Advertisement

Current Oral Health Reports

, Volume 4, Issue 2, pp 64–69 | Cite as

Oral Disease and Malnutrition in the Elderly—Impact of Oral Cancer

  • Nur Mohammad Monsur Hassan
  • Rahena Akhter
  • Lisa Staudinger
  • Nicholas Tarpey
  • Simon Basha
  • Stephen Cox
  • Haruhiko KashiwazakiEmail author
Oral Disease and Nutrition (F Nishimura, Section Editor)
  • 145 Downloads
Part of the following topical collections:
  1. Topical Collection on Oral Disease and Nutrition

Abstract

Purpose of Review

The purpose of this paper is to review current evidence for a concomitant relationship between oral diseases and malnutrition in the elderly. A narrative overview of current literature was undertaken to combine the context for research with critical elaboration and commentary.

Recent Findings

Oral disease is one of the most common public health issues worldwide with significant socio-economic impacts, and yet it is frequently neglected in public health policy. Epidemiologic studies show that oral disease frequently causes malnutrition in the elderly. In particular, malnutrition is associated with poor quality of life and poor efficacy of oncologic therapy in oral cancer patients.

Summary

As oral disease remains a major public health burden worldwide, it is of great importance to integrate oral health into the nutrition agenda via the Common Risk Factor Approach. As such the long-term sustainable strategy for global oral health should focus on health promotion and malnutrition prevention in the elderly.

