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Kaurani P, Kakodkar P, Bhowmick A, Samra RK, Bansal V. Association of tooth loss and nutritional status in adults: an overview of systematic reviews. BMC Oral Health 2024; 24:838. [PMID: 39049002 PMCID: PMC11267674 DOI: 10.1186/s12903-024-04602-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Association of tooth loss and nutritional status has been widely researched with conflicting results. This overview aimed to analyse and summarize findings from systematic reviews on association of tooth loss with nutritional status, in view of their quality assessment and methodological characteristics. METHODS Overview was conducted as per Cochrane Overviews of Reviews guidelines. 5 databases (PubMed, Dentistry and Oral Sciences Source, Scopus, Cochrane Register of Systematic Reviews, Epistemonikos.org) and one online source (Google Scholar) were searched for systematic reviews published between 2010 - July 2022, with inclusion criteria; population: participants aged 18 years or above, intervention/exposure: loss of teeth, comparison: not applicable, outcome: nutritional status, study: systematic reviews and meta-analysis. Reviews on association of prosthetic interventions with nutritional status were not included. Data were extracted for study characteristics, details of primary studies, and main findings. Narrative synthesis of data, overlap of primary studies and quality assessment of studies were done using AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews). RESULT Of 1525 articles found, seven systematic reviews were selected (four were systematic reviews, three were systematic reviews with meta-analysis). Five studies showed some or positive association, one found weak association and for one study the association was unclear. Overlap of primary studies was 'very slight'. Meta-analysis of two studies concluded fully or partially edentulous individuals were more likely to be malnourished or at risk of malnutrition, (RR = 1.095, 95% CI 1.007 to 1.190, p = 0.033. RR = 1.22; 95% CI 1.11 to 1.32 p < 0.01), but one found that edentulism was not associated with malnutrition. (RR = 1.072, 95% CI 0.9657-1.200). Quality assessment revealed four studies were 'high', one was 'low' and two were 'critically low.' CONCLUSION This overview confirms the association between tooth loss and nutritional status specially in elderly. It is evident that tooth loss increases the likelihood of poor nutritional status. Overall, studies show high heterogeneity in the methodology and quality assessment reveals low confidence in the available evidence. Future studies should use standard assessment tools for tooth loss and nutritional status.
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Affiliation(s)
- Pragati Kaurani
- Department of Prosthodontics and Crown & Bridge, Mahatma Gandhi Dental College and Hospital, Jaipur, India
| | | | - Anamitra Bhowmick
- West Bengal University of Health Sciences, Kolkata, West Bengal, India
| | - Rupandeep Kaur Samra
- Department of Prosthodontics and Crown & Bridge, DJ College of Dental Sciences and Research, Modinagar, Ghaziabad, Uttar Pradesh, 201204, India.
- , House no.10, Doctor's Colony, Bhadson Road, Patiala, Punjab, 147001, India.
| | - Vineeta Bansal
- Department of Clinical Nutrition and Dietetics, Mahatma Gandhi Medical College and Hospital, Jaipur, India
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2
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Brígido JA, de Oliveira da Rosa WL, Lund RG. The effect of prosthetic rehabilitation with or without dietary advice on nutritional status in elderly patients: a systematic review. Aging Clin Exp Res 2023; 35:2399-2411. [PMID: 37837498 DOI: 10.1007/s40520-023-02578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/24/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Elderly people frequently report tooth loss, affecting their nutritional status. There is a gap in the scientific evidence about the influence of prosthodontic rehabilitation on nutritional status. OBJECTIVE To investigate the influence of prosthodontic rehabilitation combinates or not with dietary advice on nutritional status in elderly patients. METHODS A systematic literature search was conducted in three electronic databases to identify randomized clinical trials that evaluated the effect of prosthetic rehabilitation on nutritional status in subjects aged 60 years or older, with a follow-up of at least 1 month after prosthesis rehabilitation. RESULTS Of the 1517 articles identified in the initial search, 12 were selected for the final review. No significant difference between the types of prosthesis were found regarding the chewing by the elderly population. Although patients who received prosthetic treatment had significant improvement in chewing ability, a consistent pattern of improvement in nutritional status was not observed when they did not receive dietary advice. In addition, the association between the condition of the dentition, the masticatory performance and nutritional change of elderly patients has been found. Studies that evaluated simultaneous complete denture treatment and simple dietary advice showed an improvement of nutrient intake in elderly patients. CONCLUSIONS Isolated prosthetic rehabilitation may not have the effect of exerting a change in nutritional status of edentulous elderly patients. In general, simultaneous dietary consulting and prosthetic treatment in combination may improve dietary habits, since masticatory capacity and efficiency are not the only factors that influence the nutritional status of a patient.
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Affiliation(s)
| | - Wellington Luiz de Oliveira da Rosa
- Pelotas Dental School, Graduate Program in DentistryFederal University of Pelotas (UFPEL) Rio Grande do Sul, R Gonçalves Chaves 457, Pelotas, 96015-560, Brazil
| | - Rafael Guerra Lund
- Pelotas Dental School, Graduate Program in DentistryFederal University of Pelotas (UFPEL) Rio Grande do Sul, R Gonçalves Chaves 457, Pelotas, 96015-560, Brazil.
