Nutrition: Life Cycle Nutritional Needs

So this module was really interesting! It is mostly about what foods/nutrients have ingest before you have your baby, and what to feed your babies when their born, preschoolers, school aged children and adolescents. There's a lot of great tips for new moms, and parents that are having a hard time getting their child to eat healthy food. This module also contains the difference for breast feeding and bottle feeding. Enjoy!

Prenatal Care
- Calcium and phosphorus are particularly important for your unborn child.
- If the mother is calcium and phosphorus deficient, her body will compensate for this by drawing calcium from her bones. Her teeth however will not be affected.
- Canadian Health Food Guide recommends 3-4 serving per day of milk products to meet the calcium requirements.
- The mothers dental health is important to prevent the pain of a toothache or soreness in the mouth, both of which may prevent proper eating.

Other Key Nutrients During Pregnancy
Vitamin D: Supports fetus and the mother, helps absorb calcium and phosphorous. A good source of vitamin D is sunshine, but it is also found in fortified milk and margarine.
Iron: required for mothers increased blood volume, very important to store extra iron for the baby in the 2nd and 3rd trimesters.
Folic Acid: found in green leafy vegetables and supplements. It supports the production of red blood cells, and prevents fetal neural tube defects. The lack of folic acid has be proven to help contribute to spinal bifida and MS.
Essential Fatty Acids: assists baby with a healthy brain, visual, and emotional development.

Birth to 6 Months Old:
- The Canadian Paediatric Society suggests exclusive breastfeeding or iron fortified formula until 6 months of age.
- Vitamin D supplements are also required

6 Months - to a Year Old:
- Begins transition period when solid foods are introduced. The order to introduce solids is:

• Infant cereals (single grains, then mixed)- these are iron fortified, and rice cereal is the least apt to provoke a food allergy
• vegetables (pureed)
• fruits (pureed)
• meat (cut up into extremely small pieces)
• cheese and yogurt 

 - breast feeding or formula continues until at least 9-12 months when whole cows milk can be introduced. 2%, 1%, or skim milk is not recommended until after two years of age.

Breastfeeding                                 vrs                           Bottle Feeding
- build antibodies                                           -time and frequency
-nutrition and ease of digestion                     of feeding decreses
- strengthens the facial muscles                    - the mother doesnt
- convenient and free                                      have to watch her
- obesity prevention                                        diet so closely
- smarter babies                                            - other people can
- emotional bonding                                        feed the baby
(skin to skin contact)

Histology, Pathology, and Embrology: The Clinical Importance of Enamel and Dentin and their Composition

Enamel

Located: above the anatomical crown
Physical characteristics

• Origin: ectoderm
• Hardness: hardest tissue in the body
• dentin and bone come from the mesenchyme
• Permeability: allows for exhange of ions- flouride application
• Non-Vital: not a living tissue, it has chemical reactions (mineralization vrs demineralization), contains no cells, no blood vessels or nerves, no power of growth and repair, any inperfections during development is permanent, no more enamel is laid down after the tooth has eurrupted.
• Thickness: like the sharp part of a knife; 2-2.5mm
• Color: yellowish white to gray white, translucent, tends to look whiter then it actually is becuase of the colors surrounding the tooth.
• it also reflects underlying dentin
• Chemica compostion: 96% hydroyaplite, yeah I dont know what that meanas either. (inorganic), 2.3% water, 1.7% organic collagen
• Microscoaclly enamel looks hard, shiny and translucent.

- In baby teeth there is only enamel present (little dentin and little cementum) therefore the teeth are whiter due to less dentin

Atttition is worn away biting surfaces making changes in dentin where the enamel worn

you can see how the tooth has been worn away, and the brown part showing is actually the dentin being exposed. This is caused by excessive grinding of the teeth.

Under a microscope you can see tiny rods/prisms ectending prependicular from the deno-enamel junction (where the dentin and enamel meet) to outer surface, they are made by ameloblasts and those cells determine the shape. The rods can have curvatures, and there is about 5-12 million rods on each tooth. They fit together like a key hole shape

Development of Enamel

• Bell Stage
• ameloblasts lay down a gel matrix
• they move away from the DEJ towards the OEE
• Mineralization Stage
• occurs after the matrix has been deposited
• emeoloblasts deposit minerals of calcium and phosphrous into the matrix and crystalization occurs
• occurs at the cusp tip (center) and moves outward
• Maturation Stage
• minerals increase in size, and are tightly packed together
• if lack of growth of packing, hypocalcification can occur or hyoplasa.

In development incemental lines of Retzius are created. They represent the metabolic changes during enamel formation. They curve our and away from the DEJ (looks like rings on a tree). This is a normal occurance, beacuse there are periods of metabolic disturbances during amelogensis. The importance of these lines are that decay (cavities) follow the lines of enamel rods to the dentin, and then the decay increases rapidly when it reaches the dentin.