Keywords

Oral disease Oral cancer Malnutrition Elderly 

Notes

Compliance with Ethical Standards

Conflict of Interest

All authors declared that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Beaglehole RBH, Crail J, Mackay J. The oral health atlas: mapping a neglected global health issue. Brighton: FDI World Dental Federation; 2009.Google Scholar
  2. 2.
    The L. Oral health: prevention is key. Lancet. 373(9657):1. doi: 10.1016/S0140-6736(08)61933-9.
  3. 3.
    Jin LJ, Armitage GC, Klinge B, Lang NP, Tonetti M, Williams RC. Global oral health inequalities: task group—periodontal disease. Adv Dent Res. 2011;23(2):221–6. doi: 10.1177/0022034511402080.CrossRefPubMedGoogle Scholar
  4. 4.
    Benjamin RM. Oral health: the silent epidemic. Public health reports (Washington, DC : 1974). 2010;125(2):158–9.Google Scholar
  5. 5.
    Shahmoradi N, Kandiah M, Peng LS. Impact of nutritional status on the quality of life of advanced cancer patients in hospice home care. Asian Pacific journal of cancer prevention : APJCP. 2009;10(6):1003–9.PubMedGoogle Scholar
  6. 6.
    • Cohen S, Danzaki K, MacIver NJ. Nutritional effects on T-cell immunometabolism. Eur J Immunol. 2017; doi: 10.1002/eji.201646423. This paper outlines the importance of nutrient uptake on T cell metabolism and behaviour and discusses the link between malnutrition and immunity PubMedGoogle Scholar
  7. 7.
    Morley JE. Anorexia of aging: physiologic and pathologic. Am J Clin Nutr. 1997;66(4):760–73.PubMedGoogle Scholar
  8. 8.
    Bhattacharya PT, Misra SR, Hussain M. Nutritional aspects of essential trace elements in oral health and disease: an extensive review. Scientifica. 2016;2016:5464373. doi: 10.1155/2016/5464373.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Steele J, Shen J, Tsakos G, Fuller E, Morris S, Watt R, et al. The interplay between socioeconomic inequalities and clinical oral health. J Dent Res. 2015;94(1):19–26. doi: 10.1177/0022034514553978.CrossRefPubMedGoogle Scholar
  10. 10.
    Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe tooth loss: a systematic review and meta-analysis. J Dent Res. 2014;93(7 Suppl):20s–8s. doi: 10.1177/0022034514537828.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Sheiham A, Steele JG, Marcenes W, Finch S, Walls AW. The impact of oral health on stated ability to eat certain foods; findings from the National Diet and Nutrition Survey of older people in Great Britain. Gerodontology. 1999;16(1):11–20.CrossRefPubMedGoogle Scholar
  12. 12.
    Sheiham A, Steele J. Does the condition of the mouth and teeth affect the ability to eat certain foods, nutrient and dietary intake and nutritional status amongst older people? Public Health Nutr. 2001;4(3):797–803.CrossRefPubMedGoogle Scholar
  13. 13.
    van der Putten GJ, De Visschere L, van der Maarel-Wierink C, Vanobbergen J, Schols J. The importance of oral health in (frail) elderly people—a review. Eur Geriatr Med. 2013;4(5):339–44. doi: 10.1016/j.eurger.2013.07.007.CrossRefGoogle Scholar
  14. 14.
    Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010;58(9):1734–8. doi: 10.1111/j.1532-5415.2010.03016.x.CrossRefPubMedGoogle Scholar
  15. 15.
    Khan S, Musekiwa A, Chikte UM, Omar R. Differences in functional outcomes for adult patients with prosthodontically-treated and -untreated shortened dental arches: a systematic review. PLoS One. 2014;9(7):e101143. doi: 10.1371/journal.pone.0101143.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Sobolik CF. Alveolar bone resorption. J Prosthet Dent. 1960;10(4):612–9. doi: 10.1016/0022-3913(60)90240-7.CrossRefGoogle Scholar
  17. 17.
    Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988;17(4):232–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Fiske J, Davis DM, Frances C, Gelbier S. The emotional effects of tooth loss in edentulous people. Br Dent J. 1998;184(2):90–3. discussion 79 CrossRefPubMedGoogle Scholar
  19. 19.
    Donnelly LR, Clarke LH, Phinney A, MacEntee MI. The impact of oral health on body image and social interactions among elders in long-term care. Gerodontology. 2016;33(4):480–9. doi: 10.1111/ger.12187.CrossRefPubMedGoogle Scholar
  20. 20.
    Cobb CM, Williams KB, Gerkovitch MM. Is the prevalence of periodontitis in the USA in decline? Periodontol. 2009;50:13–24. doi: 10.1111/j.1600-0757.2008.00284.x.CrossRefGoogle Scholar
  21. 21.
    • Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014;93(11):1045–53. doi: 10.1177/0022034514552491. A meta-analysis of 68 studies from 26 countries between 1990 and 2010 demonstrating a significant decline in the prevalence and incidence of severe tooth loss at the global, regional, and country levels CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Thomson WM, Shearer DM, Broadbent JM, Foster Page LA, Poulton R. The natural history of periodontal attachment loss during the third and fourth decades of life. J Clin Periodontol. 2013;40(7):672–80. doi: 10.1111/jcpe.12108.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Boehm TK, Scannapieco FA. The epidemiology, consequences and management of periodontal disease in older adults. J Am Dent Assoc. 2007;138(Suppl):26s–33s.CrossRefPubMedGoogle Scholar
