Introduction.¿ Diet plays a key role in disease prevention in older
age. Although nutritional state is influenced by various factors,
dental status can have an important impact. Poor oral health and
loss of teeth can have significant negative effects on dietary intake
and nutritional status for older patients. Increasingly, patients are
retaining some natural teeth into old age (partially dentate). Many
receive removable partial dentures to replace all missing teeth
despite their potential to increase the risk of further dental
disease. Alternative, functionally-orientated treatments exist
including the shortened dental arch (SDA). Instead of aiming to
replace all missing teeth, this provides patients with 10 pairs of
teeth that are easy to maintain whilst ensuring acceptable
function and aesthetics. The aim of this study was to compare
the impact of two different tooth replacement strategies on the
nutritional status of partially dentate older patients. The study
compared conventional treatment using removable partial
dentures and functionally-orientated treatment based on the
SDA.
Method.¿ Fifty partially dentate patients (mean age 68.8 years)
completed a randomized controlled clinical trial. 26 patients were
allocated to conventional treatment with removable partial
dentures and 24 were allocated to functionally-orientated
treatment with adhesive bridgework used to create 10 pairs of
teeth. Nutritional status was assessed at baseline and 1 month
after treatment using a range of haematological markers and the
Mini Nutritional Assessment (MNA).
Results.¿ One month after treatment intervention, haematological
measures did not illustrate a clear picture of improvement for
either group. For the conventional group average levels of vitamin
B12 (P = 0.68), albumin (P = 0.20) and cholesterol (P = 0.50) all
increased. For the functionally-orientated group average levels of
vitamin B12 (P = 0.62), albumin (P = 0.16) and vitamin D (P = 0.37)
all increased. MNA scores improved for both treatment groups
postoperatively. For the conventional group mean MNA score
increased from 23.3 to 24.4 (P = 0.03). For the functionallyorientated group mean MNA score increased from 23.2 to 24.1
(P = 0.03).
Conclusions.¿ Haematological markers did not demonstrate any
statistically significant improvements in nutritional status for
either treatment group. However, MNA scores improved for both
conventional and functionally-orientated groups after treatment
intervention (P = 0.03).