Solutions manure For The Dental Hygienist's
Guide to Nutritional Care, 6th Edition by 2025
Lisa F. Mallonee & Linda Boyd & Cynthia A.
Stegeman Chapter 1-21
A patient with scurvy presents with swollen, bleeding gums. Which nutrient is
deficient?
A. Vitamin A B. Vitamin C C. Vitamin D D. Iron
Answer: B. Vitamin C. Rationale: Vitamin C is required for collagen synthesis;
deficiency causes bleeding gingiva.
1. Which sugar substitute is noncariogenic and used in gum to stimulate saliva?
A. Sucrose B. Xylitol C. Glucose D. Fructose
Answer: B. Xylitol. Rationale: Xylitol is not fermented by oral bacteria and
reduces S. mutans.
2. Frequent sipping of acidic beverages primarily causes:
A. Caries B. Erosion C. Abrasion D. Attrition
Answer: B. Erosion. Rationale: Acid exposure dissolves enamel chemically,
leading to erosion.
,3. Best dietary advice to reduce caries risk from juice consumption:
A. Sip throughout day B. Drink with meals C. Bedtime juice allowed D. Replace
with candy
Answer: B. Drink with meals. Rationale: Consuming fermentable carbs at meals
reduces frequency of acid attacks.
4. Which vitamin is essential for calcium absorption and tooth mineralization?
A. Vitamin K B. Vitamin D C. Vitamin C D. Vitamin B12
Answer: B. Vitamin D. Rationale: Vitamin D facilitates intestinal calcium
absorption.
5. A vegan patient has glossitis and paresthesia. Which deficiency is likely?
A. B12 B. Vitamin C C. Niacin D. Iron
Answer: A. Vitamin B12. Rationale: B12 deficiency causes glossitis and
neurologic symptoms; vegans are at risk.
6. Best immediate action for a child with early childhood caries risk who bottles at
night:
A. Explain brushing only B. Recommend no bedtime bottle of milk/juice C.
Prescribe antibiotics D. Give candy after bottle
Answer: B. Recommend no bedtime bottle. Rationale: Prolonged exposure to
fermentable carbohydrates at night increases caries.
7. Which mineral deficiency can cause enamel hypoplasia?
A. Zinc B. Fluoride C. Calcium/phosphorus D. Potassium
Answer: C. Calcium/phosphorus. Rationale: Inadequate minerals during
development impair enamel formation.
8. Best counseling for a patient using chewing tobacco to reduce oral cancer risk:
A. Switch to cigarettes B. Encourage cessation and referral C. Use more tobacco
D. Reduce water intake
Answer: B. Encourage cessation and referral. Rationale: Tobacco cessation
reduces oral cancer and mucosal disease risk.
9. Which nutrient excess can cause xerostomia and mucosal dryness?
A. Vitamin C B. Vitamin A (hypervitaminosis A) C. Iron D. Vitamin B2
Answer: B. Vitamin A. Rationale: Hypervitaminosis A may cause dry, cracked
mucosa.
10.Primary cariogenic bacteria associated with smooth-surface caries:
A. Lactobacillus B. Streptococcus mutans C. Actinomyces D. Candida
Answer: B. Streptococcus mutans. Rationale: S. mutans initiates caries by
fermenting sugars and producing acid.
, 11.A patient with chronic alcohol use presents with glossitis and cheilosis. Likely
deficiency:
A. Thiamine (B1) B. Riboflavin (B2) C. B12 D. Vitamin D
Answer: B. Riboflavin. Rationale: Riboflavin deficiency causes angular cheilitis
and glossitis; alcoholics commonly deficient.
12.Best advice to reduce dental erosion from citrus fruit consumption:
A. Rinse with water after eating and avoid brushing immediately B. Brush
immediately C. Use bleaching D. Drink citrus at bedtime
Answer: A. Rinse with water and delay brushing. Rationale: Rinsing dilutes acid;
brushing immediately can abrade softened enamel.
13.Which macronutrient is most cariogenic per gram?
A. Protein B. Fat C. Carbohydrate D. Alcohol
Answer: C. Carbohydrate. Rationale: Carbohydrates, especially sugars, are
metabolized by bacteria to acids.
14.Best fluoride recommendation for a high-caries adult patient:
A. No fluoride needed B. Daily topical fluoride toothpaste and possible in-office
varnish C. Avoid fluoride entirely D. Use only mouthwash
Answer: B. Daily topical fluoride and varnish. Rationale: Topical fluoride
strengthens enamel and reduces caries.
15.Which condition increases risk for candidiasis in the mouth?
A. Antibiotic use B. High saliva flow C. Low carb diet D. Fluoride varnish
Answer: A. Antibiotic use. Rationale: Broad-spectrum antibiotics disrupt normal
flora, allowing Candida overgrowth.
16.Best dietary strategy to manage xerostomia:
A. Avoid fluids B. Sip water frequently and use sugar-free gum C. Eat sticky
candy D. Decrease saliva stimulants
Answer: B. Sip water and sugar-free gum. Rationale: Hydration and sugar-free
gum stimulate saliva and protect teeth.
17.Which dietary factor most contributes to root caries in older adults?
A. Low-carbohydrate diet B. Xerostomia and frequent carbohydrate exposure C.
High calcium intake D. Vegetarian diet
Answer: B. Xerostomia and carbs. Rationale: Reduced salivary flow exposes root
surfaces to cariogenic challenge.
18.A pregnant patient asks about fluoride safety. Best response:
A. Avoid fluoride entirely B. Use topical fluoride toothpaste; systemic
supplementation per provider C. Use unlimited fluoride supplements D. Fluoride
causes miscarriage
Guide to Nutritional Care, 6th Edition by 2025
Lisa F. Mallonee & Linda Boyd & Cynthia A.
