ORCID Profile
0000-0002-5015-5620
Current Organisations
University of Adelaide
,
Universidade Federal de Juiz de Fora
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Publisher: MDPI AG
Date: 15-12-2021
Abstract: Grip strength and walking speed are considered to be important indicators of physical frailty. However, no study has contemporaneously examined any association of multiple oral functions with grip strength and walking speed. The purpose of this study was to examine which oral functions are associated with muscle strength (grip strength), physical performance (walking speed) or both. The study participants were 511 community-dwelling people (254 men and 257 women) aged 77–81 years old. Six oral functions—oral wetness, occlusal force, tongue-lip motor function, tongue pressure, masticatory performance and swallowing function—were measured. Grip strength and walking speed were also measured. A partial correlation analysis, adjusted for gender, showed that occlusal force, tongue-lip motor function, masticatory performance and swallowing function were significantly associated with both grip strength and walking speed. In addition, tongue pressure was significantly associated with grip strength. A general linear model showed that tongue pressure and occlusal force were significantly associated with grip strength. Swallowing function and tongue-lip motor function were significantly associated with walking speed. It is suggested that there are different oral function measures for muscle strength and physical performance, and these oral function measures could be a useful proxy for physical frailty.
Publisher: Elsevier BV
Date: 03-1998
DOI: 10.1016/S0300-5712(97)00010-9
Abstract: This review aims to clarify the nomenclature of carbohydrates, including novel manufactured carbohydrates which are becoming increasingly popular within the food industry, and to summarise what is known about the effects of different carbohydrates on dental health. This review compiles information from articles published in mainstream microbiological, nutritional and dental journals that are of relevance to carbohydrates and dental health. The review considers literature on classification of carbohydrates by chain length, for ex le mono-di-oligo- and poly-saccharides and classification for dental health purposes, namely intrinsic, non-milk extrinsic sugars. This paper includes a comprehensive review of information on novel carbohydrates including isomaltosaccharides, fructo-oligosaccharides and gluco-oligosaccharides, maltodextrins and glucose syrups. Information on polyols and non-starch polysaccharides is also presented and current knowledge on the dental effects of all carbohydrates are discussed. There is a wealth of information on dietary sugars and the effects of sugars on dental health is established knowledge. However, the range of 'novel' manufactured carbohydrates which are becoming available for food use is increasing and information regarding the cariogenicity of these substances is sparse. Research indicates that maltodextrins and glucose syrups are cariogenic, however, initial studies on some synthetic oligosaccharides have suggested reduced cariogenicity compared to sucrose. Further human plaque pH and in vitro and in vivo tests of cariogenicity are required to clarify these initial observations.
Publisher: Medknow
Date: 2018
Publisher: Oxford University Press (OUP)
Date: 09-1998
DOI: 10.1046/J.1472-765X.1998.00403.X
Abstract: Representative strains of oral streptococci, lactobacilli and bifidobacteria were incubated overnight with lactulose or other carbohydrates and the final pH recorded. Most bacteria tested were able to metabolize lactulose with the exception of strains of Streptococcus salivarius, Lactobacillus acidophilus and Lact. fermentum. Streptococcus mutans produced most acid overnight but the initial rate of acid production from lactulose by uninduced cultures was very low. Plaque pH was monitored in 12 volunteers following rinsing the mouth with lactulose, sucrose or sorbitol or Lactulose BP. These studies in vivo showed both lactulose and Lactulose BP to exhibit low acidogenic potential. Thus, although plaque bacteria are capable of fermenting lactulose, the results suggest that lactulose is likely to pose a small acidogenic challenge to teeth under normal conditions of use.