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3
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Funke N, Fankhauser N, Mckenna GJ, Srinivasan M. Impact of shortened dental arch therapy on nutritional status and treatment costs in older adults: a systematic review. J Dent 2023; 133:104483. [PMID: 37001792 DOI: 10.1016/j.jdent.2023.104483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE This review was undertaken to evaluate, whether a shortened dental arch (SDA) was a good alternative to a conventional prosthodontic rehabilitation (RPD) in older adults when nutritional and economic factors are compared. DATA A total of 92 studies were included for the full-text analysis, and finally 4 reports from two RCTs qualified for data extraction and analysis. The final search update was performed on 06.11.2022 and no further searches and updates were performed after this date. SOURCES Electronic databases [PubMed (MEDLINE), Embase, CENTRAL] were systematically searched to identify studies comparing nutritional and economic outcomes in partially edentate adults rehabilitated with conventional RPD and SDA therapy. STUDY SELECTION Studies were excluded if there were less than 10 participants per group, and if the subjects were not clinically followed up in recall visits. Two investigators performed the data extraction and were reciprocally blinded. Inter-investigator reliability was assessed using Cohen's unweighted kappa (κ). A meta-analysis could not be performed and the results were reported qualitatively. RESULTS The calculated κ ranged between 0.80 and 1.00. Three reports from two studies reported on nutritional outcomes and one report provided information on economic benefits, when comparing between the SDA therapy and conventional prosthodontic rehabilitation. No significant difference was recorded in the nutritional status of patients rehabilitated using the SDA concept compared with RPDs. Higher costs for treatment provision and maintenance for patients in the RPD group was found when compared to SDA treatment. CONCLUSIONS This systematic review identified the shortened dental arch concept as a reasonable alternative to the conventional prosthodontic rehabilitation where cost-effectiveness and nutrition are concerned based on the limited evidence obtained from current literature. CLINICAL SIGNIFICANCE SDA therapy may be considered as a feasible treatment concept in older adults especially in those with complex medical statuses and limited finances.
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Yan GLK, Tan MN, Wong ML, Tay CM, Allen PF. Functional Dentition, Chronic Periodontal Disease and Frailty in Older Adults-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:502. [PMID: 36612820 PMCID: PMC9819030 DOI: 10.3390/ijerph20010502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The likelihood of experiencing the impact of chronic disease rises with age, and cumulative functional deficits over time increase the risk of frailty in older adults. The exact causes of frailty are not clear, and research is needed to identify appropriate intervention measures to reduce risk of developing frailty in old age. OBJECTIVE To review the evidence on the relationship between frailty, dental status and chronic periodontitis and to determine if improvements in oral health of older adults can contribute to reversal of frailty. RESULTS The oral cavity is the entry point to the gastro-intestinal tract, and natural teeth facilitate efficient mastication of food prior to swallowing and subsequent digestion. The loss of natural teeth, which is gradual and cumulative over the life course, is associated with diminished nutritional intake, especially in older adults. Furthermore, chronic periodontitis has been postulated as a risk factor for frailty. The evidence supporting a strong relationship between oral health status and frailty is not clearcut. Cross sectional studies suggest an association with missing teeth and chronic periodontal inflammation. However, there are very few longitudinal studies and accordingly, it is not currently possible to claim a causal relationship. As yet, there is no evidence to suggest that improvements in oral health contribute to reversal of frailty. CONCLUSION Longitudinal studies with robust designs are required to better inform the relationship across functional dentition, chronic periodontitis and frailty in older adults.
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Affiliation(s)
- Gabriel Lee Keng Yan
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Mei Na Tan
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Mun Loke Wong
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Chong Meng Tay
- National University Centre for Oral Health, Singapore 119085, Singapore
| | - Patrick Finbarr Allen
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
- Department of Restorative Dentistry, Cork Dental School and Hospital, University College Cork, T12 DC4A Cork, Ireland
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5
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Khoury C, Samot J, Helmer C, Rosa RW, Georget A, Dartigues JF, Arrivé E. The association between oral health and nutritional status in older adults: a cross-sectional study. BMC Geriatr 2022; 22:499. [PMID: 35689206 PMCID: PMC9188061 DOI: 10.1186/s12877-022-03133-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/09/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives This work aimed to describe the nutritional status of French older adults (age ≥ 90 years) and studied the association between oral health and nutritional status. Methods A cross-sectional study was carried out in 2014 among the participants of a cohort on cerebral and functional aging in France at their 25-year follow up (the PAQUID cohort). Nutritional status (Mini Nutritional Assessment [MNA]) and oral health status (number of decayed, missing, and filled teeth [DMFT], number of posterior occluding pairs, xerostomia [Xerostomia Inventory], and prosthetic rehabilitation) were recorded at the participants’ living places by two dentists. Univariate and multivariate logistic regressions were used to explore the association between oral health and nutritional status, with adjustments for potential confounders. Odds ratios (OR) were estimated with their 95% confidence interval (CI). Results 87 participants were included in the analyses: 74.7% were females and the mean age was 94.1 years (± 3.0). Malnutrition or risk of malnutrition (MNA < 24) was present in 23 participants (26.4%), with only one having malnutrition. The mean DMFT score was 26.5 (± 5.3). The mean number of posterior occluding pairs was 1.5 (± 2.3). Twenty-one participants had xerostomia (24.1%). Only 8.1% of the participants had all their teeth or adequate dentures; 47.1% had inadequate dentures, while 44.8% had no dentures despite tooth loss. After adjustment, xerostomia (OR = 8.79; 95% CI = 2.38–39.10; p = 0.002) was found to be associated with malnutrition or risk of malnutrition. Conclusion Being at risk of malnutrition was common among people ≥ 90 years old and was associated with xerostomia. NCT04065828.
