Nutritional Counseling for Tooth Decay

Overseen By Tami Terri

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Loma Linda University

Disqualifiers: Under 18, Less than 20 teeth

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether nutritional counseling can help reduce sugar intake, snacking, and tooth decay (including cavities and other dental issues). Participants will either receive advice based on Stephan's Curve (a method to guide eating habits) or have their dental health monitored. Suitable candidates are over 18, have at least 20 teeth, and are available for the study. As an unphased trial, this study provides a unique opportunity to contribute to innovative research on dental health and nutrition.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that nutritional counseling is safe for reducing tooth decay?

Research has shown that nutritional counseling is generally safe. This guidance helps individuals make better eating choices and carries very low risk. It does not involve medication or medical procedures, so serious side effects are unlikely.

For dental health, nutritional counseling emphasizes reducing sugar intake and snacking less often, as these habits can lead to tooth decay. Since these changes aim to improve diet, the main "risk" might be adjusting to new eating habits. No negative effects from nutritional counseling itself are known.

Prospective participants in a trial that includes nutritional counseling can feel confident in its safety and tolerability based on current research.

Why are researchers excited about this trial?

Researchers are excited about nutritional counseling for tooth decay because it takes a preventative approach by focusing on dietary habits. Unlike traditional treatments that often involve fluoride treatments or dental fillings to address existing decay, this method aims to reduce decay risk by educating patients on minimizing sugar intake and snacking frequency. This innovative counseling is based on Stephan's Curve, which helps individuals understand how their eating habits affect their oral health, potentially leading to better long-term dental outcomes.

What evidence suggests that nutritional counseling is effective for reducing tooth decay?

This trial will compare the effects of nutritional counseling with a control group. Studies have shown that nutritional counseling can significantly reduce severe early childhood cavities by 32%. This approach offers more than basic advice; it provides detailed guidance on diet and nutrition. Research indicates that consuming high amounts of sugar and certain carbohydrates increases the risk of tooth decay. By focusing on reducing sugar intake and improving snacking habits, nutritional counseling helps decrease cavities and other dental issues. Overall, this method has proven more effective in improving oral health compared to simpler nutritional advice. ^{1 2 3 4 5}

Who Is on the Research Team?

So Ran Kwon, DDS, MS, PhD, MS

Principal Investigator

Loma Linda University

Are You a Good Fit for This Trial?

This trial is for adults over 18 who can read and speak English, are willing to follow the study rules, and are available during the study period. It's designed for those with tooth decay issues like cavities or extensively decayed primary molars.

Inclusion Criteria

I am available for the duration of the study.

I will follow the study's rules and procedures.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Baseline Assessment

Participants provide personal health history and undergo an oral examination to assess dental health through a DMFT score. Daily added sugar consumption is calculated using the 'Sugar Intake calculator'.

1 day

1 visit (in-person)

Intervention

Participants in the intervention group receive nutritional counseling using Stephan's curve. All participants track daily snacking frequency and type/amount of snacks.

2 weeks

Follow-up

Participants return for a follow-up to evaluate changes in dental health, sugar consumption, and snacking habits.

1 day

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Nutritional Counseling

Trial Overview The trial is testing a nutritional counseling tool aimed at reducing sugar intake and snacking frequency. The effectiveness will be measured by changes in participants' Decayed, Missing, and Filled Teeth (DMFT) scores.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Visual assessment of DMFT, added sugar consumption calculation, frequency of snacking calculation, plus Stephan's Curve-based nutritional counseling.

Group II: Control Active Control 1 Intervention

Visual assessment of DMFT, added sugar consumption calculation, frequency of snacking calculation.

Who Is Running the Clinical Trial?

Loma Linda University

Lead Sponsor

Trials

322

Recruited

267,000+

Published Research Related to This Trial

Nutrition plays a crucial role in oral health, with deficiencies like vitamin B impacting dental health and potentially worsening conditions like periodontal disease.

Dentists and hygienists can help identify patients at risk for nutritional deficiencies through examinations and provide guidance on healthy eating and reputable nutrient supplements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition and oral health. Dorsky, R.[2006]

Dental healthcare providers should expand their understanding of 'dental nutrition' to include not just the impact of food on dental diseases like cavities and gum disease, but also the overall nutritional health of their patients.

