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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 2  |  Page : 34-36

Effect of different prosthodontic treatment modalities on nutritional parameters of patients in Telangana, India


Sr. Lecturer, Department of Prosthodontics, Meghna Institute of Dental Sciences, Nizamabad, Telangana, India

Date of Submission07-Nov-2021
Date of Acceptance02-Dec-2021
Date of Web Publication24-Dec-2021

Correspondence Address:
Dr. S Phanindra
Department of Prosthodontics, Meghna Institute of Dental Sciences, Nizamabad - 503 003, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmo.ijmo_17_21

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  Abstract 


Background: Oral health is a mirror of general health. Certain risk factors are common between oral and systemic diseases. The absence of teeth also affects oral health by altering the quality of life. Hence, the nutritional changes occurring in elderly patients following prosthodontic rehabilitation are evaluated. Materials and Methods: A total of 100 patients who underwent prosthodontic treatment for missing teeth were included in the study. Twice measurement of nutritional parameters was done: Initially at the time of diagnosis and then 5 months following commencement of the prosthodontic treatment. Dental analysis, evaluation of the diet, anthropometric assessment, and analysis of serum biochemical values were done in all the patients, and tabulated records were maintained. Independent Student's t-test and Tukey's test were done to assess the level of significance. Results: A total of 100 patients were included in the study. The complete denture (CD) group showed the highest alteration in the mean values of the nutritional parameters followed by the removable partial denture group. A significant change was seen in the body mass index, protein, carbohydrate, and iron levels among the different patients who were grouped based on the mode of treatment modality. The CD group showed significantly higher mean change in carbohydrates value compared with mean change in patients receiving fixed treatment. Conclusion: Our results conclude that nutrition and diet form an integral part of prosthodontic treatment to maintain the health of elderly population.

Keywords: Denture, edentulous, prosthodontic treatment


How to cite this article:
Phanindra S. Effect of different prosthodontic treatment modalities on nutritional parameters of patients in Telangana, India. Int J Med Oral Res 2021;6:34-6

How to cite this URL:
Phanindra S. Effect of different prosthodontic treatment modalities on nutritional parameters of patients in Telangana, India. Int J Med Oral Res [serial online] 2021 [cited 2022 May 20];6:34-6. Available from: http://www.ijmorweb.com/text.asp?2021/6/2/34/333676




  Introduction Top


It is a much-accepted fact that there exists some relationship between the health of oral tissues[1] and general health. By having a review on the data published in the literature, it is much evidence that both oral and systemic diseases have in common certain risk[2],[3],[4] life along with nutrition and food habits. As far as dental implants are concerned, reports of initial analysis involving both functional and esthetic components of life have been proved to be in favor of both patients[5] and the dentists. Therefore, prosthodontic treatment should also include evaluation of patient's nutritional factors, such as smoking, and glucose control of teeth due to any reason affects the health of oral tissues and the body in a huge way by altering the quality of history and diet as its primary goal was planned to evaluate the dietary and nutritional changes in geriatric patients following rehabilitation by prosthodontic treatment.

Aim and objectives

Hence, the aim and objective of this study was to evaluate the dietary and nutritional changes in elderly patients following rehabilitation by prosthodontic treatment.


  Materials and Methods Top


All procedures performed in the study were conducted in accordance with the ethical standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval, and clearance was obtained from the ethical committee of our institution. A written informed consent was obtained from each participant. Our study was conducted from May 2019 to December 2019 after board review at Meghna Institute of Dental Sciences Nizamabad, Telangana, using a cross-sectional analytical design. The patients were recruited from prosthodontics outpatient department in Meghna Institute of Dental Sciences Nizamabad, Telangana. All the parameters were measured twice: Initially at the time of diagnosis and then 5 months following commencement of the prosthodontic treatment. Only those patients who fulfilled the following inclusion criteria were included in the study:

  • Patients above 60 years of age (to avoid biasness in the results of the study)[6]
  • Patients without any history of systemic illness, known as drug allergy
  • Patients without any medical history of the limitation of any extremity or functional limitation
  • Patients without any psychological disorder
  • Patients who were not financially above the poverty line[6],[7]
  • Patients without any history and present habit of tobacco chewing or smoking, alcohol consumption, and any other known addictive habit according to the World Health Organization criteria.[8],[9]


