Association Between Major and Trace Minerals in Health of Oral-Dental Tissues 2023-2024 PDF

Presented by: DR. Hagar Samir Lecturer Of Oral Biology Oral Biology Departement Faculty Of Dentistry-Alexandria University Nutrition and Oral Health Course 2023-2024  Contents Essential Minerals: (defintion, functions, types) Major Minerals (...

Presented by: DR. Hagar Samir Lecturer Of Oral Biology Oral Biology Departement Faculty Of Dentistry-Alexandria University Nutrition and Oral Health Course 2023-2024  Contents Essential Minerals: (defintion, functions, types) Major Minerals (Macrominerals): (defintion,types) Trace Minerals (Microminerals): (defintion, types) WHO classification of trace elements. Source, biological and oral function of Major Minerals as: (Sodium, Potassium, Calcium, Phosphorus, Magnesium, Sulphur ) Source, biological and oral function of Trace Minerals as: (Iron, Copper, zinc, cobalt, chromium,fluride, selenium )  Essential Minerals Minerals are inorganic elements required by the body in small amounts for a variety of functions. Minerals are vital for our body to keep it healthy.  Essential Minerals Their functions including; ✓ keeping our brain, heart, bones, and muscles functioning optimally. ✓ They’re also vital for the production of hormones and enzymes. ✓They’re of great importance to general and oral health. “Your body can affect your ❖The amounts needed in the body are mouth and, likewise, your mouth can affect your body” not an indication of their importance.  The manifestations of undernutrition and overnutrition of micronutrients on the oral health are numerous and can result in defects of the dental hard tissues as well as oral mucosa. Essential minerals are:  They’re called macrominerals because we need to consume more than 100 mg/day for each macromineral. They account for 96% of the total body weight.  Trace elements are chemical micronutrients which are required in minute quantity, less than 100 mg/day of each micromineral. They account for only 0.02% of the total body weight.  As each trace element act as a co-factor to many enzymes, deficiency of one trace element is not associated with any specific clinical presentation, but rather presents as a combination.  WHO classification of trace elements: ✓There are 19 trace elements divided into three groups (WHO classification): Essential elements: include zinc (Zn), copper (Cu), selenium (Se), chromium (Cr), cobalt (Co), iodine (I), manganese (Mn), and molybdenum (Mo). Probably essential elements Potentially toxic elements as lead. Types of Trace minerals : Iron Copper Zinc Cobalt Chromium Fluride Selenium Iodine  Major Major minerals minerals  Major minerals Calcium Sources Milk and milk products canned fish with bones (salmon, sardines) greens (broccoli, mustard greens) legumes  Major minerals Calcium Function Important for healthy bones and teeth helps muscles relax and contract Important in nerve functioning, blood clotting, blood pressure regulation, immune system health ✓It is found in the osseous tissue in the form of hydroxyapatite, an inorganic crystal made up of calcium and phosphorus. ✓Calcium is essential for bone growth and tooth developments. ✓Enhance enamel remineralization. Clues for deficiency& Overdose: ❖Calcium deficiency can lead to fatigue, muscle cramps, increased risk of fractures (Osteoporosis). ❖Overdose of calcium leads to bone pain, constipation, and calculus deposition on teeth.  Major minerals Phosphorus Sources Meat, chicken,fish, eggs, milk, processed foods, almonds  Major minerals Phosphorus Function Important for healthy bones and teeth Found in every cell. ✓Phosphorus combine with calcium for strengthening of bones and teeth. ✓Without phosphorous, the calcium in our body goes waste. ✓Lack of phosphorus in the body makes our bones weak and can cause oral diseases, gingival bleeding, arthritis. ✓Overdose of phosphorous leads to calcium being drawn to blood from bones leading to weak and brittle bones.  Major minerals Sodium Sources Table salt soy sauce processed foods small amounts in milk, breads, vegetables, and fruites.  Major minerals Sodium Function Needed for 1. proper fluid balance 2. nerve transmission 3. muscle contraction. 4. Improve brain function.  Sodium Major minerals ✓A high sodium intake increase the amount of calcium excreated through urine, which can lead to osteoporosis and tooth loss. ✓In extreme situations, there is a risk for dry mouth syndrome that could cause gum disease and tooth decay. low sodium in blood ( as in severe vomiting or diarrhea) leads to weakness, fatigue, headache,, vomiting, and loss of consciousness.  Major minerals Potassium Sources Meats Milk Fresh fruits (esp. Bananas and avocados) and vegetables, Whole grains, legumes  Major minerals Potassium Function Needed for proper fluid balance, nerve transmission, and muscle contraction. Deficiency: Muscle cramps and spasms Palpitations (heart beats faster and harder) Weakness, numbness Tingling sensations in hands and feet (called paraesthesia) Constipation.  Major minerals Potassium Role in Oral Health Potassium mouthrinse used with toothbrushing. It reduce dentinal hypersensitivity.  