Association between functional dental state and dietary intake of Chinese vegetarian old age home residents

Evaluation of jaw function, oral health-related quality of life, and nutritional status during oral rehabilitation procedures - a pilot study

AIMS

To evaluate limitations in jaw function, oral health-related quality of life (OHRQoL), and nutritional status during extensive oral rehabilitation procedures.

MATERIAL METHODS

Fourteen participants (mean age ± SD: 70 ± 3.8) undergoing major oral rehabilitation involving the restoration of a minimum of eight teeth were recruited in the study. Jaw function limitations scores (JFLS), oral health-impact profile (OHIP), and nutritional status were measured at different time points during, six months, and one year after the rehabilitation procedures. Nutritional status was evaluated by measuring the body weight and arm and calf muscle circumference. The effect of time points on the measured variables was evaluated with Friedman's test. Trends in nutritional status were evaluated with linear regression analysis.

RESULTS

The results of the analysis showed significant main effects of time points on the JLFS (p < .001) and OHIP scores (p = .005). However, there was no effect of time points on the body weight (p = .917) and calf muscle circumference (p = .424), but a significant effect on arm circumference (p = .038). Further, there was a decreasing trend for body weight (64.3%), arm (71.4%), and calf circumference (64.3%) in the majority of the patients.

CONCLUSION

The results of the preliminary study suggest that people undergoing extensive oral rehabilitation procedures show improvement in jaw function and an increase in OHRQoL after the rehabilitation procedure. Despite no major changes in the nutritional indicators, most patients showed a negative trend in their body weight, arm circumference, and calf circumference, suggesting that they may be susceptible to nutritional changes.

Influence of Age on Associations of Occlusal Status and Number of Present Teeth with Dementia in Community-Dwelling Older People in Japan: Cross-Sectional Study

While occlusal status has been reported to be related to cognitive function, little is known about the influence of age on that relationship. The present study examined the associations of tooth loss and occlusal status with dementia in the older people, as well as the effects of age on those relationships. A total of 196 older participants (median age: 84 years) were enrolled. Occlusal status was assessed using functional tooth units (FTU), calculated based on the number of paired natural or artificial teeth. Logistic regression analysis was then performed using dementia as the objective variable, and FTU or number of teeth as explanatory variables. The results showed that higher FTU was associated with lower risk of dementia. Furthermore, when stratified by median age, the association was greater for those aged less than 84 years. On the other hand, there was no significant association of number of present teeth with dementia. These results suggest that the risk of dementia is lower for individuals with better occlusion and that occlusal factor may have a greater effect on dementia onset in younger older people. It is thus recommended that both occlusal function and age be incorporated as factors in programs developed for dementia prevention.

Knowledge and Perception of Orthodontic Treatment among General and Non-Orthodontic Dental Specialists: A Comparative Study

The objective of this study is to discover any possible association of gender or practitioner classification with orthodontic knowledge and attitudes towards orthodontic treatment. Descriptive cross-sectional research was conducted on two groups of dentists in the Ha'il region of Saudi Arabia. Group I included general practitioners, while Group II had non-orthodontic specialists. The findings suggest a statistically significant (p < 0.05) difference between the knowledge and attitudes of general practitioners and non-orthodontic specialists. Independent two tailed t-scores for difference in Knowledge (t-score = 3.19919, p = 0.003) and Attitude (t-score = 2.16314, p = 0.048319), highlight significant disparities in the knowledge and attitudes of general practitioners and non-orthodontic specialists. However, no statistically significant difference was observed in terms of knowledge and attitudes based on gender differences. This study captures and highlights subtle information that is very significant in dealing with critically important orthodontics issues. The study suggests that it is possible that a non-orthodontic specialist may suggest an altogether different line of treatment with different consequences when compared to a general practitioner and vice versa. This may result in unwanted, permanent orthodontic effects, highlighting the significance of the early stage of orthodontic treatment awareness. This research reveals disparities between the perceptions of general practitioners and non-orthodontic specialists about the stage and relevance of orthodontic treatment. It is strongly advised to see an orthodontic expert rather than a general practitioner or non-orthodontic specialist for orthodontic issues.

