Springfield Technical Community College

ACADEMIC AFFAIRS

Course Number:	DHYG 200	Department:	Dental Hygiene	
Course Title:	Nutrition	Semester:	Spring	Year:	1997	

Objectives/Competencies

Course Objective	Competencies	
1.	Explain what is meant by the term nutrition.
2.	Explain and differentiate between:
a.	minimum dietary allowance.
b.	Recommended dietary allowance, and
c.	U.S. recommended dietary allowance.
3.	Identify the categories of the various nutrients and their respective functions with regard to an individual’s overall health.
4.	Recognize, describe and explain abnormal oral manifestations and systemic disorders which manifest themselves due to nutritional deficiencies in the diet.
5.	Identify the basic food groups and list the types of foods found in each group.  Include the major nutrients which can be obtained from each food category.
6.	List the factors which might influence the technique of evaluating and modifying a patient’s dietary history and nutritional status.

7.	Evaluate and assess assigned dietary histories for the maintenance of the patient’s optimal dental/general health.
	1.	Nutritional Values
a.	Differentiate between the U.S. Diet and the recommended diet.
b.	Briefly explain what influences our choices of food.
c.	Explain what nutrition is and what it encompasses.
d.	Define the term nutrients.
e.	Identify the function of nutrients.
f.	Briefly explain how nutrients are classified.
g.	Differentiate between essential and non-essential nutrients.
h.	List the classes of nutrients.
i.	Differentiate between macronutrients and micronutrients.
j.	Briefly describe what is meant by the phrase nutrient dense.
k.	Differentiate between a high density food and a low density food item.
l.	Define malnutrition.
m.	Differentiate between undernutrition and overnutrition.
n.	Explain what is meant by the term toxic.
o.	Explain how one conducts a nutritional assessment.

2.	Energy Values
a.	List the four basic forms of energy and state their main function.
b.	Define the term kilocalorie.
c.	List the four variables that determine the nutritional quality of a food.
d.	Identify the variables that we are able to control in maximizing the value of a food item.
e.	Briefly explain how we, the consumer, can maximize the nutrient quality of a given food item during purchasing, storage and preparation of our food items.
f.	Differentiate between the following terms:  fresh, frozen, canned, and dried.
g.	List the four factors responsible for overall energy.
h.	Define basal metabolism.
i.	Differentiate between basal metabolism and basal metabolic rate.
j.	Identify the factors which influence the basal metabolic rate.
k.	Determine your caloric intake for maintenance of your current weight.
-	Explain how body weight can remain constant.
-	Convert calories to pounds and vice-versa.
-	Explain how body weight can fluctuate.
l.	Utilize the formula for determining weight loss.
m.	Differentiate between the minimum daily requirement and the U.S. recommended dietary allowance.
n.	Identify the groups found under the U.S. RDA’s.
o.	Describe the function of the Enrichment Act of 1942 and further state its advantages and disadvantages.
p.	Describe, in detail, how nutritional information is formulated and read on a food label.
q.	Read and decipher a food label.

