Question 1

Which components should the dental hygienist include while assessing the quality of a patient's meal pattern and eating habits? (Select all that apply.)

Accepted Answer

While assessing the quality of a patient's meal pattern and eating habits,having the patient complete a food diary is essential.Using the diary and MyPlate,the dental hygienist can actively involve the patient by having her highlight all fermentable carbohydrates and classify them as cariogenic or noncariogenic.This not only enables the patient to identify the caries potential,but it also provides the ideal opportunity to suggest alternative food selections.

Question 2

Genetically modified organisms (GMOs)are formed by inserting lab-manufactured DNA into a plant,animal,or microorganism.The first genetically modified (GM)food,introduced in the mid-1990s,was the herbicide-resistant soybean.

Accepted Answer

The first statement is false; the second is true.GMOs are formed by taking genetic material (DNA)from one plant,animal,or microorganism and inserting it into the permanent genetic code of another.This technology is also referred to as genetic engineering and biotechnology.

Question 3

Each,except one,can cause the pH of human interproximal plaque to fall to less than 5.5.Which is the exception?

Accepted Answer

Note that eggs contain a significant amount of protein.Protein contributes to the buffering action of saliva.The remaining selections are carbohydrates or contain natural sugars.

Question 4

Each is true of genetically modified (GM)foods,except one.Which is the exception?

Accepted Answer

Although the FDA evaluates whether a new plant is safe to eat,they consider GM foods substantially equivalent to unmodified,"natural" foods.This means that GM foods are not subject to FDA regulations.Companies who create new GM foods are not required to consult the FDA,nor are they required to follow any recommendation made by the FDA.Note that the Environmental Protection Agency (EPA)evaluates GM plants for environmental safety.Another agency,the U.S.Department of Agriculture,evaluates whether the plant is safe to grow.

Question 5

Which nutrients have a significant effect on the development of prenatal salivary gland development? (Select all that apply.)

Accepted Answer

The availability of essential nutrients during the development of salivary glands,which begins during the fourth week in utero,has a significant effect on the amount of saliva and its composition.Of particular importance are vitamin A,iron,and protein,which have a role in normal growth,development,and secretion of saliva.

Question 6

Which provide mechanisms that increase tooth resistance to demineralization and the caries process? (Select all that apply.)

Accepted Answer

Although citrus fruits such as grapefruit stimulate salivary production,they are considered cariogenic because of their ability to lower salivary pH and increase caries risk.Probiotics,live bacteria that are beneficial to the host,may have properties that interrupt caries formation.Pit and fissure sealants together with fluorides are key components of preventive dentistry.Xylitol is a sugar alcohol found naturally in plants.Chewing gums,mints,and candies containing xylitol inhibit enamel demineralization via increased salivary flow,increased oral clearance,and salivary buffering.

Question 7

Which are major factors in the dental caries process? (Select all that apply.)

Accepted Answer

Antimicrobial oral products containing chlorhexidine help to reduce caries by suppressing harmful plaque and organisms.Dental hygienists should advise patients about the staining potential of chlorhexidine.Depth of natural pits and fissures and the position of the teeth are relevant factors in the development of caries.Deep pits and fissures increase susceptibility for dental caries because of the potential for plaque biofilm and food to be trapped in these areas.Overlapping and crowding of teeth also offer areas for these materials to collect and ferment,compounded by the difficulty of keeping these areas clean.Race,ethnicity,and income influence caries prevalence rates because socioeconomic factors are integrally involved in food selection and access to preventive care.

Question 8

Each applies to the Caries Management by Risk Assessment,except one.Which is the exception?

Accepted Answer

Caries Management by Risk Assessment is a popular protocol used by dental professionals to identify risk of caries and to determine preventive and therapeutic goals for both children and adult patients.It is approved by both the American Dental Association and the American Academy of Pediatric Dentistry.The steps identified in the question are correct.Disease indicators may include low income and frequent snacking.Caries-protective factors can include use of products with xylitol and daily flossing.Also included are results of a clinical exam.A large number of existing restorations is an indicator of risk for future caries activity.Dental hygienists can learn more and acquire appropriate forms on the American Dental Association website.

Question 9

Which accurately describe aspects of genetically modified foods? (Select all that apply.)

Accepted Answer

Although the United States is the leading producer of GM foods,developing countries are planting GM crops at a more rapid rate than rich countries.Because the purpose of genetic modification is to increase food production by creating disease and insect-resistant crops with improved nutritional quality,GM is seen as a way to alleviate malnutrition in developing countries.Few fresh fruits and vegetables are GM but highly processed foods,such as vegetable oils or breakfast cereals,most likely contain some percentage of GM ingredients.

Question 10

Which accurately describes the cariogenic potential of foods,habits,and digestion? (Select all that apply.)

Accepted Answer

Fresh fruit is a food group considered of low cariogenicity because of its low percentage of carbohydrate and high percentage of water.However,fresh fruit juices,which lack the benefit of fiber,contain a high concentration of fructose,a risk factor in dental caries.This is especially a concern in toddlers given unlimited amounts in a sip cup or bottle.The dental hygienist should caution parents against sharing utensils with children,a practice that allows transfer of the cariogenic microorganism Streptococcus mutans.An acidic saliva is measured by a low pH and predisposes teeth to decay.