Associations between the composition of functional tooth units and nutrient intake in older men: the Concord Health and Ageing in Men Project

OBJECTIVE

Inadequate nutrient intakes have been linked with poor dentition in older adults. The aim of this study was to investigate the associations between the composition of functional tooth units (FTU) and nutrient intakes in older men.

DESIGN

A cross-sectional study with a standardised validated diet history assessment and comprehensive oral health assessments. FTU were categorised by dentition type: (i) Group A (Natural FTU Only), (ii) Group B (Natural and Replaced FTU) and (iii) Group C (No Natural FTU). Attainment of nutrient reference values (NRV) for sixteen micronutrients was incorporated into a micronutrient risk variable, dichotomised 'good' (≥ 12) or 'poor' (≤ 11), and for seven macronutrients into a macronutrient risk variable, dichotomised 'good' (≥ 5) or 'poor' (≤ 4).

SETTING

Subjects selected from the local Sydney geographical areas.

PARTICIPANTS

Community-dwelling older men (n 608).

RESULTS

32 % (n 197) of participants were categorised as Group A, 27 % (n 167) as Group B and 40 % (n 244) as Group C. In adjusted logistic regression analysis, being in Group C, compared with Group A, was associated with intakes below NRV recommendations for fibre (OR: 2·30, 95 % CI 1·30, 4·05). Adjusted analysis also showed that men in Group C, compared with Group A, were more likely to have poor intake of macronutrients (OR: 2·00, 95 % CI 1·01, 3·94).

CONCLUSIONS

Our study shows statistically significant associations between the composition of FTU and poor macronutrient intakes. Maintaining natural pairs of occluding FTU may be important for attaining adequate nutrient intakes in older men.

Assessment of masticatory function in older individuals with bimaxillary implant-supported fixed prostheses or with a natural dentition: A case-control study

STATEMENT OF PROBLEM

A clinical assessment of the masticatory performance of edentulous people treated with bimaxillary implant-supported fixed prostheses is lacking.

PURPOSE

The purpose of this case-control study was to compare the masticatory performance of edentulous people treated with bimaxillary implant-supported fixed prostheses to that of those with a natural dentition by using a simplified comminution test with hard viscoelastic test food and a mixing ability test.

MATERIAL AND METHODS

Thirty-six participants were recruited and divided into 2 equal groups (n=18) based on their dental status. The experimental group (7 women, mean ±standard deviation age=69.8 ±7.5 years) had bimaxillary implant-supported fixed prostheses, and the control group (9 women, mean ±standard deviation age=68.3 ±5.6 years) had a natural dentition. A hard viscoelastic food comminution test and a mixing ability test with 2-colored chewing gum were performed in both groups. The number and total area of the particles during the comminution test and the variance of hue during the mixing ability test were measured. The data were analyzed with the parametric (paired t test) and nonparametric (Mann-Whitney U) tests to assess differences between the groups (α=.05).

RESULTS

The experimental group exhibited significantly fewer pieces in the food comminution test than the control group (P=.001). The experimental group also showed significantly higher variance of hue values than the control group (P<.001).

CONCLUSIONS

Patients treated with bimaxillary implant-supported prostheses had reduced masticatory performance in comparison to those with a natural dentition, despite having been provided with satisfactory and well-functioning prostheses.

Apolipoprotein ɛ4 Allele and Dental Occlusion Deficiency as Risk Factors for Alzheimer's Disease

Compromised dentition has been suggested to pose a significant risk factor for dementia. It was mainly investigated through insufficient tooth number, disregarding contact between opposing teeth (dental occlusion). The ɛ4 allele of apolipoprotein (APOE4) is the primary genetic marker for the late onset of Alzheimer's disease (AD). However, APOE4 and dental occlusion have not yet been investigated as possible associated risk factors for AD. The study was aimed to examine the impact of dental status and different APOE gene variants on AD occurrence. Secondly, sociodemographic variables were investigated as factors potentially associated with AD. The case-control study included two groups: 116 patients with AD (according to the NINDS-ADRDA criteria) and 63 controls (Mini-Mental State Examination scores ≥24). The analysis of APOE gene polymorphism was conducted through PCR reaction. Dental examination included recording of number of teeth, presence of fixed or removable dentures, and number of functional tooth units (FTU). Regression analysis was used to investigate the joint effect of the clinical and genetic variables on AD. Results showed that patients with AD were more often carriers of ɛ3/ɛ4 genotype and ɛ4 allele, had lower number of teeth and FTU, and were less likely to be married, live in home, and had less chronic diseases, compared to the controls. Regression analysis showed that presence of APOE4 allele and the number of total FTU remained associated with AD, even when adjusted for age, sex, and level of education. In conclusion, deficient dental occlusion and presence of APOE4 may independently increase risk for AD.