Publisher: ACM
Date: 27-04-2013
Publisher: Wiley
Date: 11-08-2011
Publisher: Public Library of Science (PLoS)
Date: 29-07-2016
Publisher: Cambridge University Press (CUP)
Date: 06-2002
Publisher: Wiley
Date: 28-10-2010
Publisher: Elsevier BV
Date: 2016
Publisher: Springer Science and Business Media LLC
Date: 12-1999
Abstract: Eating cheese by itself increases plaque calcium concentration - which is probably one mechanism of the well-established action of cheese in reducing experimental caries. The objective of the present study was to determine whether consumption of cheese as part of a cooked, mixed meal (ie as it is habitually consumed) is able to increase plaque calcium concentration. Plaque s les were obtained from 16 adult volunteers before and 5 minutes after consumption of either a 15 g cube of cheese, one of two cheese-containing test meals, or one of two control meals. Each subject tested each of the four meals on a separate occasion. Plaque calcium concentration was measured using atomic absorption spectrophotometry. The test meals increased plaque calcium concentrations to a significantly greater magnitude than the control meals (P < 0.05). A non-significant trend was observed towards a larger magnitude of change in plaque calcium concentration in the 8 subjects with the lowest, compared with the 8 subjects with the highest baseline concentration. The findings suggest that cheese-containing meals increase plaque calcium concentration and thus probably protect against dental caries.
Publisher: Wiley
Date: 05-2013
Publisher: Elsevier
Date: 2009
Publisher: ACM
Date: 05-05-2012
Publisher: ACM
Date: 10-04-2010
Publisher: Cambridge University Press (CUP)
Date: 08-2004
DOI: 10.1079/BJN20041199
Abstract: Monitoring adolescent diets over time enables the assessment of the effectiveness of public health messages which are particularly important in vulnerable groups such as adolescents. In 2000, 424 children aged 11–12 years old completed two 3 d estimated dietary records. On the fourth day one nutritionist interviewed each child to clarify the information in the diary and foods were quantified with the aid of food models. Nutrient intake was calculated using computerised food tables. These children attended the same seven schools in the same Northumberland area as the 11- to 12-year-old children who recorded their diet using the same method in 1980 ( n 405) and 1990 ( n 379), respectively. Height and weight, and parental occupation were recorded in all three surveys for each child. Height and weight were used to calculate BMI, weight was used to estimate BMR and parental occupation was used to determine social class. Comparing the macronutrient intakes in 2000 with 1980 and 1990, energy intakes (EI) fell in boys (to 8·45 MJ) and girls (to 7·60 MJ). This fall may, at least in part, be due to an increase in low energy reporting. For 1980, 1990 and 2000 the percentage of boys with EI:BMR below 1·1 was 6, 15 and 23%, respectively for girls, 3, 14 and 18%, respectively. Percentage energy from fat was unchanged between 1980 and 1990 but fell to 35% (about 76 g/d) in 2000, alongside a 3% increase in percentage energy from starch (30%). Percentage energy from non-milk extrinsic sugars remained above recommendations (16% about 82 g/d). The number of overweight and obese children increased from 11% to 30% between 1980 and 2000. Positive changes have occurred in the Northumbrian adolescent diet but social inequalities, reported in previous surveys, remain.
Publisher: Springer Science and Business Media LLC
Date: 20-12-1999
Publisher: SAGE Publications
Date: 07-2007
DOI: 10.1177/154405910708600712
Abstract: Removable partial dentures may adversely affect remaining tissues and have a low prevalence of use. This randomized controlled trial was designed to compare the time to survival of cantilever resin-bonded fixed partial dentures and conventional removable partial dentures to restore shortened lower dental arches. We randomly allocated 25 male and 35 female patients (median age, 67 years) to fixed or removable partial denture groups of 30 persons, matched for age and sex. Survival of the prostheses was assessed, based on listed criteria, at each review or when problems arose. Although the removable partial denture group required rather more maintenance visits, the difference in survival rates was not statistically significant (hazard ratio = 0.59, with 95% CI 0.27, 1.29). In the absence of significant differences in five-year survival, the reported advantages of fixed partial dentures, including reduced maintenance frequency, offer positive support for the use of resin-bonded fixed partial dentures.
