Relationship between oral health status and nutritional status in a group of older persons: denture status

Main Article Content

Ratthawit Phetchan
Potchaman Sinavarat
Chuchai Anunmana
Widchaya Kanchanavasita


Objective: The aim of the study was to investigate the effects of tooth loss, denture replacement, and denture status, i.e. retention, stability, occlusion and defect on nutritional status in the pre-ageing and ageing people residing at home.

Materials and Methods: This cross-sectional study was conducted in a rural area, northern Thailand. The study population (290 persons) comprised free living participants aged 50 years or more. Subjects (115 persons) aged 50-59 were the pre-ageing group and individuals (175 persons) aged 60 and over were the ageing group. Subjects had interviews, oral examinations, and denture examinations. The Short-Form Mini-Nutritional Assessment (MNA-SF) was used to assess nutritional status. Association between dentition status, denture status, and nutritional status were analyzed using Chi-square test and Fisher’s exact test.

Results: Fifteen participants (13%) in the pre-ageing group and 50 participants (28.7%) in the ageing group
used removable dentures. Among the participants who used dentures, all participants in the pre-ageing (15
persons) wore partial dentures while 36 participants (20.6%) in the ageing group wore partial dentures and 14 participants (8.0%) wore complete dentures. The results revealed that the state of tooth loss without denture replacement resulted in the lowest MNA-SF score in both pre-ageing and ageing groups. Higher scores were achieved in persons with removable denture replacement while persons with adequate dentition had the highest scores. The association between dentition status and nutritional status in the pre-ageing group was not found, but the statistically significant association existed in the ageing group (p<0.05). Additionally, the association between the denture status and nutritional status in both pre-ageing and ageing participants were not found (p>0.05).

Conclusion: To improve the quality of life of older persons, oral hygiene care and appropriate dental treatments should be emphasized to maintain natural dentition and prevent tooth loss. This strategy should be started before those adults reach their old age. In addition, dentists should provide appropriate dietary advice to denture wearers, especially in the ageing group, and encourage them to eat various foods by proper preparing so that they can have adequate nutrient content.

Article Details

How to Cite
Phetchan R, Sinavarat P, Anunmana C, Kanchanavasita W. Relationship between oral health status and nutritional status in a group of older persons: denture status. M Dent J [Internet]. 2020 Apr. 28 [cited 2024 Feb. 25];40(1):23-35. Available from:
Original articles


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.

Bradbury J, Thomason JM, Jepson NJA, Walls AWG, Allen PF and Moynihan PJ. Nutritional counseling increases fruit and vegetable intake in the edentulous. J Dent Res 2006; 85: 463-8.

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

Hamasha AA, Hand JS, Levy SM. Medical conditions associated with missing teeth and edentulism in the institutionalized elderly. Spec Care Dentist 1998; 18: 123-7.

Abnet CC, Qiao YL, Dawsey SM, Dong ZW, Taylor PR, Mark SD. Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. Int J Epidemiol 2005; 34: 467-74.

Semba RD, Blaum CS, Bartali B, Xue QL, Hicks MO, et al. Denture use, malnutrition, frailty, and mortality among older women living in the community. J Nutr Health Aging 2006; 10: 161-70.

Vargas CM, Yellowitz JA, Hayes KL. Oral health status of older rural adults in the United States. J Am Dent Assoc 2003; 134: 479-86.

Bush HM, Dickens NE, Henry RG, Durham L, Sallee N, Skelton J, et al. Oral health status of older adults in Kentucky: results from the Kentucky Elder Oral Health Survey. Spec Care Dentist 2010; 30: 185-92.

Ervin RB, Dye BA. The effect of functional dentition on healthy eating index scores and nutrient intakes in a nationally representative sample of older adults. J Public Health Dent 2009; 69: 207-17.

Michael CG, Javid NS, Collaizzi FA, et al. Biting strength and chewing forces in complete denture wearers. J Prosthet Dent 1990; 63: 549.

Razak AP, Richard KMJ, Thankachan RP, Hafiz AKA, Kumar KN, Sameer KM. Geriatric oral health: A review article. J Int Oral Health 2014; 6: 110-6.

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.

Moynihan PJ, Bradbury J. Compromised dental function and nutrition. Nutrition 2001; 17: 177-8.

