Professional Documents
Culture Documents
Teresa A. Marshall
J Am Dent Assoc 2009;140;670-674
2011 American Dental Association. The sponsor and its products are not endorsed by the ADA.
CLINICAL PRACTICE N U T R I T I O N
dations that may decrease Quantity < 12 ounces/day Low 6-8 ounces of 100 percent
juice or other sugared
caries risk. The caries 12-20 ounces/day Moderate beverage/day; < 12 ounces
process depends on the > 20 ounces/day High of sugared soda pop/day
presence of host and envi- Timing With meals Low With meals
ronmental factors, With snacks Moderate
including exposure to fer- Between meals/snacks High
mentable carbohydrates.
TABLE 2
Dinner Subway (Milford, One 12-inch Take out Low Subway meatball
Conn.) meatball sandwich sandwich
sandwich Salad
Between meals Mountain Dew See note in Work, home High Iced tea or diet
Breakfast row Mountain Dew
Notes:
1. Patient likes fruits and vegetables and is willing to drink milk on cereal.
2. Patient quantified his Mountain Dew intake as about a 12-pack per day.
3. Patient reported swishing, but not holding, Mountain Dew in his mouth.
4. Although the patient accepted diet Mountain Dew, he was unwilling to give up all of his Mountain Dew at this time. We negoti-
ated limiting Mountain Dew to lunch only with a water rinse after consumption.
5. Patient denied regular intake of candy, baked goods and snack foods.
* The patient was a 25-year-old man who was 5 feet, 10 inches tall and weighed 276 pounds. Reported alcohol intake included three to four
drinks once a week.
and educational resourcesand engaging the The questions asked to assess the topics out-
patient in the process are considered more suc- lined in the Diet Assessment of Caries Risk tool
cessful strategies for ensuring the patients com- should be tailored to the age and culture of the
pliance than are telling the patient what to do or patient and to the oral health care professionals
to quit.12,13 style. However, all questions should be open-
Oral health care practitioners should include ended and nonjudgmental so as to minimize the
an assessment of diet-related caries risk factors patients guilt and encourage honest responses.
in the patients initial health history. Adminis- Receiving accurate information from the patient
tering this assessment before performing the oral is essential for negotiating dietary changes that
examination will not interrupt the flow of the oral support oral and systemic health.
examination and can improve patients perception
of dietary questions and honesty of response. In CONCLUSIONS
contrast, if the oral health care practitioner has a Although marginal dietary habits that increase
wide-eyed look after performing the oral exami- the quantity and frequency of fermentable carbo-
nation and asks the patient vague questions hydrate exposures are known to increase the risk
about dietary habits, a patients defenses may be of developing caries, oral health care profes-
raised and he or she may minimize reporting sionals do not assess patients dietary habits
actual behaviors. owing to resource and time limitations. Assessing