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arginine\tand\turea.\tFor\texample,\t\nStreptococcus\tsalivarius\n,\tone\tof\tthe\tmajor\talkali\tproducers\tin\tthe\nmouth,\texpresses\tthe\turease\tgene\tunder\tacidic\tpH\tand\tin\tthe\tpresence\tof\texcessive\tcarbohydrates\n(\nDuran-Pinedo\tand\tFrias-Lopez,\t2015\n).\tGenetic\tvariations\tof\tthe\ttype\tand\tquantity\tof\tbacteria\npresent\tin\tthe\toral\tcavity\tcontribute
|
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present\tin\tthe\toral\tcavity\tcontribute\n\tto\tan\tindividual’s\tincreased\trisk\tfor\tcaries\tand\tperiodontal\ndisease,\tbut\tthe\tquantity\tand\tquality\tof\toral\thygiene\tcontributes\tdirectly\tto\tthe\trisk\tof\toral\tinfectious\ndisease.\nSubstrate\nFermentable\tcarbohydrates,\tthose\tcarbohydrates\tsusceptible\tto\tthe\tactions\tof\tsalivary\tamylase,\tare
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] |
the\tideal\tsubstrate\tfor\tbacterial\tmetabolism.\tThe\tacids\tproduced\tby\ttheir\tmetabolism\tcause\ta\tdrop\tin\nsalivary\n\tpH\tto\tless\tthan\t5.5,\tcreating\tthe\tenvironment\tfor\tdecay.\tBacteria\tare\talways\tpresent\tand\nbegin\tto\treduce\tpH\twhen\tthey\thave\texposure\tto\tfermentable\tcarbohydrates.
|
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] |
Because\tthe\tDietary\tGuidelines\tfor\tAmericans\tand\tthe\tMyPlate\tFood\tGuidance\tsystem\tsupport\ta\ndiet\thigh\tin\tcarbohydrates,\tit\tis\timportant\tto\tbe\taware\tof\tthe\tcariogenicity\tof\tfoods.\t\nCariogenicity\nrefers\tto\tthe\tcaries-promoting\tproperties\n\tof\ta\tdiet\tor\tfood.\tThe\tcariogenicity\tof\ta\tfood\tvaries,
|
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eaten\t(\nBox\t24.1\n).\tIndividuals\tshould\tbe\taware\tof\tthe\tform\tof\tfood\tconsumed\tand\tthe\tfrequency\tof\nintake\tto\tintegrate\tpositive\tdiet\tand\toral\n\thygiene\thabits\tto\treduce\trisk\tof\toral\tdisease.\nBOX\t24.1
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Factors\tAffecting\tCariogenicity\tof\tFoods\nFrequency\tof\tconsumption\nFood\tform\t(liquid\tor\tsolid,\tslowly\tdissolving)\nSequence\tof\teating\tcertain\tfoods\tand\tbeverages\nCombination\tof\tfoods\nNutrient\tcomposition\tof\tfoods\tand\tbeverages\nDuration\tof\texposure\tof\tteeth\nFermentable\tcarbohydrates\tare\tfound\tin\tthree\tof\tthe\tfive\tMyPlate\n\tfood\tgroups:\t(1)\tgrains,\t(2)
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food\tgroups:\t(1)\tgrains,\t(2)\nfruits,\tand\t(3)\tdairy.\tAlthough\tsome\tvegetables\tmay\tcontain\tfermentable\tcarbohydrates,\tlittle\thas\nbeen\treported\tabout\tthe\tcariogenicity,\tor\tcaries-promoting\tproperties,\tof\tvegetables.\tExamples\tof\ngrains\tand\tstarches\tthat\tare\tcariogenic\tby\tnature\tof\ttheir\tfermentable\tcarbohydrate\tcomposition
|
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0.03682856634259224,
0.10489532351493835,
0.06103282421827316,
-0.01309233158826828
] |
include\tcrackers,\tchips,\tpretzels,\thot\tand\tcold\tcereals,\tand\tbreads.\nAll\tfruits\n\t(fresh,\tdried,\tand\tcanned)\tand\tfruit\tjuices\tmay\tbe\tcariogenic.\tFruits\twith\thigh\twater\ncontent,\tsuch\tas\tmelons,\thave\ta\tlower\tcariogenicity\tthan\tothers,\tsuch\tas\tbananas\tand\tdried\tfruits.
|
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] |
Fruit\tdrinks,\tsodas,\tice\tteas,\tand\tother\tsugar-sweetened\tbeverages;\tdesserts;\tcookies;\tcandies;\tand\ncake\tproducts\tmay\tbe\tcariogenic.\tDairy\tproducts\tsweetened\twith\tfructose,\tsucrose,\tor\tother\tsugars\ncan\talso\tbe\n\tcariogenic\tbecause\tof\tthe\tadded\tsugars;\thowever,\tdairy\tproducts\tare\trich\tin\tcalcium,\tand
|
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] |
their\talkaline\tnature\tmay\thave\ta\tpositive\tinfluence,\treducing\tthe\tcariogenic\tpotential\tof\tthe\tfood.\nLike\tother\tsugars\t(glucose,\tfructose,\tmaltose,\tand\tlactose),\tsucrose\tstimulates\tbacterial\tactivity.\nThe\tcausal\trelationship\tbetween\tsucrose\tand\tdental\tcaries\thas\tbeen\testablished\t(\nMoynihan\tand\nKelly,\t2014\n).
|
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] |
Moynihan\tand\nKelly,\t2014\n).\n\tAll\tdietary\tforms\tof\tsugar,\tincluding\thoney,\tmolasses,\tbrown\tsugar,\tagave,\tand\tcorn\nsyrup\tsolids,\thave\tcariogenic\tpotential\tand\tcan\tbe\tused\tby\tbacteria\tto\tproduce\tacids\tthat\terode\nenamel.\nCaries\tpromotion\tby\tindividual\tfoods\nIt\tis\timportant\tto\tdifferentiate\tbetween\tcariogenic,\tcariostatic,\tand\tanticariogenic\tfoods.