Enamel Lamellae are microspoic separations or crack left between ename rods, they are cuased by developmental problems or stress on the tooth. They may be more suseptable to decay. If the cracks are severe they can extend to the surface, appearing as a visable crack in enamel.

Enamel Tuffs look like "clumps of grass" at the DEJ and extending shortly to the enamel

Enamel Spindles are an odonotblast that us trapped between an emeolobloast in early devlopment and that odonotblast process is caught in the enamel. This is a living tissue that has a thin corkscrew shape.

A= Enamel Lamellae

B= Enamel Tuffs

C= Enamel Spindles



Histology, Pathology, and Embrology: How The Tooth Develops

The sciencey term for tooth developing is called odontogesis

Note: Not all teeth develop at the same time

DL = Dental Lamina

OE = Dental Lamina

DP = Dental Papilla

DF = Dental Sac

SL = Successors Lamina

Ignore the rest

Development

Starts out as a tooth germ or bud (that whole picture would be considered a tooth bud). It comes from the ectoderm

So the tooth germ has three major parts

1. Enamel Organ - a knob like growth from the dental lamina, which came from epithelium
2. Dental Papilla - comes from the mesenchyme and will become dentin and pulp
3. Dental Sac - several rows of flat cells that come from the mesenchyme and will become periodontal ligaments, cementum, and lamina dura.

The enamel organ has 3 stages of development, the bud stage the cap stage, and the bell stage. The picture above is in the bells stage.

•  Bud Stage
• Initiation stage of tooth development
• Thickening of oral epithelium forming the dental lamina
• As it begins to invaginate it moves to the cap stage
• Cap Stage
• Occurs around week eight
• The cells begin to proliferate
• Enamel organ begins to surround mesenchyme
• Formation of dental papilla and dental sac
• Now have developed 3 out of 4 components of the enamel organ
• inner/outer enamel epithelial (part of enamel organ)
• stelliate reticulum (membrane inside enamel organ)
• Bell Stage
• Occurs around week 10-11
• Appearance of all four layer of enamel organ
• 1. Outer Enamel Epithelium (OEE)
• Outside layer on the surface of enamel organ
• cubodial cells
• protective layer for entire enamel organ
• 2. Inner Enamel Organ (IEE)
• line the enamel organ (inside of EO) - concave
• cuboidal and elongate to columnar as they differentiate
• become ameloblayst (enamel forming cells)
• IEE separated from dental papilla
• Basement membrane becomes the future dento-enamel junction
• Stellate Reticulum (SR)
• cells between the OEE and the IEE
• loose network of epithelial cells that are star-shaped
• provide protection/cushion
• part of nourishment for IEE- transport to stratum intermedium
• Stratum Intermedium (SI)
• layer of flat epithelial cells inside the stellate reticulum
• between SR and IEE
• nourishes the IEE

Histology, Pathology, and Embrology: From the very begining... Development of the mouth while still in your moms womb

First off...
Histology: is the study of tissues
Tissue: is a group of similar cells combined into a specialized manner and preform a particular function. A tissue contains intercellular substances between cells, and contains tissue fluid surrounding the cell.

• Tissues vary greatly in appearance and structure
• Examples of tissues are: hard bone, sturdy/elastic skin, lining of respiratory tract, salivatory glands, blood, and soft muscle.

Components of Tissue
1. Cells: Differ in size, shape and structure. Ex: red blood cells (have no nucleus), white blood cells (one or several nuclei), muscle cells (contract), fat (have a displaced nucleus)

2. Intercelluar Substance: in between cells in all tissue of the body. It is a by-product of the cell. There are two main forms 1) Fibrous or thread, 2) Amorphous (without form/unicellular)

3. Tissue Fluid: part of the blood plasma which can diffuse thought the capillary wall (nutrients and wastes). Different tissue have different amount of tissue fluid. Ex: blood has a large tissue fluid, while skin has a small tissue fluid.

Human tissues are classified into four primary groups.
1. Epithelial tissue: is skin, it occurs as covering or lining membranes. All epithelial tissue rests on connective tissue, but are not alike in shape and arrangement. The major groups of epithelial tissue are surface cells of covering and lining membrane, and glandular tissue.

Shape :

• Squamous = flat
• Cubodial = cube
• Columnar = column
• Transitional = changes shape

Arrangement:

• Simple: a single layer
• Stratified: several layers
• Pseudstratisfied: appears to be several layers but its actually only one.

2. Connective tissue differs greatly in form and function, and all lining of the epithelial and glandular tissue resides on the connective tissue. There are six types of connective tissue: fibours, loose alveolar, aclipose, hemopoetic, cartilage and bone.

• Specialized connective tissue are fat displaced nucleus', hemopoetic=blood, cartilage, and bone.