Question 11

Demineralization of enamel occurs when the critical pH of 5.5 is reached.In interproximal areas or in deep pits and fissures,the pH can decrease to 5 and remain at that pH for 30 minutes.

Accepted Answer

The first statement is true; the second is false.In interproximal areas or deep pits and fissures,the pH can decrease to 4 and remain at that pH for an hour.Note that the effect increases as the number of exposures increase.Cumulatively,more than 2 hours of acid exposure in 1 day is considered high.The general mechanism is that after consumption of a carbohydrate,metabolism by salivary amylase begins within 2 to 3 minutes and can persist for hours.Concentration of the resultant acids escalates as carbohydrate intake continues.The pH of acids produced by bacteria in plaque biofilm is eventually neutralized (increases to about 7)after elimination of cariogenic foods as saliva exerts its protective action.

Question 12

Grapefruit and other fruits containing citric acid are considered noncariogenic because of these foods can stimulate saliva production.

Accepted Answer

The statement is not correct,but the reason is correct.Although grapefruit and other fruits containing citric acid can stimulate salivary production,they are not considered noncariogenic because of their ability to lower salivary pH and increase caries risk.The dental hygienist should advise that these fruits be eaten within a meal,or that citrus fruits be followed by a noncariogenic food.

Question 13

Which food would be least beneficial for an individual wanting to restrict both plaque acid and fat intake?

Accepted Answer

Although all foods in this question produce little or no plaque acid,American cheese is high in fat.The dental hygienist can suggest a lower fat cheese as an alternative.Note that all selections contain a significant amount of protein and that protein contributes to the buffering action of saliva.This makes snacks rich in protein an excellent substitution for carbohydrate dense snacks.

Question 14

Each group represents situations presenting high caries risk,except one.Which is the exception?

Accepted Answer

Although vegans are often deficient in protein,they are not at high risk for caries.Their strict adherence to plant-based diets generally precludes foods highly associated with increased caries risk.Note that polypharmacy is a term referring to patients taking numerous medications.Xerostomia,or dryness of the oral tissues,is a frequent side effect of multiple medications,which significantly increases caries risk.

Question 15

Probiotics are live bacteria that are beneficial to the host.Emerging research indicates consumption of probiotics may have properties that interrupt caries formation.

Accepted Answer

Both statements are true.Food sources of probiotics include yogurt,kefir,buttermilk,tempeh,miso,and sauerkraut.Emerging research also indicates that consumption of cranberries,tea,coffee,and wine might have cariostatic properties.

Question 16

Nonnutritive sweeteners are not metabolized by microorganisms and do not promote dental caries.Products made with a nonnutritive sweetener can be used as frequently as 8 to 10 times per day.

Accepted Answer

The first statement is true; the second is false.Products made with a nonnutritive sweetener,such as aspartame,should be used in moderation; two to three times per day is advised.Some patients might not tolerate large amounts.The dental hygienist should recommend alternative noncariogenic food items and oral self-care.Note that foods made from these sweeteners are generally higher in cost and might not be feasible for low-income patients.

Question 17

Malnutrition in developing countries is a consequence of each,except one.Which is the exception?

Accepted Answer

Malnutrition in developing countries is a consequence of a dearth (extreme loss)of certain vitamins in staple foods,losses during crop processing,and overreliance on a single primary food source.Genetic modification of agricultural crops is addressing this world concern.A successful example is Golden Rice,which is genetically modified to improve the vitamin A status of young children in developing countries by effectively converting beta-carotene into vitamin A.

Question 18

Which ingredients are anticariogenic? (Select all that apply.)

Accepted Answer

Oral products containing xylitol,a sugar alcohol,can protect teeth by buffering saliva and decreasing fermentation of carbohydrates.The caries-protective features of many types of fluoride are well documented.Chlorhexidine rinses reduce cariogenicity by their antibacterial protection.Glycyrrhiza,the active ingredient in licorice,can be considered anticariogenic.However,glycyrrhiza is contraindicated with some antihypertensive medications.Like chlorhexidine,glycyrrhiza has the potential to stain teeth.The dental hygienist should caution patients that many so-called vitamin and mineral waters are sweetened with sugar.

Question 19

Protein and fat are considered cariogenic because consumption of foods with these two nutrients following a fermentable carbohydrate may decrease pH.

Accepted Answer

Neither the statement nor the reason is correct.Protein and fat are considered cariostatic,not cariogenic,not only because they do not decrease pH,but also they can actually increase plaque ph when consumed after a fermentable carbohydrate.Generally,protein can contribute to the buffering effects of saliva.When recommending snacks such as low-fat milk and yogurt,the dental hygienist can convey this information to patients.Examples of other cariostatic foods include seafood,poultry,eggs,nuts,seeds,and margarine.

Quiz 18: Nutritional Aspects of Dental Caries: Causes, Prevention, and Treatment