3.	Carbohydrates
a.	Explain what a carbohydrate is composed of chemically.
b.	Briefly explain how your metabolic rate is related to your carbohydrate consumption.
c.	Relate how many kilocalories are expended for every 100 kcal of carbohydrates consumed.
d.	Differentiate between digestible carbohydrates and indigestible carbohydrates.
e.	Identify one important indigestible carbohydrate and list where this item is found in relative abundance.
f.	List the main functions of carbohydrates.
g.	List the digestible carbohydrates and relate how they differ from one another chemically.
h.	Give the synonym for carbohydrates.
i.	List the monosaccharides which are of importance in nutrition; list food sources for each category.
j.	Explain the importance of glucose in the body.
k.	Briefly describe what occurs in Kreb’s cycle.
l.	List the disaccharides which are of importance in nutrition; list food sources for each category.
m.	Identify the components of each disaccharide given.
n.	Define oligosaccharide.  Which one is of importance in nutrition.
o.	Differentiate between a disaccharide and a polysaccharide.
p.	Differentiate between insoluble and soluble fiber.
q.	List food sources of soluble and insoluble fiber.
r.	Explain why fiber is of importance in your daily diet.
s.	State the recommended daily intake of fiber as stated by the national institutes.
t.	Differentiate between simple and complex carbohydrates with regard to taste, absorption, fiber content, vitamin/mineral contents, and food sources.
u.	Simply chart the digestive process of a carbohydrate.
v.	Define the following:  hypoglycemia, ketosis, endogenous, and gluconeogenesis, Type I diabetes, and Type II diabetes.
w.	Differentiate between Type I and Type II diabetes.
x.	Differentiate between natural and synthetic sweeteners.
y.	List the current synthetic sweeteners utilized in the United States.
z.	Define a sugar alcohol.
aa.	Identify the sugar alcohol currently used today.

4.	Carbohydrates and Caries
a.	List the three main factors relating sugar and dental decay.
b.	Briefly explain the chemoparasitic theory proposed by Miller.
c.	Explain how carbohydrates affect dental caries formation.
d.	Identify which carbohydrates will be more apt to cause dental caries and why.
e.	Explain the nursing bottle syndrome.
f.	Describe the role of the various bacteria in caries formation.
g.	Explain how the following affect one’s susceptibility to dental caries:
-	Size of the sugar molecule.
-	Concentration of the sugar.
-	Oral clearance.
-	Form and composition of the sugar.
-	Frequency of intake.
-	Type of sugar.
-	Bacterial flora present in the oral cavity.
-	Tooth surface exposed to the sugar molecule.
h.	Explain the five major factors in the dental caries process.
i.	Recognize the various types of sugar, sugar alcohols, natural sweeteners, synthetic sweeteners and explain their relative importance in nutrition.
j.	List the characteristics of a non-carlogenic food item.

5.	Protein
a.	Identify the basic unit of a protein.
b.	Describe the chemical composition of a protein.
c.	Explain what is meant by denaturing and list the means by which proteins can be denatured.
d.	List the functions of a protein.
e.	Briefly describe the digestion/metabolism of proteins.
f.	Describe what is meant by protein turnover.
g.	Define the terms nitrogen balance, positive nitrogen balance, and negative nitrogen balance.
h.	List the conditions that may affect one’s nitrogen balance.
i.	Differentiate between essential and non-essential amino acids.
j.	Identify the essential amino acids.
k.	Differentiate between complete and incomplete proteins.
l.	Demonstrate the ability to identify the food sources of complete and incomplete proteins.
m.	List the various ways in which one’s protein concentration is measured.
n.	State the recommended dietary allowance of protein.
o.	Calculate one’s recommended dietary protein allowance utilizing the mathematical format provided.
p.	Briefly describe the effects of excess protein in the diet.
q.	List and briefly describe the protein deficiencies seen in developed countries, underdeveloped countries and poverty stricken areas.
r.	Describe how infection and a protein deficiency are related.
s.	List the oral malformations/disruptions that may result from insufficient protein in the diet.
t.	Be able to identify by slides, photos, etc. the aforementioned conditions and/or oral malformations/disruptions associated with either excesses or deficiencies of protein.
u.	Relate the effect of protein deficiency on periodontal disease.
v.	Identify the major food sources of proteins.

