Comparative evaluation of nutritional status of elderly dentulous and completely edentulous patients wearing complete dentures

Abstract

Introduction: The scientific progress has reached a level where nutritional interventions may play a part in the prevention of degenerative conditions of age, improvement of quality of life and impact on health care burden and resources. Moreover a timely intervention can stop weight loss in elderly at risk of malnutrition or undernourished. Evaluation of nutritional status is important for any nutrition or dietary modification. We therefore did a comparative study of evaluation of nutritional status of elderly dentulous and completely edentulous patients wearing complete dentures. Rationale: To evaluate nutritional status in dentulous and edentulous denture wearing elderly patient. To evaluate any relationship between edentulous denture wearer patient and malnutrition. To determine if the recommended dietary allowance is met by elderly dentulous and completely edentulous patients wearing complete dentures. To find out the need of nutritional supplement for edentulous complete denture wearer patients. Objectives: The objectives were to evaluate nutritional status in dentulous and edentulous denture wearing elderly patients and to find out any relationship between edentulous denture wearer patients and malnutrition. We also tried to find out the need of nutritional supplement for edentulous denture wearer patients. Material & Method: A total of 100  healthy Male and Female  patients  between the age of 60  to 80 years attending the OPD of Department of Prosthodontics, Faculty of Dental Sciences, Dharmsinh Desai University, Nadiad, Gujarat were selected and divided into two sample groups dentulous and edentulous. Subjects with no natural teeth who reported wearing complete maxillary and   mandibular dentures for at least 6 months were taken as the edentulous sample and subjects with at least 24 teeth who did not wear dentures were taken as dentulous sample. Mini Nutrition Assesment Tool, 24 Hour Diet Recall & Food Frequency Form were used to evaluate the nutritional status of the subjects. The data on food consumption was converted to the calorie content of the diet and the percentage of recommended dietary allowance (RDA) was calculated for the subject according to the age, gender and activity level. Statistical analysis was done using the Chi square P value test. No investigation or intervention was conducted on patients, humans or other animals hence, ethical consideration was not applicable in this study. Null hypothesis: “There is no difference in the nutritional intake of the dentulous patients and edentulous patients wearing complete dentures”. Result: It was observed in this study that only 62% of the edentulous subjects were taking fruits frequently against 88% of dentulous subjects. In the same way, while 54% of dentulous subjects were consuming nuts and oil seeds, only 36% of edentulous subjects consumed them & the result is statistically significant. There was a direct relationship between edentulousness and malnutrition. 94% of the dentulous subjects in our study were well nourished according to MNA having score from 24 to 30 against 62% of edentulous subjects. The risk of malnutrition was eight times higher in edentulous as compared to dentulous subjects, 34% & 4% respectively which is highly significant statistically. Only negligible portion was malnourished that was 2% for dentulous and 4% for edentulous subjects. Further, there was a positive correlation between the MNA score and calorie intake per day in percentage of RDA. All the subjects detected to be malnourished were taking less than 75% of RDA calorie intake. Amongst 17 edentulous subjects (34%) at risk of malnutrition, more than half (n=10) were consuming less than 75% of RDA. Even though statistically insignificant, maximum subjects in both the categories belonged to >25kg/m2 (over weight) that is total 60% of dentulous and 44% of edentulous subjects. On further division, 38% of dentulous and 28% of edentulous subjects were preobese while those belonging to obese category were 22% and 16% respectively. Conclusion: Undernutrition as well as obesity were common health hazards in our geriatric population. Early management by nutritional intervention, combined with oral health care, is of great importance for the improvement of nutritional parameters and the prognosis of prosthetic treatment