|
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] |
Cariogenic\nfoods\tare\tthose\tthat\tcontain\tfermentable\tcarbohydrates,\twhich,\n\twhen\tin\tcontact\twith\nmicroorganisms\tin\tthe\tmouth,\tcan\tcause\ta\tdrop\tin\tsalivary\tpH\tto\t5.5\tor\tless\tand\tstimulate\tthe\tcaries\nprocess.\nCariostatic\n\tfoods\tdo\tnot\tcontribute\tto\tdecay,\tare\tnot\tmetabolized\tby\tmicroorganisms,\tand\tdo\tnot
|
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cause\ta\tdrop\tin\tsalivary\tpH\tto\t5.5\tor\tless\twithin\t30\tminutes.\tExamples\tof\tcariostatic\tfoods\tare\nprotein\tfoods\tsuch\tas\teggs,\tfish,\tmeat,\tand\tpoultry;\tmost\tvegetables;\tfats;\n\tand\tsugarless\tgums.\nAccording\tto\tthe\tAmerican\tDental\tAssociation\t(ADA)\t(\nADA,\t2014\n),\tsugarless\tgum\tmay\thelp\tto\treduce
|
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] |
ADA,\t2014\n),\tsugarless\tgum\tmay\thelp\tto\treduce\ndecay\tpotential\tbecause\tof\tits\tability\tto\tincrease\tsaliva\tflow\tand\tbecause\tit\tuses\tnoncarbohydrate\nsweeteners.\nAnticariogenic\n\tfoods\tare\tthose\tthat,\twhen\teaten\tbefore\tan\tacidogenic\tfood,\tprevent\tplaque\tfrom\nrecognizing\tthe\tacidogenic\tfood.\tExamples\tare\taged\tcheddar,\tMonterey\tJack,\n\tand\tSwiss\tbecause\tof
|
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and\tSwiss\tbecause\tof\nthe\tcasein,\tcalcium,\tand\tphosphate\tin\tthe\tcheese.\tThe\tfive-carbon\tsugar\talcohol,\t\nxylitol\n,\tis\nconsidered\tanticariogenic\tbecause\tbacteria\tcannot\tmetabolize\tfive-carbon\tsugars\tin\tthe\tsame\tway\tas\nsix-carbon\tsugars\tsuch\tas\tglucose,\tsucrose,\tand\tfructose.\tIt\tis\tnot\tbroken\tdown\tby\tsalivary\tamylase
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0.0598866268992424,
0.020941531285643578,
0.14980199933052063,
-0.022940177470445633
] |
and\tis\tnot\tsubject\tto\tbacterial\tdegradation.\tSalivary\tstimulation\tleads\tto\tincreased\n\tbuffering\tactivity\nof\tthe\tsaliva\tand\tsubsequent\tincreased\tclearance\tof\tfermentable\tcarbohydrates\tfrom\ttooth\tsurfaces.\nAnother\tanticariogenic\tmechanism\tof\txylitol\tgum\tis\tthat\tit\treplaces\tfermentable\tcarbohydrates\tin\tthe\ndiet.\t\nS.\tmutans
|
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] |
diet.\t\nS.\tmutans\n\tcannot\tmetabolize\txylitol\tand\tis\tinhibited\tby\tit.\tThe\tantimicrobial\tactivity\tagainst\t\nS.\nmutans\n\tand\tthe\teffect\tof\tgum\tchewing\ton\tsalivary\tstimulation\tare\tprotective.\n\tConsumers\tshould\tbe\nadvised\tto\tlook\tfor\tchewing\tgum\tin\twhich\txylitol\tis\tlisted\tas\tthe\tfirst\tingredient.\nRemineralization
|
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] |
Remineralization\n\tis\tmineral\trestoration\tof\tthe\thydroxyapatite\tin\tdental\tenamel.\tCasein\nphosphopeptide-amorphous\tcalcium\tphosphate\t(CPP-ACP)\tis\ta\tsubstance\tthat\tpromotes\nremineralization\tof\tenamel\tsurfaces\t(\nCochrane\tet\tal,\t2012\n).\tIt\tis\tcurrently\tavailable\tas\tan\tingredient\ntrademarked\tas\tRecaldent
|
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] |
trademarked\tas\tRecaldent\n\t(Cadbury\tEnterprises,\tAustralia)\tin\tsome\tbrands\tof\tchewing\tgum.\tA\nrandomized\tprospective\tstudy\ton\tits\tefficacy\tin\ta\tspecific\tpopulation\twith\tearly\tcaries\tshowed\tno\neffect\t(\nBeerens\tet\tal,\t2017\n).\nFactors\taffecting\tcariogenicity\tof\tfood
|
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] |
Beerens\tet\tal,\t2017\n).\nFactors\taffecting\tcariogenicity\tof\tfood\nCariogenicity\talso\tis\tinfluenced\tby\tthe\tvolume\tand\tquality\tof\tsaliva;\tthe\tsequence,\tconsistency,\tand\nnutrient\tcomposition\tof\tthe\tfoods\teaten;\tdental\tplaque\tbuildup;\n\tand\tthe\tgenetic\tpredisposition\tof\tthe\nhost\tto\tdecay.\nForm\tand\tconsistency
|
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host\tto\tdecay.\nForm\tand\tconsistency\nThe\tform\tand\tconsistency\tof\ta\tfood\thave\ta\tsignificant\teffect\ton\tits\tcariogenic\tpotential\tand\tpH-\nreducing\tor\tbuffering\tcapacity.\tFood\tform\tdetermines\tthe\tduration\tof\texposure\tor\tretention\ttime\tof\ta\nfood\tin\tthe\tmouth,\twhich,\tin\tturn,\taffects\thow\tlong\tthe\tdecrease\tin\tpH\tor\tthe\tacid-producing\tactivity
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will\tlast.\tLiquids\tare\n\trapidly\tcleared\tfrom\tthe\tmouth\tand\thave\tlow\tadherence\t(or\tretentiveness)\ncapabilities.\tSolid\tfoods\tsuch\tas\tcrackers,\tchips,\tpretzels,\tdry\tcereals,\tand\tcookies\tcan\tstick\tbetween\nthe\tteeth\t(referred\tto\tas\tthe\t\ninterproximal\tspaces\n)\tand\thave\thigh\tadherence\t(or\tretention)\tcapability.
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)\tand\thave\thigh\tadherence\t(or\tretention)\tcapability.\nConsistency\talso\taffects\tadherence.\tChewy\tfoods\tsuch\tas\tgum\tdrops\tand\tmarshmallows,\talthough\nhigh\tin\tsugar\tcontent,\n\tstimulate\tsaliva\tproduction\tand\thave\ta\tlower\tadherence\tpotential\tthan\tsolid,\nsticky\tfoods\tsuch\tas\tpretzels,\tbagels,\tor\tbananas.\tHigh-fiber\tfoods\twith\tfew\tor\tno\tfermentable
|
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] |
carbohydrates,\tsuch\tas\tpopcorn\tand\traw\tvegetables,\tare\tcariostatic.
