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( Lin Ying-Chun) 1 (Chou Tsau-Mau) 2,3 (Chen Jen-Hao) 2,3 (Lee Huey-Er) 2,3.

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(LinYing-Chun)1(Chou Tsau-Mau)2,3(Chen Jen-Hao)2,3(LeeHuey-Er)2,3

1Faculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, Taiwan.2Faculty of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Taiwan3Department of Prosthodontics, Kaohsiung Medical University Hospital, Taiwan

Approximately 18% of the population in Taiwan is edentulous1. However, the relationship between chewing ability and diet among the edentulous has received limited attention in the dental literature. Although dental prostheses help restore some of the lost function, the edentulous will experience diminished masticatory function2 that subsequently predisposes this group to a higher risk of malnutrition.3 The results from various studies established that the diets among the edentulous population are lower in fruits and vegetables than among the dentate population.4, 5

The Association of Self-Reported Chewing Ability and Dietary Intake in Public Funded Complete Denture Patients in Kaohsiung City.

Purpose

The purpose of this study was to investigate the relationship between chewing ability and diet among edentulous patients whose dentures were funded by the Department of Health in Kaohsiung City, Taiwan.

Materials and Methods

A cluster sample of 103 elderly edentulous subjects 65 years and older (68 males and 35 females) was randomly gathered and assessed by use of a questionnaire.

Nutritional analysis consisted of a 24-hour dietary intake analysis in accordance with the recommendation of Shinkai6 and the Nutritional Health Survey in Taiwan (NAHST). Output variables were obtained by instructing the subjects to record their food intake. The food intake was then placed into one of five food group categories: grains, milk products, meat and beans, vegetables, and fruits. This study followed the Department of Health (DOH) in Taiwan conversion tables for food categories and servings as well as RDA guidelines for the five food groups for geriatric populations.

All of the variables were analyzed using Chi-square tests. Fisher’s exact test was used instead of the Chi-square test in instances when there were fewer than five cases in a given category.

Introduction

Results

Table 1 shows that 58% of the subjects were dissatisfied with their dentures and 51% reported discomfort during mastication. Table 2 reveals that among the 103 subjects in this study, only 4 individuals (3.9%) satisfied the RDA standards for all five food groups. In addition, 4 subjects (3.9%) reported satisfying none of the RDA food group standards. Table 3 shows that only 17 of the 103 subjects (16.5%) satisfied the RDA standards for vegetables.

Discussion

It is of concern that 58% of the denture patients in this study reported being dissatisfied with their current complete dentures and 51% reported experiencing discomfort when chewing. In addition, this study revealed a statistically significant correlation between chewing discomfort and diminished nutritional consumption. Although the standard metrics applied to denture analysis such as retention, stability occlusal function etc. were not included in this study, the results suggest that a disproportionate number of the subjects’ dentures were structurally inadequate, subsequently impacting dietary consumption in a detrimental manner.

In the Taiwanese society, vegetables are a highly valued part of the normal diet. In addition, fresh vegetables are readily available and affordable year around at the local markets. Consequently it is difficult to diminish the impact denture discomfort during chewing has on the vegetable consumption of these subjects. Reduced consumption of vegetables may predispose the subjects to diminished vitamin, nutrient and dietary fiber intake that is vital to this age group. The correlation between chewing discomfort and the inability to satisfy reasonable daily nutritional standards suggests that additional dental assistance for the elderly may be beneficial.

Conclusion

1.This study demonstrated that patient satisfaction with their denture and the absence of

discomfort during mastication can significantly influence the quality and quantity of

nutrition elderly patients consume.

2.In this study 58% of the subjects expressed dissatisfaction with their existing dentures and

51% reported discomfort during chewing.

3.Only 4% of the subjects reported consuming the RDA of all five food groups, and 4% of the

subjects did not meet the RDA standards for any of the five food groups.

4.The vegetable group showed the lowest level of RDA satisfaction with only 17% of the

subjects meeting the RDA standards. Discomfort from the dentures during chewing

significantly impacted the consumption of vegetables.

References

[1]李雅惠。台灣中老年人全口無牙相關因素之研究。【碩士論文】高雄:高雄醫學大學口腔衛生學系碩士在職專班。2005。

[2]Gotfredsen K, Walls AW. What dentition assures oral function? Clin Oral Implants Res. 2007;18:34-45.

[3]de Oliveira TR, Frigerio ML. Association between nutrition and the prostheticcondition in edentulous elderly. Gerodontology. 2004;21:205-208.

[4]Bradbury J, Thomason JM, Jepson NJ, Walls AW, Mulvaney CE, Allen PF,Moynihan PJ. Perceived chewing ability and intake of fruit and vegetables. J Dent Res. 2008;87:720-725.

[5]Yoshihara A, Watanabe R, Nishimuta M, Hanada N, Miyazaki H. Therelationship between dietary intake and the number of teeth in elderly Japanese subjects. Gerodontology. 2005;22:211-218.

[6]Shinkai RS, Hatch JP, Rugh JD, Sakai S, Mobley CC, Saunders MJ. Dietary in edentulous subjects with good and poor quality complete intake dentures. JProsthet Dent. 2002;87:490-498.