Association of oral health status with the risk of malnutrition and pneumonia in geriatric patients

Abstract

Background: Older persons are at risk of compromised oral conditions, including dental infections, periodontal problems, tooth loss, benign mucosal lesions, xerostomia, oral candidiasis, and oral cancer. Poor oral hygiene has contributed to increase the risk of aspiration pneumonia, as well as malnutrition, in geriatric patients. We described cases of poor oral health status associated with increased risk of malnutrition and pneumonia in geriatric. Case Report: The patients were an 80-year-old female and a 61-year-old male who were referred from the Internal Medicine Department to the Oral Medicine Clinic at the Dr. Hasan Sadikin Hospital, Bandung, for the evaluation and management of oral health problems. Their medical histories revealed that they had low nutritional intake prior to being hospitalized. Clinically, both patients had pale conjunctiva and appeared underweight. Anthropometry measurements of the female patient showed her body weight was 36 kg, height was 150 cm, and upper-arm circumference measurement was 20 cm, whereas the male patient was measured at 43 kg, 174 cm, and 20 cm, respectively. The nutritional status based on percentage upper-arm circumference measurement method or called % Lingkar Lengan Atas of both patients were 66.8%. Intraoral findings showed coated tongues, multiple gangrene radix at all regions, plaque, and calculus seen on most tooth surfaces, and a lack of saliva. A thorax radiography examination found the patients had pneumonia. A diagnosis of community-acquired pneumonia, severe malnutrition, xerostomia, and periodontitis was made for each patient. The management of the patients included administering systemic antibiotics, promoting their nutritional status gradually with adequate intake, and improving their oral health status with an antiseptic mouthwash and the rehabilitation of malfunctioning teeth. Conclusion: Oral health status has a close relationship with the risk of malnutrition and pneumonia in geriatric patients. Therefore, comprehensive management is needed to improve the quality of life of geriatric patients.