Background
Methods
Participants
Recording of subject data
Assessment of nutritional condition
Dental examination
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Dental findings/status (DMF-T) [26]: The DMF-T is a caries index to quantify the number of decayed teeth, missing teeth and filled teeth with values ranging from 0 to 28 without wisdom-teeth. The DMF-T was assessed visually with mirror and probe. Based on the number of decayed, missing, and filled teeth, the DMF-T was determined as follows: All teeth with a reasonable suspicion of/or definitely showing a cavity in the dentine layer, were assigned to the D (=decayed) component; filled and crowned teeth were evaluated and assigned to component F (=filled); missing teeth were assigned to the M component (=missing).
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Periodontal screening (PSR ® /PSI) [27]: Periodontal treatment need was determined by probing depth of periodontal pocket and by extend of the resulting bleeding. The periodontal situation (periodontal treatment need) was evaluated with the periodontal screening index (PSR®/PSI). The examination was performed with the WHO probe (Morita, Kyoto, Japan) at 6 points per tooth and the PSR®/PSI score was recorded using the following criteria:
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➢PSR®/PSI 0: if pocket depth < 3.5 mm, no bleeding and no calculus.
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➢PSR®/PSI 1: if pocket depth < 3.5 mm, bleeding on probing and no calculus.
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➢PSR®/PSI 2: if pocket depth < 3.5 mm, bleeding on probing and calculus is present.
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➢PSR®/PSI 3: if pocket depth is 3.5–5.5 mm.
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➢PSR®/PSI 4: if pocket depth is > 5.5 mm.
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Statistical analysis
Results
Subjects
Age in years mean (SD) [median; range] | 84.1 (8.6) [85.9; 56–102] | |
---|---|---|
Gender | Female | 68 (78%) |
Male | 19 (22%) | |
Current smoker | Non-smoker | 75 (86%) |
Smoker | 12 (14%) | |
Body-mass-index in kg/m2
mean (SD) [median; range] | 26.2 (5.0) [25.2; 21.8–29.0] | |
Dementia (yes/no) | No | 39 (45%) |
Yes | 48 (55%) | |
Totally bedridden | No | 82 (94%) |
Yes | 5 (6%) |
Nutritional condition (MNA)
Declined food intake over the past 3 months a
| Severe decrease | 1 (1%) |
Moderate decrease | 19 (21%) | |
No decrease | 67 (78%) | |
Weight loss during the past 3 months a
| >3 kg | 5 (6%) |
1–3 kg | 14 (17%) | |
no | 65 (74%) | |
Unknown | 3 (3%) | |
Mobility a
| Bed of chair bound | 21 (24%) |
Able to get out of bed / chair but does not go out | 17 (20%) | |
Goes out | 49 (56%) | |
Psychological stress or acute disease a
| No | 72 (83%) |
Yes | 15 (17%) | |
Neuropsychological problems a
| No problems | 39 (45%) |
Mild dementia | 26 (30%) | |
Severe dementia or depression | 22 (25%) | |
Body-mass-index | <19 | 2 (2%) |
19–21 | 11 (13%) | |
21–23 | 19 (22%) | |
>23 | 55 (63%) | |
MNA screening points (median and IQR) | 11 (9–13) | |
Risk for malnutrition | Normal nutritional status (12–14 MNA screening points) | 42 (48%) |
At risk of malnutrition (8–11 MNA screening points) | 45 (52%) |
