Oral health and nutritional status in care-dependent, community-dwelling older adults in Zurich, Switzerland

Authors

  • Lea Angst Clinic of General-, Special Care, and Geriatric Dentistry, Centre for Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Orthodontics, Centre for Dental Medicine, University of Zurich, Zurich, Switzerland.
  • Patricia D. Ferreira Lourenço Clinic of General-, Special Care, and Geriatric Dentistry, Centre for Dental Medicine, University of Zurich, Zurich, Switzerland
  • Murali Srinivasan Clinic of General-, Special Care, and Geriatric Dentistry, Centre for Dental Medicine, University of Zurich, Zurich, Switzerland

DOI:

https://doi.org/10.61872/sdj-2024-02-09

PMID:

38739774

Keywords:

Geriatric dentistry, Oral Health, Nutrition, Community-dwelling older adults, gerodontology

Abstract

The aim of this study was to assess the oral health status (OHS), Oral health impact profile (OHIP-G-14), and the nutritional status (NS) in community-dwelling, dependent older adults. Information on OHS including DMF(T), plaque (PI) and gingival (GI) indices, community-periodontal-index-for-treatment-needs (CPITN), OHIP-G-14, maximum bite force (MBF), chewing efficiency [subjective (SA) and quantitative (VoH) assessments] were collected. NS was obtained by Mini-nutritional assessment (MNA) and body mass index (BMI). Cognitive status was evaluated by the mini-mental state examination (MMSE). 240 elders (mean-age = 81.5 ± 8.9y; men =85, women =155) were recruited. Average number of teeth, functional occlusal units and DMF(T), were 18.8 ± 8.9, 7.7 ± 3.5, and 22.3 ± 5.3 respectively. Mean PI, GI, CPITN and OHIP-G-14 were 1.8 ± 0.8, 1.2 ± 0.8, 1.9 ± 1.1, and 8.0 ± 12.0, respectively. MBF, VoH, SA were 219.6 ± 193.6, 0.3 ± 0.2, and 3.3 ± 1.4, respectively. MNA and BMI were 22.9 ± 4.7 and 25.5 ± 5.3, respectively. Number of teeth reduced significantly with age (P < 0.001), cognitive decline (P < 0.001). Oral hygiene significantly deteriorated with cognitive decline (P < 0.001). OHIP scores were negatively affected by increasing cognitive decline (P < 0.001). MNA deteriorated in women (P = 0.026), with increasing age (P = 0.015), and advancing cognitive decline (P < 0.001). BMI reduced with advancing age (P = 0.003) and in women (P = 0.016). Based on the findings of this study, it may be concluded that advancing age and cognitive decline, negatively impacted the oral health, oral function, oral health-related quality of life, and the nutritional state of care-dependent community-dwelling older adults.

References

Kassebaum NJ, Smith AGC, Bernabe E, Fleming TD, Reynolds AE, Vos T, et al. Global, Regional, and Nation-al Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res. 2017;96(4):380-7.

Toniazzo MP, Amorim PS, Muniz F, Weidlich P. Relationship of nutritional status and oral health in elderly: Systematic review with meta-analysis. Clin Nutr. 2018;37(3):824-30.

Sheiham A, Steele JG, Marcenes W, Lowe C, Finch S, Bates CJ, et al. The relationship among dental status, nutrient intake, and nutritional status in older people. J Dent Res. 2001;80(2):408-13.

Saunders MJ, Stattmiller SP, Kirk KM. Oral health issues in the nutrition of institutionalized elders. J Nutr Elder. 2007;26(3-4):39-58.

Fitzpatrick J. Oral health care needs of dependent older people: responsibilities of nurses and care staff. J Adv Nurs. 2000;32(6):1325-32.

Sweeney MP, Manton S, Kennedy C, Macpherson LM, Turner S. Provision of domiciliary dental care by Scottish dentists: a national survey. Br Dent J. 2007;202(9):E23.

