that nutritional factors have definite influence
on the incidence of periodontal problems (Table
Summary of Literature Pertaining to the Influence
of Nutritional Factors on the Incidence of
||Absence of any
than 37 years we have been treating people from
all walks of life and from practically all
economic groups for their dental problems. From
our records, using a random sampling technique,
we have analysed these data. Table 2 shows the
incidence of dental problems in Bombay Hospital.
Bombay's population being so cosmopolitan in
caste, creed, hygienic habits, nutritional
behaviour and income groups that the figures
might as well be taken as representative of the
entire country (except, of courses for climatic
and hereditary condition).
Incidence of Dental Problems in Bombay
Relationship of Nutrition with the Incidence of
the effect of nutritional factors, the patients
were divided in two main groups on the basis of
inquiry regarding their food habits. These were
and caloric groups were determined on the basis
of average daily intake of food and on the basis
of standard food value tables showing the
nutritional values of various Indian foods. It
could be summarised from these data (Table 3)
that the incidence of caries is lower in
Incidence of Dental Problems in Bombay in
Relation to General Nutrition
Low Calorie Group
High Calorie Group
||Protein Intake 60g
Calorie Intake 1900
|Protein Intake 35g
Calorie Intake 2500
|Periodontal Bone Absorption
following ingredients in the food are connected
with dental problems.
has been implicated in various physiological and
biochemical functions of the body. Besides its
involvement in the functions like electron
transport, metabolism of tyrosine, absorption of
iron and incorporation of plasma iron in
ferritin, adrenal cortex functions and formation
of collagen and intercellular cement substance,
it has also been shown to exert its influence on
bone formation. It was therefore well within the
context to examine intake of this vitamin in
relation to the occurrence of periodontal
problems. The sufficient and low vitamin C
intakes were arbitrarily grouped according to the
standard food-value tables and the inquiries
regarding food-habits with the subjects. There
seems an apparent influence of the high vitamin C
intake in vegetarians on the occurrence of
and Other Allied Agents
and proteins have potential of being classified
as anti-caries nutrients, like fluorides and
phosphates. Both the amount and quality of
protein are important factors in influencing
dental caries. In vegetarian diet, a large
proportion of the ingested protein is digestible
and therefore, utilizable. This is not so in the
non-vegetarian diet. Only 6-8% of the protein
from a steak is digestible whereas over 70-80% of
the protein in pulses (dal) is digestible.
important aspect of the vegetarian food is its
fibre content. Since almost 30-40% of the
vegetarian food is cellulose and therefore
non-digestible, it forms the major part of the
roughage. This acts as a bolus and in turn helps
in maintaining regular bowel movements. A stomach
upset or constipation results in the formation of
various organic acids such as lactic acid,
pyruvic acid, citric acid etc. in the mouth.
These organic acids are known to form dental
plaque which is responsible for the formation of
dietary fluoride in various countries ranges from
0.2 to 2.7 mg. Absorbed fluoride ions are
transported in the blood in both exchangeable and
bound forms. Soft tissues do not store fluoride
other than in sites of ectopic calcification.
Excretion of absorbed fluoride is chiefly by way
of urine. Levels of skeletal fluoride are
directly related to the levels of fluoride found
in drinking water and to age. Fluoride is well
known for its anti caries properties. The
fluoride content of vegetarian and non-vegetarian
diet is given below.
It can be
seen from the table that vegetarian diet does not
show wide variation in terms of its fluoride
content and therefore in turn provides a constant
dose of fluoride. A daily dose of 1-2 ppm seems
optimal for the prevention of dental caries.
traditional belief and recent interest in
'natural food' suggests that fruits and vegetable
make a positive contribution in dental health by
inhibiting caries and increasing the resistance
of the periodontal tissues.
dentition is better suited for vegetarian diet.
Broad surface molars are specially suited to chew
coarse fibrous food.
vegetarian foods have a cleansing action. A few
gargles after a meal may be enough to clean the
mouth. However, if some fibrous particle remains
in between the teeth (inter dental space) unlike
meat fibres, they do not ferment or traumatise
the tissue. Thus brushing morning and night may
be enough to prevent dental problems.
and fruits are a very healthy source of natural
vitamins like vitamin C and other minerals.
does not change fast and therefore vegetarian
food does not decompose. Salivary pH has an
important role to play in oral health. Most dairy
products like milk, butter, and vegetable oil
keep saliva almost neutral. Most vegetables, dry
fruits, apples, grapes and bananas may keep
saliva slightly alkaline. Meat, sea food and
chicken are acid forming foods. Acidic saliva
normally helps causing dental decay.
appears that evidence is strongly in favour of a
vegetarian diet. There seems to be no doubt that
the incidence of dental problems is less in a
M.E., et al. Influence of nutritional
factore, in periodontal diseases, J. NZ
Soc.Periodontal diseases 1981, 51, 15-9.
Lukosalo et al. Caries, periodontal
status and some salivary factore, in
Lacto vegetarians Dept. of Community
Health, University of Kupio, Finland.
D.A. et al. Apples, salted peanuts and
plaque. PH British Dent J. 1977: 142,
I am very
- Dr. P.
R. Sharma, M.Sc. D.Sc. Geneve Institute
Des Science, II, 1211 Geneve 4
C.D.S. Laxmanan, L.D.S. RCS, England,
Consultant, Dental Surgeon, Bombay
- Dr. H.
M. Dholakia, L.D.S. RCS, England.
Visiting Professor, Belgaum Dental
- Dr. B.
N. Apte, M.Sc., Ph.D, Consultant
Molecular Geneticist. Bombay Hospital
Institute of Medical Sciences.
Part of the
article is from the paper read by Dr. N. C.
Sharma in the Ist Int. Conference of the surgery
in Tropics January 1978 at Bombay Hospital.