|
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Exposure\nThe\tduration\tof\texposure\tmay\tbe\tbest\texplained\twith\tstarchy\tfoods,\twhich\tare\tfermentable\ncarbohydrates\tsubject\tto\tthe\taction\tof\tsalivary\tamylase.\n\tThe\tlonger\tstarches\tare\tretained\tin\tthe\nmouth,\tthe\tgreater\ttheir\tcariogenicity.\tGiven\tsufficient\ttime,\tsuch\tas\twhen\tfood\tparticles\tbecome
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lodged\tbetween\tthe\tteeth,\tsalivary\tamylase\tmakes\tadditional\tsubstrate\tavailable\tas\tit\thydrolyzes\nstarch\tto\tsimple\tsugars.\tProcessing\ttechniques,\teither\tby\tpartial\thydrolysis\tor\tby\treducing\tparticle\nsize,\tmake\tsome\tstarches\trapidly\tfermentable\tby\tincreasing\ttheir\n\tavailability\tfor\tenzyme\taction.
|
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availability\tfor\tenzyme\taction.\nSugar-containing\tcandies\trapidly\tincrease\tthe\tamount\tof\tsugar\tavailable\tin\tthe\toral\tcavity\tto\tbe\nhydrolyzed\tby\tbacteria.\tSucking\ton\thard\tcandies\tsuch\tas\tlollipops\tor\tsugared\tbreath\tmints\tresults\tin\nprolonged\tsugar\texposure\tin\tthe\tmouth.\tSimple\tcarbohydrate-based\tsnacks\tand\tdessert\tfoods\t(e.g.,
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carbohydrate-containing\tfoods\twas\tassociated\twith\tgreater\tincidence\tof\tdental\tcaries\t(\nGarcia\tet\tal,\n2017\n).\nNutrient\tcomposition\nNutrient\tcomposition\tcontributes\tto\tthe\tability\tof\n\ta\tsubstrate\tto\tproduce\tacid\tand\tto\tthe\tduration\tof\nacid\texposure.\tDairy\tproducts,\tby\tvirtue\tof\ttheir\tcalcium-\tand\tphosphorus-buffering\tpotential,\tare
|
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] |
considered\tto\thave\tlow\tcariogenic\tpotential.\tEvidence\tsuggests\tthat\tcheese\tand\tmilk,\twhen\nconsumed\twith\tcariogenic\tfoods,\thelp\tto\tbuffer\tthe\tacid\tpH\tproduced\tby\tthe\tcariogenic\tfoods.\nBecause\tof\tthe\tanticariogenic\tproperties\tof\tcheese,\teating\tcheese\n\twith\ta\tfermentable\tcarbohydrate,
|
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with\ta\tfermentable\tcarbohydrate,\nsuch\tas\tdessert\tat\tthe\tend\tof\ta\tmeal,\tmay\tdecrease\tthe\tcariogenicity\tof\tthe\tmeal\tand\tdessert\n(\nRavishankar\tet\tal,\t2012\n).\nNuts,\twhich\tdo\tnot\tcontain\ta\tsignificant\tamount\tof\tfermentable\tcarbohydrates\tand\tare\thigh\tin\tfat
|
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0.025483358651399612,
0.0764998346567154,
-0.01662558689713478
] |
and\tdietary\tfiber,\tare\tcariostatic.\tProtein\tfoods\tsuch\tas\tseafood,\tmeats,\teggs,\tand\tpoultry,\talong\twith\nother\tfats\tsuch\tas\toils,\tmargarine,\tbutter,\n\tand\tseeds,\tare\talso\tcariostatic.\nSequence\tand\tfrequency\tof\teating\nEating\tsequence\tand\tcombination\tof\tfoods\talso\taffect\tthe\tcaries\tpotential\tof\tthe\tsubstrate.\tBananas,
|
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] |
which\tare\tcariogenic\tbecause\tof\ttheir\tfermentable\tcarbohydrate\tcontent\tand\tadherence\tcapability,\nhave\tless\tpotential\tto\tcontribute\tto\tdecay\twhen\teaten\twith\tcereal\tand\tmilk\tthan\twhen\teaten\talone\tas\na\tsnack.\tMilk,\tas\ta\tliquid,\n\treduces\tthe\tadherence\tcapability\tof\tthe\tfruit.\tCrackers\teaten\twith\tcheese\nare\tless\tcariogenic\tthan\twhen\teaten\talone.
|
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] |
are\tless\tcariogenic\tthan\twhen\teaten\talone.\nThe\tfrequency\twith\twhich\ta\tcariogenic\tfood\tor\tbeverage\tis\tconsumed\tdetermines\tthe\tnumber\tof\nopportunities\tfor\tacid\tproduction.\tEvery\ttime\ta\tfermentable\tcarbohydrate\tis\tconsumed,\ta\tdecline\tin\npH\tis\tinitiated\twithin\t5\tto\t15\tminutes,\tcausing\tcaries-promoting\tactivity.\tSmall,\tfrequent\n\tmeals\tand
|
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] |
meals\tand\nsnacks,\toften\thigh\tin\tfermentable\tcarbohydrate,\tincrease\tthe\tcariogenicity\tof\ta\tdiet\tmore\tthan\ta\tdiet\nconsisting\tof\tthree\tmeals\tand\tminimal\tsnacks.\tEating\tseveral\tcookies\tat\tonce,\tfollowed\tby\tbrushing\nthe\tteeth\tor\trinsing\tthe\tmouth\twith\twater,\tis\tless\tcariogenic\tthan\teating\ta\tcookie\tseveral\ttimes\nthroughout\ta\tday.\t\nTable\t24.1
|
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] |
throughout\ta\tday.\t\nTable\t24.1\n\tlists\tmessages\tthat\tcan\tbe\tgiven\tto\tchildren\tto\treduce\tthe\n\trisk\tof\ndeveloping\tdental\tcaries.
|
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0.055311933159828186,
0.014158534817397594
] |
TABLE\t24.1\nNutrition\tMessages\tRelated\tto\tOral\tHealth\tfor\t3-\tto\t10-Year-Old\tChildren\tand\tTheir\tCaregivers\nMessage\nRationale\nEat\tstarchy,\tsticky,\tor\tsugary\tfoods\twith\nnonsugary\tfoods.\nThe\tpH\twill\trise\tif\ta\tnonsugary\titem\tthat\tstimulates\tsaliva\tis\neaten\timmediately\tbefore,\tduring,\tor\tafter\ta\tchallenge.\nCombine\tdairy\tproducts\twith\ta\tmeal\tor\nsnack.
|
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] |
Combine\tdairy\tproducts\twith\ta\tmeal\tor\nsnack.\nDairy\n\tproducts\t(nonfat\tmilk,\tyogurt)\tenhance\tremineralization\nand\tcontain\tcalcium.\nCombine\tfibrous\tfoods\tsuch\tas\tfresh\tfruits\nand\tvegetables\twith\tfermentable\ncarbohydrates.\nFibrous\tfoods\tinduce\tsaliva\tproduction\tand\tbuffering\tcapacity.\nSpace\teating\toccasions\tat\tleast\t2\thours
|
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Space\teating\toccasions\tat\tleast\t2\thours\napart\tand\tlimit\tsnack\ttime\tto\t15-30\nminutes.\nFermentable\tcarbohydrates\teaten\tsequentially\tone\tafter\nanother\tpromote\tdemineralization.\nLimit\tbedtime\tsnacks.\nSaliva\tproduction\tdeclines\tduring\tsleep.\nLimit\tconsumption\tof\tacidic\tfoods\tsuch\tas\nsports\tdrinks,\tjuices,\tand\tsodas.
