Abstract
Diet and nutrition have a significant impact on oral health among adolescents. They affect the progression and development of oral diseases and other conditions such as periodontal disease, caries, and erosion. Nutrition ideally refers to the vitamins and minerals that comprise of micronutrients and macronutrients such as fats, proteins, and carbohydrates. Nutrition offers the body diverse nutritional needs. Diet refers to the specific foods consumed. The relationship between nutrition and diet on oral health is bidirectional. When the integrity of the oral cavity is compromised, it has a negative influence on adolescents' ability to eat. Epidemiological studies, clinical trials, and case-control studies have been essential in the provision of useful information. However, various nutrition studies exhibit differences in data reliability and interpretation (Pflipsen & Zenchenko, 2017) .
Many epidemiological studies that study the impact of diet and nutrition on the health of adolescents are mainly observationally creating the implications that the compared groups of adolescents have significant differences depending on several uncontrolled factors. Such epidemiological studies develop insights into the various nutritional factors that generate specific outcomes in adolescents' significantly huge populations. Poor nutrition and an unhealthy diet affect the growth of the jaws and teeth during adolescents. Dietary acids common in soft drinks are closely associated with dental erosion among adolescents. Various scientific researches indicate that there is a close association between free sugar intake and dental caries. Factors such as high sugar intake and under nutrition exacerbate caries. Tooth loss and dental carries have a negative impact on an adolescent's ability to eat and self-esteem (Pflipsen & Zenchenko, 2017) . This characteristic does not only happen among adolescents but also in older people. This paper aims to discuss the negative impacts of poor diet and nutrition on the oral health of adolescents and the cost of treatment implications.
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Body
Oral diseases among adolescents are highly prevalent in European countries. However, the diseases are not communicable. According to statistics by the world health organization, an estimated 20 to 90 % of children above the age of 6 years have dental caries (Pflipsen & Zenchenko, 2017) . Inequalities have contributed significantly to oral health deterioration. The economic disadvantages adolescents have limited access to healthy diet and nutrition. Access to dental care and treatment among these vulnerable adolescents is also limited. Mouth diseases comprise of a huge economic burden to the healthcare facilities. Treatment of dental diseases is significantly high, comprising 5-10% of the overall health care expenditure in European countries (Peres et al., 2019) . The most common oral health challenges among adolescents in European countries include dental erosion, dental caries, and periodontal disease.
According to the national health and nutrition examination survey, 59% of the adolescents between the ages of 12 and 19 have developed dental caries in their permanent teeth. Hispanic adolescents are largely affected by dental carries due to low levels of income in their families. The low-income characteristics hinder access to a healthy diet and nutrition. There have been more cases of tooth decay that remain untreated among Hispanic adolescents. Black adolescents are also vulnerable due to low-income characteristics hindering access to a healthy diet and nutrition. The action of acids available in sugary foods results in loss of teeth; a condition referred to as dental caries. Initially, dental cavities exhibit no symptoms in adolescents at the early stages. The advanced stages of dental cavities are characterized by sepsis, pain, and infections—the final stage results in the extraction of the teeth. Dental erosion is an oral health challenge characterized by progressive loss of tooth substances that are etched away by dietary acids. Carbohydrates have high sugar content, and as a result, they are closely associated with dental caries among adolescents. Dental erosion continuously reduces the size of the teeth, eventually resulting in total tooth destruction (Peres et al., 2019) .
Periodontal disease is common among adolescents who practice poor oral hygiene and consume tobacco. However, scientific research illustrates a close correlation between diet and periodontal disease. Adolescents who are malnourished have high chances of developing periodontal disease. The deficiency of vitamin C results in the development of scurvy related periodontitis. Adolescents comprise of the highest consumers of foods and drinks that are rich in sugar. Such foods include cakes, confectionaries, sucrose, and honey, among others. The world health organization recommends a reduction in the intake of sugary foods among adolescents to reduce the cases of oral health diseases among adolescents and adults.
