Tooth loss: does it affect dietary intake and nutritional status?

A Mediterranean diet high in fruits, vegetables, fish and wholegrains has been associated with decreased depression. Is there a key ingredient?

Mastication is a key function of teeth and tooth loss reduces masticatory function and chewing ability. This can lead to a reduction of food choice and variation in the diet.   A good diet is important for a health life and studies have been conducted on the interrelationship between tooth loss, diet and nutritional status.

The aim of this review was to assess the longitudinal evidence on whether tooth loss affects dietary intake and nutritional status among adults.

Methods

Searches were conducted in the Medline, Embase, LILACS, OpenGrey and Google Scholar databases. Longitudinal studies of population-based or clinical samples of adults exploring the effect of tooth loss on food/dietary/nutrient intake and/or nutritional status were considered.  Two reviewers independently selected studies abstracted data and assessed study quality using the Newcastle-Ottawa Scale for cohort studies.Meta-analysis was not carried out because of the high level of heterogeneity a narrative summary was presented.

Results

  • 10 reports of 8 cohort studies were included.
  • 5 studies were subsets of population –based cohorts.
  • Sample sizes ranged from 134 to 59,467 and age varied from 30 to 65+ years.
  • 7 studies were considered to be of poor quality, 1 of fair quality.
  • There was considerable variation across the studies in terms of both the exposure and outcomes
  • 5 studies reported the association between tooth loss and nutrient intake, 4 showed some significant associations, although results were inconsistent across measures of tooth loss and food intake.
  • 4 studies reported the association between tooth retention and nutritional status, 3 studies showed some significant associations. However, results were contradictory.

Conclusions

The authors concluded: –

This systematic review indicates there is weak evidence on the association of tooth loss with nutrient intake and nutritional status. Inconsistent findings were reported across the 8 longitudinal studies identified. The only consistent association, as reported in two studies, was for greater self-reported tooth loss and small decreases in dietary cholesterol. Additional high-quality longitudinal studies should address the limitations of previous studies identified in this review.

Comments

The authors have searched a number of databases and only including prospective studies which in theory would provide good observational evidence. However, the   included studies were of low quality in part due to the marked variability in the way in which both exposures and outcomes were measured.  This means that while the review helpfully summarises the available data the findings are weak and inconsistent and further high quality studies are needed.

Links

Primary paper

Gaewkhiew P, Sabbah W, Bernabé E. Does Tooth Loss affect Dietary Intake and Nutritional Status? A Systematic Review of Longitudinal Studies. J Dent. 2017 Oct 30. pii: S0300-5712(17)30264-6. doi: 10.1016/j.jdent.2017.10.012. [Epub ahead of print] Review. PubMed PMID: 29097121.

Other references

Original review protocol on PROSPERO

 

 

 

 

 

 

 

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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