Publisher: SAGE Publications
Date: 2008
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.PLEFA.2011.04.002
Abstract: The longitudinal relationship between dietary n-6 to n-3 PUFAs ratio and periodontal disease in 235 Japanese subjects for whom data were available for the years 2003-2006 was investigated. PUFAs intake was assessed at baseline with a brief-type self-administered diet history questionnaire. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and once a year for 3 years. The number of teeth with a change in the loss of CAL ≥3 mm at any site over a year was calculated as 'periodontal disease events'. Poisson regression analysis was conducted, with dietary n-6 to n-3 PUFAs ratio as the main predictor, to estimate its influence on periodontal disease events. A high dietary n-6 to n-3 PUFAs ratio was significantly associated with greater number of periodontal disease events. The findings suggest the dietary n-6 to n-3 PUFAs ratio is associated with periodontal disease among older Japanese.
Publisher: Wiley
Date: 02-2003
DOI: 10.1046/J.1365-277X.2003.00414.X
Abstract: Those sugars in foods, which are potentially damaging to dental health, were classified by the Committee on Medical Aspects of Food Policy (COMA) as non-milk extrinsic sugars (NMES). The NMES include sugars outside the cellular structure of a food, excluding the sugars naturally present in milk and milk products. The NMES should contribute no more than 10% of energy intake (Department of Health, 1991). A number of studies have been published where NMES content of foods has been estimated. The purpose of this study was to carry out a comprehensive literature review using a methodical search strategy in order to identify the different methods that have been used for NMES estimation. Databases searched were MEDLINE, EMBASE, Health-CD and Health Management Information Consortium (HMIC) (as sources of UK government and other official publications). In total, 32 publications were found in which NMES values were reported and five different methods to estimate NMES were identified. No published method provided sufficient information to clearly differentiate between methods and inadequate detail was given to support replication of any of the methods. Of these five methods, The Ministry of Agriculture, Fisheries and Food (MAFF) have published three different descriptions of methods of NMES estimation used in UK national dietary surveys published since 1989. However, one method has been described consistently in the National Diet and Nutrition surveys published since 1994. A single, uniform approach to the estimation of NMES for application in nutritional surveys is essential for cross-comparison between surveys. The results show that there is a clear need for one standardized approach for the estimation of NMES in foods.
Publisher: Springer Science and Business Media LLC
Date: 11-2002
Publisher: Cambridge University Press (CUP)
Date: 1995
DOI: 10.1079/NRR19950013
Publisher: Elsevier BV
Date: 10-2012
DOI: 10.1016/J.JDENT.2012.07.001
Abstract: Edentulous persons have poor diet quality demonstrating a need for dietary intervention. Implant-supported mandibular overdentures (IODs) have functional advantages over conventional dentures (CD), but whether they enhance the ability to eat more healthily following dietary advice is unknown. This study aimed to compare the effectiveness of dietary intervention between IODs and CD patients. Edentulous adults (28 IOD and 26 CD) received customised dietary advice. The percentage contribution of dietary fats, carbohydrate and protein to energy (kcal) intake, dietary intakes of fibre, fruits, vegetables and antioxidants, and plasma antioxidants were assessed pre- and at 3 and 6 months post-dietary intervention. Both groups increased fruit and vegetable intake at 3 and 6 months following dietary intervention but intakes between groups did not differ. The IOD group had reduced % energy from total fat at 3 and 6 months and from saturated fat at 3 months. The CD group had reduced % energy from saturated by 6 months. The IOD group had a significantly lower % energy intake from saturated fat at 3 months and higher intake of non-starch polysaccharide (NSP) compared with the CD group. Both groups showed improvements in serum antioxidant status but the IOD group had significantly higher plasma antioxidant capacity post intervention compared with the CD group. Dietary intervention benefits denture patients. IOD patients showed moderately greater dietary improvements compared with conventional denture patients.