3. Nerve tissue: have cells that make up the nervous system are neurons. The central nervous system include the brain and spinal cord (no connective tissue)

4. Muscle tissues: there are three kinds of muscle tissue

1. Smooth muscle: non striated, walls of blood vessels (involuntary control)
2. Skeletal muscle: striated, very strong (voluntary control)
3. Cardiac muscle: appear striated or striped when magnified (involuntary control)

Embryology

When we are just forming in the womb, we are just two tubes. Larger tube is the outer body wall, the smaller inner tube is the digestive tract. In between the tubes are our internal organs. At either end of the tube is the mouth, and the other your butt.

Histology, Pathology, and Embrology: Structures of the Tooth and Their Functions

Alrighty! So here is what our teeth look inside. When we look at our own teeth, the white part of our teeth is the enamel. The dentin is what give our teeth the yellowy/grayish white color, which lies beneath the enamel. The pup holds blood vessels and nerves; when you have a sensitive tooth it is because the nerve is irritated. The cementum protects the root of our teeth, and lies below the gum line. The periodontal membrane/ligament is what hold the tooth to the bone. Short and sweet ;)

Nutrition: Human Nutrition and Canadian Standard Fundamentals

First off:
Nutrients are substances found in foods that are known to either play a role in the body, for growth, maintenance, or repair.
Essential Nutrients are substances that must be obtained from the diet. They are: carbohydrates, proteins, fats, vitamins, minerals and water.
Nutrition is the biological science of nutrients in food and the functions they preform
Malnutrition is any disorder of nutrition or undesirable health status caused by lack of  or excess of nutrients.
Non-essential nutrients are produced by our bodies. For example: cholesterol.

The essential nutrients that are required from our food is:

21 minerals

14 vitamins

8 amino acids ( 10 for children )

2 fatty acids

Some examples of poor nutrition/dietary habits are high sugar intake, lactose intolerant, diabetes, a high intake of coffee/tea, bulimia, or poor vitamin C intake. Nutrition is the foundation of the entire body.


DRI'S (Dietary Reference Intakes) are reference values that can be used in the assessment of an individuals or groups nutrient intakes, the planning of feeding programs, development of nutrition education materials, formation of policy decisions on the fortification of foods and formulation of supplements and special dietary foods.


I'm sure everyone knows this but the 4 food groups are grain products (6-8 servings a day), fruit and vegetables (7-10 servings a day), milk and alternatives (2 servings a day), and meat and alternatives (2-3 servings a day). Unfortunately there is no chips and chocolate category :(.  Together these food groups provide more than 50 nutrients essential for health and growth.


It can be pretty difficult to estimate serving sizes, but using you hand as a guild can help

• A thumb equals 25 g of most cheeses (so 2 thumbs equal a serving)
• A thumb tip equals a teaspoon, and 3 thumb tips equals a tablespoon
• A palm equals a serving of meat, fish, or poultry (that is, without fingers and thumb)
• A fist equals a cup

Use this chart as a reference if a food group is omitted from your diet, to see what key nutrients your actually missing.

Grain Products

• Carbohydrates
• Fibre
• Thiamin
• Riboflavin
• Niacin
• Iron

Vegetables and Fruit

• Carbohydrates
• Fibre
• Folacin
• Vitamin C
• Vitamin A

Milk and Alternatives

• Protein
• Fat
• Riboflavin
• Vitamin B12
• Vitamin A
• Vitamin D
• Calcium

Meat and Alternatives

• Protein
• Fat
• Niacin
• Vitamin B12
• Iron
• Zinc
• Magnesium

There are six classes of nutrients: 1) Carbohydrates, fats, protein, water, vitamins, and minerals.

Preventitive Procedures: How Plaque is Formed and Becomes Calculus, How Cavities Form, and Periodontal Disease

Gingivitis and Periodontists

First off everyone needs to know how plaque is formed. You know the shiny/ wet looking part of teeth, that is called the material alba. The material alba is the perfect place for bacteria to chill out and congregate because it is a sticky substance. After the bacteria has stuck to the material alba, it begins to colonize and produce the plaque (soft deposit). After only 24 hours of the bacteria colonizing it becomes pathogenic and start to irritate your gums. That's why its so important to brush your teeth everyday. Its important to brush off the plaque because then it has to re-colonize all over again.

the white part at the bottom of the gum line is the calculus

After the plaque has colonized and has not been removed, it will turn into calculus (a hard deposit) making removal impossible without a dentist because it cannot be removed with a tooth brush, only a scalar.

This calculus, if left untreated, will be in the sulcus (where your gum attaches to your tooth) and the gums will start to recede and become red, very sore, and bleed when you floss. This can turn into gingivitis. Gingivitis is a form of periodontal disease.

