Relationship between oral health status and nutritional status in a group of older persons: number of functional units and number of teeth

Main Article Content

Passawich Tubtimtong Tubtimtong
Potchaman Sinavarat
Chuchai Anunmana


Objective: The objectives of this study were to evaluate the oral health status i.e., dental decay, periodontal disease, number of teeth, and number of functional units and investigate the relationship between oral health status and nutritional status in the pre-ageing and ageing groups.

Materials and Methods:  The oral health status and nutritional status of 290 persons in Tubtao subdistrict, Thoeng district, Chiangrai province, Thailand, aged 50 years and over were evaluated. Study measurements included: a) questionnaire to assess sociodemographic, behavioral, general health, and oral health data of the participants; and b) oral examinations to evaluate caries, periodontal status, oral lesions, number of teeth, and number of functional units (FUs). Nutritional status was determined using the Short-Form Mini-Nutritional Assessment (MNA-SF). Association between participants’ characteristics, oral health status, and nutritional status were tested using chi-square analysis. 

Results: Participants aged 50-88 years were classified into pre-ageing group (50-59 years) and ageing group (60 years). One hundred and fifteen subjects were classified as pre-ageing group and 175 were in the ageing group. In the pre-ageing group, most participants had oral health status better than the ageing group. According to MNA-SF, about 46% and 3.5% of the pre-ageing group were at risk of malnutrition and malnutrition, respectively. Living condition and periodontal status showed significant difference of nutritional status (p<0.05). In the ageing group, the results of the nutritional status according to MNA-SF and BMI were the same as those in the pre-ageing group. The participants’ characteristics related to education, living condition, systemic diseases, feeling of mouth dryness, and avoidance of eating vegetables and fruits significantly associated with nutritional status (p<0.05). Furthermore, significant association were observed between the number of functional units, number of present teeth, and MNA-SF (p<0.05). 

Conclusion: The results of the study indicated that the participants in both groups had poorer oral health than the reports of the 7th Thailand Oral Health Survey of northern Thailand and the number of present teeth, and number of FUs of the ageing participants had association with nutritional status. Many demographic characteristics of the ageing group also related to nutritional state. The results imply the need to develop effective strategies for improving oral health care of the populations and prevent oral and dental diseases and maintain the existing natural dentition. The strategies of preventive programme should include improving of oral hygiene care, providing oral health care, promotion of social activities for the pre-ageing and ageing people, and providing diet counseling. It is without doubt that the preventive programme should be commenced before they reach old age.

Keywords: BMI, functional units, MNA-SF, nutrition, older persons, oral health


Download data is not yet available.

Article Details

How to Cite
Tubtimtong PT, Sinavarat P, Anunmana C. Relationship between oral health status and nutritional status in a group of older persons: number of functional units and number of teeth. M Dent J [Internet]. 2019 Apr. 29 [cited 2023 Dec. 9];39(1):21-33. Available from:
Original articles


Ettinger RL. Changing dietary patterns with changing dentition: how do people cope? Spec Care Dentist. 1998; 18: 33-9.

Gariballa SE, Sinclair AJ. Nutrition, ageing and ill health. BR J Nutr. 1998; 80: 7-23.

Sheiham A, Steele J. Does the condition of the mouth and teeth affect the ability to eat certain foods, nutrient and dietary intake and nutritional status amongst older people? Public Health Nutr. 2001; 4: 797-803.

Hickson M. Malnutrition and ageing. Postgrad Med J. 2006; 82: 2-8.

Käyser AF. Shortened dental arch: a therapeutic concept in reduced dentitions and certain high-risk groups. Int J Periodontics Restorative Dent. 1989; 9: 426-49.

Elias AC, Sheiham A. The relationship between satisfaction with mouth and number and position of teeth. J Oral Rehabil. 1998; 25: 649-61.

Witter DJ, van Palenstein Helderman WH, Creugers NH, Kayser AF. The shortened dental arch concept and its implications for oral health care. Community Dent Oral Epidemiol. 1999; 27: 249-58.

Meeuwissen JH, van Waas MA, Meeuwissen R, Kayser AF, van 't Hof MA, Kalk W. Satisfaction with reduced dentitions in elderly people. J Oral Rehabil. 1995; 22: 397-401.

Käyser AF. Shortened dental arches and oral function. J Oral Rehabil. 1981; 8: 457-62.

Käyser AF, Witter DJ, Spanauf AJ. Overtreatment with removable partial dentures in shortened dental arches. Aust Dent J. 1987; 32: 178-82.

Käyser AF. How much reduction of the dental arch is functionally acceptable for the ageing patient? Int Dent J. 1990; 40: 183-8.

World Health Organzation. Recent Advances in Oral Health. WHO Technical Report Series No826 Geneva, Switzerland; WHO. 1992: 16-7.

Hildebrandt GH, Dominigues BL, Schork MA, Loesche WJ. Functional units, chewing, swallowing, and food avoidance among the elderly. J Prosthet Dent. 1997; 77: 588-95.

Sahyoun NR, Lin CL, Krall E. Nutritional status of the older adult is associated with dentition status. J Am Diet Assoc. 2003; 103: 61-6.