Publisher: Springer Science and Business Media LLC
Date: 04-2003
Publisher: Wiley
Date: 06-1994
Publisher: Springer Science and Business Media LLC
Date: 10-1996
Abstract: Weaning practice can have a major influence on both immediate and future dental health and good dietary practices from birth have the potential to secure a healthy dentition for life. In a recently published report it is recommended that infants (an infant may be defined as a child who has not yet reached the age of one year) be weaned on foods and drinks free as far as possible of non-milk extrinsic (NME) sugars. At the same time, there has also been an increasing development of low-sugar and sugar-free products for infants. There has also been growing concern that infant drinks with low pH may cause enamel erosion in primary teeth, a phenomenon that is perhaps more widespread than has been recognised in the past. The aim of the weaning diet is to achieve a diet which fulfills nutritional requirements for the growing child and which contains a wide variety of foods and drinks. It is suggested that items high in NME sugars are not a necessary part of the diet, should be regarded as 'occasional', and not given every day. Drinks other than milk or water should constitute a minority of total drinks and be given only at main mealtimes they should not be given in bottles or at bedtime.
Publisher: Springer Science and Business Media LLC
Date: 04-01-2007
Abstract: The aim of the LIFELAX randomised controlled trial (diet and life style vs. lax atives in the management of chronic constipation) is to develop and evaluate a cost effective intervention to promote diet and lifestyle in the treatment and management of chronic constipation for older people in Primary Care. Constipation affects the quality of life in around 20% of older people in the community. In the 65 years plus population, a significant proportion of men and women both living in institutions (81% and 75% respectively) and free living (30% and 37% respectively) use laxatives. Approximately £42 million is spent each year on prescribed laxatives in England in addition to laxatives purchased over the counter. Although bowel problems are often multifactorial, diet and lifestyle have an extremely important role in their management. This paper describes one aspect of the main study, the development and piloting of the Patient information leaflets (PILs). Following review of the literature and interviews with practitioners and patients, 8 PILs were designed on: constipation, activity, bowel health, fruit and vegetables, fibre, fluid, alternative therapies and laxatives. To check the patient's understanding of terms used in the PILS and the clarity and accessibility of the information understanding, cognitive interviews (CI) were used with nine patients (selected from 3 GP surgeries), aged ≥ 55 years, who had received ≥ 3 prescriptions of laxatives over 12 months. Interviews were recorded and transcribed. Changes made following the CI process included the lay-out, words used (e.g. 'exercise' was changed to 'activity', 'gut motility' changed to 'bowel movement') and descriptions and ex les were adapted to be more appropriate for the target population. Pilot testing with CIs resulted in improvements in the PILs, which emphasises the need to pilot PILs with the target population before use. The techniques employed are relatively inexpensive and could be routinely used when preparing literature for research or clinical use including those intended for use with healthcare professionals and patients.
Publisher: SAGE Publications
Date: 18-03-2022
DOI: 10.1177/00220345221082918
Abstract: An update of the systematic review of evidence on the association between amount of sugars intake and dental caries, as well as on the effect of restricting sugars intake to % and % energy (E) on caries, was conducted, almost 10 y since the review that informed the World Health Organization (WHO) Guideline on Sugars. The aim was to systematically review epidemiological data published from 2011 to 2020 on the amount of sugars consumption and levels of caries and to report the findings for adults and children. Data sources included MEDLINE, EMBASE, Cochrane Database, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences, China National Knowledge Infrastructure, Scopus, and Google Scholar. Eligible studies reported the amount of sugars and caries, measured as prevalence, incidence, or severity. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Risk of bias was assessed using the Office of Health Assessment and Translation tool. Vote counting and harvest plots provided the basis for evidence synthesis. From 488 new papers identified, 23 studies were eligible: 4 cohort, 1 case-controlled, 12 cross-sectional, and 6 ecological. Eleven of 15 studies in children and 6 of 8 studies in adults reported at least 1 positive association between sugars and caries. Six of 7 studies in children and 4 of 4 studies in adults, with data enabling comparison of caries levels with sugars intakes %E and %E, showed lower caries when sugars intake was %E. Amalgamating with original studies yielded 64 of 78 studies showing at least 1 positive association, 20 of 78 a null association, and 3 of 78 a negative association between sugars and caries. GRADE profiles of new and original cohort data confirmed “moderate-quality” evidence that caries is lower when sugars intake is %E. Furthermore, new cohort data upgraded the quality of evidence (from “very low” to “low”) for lower caries when free sugars are %E. The findings support and strengthen original evidence underpinning the WHO recommendations for sugars.
