University Of Technology, Jamaica

UNIVERSITY OF TECHNOLOGY, JAMAICA

SYLLABUS OUTLINE

COLLEGE OF HEALTH SCIENCES SCHOOL ORAL HEALTH SCIENCES

COURSE OF STUDY: Doctor of Dental Medicine YEAR 1 (Semester 1)

MODULE TITLE: Nutrition and Oral Health

MODULE CODE: DMD1003

DURATION: 15 Hours

CREDIT VALUE: 1

PREREQUISITES: None ………………………………………………………………………………………………

1.0 MODULE DESCRIPTION

This module introduces students of the oral health sciences to the fundamental principles of nutrition applicable to their course of study. Emphasis is placed on the six major nutrients and fibre; their general functions and food sources; factors that contribute to malnutrition (under nutrition and over nutrition) and the resulting impact on the general and oral health status of individuals at all stages of the life cycle. Dietary guidelines for optimal human health as well as the role of nutrition in the aetiology and management of general and oral health will also be explored. An overview of the biochemical interrelationship among macronutrient metabolism, body composition and the nutritional status of individuals as well as methods of nutritional assessment are also presented.

2.0 MODULE OBJECTIVES/LEARNING OUTCOMES

GENERAL OBJECTIVES:

At the end of the module, students will be able to:

1. relate the principles of nutrition science and recommended guidelines to the maintenance of optimal general and oral health status and well being of individuals at different stages of the life cycle 2. explain how nutrition related factors can promote or undermine oral health 3. select appropriate methodologies to conduct nutritional assessment 4. demonstrate an awareness of the role of nutrition in the aetiology and management of general and oral health 3.0 MODULE CONTENT AND CONTEXT Unit 1: Introduction to Nutrition (4 hrs) Specific Objectives: At the end of the unit, students will be able to: 1) Define the terms: nutrition, food, diet, nutrients and health 2) Describe the six major nutrients and fibre and their roles and functions, food sources 3) Outline the process by which food is digested, absorbed and assimilated in the body 4) Describe four characteristics of a nutritious diet 5) Describe the causes and consequences of malnutrition (under nutrition and over-nutrition) 6) Identify the factors that influence food selection 7) Discuss the interrelationship between nutrition and health status 8) Explain the significance of dietary recommendations, such as the Dietary Reference intakes, are and how they are used. 9) Explain the goals of the Caribbean dietary guidelines 10) Explain how the Food Guide Pyramid and Exchange lists can be used to plan diets. 11) Distinguish between Caribbean and other Dietary recommendations and guidelines 12) List and explain the types of information provided on food labels. 13) Assess nutritional status using the appropriate methodology 14) Discuss the significance of nutrition in dentistry

CONTENT:  Key nutrition concepts Definition of terms: nutrition, food, diet, nutrients, health Classes of nutrients (carbohydrates, proteins, lipids, vitamins, minerals, water) and Fibre Characteristics of a nutritious diet: Adequacy, Balance, Moderation, Variety Factors that influence food selection (flavor, economics, demographics, culture, religion, health, social and emotional, food industry and media, environment) Causes and consequences of malnutrition Dietary Recommendations for reducing risk for specific diseases among specific groups, Food Guides and Food Labels: *Dietary Reference Intakes (DRIs): Recommended Dietary Allowances (RDA), Estimated Average Requirements (EAR), Adequate Intakes (AI). Tolerable Upper Intake level (UL), *Caribbean Dietary Recommendations * The Food Guide Pyramid * Exchange List *Food Labels

 Assessing Nutritional Health Anthropometry, Biochemical, Clinical and Dietary Assessment 24 hour recall, Food Diary or Food Intake Record, Food Frequency, Diet History) * Analyzing Nutrient Intake * Nutrition as the Foundation for General and Oral Health The oral cavity as the gatekeeper to nutrition How taste and smell affect nutrition

SUGGESTED ACTIVITIES: Observe demonstration of nutritionist conducting nutritional assessment Evaluating Food Labels of commonly consumed foods

Unit 2 Nutrition in the Etiology and Management of General and Oral Health (4 hrs) SPECIFIC OBJECTIVES: At the end of the unit, students will be able to: 1. List at least two clinical signs or symptoms for common chronic diseases conditions 2. List major risk factors for each chronic condition 3. Describe known associations between each chronic condition and oral health status 4. Suggest basic dietary recommendations for those with oral manifestations that jeopardize adequate nutrient intake 5. Discuss the nutritional implications of oral lesions 6. Discuss how general nutritional status can affect the growth and development of oral tissues and structures 7. Describe the role of specific nutrients in the development of oral tissues and structures 8. Describe how mastication, diet consistency, and texture relate to oral development 9. Describe nutritional factors possibly associated with cleft palate and other oral deformities 10. Discuss the concept of enamel demineralization and remineralization 11. Explain how dental erosion differs from the demineralization of caries 12. Describe the caries process and the role of bacteria 13. Evaluate studies related to diet and caries 14. List the major risk factors for caries formation 15. List cariogenic and cariostatic food factors 16. Discuss the roles of saliva and oral hygiene in caries 17. Describe how nutrition affects the oral mucosa 18. List groups at high nutritional risk and recognize when consultation is required 19. Provide appropriate diet recommendations for patients with periodontal conditions 20. Discuss the nutritional implications of oral conditions such as orthodontia, extractions and orthognathic surgery, dentures, dysphagia, and temporomandibular disorders 21. Provide dietary suggestions for managing the nutritional issues associated with each of these conditions 22. Discuss the appropriate use of liquid dietary supplements 23. Develop a nutritionally adequate soft and liquid diet plan for patients who are functionally impaired or dentally compromised 24. Explain how drugs and nutrients can interact 25. Explain how drug-induced nutritional problems can affect the oral condition 26. Discuss potential direct and indirect effects of various medications on the oral cavity