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0.048089612275362015,
0.03631843999028206,
0.05708607658743858,
-0.04108636826276779
] |
sports\tdrinks,\tjuices,\tand\tsodas.\nAcidic\tfoods\tpromote\ttooth\terosion\tthat\tincreases\trisk\tfor\ncaries.\nCombine\tproteins\twith\tcarbohydrates\tin\nsnacks.\nExamples:\ttuna\tand\tcrackers,\tapples\nand\tcheese\nProteins\tact\tas\tbuffers\tand\tare\tcariostatic.\nCombine\traw\tand\tcooked\tor\tprocessed\nfoods\tin\n\ta\tsnack.\nRaw\tfoods\tencourage\tmastication\tand\tsaliva\tproduction,
|
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] |
a\tsnack.\nRaw\tfoods\tencourage\tmastication\tand\tsaliva\tproduction,\nwhereas\tcooked\tor\tprocessed\tfoods\tmay\tbe\tmore\tavailable\nfor\tbacterial\tmetabolism\tif\teaten\talone.\nEncourage\tuse\tof\txylitol-\tor\tsorbitol-based\nchewing\tgum\tand\tcandies\timmediately\nafter\ta\tmeal\tor\tsnack.\n*\nFive\tminutes\tof\texposure\tis\teffective\tin\tincreasing\tsaliva
|
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] |
*\nFive\tminutes\tof\texposure\tis\teffective\tin\tincreasing\tsaliva\nproduction\tand\tdental\tplaque\tpH.\nRecommend\tsugar-free\tchewable\tvitamin\nand\tmineral\tsupplements\tand\tsyrup-\nbased\tmedication.\nSugar-free\tvarieties\tare\tavailable\tand\tshould\tbe\tsuggested\tfor\nhigh\tcaries\trisk\tgroups.\nEncourage\tchildren\twith\tpediatric\tGERD\nto\tadhere\tto\tdietary\tguidelines.
|
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] |
to\tadhere\tto\tdietary\tguidelines.\nGERD\tincreases\trisk\tfor\tdental\terosion\tand\tthus\tincreases\trisk\nfor\tcaries.\n*\nGum\tis\tnot\trecommended\tfor\tchildren\tyounger\tthan\t6\tyears\told.\nGERD\n,\tGastroesophageal\treflux\tdisease.\nModified\tfrom\tMobley\tC:\tFrequent\tdietary\tintake\tand\toral\thealth\tin\tchildren\t3\tto\t10\tyears\tof\tage,\t\nBuilding\tBlocks\n\t25:17,\t2001.
|
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Building\tBlocks\n\t25:17,\t2001.\nThe\tdecay\tprocess\nThe\tcarious\tprocess\tbegins\twith\tthe\tproduction\tof\tacids\tas\ta\tbyproduct\tof\tbacterial\tmetabolism\ntaking\tplace\tin\tthe\tdental\tplaque.\tDecalcification\tof\tthe\tsurface\tenamel\tcontinues\tuntil\tthe\tbuffering\naction\tof\tthe\tsaliva\tis\table\tto\traise\tthe\tpH\tabove\n\tthe\tcritical\tlevel.\tSee\t\nBox\t24.2\n\tfor\tprevention
|
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] |
the\tcritical\tlevel.\tSee\t\nBox\t24.2\n\tfor\tprevention\nguidelines\tand\tthe\tPractice\tPaper\tof\tthe\tAcademy\tof\tNutrition\tand\tDietetics\ton\tOral\tHealth\tand\nNutrition\t(\nMallonee\tet\tal,\t2014\n).\nBOX\t24.2\nCaries\tPrevention\tGuidelines\nBrush\tat\tleast\ttwice\tdaily,\tpreferably\tafter\tmeals.\nRinse\tmouth\tafter\tmeals\tand\tsnacks.
|
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] |
Rinse\tmouth\tafter\tmeals\tand\tsnacks.\nChew\tsugarless\tgum\tfor\t15-20\tmin\tafter\tmeals\tand\tsnacks.\nFloss\ttwice\tdaily.\nUse\n\tfluoridated\ttoothpastes.\nPair\tcariogenic\tfoods\twith\tcariostatic\tfoods.\nSnack\ton\tcariostatic\tand\tanticariogenic\tfoods\tsuch\tas\tcheese,\tnuts,\tpopcorn,\tand\tvegetables.\nLimit\tbetween-meal\teating\tand\tdrinking\tof\tfermentable\tcarbohydrates.
|
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] |
Limit\tbetween-meal\teating\tand\tdrinking\tof\tfermentable\tcarbohydrates.\nPlaque\n\tis\ta\tsticky,\tcolorless\tmass\tof\tmicroorganisms\tand\tpolysaccharides\tthat\tforms\taround\tthe\ntooth\tand\tadheres\tto\tteeth\tand\tgums.\tIt\tharbors\tacid-forming\n\tbacteria\tand\tkeeps\tthe\torganic
|
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] |
bacteria\tand\tkeeps\tthe\torganic\nproducts\tof\ttheir\tmetabolism\tin\tclose\tcontact\twith\tthe\tenamel\tsurface.\tAs\ta\tcavity\tdevelops,\tthe\nplaque\tblocks\tthe\ttooth,\tto\tsome\textent,\tfrom\tthe\tbuffering\tand\tremineralization\taction\tof\tthe\tsaliva.\nIn\ttime\tthe\tplaque\tcombines\twith\tcalcium\tand\thardens\tto\tform\t\ncalculus\n.