Publisher: Elsevier BV
Date: 06-2003
Publisher: Wiley
Date: 24-03-2021
DOI: 10.1111/JGS.17106
Abstract: To determine any independent influence of occlusal force and of number of natural teeth on decline in body mass index (BMI) among older Japanese adults. Longitudinal study over a 3‐ to 6‐year period. Urban and rural area in Japan. Independently living Japanese adults aged 69–71 years and 79–81 years at baseline. This analysis excluded participants who were defined as underweight at baseline. Information was collected on age, gender, occlusal force, the number of teeth, BMI, socioeconomic factors, medical history, the number of daily prescription medications, cognitive function, depressive symptoms, hand grip strength, and physical function. Maximal occlusal force was measured with a pressure‐sensitive sheet. Nutritional status was assessed using BMI, and participants with BMI .5 were defined as underweight. Then, they were ided into two groups: a “BMI declined” group who were defined as underweight at either 3‐ or 6‐year follow‐up survey, and a “BMI maintained” group who were not defined as underweight at both follow‐up surveys. Logistic generalized estimating equation (GEE) models were used to assess the effect of occlusal force and the number of teeth at baseline on decline in BMI over 3 or 6 years, after adjusting for possible covariates associated with nutritional status. The final analysis included 704 participants. Eighty‐six (12.2%) participants were classified into the BMI declined group. Logistic GEE models showed that the number of teeth was not significantly associated with decline in BMI. However, occlusal force was significantly associated with decline in BMI (odds ratio = 0.90, 95% confidence interval = 0.83–0.97) after adjusting for covariates. Participants with lower occlusal force were more likely to be in the BMI less than 21.5 kg/m 2 . The findings suggest that to prevent decline in oral function is important to maintain nutritional status.
Publisher: SAGE Publications
Date: 24-04-2021
DOI: 10.1177/00220345211007747
Abstract: The study aimed to quantify the excess risk of interaction between high free sugars (sugars) intake and lack of exposure to water fluoridation on child dental caries. Data from the Australian National Child Oral Health Study, a population-based survey of 24,664 children aged 5 to 14 y, were collected using parental questionnaires and oral epidemiological examinations by trained examiners. Information on socioeconomic status, dental health behaviors, and dental service use was used as covariates. The number of servings of sugars-containing foods and drinks consumed in a usual day was assessed as the main exposure, categorized into 5 groups. Residential history was used to calculate lifetime exposure to fluoridated water (LEFW), categorized as low ( %), medium (25% to %), or high (75%–100%). Caries prevalence (dmfs/DMFS ) and experience (dmfs/DMFS) in the primary (ages 5–10 y) and permanent (ages 8–14 y) dentitions were the main dependent variables. The association of sugars intake and LEFW with each outcome was estimated in multivariable log-Poisson regression models with robust standard error estimation, adjusted for covariates. The relative excess risk due to interaction (RERI) between sugars intake and LEFW was estimated. Strong positive gradients in all outcomes were observed across sugars intake groups. Relative to the lowest intake group, the 3 highest intake groups had significantly higher adjusted prevalence ratios for having caries and higher adjusted mean ratios of caries experience in both dentitions, after controlling for all covariates. LEFW strongly and consistently attenuated the effects of all levels of sugars intake on the outcomes. RERI estimates indicated that a combination of lack of exposure to fluoridated water and high sugars intake resulted in greater excess risk of primary and permanent caries than if there was no interaction. Evidently, children with high sugars intakes and low exposure to water fluoridation are at disproportionately higher risk of dental caries.
