The compartmentalization involved in viewing the mouth separately from the rest of the body must cease because oral health affects general health by causing considerable pain and suffering and by changing what people eat, their speech and their quality of life and well-being. Oral health also has an effect on other chronic diseases (1). Because of the failure to tackle social and material de-terminants and incorporate oral health into general health promotion, millions suffer intractable toothache and poor quality of life and end up with few teeth.Health policies should be reori-ented to incorporate oral health using sociodental approaches to assessing needs and the common risk factor approach for health promotion (1, 2). Oral diseases are the most common of the chronic diseases and are important public health problems because of their prevalence, their impact on individuals and society, and the expense of their treatment. The determinants of oral diseases are known — they are the risk factors common to a number of chronic diseases: diet and dirt (hygiene), smok-ing, alcohol, risky behaviours causing injuries, and stress — and effective public health methods are available to prevent oral diseases.In some countries, oral diseases are the fourth most expensive diseases to treat. Treating caries, estimated at US$ 3513 per 1000 children, would exceed the total health budget for children of most low-income countries (3). The situation for adults in developing coun-tries is worse, as they suffer from the accumulation of untreated oral diseases. There are few efﬁcient dental care sys-tems to cope with their problems, and where there are, the cost is beyond most people’s means. Millions with untreated caries have cavities and suppuration, yet planners continue to overlook oral dis-eases, despite their signiﬁcant impact on cost and quality of life. This oversight will lead to more decay and expensive, ineffective clinical interventions.

/pdf/oral-health-general-health-and-quality-of-life-4yjd7n40zt.pdf

Oral health, general health and quality of life.

An adequate dentition is of importance for well-being and life quality. Despite advances in preventive dentistry, edentulism is still a major public health problem worldwide. In this narrative review, we provide a perspective on the pathways that link oral to general health. A better understanding of disease indicators is necessary for establishing a solid strategy through an organized oral health care system to prevent and treat this morbid chronic condition.

/pdf/the-impact-of-edentulism-on-oral-and-general-health-9i4m9vt206.pdf

The Impact of Edentulism on Oral and General Health

Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral health has been associated with mastication and nutritional problems, especially among the elderly, with highly negative effects on their quality of life. In this nonsystematic review, the authors discuss the importance of evaluating the oral health of the geriatric population in a comprehensive manner, beyond simple clinical assessments.

/pdf/oral-health-in-the-elderly-patient-and-its-impact-on-general-2bt2b7d5ys.pdf

Oral health in the elderly patient and its impact on general well-being: a nonsystematic review

Dental implants have become an increasingly popular treatment choice for replacing missing teeth. Yet, little is known about the prevalence and sociodemographic distribution of dental implant use in the United States. To address this knowledge gap, we analyzed data from 7 National Health and Nutrition Examination Surveys from 1999 to 2016. We estimated dental implant prevalence among adults missing any teeth for each survey period overall as stratified by sociodemographic characteristics. We calculated absolute and relative differences from 1999-2000 to 2015-2016 and fit logistic regression models to estimate changes over time. We also used multivariable logistic regression to estimate independent associations of sociodemographic covariates with the presence of any implant. We projected the proportion of patients treated with dental implants into the year 2026 under varying assumptions of how the temporal trend would continue. There has been a large increase in the prevalence of dental implants, from 0.7% in 1999 to 2000 to 5.7% in 2015 to 2016. The largest absolute increase in prevalence (12.9%) was among individuals 65 to 74 y old, whereas the largest relative increase was ~1,000% among those 55 to 64 y old. There was an average covariate-adjusted increase in dental implant prevalence of 14% per year (95% CI, 11% to 18%). Having private insurance (vs. none or public insurance) or more than a high school education (vs. high school or less) was each associated with a 2-fold increase in prevalence, with an almost 13-fold (95% CI, 8 to21) increase for older adults. Dental implant prevalence projected to 2026 ranged from 5.7% in the most conservative scenario to 23% in the least. This study demonstrates that dental implant prevalence among US adults with missing teeth has substantially increased since 1999. Yet access overall is still very low, and prevalence was consistently higher among more advantaged groups.

Trends in Dental Implant Use in the U.S., 1999–2016, and Projections to 2026:

Among seniors, food choice and related activities are affected by health status, biological changes wrought by aging and functional abilities, which are mediated in the larger arena by familial, social and economic factors. Determinants of healthy eating stem from individual and collective factors. Individual components include age, sex, education, physiological and health issues, psychological attributes, lifestyle practices, and knowledge, attitudes, beliefs and behaviours, in addition to other universal dietary determinants such as income, social status and culture. Collective determinants of healthy eating, such as accessible food labels, an appropriate food shopping environment, the marketing of the “healthy eating” message, adequate social support and provision of effective, community-based meal delivery services have the potential to mediate dietary habits and thus foster healthy eating. However, there is a startling paucity of research in this area, and this is particularly so in Canada. Using search and inclusion criteria and key search strings to guide the research, this article outlines the state of knowledge and research gaps in the area of determinants of healthy eating among Canadian seniors. In conclusion, dietary self-management persists in well, independent seniors without financial constraints, whatever their living arrangements, whereas nutritional risk is high among those in poor health and lacking in resources. Further study is necessary to clarify contributors to healthy eating in order to permit the development and evaluation of programs and services designed to encourage and facilitate healthy eating in older Canadians.

Determinants of healthy eating in community-dwelling elderly people.

Objectives: To assess how the dental status of older people affected their stated ability to eat common foods, their nutrient intake and some nutrition-related blood analytes.Design: Cross-sectional survey part of nation-wide British National Diet and Nutrition Survey: people aged 65 years and older. Data from a questionnaire were linked to clinical data and data from four-day weighed dietary records. Two separate representative samples: a free-living and an institutional sample. Seven-hundred-and-fifty-three free-living and 196 institution subjects had a dental exam and interview.Results: About one in five dentate (with natural teeth) free-living people had difficulty eating raw carrots, apples, well-done steak or nuts. Foods such as nuts, apples and raw carrots could not be eaten easily by over half edentate (without natural teeth but with dentures) people in institutions. In free-living, intakes of most nutrients and fruit and vegetables were significantly lower in edentate than dentate. Perceived chewing ability increased with increasing number of teeth. Daily intake of non-starch polysaccharides, protein, calcium, non-haem iron, niacin, vitamin C and intrinsic and milk sugars were significantly lower in edentate. Plasma ascorbate and retinol were significantly lower in the edentate than dentate. Plasma ascorbate was significantly related to the number of teeth and posterior contacting pairs of teeth.Conclusions: The presence, number and distribution of natural teeth are related to the ability to eat certain foods, affecting nutrient intakes and two biochemical measures of nutritional status.

/pdf/does-the-condition-of-the-mouth-and-teeth-affect-the-ability-1p4sk9rip4.pdf

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?

J Steele

Papers

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?