The Impact of Nutrition and Diet on Oral Health. Группа авторов
Читать онлайн книгу.
Periodontal Disease
The role of macroelements in periodontal disease has not been the primary concern of studies relating to this disease, although a recent, comprehensive review summarized the current evidence for a range of elements [61], including those of interest here.
Some anecdotal evidence exists correlating urinary potassium excretion (linked to potassium food intake) inversely to the severity of periodontitis [62], although other studies were not able to demonstrate an association [63, 64].
The evidence for calcium intake, however, is stronger, and in particular to alveolar bone health. A total of 12 studies in humans and 5 in animals have been discussed [68], with the National Health and Nutrition Examination Survey (11,787 participants) [65] and Danish Health Examination Survey (3,287 participants) studies [66] being perhaps the most relevant, despite their cross-sectional nature. Both studies provided evidence for an inverse relationship between calcium intake and the severity of periodontitis. Further evidence was also provided by the earlier mentioned Niigata [67] and MONICA [10] studies. Some indirect evidence on the value of calcium (and vitamin D) supplements in preventing periodontal disease (bone loss from the hip and tooth loss were determined) was provided in an aforementioned study [13]. A trend for better periodontal health in participants taking calcium and vitamin D supplements was observed in a small cross-sectional study (51 participants) [68, 69]. However, further studies are necessary as there is insufficient evidence to recommend an appropriate dose of calcium and vitamin D.
Similar to potassium, the evidence for phosphorus is equivocal as 2 studies reported no evidence, whereas one did [61]. It could be argued that because of phosphate’s importance in calcium metabolism, phosphorus deserves more attention.
Saliva
It would perhaps be logical to assume that an increase in, for example, calcium intake would result in an increase in salivary calcium via systemic means, thereby reducing risk to caries, erosive tooth wear, and potentially also periodontal disease. However, this does not appear to be the case as salivary calcium (approximately 24 mg calcium is secreted via saliva daily [70]) is directly related to the tightly controlled plasma calcium concentration with excess calcium being excreted via the kidneys rather than in saliva [71] – intake of a single dose of calcium (1,215 mg) had no effect on salivary and plasma calcium concentrations [72]. Therefore, saliva does not appear to be contributing to calcium (and phosphate) homeostasis. Furthermore, it must be noted that our understanding of the intra-oral pharmacokinetics of the macroelements, when administered topically, is still rather poor.
Conclusions
The macroelements calcium, potassium, sodium, phosphorus and chlorine are of vital importance to human life. Adequate daily intake of these elements is required to maintain a wide range of bodily functions. From an oral health perspective, calcium in particular but also phosphate play a predominant role in maintaining the teeth and their function. Inadequate calcium intake has also been linked to an increased severity of periodontal disease. The roles of sodium, potassium, and in particular chloride, in maintaining oral health, however, are largely unstudied but they appear to be of limited relevance.
References
1Lippert F: An introduction to toothpaste – its purpose, history and ingredients; in van Loveren C (ed): Toothpastes. Monogr Oral Sci, Basel, Karger, 2013, vol 23, pp 1–15.
2Ligtenberg AJ, Veerman ECI: Saliva: Secretion and Functions (ed 1). Basel, Karger, 2014.
3Christakos S, Dhawan P, Porta A, Mady LJ, Seth T: Vitamin D and intestinal calcium absorption. Mol Cell Endocrinol 2011;347:25–29.
4Yoshihara A, Watanabe R, Nishimuta M, Hanada N, Miyazaki H: The relationship between dietary intake and the number of teeth in elderly Japanese subjects. Gerodontology 2005;22:211–218.
5Iwasaki M, Taylor GW, Manz MC, Yoshihara A, Sato M, Muramatsu K, Watanabe R, Miyazaki H: Oral health status: relationship to nutrient and food intake among 80-year-old Japanese adults. Community Dent Oral Epidemiol 2014;42:441–450.
6Iwasaki M, Yoshihara A, Ogawa H, Sato M, Muramatsu K, Watanabe R, Ansai T, Miyazaki H: Longitudinal association of dentition status with dietary intake in Japanese adults aged 75 to 80 years. J Oral Rehabil 2016;43:737–744.
7Sheiham A, Steele JG, Marcenes W, Lowe C, Finch S, Bates CJ, Prentice A, Walls AW: The relationship among dental status, nutrient intake, and nutritional status in older people. J Dent Res 2001;80:408–413.
8Lee JS, Weyant RJ, Corby P, Kritchevsky SB, Harris TB, Rooks R, Rubin SM, Newman AB: Edentulism and nutritional status in a biracial sample of well-functioning, community-dwelling elderly: the health, aging, and body composition study. Am J Clin Nutr 2004;79:295–302.
9Antonenko O, Bryk G, Brito G, Pellegrini G, Zeni SN: Oral health in young women having a low calcium and vitamin D nutritional status. Clin Oral Investig 2015;19:1199–1206.
10Adegboye AR, Fiehn NE, Twetman S, Christensen LB, Heitmann BL: Low calcium intake is related to increased risk of tooth loss in men. J Nutr 2010;140:1864–1868.
11Adegboye AR, Twetman S, Christensen LB, Heitmann BL: Intake of dairy calcium and tooth loss among adult Danish men and women. Nutrition 2012;28:779–784.
12Hung HC, Colditz G, Joshipura KJ: The association between tooth loss and the self-reported intake of selected CVD-related nutrients and foods among US women. Community Dent Oral Epidemiol 2005;33:167–173.
13Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B: Calcium and vitamin D supplements reduce tooth loss in the elderly. Am J Med 2001;111:452–456.
14Brudevold