Publisher: Elsevier BV
Date: 02-2001
Publisher: Elsevier BV
Date: 11-2010
DOI: 10.1016/J.NUT.2009.09.010
Abstract: Fish oil has anti-inflammatory actions that may benefit periodontal health. We investigated the longitudinal relation between dietary ω-3 fatty acids (FAs), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) to periodontal disease in community-dwelling elderly. Fifty-five participants aged 74 y were randomly selected from a longitudinal interdisciplinary study of aging. Dietary intake data were obtained by a 3-d weighed food intake. The dietary intakes of energy, DHA, and EPA were calculated based on the Standard Food Composition Tables in Japan. Dental examinations were carried out at baseline and once a year for 5 y. The number of teeth with periodontal progression over 5 y per person was calculated as "periodontal disease events." Negative binomial regression analysis was conducted, which included DHA, EPA, and other covariates as independent variables to estimate the influence on periodontal disease events. Longitudinal data were analyzed for participants for whom data were available for 5 y (n=36). Low DHA intake was significantly associated with more periodontal disease events. The mean number of periodontal disease events for participants who consumed the lowest tertile of DHA was approximately 1.5 times larger (lowest tertile, incidence rate ratio 1.49, 95% confidence interval 1.01-2.21) than the reference group (highest tertile of DHA consumption), after simultaneously adjusting for possible confounders. The findings suggest there may be an inverse, independent relation of dietary DHA intake to the progression of periodontal disease in older people.
Publisher: Wiley
Date: 26-09-2012
DOI: 10.1111/J.1467-9566.2012.01515.X
Abstract: Approximately 60 per cent of UK patients aged 65 years or older are at risk of malnutrition or their situation worsening while in hospital. We report the results of a qualitative study embedded in research to prevent malnutrition in older people in hospital (the mappmal study). Our aim was to understand and describe processes that promote or inhibit nutrition in hospital. Throughout 2009 we examined meal services at four UK hospital sites across two regional locations, focusing on older patients admitted with dementia, for stroke or for fractured neck of femur. Data were collected through semi-structured interviews with National Health Service staff (n = 54), stakeholders (n = 6), and a focus group with former patients and carers (n = 5). We identified ward-based food work as a technical and interpersonal challenge in narratives around malnutrition. Food work constituted two overlapping spheres of activity: interpersonal engagement through feeding assistance and reassurance and the arrangement of resources that facilitate meals such as the preparation of food trolleys. Our analysis is framed by the literature on emotional labour, dirty work and the professionalisation of nursing. We demonstrate how food work is overlooked by being conceptualised as common sense and as one of the most mundane and elementary tasks in hospitals.
Publisher: Research Square Platform LLC
Date: 07-01-2021
DOI: 10.21203/RS.3.RS-60250/V3
Abstract: Background: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old ( years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan. Methods: The Newcastle 85+ Study in England (n=853) and the Tokyo Oldest Old Survey on Total Health (TOOTH n=542) comprise random s les of people aged years. Oral health markers included tooth loss, dryness of mouth, difficulty swallowing and self-reported difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression. Results: In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for gender, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26-2.46) 2.52 (1.56-4.08) 2.89 (1.52-5.50) 2.59 (1.44-4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed and complete tooth loss was associated with increased risk of frailty. Conclusion: Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.
Publisher: Springer Science and Business Media LLC
Date: 2014
Abstract: Data on fluoride exposure of infants are sparse. This study aimed to estimate total daily fluoride intake (TDFI) of infants aged 1-12 months, living in non-fluoridated and fluoridated areas in north-east England. Daily dietary fluoride intake was assessed using a three-day food diary coupled with analysis of fluoride content of food/drink consumed, using a F-ISE and diffusion method. A questionnaire with an interview was used to collect information on toothbrushing habits. TDFI was estimated from diet, plus fluoride supplements and dentifrice ingestion where used. Thirty-eight infants completed the study 19 receiving fluoridated water (mean 0.97 mgF/l) and 19 receiving non-fluoridated water (mean 0.19 mgF/l). Mean (SD) TDFI for the infants living in fluoridated and non-fluoridated areas was 0.107 (0.054) and 0.024 (0.015) mg/kg body weight per day, respectively. Diet was the only fluoride source for 87% of infants and none used fluoride supplements. For infants for whom mouth/teeth cleaning was undertaken, dentifrice contribution to TDFI ranged from 24 to 78%. Infants living in fluoridated areas, in general, may receive a fluoride intake, from diet only, of more than the suggested optimal range for TDFI. This emphasises the importance of estimating TDFI at an in idual level when recommendations for fluoride use are being considered.
