This systematic review and meta-analysis explored the association of tooth loss (complete and partial or no functional dentition) and nutritional status using a variety of validated tools in people aged 60 years and older over a 10-year period.
Many previous articles have reported that the world’s population is aging. Additionally, tooth loss is more common in older adults who are at higher risk of malnutrition, especially if they lack education and have low income.
Using the appropriate PRISMA guidelines, these authors found only seven articles that met their inclusion criteria, and each was from a different developed country using nationally representative studies.
The risk of bias in these studies was moderate. This study was limited to articles published in English and the use of medications, which are known to affect saliva, taste, and oral health, was not controlled for. The MNA measure of malnutrition does not assess the risk of micronutrient deficiencies.
The meta-analysis revealed that older adults who were completely edentulous or lacked a functional dentition were 21% more likely to be at risk for malnutrition. If medical history is adjusted, the risk increases to 32%.
The clinical implications of this study are that all health professionals can examine the mouth and identify tooth loss and refer the patient to a dentist, while oral health professionals should examine their patients for malnutrition and refer them to a dietitian.
Background/Purpose:
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 years and older 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 the inclusion criteria.
Extracted data included study and participant characteristics, dentition, and nutritional status. Risk of bias was assessed with a modified Newcastle-Ottawa scale. A random effects meta-analysis was used.
Results:
Of the 588 non-duplicated articles identified, 78 were reviewed in full text and 7 met the inclusion criteria.
Six studies were combined for a meta-analysis, which revealed that people who were completely edentulous or lacked a functional dentition were 21% more likely to be at risk of malnutrition or undernourished, compared to those who were edentulous or had a functionally adequate dentition. teething (hazard ratio, 1.21; 95% CI, 1.11 to 1.32; I 2 = 70%).
Conclusions and implications:
The findings suggest that older adults with tooth loss are at greater risk of malnutrition than those with functionally adequate dentition.
The use of validated tools to assess the risk of malnutrition in older adults with tooth loss is important to promote early intervention and referral to optimize nutrition and oral health status.
The findings were limited by heterogeneity, risk of bias, and overall quality of the studies reviewed. Cohort studies are needed that adjust for known confounders and use consistent approaches to assess tooth loss and nutritional status.
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.
Detection of malnutrition in this population by healthcare professionals, including dentists and dieticians, can lead to appropriate referrals to optimize oral health and nutrition status. More research is needed with consistent approaches to assess tooth loss and nutritional status.