Janssens B, Vanobbergen J, Petrovic M, Jacquet W, Schols J, De Visschere L. The oral health condition and treatment needs assessment of nursing home residents in Flanders (Belgium). Community Dent Health. 2017;34(3):143-51.

De Visschere LM, Grooten L, Theuniers G, Vanobbergen JN. Oral hygiene of elderly people in long-term care institutions--a cross-sectional study. Gerodontology. 2006;23(4):195-204.

Schmalz G, Denkler CR, Kottmann T, Rinke S, Ziebolz D. Oral Health-Related Quality of Life, Oral Conditions, and Risk of Malnutrition in Older German People in Need of Care-A Cross-Sectional Study. J Clin Med. 2021;10(3).

Chalmers JM, Carter KD, Spencer AJ. Caries incidence and increments in Adelaide nursing home residents. Spec Care Dentist. 2005;25(2):96-105.

Höpflinger F, Bayer-Oglesby L, Zumbrunn A. Pflegebedürftigkeit und Langzeitpflege im Alter Aktualisierte Szenarien für die Schweiz. Bern: Schweizerisches Gesundheitsobervatroium; 2015.

Schneider C, Zemp E, Zitzmann NU. Oral health improvements in Switzerland over 20 years. Eur J Oral Sci. 2017;125(1):55-62.

Zitzmann NU, Staehelin K, Walls AW, Menghini G, Weiger R, Zemp Stutz E. Changes in oral health over a 10-yr period in Switzerland. Eur J Oral Sci. 2008;116(1):52-9.

Müller F, Naharro M, Carlsson GE. What are the prevalence and incidence of tooth loss in the adult and elderly population in Europe? Clin Oral Implants Res. 2007;18 Suppl 3:2-14.

Thompson GW, Kreisel PS. The impact of the demographics of aging and the edentulous condition on dental care services. J Prosthet Dent. 1998;79(1):56-9.

Baxter JC. Nutrition and the geriatric edentulous patient. Spec Care Dentist. 1981;1(6):259-61.

van der Bilt A, Olthoff LW, Bosman F, Oosterhaven SP. The effect of missing postcanine teeth on chewing performance in man. Arch Oral Biol. 1993;38(5):423-9.

Mercier P, Poitras P. Gastrointestinal symptoms and masticatory dysfunction. J Gastroenterol Hepatol. 1992;7(1):61-5.

Krall E, Hayes C, Garcia R. How dentition status and masticatory function affect nutrient intake. J Am Dent Assoc. 1998;129(9):1261-9.

Greksa LP, Parraga IM, Clark CA. The dietary adequacy of edentulous older adults. J Prosthet Dent. 1995;73(2):142-5.

Papas AS, Palmer CA, Rounds MC, Russell RM. The effects of denture status on nutrition. Spec Care Dentist. 1998;18(1):17-25.

Martínez Steele E, Baraldi LG, Louzada ML, Moubarac JC, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. 2016;6(3):e009892.

Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22(5):936-41.

Martínez Steele E, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. Popul Health Metr. 2017;15(1):6.

Machado PP, Steele EM, Louzada M, Levy RB, Rangan A, Woods J, et al. Ultra-processed food consumption drives excessive free sugar intake among all age groups in Australia. Eur J Nutr. 2020;59(6):2783-92.

Boumendjel N, Herrmann F, Girod V, Sieber C, Rapin CH. Refrigerator content and hospital admission in old people. Lancet. 356. England2000. p. 563.

Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(Suppl 1):S31-s4.

Oral Health Surveys [press release]. Geneva, Switzerland: WHO Library Cataloguing-in-Rublication Da-tha2013.

Linn BS, Linn MW, Gurel LEE. Cumulative illness rating scale. Journal of the American Geriatrics Society. 1968;16(5):622-6.

Whiteneck GG. Craig Handicap Assessment and Reporting Technique. In: Kreutzer JS, DeLuca J, Caplan B, editors. Encyclopedia of Clinical Neuropsychology. New York, NY: Springer New York; 2011. p. 728-30.