Publisher: Wiley
Date: 23-11-2017
DOI: 10.1111/CDOE.12353
Abstract: The burden of oral disease is high in populations across the world. This is because of high consumption of free sugars. The WHO Guideline on Sugars Intake for Adults and Children recommended limiting free sugars to no more than 5% energy intake to protect oral health throughout the life-course. The objectives of this paper are to consider the implications of the Guideline for dental health practice and to advocate use of the common risk factor approach when providing dietary advice. As part of a broad range of actions needed to reduce free sugars intake, improved education for dental health professionals and supporting patients to eat less free sugars are key actions for the dental profession. All dental health professionals should have the skills and confidence to provide their patients with healthier eating advice, including how to limit free sugars intake. It is therefore important that dental health professionals receive adequate education in diet and nutrition, and there is a need for dental educational regulating bodies to define the content of the dental curriculum with respect to nutrition. All patients, or their parents or carers, should receive dietary advice to reduce free sugars within the context of a healthy diet for the prevention of all NCDs. Dietary advice should: (i) focus on reducing the amount of free sugars consumed (ii) be tailored according to the patient's body mass status (eg underweight, overweight, normal weight) (iii) encourage the consumption of fresh fruits and vegetables, nuts, seeds, and wholegrain starch-rich foods (iv) discourage the consumption of foods high in saturated fat and salt and (v) discourage the consumption of all drinks containing free sugars. The dental health professional has an opportunity to support patients to reduce their intake of free sugars-such advice and support will have positive impacts beyond the mouth.
Publisher: SAGE Publications
Date: 09-12-2013
Abstract: A systematic review of studies in humans was conducted to update evidence on the association between the amount of sugars intake and dental caries and on the effect of restricting sugars intake to 10% and 5% energy (E) on caries to inform the updating of World Health Organization guidelines on sugars consumption. Data sources included MEDLINE, EMBASE, Cochrane Database, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences, China National Knowledge Infrastructure, Wanfang, and South African Department of Health. Eligible studies reported the absolute amount of sugars and dental caries, measured as prevalence, incidence, or severity. The review was conducted and reported in accordance with the PRISMA statement, and the evidence was assessed according to GRADE Working Group guidelines. From 5,990 papers identified, 55 studies were eligible – 3 intervention, 8 cohort, 20 population, and 24 cross-sectional. Data variability limited meta-analysis. Of the studies, 42 out of 50 of those in children and 5 out of 5 in adults reported at least one positive association between sugars and caries. There is evidence of moderate quality showing that caries is lower when free-sugars intake is 10% E. With the 5% E cut-off, a significant relationship was observed, but the evidence was judged to be of very low quality. The findings are relevant to minimizing caries risk throughout the life course.
Publisher: Cambridge University Press (CUP)
Date: 07-2005
DOI: 10.1079/BJN20051448
Abstract: Consistent information on the non-milk extrinsic sugars (NMES) content of foods and the NMES intake by the population is required in order to allow comparisons between dietary surveys. A critical appraisal of methods of NMES estimation was conducted to investigate whether the different published methods for estimating the NMES content of foods lead to significantly different values for the dietary intake of NMES by children and to consider the relative practicality of each method. NMES values of foods were calculated using three different published descriptions of methods of NMES estimation, and the values were compared within food groups. Dietary intake values for English children aged 11–12 years were calculated using each method and compared in terms of overall NMES intake and the contribution of different food groups to NMES intake. There was no significant difference in the dietary intake of NMES in children between the method used in the National Diet and Nutrition Surveys (NDNS) (81·9 g/d 95 % CI 79·0, 84·7) and a method developed by the Human Nutrition Research Centre (84·3 g/d 95 % CI 81·4, 87·2) at Newcastle University, UK, although the latter gave slightly higher values. An earlier method used by the Ministry of Agriculture, Food and Fisheries gave significantly higher values than the other two methods (102·5 g/d 95 % CI 99·3, 105·6 P ·05). The method used in the NDNS surveys and the method used by the Human Nutrition Research Centre at Newcastle University are both thorough and detailed methods that give consistent results. However, the method used in the NDNS surveys was more straightforward to apply in practice and is the best method for a single uniform approach to the estimation of NMES.