6.	Lipids and other Fats
a.	List the chemical components of fats.
b.	List the recommended intake percentage of fat for our total caloric intake.
c.	List the various functions of fats/lipids.
d.	Identify the four classes of lipids.
e.	Differentiate between visible and invisible fats.
f.	Define hydrogenation and its effect on fats.
g.	Define triglycerides and indicate where they are found in the body.
h.	Identify the normal range for triglycerides.
i.	Classify lipids according to their saturation levels; and 
-	Explain how serum cholesterol levels are affected by these fats.
-	Identify the food sources of each.
-	Identify their consistency at room temperature.
-	List their effects on the various lipoproteins in the body.
j.	Define the term essential fatty acid.
k.	Identify man’s essential fatty acid.
l.	Relate the deficiency symptoms of linoleic acid.
m.	Identify the food sources of linoleic acid.
n.	Describe the role of cholesterol in the body.
o.	List the recommended daily dietary intake of cholesterol.
p.	Differentiate between low density, very low density, and high density, and high density lipoproteins.
q.	Briefly explain how increased concentration levels of the aforementioned lipoproteins affect one’s risk for heart disease.
r.	Explain how fats affect one’s oral health.  Be able to substantiate your answers.
s.	Briefly describe the metabolism of fats.
t.	Calculate weight loss by cutting back on one’s dietary fat.
u.	Calculate the total calories from fats for any given food label.
v.	Effectively utilize a formalized cholesterol evaluation.

7.	Water
a.	List the functions of water.
b.	Identify those minerals associated with water balance.
c.	Explain how fluid and electrolyte imbalances may occur.
d.	Explain how excessive amounts of salt causes dehydration.
e.	Explain the recommended intake of water per day.
f.	Explain how water needs can be calculated.

8.	Vitamins
a.	Define the term vitamin.
b.	Explain how vitamins are classified.
c.	Differentiate between fat soluble and water soluble vitamins.
d.	Identify the fat soluble vitamins.
e.	List the water soluble vitamins.
f.	Explain the interrelationship between the B-complex vitamins.
g.	Name the three functional groups of the B-complex vitamins and their constituents.
h.	For each of the discussed vitamins:
-	Identify their major functions.
-	Describe the major general and oral manifestations of each deficiency disease and disorder that occurs when there is an inadequate amount of intake of that particular vitamin.
-	List the RDA’s for each vitamin.
-	Identify the major food and non-food sources of each vitamin.
i.	If applicable, name the precursor(s) for each vitamin.
j.	Explain why a pregnant or lactating woman usually requires doses in excess of the standard adult.
k.	Recognize the disease states and oral manifestations of the various vitamin deficiencies.

9.	Minerals
a.	Define the term mineral
b.	Identify the overall functions of minerals
c.	Explain how minerals are classified
d.	For each of the given minerals:
-	Identify their major respective functions
-	Describe the major general and oral manifestations of each disorder and deficiency disease that occurs when there is no inadequate amount of intake of that particular mineral.
-	List the RDA’s for each mineral
-	Recognize their major food sources
-	List their effect on caries susceptibility

10.	Fluoride
a.	Explain what dental fluorosis is, describe it, and further state when it will most likely occur.
b.	Relate where the primary and secondary absorption sites are for fluoride.
c.	Identify where and how fluoride is distributed in the body.
d.	List the excretion sites for fluorides and how it varies from adults to children.
e.	List the storage sites of fluoride in the human body.
f.	Identify the optimum amount of fluoride recommended for the water supply.
g.	List the anticariogenic action of fluoride.
h.	Identify and relate the supplemental fluoride dosage schedule.
i.	Explain why fluoride is best taken when the teeth are mineralizing.

11.	Food Groups
a.	Define a balanced diet.
b.	Identify the basic food groups.
c.	Identify the chief nutrients provided by each of the basic food groups.
d.	List the foods and their particular portions (serving sizes) in each of the food categories.
e.	List the recommended number of servings per day in each of the four food groups.
f.	Briefly describe how our nutritional requirements may vary during the stages of our lives.
g.	Identify the foods rich in vitamins C and A.
h.	Identify the groups of nutrients provided in the:
-	vegetable group
-	fruit group
-	milk group
-	protein group
-	grain group

12.	Food Factors Promoting Dental Caries
a.	Identify the controllable and uncontrollable factors which influences dental caries.
b.	Explain how the following are correlated with dental caries promotion:
-	frequency of eating
-	physical nature of food/snacks
-	concentration and amount of sugar added to foods
-	cariogenic potential of the foods eaten
c.	Identify those foods which are the least and the most acidogenic.

