The impact of oral rehabilitation coupled with healthy dietary advice on the nutritional status of adults: A systematic review and meta-analysis

Abstract

As natural teeth are lost, many older adults choose softer foods lacking in essential micronutrients and fiber, yet replacing missing teeth alone does not positively influence diet. Dietary intervention in combination with treatment to replace missing teeth is increasing, though understanding of effective intervention components is limited. This systematic review synthesized literature relating to oral rehabilitation coupled with dietary intervention in adults. The primary outcome was dietary intake; secondary outcomes pertained to oral health and dietary intervention characteristics including: theoretical basis and behavior change techniques (BCTs). MEDLINE, Web of Science, PubMed and CENTRAL were searched. Nine studies were included. Study designs were heterogeneous involving 526 participants. Narrative synthesis identified improvements in at least one aspect of participants' oral health (i.e. biting/chewing) alongside at least one positive diet/nutrition outcome post-intervention for all studies. F/V results were pooled for three studies using meta-analysis techniques resulting in a standardized mean difference (SMD) of 0.29 [CI À0.54, 1.12], p ¼ 0.49, but with marked heterogeneity (p ¼ 0.0007). Few interventions were theory-based and intervention components were poorly described. Overall, narrative synthesis indicated support for dietary intervention coupled with oral rehabilitation on diet. Meta-analysis was only possible with three studies highlighting limitations. Large-scale, appropriately described trial methodologies are needed. Trial registry: This review was prospectively registered with PROSPERO on the 11 July 2017 [CRD42017071075].

Development and feasibility of a tailored habit-based dietary intervention coupled with natural tooth replacement on the nutritional status of older patients

“…The aim of phase 2 was to evaluate the feasibility of a habit-based dietary intervention in combination with natural tooth replacement on an older adult. These phases were fundamental for allowing for a greater understanding (8,10) How helpful did you find setting goals and targets?…”

“…10 (8,10) of the requirements involved in optimising this dietary intervention amongst older adults [20].…”

“…Consequently, dietary advice in addition to mastication restoration may be required to facilitate a change in nutritional status. To date, a number of studies exist that support and recommend the provision of dietary advice and education alongside prosthodontic tooth replacement for older adults, although this advice is largely limited to fully edentate individuals rather than those that are partially dentate [8]. However, this systematic review evidence also demonstrated that few of these interventions were theory-based, despite greater levels of effectiveness and successful implementation of an intervention based on theory [9][10][11].…”

Development and Feasibility of A Tailored Habit-based Dietary Intervention Coupled With Natural Tooth Replacement On The Nutritional Status Of Older Patients

“…On a scale of 1 (not helpful) to 10 (very helpful), median scores ranged from 8 to 10 for the following statements observed in Table 3 on helping to improve diet and overcome barriers to healthy eating: How helpful did you nd sticking to a routine (speci c meal times)? 8 (8,10) How helpful did you nd the feedback on your progress at each of the sessions? 10 (8, 10)…”

Development and Feasibility of A Tailored Habit-based Dietary Intervention Coupled With Natural Tooth Replacement On The Nutritional Status Of Older Patients

“…On a scale of 1 (not helpful) to 10 (very helpful), median scores ranged from 8 to 10 for the following statements observed in Table 3 on helping to improve diet and overcome barriers to healthy eating: How helpful did you find setting goals and targets? 9 (8,10) How helpful did you find sticking to a routine (specific meal times)? 8 (8,10) How helpful did you find the feedback on your progress at each of the sessions?…”