Gina is a 74-year-old woman with a history of type 2 diabetes, hypertension, and

Question

Gina is a 74-year-old woman with a history of type 2 diabetes, hypertension, and arthritis. She states that her dentist told her she has xerostomia and periodontal disease and will need multiple tooth extractions and a full maxillary (upper) and partial mandibular (lower) denture. Because of the condition of her teeth she consumes soft foods and lots of diet soda because her mouth always feels dry. She takes glyburide for glucose control, amlodipine (Norvasc) for blood pressure control, and glucosamine and chondroitin to alleviate her arthritis. She is 5’1” and weighs 176 lb. She lives alone, but receives assistance with food shopping and cooking from her family and friends. She occasionally conducts self-monitoring fasting glucose via fingerstick and states that her usual reading is 150 mg/dl. Nutrition diagnostic statements 1. Chewing difficulty secondary to poor dentition and xerostomia as evidenced by patient report and choice of soft foods. 2. Altered nutrition-related laboratory value (glucose) secondary to diabetes and possibly food choices as evidenced by inadequate blood glucose control.

1. What factors influence cariogenicity of foods? (2)

2. What dietary/nutrition recommendations do you have for the dental conditions (anticipated extractions, dry mouth, full and partial dentures)? (4)

3. What nutritional deficiencies present in the oral cavity first? (4)

4. What nutritional deficiencies increase the permeability of the gingival barrier and increase risk for periodontal disease? What foods are high in these nutrients? (5)

5. What foods will Gina want to avoid because of xerostomia? (2)

6. What medications alter the integrity of the oral mucosa, taste sensation or salivary production? (3)

7. How will reduced saliva influence Gina’s oral health? Why? (5)

Explanation / Answer

1). The cariogenicity is influenced by the following factors in the food:

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