|
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] |
calculus\n.\nAn\tacidic\tpH\tis\talso\trequired\tfor\tplaque\tformation.\tSoft\tdrinks\t(diet\tand\tregular),\tsports\nbeverages,\n\tcitrus\tjuices\tand\t“ades”\t(such\tas\tGatorade\tand\tPowerade,\tetc.),\tand\tchewable\tvitamin\tC\nsupplements\thave\thigh\tacid\tcontent\tand\tmay\tcontribute\tto\terosion\t(\nTedesco\tet\tal,\t2012\n).\tResearch
|
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Tedesco\tet\tal,\t2012\n).\tResearch\nusing\tNational\tHealth\tand\tNutrition\tExamination\tSurvey\tIII\tdata\treported\tsignificantly\tmore\tdental
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chemical\tprocess\tin\tthe\tpresence\tof\tacid\t(\nGarcia\tet\tal,\t2017\n).\tThe\tcurrent\tpopular\tpractice\tof\ndrinking\tfruited\twater\tis\ta\thazard\tto\tdental\tenamel.\tFruited\twaters\tlike\twater\twith\tlemon\tor\tother\ncitrus\tadded\thave\tbeen\tshown\tto\n\thave\tpH\tlevels\tas\tlow\tas\t3.\tRegular\ttap\twater\thas\ta\tpH\tof\t6\tto\t8.\nRoles\tof\tsaliva
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Roles\tof\tsaliva\nSalivary\tflow\tclears\tfood\tfrom\taround\tthe\tteeth\tas\ta\tmeans\tto\treduce\tthe\trisk\tof\tcaries.\tThe\nbicarbonate-carbonic\tacid\tsystem,\tcalcium,\tand\tphosphorus\tin\tsaliva\talso\tprovide\tbuffering\taction\tto\nneutralize\tbacterial\tacid\tmetabolism.\tOnce\tbuffering\taction\thas\trestored\tpH\tabove\tthe\tcritical\tpoint,\nremineralization
|
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] |
remineralization\n\tcan\toccur.\tIf\tfluoride\tis\tpresent\tin\tthe\tsaliva,\tthe\tminerals\tare\tdeposited\tin\tthe\tform\nof\t\nfluoroapatite\n,\twhich\tis\tresistant\tto\terosion.\tSalivary\tproduction\tdecreases\tas\ta\tresult\tof\tdiseases\naffecting\tsalivary\tgland\tfunction\t(e.g.,\tSjögren’s\tsyndrome);\tas\ta\tside\teffect\tof\tfasting;\tas\ta\tresult\tof
|
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] |
prescription\tor\tover\tthe\tcounter\tmay\tcause\tdry\tmouth.\tThe\tdegree\tof\txerostomia\tmay\tvary\tbut\tmay\nbe\tcaused\tby\tmedications\tsuch\tas\tthose\tto\ttreat\tdepression,\thypertension,\tanxiety,\thuman\nimmunodeficiency\n\tvirus\t(HIV),\tand\tallergies.\nCaries\tpatterns\nCaries\tpatterns\tdescribe\tthe\tlocation\tand\tsurfaces\tof\tthe\tteeth\taffected.\t\nCoronal\tcaries\n\taffects\tthe
|
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] |
Coronal\tcaries\n\taffects\tthe\ncrown\tof\tthe\ttooth,\tthe\tpart\tof\tthe\ttooth\tvisible\tabove\tthe\tgum\tline,\tand\tmay\toccur\ton\tany\ttooth\nsurface.\tAlthough\tthe\toverall\tincidence\tof\tdecay\tin\tthe\tUnited\tStates\thas\tdeclined,\tmany\tstates\nreport\t40%\tto\t70%\tof\tchildren\thaving\tsome\tdecay\tby\tage\n\t8\t(\nCDC,\t2017\n).\nRoot\tcaries
|
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] |
8\t(\nCDC,\t2017\n).\nRoot\tcaries\n,\toccurring\ton\tthe\troot\tsurfaces\tof\tteeth\tsecondary\tto\tgingival\trecession,\taffects\ta\nlarge\tportion\tof\tthe\tolder\tpopulation.\tRoot\tcaries\tis\ta\tdental\tinfection\tthat\tis\tincreasing\tin\tolder\nadults,\tpartly\tbecause\tthis\tpopulation\tis\tretaining\ttheir\tnatural\tteeth\tlonger.\tThe\tgums\trecede\tin
|
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] |
older\tage,\texposing\tthe\troot\tsurface.\tOther\tfactors\trelated\tto\tthe\tincreased\tincidence\n\tof\tthis\tdecay\npattern\tare\tlack\tof\tfluoridated\twater,\tpoor\toral\thygiene\tpractices,\tdecreased\tsaliva,\tfrequent\teating\nof\tfermentable\tcarbohydrates.\tDementia\tappears\tto\tincrease\trisk\tof\tdental\tcaries,\twhich\tis\tlikely
|
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] |
related\tto\ta\tdecline\tin\tself-care\tand\tmotor\tskills\t(\nBrennan\tand\tStrauss,\t2014\n).\tManagement\tof\troot\ncaries\tincludes\tdental\trestoration\tand\tnutrition\tcounseling.\tPoor\toral\thealth\tfrom\n\tcaries,\tpain,\tor\nedentulism\toften\tadversely\taffects\tdietary\tintake\tand\tnutritional\tstatus\tin\tolder\tadults.\t(See\t\nChapter\n19\n.)\nLingual\tcaries
|
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0.0698113664984703,
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] |
Chapter\n19\n.)\nLingual\tcaries\n,\tor\tcaries\ton\tthe\tlingual\tside\t(surface\tnext\tto\tor\ttoward\tthe\ttongue)\tof\tthe\tanterior\nteeth,\tis\tseen\tin\tpersons\twith\tgastrointestinal\treflux,\tbulimia,\tor\tanorexia-bulimia\t(see\t\nChapter\t21\n).\nFrequent\tintake\tof\tfermentable\tcarbohydrates,\tcombined\twith\tregurgitation\n\tor\tinduced\tvomiting\tof
|
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] |
or\tinduced\tvomiting\tof\nacidic\tstomach\tcontents,\tresults\tin\ta\tconstant\tinflux\tof\tacid\tinto\tthe\toral\tcavity.\tThe\tacid\tcontributes\nto\terosion\tof\ttooth\tsurfaces\tthat\tcan\tresult\tin\ttooth\tsensitivity\tand\tdental\tcaries.\tThe\tpattern\tof\nerosion\tmay\tbe\tindicative\tof\terosion\tfrom\treflux\tversus\tfrom\tfoods\tor\tbeverages\t(\nSchlueter\tet\tal,\n2012\n).\nFluoride
|
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] |
Schlueter\tet\tal,\n2012\n).\nFluoride\nFluoride\tis\tan\timportant\telement\tin\tbones\tand\tteeth\n\t(\nPalmer\tand\tGilbert,\t2012\n).\tUsed\tsystemically\nand\tlocally,\tit\tis\ta\tsafe,\teffective\tpublic\thealth\tmeasure\tto\treduce\tthe\tincidence\tand\tprevalence\tof\ndental\tcaries\t(\nADA,\t2014\n;\t\nCDC,\t2017\n).\tWater\tfluoridation\tbegan\tin\t1940;\tby\t1999\tthe\tCDC\tlisted
