Nutritional Counselling

Limited resources, lack of financial incentive, inadequate skills in nutrition counselling and time constraints may restrict many dental professionals from providing nutritional counselling as part of their routine preventive oral disease strategy. However, sharing the responsibilities among the allied dental health professionals (i.e. dental nurses, dental hygienists) can provide a way of incorporating nutritional counselling into the dental visit.

While there are no qualified dental nurses in India, this job can be delegated to other personnel (i.e. receptionist – with proper training) working in the dental practice and can be incorporated as part of the waiting room procedure.

Do dentists in India think nutritional counselling is an important part of providing comprehensive care? Currently do dentists find the time for nutritional counselling particularly amongst high-risk patients? Would dentists be happy if other trained personnel provided this service on behalf of dentist?

Let’s discuss:

Professor Raman Bedi raman.bedi@kcl.ac.uk

The following brief note has been agreed by a global expert group and is taken from the website Alliance for Cavity Free Future.

Nutritional Counselling

Description:

Nutrition counselling has an important place in the dental care setting given the clear relationship between dietary factors and dental caries and the association between obesity, diabetes and periodontitis. Nutritional counselling can be defined as a cooperative mode of interaction between the patient and health care provider aimed at assisting patients in adopting healthy dietary behaviours associated with improved health outcomes. Moreover, it is an important step in determining whether nutritional deficiencies/imbalances exist and assessing the need for necessary referrals.

The association between dietary factors and adverse oral health outcomes is multi-factorial and complex with inter-related pathways between dietary intake (food consumptions), nutritional status (body composition, biomarker levels of micronutrients) and lifestyle behaviours. Patients should be informed that not only the types of carbohydrates but how the frequency, consistency, and position of their consumption in meals can increase risk of dental caries. For example, patients can decrease risk of caries through behaviour modifications such as, minimizing the frequency of sugary foods, decreasing the consumption of those with sticky consistencies or fine particles and ending meals with low cariogenic foods. Additionally, edentulous patients have significantly lower intakes of dietary fibre, protein, vegetables, calcium, iron, and other essential vitamins than dentate individuals, so dental care professionals should provide nutritional counselling based on the patients unique oral health needs. Personalized and tailored nutritional counselling such as the guidance provided by dental care professionals should be altered based on age, socio-cultural background and health literacy.

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