Interrelationship between dental health status and nutritional status among elderly subjects in India

Abstract

Background:Poor dental health status has been suggested to negatively impact the food selection, ultimately leading to malnutrition.Objective:This study was undertaken to assess the association of dental health and nutritional status among elderly subjects in India.Methodology:A community-based cross-sectional study was conducted during 2015–2016 in district Nainital, Uttarakhand state, India. A total of 1003 elderly population were enrolled from 30 clusters (villages) identified using population proportionate to size sampling methodology. Information on sociodemographic profile and anthropometric measurements was collected. Body mass index (BMI) and Mini Nutritional Assessment scale (MNA) were calculated for assessment of nutritional status. A trained professional assessed the dental health status through physical examination. Dietary intake data was collected using 24-h dietary recall methodology.Results:We found that the prevalence of complete edentulism was 11%. Use of dentures was reported among only 9.6% subjects who were completely edentulous. Prevalence of underweight as defined by BMI and malnutrition as defined by MNA was higher among subjects with complete loss of teeth complete loss of teeth and chewing problems chewing problems and who did not wear dentures when compared with others. Subjects who wore dentures had significantly lower prevalence of malnutrition when compared with subjects who did not wear dentures.Conclusion:Dental health status was significantly associated with poor nutritional status among elderly subjects in India. There is a need for providing restorative dental healthcare services to elderly population to improve their nutritional status.

Edentulism and all–cause mortality among Brazilian older adults: 11–years follow–up

“…13,24 Among present-day Brazilian older adults, this could be partially true because their teeth were lost in early adulthood. 5 However, poor nutritional status, that is also related to edentulism, [8][9][10] predicts chronic inflammation and circulatory diseases 32 and, hence, higher mortality. 11,22,33 The second pathway places edentulism and mortality at their final points and lists nutritional factors as their mediator.…”

“…This is because tooth loss, edentulism, and related chewing problems affect nutritional behaviors (decrease in protein and fiber intake and increase in fat, carbohydrate, and processed food intake) and predispose individuals to malnutrition, underweight, or even overweight/obesity. [8][9][10] Both poor nutritional status and obesity predict all-and specific-cause mortality. 22,33 In our study, the association between edentulism and all-cause mortality was attenuated by 12.8% after adjusting for nutritional status, but remained significant.…”

“…16,22 Studies assessing the association between tooth loss and malnutrition using nutritional assessment measures other than those based on BMI have demonstrated stronger associations. 9,10 Similarly, the association between oral health and mortality after adjusting for nutritional factors, including serum albumin level 24 or nutrient intake, 12 resulted in greater attenuation than in studies using BMI. 13,34 This could be because underweight captures only the information on body mass, but cannot qualify the loss.…”

“…3 Prevalence of edentulism depends on the region 4 and sociodemographic characteristics of the individual, 5,6 approximating to 10% in those aged ≥50 years worldwide 7 and 54% in Brazilian adults aged 65-74 years. 5 Edentulism is considered a disability, 2 affecting the quality of life, 1 nutritional aspects, 8,9,10 and morbidity of the individual. 6 Furthermore, several cohort studies 11,12,13,14,15 and recent systematic reviews 4,16,17 have reported reduced survival rates among older edentulous individuals.…”

“…states that edentulism and related chewing problems predispose individuals to poor nutritional intake, 8 and malnutrition. 10 Furthermore, tooth loss could carry effects from a previous low-grade chronic inflammation due to periodontal disease, 3,19 which, together with "inflammaging", 20 increases the risk for arteriosclerotic diseases. 11,21,22 Both malnutrition and chronic inflammation predict lower survival rates 23 and have been used to adjust the relationship between oral impairments and mortality in some studies, 12,13,21,24 although evidence of this association remains unclear.…”