sugars intake, nutrition, oral health, caries
In this paper, an overview of diet, nutrition and oral health associations is presented and recommendations for inclusion of this topic in the dental hygienists curriculum are made. Nutrition and diet impact upon many oral diseases including periodontal disease, oral infections, oral cancer, enamel developmental defects, dental caries and dental erosion. Poor nutritional status compromises the immune status increasing the severity of oral infections, whereas good nutrition may protect against certain oral conditions, e.g. noma. Nutritional affects the teeth pre-eruptively during development but this effect is of much less importance than the local effect of diet in the mouth, e.g. in the causation of dental erosion and dental caries. Dental erosion is perceived to be increasing and is in particular associated with consumption of acidic drinks. Dental caries in many European countries remains unacceptably high, and evidence for an association between sugars and dental caries is indisputable; intakes of free sugars below 15 – 20 kg per year are associated with good dental health. Fluoride increases the safe threshold for sugars intake yet alone, it does not eliminate caries. Dietary advice for dental health must be consistent with advice for general health. Current dietary recommendations for the prevention of chronic diseases promote increased consumption of fruit vegetables and starchy wholegrain foods and reduced consumption of fat (especially saturated) free sugars and salt: these dietary changes would be likely to reduce oral diseases. It is recommended that the dental hygienist has a broad background knowledge of general nutrition, an in-depth knowledge of the associations between nutrition and oral health and good communication skills necessary to impart dietary advice and support behavioral changes.