CONTENT Nutritional and Oral Implications of Common Chronic Conditions: Hypertension, Osteoporosis Nutrition in the Growth and Development of Oral Structures Diet, Nutrition and Teeth Nutrition and the Peridontium Nutritional Concerns for the Dentally Compromised Patient How Medications can Affect Nutrition, Diet and Oral Health

SUGGESTED ACTIVITIES: Research Project

Unit 3: Nutrition for Oral Health Promotion through the Life Cycle (4 hrs) SPECIFIC OBJECTIVES: At the end of the unit, students should be able to:

1) Describe the nutritional needs of pregnant and lactating women 2) Describe the general and oral health benefits of breastfeeding for the infant and the mother 3) List and describe the caloric and nutrient needs of infants, toddlers, and school-aged children 4) Identify and discuss the most common nutritional problems of children 5) Discuss the nutrition related oral health issues of infants and children 6) Describe the role of snacks in the food pattern of toddlers and children, and identify snacks of low cariogenicity 7) Identify key adolescent issues that affect dietary habits and oral health 8) Discuss the health and oral implications of eating disorders 9) Identify key adult issues that affect dietary habits and oral health 10) Discuss diet education strategies appropriate for adolescents and adults 11) List and discuss the factors that affect the nutritional requirements of older persons 12) Describe how nutritional requirements of elders may differ from those of younger persons 13) List and explain the oral considerations for patients with conditions such as osteoporosis and impaired cognition 14) List the common oral conditions of elders and describe how they can affect nutritional status 15) List solutions to some of the common nutritional problems of older people 16) Discuss why people with special health care needs in particular require nutrition and dental services 17) List and describe common oral dysfunction seen in people with special health care needs and the nutritional implications of these problems 18) Describe common nutritional concerns for children with special health care needs 19) Discuss different feeding strategies to enhance food intake and overall health of this population 20) Identify ways to help minimize oral disease, which can lead to compromised nutritional status in people with special health care needs

CONTENT Nutrition in Pregnancy and Lactation Nutritional requirements for general and oral health of pregnant and lactating women, development of the foetus and newborn Nutrition in Infancy, and Childhood Nutritional requirements for infants and children and implications for their growth development, health and nutritional status Breastfeeding and implications for oral health and general health and development of the newborn Complementary and Replacement feeding and implications for oral health and general health and development of the infant Baby bottle tooth decay Common nutrition related problems and their implications for general and oral health of infants and children Snacking Poor oral health and hygiene and dental caries Oral Health Nutrition and Dietary considerations in Adolescence and Adulthood Nutritional requirements for adolescents and adults Key Issues affecting Adolescent and adult nutritional status Eating Disorders Communication strategies for adolescents and adults Common chronic non-communicable diseases affecting adults: Hypertension, diabetes, cancer The Older Dental Patient Nutritional requirements of older adults Factors affecting nutritional status of the elderly (DETERMINE) Solutions to some common nutritional problems of the elderly

Oral and Nutritional Concerns for People with Special health care needs

SUGGESTED ACTIVITIES Research Project

4.0 LEARNING AND TEACHING APPROACHES

 Lectures and Discussion will be the major modalities for communicating core concepts in nutrition and its applications to dentistry. Class discussions will be facilitated within all lecture session as a means of explaining the role of nutrition in general and oral health. This will facilitate shared learning and strengthen student critical thinking and reasoning skills.  Demonstrations: Techniques for assessing nutritional status will be done through practical demonstrations. Students will also be assigned to working groups to assess and interpret nutritional status of peers.  Class/Group Presentations: Students will be assigned topics specific to core concepts of the roles and functions of micro-nutrients and their implication in the development of oral structures as well as preventative dentistry.  Web Resources: Students will be encouraged to used web tutorials in their own time to search and retrieve nutrition resource material for dental practice such as Journal articles, blogs, podcasts etc.

5.0 ASSESSMENT PROCEDURES

Test 20% Research project 30% Final Exam 50%

6.0 BREAKDOWN OF HOURS

Number of hours assigned to: o Classroom lecture 12Hrs o Assessment 3Hrs

7.0 TEXTBOOKS AND REFERENCES REQUIRED Palmer A. Carole Diet and Nutrition in Oral Health 2nd Ed., Prentice Hall Upper Saddle River, New Jersey, 2006

Recommended Lippincott’s Illustrated Reviews: Biochemistry.. Champe & Harvey. 4th Edition. 2008 Smolin L. A. and Grosvenor M, B. Nutrition Science and Applications (third edition), Saunders College Publishing, 2000 or Latest Edition

Touger-Decker R, Sirois D, Mobley C Nutrition and Oral Medicine, Humana Press Inc. 2005

Rugg-Gunn A. J. and Nunn J. Nutrition, Diet, and Oral Health. Oxford University Press. 1999.

Supplementary Reading Journal of American Dental Association (JADA)

Trahms and Pipes. Nutrition in Infancy and Childhood. McGraw-Hill Press. 1997

8.0 Syllabus Developer: Vanessa White Damian K Francis

9.0 August 25, 2010

10.0 DATE OF ACCEPTANCE

Spaces for signature by Programme Director and OCDE