Major minerals Magnesium Sources Legumes Leafy green vegetables Nuts and seeds Chocolate Seafood.  Major minerals Magnesium Function They are responsible for over 600 enzymatic reactions. Found in bones and teeth. Needed for making protein, muscle contraction, nerve transmission, immune system health. Clues for deficiency: Weakness, tiredness, loss of appetite, Painful muscle spasms, Muscle cramps  Magnesium is a fantastic mineral for overall health, and it plays a critical role in building strong teeth and bones. Magnesium helps the body absorb calcium, which is critical to building strong teeth and tooth enamel.  You COULD BE AT RISK FOR A MAGNESIUM DEFICIENCY IF: You drink carbonated beverages,this adds large amounts of phosphates to your system. Phosphates bind to the magnesium in your digestive tract and flush it out of your body. You drink caffeinated or alcoholic beverages daily, which stimulates your kidneys to excrete extra magnesium. You eat refined sugars and sweets regularly, which causes your body to excrete magnesium through the kidneys.  Presented by: DR. Hagar Samir Lecturer Of Oral Biology Oral Biology Departement Faculty Of Dentistry-Alexandria University Nutrition and Oral Health Course Part II  Trace Major minerals minerals  Trace minerals Iron ✓Iron is the most abundant essential trace element in the human body. Sources Red meats; fish; shellfish Egg yolks Legumes Dark, leafy greens as spinach Cereals  Trace minerals Iron Function Part of a molecule (hemoglobin) found in red blood cells that carries oxygen in the body Needed for energy metabolism  Iron Trace minerals The manifestation of low serum levels are: 1) Iron deficiency anemia (most common): The oral manifestations angular cheilitis, atrophic glossitis, generalised oral mucosal atrophy, candidal infections. 2) Tumor progression in head and neck carcinomas.  Copper Trace minerals ✓Copper in its many forms is the most abundant mineral in the body. Sources Nuts and seeds Legumes Whole grains Drinking water Meats.  Trace minerals Copper Function It is involved in the release process of energy inside the cell It has antioxidant properties It is also essential in vitamin C and iron metabolism.  Trace minerals Copper Caries-promoting effect of Copper Copper is defined as a material which increases caries through demineralization of the outer layer of enamel. In decayed teeth, a higher level of copper is found compared to healthy teeth.  Trace minerals Zinc ✓Zinc is a mineral with a wide application in human health. ✓In the oral cavity, it is naturally present at various sites such as dental plaque, dental hard tissues and saliva. Sources Liver, meat Fish milk wheat germ, whole-grain products fortified cereals.  Trace minerals Zinc Function It is important for smell and taste sensation, as Zinc is essential for the taste buds to get stimulated. Act as Co-factor of many enzymes. Needed for synthesis of protein and collagen. It has antioxidant properties. It boosts immune system, and aids to regulate appetite.  Trace minerals Zinc Zinc deficiency is well known to cause anosmia and taste dysfunction. This is because one of the enzymes critical to maintain taste and smell function is a zinc dependent enzyme. Sneezing may be an indicator of local Zn deficiency. Acute viral infection of the nasopharyngeal mucosa may lead to a decrease in local Zn level.  Trace minerals Zinc Zinc & COVID-19: zinc may help to combat against corona virus symptoms. zinc strengthens the immune system of the body, and inhibits viral replication. zinc-containing metalloenzymes (enzymes containing metal ions) promotes cell division in basal stem cells, thus replacing the dead cells.  Zinc Corona virus also causes anosmia. Trace minerals Virus enters the basal stem cells and structural support cells that have an involvement in odorant transformation of the olfactory epithelium. Inside these cells, virus replicates and causes cellular injury. These cells support the receptors and neurons of the olfactory epithelium. The possible explanation of this role is that 1. Zinc strengthens the immune system of the body 2. Inhibits viral genome replication. 3. Zinc-containing metalloenzymes (enzymes containing metal ions) promotes cell division in basal stem cells, thus replacing the dead cells. In this manner, zinc may help to combat against corona virus symptoms.  Zinc Trace minerals Role in Oral Health and Diseases: It is effective against common oral health problems such as dental caries, gingivitis, periodontitis and malodour. It is used in oral health care products (the mouth rinses and toothpastes) to inhibiting the formation of dental calculus. promote remineralization under caries.  Trace minerals Cobalt ✓Cobalt is an essential trace element for the human body ✓it forms an integral part of vitamin B12 Function It has a substantial role in the formation of Sources amino acids and neurotransmitters.  Trace minerals Cobalt Clues for deficiency: Deficiency related to vitamin B12 can occur after feeding a cobalt-deficient diet, as cobalt is a component of vitamin B12. The manifestation of cobalt deficiency in oral cavity is pernicious anemia which is characterized by glossitis, burning sensation, red tongue.  