 

You can see the red and inflamed gums along the gum line

If you still don't brush and most importantly do not floss it can become much worse. You can start to get periodontists which is the recession of bone!

You can see how the gums have receded all the way down to the bone and look like they're about to fall out, because the supporting structures are gone just because of plaque and it being pathogenic.

Cavities

Pharmacology: Care and Matienance of Drugs and Where they Come From (kind of boring, but I gotta learn it haha)

Pharmacology is the study of drugs encompassing drug origin, chemical composition, indications and actions on the body. The definition of a drug is a chemical substance that when administered to an organism produces a response.


Drugs can come from plants, animals, minerals, synthetically made and genetically engineered. Morphine comes from the opium plant. Some examples of these are insulin that comes from an animals pancreatic endocrine glands of mammals and treats diabetes. Magnesium sulfate comes from the mineral salts. Diazepam is a man made drug that is used to treatment of seizures. Human R. Insulin is genetically engineered to mass produce the drugs at are identical to human hormones.

 << LOL

 Opium Plants

The purpose of drugs are to diagnose, treat, prevent, and cure humans and animals by antibiotics, immunizations, vitamins etc.


There are factors to why drugs sometimes don't work or have too much of an effect on a patient. The factors the effect drug action are: does, cooperation, presence of other drugs, age, gender, genetic, body composition, diet, disease, and liver/kidney function.

Preventitive Procedures: Dental Probing

I don't know if a lot of people have had this done before, but the main purpose of probing is to see how deep your gums are attached too your tooth. A healthy gingival pocket is 1-3mm, anything deeper then that has the potential to be periodontal disease (gingivitis or periodontist).

For people with healthy gums probing can be very uncomfortable because the gum tissue is tightly wrapped around the tooth. For unhealthy gums the probe will fit easily between the gums and most likely bleed.

Other purposes for dental probing is to identify ginigival bleeding, measure the size of an oral lesion , aid in the detection of calculus underneath the gums.

Preventitive Procedures: Selective Polishing, Tooth Brushing and Flossing Techniques

Rubber Cup Polishing

The first thing that everyone should know is, polishing is a selective procedure. Not every patient needs to have their teeth polished or every single tooth in the mouth only the teeth with a stain.

The purpose of polishing are too remove extrinsic (stains on the outside of the tooth) stains that cannot be removed but brushing or scaling.

RCP is also used for polishing amalgam (form of filling), which makes the filling more resistant to tarnishing and corrosion. It prepares the teeth for cavity preventing agents like sealants. Also used before cementation of orthodontic bands, crowns, and bridges. Lastly, for polishing of the root surfaces that have been exposed during periodontal surgery to reduce endotoxins and bacteria on the cementum.

The Effects of Rubber Cup Polishing

A RCP and cause a person to have a bacteremia which means there is an introduction of bacteria that is localized in the mouth, and then goes into your blood stream. This happens when plaque is not under control and then the RCP brush irritates the gum tissue causing it to bleed and then the plaque gets into the blood stream. This can also clog your arteries so floss and brush your teeth daily!!!

Another effect RCP has is that it produces aerosols. The biological contaminant of aerosols stay suspended for long periods, increasing disease transmission to the dental team and patients.

Another very important effect of RCP is that it removes 2mm of your tooth enamel. Which is why dental assistants want to selectively polish the teeth. It is also important to have the fluoride treatment after the polish because it puts that enamel back(we'll talk about this later)! Newly erupted teeth should not be polished because the tooth enamel isn't fully mineralized.

It can also cause teeth to have a rougher surface if a very abrasive polishing paste was used to get off a tough stain. A rougher surface is a perfect place for bacteria to colonize and ferment the carbohydrates to make the acid that gives you a cavity.

Note: Stains and deposits removed by polishing will return promptly if plaque control is not carried out faithfully (brushing and flossing).

Self Care With Tooth Brushing and Flossing

Have you ever wondered if a product your using REALLY works? Well if it has the Canadian Dental Association (CDA) seal of recognition, then it has been tested and proven to work. I'm not saying that products that do not have this seal don't work, but if you want to be 100% sure, look for this seal.

Purposes of Dental Flossing

With the effective use of dental floss it accomplishes the removal of dental plaque and debris that adhere to the teeth, restorations, orthodontic appliances, fixed prostheses, pontics and around implants from the gingiva (gums) in the interproximal (contacts areas in between the teeth) area and the sulcus (the area when the gums attach to the tooth. Also the place were plaque and food debris are harboured. Very important to clean) space. Flossing also aids in identifying the presence of subgingival (below the gum line) calculus (plaque turned into a hard deposit). It also reduces gingival bleeding. A lot of people might be surprised by this, but the reason your gums bleed when you floss is because your not flossing enough! The bleeding means that your gums are irritated by the plaque and food build up.