13.	Nutrition in the Oral Cavity
a.	Via slides, recognize the oral deficiencies manifested by insufficient amounts of vitamins and minerals.
b.	Explain what methods of treatment are available to clients exhibiting acute oral mucosal problems.

14.	Counseling Procedures for Dental Caries Prevention
a.	Differentiate between nutritional counseling and diet counseling and explain what types of clients fall into each category.
b.	List the three rules to achieving effective communication.
c.	Relate which four combined elements make for an effective communication technique and how they are utilized.
d.	List the two types of counseling techniques and identify which one would be most advantageous to utilize.
e.	Identify the guidelines for counseling.
f.	List the basic factors that motivate people.
g.	Identify and explain the four preliminary decision stages.
h.	Relate the instructions for keeping an adequate food diary.
i.	Recognize and circle in red those foods which are considered carcinogenic.
j.	Explain the causes and the process of dental decay.
k.	Calculate the total number of exposures to carcinogenic foods and the total number of minutes of exposure per day.
l.	Calculate the total number of servings from the major food groups and the total exposure in each group per day.
m.	Guide the patient in assessing his/her summary evaluations.
n.	Allow the patient to suggest alterations in the diet to minimize the inadequacies that were found (if any).

15.	Control of Rampant Caries
a.	Identify those elements which may play a role in rampant caries.
b.	Identify the rationale of behavior modification in the control of rampant caries.
c.	Relate the guidelines for counseling a client with rampant caries.
d.	Analyze the food diet diary.
e.	Analyze and record the following:
-	Environmental stimuli.
-	Frequency of eating.
f.	Allow the client to prescribe his/her own solutions to the diet inadequacies (if any).
g.	List and briefly explain the types of tests available which may serve as a motivating factor for the control of rampant caries.

16.	Nutritional Guidance for Client with Gingivitis or Periodontitis
a.	List the three general components involved in the etiology of periodontal disease.  Briefly explain each.
b.	List how the noted vitamin deficiencies, etc. are involved in the development of periodontal disease.
c.	Explain how the physical nature of a food affects the periodontium.
d.	List the management factors for the ANUG patient.
e.	Relate how the diet is affected prior to and following periodontal surgery.
f.	Explain clearly to an individual the relationship between nutrition and the periodontium.

17.	Nutrition and the Oral Surgery Patient
a.	List the three stages involved in wound healing.  Briefly describe each.
b.	Briefly explain the immune response to disease and infection.
c.	Explain the need for the following in the healing process:
-	Protein
-	Calories
-	Vitamins
-	Minerals
-	Water
d.	Differentiate between the pre- and postoperative diet.
e.	Briefly explain the type of diet to be followed by a patient with a fractured jaw.
f.	Explain briefly the type of diet which may have to be followed by an oral cancer patient.
g.	Differentiate between a preoperative and a postoperative diet for the cleft palate patient.

18.	Nutrition for the Elderly
a.	Identify the nutrient recommendations for the elderly.
b.	List the oral problems seen in many elderly patients.
c.	Identify those problems associated with food intake, digestion, and utilization.
d.	Identify those psychological factors which may contribute to malnutrition in the elderly and how these factors may be alleviated.
e.	Offer sound dietary suggestions for denture wearers.
f.	Relate to a denture wearer the sequencing of eating food.

19.	Health Foods
a.	List the foremost function of food and expound on each.
b.	Relate the direct and indirect factors which influence food preferences.
c.	Identify the major influences on food habit formation.
d.	Define the following:
-	Health food
-	Organically grown food
-	Natural food
e.	Differentiate between fact and fallacy.
f.	Familiarize yourself with a vegetarian diet.
g.	Identify the various levels of vegetarianism and the food items that they may include and exclude.