Oral health, nutrient intake and dietary quality in the very old

Background. Limited food choices and inadequate nutrient intake are linked to poor oral health. The authors describe relationships between dietary variety, nutrient intake and oral health measures in community-dwelling, rural Iowans aged 79 years and older. Methods. Dental examinations were conducted by trained and calibrated examiners, and trained interviewers completed standardized interviews in subjects' homes. Subjects (n = 220) then completed three-day dietary records. Adequate nutrient intakes were defined using the Dietary Reference Intakes of the Food and Nutrition board of the National Academy of Sciences. Results. Mean daily nutrient intakes were significantly lower in subjects who had fewer natural or functional teeth and ill-fitting mandibular dentures than in subjects who had more teeth or did not have these problems. Adequacy of intakes was lower in subjects who had fewer natural or functional teeth and ill-fitting mandibular dentures. Mean daily nutrient intakes did not differ between subjects with well-fitting dentures (either complete or partial) and subjects with natural teeth. Neither mean daily intake nor adequacy of intake was associated with subjects' perceptions of oral health problems, chewing difficulties or temperature sensitivity. Conclusions. The presence of natural teeth and well-fitting dentures were associated with higher and more varied nutrient intakes and greater dietary quality in the oldest old Iowans sampled. Clinical Implications. Maintenance of natural dentition or provision and maintenance of adequate mandibular prostheses are important for nutrient intakes to support systemic health.