After selecting the patients for the study, the following investigations were performed: Dental analysis, evaluation of the diet, anthropometric assessment, and analysis of serum biochemical values. Examination of dentition involved assessment of the distribution of teeth (distal extension case or not), number of missing teeth in the edentulous area, and the type of prosthetic treatment recommended. While planning for the treatment, third molars were not included. Accordingly, patients were divided into the following groups: Completely edentulous and partially edentulous (PE). Posttreatment, daily dietary and nutritional records of the patients were maintained. The nutritional status of the patients was measured, and all the collected data were tabulated in terms of energy and nutritional values, which include fats, proteins, carbohydrates, and kilocalories 7 body mass index (BMI). For biochemical assessment, 10 ml of fasting blood samples were taken from all the patients at initial assessment time and after 5 months. For evaluation of malnutrition, serum albumin and cholesterol were used as biomarkers. Cholesterol oxidase method and bromocresol green dye-binding method were used for the assessment of total cholesterol and albumin levels[2],[4],[9],[10],[11],[12],[13],[14] following prosthodontic treatment. All tests were repeated after 5 months. All the results were evaluated using the Statistical Package for the Social Sciences software. Independent Student's t-test and Tukey's test were used to assess the level of significance.


  Results Top


A total of 100 patients were included in the study. The complete denture (CD) group showed the highest alteration in the mean values of the nutritional parameters followed by the removable partial denture (RPD) group. [Table 1] shows the comparison of initial mean value and mean value after 5 months in all the nutritional parameters between different groups. Although nonsignificant (P > 0.05) difference was observed while comparing the mean change in albumin, cholesterol, calcium, and vitamins groups; other remaining variables showed statistically significant variation. The CD group showed significantly higher mean change in carbohydrate value compared with mean change in patients receiving fixed treatment. While comparing the mean change at baseline and 5 months after the completion of the treatment in the different missing teeth groups, out of all nutritional parameters, proteins and Vitamin B showed statistically significant variation. Mean changes from baseline to 5 months measured in variables when compared between completely and PE patients and between the removable prosthesis and fixed prosthesis, respectively.
Table 1: Dental status of the patients highlight the mean change in variables from baseline to 5 months measured in different prosthetic groups

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  Discussion Top


We observed significant improvement in body weight and BMI in the group of patients who received CD compared with patients who received RPD and fixed partial denture (FPD). Kanehisa et al.[1] observed similar results in their study, in which they found a significant increase in mean body weight between denture wearers and nonwearers. The possible reason for this increase in mean body weight may be because of the improvement in mastication due to denture wearing and increased comminution and nutrient absorption from gastrointestinal tract.[15] At the same time, contrasting results were obtained by Sahyoun et al.[4] who found elevated BMI in edentulous patients compared with denture wearers. According to them, this might be due to increase in consumption of rich calories of food by edentulous patients, which subsequently resulted in increase in BMI of the body. We also observed a nonsignificant increase in the values of serum albumin in patients who received prosthodontic treatment. Our results were in correlation with the results obtained by Sahyoun NR et al.[4] who also observed an increase in serum albumin values in denture users. We also found an increase in intake of nutritional values in patients having CD compared with patients using RPD or FPD. Similar results were obtained by Krall et al.[2] who, from their study, concluded that patients with RPDs had similar nutritional intake values when compared with persons with intact dentition status. Furthermore, they also reported better nutritional consumption values for these persons compared with patients with missing teeth who had not undergone prosthetic rehabilitation and in persons who wore CDs. From these results, we also noticed a significant increase in the consumption of proteins in patients who wore CD compared with patients wearing RPDs and FPDs. Our results were in correlation with the results of Sheiham et al.[3] who also observed a significant increase in calcium intake on denture wearers. We did not observe any significant increase in mean Vitamin A and C uptake values in different denture wearer groups. While comparing the mean body weight, BMI, calories, calcium, iron, and Vitamin B, a statistically significant increase in value was seen in patients wearing removable dentures compared with patients wearing fixed dentures. As stated by Tsai and Chang,[16] poorer masticatory ability in nondenture wearers and removable denture wearers might predispose them to greater nutritional risk compared with patients wearing FPDs. McKenna et al.[6] investigated the impact of tooth replacement on the nutritional status of partially dentate older patients and concluded that prosthodontic rehabilitation may play an important role in the nutritional status of partially dentate elders.