Masticatory satisfaction, ability, and performance in partially dentate patients after periodontal therapy

Abstract Introduction Understanding the effects of periodontal therapy is essential in performance and satisfaction of partially dentate patients. Objective To assess the effect of subgingival periodontal treatment in performance and masticatory satisfaction and ability as reported by partially dentate patients with untreated chronic periodontitis. Materials and method Patients were given nonsurgical periodontal treatment and masticatory satisfaction, ability, and performance were evaluated before and after treatment. Performance was assessed based on sieving chewed standardized chewable material, while satisfaction and ability were analyzed using a questionnaire based on OHIP-EDENT. Result Mean numbers of functional tooth units were 10.36 ± 1.43 anterior and 6.73 ± 0.79 posterior teeth. Masticatory performance did not vary significantly (p = 0.075), and mean particle sizes before and after treatment were 4.23 ± 1.84 mm and 3.90 ± 0.75 mm, respectively. Overall satisfaction and ability scores after treatment were higher (p > 0.05) compared with scores prior to the periodontal intervention. Conclusion Periodontal treatment improves masticatory satisfaction and ability with no effect on performance.

Unilateral Mastication Evaluated Using Asymmetric Functional Tooth Units as a Risk Indicator for Hearing Loss

BACKGROUND

Some previous studies reported hearing ability can be reduced by impaired masticatory ability, but there has been little evidence reported of an association between hearing loss and unilateral mastication. Therefore, this study aimed to investigate the relationship between unilateral mastication (UM), estimated from individual functional tooth units (FTUs), and hearing loss in a representative sample of Korean adults.

METHODS

The analyzed data were obtained from 1,773 adults aged 40-89 years who participated in Korean national survey. Hearing loss was defined as a pure-tone average of >25 dB at frequencies of 0.5, 1, 2, and 4 kHz in either ear. In each subject, UM was calculated as the difference in the sums of the FTU scores, which is an index of posterior tooth occlusion, on the two sides of the oral cavity. The scores were used to classify the UM into low, moderate, and high. The adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) were calculated in multivariable logistic regression analyses.

RESULTS

When controlling for sociodemographic factors, the aOR for hearing loss was 3.12 (95% CI, 1.21-8.03) for high UM relative to low UM. This association remained in a fully-adjusted model containing factors related to noise exposure (aOR 2.88; 95% CI, 1.12-7.46).

CONCLUSION

Adults with high UM as measured using FTUs showed a higher occurrence of hearing loss than those with low UM.

Relationship between dental occlusion and functional dependence in elderly Caucasians

OBJECTIVE

To determine whether a relationship exists between the number of functional masticatory units (FMUs) and the level of functional dependence of elderly.

SUBJECTS AND METHODS

The study group comprised 502 elderly Caucasians living in nursing homes in north-west Spain and Portugal. The number of FMUs was counted on direct visual inspection. The degree of dependence was assessed using the Barthel index. The results were validated in a group of 156 elderly. Statistical analysis of the results was performed using a generalised linear model (GLM), a logistic GLM, a ROC-GLM curve and a confusion matrix.

RESULTS

The number of FMUs significantly affected the Barthel index score (explained deviance = 27.5%). The number of FMUs was significantly associated with a lower probability of dependence, both for women (explained deviance = 31%) and for men (explained deviance = 33%). The model based on FMUs showed a good discriminatory capacity for dependence (AUC = 0.84 in women and 0.82 in men). The predictive capacity of the dependence model based on FMUs was very high (sensitivity = 0.9 in women and 0.8 in men).

CONCLUSIONS

In institutionalised elderly Caucasians, the number of FMUs is significantly associated with the Barthel index score and could be a predictive factor for dependence.