  24. 24.
    Cekici A, Kantarci A, Hasturk H, Van Dyke TE. Inflammatory and immune pathways in the pathogenesis of periodontal disease. Periodontol. 2014;64(1):57–80. doi: 10.1111/prd.12002.CrossRefGoogle Scholar
  25. 25.
    Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol. 2008;79(8 Suppl):1560–8. doi: 10.1902/jop.2008.080213.CrossRefPubMedGoogle Scholar
  26. 26.
    Brinkmann O, Zhang L, Giannobile WV, Wong DT. Salivary biomarkers for periodontal disease diagnostics. Expert opinion on medical diagnostics. 2011;5(1):25–35. doi: 10.1517/17530059.2011.542144.CrossRefPubMedGoogle Scholar
  27. 27.
    Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91(10):914–20. doi: 10.1177/0022034512457373.CrossRefPubMedGoogle Scholar
  28. 28.
    Das M, Das R. Need of education and awareness towards zinc supplementation: a review. International Journal of Nutrition and Metabolism. 2012;4(3):45–50.Google Scholar
  29. 29.
    Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917.CrossRefPubMedGoogle Scholar
  30. 30.
    Johnson NW, Jayasekara P, Amarasinghe A. Squamous cell carcinoma and precursor lesions of the oral cavity: epidemiology and aetiology. Periodontol. 2011;57(1):19–37.CrossRefGoogle Scholar
  31. 31.
    Chandu A, Smith AC, Rogers SN. Health-related quality of life in oral cancer: a review. J Oral Maxillofac Surg. 2006;64(3):495–502.CrossRefPubMedGoogle Scholar
  32. 32.
    • Iyengar NM, Kochhar A, Morris PG, Morris LG, Zhou XK, Ghossein RA, et al. Impact of obesity on the survival of patients with early-stage squamous cell carcinoma of the oral tongue. Cancer. 2014;120(7):983–91. A retrospective study of patients treated for SCC of the tongue, demonstrating that obesity is an adverse independent prognositc variable of disease specific survival CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Liu SA, Tsai WC, Wong YK, Lin JC, Poon CK, Chao SY, et al. Nutritional factors and survival of patients with oral cancer. Head & neck. 2006;28(11):998–1007.CrossRefGoogle Scholar
  34. 34.
    den Hollander D, Kampman E, van Herpen CM. Pretreatment body mass index and head and neck cancer outcome: a review of the literature. Crit Rev Oncol Hematol. 2015;96(2):328–38.CrossRefPubMedGoogle Scholar
  35. 35.
    van Bokhorstde van der S, van Leeuwen PA, Kuik DJ, Klop WM, Sauerwein HP, Snow GB, et al. The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer. 1999;86(3):519–27.CrossRefGoogle Scholar
  36. 36.
    Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, Saxton JP, Lavertu P. Enteral nutrition during the treatment of head and neck carcinoma. Cancer. 2001;91(9):1785–90.CrossRefPubMedGoogle Scholar
  37. 37.
    Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, et al. Definition and classification of cancer cachexia: an international consensus. The Lancet Oncology. 2011;12(5):489–95. doi: 10.1016/s1470-2045(10)70218-7.CrossRefPubMedGoogle Scholar
  38. 38.
    • Aapro M, Arends J, Bozzetti F, Fearon K, Grunberg SM, Herrstedt J, et al. Early recognition of malnutrition and cachexia in the cancer patient: a position paper of a European School of Oncology Task Force. Ann Oncol. 2014;25(8):1492–9. doi: 10.1093/annonc/mdu085. Guidelines and recommendations for management of cancer patient post-treatments to reduce the risk of malnutrition and cachexia and improve the overall quality of life. CrossRefPubMedGoogle Scholar
  39. 39.
    Delafuente J. Nutrients and immune responses. Rheum Dis Clin N Am. 1991;17(2):203.Google Scholar
  40. 40.
    Copeland EM, Daly JM, Dudrick SJ. Nutrition as an adjunct to cancer treatment in the adult. Cancer Res. 1977;37(7 Part 2):2451–6.PubMedGoogle Scholar
  41. 41.
    •• Talwar B, Donnelly R, Skelly R, Donaldson M. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. The Journal of Laryngology & Otology. 2016;130(S2):S32–40. Nutritional management guidelines and considerations for head and neck cancer patients pre- and post-treatment CrossRefGoogle Scholar
  42. 42.
    Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG. Role of nutritional status in predicting quality of life outcomes in cancer—a systematic review of the epidemiological literature. Nutr J. 2012;11(1):27.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Egestad H, Nieder C. Differences in quality of life in obese and normal weight head and neck cancer patients undergoing radiation therapy. Support Care Cancer. 2015;23(4):1081–90.CrossRefPubMedGoogle Scholar
  44. 44.
    Badr H, Lipnick D, Gupta V, Miles B. Survivorship challenges and information needs after radiotherapy for oral cancer. Journal of Cancer Education. 2016:1–9.Google Scholar
  45. 45.