  Conclusion Top


We conclude that both nutrition and diet form an integral part of prosthodontic treatment in maintaining the health of the body among elderly population. Further studies with higher study groups and more parameters are required to explore the treatment modalities available for geriatric patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kanehisa Y, Yoshida M, Taji T, Akagawa Y, Nakamura H. Body weight and serum albumin change after prosthodontic treatment among institutionalized elderly in a long-term care geriatric hospital. Community Dent Oral Epidemiol 2009;37:534-8.  Back to cited text no. 1
    
2.
Krall E, Hayes C, Garcia R. How dentition status and masticatory function affect nutrient intake. J Am Dent Assoc 1998;129:1261-9.  Back to cited text no. 2
    
3.
Sheiham A, Steele JG, Marcenes W, Lowe C, Finch S, Bates CJ, et al. The relationship among dental status, nutrient intake, and nutritional status in older people. J Dent Res 2001;80:408-13.  Back to cited text no. 3
    
4.
Sahyoun NR, Lin CL, Krall E. Nutritional status of the older adult is associated with dentition status. J Am Diet Assoc 2003;103:61-6.  Back to cited text no. 4
    
5.
Jin LJ, Chiu GK, Corbett EF. Are periodontal diseases risk factors for certain systemic disorders – What matters to medical practitioners? Hong Kong Med J 2003;9:31-7.  Back to cited text no. 5
    
6.
McKenna G, Allen PF, Flynn A, O'Mahony D, DaMata C, Cronin M, et al. Impact of tooth replacement strategies on the nutritional status of partially-dentate elders. Clin Oral Investig 2015;19:1991-8.  Back to cited text no. 6
    
7.
Bryant SR, Zarb GA. Outcomes of implant prosthodontic treatment in older adults. J Can Dent Assoc 2002;68:97-102.  Back to cited text no. 7
    
8.
Palmer CA. Gerodontic nutrition and dietary counseling for prosthodontic patients. Dent Clin North Am 2003;47:355-71.  Back to cited text no. 8
    
9.
Shah N, Parkash H, Sunderam KR. Edentulousness, denture wear and denture needs of Indian elderly – A community-based study. J Oral Rehabil 2004;31:467-76.  Back to cited text no. 9
    
10.
Planning Commission Further Lowers Poverty Line to Rs. 28/Day. New Delhi, India: India Today; March 19, 2012. Available from: http://indiatoday.intoday.in/story/indiapoverty-line-now-lowered-to-rs-28-per-day/1/178483.html. [Last accessed on 2014 Jun 13].  Back to cited text no. 10
    
11.
Muller K, Morais J, Feine J. Nutritional and anthropometric analysis of edentulous patients wearing implant overdentures or conventional dentures. Braz Dent J 2008 Feb;19(2):145-150.  Back to cited text no. 11
    
12.
DSM-IV Criteria for Alcohol Abuse and Alcohol Dependence. Reference for the whole section. Available from: http://www.alcoholcostcalculator.org/business/about/dsm.html. [Last accessed on 2014 Jun 13].  Back to cited text no. 12
    
13.
Seman K, Manaf HA, Ismail AR. Association between functional dentition with inadequate calorie intake and underweight in elderly people living in “Pondok” in Kelantan. Arch Orofac Sci 2007;2:10-9.  Back to cited text no. 13
    
14.
Lamster IB. Oral health care services for older adults: A looming crisis. Am J Public Health 2004;94:699-702.  Back to cited text no. 14
    
15.
Greksa LP, Parraga IM, Clark CA. The dietary adequacy of edentulous older adults. J Prosthet Dent 1995;73:142-5.  Back to cited text no. 15
    
16.
Tsai AC, Chang TL. Association of dental prosthetic condition with food consumption and the risk of malnutrition and follow-up 4-year mortality risk in elderly Taiwanese. J Nutr Health Aging 2011;15:265-70.  Back to cited text no. 16
    



 
 
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