Page 38 - Dental Practice August 2022

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oral medicine section

They concluded that: ‘Physicians should pay special attention to TAKE-HOME MESSAGES
oral manifestations during physical examination in high-risk • Always go from a food first perspective and
populations such as the elderly, vegetarians, and patients with advise a wide and varied diet to avoid the defi-
digestive problems.’ ciencies mentioned in this article. This includes:
The study also advised that deficiency can lead to neurologi- » Oily fish two or three times a week, while
cal problems later in life. While Miranti et al (2017)advised of avoiding hydrogenated vegetable fats to
link between B vitamin deficiency and gastric cancer. So, by achieve omega 3:6 ratio
noticing this and auctioning a GP referral, you could be poten- » 10-11 portions of fruit and vegetables a day
tially preventing a serious health issue in your patient. » 6-8 glasses of water per day.
B vitamins are synthesised and absorbed in the small intes-
tine, so if your patient has digestion/absorption issues, supple-
mentation may not help them as they may struggle to absorb • Do not supplement blindly as there may be an
them and will only provide them with what my nutrition teacher underlying issue affecting absorption, green
explained in the classroom as ‘expensive urine’. If the patient has pharmacy can provide side effects too and
digestive issues, they need to see their GP and/or everyone has their own individual needs, not to
nutritionist/dietician to help them with this. mention the risk of drug interactions.
Supplementation may be needed in the form of an injection,
which will bypass the digestive system. Action to take here would • The ability to use an inner detective when notic-
be to refer to GP. B vitamins can be found in most food sources, ing conditions, are there a few symptoms com-
which include meats, seafood, dairy such as cheese and milk, bined which tells the clinician something about
dark leafy vegetable, beans, legumes. the patient? For example, if a patient has a
cracked and quivering tongue this could highlight
ESSENTIAL FATTY ACIDS/ OMEGA3 that the patient is highly stressed or fatigued.
The National Institutes of Health describes the most common Asking them how they are in themselves might
sign of deficiency as ‘rough, scaly skin and dermatitis’. This can mean they open up and give an insight as to
be noticed as dry flaky lips or flaky skin under the eyes. what is affecting their motivation with routine.
One of the reasons omega 3 is so important is because of the
anti-inflammatory effect it has on the body. However, in mod-
ern diets, a lot of our patients eat more omega 6 foods, usually • Refer to the appropriate person if the patient
processed foods rich in vegetable oils. This is problematic, as can benefit from this and they are open to it, it
omega 6 has a proinflammatory effect in the body. really does take a village when caring for
Hibbeln et al (2014) discussed the importance of the omega patients and it is very important to work within
3:6 ratio and if more omega 6 is consumed than omega 3 this scope. Connect with people that can be referred
‘leads to a tilt toward inflammatory processes in the body’. to, to create an inner circle of like minded peo-
Simopoulos (2002) concluded in a literature review that a ple to provide the best care for the patient. This
beneficial ratio of 2/3 of omega three to one on omega 6 sup- can be the patients GP, a local nutritionist/dieti-
presses inflammation’ Recommend your patients eat oily fish cian or any other healthcare professional that is
two or three times a week, while reducing foods containing relevant to the patient.
hydrogenated vegetable oils to help them to achieve this balance.

ZINC
According to Pisano and Hilas (2016): ‘Zinc deficiency may lead
to loss of appetite, impaired immune function, weight loss,
delayed healing of wounds, eye and skin lesions, and smell and
taste disturbances’. Even though there may not be a physical
manifestation present, a patient will often talk about a bad taste About the AUTHOR
or even lack of taste with the clinician. Ozler et al (2014) advised
that: ‘The findings suggest a relationship with zinc deficiency Nina Lord
and recurrent aphthous stomatitis’. Suggesting frequent oral Dental Therapist
Nutritional Therapist
ulceration could be connected to zinc deficiency. Food sources Nina has worked in the dental industry for 20 years and
include lamb, shellfish, nuts, seeds, legumes and eggs. progressed from working as a dental nurse to a dental
therapist in June 2013 at Sheffield University. Not long
For a complete list of references, email: into her career, Nina became passionate about taking a
info@dental-practice.biz whole-body approach with her patients and after three
years of studying while working, Nina graduated as
a nutritional therapist in February 2020.

38 Dental Practice // July-August 2022 // Vol 18 No 4