CARBOHYDRATES

Katrina A. Hernandez, DMD

OLFU, College of Dentistry
 Carbohydrates
main source of energy

providing 4 kcals per gram

also essential for the oxidation of fats

synthesis of certain non-essential amino acids

 Main source of carbohydrates:

Starch Sugar Cellulose

Most important Monosaccharides - Indigestible component

carbohydrate in the glucose, fructose and of carbohydrate
human diet galactose substance that exists in
Disaccharides - sucrose, the cell walls of plants
lactose and maltose and is used to make
paper, plastic, and
various fabrics and fibres
 • Energy Production
• Energy Storage
• Building Macromolecules
Function: • Sparing Protein
• Lipid Metabolism
 Glucose is the main
E n ergy source of energy for
your body
 If the body already has enough
energy to support its functions,
the excess glucose is stored as
glycogen
Energy
Storage
 Building Macromolecules
A l t h o u g h m o s t a b s o r b e d g l u c o s e i s u s e d t o m a k e e n e r g y,

some glucose is converted to ribose and deoxyribose, which

are essential building blocks of important macromolecules,

s u c h a s R N A , D N A , a n d AT P .
 Sparing Protein
In a situation where there is not enough glucose to meet the body’s needs, glucose

is synthesized from amino acids.

 Lipid Metabolism
This is because an increase in blood glucose stimulates release of the hormone

insulin, which tells cells to use glucose (instead of lipids) to make energy.
 Hyper and Hypo States

Normal physiological conditions and

disease state affect carbohydrate
metabolism which is reflected in
serum glucose levels.
 Hyper and Hypo States
A blood glucose level that is elevated above
120mg/dl is known as H Y P E R G LY C E M I A

A blood glucose level that is below 70mg/dl is known as H Y P O G LY C E M I A

Dental Management
 Hypoglycemia

• An appointment scheduled after a meal or snack is recommended for

those patients who are at risk of hypoglycemia.

• To avoid hypoglycemic episodes during a dental procedure, including a

prophylaxis, blood glucose values are to be obtained.
 Hypoglycemia

• If the blood glucose value is above 70 mg/dL, the patient should

consume a meal or snack to prevent recurrence of hypoglycemia
before proceeding with dental treatment.

• Common symptoms of an alert level of hypoglycemia include:

shakiness, irritability, confusion and hunger, while symptoms of
severe hypoglycemia include loss of consciousness, seizures and
coma.
 Hyperglycemia
• Prior to initiating any invasive dental treatments, blood glucose levels of
patients with diabetes should be less than 200 mg/dL.

• Blood glucose levels tend to be more stable in the morning; therefore,

morning appointments may be more beneficial for this patient.

• Stress reduction techniques, such as use of headphones, and short

appointments may help keep blood glucose levels from rising
 Hyperglycemia
• The dental patient with uncontrolled hyperglycemia may require
prophylactic antibiotic therapy.

• Systemic antibiotic therapy or topical antimicrobial therapies are

accepted treatment modalities for aggressive treatment of oral
infections
 Carbohydrate Excess
Evidence based on the scientific literature indicates that sugar

consumption at typical levels does not directly contribute to any

chronic health or behavioral problems UNLESS excessive sugar

consumption results in energy imbalance and weight gain.

C A R B O H Y D R AT E E F F EC T
O N O R A L H EA LT H
 the most frequently consumed form of
sugar
SUCROSE can lower the ph of dental plaque,
hastening the dissolution of the enamel

“arch-criminal” in the dental caries

formation
• The presence of sucrose and other
carbohydrates in the mouth increases the
volume and rate of plaque formation

• Even low amounts of sucrose in the mouth

promote the production of polysaccharides
(glucans) by streptococcus mutans
• the bacteria found in dental plaque permit
adherence of bacterial colonies to the
tooth
 ADA has recommended that fermentable carbohydrates

usually consumed frequently or repeatedly (chewable tablets,

cough drops, breath mints) be replaced with products

containing non-cariogenic sweeteners.

Despite the difference in the sugar content of carbonated

beverages, fruit drinks, and juices (about 10%), and sport

drinks (about 4.4% sugars), all appear to have similar

cariogenic potential.
 EROSION
• Tooth erosion occurs when the
tooth is repeatedly exposed to an
acidic food or liquid.

• can also occur with diet sodas.

• The enamel gradually dissolves

and the outer layer is removed
with frequent exposure to acidic
liquids.