Oral Health and Nutritional Status of Adults Attending Dental Clinics in Korle-Bu

Abstract

Background: The ageing process involves physiological and nutritional changes and many health issues have been associated with these changes. Poor oral health, which affects chewing and swallowing is common in the ageing population (≥50years) and has an influence on their overall nutrition and general health. A number of studies have linked missing teeth and other oral issues to poorer diets, however not many studies have related these results to effects on BMI, energy and micronutrient intakes in Ghana. Knowledge of changes in nutritional status due to poor oral health will not only help in better management of nutritional problems, but will also enable better clinical outcome. Aim: - To determine the oral health and nutritional status of adults 50 years and above attending clinic at the Korle-Bu Dental School Clinic and Maxillofacial Unit (MFU) of the Korle-Bu Teaching Hospital (KBTH) Methodology: This study was a cross-sectional study, involving older adults (50+ years) with or without oral health problems, visiting the dental clinics. Patients attending the clinics on the days of data collection that met the inclusion criteria and consented were included in the study. A total of 255 participants comprising 190 cases; who had visited the clinic with a particular oral problem and 65 participants as controls were recruited in the study. The patients were interviewed using structured questionnaires for sociodemographic information which included age, gender, educational level and employment status. Oral health and medical history were also obtained from log books for the cases. Food Frequency questionnaires and 24-Hour Recalls were used to collect information on frequency and pattern of food and nutrient intakes. Results: Most (41.6%) of the participants surveyed were obese and none was underweight. There was no significant association of weight categories with age, marital status and employment status. However, there was a significant association of weight categories with employment status. There was a significant association between weight category and bad breath with overweight people having significant level of reported bad breath. The mean energy intake was 1392kcal. Fruits juices and evaporated milk were taken just once or twice a week. Cereal products were major sources of energy. Fish was major source of animal protein and consumed daily. Watermelon was the most consumed fruit. Most people took their vegetables in the form of stews or soups or as gravy and light soup in a week. Nuts, chocolate and toffees/candies were rarely consumed and more than 70% of participants never took any in a week. Toothache, cavities, loose teeth, gum infection, tooth loss, mouth ulcers, halitosis and issues like broken or cracked tooth or dentures were some of the specific oral problems reported. About 80% of participants had lost one or more teeth and extraction was the highest cause of tooth loss. Most (24.3%) of the participants had lost their teeth over ten years and 23.1% were over 70 years of age. Periodontal disease (14.1%) and dental caries (9.4%) were the most occurring among those treated at the clinics. About 39.6% of participants said oral problem had affected their food intake while 34.3% said they had changed their diets due to oral problems opting for liquid or soft foods as a way of coping with the oral problems. Majority had stopped eating hard foods like nuts and chips while others had stopped meat/ fish, fruits/vegetables. Conclusion: Majority of the participants were either overweight or obese even though their estimated nutrient intakes did not meet recommended energy and macronutrients requirements for older adults. Frequency of intakes of fruits and vegetables, the major sources of micronutrients were also low indicating inadequate micronutrients intakes. Most of the participants had had some form of oral problem in the past or were still experiencing some sort of oral problem. All the participants observed the basic good oral hygienic practice of brushing the teeth at least once a day and several had visited the dentist before. The participants indicated that their oral health condition affected their food intake and hence inadequate nutrient intake in the elderly.