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Affiliation(s)
- Claudine Khoury
- Université de Bordeaux, UFR d'Odontologie, Bordeaux, France.,CHU de Bordeaux, Pôle de médecine et chirurgie bucco-dentaire, Bordeaux, France
| | - Johan Samot
- Université de Bordeaux, UFR d'Odontologie, Bordeaux, France.,CHU de Bordeaux, Pôle de médecine et chirurgie bucco-dentaire, Bordeaux, France
| | - Catherine Helmer
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | | | - Aurore Georget
- CHU de Bordeaux, USMR, Pôle de Santé publique, Bordeaux, France
| | - Jean-François Dartigues
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Elise Arrivé
- Université de Bordeaux, UFR d'Odontologie, Bordeaux, France. .,CHU de Bordeaux, Pôle de médecine et chirurgie bucco-dentaire, Bordeaux, France.
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Atanda AJ, Livinski AA, London SD, Boroumand S, Weatherspoon D, Iafolla TJ, Dye BA. Tooth retention, health, and quality of life in older adults: a scoping review. BMC Oral Health 2022; 22:185. [PMID: 35585618 PMCID: PMC9118621 DOI: 10.1186/s12903-022-02210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This scoping review describes the relationship between tooth retention, health, and quality of life in older adults. METHODS Seven databases were searched for English language articles for subjects ≥ 65 y from 1981 to 2021. Exposure was tooth retention (≥ 20), and outcomes were general/systemic health and quality of life. Methodological quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0 tool. RESULTS 140 articles were included, only four were randomized trials. Inter-rater agreement (κ) regarding study inclusion was 0.924. Most were assessed with low risk of bias (n = 103) and of good quality (n = 96). Most studies were conducted in Japan (n = 60) and Europe (n = 51) and only nine in the US. Tooth retention was referred to as "functional dentition" in 132 studies and "shortened dental arch" in 19 studies. Study outcomes were broadly synthesized as (1) cognitive decline/functional dependence, (2) health status/chronic diseases, (3) nutrition, and (4) quality of life. DISCUSSION There is a positive relationship between tooth retention, overall health, and quality of life. Older adults retaining ≥ 20 teeth are less likely to experience poorer health. Having < 20 teeth increases the likelihood for functional dependence and onset of disability, and may affect successful ageing. This review supports the general finding that the more teeth older adults retain as they age, the less likely they are to have adverse health outcomes. However, significant knowledge gaps remain which can limit decision-making affecting successful ageing for many older adults. This review highlights the need to consider, as an important marker of oral health and function, the retention of a functional minimum of a natural dentition, rather than a simple numeric score of missing teeth.
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Affiliation(s)
- Adejare Jay Atanda
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, OD, National Institutes of Health, Bethesda, MD, USA
| | - Steven D London
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Shahdokht Boroumand
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | | | - Timothy J Iafolla
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | - Bruce A Dye
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- School of Dental Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
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Gomez GGF, Cho SD, Varghese R, Rajendran D, Eckert GJ, Bhamidipalli SS, Gonzalez T, Khan BA, Thyvalikakath TP. Nutritional Assessment of Denture Wearers Using Matched Electronic Dental-Health Record Data. J Prosthodont 2022; 31:e53-e65. [PMID: 35322481 PMCID: PMC9545162 DOI: 10.1111/jopr.13505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To assess the nutritional profile of denture wearers through a retrospective cohort study using nutritional biomarkers from matched electronic dental and health record (EDR‐EHR) data. Materials and methods The case group (denture wearers) included matched EDR‐EHR data of patients who received removable partial, complete, and implant‐supported prosthodontic treatments between January 1, 2010 and December 31, 2018, study time. The control (nondenture wearers) group did not have recorded denture treatments and included patient records within 1 year of the denture index date (first date of case patients’ receiving complete or partial denture) of the matching cases. The qualified patients’ EDR were matched with their EHR based on the availability of laboratory reports within 2 years of receiving the dentures (index date). Nutritional biomarkers were selected from laboratory reports for complete blood count, comprehensive and basic metabolic profile, lipid, and thyroid panels. Summary statistics were performed, and general linear mixed effect models were used to evaluate the rate of change over time (slope) of nutritional biomarkers before and after the index date. Likelihood ratio tests were performed to determine the differences between dentures and controls. Results The final cohort included 10,481 matched EDR‐EHR data with 3,519 denture wearers and 6,962 controls that contained laboratory results within the study time. The denture wearers’ mean age was 57 ±10 years and the control group was 56 ±10 years with 55% females in both groups. Pre‐post analysis among denture wearers revealed decreased serum albumin (p = 0.002), calcium (p = 0.039), creatinine (p < 0.001) during the post‐index time. Hemoglobin (Hb) was higher pre‐index, and was decreasing during the time period but did not change post‐index (p < 0.001). Among denture wearers, completely edentulous patients had a significant decrease in serum albumin, creatinine, blood urea nitrogen (BUN), but increased estimated glomerular filtration rate (eGFR). In partially edentulous patients, total cholesterol decreased (p = 0.018) and TSH (p = 0.004), BUN (p < 0.001) increased post‐index. Patients edentulous in either upper or lower arch had decreased BUN and eGFR during post‐index. Compared to controls, denture wearers showed decreased serum albumin and protein (p = 0.008), serum calcium (p = 0.001), and controls showed increased Hb (p = 0.035) during post‐index. Conclusions The study results indicate nutritional biomarker variations among denture wearers suggesting a risk for undernutrition and the potential of using selected nutritional biomarkers to monitor nutritional profile.
