Nutrition and Dentition

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Background

Foods are made up of different nutrients. These nutrients include but are not limited to vitamins, minerals, carbohydrates, protein, and fat. Each of these nutrients is necessary to maintain a healthy, functioning body.

Chewing is one of the first steps a person does to eat their food and get these nutrients. There are 32 teeth in the mouth, sixteen on the top and bottom. When talking about the state or condition of teeth, we are talking about dentition. When an individual has a lack of teeth, they are edentulous. These words are used throughout this article to describe teeth.

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The Issue

Dentition in older adults can highly affect nutritional status 7, 11. The aim of this article is to review the nutritional status for older adults who have either decreased or complete lack of teeth. While oral health is important for all ages, it is especially important in the elderly population.

According the Center for Disease Control, 1 in 5 individuals aged 65 years or older have lost their teeth6. This leaves individuals at a greater risk for a number of health issues including malnutrition and increased risk of chronic diseases 1,7,9,11. Malnutrition is defined in multiple ways, however, it is generally known as a “lack of nutrition” due to a decreased food intake 10. Food intake is important because it contains nutrients that are essential for body function.

There are modified texture diets such as mechanical soft, pureed, and chopped meat, which change the consistency of food and make it easier to chew. However, those without teeth have a lower intake of fruits and vegetables, due to the tough texture of these foods 1, 3. These foods have a greater amount of nutrients that are necessary to a healthy diet.

Dentures or artificial teeth can be an option for edentulous individuals. There are partial and full dentures, however, those can be painful, expensive, and fit poorly. This issue is not just prevalent in the United States but worldwide.

The Evidence

Research has shown that poor dentition can play a important role in food intake and quality 1, 5, 7,9,11. Finding that smokers and individuals with a lower level of education have a greater risk of periodontal disease, a disease of the gums and mouth11. They were also less likely to consume adequate servings of fruits and vegetables, leading to decreased overall food intake 11. Lower food intake over a period can lead to loss of lean body mass and malnutrition4. This can lead to a disease known as sarcopenia, which is a loss of lean tissue mass with that comes with age 4. Edentulous individuals that consume decreased amounts of fruits and vegetables are at a higher risk for Type 2 Diabetes and heart disease 1, 7,9,11. These are lifelong diseases that can affect the heart and the body’s ability to process sugar 2. This begs the question, what can be done preventatively to improve oral health?

Evidence has also shown that poor dentition can be related to poor nutrition through anxiety and fear 1. Imagine going to lunch with friends, and not knowing if a restaurant will have food you will be able to eat, so you don’t eat lunch. These are the concerns that can lead to malnutrition and put older individuals at risk for hospitalization related to chronic diseases.

Recently, a study published in 2014 found that, those with less than 21 teeth, which was defined as ‘poor dentition’, was linked to decreased protein, micronutrient, and dietary fiber intake 1, 11. Educating the older population on appropriate oral health care as well as options to main appropriate nutritional status may be key to decreasing hospitalizations and preventing malnutrition.

Summary

There is clear evidence of an increased risk of type 2 diabetes and heart disease when dentition is poor in the elderly population 1, 7,9,11. This can be related to multiple factors, which include living situation and the type of job they have as well as overall health status, and poor oral health habits. Some of these factors listed above are related to habits formed at a young age. While this was not discussed in detail, perhaps some preventative measures can help with to increase oral health and prevent dental issues later on in life. As well the need for education and counseling for the older population to make them aware of the dental issues.

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