|
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] |
CDC,\t2017\n).\tWater\tfluoridation\tbegan\tin\t1940;\tby\t1999\tthe\tCDC\tlisted\nwater\tfluoridation\tas\tone\tof\tthe\ttop\t10\tgreatest\tpublic\thealth\tachievements\tof\tthe\t20th\tcentury\nbecause\tof\tits\tinfluence\ton\tdecreasing\tthe\trate\tof\tdental\n\tcaries\t(\nCDC,\t2017\n).\tThe\teffect\tof\tfluoride\ton
|
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] |
caries\t(\nCDC,\t2017\n).\tThe\teffect\tof\tfluoride\ton\ncaries\tprevention\tcontinues\twith\twater\tfluoridation,\tfluoridated\ttoothpastes,\toral\trinses,\tand\ndentifrices,\tas\twell\tas\tbeverages\tmade\twith\tfluoridated\twater.\tOptimal\twater\tfluoridation\nconcentrations\t(0.7\tto\t1.2\tppm)\tcan\tprovide\tprotection\tagainst\tcaries\tdevelopment\twithout\tcausing\ntooth\tstaining\t(
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] |
tooth\tstaining\t(\nADA,\t2014\n).\tDespite\tthe\tpositions\tfrom\tthe\tADA\tand\n\tthe\tAcademy\tof\tNutrition\tand\nDietetics\t(AND),\tand\tthe\tdata\tfrom\tthe\tCDC\ton\tfluoride\tfor\toral\thealth,\tthere\tis\ta\tcontroversy\tover\nthe\tuse\tof\ttopical\tfluoride\ton\tteeth\tand\tsystemic\tfluoridation\tin\twater\tsupplies.\tArguments\tagainst
|
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] |
widespread\tfluoride\tuse\tinclude\tclaims\tthat\tit\tcan\tbe\tcarcinogenic\tand\ttoxic;\thowever,\tconsumers\nshould\tbe\turged\tto\tread\tthe\tevidence.\nMechanism\tof\taction\nThere\tare\n\tfour\tprimary\tmechanisms\tof\tfluoride\taction\ton\tteeth:\t(1)\twhen\tincorporated\tinto\tenamel
|
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promoting\tthe\n\tdevelopment\tof\ta\ttooth\tsurface\tthat\thas\tincreased\tresistance\tto\tdecay;\tand\t(4)\thelps\nto\tdeter\tthe\tharmful\teffects\tof\tbacteria\tin\tthe\toral\tcavity\tby\tinterfering\twith\tthe\tformation\tand\nfunction\tof\tmicroorganisms.\nFood\tsources\nMost\tfoods,\tunless\tprepared\twith\tfluoridated\twater,\tcontain\tminimal\tamounts\tof\tfluoride,\texcept\tfor
|
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brewed\ttea,\twhich\thas\tapproximately\t1.4\tppm\t(\nMorin,\t2006\n).\tFluoride\n\tmay\tbe\tadded\tunintentionally\nto\tthe\tdiet\tin\ta\tnumber\tof\tways,\tincluding\tthrough\tthe\tuse\tof\tfluoridated\twater\tin\tthe\tprocessing\tof\nfoods\tand\tbeverages.\tFruit\tjuices\tand\tdrinks,\tparticularly\twhite\tgrape\tjuice\tproduced\tin\tcities\twith
|
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fluoride\tcontent,\tit\tis\tdifficult\tto\testimate\tamounts\tconsumed.\nSupplementation\nHealth\tprofessionals\tshould\tconsider\ta\tchild’s\tfluid\tintake\tas\twell\tas\tfood\tsources\tand\tthe\tavailability\nof\tfluoridated\twater\tin\tthe\tcommunity\tbefore\tprescribing\tfluoride\tsupplements.\tBecause\tbones\tare
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repositories\tof\tfluoride,\tbone\tmeal,\tfish\tmeal,\tand\tgelatin\tmade\tfrom\tbones\tare\tpotent\tsources\tof\tthe\nmineral.\tIn\tcommunities\twithout\tfluoridated\twater,\tdietary\tfluoride\tsupplements\n\tmay\tbe\nrecommended\tfor\tchildren\tages\t6\tmonths\tto\t16\tyears.\nFluoride\tcan\tbe\tused\ttopically\tand\tsystemically.\tWhen\tconsumed\tin\tfood\tand\tdrink,\tit\tenters\tthe
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0.06324571371078491,
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0.022117776796221733,
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0.0456463024020195,
0.03101322427392006,
0.004874266218394041,
0.042980603873729706,
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0.036824703216552734,
0.0754605233669281,
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-0.047477349638938904,
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0.09544138610363007,
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0.04236900433897972,
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0.08970905095338821,
0.08903047442436218,
-0.024515528231859207,
-0.05323299765586853,
0.07167045027017593,
0.006373520940542221,
-0.06531573832035065,
-0.011311355978250504,
0.09368900954723358,
-0.022386115044355392,
-0.014564958401024342,
-0.06431711465120316,
0.07360725849866867,
0.06054732948541641,
0.04653042554855347,
-0.015152014791965485,
-0.03672688454389572,
0.04592416062951088,
0.0649118572473526,
0.11740919947624207,
0.002712208079174161
] |
systemic\tcirculation\tand\tis\tdeposited\tin\tbones\tand\tteeth.\tSystemic\tsources\thave\ta\ttopical\tbenefit\tas\nwell\tby\tproviding\tfluoride\tto\tthe\tsaliva.\tA\tsmall\tamount\tof\tfluoride\tenters\tthe\tsoft\ttissues;\tthe\nremainder\tis\texcreted.\tThe\tprimary\tsource\n\tof\tsystemic\tfluoride\tis\tfluoridated\twater;\tfood\tand\nbeverages\tsupply\ta\tsmaller\tamount.\t\nTable\t24.2
|
[
0.003427267773076892,
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0.014885487966239452,
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0.06977254897356033,
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0.02585875801742077,
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0.05916980654001236,
0.094361811876297,
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0.016046786680817604,
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0.06265950947999954,
0.06664559990167618,
0.07635705173015594,
0.07602487504482269,