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Affiliation(s)
- Grace Gomez Felix Gomez
- Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN.,Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN
| | - Sopanis D Cho
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN
| | - Roshan Varghese
- GlaxoSmithKline consumer healthcare, Weybridge, United Kingdom
| | - Divya Rajendran
- Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN.,Innovation Associates, Inc., Indianapolis, IN
| | - George J Eckert
- Department of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Sruthi Surya Bhamidipalli
- Department of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Theresa Gonzalez
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN
| | - Babar Ali Khan
- Department of Pulmonary & Critical Care, Indiana University School of Medicine, Indianapolis, IN
| | - Thankam Paul Thyvalikakath
- Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN.,Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN
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Honeywell S, Samavat H, Touger-Decker R, Parrott JS, Hoskin E, Zelig R. Associations between Dentition Status and Nutritional Status in Community-Dwelling Older Adults. JDR Clin Trans Res 2022; 8:23800844211063859. [PMID: 35000489 DOI: 10.1177/23800844211063859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVE Older adults are at higher risk of malnutrition. The aim of this study was to explore associations between nutritional status and dentition status among older adults seeking care in a dental clinic. METHODS This was a cross-sectional study of data from older adults (65-89 y) who received care at a northeastern US urban dental school clinic between June 2015 and June 2020 (N = 305). Clinical and demographic data were obtained from the electronic health record; nutritional status was determined using the Self-Mini Nutritional Assessment (Self-MNA), and odontograms and digital radiography were used to determine dental data. Adjusted multivariable models were used to explore associations between variables. RESULTS The sample was 53.8% female with a median age of 72.0 y. The median Self-MNA score was 13, reflective of normal nutritional status; 29.5% were at risk of or had malnutrition. Median numbers of teeth and posterior and anterior occluding pairs of teeth (POP, AOP) were 18.0, 2.0, and 5.0, respectively. Those with normal nutritional status had significantly more teeth, POPs, and AOPs than those at risk of or with malnutrition (P = 0.015, P = 0.015, and P = 0.039, respectively). Every additional unit increase in the number of natural or restored teeth or POP was associated with significantly lower odds of being at risk of or with malnutrition (3% and 13%, respectively). Having functional dentition was associated with 46% lower odds of being at risk of or with malnutrition. CONCLUSION This study demonstrated that older adults who had more teeth, better occlusion, and functional dentition were more likely to be of normal nutritional status than those who had less teeth, had poorer occlusion, and lacked functional dentition. Further research with larger, more diverse samples and varied measures of dentition are needed to better understand the associations between nutritional status and dentition status. KNOWLEDGE TRANSFER STATEMENT The findings from this study suggest that older adults with fewer teeth and therefore less efficient occlusion are at higher risk for malnutrition than those with more teeth and better occlusion. Health care professionals should include screening for dentition and malnutrition as part of their routine practice to identify patients who may have tooth loss and be at risk of malnutrition and refer them accordingly for interventions to optimize oral health and nutritional status.
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Affiliation(s)
- S Honeywell
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - H Samavat
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - R Touger-Decker
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
- Department of Diagnostic Sciences, School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - J S Parrott
- Department of Interdisciplinary Studies, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - E Hoskin
- Division of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - R Zelig
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
- Department of Diagnostic Sciences, School of Dental Medicine, Rutgers University, Newark, NJ, USA
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9
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Gotfredsen K, Rimborg S, Stavropoulos A. Efficacy and risks of removable partial prosthesis in periodontitis patients: A systematic review. J Clin Periodontol 2021; 49 Suppl 24:167-181. [PMID: 34761421 DOI: 10.1111/jcpe.13519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/27/2021] [Accepted: 06/08/2021] [Indexed: 01/24/2023]
Abstract
AIM The aim of this systematic review was to answer the following focused question: "In partially edentulous patients with periodontitis, are removable dental prostheses (RDPs) more efficacious than no prosthetic treatment, treatment to a shortened dental arch (SDA), or tooth-supported fixed dental prostheses (FDPs)?" MATERIALS AND METHODS A systematic literature search was performed electronically for the period 1966-2020. Two authors independently assessed the studies for eligibility according to the PRISMA guidelines. Risk assessment was performed using RoB 2.0 and the Newcastle-Ottawa Scale. RESULTS Two retrospective studies indicated that RDPs increased the risk of tooth loss compared to FDPs in patients with a history of periodontitis. Prospective studies found that RDPs could be maintained without any significant periodontal destruction on a long-term basis. Owing to the heterogeneity of the data, no meta-analysis could be performed. Several studies indicated that RDP increased plaque accumulation. RDPs had only a limited effect on masticatory efficiency and nutritional status. RDPs may improve oral-health-related quality of life (OHRQoL), but to a lesser extent compared with that of patients treated to an SDA. CONCLUSIONS There is no strong evidence that RDPs per se will cause periodontal destruction including tooth loss. RDPs do not inevitably improve masticatory efficiency but improve OHRQoL, although less than for patients treated with FDPs including resin-bonded FDPs.