Hildebrandt GH LW, Lin CF, Bretz WA. Comparison of the number and type of dental functional units in geriatric populations with diverse medical backgrounds. J Prosthet Dent. 1995; 73: 253-61.

Kapur KK, Soman SD. Masticatory performance and efficiency in denture wearers. J Prosthet Dent. 2006; 95: 407-11.

Appollonio I, Carabellese C, Frattola A, Trabucchi M. Influence of dental status on dietary intake and survival in community-dwelling elderly subjects. Age Ageing. 1997; 26: 445-56.

Witter DJ, De Haan AF, Kayser AF, Van Rossum GM. A 6-year follow-up study of oral function in shortened dental arches. Part II: Craniomandibular dysfunction and oral comfort. J Oral Rehabil. 1994;21(4):353-66.

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

McHugh ML. Interrater reliability: the kappa statistic. Biochemia medica. 2012; 22: 276-82.

Sebring NG, Guckes AD, Li SH, McCarthy GR. Nutritional adequacy of reported intake of edentulous subjects treated with new conventional or implant-supported mandibular dentures. J Prosthet Dent. 1995; 74: 358-63.

de Andrade FB, de Franca Caldas A, Jr., Kitoko PM. Relationship between oral health, nutrient intake and nutritional status in a sample of Brazilian elderly people. Gerodontology. 2009; 26: 40-5.

Harris D, Haboubi N. Malnutrition screening in the elderly population. J R Soc Med. 2005; 98: 411-4.

Poulia KA, Yannakoulia M, Karageorgou D, Gamaletsou M, Panagiotakos DB, Sipsas NV, et al. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly. Clin Nutr. 2012; 31: 378-85.

Soini H, Routasalo P, Lagstrom H. Characteristics of the Mini-Nutritional Assessment in elderly home-care patients. Eur J Clin Nutr. 2004; 58: 64-70.

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63.

World Health Organization, editor. Oral health surveys: basic methods 5th ed2013.

JH Z. Biostatistical analysis. 5th ed. New Jersey: Prentice Hall; 2009.

Chai J, Chu FC, Chow TW, Shum NC, Hui WW. Influence of dental status on nutritional status of geriatric patients in a convalescent and rehabilitation hospital. Int J Prosthodont. 2006; 19: 244-9.

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: 408-13.

Wostmann B, Michel K, Brinkert B, Melchheier-Weskott A, Rehmann P, Balkenhol M. Influence of denture improvement on the nutritional status and quality of life of geriatric patients. J Dent. 2008; 36: 816-21.

De Marchi RJ, Hugo FN, Hilgert JB, Padilha DM. Association between oral health status and nutritional status in south Brazilian independent-living older people. Nutrition. 2008; 24: 546-53.

Srisilapanan P, Malikaew P, Sheiham A. Number of teeth and nutritional status in Thai older people. Community Dent Health. 2002; 19 :230-6.

Marshall TA, Warren JJ, Hand JS, Xie XJ, Stumbo PJ. Oral health, nutrient intake and dietary quality in the very old. J Am Dent Assoc. 2002; 133: 1369-79.

Leake JL, Hawkins R, Locker D. Social and functional impact of reduced posterior dental units in older adults. J Oral Rehabil. 1994; 21: 1-10.

Bureau of Dental Health DOH, Ministry of Public Health. The 7th national oral health survey report, Thailand 2012. Bangkok; 2013.

Ueno M, Yanagisawa T, Shinada K, Ohara S, Kawaguchi Y. Category of functional tooth units in relation to the number of teeth and masticatory ability in Japanese adults. Clin Oral Investig. 2010; 14: 113-9.

Tatematsu M, Mori T, Kawaguchi T, Takeuchi K, Hattori M, Morita I, et al. Masticatory performance in 80-year-old individuals. Gerodontology. 2004;21:112-9.

Ow RK, Loh T, Neo J, Khoo J. Perceived masticatory function among elderly people. J Oral Rehabil.1997; 24: 131-7.

Agerberg G, Carlsson GE. Chewing Ability in Relation to Dental and General Health. Acta odontologica Scandinavica. 1981; 39: 147-53.

Osterberg T, Carlsson GE, Tsuga K, Sundh V, Steen B. Associations between self-assessed masticatory ability and some general health factors in a Swedish population. Gerodontology. 1996;13(2):110-7.

Witter DJ, van Elteren P, Kayser AF, van Rossum MJ. The effect of removable partial dentures on the oral function in shortened dental arches. J Oral Rehabil. 1989; 16: 27-33.

Witter DJ, Van Elteren P, Kayser AF, Van Rossum GM. Oral comfort in shortened dental arches. J Oral Rehabil. 1990; 17: 137-43.

Slade GD, Spencer AJ, Roberts-Thomson K. Tooth loss and chewing capacity among older adults in Adelaide. Aust N Z J Public Health. 1996; 20: 76-82.

Armellini D, von Fraunhofer JA. The shortened dental arch: a review of the literature. J Prosthet Dent. 2004; 92: 531-5.

Donini LM, Savina C, Rosano A, Cannella C. Systematic review of nutritional status evaluation and screening tools in the elderly. J Nutr Health Aging. 2007; 11: 421-32.

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