1. Nutritional Case Study Presented By:
Darcie Vlangas Jessica Blanchette Megan McWilliams Talayna Duval Amy Brine

2. Andrew Barker
18 Year old male College Student Preparing for finals Stays up late to study and gets up early for class

3. Subjective Information

4. Medical History Dental care and x-rays 3 months ago
The following were indicated as positive on med hx form
Bad breath
Bleeding Gums
Sensitivity to sweets
Sores/Growths in mouth
Flossing occasionally- only when food gets stuck
Brushes once a day at night
Participates in sports (doesn’t use a mouthguard)
He is in good health
Physical was just over 1 year ago
Allergy to latex
No medications

5. Chief Complaint Dietary History
“I keep getting sores on my tongue and the inside of my cheeks”
Dietary History
9am - coffee w/sugar and cream
11am- coffee w/sugar and cream
2pm- Burger, French fries, soda
6pm- pizza and soda
9pm- cereal with milk
11pm- Doritos and soda

6. Patient Images

7. Objective Information

8. Soft Tissue Exam Extraoral examination unremarkable.
Intraoral examination
5mm red, flat, oval lesion on left side buccal mucosa
three red, enlarged foliate papilla left side of tongue

9. Hard Tissue Exam

10. Periodontal Charting

11. Plaque Index

12. Radiographs

13. Assessment

14. Nutritional Deficiencies
Possible Causes
stress
poor diet
inadequate nutrient intake
bruxism
Irritation- biofilm, chemical, mechanical
GERD/vomiting
lack of sleep
poor oral hygiene
Nutritional Deficiencies
whole grains
fruits
vegetables
protein
dairy
vitamins (B12/B complex)

15. Impact on clinical practice and patient management:
He is in pain because of the lesions on the buccal mucosa and tongue, he may be non-compliant with oral hygiene
If he’s non- compliant with the nutritional counseling he will still be deficient in vitamins and may not improve
May have need for topical/oraqix/LA to control pain
GOAL:
Nutritional counseling
Stress reduction
Improve OH
Healthy mouth healthy body

16. Additional Questions
Do you know the correlation between a good diet and good health?
Is this dietary history typical to your day to day regimen?
Do you consume your beverages slowly throughout the day sipping, or do you drink your coffee and soda quickly?
Do you ever experience G.E.R.D (acid reflex) or do you regularly vomit?
Do you ever clench your teeth?
Do you understand the importance of wearing a mouthguard while participating in sports?

17. PLAN

18. Recommendations Dietary Suggestions:
Decrease/Replace soda/coffee consumption with water
Whole wheat pastas Include fruit & vegetables
Increase Protein & Dairy consumption
Home Care Recommendations:
Sonicare
Fluoride mouth rinse
Flossers
Orajel
Salt rinses
Community Services Available:
Nutritional counseling
Learning center
MyPlate.gov
DH clinic

19. How to prevent the problem
Limit soda substitute with H2O
With coffee substitute sugar with sugar substitute
Don't sip on cariogenic beverages all day
Eat a well balanced meal, utilizing choosemyplate.gov
Perform adequate homecare
Visit dentist to restore carious lesions and remove decay
Continue visiting hygienist regularly for prophy
Relieve stress

20. Reassessment Follow up: Outcome Assessed by:
3-4 weeks to evaluate tissues and healing
Outcome Assessed by:
Subjective information
How has the patient been feeling lately
Periodontal reevaluation
Soft tissue exam
Intra oral camera
Plaque score
Current dietary intake
Utilized from my plate journal