Silness J, Loe H. Periodontal Disease in Pregnancy. II. Correlation between Oral Hygiene and Periodontal Condtion. Acta Odontol Scand. 1964;22:121-35.

Van der Weijden GA, Timmerman MF, Nijboer A, Reijerse E, Van der Velden U. Comparison of different approaches to assess bleeding on probing as indicators of gingivitis. J Clin Periodontol. 1994;21(9):589-94.

Muthukumar S, Suresh R. Community periodontal index of treatment needs index: an indicator of anaero-bic periodontal infection. Indian J Dent Res. 2009;20(4):423-5.

Thomson WM, Chalmers JM, Spencer AJ, Williams SM. The Xerostomia Inventory: a multi-item approach to measuring dry mouth. Community Dent Health. 1999;16(1):12-7.

Schimmel M, Christou P, Miyazaki H, Halazonetis D, Herrmann FR, Muller F. A novel colourimetric tech-nique to assess chewing function using two-coloured specimens: Validation and application. J Dent. 2015;43(8):955-64.

Schimmel M, Christou P, Herrmann F, Muller F. A two-colour chewing gum test for masticatory efficiency: development of different assessment methods. J Oral Rehabil. 2007;34(9):671-8.

Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994;11(1):3-11.

John MT, Patrick DL, Slade GD. The German version of the Oral Health Impact Profile--translation and psychometric properties. Eur J Oral Sci. 2002;110(6):425-33.

Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epi-demiol. 1997;25(4):284-90.

Guigoz Y, Vellas BJ. [Malnutrition in the elderly: the Mini Nutritional Assessment (MNA)]. Ther Umsch. 1997;54(6):345-50.

Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The Mini Nutritional Assess-ment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15(2):116-22.

Monteiro CA, Cannon G, Moubarac JC, Levy RB, Louzada MLC, Jaime PC. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2018;21(1):5-17.

Ziebolz D, Werner C, Schmalz G, Nitschke I, Haak R, Mausberg RF, et al. Oral Health and nutritional status in nursing home residents-results of an explorative cross-sectional pilot study. BMC Geriatr. 2017;17(1):39.

Lamy M, Mojon P, Kalykakis G, Legrand R, Butz-Jorgensen E. Oral status and nutrition in the institutional-ized elderly. J Dent. 1999;27(6):443-8.

Samnieng P, Ueno M, Shinada K, Zaitsu T, Wright FA, Kawaguchi Y. Oral health status and chewing ability is related to mini-nutritional assessment results in an older adult population in Thailand. J Nutr Gerontol Ge-riatr. 2011;30(3):291-304.

Schneider C, Zemp E, Zitzmann NU. Dental care behaviour in Switzerland. Swiss Dent J. 2019;129(6):466-78.

Corish CA, Bardon LA. Malnutrition in older adults: screening and determinants. Proc Nutr Soc. 2019;78(3):372-9.

Hamilton IR. Biochemical effects of fluoride on oral bacteria. J Dent Res. 1990;69 Spec No:660-7; discussion 82-3.

N'Gom P I, Woda A. Influence of impaired mastication on nutrition. J Prosthet Dent. 2002;87(6):667-73.

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Published

2024-05-10

How to Cite

Angst, L., Ferreira Lourenço, P. D., & Srinivasan, M. (2024). Oral health and nutritional status in care-dependent, community-dwelling older adults in Zurich, Switzerland. SWISS DENTAL JOURNAL SSO – Science and Clinical Topics, 134(2), 122-144. https://doi.org/10.61872/sdj-2024-02-09

How to Cite

Angst, L., Ferreira Lourenço, P. D., & Srinivasan, M. (2024). Oral health and nutritional status in care-dependent, community-dwelling older adults in Zurich, Switzerland. SWISS DENTAL JOURNAL SSO – Science and Clinical Topics, 134(2), 122-144. https://doi.org/10.61872/sdj-2024-02-09