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Affiliation(s)
- Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susie Rimborg
- Copenhagen University Library, Faculty Library of Natural and Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Andreas Stavropoulos
- Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.,Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
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10
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Chen TC, Cheng DH, Hsu ML, Lei YP. Application of masticatory control in dental treatment for elderly individuals. J Chin Med Assoc 2021; 84:125-128. [PMID: 33306597 DOI: 10.1097/jcma.0000000000000467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Taiwan transitioned to an aged society in 2018. Appropriate dental treatment is important for elderly individuals. Previously, reconstruction of the dentition was thought to help regain chewing function. However, concerns of the elderly population, such as decline in learning ability and saliva secretion, complicate dental reconstruction. Overlooking the special needs of elderly individuals may lead to impaired chewing function, resulting in nutritional imbalances and increased burden on the digestive tract, causing more health disorders. For the elderly population, treatment must be aimed at restoring as much chewing function as possible with minimal changes. Additionally, regular oral hygiene care, proper design of fixed partial dentures, and implant placement greatly reduce the difficulty in adapting to a new prosthesis. These measures allow us to provide better quality of life for elderly individuals.
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Affiliation(s)
- Ta-Chung Chen
- Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Dong-Hui Cheng
- Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ming-Lun Hsu
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yen-Ping Lei
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC
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11
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Zelig R, Goldstein S, Touger-Decker R, Firestone E, Golden A, Johnson Z, Kaseta A, Sackey J, Tomesko J, Parrott JS. Tooth Loss and Nutritional Status in Older Adults: A Systematic Review and Meta-analysis. JDR Clin Trans Res 2020; 7:4-15. [PMID: 33345687 DOI: 10.1177/2380084420981016] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND/OBJECTIVE Older adults are at risk for tooth loss and compromised nutritional status. Our objective was to conduct a systematic review and meta-analysis to answer the following question: Among adults aged ≥60 y living in developed countries, what are the associations between tooth loss and nutritional status as assessed by a validated nutrition screening or assessment tool? METHODS PRISMA guidelines were followed. PubMed, Scopus, CINAHL, Web of Science, and MEDLINE were searched for studies published in English between 2009 and 2019 that met inclusion criteria. Data extracted included study and participant characteristics, dentition, and nutritional status. Risk of bias was assessed with a modified Newcastle-Ottawa Scale. Random effects meta-analysis was used. RESULTS Of the 588 unduplicated articles identified, 78 were reviewed in full text, and 7 met inclusion criteria. Six studies were combined for a meta-analysis, which revealed that individuals who were completely edentulous or who lacked functional dentition had a 21% increased likelihood of being at risk of malnutrition or being malnourished, as compared with those who were dentulous or had functionally adequate dentition (risk ratio, 1.21; 95% CI, 1.11 to 1.32; I2 = 70%). Whether the article statistically adjusted for medical history explained most of the heterogeneity in the pooled effect. CONCLUSIONS AND IMPLICATIONS Findings suggest that older adults with tooth loss are at greater risk of malnutrition than those with functionally adequate dentition. Use of validated tools to assess risk of malnutrition in older adults with tooth loss is important to promote early intervention and referral to optimize nutrition and oral health status. Findings were limited by heterogeneity, risk of bias, and overall quality of the studies reviewed. Cohort studies that adjust for known confounders and use consistent approaches to assess tooth loss and nutritional status are needed. KNOWLEDGE TRANSFER STATEMENT The results of this study suggest that older adults with tooth loss are at greater risk of malnutrition than those with functionally adequate dentition. Screening of this population for malnutrition by health care professionals, including dentists and dietitians, may result in corresponding referrals to optimize nutrition and oral health status. Further research is needed with consistent approaches to assess tooth loss and nutritional status.
