Nutrition and Oral Medicine (Nutrition and Health)

38 Part I / Nutrition and HealthTable 4Dietary Guidelines for Biting or Chewing Difficulties Associated With Dental ProceduresEating fruits and vegetables• Turn fruits and vegetables into chopped salads.Fruit salad in bite-size pieces made from fresh cut-up fruit.Chopped greens, tomatoes, cucumbers.Corn salsa (take fresh corn off the cob and mix with salsa).• Choose either very soft breads and crackers or very crisp ones (limit those that are “chewy” such asbagels, soft rolls, bread crusts).• If raw vegetables are tough to chew even chopped, steam or stir fry for 5 min and then chop and chillfor a salad.• Pasta salads (pasta mixed with chopped vegetables or beans and chilled).Snacks foods that are easy to eat• Bite-size tortilla chips broken in half.• Bite-size rice cakes.• Fruit smoothies: frozen fresh fruit and yogurt or milk in the blender (high in calcium also).• Frozen berries or grapes (great to suck on).• Flour tortilla pizza strips (flour tortillas with a layer of salsa and cheese, microwave for 1 min, thencut in strips.Drinking liquids• Drink at least 8 cups of liquid (= amount of water) daily.Adequate fiber• Dietary fiber intake may decrease; using these tips for eating chopped and cut food will help maintainfiber intake.• If needed or desired, try 1/2 to 1 cup of bran cereal daily and include high-fiber foods such as corn,blueberries, cooked dried beans.Adapted with permission from University of Medicine and Dentistry of New Jersey.Intermaxillary fixation (wiring the maxilla and mandible together) may be necessaryafter major reconstructive jaw surgery or to immobilize a fractured jaw and may lastseveral weeks. During this period, patients may be at increased nutritional risk becauseof impaired eating ability. If the jaw wiring is prolonged, food intake may decreasedramatically. Weight loss is common after jaw fixation owing to the limited volume offood eaten. If patients have suffered injury, they will often be in negative nitrogen balanceas well, indicating breakdown of body protein and increased risk for malnutrition.A liquid or blenderized diet is generally indicated during jaw immobilization (59), andsix to eight small meals a day may be required to obtain adequate calories and protein.Blenderized liquid foods that can pass through a straw are generally well tolerated (60). Liquidsupplements given to healthy orthognathic surgery patients for 6 wk after surgery aidedpatients in maintaining nitrogen balance, body weight, and balanced nutrient intake (61).3.2. Tooth ReplacementThe overall risk for caries in individuals aged 45 and older has not decreased appreciably.The increase in restorative care needed between 1990 and 2030 will be highest inadults over the age of 44 yr (62). The prevalence of root caries and the number of restored