Abstract
BackgroundLow masticatory ability and the resulting decrease in intake of masticable foods can result in undernutrition. The present study investigated the relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly.MethodsThe data analyzed in this study were retrieved from the baseline data of the 2007 Fujiwara-kyo study, a prospective cohort study of community-dwelling elderly individuals. Subjects included 1591 men and 1543 women, both with a median age of 71 years. The maximum occlusal force was measured as an objective index of masticatory ability. Foods were divided into five groups based on hardness: Group 1 (bananas, etc.), 0.53 kg; Group 2 (boiled rice, etc.), 1.22 kg; Group 3 (raisins, etc.), 2.93 kg; Group 4 (raw carrots, etc.), 4.38 kg; and Group 5 (beef jerky), 6.56 kg. To obtain a subjective index of masticatory ability, a questionnaire-based survey was conducted to determine whether subjects could masticate foods within each group. As nutritional indices, serum albumin levels and body mass index (BMI) data were used.ResultsThe median number of teeth was 21. The proportion of subjects for whom all five food groups were masticable showed a significant decrease in the number of teeth in both males and females. Logistic regression analysis showed that, after adjustment for confounders, no significant relationships were observed between the number of teeth and the masticatory ability with nutritional indices in males. In females, a maximum occlusal force of 100 to 300 N (OR = 1.65; 95% CI = 1.06–2.55) or less than 100 N (OR = 1.95; 95% CI = 1.15–3.31) showed a significant correlation with serum albumin levels below 4.4 g/dL (reference: 500 N or more). In addition, the masticability of all five food groups showed a significant correlation with BMI < 21.0 kg/m2 (OR = 0.62; 95% CI = 0.46–0.85) in females.ConclusionsA low number of teeth was associated with low masticatory ability in both males and females. Low masticatory ability was associated with low plasma albumin levels and low BMI in females. Not smoking, maintaining grip strength, preventing cancer, and masticatory ability are important for preventing undernutrition.
Highlights
Low masticatory ability and the resulting decrease in intake of masticable foods can result in undernutrition
A comparison between the sexes showed that the maximum occlusal force was significantly greater in males than in females, but no difference in the number of teeth and the proportion for whom group-5 foods were masticable was found between males and females
In females (Table 5), maximum occlusal force of 100 to 300 N (OR: 1.65; 95% Confidence interval (CI): 1.06 to 2.55), a maximum occlusal force below 100 N (OR: 1.95; 95% CI: 1.15 to 3.31), and being an ex-smoker status (OR: 2.53; 95% CI: 1.42 to 4.50) showed significant correlations with serum albumin levels below 4.4 g/ dL
Summary
Low masticatory ability and the resulting decrease in intake of masticable foods can result in undernutrition. The present study investigated the relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly. Tooth loss is associated with an impairment of daily activities and an increased incidence of severe diseases. One hypothesis for the connection between the number of teeth and serious disease points to inflammation caused by periodontal disease. A second hypothesis is that people with low masticatory ability have an insufficient nutrient intake. In this context, the levels of plasma vitamin C, which has antioxidant activities, are lower in edentulous people [8]. In elderly people with multiple tooth loss, it is not unreasonable to expect that low masticatory ability may lead to undernutrition; few studies verifying this sequential relationship have been published
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