Association between tooth loss and obesity in Brazilian adults: a population-based study

OBJECTIVE: To examine the association between tooth loss and general and central obesity among adults. METHODS: Population-based cross-sectional study with 1,720 adults aged 20 to 59 years from Florianópolis, Southern Brazil. Home interviews were performed and anthropometric measures were taken. Information on sociodemographic data, self-reported diabetes, self-reported number of teeth, central obesity (waist circumference [WC] > 88 cm in women and > 102 cm in men) and general obesity (body mass index [BMI] ≥ 30 kg/m²) was collected. We used multivariable Poisson regression models to assess the association between general and central obesity and tooth loss after controlling for confounders. We also performed simple and multiple linear regressions by using BMI and WC as continuous variables. Interaction between age and tooth loss was also assessed. RESULTS: The mean BMI was 25.9 kg/m² (95%CI 25.6;26.2) in men and 25.4 kg/m2 (95%CI 25.0;25.7) in women. The mean WC was 79.3 cm (95%CI 78.4;80.1) in men and 88.4 cm (95%CI 87.6;89.2) in women. A positive association was found between the presence of less than 10 teeth in at least one arch and increased mean BMI and WC after adjusting for education level, self-reported diabetes, gender and monthly per capita income. However, this association was lost when the variable age was included in the model. The prevalence of general obesity was 50% higher in those with less than 10 teeth in at least one arch when compared with those with 10 or more teeth in both arches after adjusting for education level, self-reported diabetes and monthly per capita family income. However, the statistical significance was lost after controlling for age. CONCLUSIONS: Obesity was associated with number of teeth, though it depended on the participants' age groups.

Oral health status and chewing ability is related to mini-nutritional assessment results in an older adult population in Thailand

In a cross-sectional study, we investigated the relationship of Mini-Nutrition Assessment (MNA) results with chewing ability tests and oral examinations (number of teeth present and functional tooth units (FTUs)). The participants were 612 older people (Mean [SD] age: 68.8 [5.9]). According to the MNA score, 25.1% of participants were categorized as having normal nutrition, 67.2% were categorized as at risk of malnourishment, and 7.7% were categorized as having malnutrition. The mean numbers of teeth present and FTUs were [15.5] and [8.9], respectively. The ANCOVA analyses adjusted for age and gender showed that participants with malnutrition had lower numbers of teeth present (8.8), FTUs (8.4), and chewing ability (6.8) than those with normal nutrition (13.3, 10.4 and 7.8) (p < 0.05). Nutritional status was associated with mean numbers of teeth present, FTUs, and chewing ability. Therefore, it was concluded that retention of natural teeth with appropriate numbers of FTUs by replacing missing teeth with dentures and improving chewing ability will help the reduce risk of malnutrition in older adults.

Dietary issues inpatients face with being vegetarian: an integrative review

This article reviews the literature from 1985 through 2010 on research related to the dietary issues vegetarian inpatients may encounter in the acute care setting. A thematic portrayal of vegetarianism in the context of the inpatient setting is described. Implications for future research and nursing practice are identified.

Masticatory ability and functional tooth units in Japanese adults

The purposes of this study were (i) to examine the relationship between the number of natural teeth and the number of functional tooth units in Japanese adults, (ii) to evaluate how functional tooth units relate to subjective masticatory ability and (iii) to determine the minimum number of natural teeth and functional tooth units needed to maintain adequate self-assessed chewing function. A self-administered questionnaire was given and dental examination was conducted for 2164 residents aged 40 to 75 years. Counts were made on the number of functional tooth units of natural teeth (n-functional tooth units), the sum of natural teeth and artificial teeth on implant-supported and fixed prostheses (nif-functional tooth units) and the sum of natural teeth and artificial teeth on implant-supported, fixed and removable prostheses (total-functional tooth units). The average number of natural teeth, n-functional tooth units and nif-functional tooth units decreased with age, but these were often replaced by functional tooth units from artificial teeth on removable prostheses. Total-functional tooth units in 50-59 year old people were slightly lower compared with those in other age groups. Subjects who reported that they could chew every food item on an average had 23.4 total natural teeth, 12.6 posterior natural teeth, 7.6 n-functional tooth units, 8.6 nif-functional tooth units and 10.4 total-functional tooth units, and subjects without chewing difficulties had fewer functional tooth units from removable prostheses. Maintaining 20 and more natural teeth and at least eight nif-functional tooth units is important in reducing the likelihood of self-assessed chewing difficulties.