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0.016332756727933884,
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0.013927016407251358,
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0.029847173020243645,
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0.03560207784175873,
0.024166427552700043,
0.007452572230249643,
-0.0868719294667244,
0.0561537928879261,
0.09272021055221558,
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-0.08353345841169357,
0.11077746748924255,
0.024044089019298553,
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-0.0045489962212741375,
-0.05677434056997299,
-0.04069032520055771,
-0.0024447545874863863,
0.09321504831314087,
-0.0352189876139164,
-0.051263611763715744,
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0.0058325245045125484,
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0.012616675347089767,
0.03673305734992027,
0.06497153639793396,
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0.01359801646322012,
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0.05700480565428734,
0.006815460044890642,
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0.1105063185095787,
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0.02137867733836174,
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0.0795188695192337,
0.11723250150680542,
-0.008588001132011414,
-0.03771144896745682,
0.05519203841686249,
0.02632153034210205,
-0.04400401562452316,
0.007932114414870739,
0.095853790640831,
-0.07321193814277649,
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0.028476940467953682,
-0.007112759165465832,
0.04206886515021324,
-0.011730311438441277,
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0.038102999329566956,
0.061481911689043045,
0.10202533006668091,
-0.018217740580439568
] |
beverages\tsupply\ta\tsmaller\tamount.\t\nTable\t24.2\n\tcontains\ta\tschedule\tof\tfluoride\tsupplementation.\nTABLE\t24.2\nDietary\tFluoride\tSupplement\tSchedule\nFLUORIDE\tION\tLEVEL\tIN\tDRINKING\tWATER\t(ppm)\n*\nAge\n<0.3\tppm\n0.3-0.6\tppm\n>0.6\tppm\nBirth-6\tmo\nNone\nNone\nNone\n6\tmo-3\tyr\n0.25\tmg/day\n†\nNone\nNone\n3-6\tyr\n0.50\tmg/day\n0.25\tmg/day\nNone\n6-16\tyr\n1.0\tmg/day
|
[
-0.036446698009967804,
-0.059975117444992065,
0.015204613097012043,
0.03895336017012596,
-0.003979264292865992,
0.0045735472813248634,
0.07226438075304031,
0.09745434671640396,
-0.038380201905965805,
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] |
†\nNone\nNone\n3-6\tyr\n0.50\tmg/day\n0.25\tmg/day\nNone\n6-16\tyr\n1.0\tmg/day\n0.50\tmg/day\nNone\n*\n1\tppm\t=\t1\tmg/L.\n†\n2.2\tmg\tof\tsodium\tfluoride\tcontains\t1\tmg\tof\tfluoride\tion.\nApproved\tby\tThe\tAmerican\tDental\tAssociation,\tThe\tAmerican\tAcademy\tof\tPediatrics,\tand\tThe\n\tAmerican\tAcademy\tof\tPediatric\tDentistry,\t1994.
|
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American\tAcademy\tof\tPediatric\tDentistry,\t1994.\nFluoride\tsupplements\tare\tnot\trecommended\tfor\tformula-fed\tinfants\tor\tfor\tbreastfed\tinfants\tliving\nin\tfluoridated\tcommunities\tif\tthese\tinfants\treceive\tdrinking\twater\tbetween\tfeedings.\tIf\tthe\tinfant\ndoes\tnot\tdrink\twater\tbetween\tfeedings\tor\tdrinks\tbottled\twater\twhen\ton\ta\tdiet\tof\tonly\tbreastmilk,
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] |
more\tconcentrated\tforms\tapplied\tby\tdental\tprofessionals\tin\tthe\tform\tof\tgels,\tfoams,\tand\trinses.\nFrequent\tfluoride\texposure\tvia\n\ttopical\tfluorides,\tfluoridated\ttoothpastes,\trinses,\tand\tfluoridated\nwater\tis\timportant\tin\tmaintaining\tan\toptimal\tconcentration\tof\tfluoride,\tbut\texcess\tintake\tshould\tbe\navoided.\nExcess\tfluoride\nFluorosis
|
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] |
avoided.\nExcess\tfluoride\nFluorosis\n\toccurs\twhen\ttoo\tmuch\tfluoride\tis\tprovided\tduring\ttooth\tdevelopment\tand\tcan\trange\tfrom\nmild\tto\tsevere\tand\tpresent\ton\tteeth\tfrom\tunnoticeable\tto\tvery\tapparent\tdark\tspots\ton\tteeth.\tCauses\nof\tmild\n\tfluorosis\tfrom\texcessive\tfluoride\tintake\tinclude\tmisuse\tof\tdietary\tfluoride\tsupplements,
|
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] |
ingestion\tof\tfluoridated\ttoothpastes\tand\trinses,\tor\texcessive\tfluoride\tintake\tsecondary\tto\tfluoride\tin\nfoods\tand\tbeverages\tprocessed\tin\tfluoridated\tareas\tand\ttransported\tto\tother\tareas.\tTopical\tfluorides,\navailable\tas\tfluoridated\ttoothpastes\tand\tmouthwashes,\tare\teffective\tsources\tof\tfluoride\tthat\tcan\tbe\nused
|
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] |
used\n\tin\tthe\thome,\tschool,\tor\tdental\toffice.\tCaries\tprevention\tefforts\tin\tpreschool\tchildren\tinclude\ndiet\tmodification,\twater\tfluoridation,\tor\tsupplements\tin\tnonfluoridated\tareas,\tand\tsupervised\ttooth\nbrushing\twith\tfluoridated\ttoothpaste\t(\nADA,\t2014\n).\nChildren\tyounger\tthan\t6\tyears\tof\tage\tshould\tnot\tuse\tfluoridated\tmouthwashes,\tand\tolder\tchildren
|
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] |
should\tbe\tinstructed\tto\trinse,\tbut\tnot\tswallow,\tmouthwash.\n\tNo\tmore\tthan\ta\tpea-size\tamount\tof\ntoothpaste\tshould\tbe\tplaced\ton\ta\tchild’s\ttoothbrush\tto\treduce\tthe\trisk\tof\taccidental\tfluoride.\nFluoride\tis\tmost\teffective\twhen\tgiven\tfrom\tbirth\tthrough\tages\t12\tto\t13,\tthe\tperiod\twhen\nmineralization\tof\tunerupted\tpermanent\tteeth\toccurs.
