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Importance of Nutrition in Orthodontics

The importance of diet and nutrition for has been recognized in health and disease for ages. More so the history of has been to a large extent a struggle to obtain food. Continue reading Importance of Nutrition in Orthodontics

With the recognition of proteins, carbohydrates and fats as energy yielding foods and  the discovery of vitamins and minerals , great advances have been made in the knowledge of nutrition and its practical application.

Nowadays  we live in a very diet conscious society where more and more people are adopting a healthy lifestyle through a healthy diet. The  evidence for which can be obtained from knowing the fact that books written on Nutrition and diet are amongst the fastest moving books off the shelves.

But despite  these advances  malnutrition is widely prevalent in many parts of the world more so in India than anywhere else. Adequate nutrition is important for proper body growth, its development and maintenance.

Nutritional imbalances affect the normal growth and development of the individual directly or indirectly. Deficiencies resulting during the formative stages of organs results in a more severe and irreversible damage , which follows the general rule that earlier the deficiency greater is the damage. Poor nutrition reduces the resistance of the tissues to infections and increases the length of healing period after surgery or an injury.

The proper nutritional status of the patient is of utmost importance in orthodontic treatment, since success depends on the response of bone to stimulation and reformation for the accomplishment of desired results.

Only when we begin to understand these vital nutrients and the role played by each one in the normal development of orofacial region and the body as a whole can we realize its relevance in clinical application. This will facilitate a comprehensive approach to orthodontic treatment as a whole.

DEFINITIONS:

Nutrition is a dynamic process in which the food that is consumed is utilized for nourishing the body. It can be defined as the study of ingestion , digestion, absorption, transport, metabolism and excretion of the chemicals found in the food.

Diet: The term diet refers to the total oral intake of substances that furnish nourishment and/or calories to the body.

NUTRITION IN GROWTH AND DEVELOPMENT

Nutrition plays a vital role in the growth and development of an individual. Development is a process which commences at conception and continues through birth until death. The perceptible visible evidences of developmental changes is Growth.

Guilford in 1874 was amongst the first to advocate dietary deficiencies as an underlying cause of dentofacial irregularities. Important relationship exists between diet and development which can be seen during the nutrition of the foetus; placenta is the provider of the essential nutrient substrates and fetal tissue synthesizes its own proteins and nucleic acids. Therefore interferences with substrate availability results in decreased protein metabolic activity.

Miller suggested that “ critical periods” exist during the development of an organ and that stress imposed by the nutritional imbalance during critical periods can result in irreversible changes. Critical periods are defined as that time in the development of an organ system which is marked by the rapid synthesis  and accretion of protein. The critical period roughly equates with the intense hyperplastic growth phase. If imbalance occurs during hyperplastic phase then it causes irreversible damage to the tissues. If it occurs during hypertrophic phase then the growth may stop temporarily but will catch up later when adequate amounts of missing nutrients become available. Dietary deficiencies of essential nutrients during the critical periods of growth have caused retardation of growth and morphologic alterations of the orofacial area in both humans and animals.

It has been shown in animal studies that certain hormones like the pituitary hormone are sensitive to nutritional deficiencies. Animals fed on diets deficient in folic acid , riboflavin and zinc , have borne offsprings with increased risk of cleft lip and palate. Even short periods of malnutrition (7-12 months) have resulted in an increase in open bites, a reduction in dimension of dental arches with inadequate space for teeth, insufficient dental eruption, the absence of natural diastema between the front deciduous teeth and shorter roots and interosseous rotation of the permanent teeth.

Malnutrtion has also been associated with shorter mandibles in the antero posterior dimension, marked reduction in the ascending ramus, condylar region and the setting of the premolars; dentoalveolar inclination in the incisor region and reduction in the mesio-distal dimension of the third molars.

Radiologic, histologic and histo chemical studies have demonstrated such abnormalities in osseous tissues as the reduction of the cortex and enlargement of the medulary spaces and a weakening of the osteoblastic and osteoclastic activity.