Trace minerals Chromium ✓The word “chrome” is a Greek word which means “color.” ✓Chromium is an important mineral for obese people Function Sources Unrefined foods, especially plays an important role liver in glucose metabolism by serving as a cofactor Yeast for insulin action. whole grains regulate blood sugar nuts (glucose) levels cheeses  Chromium is one of insulin’s closest friends chromium helps insulin in reducing the blood glucose, by stimulating glucose uptake from the muscles and other tissues. When the chromium levels are less, the insulin is less effective in reducing blood sugar.  Trace minerals Chromium Clues for deficiency: Hyperglycemic status of diabetic patients may lead to oral manifestations noted in diabetics such as: delayed wound healing, periodontitis, various oral fungal infections.  Trace minerals Fluoride ✓Fluorine makes negligible part of body weight Sources Drinking water (either fluoridated or naturally containing fluoride) fish.  Trace minerals Fluoride Function Involved in formation of bones and teeth, is found in the form of fluorapatite. Helps prevent tooth decay. Promote remineralization of enamel Xylitol is a natural sugar alcohol found in plants as fruits and vegetables Role in Oral Health : Xylitol is another nutrient against caries Used in chewing gum to prevent caries  Trace minerals Selenium ✓Selenium is a vital trace element which is an essential component of antioxidant enzymes. Sources Liver, kidneys, meat Sea products Grains Milk products Fruits, and vegetables.  Trace minerals Selenium Function: 1. Acts as a powerful antioxidant. 2. Reduce risk of certain cancers. 3. Protect against heart disease. 4. Important for thyroid health (for the production of thyroid hormones). 5. Helps prevent mental decline (alzheimer’s disease). 6. Improve immune system (as in influenza, tuberculosis, and hepatitis c) 7. Reduce the symptoms of asthma  Trace minerals Selenium Function: Increase in dental caries It is settled in the micro-crystal structure of the enamel at the initial caries and made it more sensitive toward dissolution.  Trace minerals Selenium Clues for deficiency: Selenium deficiency associated with an increased risk of disease progression as in HIV. Increased risk of autoimmune thyroiditis and hypothyroidism  Trace minerals Selenium  Trace minerals Iodine ✓Iodine is a vital trace element required at all stages of life especially during formative years. Function Iodine plays an important Sources role in general growth and development of the body. Iodine is essential for thyroid gland in order to make thyroid hormones  Trace minerals Iodine Function: 1. Iodine plays an imperative role in oral mucosa and in salivary glands physiology. 2. Oral immune defense mechanism. 3. Iodine rich zones of the world showed greater attrition, and lesser dental caries.  Trace minerals Iodine Deficincy: It is the most common cause of thyroid gland disesese Hypothyroidism (UNDERACTIVE THYROID) It can cause symptoms including 1. severe tiredness 2. Enlarged thyroid (Goitre) 3. Feeling cold 4. Weight gain ✓Deficiency can developed in people who are pregnant or breast feeding, and new born babies.  References 1. Kulkarni N, Kalele K, Kulkarni M, Kathariya R. Trace elements in oral health and disease: An updated review. J Dent Res Rev 2014;1:100-4. 2. Fatima T, Haji Abdul Rahim ZB, Lin CW, Qamar Z. Zinc: A precious trace element for oral health care? J Pak Med Assoc. 2016 Aug;66(8):1019-23. PMID: 27524540. Antioxidants Improve Our Oral Health Nutrition and Oral Health Course  Antioxidants Definition :- A substance that can inhibit oxidation and counteract deterioration of stored food products. If we break down the word: Anti (against) + oxidants (oxidation) which means antioxidants are substances that prevent cell damage caused by oxidation process which release free radicals. Under certain conditions, oxygen molecules can split into single atoms  Definition :- Molecules with single unpaired electrons in their outer shells Free (orbits).This state is extremely unstable and make them readily radicles react with organic or inorganic components. When these atoms generated in cells, they attack nucleic acids and variety of membranous molecules  These atoms, known as free radicals, can bind with other electrons, causing damage to occur within the body. "Antioxidant" can counteract unstable molecules free radicals that damage DNA, cell membranes, and other parts of cells.  Because free radicals lack a full complement of electrons, they steal electrons from other molecules and damage those molecules.  1) DNA damage 2) lipid peroxidation Free radicals cause tissue 3) protein damage damage by 4) Membranous damage different mechanisms 5) oxidation of important enzymes [e g anti proteases] as 6) stimulation of pro- inflammatory cytokines release  Antioxidants neutralize free radicals by giving up some of their own electrons. In making this sacrifice, they act as a natural "off" switch for the free radicals. While a variety of free radicals exists, high amounts of free radicals in the body – referred to as oxidative stress – can cause permanent damage to our DNA and promote the development of disease.  