Relationship between chewing ability and high-level functional capacity in an 80-year-old population in Japan

OBJECTIVES

To evaluate the association between high-level functional capacity and chewing in a middle-old community-based population.

BACKGROUND

Although basic and instrumental activities of daily living are known to be associated with chewing ability in the elderly, an association between higher levels of competence and chewing ability has not been evaluated in the elderly.

MATERIALS AND METHODS

The association between chewing ability using a number of different foods and high-level functional capacity by the Tokyo Metropolitan Institute of Gerontology was evaluated in 694, 80-year-old people residing in Fukuoka Prefecture, Japan.

RESULTS

A significant correlation was found, using multiple regression or logistic regression analyses adjusted for various confounding factors, between the number of total chewable foods, hard foods or moderately hard foods, and total functional capacity, instrumental activity, intellectual activity or social role ability. In contrast, the number of slightly hard foods, easily chewable foods and remaining teeth were only partly related to total functional capacity and intellectual activity.

CONCLUSION

High-level functional capacity including intellectual activity and social role in middle-old elderly was associated with the ability to chew hard foods than to chew easily chewable foods. Maintenance of chewing ability in elderly might result in better intellectual activity and social role.

Hand Function and Oral Hygiene in Older Institutionalized Brazilians

OBJECTIVES

To evaluate whether the oral hygiene of institutionalized older people differs significantly between groups of participants with different degrees of hand function.

DESIGN

Cross-sectional study.

SETTING

Residents of a long-term institution of Porto Alegre, Brazil.

PARTICIPANTS

Forty-nine institutionalized older people. Subjects restricted to bed or with Mini-Mental State Examination (MMSE) scores less than 15 were excluded.

MEASUREMENTS

Dental (Silness and Löe Index) and denture plaque (Modified Ambjornsen Plaque Index) scores were assessed as a measure of oral hygiene. Hand functions were assessed using the Jebsen-Taylor and the Purdue pegboard tests. Participants were grouped according to their levels of hand function (regarded as good if test values were at the median or higher in the case of Purdue pegboard test and below the median in the case of Jebsen-Taylor test). Existence of differences between groups was checked using univariate analysis of variance, adjusting for age, sex and cognitive status according to MMSE.

RESULTS

Dentate participants with poor hand function according to the Dominant Hand Purdue test harbored significantly more dental plaque after adjustment for age, sex, and cognitive status. Complete denture wearers with poor hand function according to the Dominant Hand and Sum of Three Steps Purdue tests and the total Jebsen-Taylor test also had significantly more denture plaque after adjustment.

CONCLUSION

The results support the notion that hand function plays a central role in oral hygiene, mainly removal of dental and denture plaque, in institutionalized older people.

Association of total tooth loss with smoking, drinking alcohol and nutrition in elderly Japanese: analysis of national database

OBJECTIVE

Various factors may be associated with edentulism in elderly people. Association of total tooth loss with smoking, alcohol intake and nutrition in non-institutionalised elderly Japanese was assessed utilising national database.

MATERIALS AND METHODS

Records of independent surveys, the Survey of Dental Diseases (SDD) and the National Nutrition Survey (NNS) in 1999 were electronically linked using the household identification number.

RESULTS

Among the records of 6903 subjects in the SDD and 12 763 subjects in the NNS, 6805 records were successfully linked. Overall, prevalence of total tooth loss in adults was very similar in males and females at approximately 7.0%, and the smoking rate was 47.6% and 9.9% respectively. Total tooth loss was a rare phenomenon (<2%) in age groups of <60 years. According to the multiple logistic regression analysis involving 2200 subjects aged 60 years or older, significant variables were age, current smokers and vitamin C intake in males, and age and current smokers in females. The variable for current drinkers was significant in females but the odds ratio was <1.0. No significant relationship was detected with respect to former smokers and drinkers, body mass index, vitamin E intake and blood glucose level.

CONCLUSIONS

Current smoking was associated with total tooth loss, although smoking rate was low in females. Gender difference in the association was suggestive with respect to drinking alcohol and vitamin C intake.

