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1 Division of General Internal Medicine, Geriatrics and Health Policy, University of Louisville, and Louisville VA Medical Center, 501 East Broadway, Suite 320-06, Louisville, KY 40202; 2 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Department of Epidemiology, Harvard School of Public Health, Boston, MA; 3 Department of Epidemiology, Harvard School of Public Health, Boston, MA; and 4 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Department of Epidemiology, Harvard School of Public Health, Boston, MA;
* corresponding author, csritchie{at}louisville.edu
Recent associations between oral health and systemic disease have led to renewed interest in the mouth and its contribution to health outcomes. Many pathways for this relationship have been postulated, among them the potential mediating role of nutrition. The link between various nutrients and systemic disease has been established, but relatively little work has been done in relating oral conditions with nutrition. We searched MEDLINE, from 1966 to July, 2001, to identify articles relating specific oral measures to nutrition outcomes. We included original articles written in English with a sample size greater than 30 that used objective oral health measures. We reviewed a total of 56 articles. Only a small proportion of these studies were methodologically sound. Although many studies were small and cross-sectional, the literature suggests that tooth loss affects dietary quality and nutrient intake in a manner that may increase the risk for several systemic diseases. The impact of tooth loss on diet may be only partially compensated for by prostheses. To date, there is little information relating periodontal disease and oral pain and nutrition. A few studies suggest poorer nutrition among individuals with xerostomia and altered taste. Further, impaired dentition may contribute to weight change, depending on age and other population characteristics. There is a paucity of well-designed studies addressing oral health and nutrition. Before we can acquire a better understanding of how nutrition and oral health interrelate, however, more studies will be required to confirm these associations—preferably longitudinal studies with larger sample sizes and better control of important confounders.
Key words. Oral health, periodontal disease, tooth loss, prostheses, nutrition, systemic disease
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