Forms of Antioxidants It's much better to get the antioxidants the body needs through a healthy diet, rather than topical application. Its mandatory to add fresh fruits and vegetables to a healthy, nutritional diet.  They are commonly found in berries and fruits with deep, rich colors. This include spinach, Antioxidants cherries, blackberries, cabbage and sweet rich food potatoes. Also found in variety of spices, including ginger, cinnamon, turmeric, and green tea. Some tasty treats, such as dark chocolate. Benefits for patient oral health can be achieved by antioxidants. The chemical compound found in berries, dark chocolate, and other commonly eaten foods may be able to help boost our oral health, according researchers. Forms of Antioxidants They are available from different sources, including vitamins, minerals, enzymes and hormones, as well as food and herbal supplements. These supplements may be in bar, gel, capsule, drops and tablet forms.  Forms of Antioxidants Topical lotions and gels Antioxidants can also be used especially for patients who deal with oral inflammation, and those who smoke or consume diets low in nutritional value.  Antioxidants act like a natural defense mechanism in our bodies. Antioxidants can help to offset the damage caused by free radicals and promote better health overall. So, if certain types of foods can have a negative impact on our oral health, it only makes sense that other types of foods can help to improve our oral  Many of the diseases linked to oxidative stress are either started or exacerbated by chronic inflammation. Chronic inflammation in gingiva leads to development of periodontal disease.  Antioxidants have the ability to act like scavengers that move throughout the body neutralizing free radicals, both in the mouth and the rest of the body.  To provide this type of protection, it becomes important that we add more antioxidants to our diets. In cases where disease and inflammation have already developed, an increased consumption of antioxidants can lead to preventing any future damage, while also repairing the damage that has already occurred Reactive Oxygen Species (ROS) ✓ ROS an extremely powerful oxidant that includes free radicals and nonradical molecules. Free radicals must be ROS. Reactive Oxygen Species (ROS) In the dental field ROS can be reduced by 1. Treatment of periodontal diseases 2. Antibacterial therapy of root disinfection. 3. Dental bactericide for dental fillings. Sources of free radicals> 1. Normal metabolic process in body 2. Some external sources, including X-rays, ozone, smoking. 3. Dental treatments. 4. Oral inflammation is the main source of inflammatory response and the increase ROS in oral cavity. 5. Some dental procedures, such as bleaching, implants, fillings, crowns, veneers, orthodontics, and tooth extractions, may also produce ROS.  Oxidative stress The phenomenon of excess oxidants It is caused by an imbalance in the production of free radicals in the antioxidant system.  Oxidative stress As a direct result of lies at the heart of excessive ROS activity periodontal Antioxidant deficiency tissue damage that results from Activation of host microbial transcription factors and interactions, either the creation of pro inflammatory state  How does it work ? After local damage to the oral cavity, the free-radical- rich gingival fluid mixed with saliva stimulates the production of ROS in other oral tissues. Oxidative stress in the oral cavity is mainly related to infection and inflammation of the gingiva and other soft tissues, but other factors may also lead to oxidative stress. The sources of ROS are also relatively wide, mainly including food, cigarettes, alcohol, dental materials, and drugs  Oxidative stress In the dental procedures, oxidative stress and oxidative damage also occur. Periodontal inflammation is a direct result of increased ROS and oxidative damage products in the oral cavity. Dental procedures such as implants, bleaching, and fillings also lead to oxidative damages  Oxidative stress Periodontitis is a chronic inflammation of periodontal tissue. It can lead to loss of alveolar bone or even tooth loss when it is serious, and oxidative stress become a part of the pathogenesis of periodontal disease.  1. Destroying the free radicals that damage cells Or convert them to less reactive species. 2. Block oxidation process by neutralizing free radicles, so Antioxidants antioxidants become oxidized. help in: 3. Promoting the growth of healthy cells. 4. Protecting cells against premature, abnormal ageing. 5. Help fight age- related macular degeneration. 6. Provide excellent support for the body’s immune system In dentistry, reducing oxidative stress in oral environment with antioxidants to improve individual general health. Thus, consuming more of natural antioxidant containing foods like carotenoids, retinoids, vitamins are advisable. Synthetic supplements in case of natural sources deficiency can lead to a long disease-free life.  A healthy smile requires a healthy diet. Don’t let the health of your smile suffer because of a diet that doesn’t provide the protection needed to enjoy quality oral health for a lifetime.