Dental (DMF-T) and periodontal findings (PSR®/PSI)
Parameter | Mean (SD) [median] | ||
---|---|---|---|
All participants (n = 87) | DMF-T index | 26.4 (3.1) [28] | |
Decayed teeth | 1.1 (2.4) [0] | ||
Missing teeth | 21.2 (8.8) [26,5] | ||
Filled teeth | 4.1 (6.5) [0] | ||
Edentulous residents |
n = 41 (47%) | ||
Residents with teeth (n = 46) | DMF-T index | 25.0 (3.7) [27] | |
Decayed teeth | 2.0 (3.1) [1] | ||
Missing teeth | 15.0 (8.3) [15] | ||
Filled teeth | 8.0 (7.4) [6] | ||
Remaining teeth (≥14 teeth) |
n = 21 (45%) | ||
PSI / PSR [n = 38] | Score 1 | 1 (3%) | |
Score 2 | 7 (18%) | ||
Score 3 | 16 (42%) | ||
Score 4 | 14 (37%) |
Association of dentition and nutritional status
Risk factors | Nutritional status | Univariate analysis | Multivariate analysis a
| ||||
---|---|---|---|---|---|---|---|
Not at risk of malnutrition (12–14 MNA screening points)
n = 42 (48%) | At risk of malnutrition (8–11 MNA screening points)
n = 45 (52%) | OR |
p-value | OR |
p-value | ||
General parameters | |||||||
Age in years [mean (SD)] | 83.1 (9.3) | 84.9 (7.3) | n.a. | 0.33 | 1.0 (CI95 0.9–1.1) | n.s. | |
Gender (female) | 31 (46%) | 37 (54%) | 1.1 (CI95 0.4–2.7) | 0.81 | 1.2 (CI95 0.4–3.8) | n.s. | |
Smoking status (yes) | 6 (50%) | 6 (50%) | 0.9 (CI95 0.3–3.1) | 0.86 | 0.8 (CI95 0.2–3.1) | n.s | |
Dementia according to medical records (yes) | 17 (40%) | 31 (60%) | 2.5 (CI95 1.1–5.6) | 0.03 | 3.1 (CI95 1.2–8.2) | 0.02 | |
Permanently bedridden according to medical records (yes) | 1 (2%) | 4 (9%) | 4.0 (CI95 0.4–37) | 0.19 | n.a. | n.a. | |
Neuropsychological problems according to MNA | No problems | 26 (62%) | 13 (29%) | n.a. | <0.0001 | n.a. | n.a. |
Mild dementia | 14 (17%) | 12 (27%) | |||||
Severe dementia or depression | 2 (2%) | 24 (44%) | |||||
Mobility according to the MNA | Bed of chair bound | 1 (2%) | 20 (44%) | n.a. | <0.0001 | n.a. | n.a. |
Able to get out of bed / chair but does not go out | 8 (19%) | 9 (20%) | |||||
Goes out | 33 (79%) | 16 (36%) | |||||
Body-mass-index kg/m2 [mean (SD)] | 27.7 (4.5) | 24.7 (5.1) | n.a. | 0.005 | n.a. | n.a. | |
Oral parameters | |||||||
Edentulous | 16 (38%) | 25 (56%) | 2.0 (CI95 0.8–5.8) | 0.1 | 2.8 (CI95 1.1–7.3) | 0.03 | |
Remaining teeth | 26 (62%) | 20 (44%) | |||||
DMF-T (only those with teeth n = 46) | 25.6 (2.9) | 24.5 (4.3) | n.a. | 0.34 | n.a. | n.a. | |
PSI / PSR score (n = 37) | max. Score 1 or 2 | 5 (24%) | 3 (19%) | 1.3 (CI95 0.4–6.7) | 0.71 | n.a. | n.a. |
max. Score 3 or 4 | 16 (76%) | 13 (81%) |
Parameter | Edentulous [n = 41] | Dentulous [n = 46] | OR (CI95) |
p-value | |
---|---|---|---|---|---|
Age in years [mean (SD)] | 84.8 (8.3) | 83.6 (8.4) | n.a. | 0.51 | |
Body-mass-index kg/m2 [mean (SD)] | 26.0 (4.8) | 26.3 (5.2) | n.a. | 0.97 | |
Risk for malnutrition | No [n = 42] | 16 (38%) | 26 (62%) | 2.0 (0.8–5.8) | 0.1 |
Yes [n = 45] | 25 (56%) | 20 (44%) | |||
Gender | Female [n = 68] | 33 (49%) | 35 (51%) | 1.9 (0.8–5.0) | 0.16 |
Male [n = 19] | 8 (42%) | 11 (58%) | |||
Smoking status | No [n = 75] | 35 (47%) | 40 (53%) | 0.9 (0.2–3.0) | 0.86 |
Yes [n = 12] | 6 (50%) | 6 (50%) | |||
Dementia | No [n = 39] | 24 (62%) | 15 (38%) | 2.5 (1.1–5.9) | 0.03 |
Yes [n = 48] | 17 (36%) | 31 (64%) |