Muller F, Heath MR, Ott R. Maximum bite force after the replacement of complete dentures. Gerodontology 2001; 18: 58-62.

Moynihan PJ, Butler TJ, Thomason JM, Jepson NS. Nutrient intake in partially dentate patients: The effect of prosthetic rehabilitation. J Dent 2000; 28: 557-63.

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

McKenna G, Allen PF, Flynn A, O’Mahony D, DaMata C, Cronin M, et al. Impact of tooth replacement strategies on the nutritional status of partially-dentate elders. Gerodontology 2011; 29: e883-90.

Prakash N, Kalavathy N, Sridevi J, Premnath K. Nutritional status assessment in complete denture wearers. Gerodontology 2012; 29: 224-30.

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

Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and nutrition in US adults. J Dent Res 2003; 82: 123-6.

Cousson PY, Bessadet M, Nicolas E, Veyrune J-L, Lesourd B, Lassauzay C. Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers. Gerodontology 2012; 29: e685-92.

EI Osta N, Hennequin M, Tubert-Jeannin S, Abboud Naaman NB, EI Osta L, Geahchan N. The pertinence of oral health indicators in nutritional studies in the elderly. Clin Nutr 2014; 33: 316-21.

Toniazzo MP, Amorim P de S, Muniz FWMG, Weidlich P. Relationship of nutritional status and oral health in elderly: Systematic review with meta-analysis. Clin Nutr 2018; 37: 824-30.

Tubtimtong P, Sinavarat P, Ananmana 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 2019; 39: 21-33.

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. Communiy Dent Oral Epidemiol 1999; 27: 249-58.

Garcia-Meseguer MJ, and Serrano-Urrea R. Validation of the revised Mini Nutritional Assessment Short-Forms in nursing homes in Spain. J Nutr Health Aging 2013; 17: 26-9.

Poulia KA, Yannakonlia M, Karageorgon D, Gamaletson 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.

World Health Organization, editor. Oral health surveys: basic methods 5th ed 2013.

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

Vigild M. Denture status and need for prosthodontic treatment among institutionalized elderly in Denmark. Community Dent Oral Epidemiol 1987; 15: 128-33.

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

Shinkai RSA, Hatch JP, Rugh JD, Sakai S, Mobley CC, Saunders MJ. Dietary intake in edentulous subjects with good and poor quality complete dentures. J Prosthet Dent 2002; 87: 490-8.

Wayler AH, Baric JH, Chauncey HH and Kapur KK. Influence of age and artificial dentition on masticatory food and selection. The Gerontologist 1980; 20: 222.

Wayler AH, Muench ME, Kapur KK, Chauncey HH. Masticatory performance and food accepability in persons with removable partial dentures, full dentures and intact natural dentition. J Gerontology 1984; 39: 284-9.

Sahyoun NR, Krall E. Low dietary quality among older adults with self-perceived ill-fitting dentures. J Am Diet Assoc 2003; 103: 1494-9.

Petersen PE, Tamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2005; 33: 81-92.

Pillai RS, Mathur VP, Jain V, Shah N, Kalra S, Kumar P, et al. Association between dental prosthesis need, nutritional status and quality of life of elderly subjects. Qual Life Res 2015; 24: 2863-71

Budtz-JØrgensen E. Prosthodontics for the elderly: Diagnosis and treatment. Chicago: Quintessence Publishing Company; 1999. P. 23-48.

Lord JL, Teel S. The overdenture: patient selection, use of copings, and follow-up evaluation. J Prosthet Dent 1974; 32: 41-51.

Henking JP. Overdentures. J Dent 1982; 10: 217-25.

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

Jauhiainen L, Männistö S, Ylöstalo P, Vehkalahti M, Nordblad A, Turunen AW, et al. Food Consumption and Nutrient Intake in Relation to Denture Use in 55- to 84-Year-Old Men and Women -Results of a Population Based Survey. J Nutr Health Aging 2017; 21: 492-500.

Wallace S, Samietz S, Abbas M, McKenna G, Woodside JV, Schimmel M. Impact of prosthodontic rehabilitation on the masticatory performance of partially dentate older patients: Can it predict nutritional state? Results from a RCT. J Dent 2018; 68: 66-71.