Chapter 34
Diet and
Dietary Analysis
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Nutrient Standards for Diet
Adequacy in Health Promotion
• Considerations
• Nutrient standards
• Government standards
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Nutrient Standards (cont’d)
• Guidelines
• Dietary standards
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Food Pyramid
• Dietary guidelines for Americans
– www.healthierus.gov/dietaryguidelines
• Application of standards
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(U.S. Department of Agriculture, Center for Nutrition Policy and Promotion,
MyPyramid Food Guidance System, April 2005. Available from:
http://www.mypyramid.gov.)
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Oral Health Relationships
• Skin and mucous membrane
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Oral Health Relationships
(cont’d)
• Periodontal tissues
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Review
What are Recommended Dietary Allowances (RDAs)?
A) Caloric recommendations based on gender, age,
and activity level
B) Standards reflecting adequate nutrient intake for
healthy individuals
C) References for the amount of vitamins and
minerals needed daily
D) Guidelines on how to lose weight and be more
active
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Answer
B) Standards reflecting adequate
nutrient intake for healthy individuals
is the correct answer.
RDAs are standards that reflect
adequate nutrient intake for healthy
individuals to prevent deficiencies.
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Tooth Structure
and Integrity
• Nutrients and health of tooth structure
• Dietary assessment
• Dental caries
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Counseling for
Caries Control
• Risk factors
• Other preventive measures that
support dietary control
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(Adapted from United States Department of Health and Human Services, Public
Health Service, National Institute of Dental Research: Broadening the scope.
Long-range research plan for the 1990s. NIH Publication No. 90-1188,
Washington DC: United States Government Printing Office; 1990).
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The Dietary Assessment
• Purposes
• Preliminary preparation
– Patient history
– Clinical evaluation
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Review
The purpose of a dietary assessment includes all of
the following except:
A) analyze the diet to prevent obesity
B) study the patient’s food habits and snacking
patterns
C) identify the patient who may be at a nutritional and
oral health risk
D) determine the overall consistency of the diet
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Answer
A) Analyze the diet to prevent obesity is
the correct answer.
The dental hygienist does not give
dieting advice when doing a dietary
assessment. The hygienist studies the
food habits and compares them to the
current standards and addresses any
concerns.
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Forms for Assessment
• Food diary
• Dietary analysis recording form
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Presentation to
the Patient
• Explain the purpose
• Explain the form
• Complete the current day’s food diary
with the patient
• General directions
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Receiving the
Completed Diary
• Obtain supplemental data
• Review of diary
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24-Hour Intake Analysis
• Adequacy
• Comparison to MyPyramid Food
Guidance System
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24-Hour Intake Analysis (cont’d)
• Frequency
• Consistency
• Benefits of analysis
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Additional Counseling
• Define objectives
– Improved oral/general health status
– Dental caries control
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(Adapted with permission from Larmas, M.: Int Dent J. June 1985;35:109).
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Review
What pH level is the critical level for demineralization
of enamel?
A) below 5.5
B) above 5.5
C) 0
D) 1
E) 3.5
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Answer
A) Below 5.5 is the correct answer.
When the pH drops below 5.5 in the oral
cavity, demineralization of enamel can
occur.
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Planning Factors
• Patient attitude
• Possible barriers
• Appropriate teaching materials
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Counseling Procedures
• Setting
• Pointers for conference success
– Use patient-centered approach
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Presentation
• Review purpose
• Clarification of cariogenic foods
• Review of caries initiation process
• Frequency and time of exposure
• Retention
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Specific Dietary
Recommendations
• Examination of food diary
• Cultural or social barriers
• Collaboration on modifications
• Determine patient comprehension
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Principles for
Dietary Change
• Simple directions
• Dietary adequacy
• Caries control suggestions
• Salivary stimulation
• Rinsing after intake
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Evaluation of Progress
• Immediate
• Three-month follow-up
• Six-month follow-up
• Overall evaluation
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Factors to Teach
the Patient
• Hidden sugar content
• Medications causing xerostomia
• Facts about dental caries
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