'Inadequate' dietary habits and mastication in elderly men

OBJECTIVE

The aim of this study was to re-evaluate data about oral status, mastication and nutrition in elderly men in Malmö, Sweden, recorded in 1985-1987, to assess associations between inadequate dietary habits, oral conditions and masticatory function.

MATERIALS AND METHODS

Four hundred and eighty-one men, aged 67-68, participated in a comprehensive health examination, including tooth and denture status and masticatory tests. A separate study of dietary habits and nutritional status was made. Ninety-five men had inadequate dietary habits. The databases of dental/denture status, mastication, nutritional status and social network factors were re-evaluated for assessment of associations.

RESULTS

No significant differences between those with adequate or inadequate nutrition were found with regard to the number of teeth, occlusal contacts or removable dentures. Also self-assessed chewing did not show any differences.

CONCLUSION

Inadequate dietary habits were independent of teeth and denture status. Some correlations to social network conditions could be identified. Overweight, obesity, low physical activity and high alcohol intake were more common among those with inadequate nutritional intake.

Effect on components of the intestinal microflora and plasma neuropeptide levels of feeding Lactobacillus delbrueckii, Bifidobacterium lactis, and inulin to adult and elderly rats

The aim of this study was to compare the effects of the mixture of Lactobacillus delbrueckii subsp. rhamnosus strain GG, Bifidobacterium lactis Bb12, and inulin on intestinal populations of lactobacilli, bifidobacteria, and enterobacteria in adult and elderly rats fed the same (in quality and quantity) diet. The portal plasma levels of two neuropeptides, neuropeptide Y (NPY) and peptide YY (PYY), were also evaluated to assess the physiological consequences of the synbiotic treatment for the gastrointestinal (GI) tracts of rats of different ages. Adult (n = 24) and elderly (n = 24) male rats were fed the AIN-93 M maintenance diet. After 2 weeks of adaptation, the diet of 12 rats of each age group was supplemented with 8% inulin and with strains GG and Bb12 to provide 2.2 x 10(9) CFU of each strain g(-1) of the diet. Blood and different regions of the GI tract were sampled from all rats after 21 days of the treatment. Treatment with the mixture of strain GG, strain BB12, and inulin induced significantly different changes in the numbers of lactobacilli, bifidobacteria, and enterobacteria of the stomach, small intestine, cecum, and colon microflora. Moreover, the GG, BB12, and inulin mixture increased the concentrations of NPY and PYY for adult rats. For the elderly animals, the PYY concentration was not changed, while the NPY concentration was decreased by treatment with the GG, BB12, and inulin mixture. The results of the present study indicate that the physiological status of the GI tract, and not just diet, has a major role in the regulation of important groups of the GI bacteria community, since even the outcome of the dietary modification with synbiotics depends on the ages of the animals.

The relationship between dietary intake and the number of teeth in elderly Japanese subjects

OBJECTIVE

This study used a precise weighing method to assess whether tooth loss was related to nutrient intake in elderly Japanese subjects.

MATERIAL AND METHODS

Fifty-seven subjects aged 74 years were randomly selected from a longitudinal interdisciplinary study of ageing. Complete 3-day food intake data were obtained by a precise weighing method. The dietary intakes of energy and nutrients were calculated based on the Standard Tables of Food Composition in Japan (5th ed.). A clinical evaluation of the number of teeth present was carried out. Multiple regression standardised coefficients for each nutrient was estimated based on a continuous scale adjusted for gender, smoking habits, and educational level. After dividing the subjects into two groups according to the number of teeth present (0-19, 20+), the difference in the intake of nutrients and the amount of food consumed per day was evaluated.

RESULTS

The number of teeth present had a significant relationship with the intake of several nutrients. In particular, total protein, animal protein, sodium, vitamin D, vitamin B1, vitamin B6, niacin, and pantothenic acid were significantly associated with the number of teeth present and with the two groups (0-19, 20+). The intake of vegetables and fish, shellfish, and their products was significantly lower among subjects with fewer teeth.

CONCLUSION

This study suggests that there was a significant relationship between nutrient intake, such as minerals and vitamins from food, and tooth loss.