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Affiliation(s)
- R Zelig
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA.,Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - S Goldstein
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - R Touger-Decker
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA.,Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - E Firestone
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - A Golden
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - Z Johnson
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - A Kaseta
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - J Sackey
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - J Tomesko
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - J S Parrott
- Department of Interdisciplinary Studies, Rutgers School of Health Professions, Newark, NJ, USA
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12
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McCrum LA, Watson S, McGowan L, McGuinness B, Cardwell C, Clarke M, Woodside JV, McKenna G. Development and feasibility of a tailored habit-based dietary intervention coupled with natural tooth replacement on the nutritional status of older patients. Pilot Feasibility Stud 2020; 6:120. [PMID: 32855815 PMCID: PMC7446197 DOI: 10.1186/s40814-020-00654-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older adults suffering partial tooth loss may need additional intervention strategies other than natural tooth replacement alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with natural tooth replacement, amongst partially dentate older adults. METHODS The design and development of the dietary intervention (phase 1) consisted of analysis of the target population's dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). The dietary intervention consisted of forming three healthy dietary habits around fruits and vegetables, wholegrains and healthy proteins. Feasibility of the intervention was then tested amongst older adults who had recently completed dental treatment for natural tooth replacement in a small non-randomised single arm study (phase 2). The principal feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Supporting outcomes consisted of feasibility of screening procedures, recruitment strategies and retention/attrition rates as well as the participant's compliance to the intervention assessed through self-monitoring tracking sheets. RESULTS Twenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (phase 1). Twelve themes related to barriers (e.g. oral health, appetite) and facilitators (e.g. nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (phase 2) where eight themes were identified from feedback interview discussions. The principal outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a supporting outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g. incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention. CONCLUSION Phase 1 and phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention's effectiveness. TRIAL REGISTRATION ISRCTN66118345.
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Affiliation(s)
- Leigh-Ann McCrum
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
| | - Sinead Watson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
| | - Laura McGowan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast, BT9 5BN UK
| | - Bernadette McGuinness
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
| | - Christopher Cardwell
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
| | - Mike Clarke
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
| | - Jayne V. Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast, BT9 5BN UK
| | - Gerry McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Belfast, BT12 6BJ UK
- Centre for Dentistry, Queen’s University Belfast, Belfast, BT12 6BP UK
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13
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Sawa Y, Kayashita J, Nikawa H. Occlusal support is associated with nutritional improvement and recovery of physical function in patients recovering from hip fracture. Gerodontology 2019; 37:59-65. [PMID: 31749289 DOI: 10.1111/ger.12446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/26/2019] [Accepted: 10/30/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aimed to elucidate the association between occlusal support and nutritional improvement and recovery of activities of daily living (ADLs) among elderly patients recovering from hip fracture. BACKGROUND Many patients with hip fracture are malnourished, and malnutrition is associated with poor functional outcomes. Poor oral status is one reason for malnutrition because loss of occlusal support leads to masticatory disorders and can cause nutrient deficiencies. METHODS We evaluated 202 elderly patients aged 65 years and older (mean age, 84.9 ± 7.9 years). We assessed nutritional status using the Mini Nutritional Assessment-Short Form and ADLs using functional independence measure (FIM) scores. Occlusal support was recorded in accordance with the Eichner Index. We categorised participants into two groups according to the presence or absence of occlusal support, and statistical analyses were performed to investigate the differences between the groups. RESULTS One group contained 152 participants (mean age, 85.5 ± 7.4 years) with occlusal support, and the other group contained 50 participants (mean age, 83.0 ± 8.9 years) without occlusal support. The group with occlusal support had greater gain of FIM and higher FIM efficiency than did the other group. Multivariate analyses showed that occlusal support was independently associated with nutritional improvement [odds ratio (OR) = 4.00, 95% confidence intervals (CI) = 1.90-8.43] and motor FIM efficiency (R2 = .338, P < .001). CONCLUSIONS Our findings suggest that occlusal support is associated with nutritional improvement and the recovery of ADLs in patients recovering from hip fracture.
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Affiliation(s)
- Yukiko Sawa
- Department of Nutrition and Dietetics, Kashima Hospital, Matsue, Japan.,Department of Oral Biology and Engineering, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Hiroki Nikawa
- Department of Oral Biology and Engineering, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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14
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Suzuki H, Kanazawa M, Komagamine Y, Iwaki M, Amagai N, Minakuchi S. Changes in the nutritional statuses of edentulous elderly patients after new denture fabrication with and without providing simple dietary advice. J Prosthodont Res 2019; 63:288-292. [DOI: 10.1016/j.jpor.2018.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/17/2018] [Accepted: 12/25/2018] [Indexed: 11/27/2022]
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15
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The Association of Poor Oral Health Parameters with Malnutrition in Older Adults: A Review Considering the Potential Implications for Cognitive Impairment. Nutrients 2018; 10:nu10111709. [PMID: 30413041 PMCID: PMC6266396 DOI: 10.3390/nu10111709] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 10/30/2018] [Accepted: 11/06/2018] [Indexed: 12/20/2022] Open
Abstract
Poor dental status and chewing deficiencies have been associated with cognitive decline. Altered dietary habits and malnutrition have been suggested as linking mechanisms. The aim of the present review was thus to investigate if poor oral health, and in particular tooth loss and impaired masticatory function, may affect dietary selection and nutritional intake in older adults, and moreover, to assess if prosthodontic dental care may improve nutritional status. Extensive tooth loss may impair masticatory function. Several studies in older populations have shown that severe tooth loss and masticatory impairment are associated with limited consumption of various food types (especially fruits and vegetables), increased consumption of sugary and easy-to-chew foods, and lower dietary intake of fibre and vitamins. However, these findings are not consistently reported, due to methodological variation among studies, potential adverse causalities, and the multifactorial nature of food choices. On the other hand, a few interventional studies revealed that prosthetic rehabilitation of missing teeth, when accompanied by dietary counselling, may improve dietary habits and nutritional intake. Further research is required to improve current knowledge of these associations. Under the limitations of the current study, a functional dental arch of natural or artificial teeth is important for maintaining adequate chewing efficiency and ability, but this only partly contributes to food choices and nutritional status. The multifactorial nature of food choices necessitates the interprofessional collaboration of dental professionals, dietetics practitioners, and primary care providers to improve dietary habits and nutritional intake.