|
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] |
mineralization\tof\tunerupted\tpermanent\tteeth\toccurs.\nEarly\tchildhood\tcaries\nEarly\tchildhood\tcaries\t(ECC)\n,\toften\tcalled\t“baby-bottle\ttooth\tdecay,”\tdescribes\ta\tcaries\tpattern\tin\nthe\tmaxillary\tanterior\tteeth\tof\tinfants\tand\tyoung\tchildren.\tCharacteristics\tinclude\trapidly\tdeveloping
|
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carious\tlesions\tin\tthe\tprimary\tanterior\tteeth\tand\tthe\tpresence\tof\tlesions\ton\ttooth\tsurfaces\tnot\nusually\tassociated\twith\ta\thigh\tcaries\trisk.\tBecause\ttooth\tdecay\tremains\ta\tcommon\toral\tdisease\tof\nchildhood,\tcaries\tis\ta\tprimary\tmarker\tfor\ta\tchild’s\toral\thealth.\tGood\tbehavioral\thabits\tand\tchild\nnutrition
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nutrition\n\tpatterns\tmust\tbe\tencouraged,\tbeginning\tin\tinfancy.\nPathophysiology\tand\tincidence\nOften\tECC\tfollows\tprolonged\tbottle-feeding,\tespecially\tat\tnight,\tof\tjuice,\tmilk,\tformula,\tor\tother\nsweetened\tbeverages.\tThe\textended\tcontact\ttime\twith\tthe\tfermentable\tcarbohydrate–containing
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] |
beverages,\tcoupled\twith\tthe\tposition\tof\tthe\ttongue\tagainst\tthe\tnipple,\twhich\tcauses\tpooling\tof\tthe\nliquid\taround\tthe\tmaxillary\n\tincisors,\tparticularly\tduring\tsleep,\tcontributes\tto\tthe\tdecay\tprocess.\tThe\nmandibular\tanterior\tteeth\tusually\tare\tspared\t(\nFig.\t24.3\n)\tbecause\tof\tthe\tprotective\tposition\tof\tthe\tlip
|
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] |
Fig.\t24.3\n)\tbecause\tof\tthe\tprotective\tposition\tof\tthe\tlip\nand\ttongue\tand\tthe\tpresence\tof\ta\tsalivary\tduct\tin\tthe\tfloor\tof\tthe\tmouth.\tIn\tgeneral,\tchildren\tfrom
|
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] |
low-income\tfamilies\tand\tminority\tpopulations\texperience\tthe\tgreatest\tamount\tof\toral\tdisease,\tthe\nmost\textensive\tdisease,\n\tand\tthe\tmost\tfrequent\tuse\tof\tdental\tservices\tfor\tpain\trelief;\tyet\tthese\nchildren\thave\tthe\tfewest\toverall\tdental\tvisits\t(\nCDC,\t2017\n).\nFIG.\t24.3\nEarly\tchildhood\tcaries.\n\t\nSource:\n\t(From\tSwartz\tMH:
|
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).\nFIG.\t24.3\nEarly\tchildhood\tcaries.\n\t\nSource:\n\t(From\tSwartz\tMH:\t\nTextbook\tof\tphysical\tdiagnosis,\thistory,\tand\texamination\n,\ted\t5,\nPhiladelphia,\t2006,\tSaunders.)\nNutrition\tcare\nManagement\tof\tECC\tincludes\tdiet\tand\toral\thygiene\teducation\tfor\tparents,\tguardians,\tand
|
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caregivers.\tMessages\tshould\tbe\ttargeted\tto\tcounter\tthe\thealth\thabits\tthat\tcontribute\tto\tthis\nproblem:\tpoor\toral\thygiene,\tfailure\tto\n\tbrush\ta\tchild’s\tteeth\tat\tleast\tdaily,\tfrequent\tuse\tof\tbottles\tfilled\nwith\tsweetened\tbeverages,\tand\tlack\tof\tfluoridated\twater.\tDietary\tguidelines\tinclude\tremoval\tof\tthe
|
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] |
be\tcleaned\twith\ta\tgauze\tpad\tor\twashcloth\tafter\tall\tbottle\nfeedings.\tAll\tefforts\tshould\tbe\tmade\tto\twean\tchildren\tfrom\ta\tbottle\tby\t1\tyear\tof\tage.\tEducational\nefforts\tshould\tbe\tpositive\tand\tsimple,\tfocusing\ton\toral\thygiene\thabits\tand\tpromotion\tof\ta\tbalanced,
|
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] |
healthy\tdiet.\tBetween-meal\tsnacks\tshould\tinclude\tcariostatic\tfoods.\tWhen\tfoods\tare\tcariogenic,\tthey\nshould\tbe\tfollowed\tby\ttooth\tbrushing\tor\n\trinsing\tthe\tmouth.\tParents\tand\tcaregivers\tneed\tto\nunderstand\tthe\tcauses\tand\tconsequences\tof\tECC\tand\thow\tthey\tcan\tbe\tavoided.\nCaries\tprevention
|
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Caries\tprevention\nCaries\tprevention\tprograms\tfocus\ton\ta\tbalanced\tdiet,\tmodification\tof\tthe\tsources\tand\tquantities\tof\nfermentable\tcarbohydrates,\tand\tthe\tintegration\tof\toral\thygiene\tpractices\tinto\tindividual\tlifestyles.\nMeals\tand\tsnacks\tshould\tbe\tfollowed\twith\tbrushing,\n\trinsing\tthe\tmouth\tvigorously\twith\twater.
|
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] |
rinsing\tthe\tmouth\tvigorously\twith\twater.\nPositive\thabits\tshould\tbe\tencouraged,\tincluding\tsnacking\ton\tanticariogenic\tor\tcariostatic\tfoods,\nchewing\tsugarless\tgum\tafter\teating\tor\tdrinking\tcariogenic\titems,\tand\thaving\tsweets\twith\tmeals\nrather\tthan\tas\tsnacks.\tDespite\tthe\tpotential\tfor\ta\tdiet\tthat\tis\tbased\ton\tthe\tdietary\tguidelines\tto\tbe
|
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] |
cariogenic,\twith\tproper\tplanning\tand\tgood\toral\thygiene\ta\tbalanced\n\tdiet\tlow\tin\tcariogenic\trisk\tcan\tbe\nplanned\t(see\t\nFig.\t24.4\n\tfor\ta\tsample\tdiet).
|
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FIG.\t24.4\nA\tbalanced\tdiet\tplan\twith\tlow\tcariogenic\trisk.\nPractices\tto\tavoid\tinclude\tsipping\tsugar-sweetened\tand\tlow-pH\tbeverages\tfor\textended\tperiods.\nAdding\tlemon\tand\tother\tfruits\tto\twater\thas\tbecome\ta\tcommon\tpractice\tbut\tthis\tlowers\tthe\tpH\tand\tin\ngeneral\tshould\tbe\tavoided.\tFrequent\tsnacking\tand\teating\tsugared\tbreath\tmints\tor\thard\tcandies\tis
|
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] |
discouraged.\tOver-the-counter\tchewable\tor\tliquid\n\tmedications\tand\tvitamin\tpreparations,\tsuch\tas\nchewable\tvitamin\tC\tor\tliquid\tcough\tsyrup,\tmay\tcontain\tsugar\tand\tcontribute\tto\tcaries\trisk.\tPatients\nwith\tdysphagia\tmay\tuse\tthickening\tagents\tin\tbeverages\tor\tliquid\tfoods\t(soups)\tto\treduce\tthe\trisk\tof
|
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] |
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