nutritional+disorders

=List the Three Take Away or Big ideas From Carranza = =**On Nutritional Disorders and Periodontal Disease **=

__Nutritional Disorders:__
 Has two main factors:

1) There are no nutritional deficiencies that by themselves can cause gingivitis or periodontitis. 2) There are nutritional deficiencies that produce changes in oral cavity.

**Fat Soluble Vitamin Deficiency: **   **Water Soluble Deficiency:**
 * 1) Vitamin A: Clinical findings include: Hyperkeratosis and hyperplasia of the gingival with a tendency of increased periodontal pocket formation.
 * 2) Vitamin D: Clinical findings include: Radiographically, there is generalized partial to complete disappearance of the lamina dura and reduced density of the supporting bone, loss of trabeculae, increased radiolucency of the interstices trabecular and increased prominence of the remaining trabeculae.
 * 3) Vitamin E: No relationship but systemic vitamin E accelerates gingival wound healing.

 **1. Vitamin B complex Deficiency:**   a. Thiamin deficiency: hypersensitivity of the oral mucosa; minute vesicles on the buccal mucosa, under the tongue, or on the palate, and erosion of the oral mucosa. b. Riboflavin deficiency: severe lesions of the gingival, periodontal tissues and oral mucosa. Glossitis: by a magenta discoloration and atrophy of the papilla and angular cheilitis. c. Niacin Deficiency: glossitis, gingivitis, and generalized stomatitis. The most common finding is NUG, usually in areas of local irritation. d. Folic Acid deficiency: demonstrates necrosis of the gingiva, periodontal ligament and alveolar bone without inflammation. Ulcerative stomatitis is an early indication of the toxic effect of folic acid antagonist used in the treatment of leukemia.

 **2. Vitamin C Deficiency:**  <span style="font-family: 'Comic Sans MS',cursive;"> a. Low levels of ascorbic acid influence the metabolism of collagen within the periodontium, affecting the ability of the tissue to regenerate and repair itself. b. Asorbic acid efficiency interferes with bone formation, leading to loss of periodontal bone. c. Ascorbic acid deficiency increases the permeability of the oral mucosa to tritiated endotoxin and tritiated insulin and of normal human crevicular epithelium to tritiate dextran. d. Increasing levels of ascorbic acid enhance both the chemotactic and the migratory action of leukocytes without influencing their phagocytic activity. e. Depletion of Vitamin C may interfere with the ecologic equilibrium of bacteria in plaque and increase its pathogenicity. f. Patients with acute or chronic vitamin C deficient states and no plaque accumulation show minimal, if any changes in their gingival health status.

The destructive effects of bacterial plaque and occlusal trauma may occur on the periodontal tissues. Although the initiation of gingival inflammation and its severity depends on bacterial plaque.
 * 3. Protein Deficiency: **