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16
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Impact of oral rehabilitation on the quality of life of partially dentate elders in a randomised controlled clinical trial: 2 year follow-up. PLoS One 2018; 13:e0203349. [PMID: 30307966 PMCID: PMC6181283 DOI: 10.1371/journal.pone.0203349] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 08/19/2018] [Indexed: 11/24/2022] Open
Abstract
Objective This randomised clinical trial aimed to compare the impact of two different tooth replacement strategies for partially dentate older patients namely; removable partial dentures (RPDs) and functionally orientated treatment based on the shortened dental arch (SDA) concept, on Oral Health-related Quality of Life (OHrQOL). Methods 89 patients completed a randomised clinical trial. Patients were recruited in two centres: Cork University Dental Hospital (CUDH) and a Geriatric Day Hospital (SFDH). 44 patients were randomly allocated to the RPD group and 45 to the SDA group where adhesive bridgework was used to provide 10 pairs of occluding contacts. The impact of treatment on OHrQOL was used as the primary outcome measure. Each patient completed the Oral Health Impact Profile (OHIP-14) at baseline, 1, 6, 12 and 24 months after treatment. Results Both treatment groups reported improvements in OHIP-14 scores at 24 months (p<0.05). For the SDA group OHIP-14 scores improved by 8.0 scale points at 12 months (p<0.001) and 5.9 scale points at 24 months (p<0.05). For the RPD group OHIP-14 scores improved by 5.7 scale points at 12 months (p<0.05) and 4.2 scale points at 24 months (p<0.05). Analysis using ANCOVA showed that there were significant between group differences recorded in both treatment centres. 24 months after intervention the SDA group recorded better OHIP-14 scores by an average of 2.9 points in CUDH (p<0.0001) and by an average of 7.9 points in SFDH (p<0.0001) compared to the RPD group. Conclusions Patients in the SDA group maintained their improvements in OHrQOL scores throughout the 24 month study period. For the RPD group the initial improvement in OHrQOL score began to diminish after 6 months, particularly for those treated in SFDH. Thus, the benefits of functionally orientated treatment increased over time, particularly for the older, more systemically unwell cohort in SFDH.
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17
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Komagamine Y, Kanazawa M, Iwaki M, Jo A, Suzuki H, Amagai N, Minakuchi S. Combined effect of new complete dentures and simple dietary advice on nutritional status in edentulous patients: study protocol for a randomized controlled trial. Trials 2016; 17:539. [PMID: 27829457 PMCID: PMC5103469 DOI: 10.1186/s13063-016-1664-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/18/2016] [Indexed: 11/29/2022] Open
Abstract
Background Individuals who are edentulous have a lower intake of fruit, vegetables, fiber, and protein compared with their dentate counterparts because tooth loss is accompanied by a decrease in ability to chew. Whether or not a combination of prosthetic rehabilitation and simple dietary advice produces improvement in dietary intake among edentulous persons is unclear. We aim to investigate the effect of a simultaneous combination of simple dietary advice delivered by dentists and provision of new complete dentures on dietary intake in edentulous individuals who request new dentures. Methods/design Through a double-blinded, parallel, randomized controlled trial in which 70 edentate persons who request new complete dentures will be enrolled, eligible study participants will be randomly allocated to either a dietary intervention group receiving dietary advice or to a control group receiving only advice on the care and maintenance of dentures. Outcome measures include daily intake of nutrients and food items, assessed using a brief self-administered diet history questionnaire; antioxidant capacity, determined using blood and urine samples; nutritional status, assessed with the Mini-Nutritional Assessment-Short Form; oral health-related quality of life, assessed with the Japanese version of the Oral Health Impact Profile-EDENT and the Geriatric Oral Health Assessment Index; subjective chewing ability; masticatory performance, assessed using a color-changeable chewing gum and a gummy jelly; patient self-assessment of dentures; mild cognitive impairment, assessed with the Japanese version of the Montreal Cognitive Assessment; and functional capacity, assessed with the Japan Science and Technology Agency Index of Competence. Outcome measures, except for antioxidant capacity, are to be implemented at three time points: at baseline and at 3 and 6 months following intervention. Antioxidant capacity data are to be collected twice: at baseline and at 3 months following intervention. Differences between the groups at 3 and 6 months and within-group changes are to be compared using the paired t test. Discussion Simple dietary advice that can be implemented by a dentist would be more practical in clinical practice than tailored dietary counseling. The results of this study will provide beneficial information on dietary intake changes for both edentulous individuals requesting new complete dentures and dentists. Trial registration University Hospital Medical Information Network Center Unique Trial Number: UMIN000017879. Registered on 12 June 2015.