Stegeman Chapter 1-21
A patient with scurvy presents with swollen, bleeding gums. Which nutrient is
deficient?
A. Vitamin A B. Vitamin C C. Vitamin D D. Iron
Answer: B. Vitamin C. Rationale: Vitamin C is required for collagen synthesis;
deficiency causes bleeding gingiva.
1. Which sugar substitute is noncariogenic and used in gum to stimulate saliva?
A. Sucrose B. Xylitol C. Glucose D. Fructose
Answer: B. Xylitol. Rationale: Xylitol is not fermented by oral bacteria and
reduces S. mutans.
2. Frequent sipping of acidic beverages primarily causes:
A. Caries B. Erosion C. Abrasion D. Attrition
Answer: B. Erosion. Rationale: Acid exposure dissolves enamel chemically,
leading to erosion.
,3. Best dietary advice to reduce caries risk from juice consumption:
A. Sip throughout day B. Drink with meals C. Bedtime juice allowed D. Replace
with candy
Answer: B. Drink with meals. Rationale: Consuming fermentable carbs at meals
reduces frequency of acid attacks.
4. Which vitamin is essential for calcium absorption and tooth mineralization?
A. Vitamin K B. Vitamin D C. Vitamin C D. Vitamin B12
Answer: B. Vitamin D. Rationale: Vitamin D facilitates intestinal calcium
absorption.
5. A vegan patient has glossitis and paresthesia. Which deficiency is likely?
A. B12 B. Vitamin C C. Niacin D. Iron
Answer: A. Vitamin B12. Rationale: B12 deficiency causes glossitis and
neurologic symptoms; vegans are at risk.
6. Best immediate action for a child with early childhood caries risk who bottles at
night:
A. Explain brushing only B. Recommend no bedtime bottle of milk/juice C.
Prescribe antibiotics D. Give candy after bottle
Answer: B. Recommend no bedtime bottle. Rationale: Prolonged exposure to
fermentable carbohydrates at night increases caries.
7. Which mineral deficiency can cause enamel hypoplasia?
A. Zinc B. Fluoride C. Calcium/phosphorus D. Potassium
Answer: C. Calcium/phosphorus. Rationale: Inadequate minerals during
development impair enamel formation.
8. Best counseling for a patient using chewing tobacco to reduce oral cancer risk:
A. Switch to cigarettes B. Encourage cessation and referral C. Use more tobacco
D. Reduce water intake
Answer: B. Encourage cessation and referral. Rationale: Tobacco cessation
reduces oral cancer and mucosal disease risk.
9. Which nutrient excess can cause xerostomia and mucosal dryness?
A. Vitamin C B. Vitamin A (hypervitaminosis A) C. Iron D. Vitamin B2
Answer: B. Vitamin A. Rationale: Hypervitaminosis A may cause dry, cracked
mucosa.
10.Primary cariogenic bacteria associated with smooth-surface caries:
A. Lactobacillus B. Streptococcus mutans C. Actinomyces D. Candida
Answer: B. Streptococcus mutans. Rationale: S. mutans initiates caries by
fermenting sugars and producing acid.
, 11.A patient with chronic alcohol use presents with glossitis and cheilosis. Likely
deficiency:
A. Thiamine (B1) B. Riboflavin (B2) C. B12 D. Vitamin D
Answer: B. Riboflavin. Rationale: Riboflavin deficiency causes angular cheilitis
and glossitis; alcoholics commonly deficient.
12.Best advice to reduce dental erosion from citrus fruit consumption:
A. Rinse with water after eating and avoid brushing immediately B. Brush
immediately C. Use bleaching D. Drink citrus at bedtime
Answer: A. Rinse with water and delay brushing. Rationale: Rinsing dilutes acid;
brushing immediately can abrade softened enamel.
13.Which macronutrient is most cariogenic per gram?
A. Protein B. Fat C. Carbohydrate D. Alcohol
Answer: C. Carbohydrate. Rationale: Carbohydrates, especially sugars, are
metabolized by bacteria to acids.
14.Best fluoride recommendation for a high-caries adult patient:
A. No fluoride needed B. Daily topical fluoride toothpaste and possible in-office
varnish C. Avoid fluoride entirely D. Use only mouthwash
Answer: B. Daily topical fluoride and varnish. Rationale: Topical fluoride
strengthens enamel and reduces caries.
15.Which condition increases risk for candidiasis in the mouth?
A. Antibiotic use B. High saliva flow C. Low carb diet D. Fluoride varnish
Answer: A. Antibiotic use. Rationale: Broad-spectrum antibiotics disrupt normal
flora, allowing Candida overgrowth.
16.Best dietary strategy to manage xerostomia:
A. Avoid fluids B. Sip water frequently and use sugar-free gum C. Eat sticky
candy D. Decrease saliva stimulants
Answer: B. Sip water and sugar-free gum. Rationale: Hydration and sugar-free
gum stimulate saliva and protect teeth.
17.Which dietary factor most contributes to root caries in older adults?
A. Low-carbohydrate diet B. Xerostomia and frequent carbohydrate exposure C.
High calcium intake D. Vegetarian diet
Answer: B. Xerostomia and carbs. Rationale: Reduced salivary flow exposes root
surfaces to cariogenic challenge.
18.A pregnant patient asks about fluoride safety. Best response:
A. Avoid fluoride entirely B. Use topical fluoride toothpaste; systemic
supplementation per provider C. Use unlimited fluoride supplements D. Fluoride
causes miscarriage
