of abutment
Failure of overdenture
63
NUTRITIONAL GUDLINES FOR PATIENTS
UNDERGOING PROSTHODONTIC S
1.Eat a variety of food- Maintain ideal weight
2.Build diet around complex carbohydrates
3.Include citrus fruit or juice containing Vitamin C
everyday
4.Select fish, poultry, or dried peas, dry fruits and beans
everyday
5.Obtain adequate Calcium e.g. milk products, curd,
cottage cheese
6.Limit intake of bakery products high in fat and 64
simple sugars, Simple desserts are best (custard and
DIET RECOMMENDED FOR NEW DENTURE
WEARER:
DIET FOR FIRST POST INSERTION DAY:
Full liquid diet
Vegetable – fruit group : juices
Bread – cereal group : gruels cooked in either milk
or water
Milk group : fluid milk may be taken in any form
Meat group: meat broths , soups
Sample menu contain a glass of milk at least once 65
aday
DIET FOR THE 2ND AND 3RD POST INSERTION
DAY
pureed diet to soft diet
Bread/cereal group - khichdi, cooked cereals, milk toast
and soften bread, puffed rice.
Vegetable group - juices, well cooked carrots, green
beans, mashed potatoes, creamed vegetables.
Fruit group - well-cooked fruits (no seeds), juices.
Meat group - soft boil eggs, chopped meat, non veg
soups.
The sample menu must include butter , a glass of 66
Dairy products - milk, curds, butter milk
milk at least once a day.
DIET FOR THE FOURTH DAY AND LATER:
soft diet to regular diet as tolerated
As soon as sore spots are healed, firmer foods can be
eaten
Best to cut food into small pieces
The sample menu must include butter , a glass of
milk at least once aday
Kranti Ashoknath Bandodkar , Meena Aras, nutrition for geriatric
denture patients , J indian prosthet society 67
Nutritional status in Implant supported prosthesis
AIM : To asses the nutritional status and oral health related quality in
totally
Edentulous patients after treatment with complete denture and implant
supported prosthesis .
Treatment options included :complete denture , implant supported
complete denture ,implant supported fixed prosthesis.
Conclusion: study shown an enhancement in the quality of life and
nutrition status for implant supported prosthesis compaired to conventional
removable dentures due to increase in masticatory efficiency
Nada El Osta etal . Impact of implant spported prosthesis on 6
nutritional status and oral health perception in edentulous patients 8
DIETARY MANAGEMENT WHEN TEETH ARE
EXTRACTED:
• Poorly nourished patients: instruct
to consume
high caloric , high protein foods before
surgery.
• Milk based cooked cereals ,
soups ,mashed vegetables , ground
meat
POST , eggs are advised
OPERATIVELY: proteins ,vitamin A&C ,folic acid,
• For high risk
pyridoxine, patients
vitamin B12 , –iron
multivitamin
and zinc are needed for
tablets , collagen synthesis
immunity
regeneration of epithelium cells .
For the first 24 hrs. of extraction: nutrient dense liquids ,
high protein milk made by adding 1 cup of dry milk
powder to ¼ of fluid whole milk 69
vitamin c – citrus fruits , another source of ascorbic acid.
NUTRITION IN MAXILLOFACIAL PROSTHESIS
PATIENT
An approach that involve simple nutritional principles preceding
the surgery , continuing post operatively and preceding life long will
translate into improved prosthodontics prognosis .
Preoperative phases :
1. Assessment of nutritional status.
2. Indications for additional nutritional support are as
follows
a) Poor nutritional status
b) Significant weight loss
c) Anticipated duration of nil per orally for more than
seven days
7
d) Serum albumin values less than 3.0gm/dl
Ravi madan etal nutrition in maxillofacial prosthetic patients; the 0
unexplored frontier J Indian prosthet society dec 2007
Post operative phase:
Alternative to oral feeding – nasogastric intubation ,
TPN[total parental nutrition] , gastrostomy or
jejunostomy
Oral feeding resumed with a week of surgery –
nasogastric intubation
Patients not expecting oral resumption around a month
– TPN is preferred
Long term nill per orally is expected or patient with
swallowing disorders
gastrostomy / jejunostomy is preferred
Once oral feeding is resumed , malnutrition is the most common
due to various complications:
Loss of appetite : eat small amounts food four to six times daily
drink fluids – soups , milkshakes and curd
psychological counselling
Sore mouth : avoid spicy and salty food with rough texture
take soft nonacidic , blended or liquid foods
leaving dentures as long as possible out of the
mouth
Diarrhea ; drink plenty of water
have curd and banana regularly
regular consultation with physician
Xerostomia: take fluid intake
use artificial salivary substitutes
72
constipation : take fibre diet , figs , papaya , 8 to 10 glasses of
CONCLUSION
NUTRITION is very important for Health, Fitness &
positive lifestyle.
Improper nutrition not only effects physical appearance
but also it affects psychological status of patient
Deficiency in a variety of Nutrients over the long term
will lead to variety of diseases & has a negative
influence on the Health & the soft tissues of the oral
cavity.
Nutrition is one of the many factors which determine
success or failure of prosthetic appliances in the mouths
of aging people.
The Prosthodontist should be aware of significance of
REFERENCES
1.Text book of biochemistry – U. Satyanarayan, U. Chakrapani
2. Text book of physiology - Choudary
3Essentials of complete denture prosthodontics – Sheldon Winkler
4.Treatment for edentulous patients – Boucher
5.Kranti Ashoknath Bandodkar:Nutrition for geriatric denture
patients
J.Of Indian prosthodontics society , March 2008
6. Nada El Osta etal . Impact of implant spported prosthesis on
nutritional status and oral health perception in edentulous patients
7. Ravi Madan etal nutrition in maxillofacial prosthetic patients; the
7
unexplored frontier J Indian prosthetic society Dec 2007 4