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Affiliation(s)
- Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Maiko Iwaki
- Oral Diagnosis and General Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayami Jo
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroyuki Suzuki
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Noriko Amagai
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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18
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Kern JS, Wolfart S, Hilgers RD, Marré B, Scheller H, Strub J, Böning K, Hannak W, Luthardt RG, Heydecke G, Huppertz J, Pospiech P, Wöstmann B, Stark H, Mundt T, Jahn F, Kern M, Edelhoff D, Walter MH. The randomized shortened dental arch study: influence of two different treatments on interdental spacing over 5 years. Clin Oral Investig 2016; 21:1945-1951. [PMID: 27785586 DOI: 10.1007/s00784-016-1981-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Being a secondary outcome in a multicenter randomized controlled trial, the present analysis focused on interdental spacing in the shortened dental arch (SDA). The aim was to evaluate changes in interdental spacing in dependence of two different treatments after an observation period of up to 5 years. MATERIAL AND METHODS Patients were either treated with a partial removable dental prosthesis (PRDP) for molar replacement (PRDP group) or according to the SDA concept aiming at a premolar occlusion (SDA group) in a randomized manner. Interdental spacing in the anterior region was measured with gauges and categorized as "0" (<0.1 mm), "1" (<0.5 mm), "2" (0.5-1 mm), and "3" (>1 mm). The statistical analysis was performed with analysis of variance models followed by linear contrast. RESULTS Ninety-one patients (SDA n = 41, PRDP n = 50) were included. Changes of interdental spacing were detected in 70.7 % of all cases. A significant difference between the mean score changes was found in the mandible comparing the PRDP group and the SDA group. The respective mean score changes from baseline to 5 years were 0.23 (SD 0.49) for the PRDP group and 0.02 (SD 0.30) for the SDA group (p = 0.023). CONCLUSIONS Major interdental spacing could be observed in neither of the groups. The SDA concept resulted in a slightly better outcome. CLINICAL RELEVANCE When deciding whether to replace missing molars, the present results give further support to the SDA concept.
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Affiliation(s)
- Jaana-Sophia Kern
- Department of Prosthodontics and Biomaterials, Center for Implantology, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center for Implantology, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Ralf-Dieter Hilgers
- Department for Medical Statistics, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Birgit Marré
- Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Herbert Scheller
- Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Jörg Strub
- Department of Prosthetic Dentistry, Albert-Ludwig University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Klaus Böning
- Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Wolfgang Hannak
- Center for Dental and Craniofacial Sciences Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, CC3, Campus Benjamin Franklin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Guido Heydecke
- Department of Prosthodontics, University Medical Center Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Jan Huppertz
- Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Peter Pospiech
- Center for Dental and Craniofacial Sciences Department of Prosthodontics, Geriatic Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, CC3, Campus Benjamin Franklin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Bernd Wöstmann
- Department of Prosthetic Dentistry, Justus-Liebig University of Giessen, Schlangenzahl 14, 35392, Gießen, Germany
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Rotgerberstr. 8, 17487, Greifswald, Germany
| | - Florentine Jahn
- Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, An der alten Post 4, 07740, Jena, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Daniel Edelhoff
- Department of Prosthodontics, University Hospital of Munich, Goethestr. 70, 80336, Munich, Germany
| | - Michael H Walter
- Department of Prosthetic Dentistry, University Hospital Carl Gustav Carus, Dental School, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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19
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Wiener RC, Wiener MA. Shortened dental arch and body mass index in adults 45-65 years of age: results from National Health and Nutrition Examination Survey 2005-2008. Int Dent J 2015; 65:277-82. [PMID: 26239166 DOI: 10.1111/idj.12179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Many people have dental arches with unrestored edentulous areas posterior to natural teeth. One dental pattern is the shortened dental arch (SDA). As a result of the lack of teeth, individuals with an SDA may eat a restricted diet, including soft, highly processed foods. Such diets may increase the risk of being overweight or of obesity. We examined whether there was an association between SDA and body mass index (BMI) in adults 45-65 years of age. METHODS The data for this study were US National Health and Nutrition Examination Survey (NHANES) 2005-2008 merged files. There were 5,773 eligible participants. The data were examined for frequencies, and the results were analysed using the chi-square test and logistic regression. RESULTS There were 69.3% participants with a shortened mandibular arch and a BMI of ≥25 compared with 71.8% of participants who had a complete mandibular dental arch and a BMI of ≥25 (P=0.7246). There were 70.6% of participants with a shortened maxillary arch and a BMI of ≥25 compared with 71.9% of participants who had a complete maxillary dental arch and a BMI of ≥25 (P=0.8859). The adjusted odds ratio for shortened mandibular dental arch was 0.70 (95% CI: 0.46-1.08) for a BMI of ≥25 as compared with individuals with a BMI<25. The adjusted odds ratio for shortened maxillary dental arch was 1.06 (95% CI: 0.63-1.78) as compared with individuals with a BMI<25. CONCLUSIONS The research hypothesis that an SDA was related to higher BMI, and the corollary that restored or complete dentition had better odds of a lower BMI, were not supported.
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Affiliation(s)
- R Constance Wiener
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA.,Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Michael A Wiener
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
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