Gingival is a common oral health problem among adolescents. The disease is characterized by gum inflammation. The disease is caused by bacteria and plaque action on teeth resulting from low dental hygiene. Gingival is a type of periodontal disease that is non-destructive. If untreated, gingivitis can lead to eventual tooth loss. Practicing oral hygiene by brushing the teeth helps to control gingivitis (Gondivkar et al., 2019) . Oral health practices that help resolve gingivitis challenges include longer brushing, more frequent brushing, and flossing. The use of antiseptic mouthwash is also helpful.
Increased risk of dental treatment
In many developed countries, oral diseases comprise the fourth most expensive disease in the treatment process. In the year 2014, the costs of spending on oral diseases were estimated to be more than 113 billion dollars in the United States. The high costs of oral health treatment comprise of both curative and preventive. There has been a reduction in dental caries among adolescents by offering access to healthy diets and nutrition education programs. The costs of direct healthcare expenditures cover about 6% of the total healthcare expenses while the indirect costs are relatively higher. Oral diseases result in low concentration and absence from school by adolescents. Research indicates that over 51 million hours are lost in schools due to oral diseases (Peres et al., 2019) .
My plate is a program that encourages adolescents and adults in the United States to adopt healthy nutrition and diets to facilitate their lifetime health (MyPlate, 2017) . The program places emphasis that whatever a person drinks or eats matters with the right diet and nutrition, offering healthier people now and in the future. The beverages and foods chosen should be less fat saturated with low sugar levels and sodium levels. The program recommends that fruits are healthy in facilitating oral health. The fruits can be taken dried, frozen, canned, or can be whole. The amount of fruits taken depends on the sex, age, and physical activity levels (ChooseMyPlate, 2020) . Adolescents have relatively higher levels of physical activities compared to other age groups. They need a higher amount of fruits than the other age groups. Fruits are rich in vitamins and minerals that facilitate the development of healthy gums and teeth among adolescents and general oral health. Vitamin C is common in many fruits; it is very critical in keeping teeth strong and healthy gums. The other category of foods is vegetables. As stated in the fruits category, vegetables are important vitamins A and C, which facilitate oral health (Weisenberger & FAND, 2018) .
Conclusion
Oral diseases are common among adolescents in the United States. The high cases of oral diseases among adolescents are associated with diet and nutrition. Poor nutrition and diet have encouraged an increase in oral diseases among adolescents. Lack of access to healthy nutrition and diet is common among vulnerable adolescents from poor family backgrounds with low levels of income. Many adolescents also favor taking foods and drinks that have high sugar content. The high sugar content affects their teeth and gum development. The costs of treatment of oral diseases have remained relatively high in the United States. The Myplate program provides guidance on both preventive and curative measures in increasing oral health. Through the program, the government educates people on the most favorable nutrition and diets that encourage good oral health.
References
Pflipsen, M., & Zenchenko, Y. (2017). Nutrition for oral health and oral manifestations of poor nutrition and unhealthy habits. Gen Dent , 65 (6), 36-43.
Peres, M. A., Macpherson, L. M., Weyant, R. J., Daly, B., Venturelli, R., Mathur, M. R., ... & Benzian, H. (2019). Oral diseases: a global public health challenge. The Lancet , 394 (10194), 249-260.
Gondivkar, S. M., Gadbail, A. R., Gondivkar, R. S., Sarode, S. C., Sarode, G. S., Patil, S., & Awan, K. H. (2019). Nutrition and oral health. Disease-a-Month , 65 (6), 147-154.
Nutrients and health benefits | ChooseMyPlate . Choosemyplate.gov. (2020). Retrieved 25 May 2020, from https://www.choosemyplate.gov/eathealthy/vegetables/vegetables-nutrients-health .
MyPlate, C. (2017). Choose MyPlate.
Weisenberger, J., & FAND, C. (2018). Choose MyPlate Printable Handout. Energy .