    Barrios R, Bravo M, Gil-Montoya JA, Martínez-Lara I, García-Medina B, Tsakos G. Oral and general health-related quality of life in patients treated for oral cancer compared to control group. Health Qual Life Outcomes. 2015;13(1):9.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Barrios R, Tsakos G, Gil-Montoya J-A, Montero J, Bravo M. Association between general and oral health-related quality of life in patients treated for oral cancer. Medicina oral, patologia oral y cirugia bucal. 2015;20(6):e678–84.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Gellrich N-C, Handschel J, Holtmann H, Krüskemper G. Oral cancer malnutrition impacts weight and quality of life. Nutrients. 2015;7(4):2145–60.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Lazarus C, Husaini H, Falciglia D, DeLacure M, Branski R, Kraus D, et al. Effects of exercise on swallowing and tongue strength in patients with oral and oropharyngeal cancer treated with primary radiotherapy with or without chemotherapy. Int J Oral Maxillofac Surg. 2014;43(5):523–30.CrossRefPubMedGoogle Scholar
  49. 49.
    Morais MO, Elias MRA, Leles CR, Pinezi JCD, Mendonça EF. The effect of preventive oral care on treatment outcomes of a cohort of oral cancer patients. Support Care Cancer. 2016;24(4):1663–70.CrossRefPubMedGoogle Scholar
  50. 50.
    Pateman K, Ford P, Batstone M, Farah C. Coping with an altered mouth and perceived supportive care needs following head and neck cancer treatment. Support Care Cancer. 2015;23(8):2365–73.CrossRefPubMedGoogle Scholar
  51. 51.
    Patterson JM, McColl E, Wilson J, Carding P, Rapley T. Head and neck cancer patients’ perceptions of swallowing following chemoradiotherapy. Support Care Cancer. 2015;23(12):3531–8.CrossRefPubMedGoogle Scholar
  52. 52.
    Silander E, Nyman J, Bove M, Johansson L, Larsson S, Hammerlid E. Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer—a randomized study. Head & neck. 2012;34(1):1–9.CrossRefGoogle Scholar
  53. 53.
    Silander E, Nyman J, Hammerlid E. An exploration of factors predicting malnutrition in patients with advanced head and neck cancer. Laryngoscope. 2013;123(10):2428–34.PubMedGoogle Scholar
  54. 54.
    Trachootham D, Songkaew W, Hongsachum B, Wattana C, Changkluengdee N, Karapoch J, et al. Nutri-jelly may improve quality of life and decrease tube feeding demand in head and neck cancer patients. Support Care Cancer. 2015;23(5):1421–30.CrossRefPubMedGoogle Scholar
  55. 55.
    Berg MG, Rütten H, Rasmussen-Conrad EL, Knuijt S, Takes RP, Herpen CM, et al. Nutritional status, food intake, and dysphagia in long-term survivors with head and neck cancer treated with chemoradiotherapy: a cross-sectional study. Head & neck. 2014;36(1):60–5.CrossRefGoogle Scholar
  56. 56.
    •• Barrios R, Tsakos G, García-Medina B, Martínez-Lara I, Bravo M. Oral health-related quality of life and malnutrition in patients treated for oral cancer. Support Care Cancer. 2014;22(11):2927–33. A paper which demonstrates using two separate standardized surveys that malnourishment or risk of malnourishment reduces the oral health-related quality of life in oral cancer patients. CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Moynihan P, Thomason M, Walls A, Gray-Donald K, Morais JA, Ghanem H, et al. Researching the impact of oral health on diet and nutritional status: methodological issues. J Dent. 2009;37(4):237–49.CrossRefPubMedGoogle Scholar
  58. 58.
    Jayadeep A, Raveendran PK, Kannan S, Nalinakumari K, Mathew B, Krishnan NM, et al. Serum levels of copper, zinc, iron and ceruplasmin in oral leukoplakia and squamous cell carcinoma. Journal of experimental & clinical cancer research: CR. 1997;16(3):295–300.Google Scholar
  59. 59.
    Desai VD, Kumar MS, Bathi RJ, Gaurav I, Sharma R. Molecular analysis of trace elements in oral submucous fibrosis and future perspectives. Universal Research Journal of Dentistry. 2014;4(1):26.CrossRefGoogle Scholar
  60. 60.
    Ray J, Ghosh R, Mallick D, Swain N, Gandhi P, Ram S, et al. Correlation of trace elemental profiles in blood samples of Indian patients with leukoplakia and oral submucous fibrosis. Biol Trace Elem Res. 2011;144(1–3):295–305.CrossRefPubMedGoogle Scholar
  61. 61.
    Ismail SB, Kumar SK, Zain RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci. 2007;49(2):89–106.CrossRefPubMedGoogle Scholar
  62. 62.
    Swain N, Ray JG. Altered trace element level and antioxidant activity in whole blood of oral leukoplakia and cancer patients in comparison with healthy controls. International Journal of Oral and Maxillofacial Pathology. 2011;2(2):2–6.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Nur Mohammad Monsur Hassan
    • 1
  • Rahena Akhter
    • 2
  • Lisa Staudinger
    • 1
  • Nicholas Tarpey
    • 1
  • Simon Basha
    • 1
  • Stephen Cox
    • 2
  • Haruhiko Kashiwazaki
    • 3
    Email author
  1. 1.School of Dentistry and Health SciencesCharles Sturt UniversityOrangeAustralia
  2. 2.Faculty of DentistryThe University of SydneySydneyAustralia
  3. 3.Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental ScienceKyushu UniversityFukuokaJapan

Personalised recommendations