The article reviews recent nutrition guidelines from major U.S. health organizations and evaluates how these recommendations can be applied to improve the dietary habits of dental patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition update for the dental health professional. Karp, WB.[2005]

Diet and nutrition play a crucial role in oral health, as oral tissues depend on the nutrients derived from food for their health and function.

Incorporating diet and nutrition counseling into dental care programs is essential for preventing and managing oral diseases linked to nutritional deficiencies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary and nutritional counseling in the prevention and control of oral disease. Dreizen, S.[2008]

A survey of 79 dental nutrition experts revealed a lack of consensus on the appropriate scope of nutrition services in clinical dentistry, highlighting the need for standardized guidelines.

The study emphasizes the importance of diet assessment and counseling as key elements of preventive dental care, suggesting that improving nutrition services could enhance patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Expert opinions on nutrition issues in clinical dentistry. Palmer, CA., Dwyer, J., Clark, RE.[2015]

Patients with complex medical histories often face high nutritional risks that can negatively affect their oral health, highlighting the need for better nutritional assessment in dental care.

Dental hygienists play a crucial role in identifying patients who need nutritional intervention, enabling them to provide counseling and referrals that can enhance both oral and overall health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guidelines for nutrition screening, assessment, and intervention in the dental office. Boyd, LD., Dwyer, JT.[2016]

Older dental patients are at a higher risk of malnutrition due to various factors, including oral impairments that affect their ability to eat, which can lead to a decline in nutrition.

Dental teams should actively screen for nutritional risk factors and provide tailored dietary guidance to help patients maintain adequate nutrition, including referrals to registered dietitians when necessary.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Gerodontic nutrition and dietary counseling for prosthodontic patients. Palmer, CA.[2019]

Good nutrition is essential for maintaining healthy dental and oral structures, and nutrition counseling can help prevent dental diseases like caries caused by poor dietary choices.

The paper emphasizes the role of sucrose as a highly cariogenic food and discusses the importance of fluoride supplementation and collaboration between physicians and dentists to effectively prevent dental issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition and its importance in dental health. Braham, RL., Barkin, PR., Morris, ME., et al.[2013]

Nutrition status and oral health are closely linked, with malnutrition potentially affecting tissue integrity and recovery from infections, highlighting the importance of nutrition screening in dental practices.

Implementing a nutrition screening program in dental settings can lead to improved oral and overall health, better treatment outcomes, and enhanced communication with patients regarding their dietary needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical and laboratory assessment of nutrition status in dental practice. Touger-Decker, R.[2019]

Nutritional care plays a crucial role in preventing dental caries and periodontal diseases, especially as these issues are increasingly affecting younger individuals due to modern lifestyle factors.

The author proposes a new approach to assess dietary influences on dental health, aiming to identify specific nutritional factors that contribute to caries and provide tailored dietary advice for individuals already experiencing tooth decay.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Nutritional care and guidance in caries active patients]. Wetzel, WE.[2016]

Dental professionals can play a crucial role in identifying children at high risk for nutritional and oral health issues, particularly those born prematurely or with conditions like failure to thrive and developmental delays.

The study provides specific nutrition and oral health guidelines to help dental practitioners implement preventive interventions for these vulnerable children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Managing oral health related nutrition issues of high risk infants and children. Boyd, LD., Palmer, C., Dwyer, JT.[2004]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/20406273/

Long-term effectiveness of a nutritional program in ... Severe early childhood caries incidence was reduced by 32% (RR 0.68; 95% CI 050-0.92). The mean number of affected teeth was lower for the intervention group ( ...

2. ada.org ada.org/resources/ada-library/oral-health-topics/nutrition-and-oral-health

Nutrition and Oral Health An overview of the bidirectional relationship that exists between oral health and diet and nutrition.

3. mdpi.com mdpi.com/2076-3417/13/24/13254

Nutritional Factors Associated with Dental Caries across ... Comprehensive nutritional therapy encompassing counseling has demonstrated greater efficacy compared to simple nutritional guidance [98].

4. equityhealthj.biomedcentral.com equityhealthj.biomedcentral.com/articles/10.1186/s12939-024-02279-0

Every bite counts to achieve oral health: a scoping review on ... The interplay of oral health with nutrition is pivotal; diets high in sugars and fermentable carbohydrates exacerbate the risk for dental caries ...

5. frontiersin.org frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1534525/full

The need for effective interprofessional collaboration ... The purpose of this paper is to review the current evidence of nutritional counseling in oral health settings compared to the medical model.