4-15. NUTRITIONAL COUNSELING
In nutritional counseling, the patient must be made aware of the nature of the
problem and the important role of diet in resolving it. The relationship of sugars to
dental caries must be clearly explained to the patient. Since the length of time that
sugars are present or available to the bacterial plaque is important, the frequency of
sugar ingestion and its adhesive characteristics are significant factors to be controlled.
Direct correlation has been shown between the frequency of the between-meal snacks
("sticky" and "sweet" foods) and the activity of caries. Experience in nutrition counseling
also shows that it is important to involve the patient when working to solve the patient's
problem. The patient must provide information concerning his diet. This information is
provided by asking the patient to keep a diary of the food he eats over a period of four
or five days (including a weekend) and whether or not during this period the food intake
pattern deviates from the normal. With the help of the counselor, the patient can then
assist in the analysis of his own diet, noting the frequency and amount of sugar
ingestion as well as its potential to promote caries. It is possible that the patient may
suggest a suitable diet alteration.
The regular consumption of a balanced diet provides all the nourishment required
for a healthy body. The groups of food that are listed below are recommended as a
guide to daily food choices.
a. Bread, Cereal, Rice, and Pasta Group. Bread, cereal, rice, and pasta form
a basic food group which is commonly referred to as "the staff of life." This group
provides over 50 percent of the body's food energy needs. We normally consume more
food from this group than from any of the other groups.
b. Vegetable Group and Fruit Group. Some detergent action (for teeth
cleaning) can be expected from these foods, but they should not be used as a substitute
for brushing and flossing. With vegetables, color is the guide to food value. The
greenest and yellowest vegetables contain the most nutrients. Spinach is more
nutritious than celery, and carrots are more nutritious than corn.
c. Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts Group. The daily servings
from this group should be less than the number of servings from the vegetable group.
The cheaper grades of meat are just as nutritious as the more expensive grades;
however, the amount of fat in a cut of meat needs to be taken into account. Fish,
poultry, and dishes with dry beans and/or eggs are nutritious alternatives to red meats.
d. Milk, Yogurt, and Cheese Group. The daily servings from this group should
be equal to or less than the number of servings from the fruit group. Children need the
nutritious elements that help build bones and healthy teeth, and so do older adults.