A retrospective longitudinal study by the Regeneration Institute and Indiana University School of Dentistry shows that people using full or even partial dentures may be at risk of nutritional deficiencies.
According to a recent retrospective longitudinal study by the Indianapolis Institute of Regeneration and the Indiana University School of Dentistry, orthopedic treatment is the primary treatment for patients with complete or partial tooth loss, but such patients may also need nutritional counseling.
The study combined laboratory values of food biomarkers with dental data. Laboratory tests included a complete blood count, a basic metabolic panel, and lipid and thyroid tests. The research team compared the nutritional status of 3,519 subjects who received partial or full dentures or implant- or abutment-retaining dentures with the nutritional status of 6,962 controls who did not receive or need dentures. In addition to age and gender, the authors looked at other factors available in electronic records, including race, medical history, and insurance status. The study used records of patients treated at Indiana University School of Dentistry clinics from January 1, 2010 to December 31, 2018, and compared nutritional scores over two years.
Notable results included a significant reduction in serum albumin, creatinine, and blood urea nitrogen (BUN) in denture-retained edentulous patients and an increase in estimated glomerular filtration rate (eGFR) in the same group. Those who had dentures also had reduced serum albumin, protein, and calcium compared to controls. Patients with partial dentition showed decreased levels of thyroid-stimulating hormone (TSH), BUN, and total cholesterol. Records of patients with missing teeth in the maxillary or mandibular arch also indicated a decrease in BUN and eGFR.
The authors hypothesized that reduced serum albumin levels in denture wearers may be associated with chewing and swallowing problems, as in the elderly, as well as in patients who are already struggling with chronic inflammation and malnutrition. Generally, serum albumin and prealbumin decrease only in patients who are severely malnourished, and the study authors recommended further studies to explore the association between albumin levels and orthopedic intervention.
Senior author Dr. Thangkam Thaivalikakat, Research Fellow at the Institute of Regeneration and Director of the Center for Dental Informatics at the Indiana University School of Dentistry, shared her perspective in a press release. She said: “Dentures are a significant change for a person. They do not provide the same chewing performance, which can change eating habits. Dentists should be aware of this and make recommendations or referrals for nutritional counseling. These patients need support during the transition period and possibly ongoing monitoring.”
The authors of the study concluded that serologic testing could help monitor the health and nutritional status of denture wearers and that patients should be offered nutritional counseling when receiving orthopedic treatment.
Although serum albumin, calcium, protein, and creatinine decreased in denture wearers, mean hematological markers remained within normal limits, except for triglycerides, low-density lipoprotein, and total cholesterol. Weight and body mass index were above normal. The authors of the study noted that the latter values were indicative of overweight patients in both the control and study groups and were consistent with the local population in Indiana.
The risk of malnutrition is nothing new, and the use of electronic records has allowed for a much more realistic approach to assessing health status and progress in a wider range of patients.