Publisher: Mark Allen Group
Date: 12-2012
DOI: 10.12968/BJCN.2012.17.12.614
Abstract: This feature investigates the potential relevance to community care of a new food provision and nutritional management system for older hospital patients. A qualitative study identified the core factors contributing to inadequate food intake in older patients in hospital, including: poor mealtime ambience lack of necessary mealtime assistance inflexible meal provision lack of monitoring of nutrient intake and absence of accountability in nutritional care. Many of these factors are also relevant to older people living in the community. To address these issues, we designed a new system for the nutritional care of the older patient: ‘hospitalfoodie’. Hospitalfoodie facilitates: patient nutritional screening patient-tailored food choice and information exchange among the healthcare team. The system introduces a more flexible approach to provision of food, including the development of nutrient-dense ‘mini meals’ for older patients. The system facilitates monitoring of patient food intake against their nutrition targets and alerts staff of nutrition shortfalls. The relevance of components of hospitalfoodie to community nutritional care was explored through qualitative interviews and focus groups with a range of care providers.
Publisher: Springer Science and Business Media LLC
Date: 08-2009
Abstract: The Annual Conference of the BSSPD (British Society for the Study of Prosthetic Dentistry) was held in York on 6 and 7 April 2009. At the symposium on mandibular overdentures, presenters offered a synopsis of the research available on the efficacy of implant-supported mandibular overdentures in the edentulous mandible. Emphasis was given to both qualitative and quantitative research based on patient-centred outcomes of treatment. A draft consensus was circulated to all presenters and to the Council members of the BSSPD and to BSSPD members on the Society's website. The statement was modified in the light of their comments, audience feedback following the presentations and members' feedback. We hope that this consensus statement will be a useful guide for patients and clinicians and that it will act to stimulate wider debate. We also hope that it will prove useful to other patient and professional organisations and will inform discussions with providers of national healthcare and with independent funders.
Publisher: Wiley
Date: 23-01-2022
DOI: 10.1111/GER.12618
Abstract: Edentulous people eat less healthily, and wearing dentures impairs eating function and enjoyment. To apply a sequential approach to integrate scientific evidence, and patient and professional experience to co‐develop intervention to support better eating with dentures. Focus groups, two with purposive s les of patients and two with dental professionals, explored experiences and opinions about advice on eating with complete dentures. Findings were distilled with evidence from the literature to underpinned concepts for eating interventions. User engagement informed prioritisation of ideas and led to the development of a leaflet on eating with dentures. Patients receive no advice on what they can realistically expect when eating with dentures, and professionals lacked confidence to provide eating advice. Patients did not think dentists a credible provider of eating advice, feeling peer support more appropriate and offering numerous strategies for eating with dentures. Concepts for eating intervention included a patient leaflet, Web‐based eating interventions, patient support blogs, waiting room videos and improved nutrition training for dental professionals. User feedback informed prioritisation of ideas, leading to the development of a leaflet on eating with dentures. Justified by the data, the leaflet focused on patient‐generated tips for overcoming the functional limitations of eating with dentures, and unobtrusive healthier eating advice. Face validity with users confirmed acceptability. A systematic and rigorous integration of scientific evidence, expert experience and patient input has developed a patient‐centric, evidence‐based approach to a patent leaflet on eating with dentures that, based on initial face validity, is likely to be well received.
Publisher: Elsevier BV
Date: 08-2011
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.14219/JADA.ARCHIVE.2007.0201
Abstract: Diet plays a key role in disease prevention in older age. The aims of this report were to review the causes and consequences of a poor diet in later life and its interrelationship with oral health. Energy requirements decrease with age however, many factors, including poor oral health, loss of appetite and illness, may compromise energy intake. Absorptive capacity may reduce with age therefore, to prevent deficiencies of micronutrients, a nutrient-dense diet is essential. The first signs of micronutrient deficiencies often are manifest in the oral tissues. Consequently, the dentist has an important role in the early diagnosis of malnutrition. Furthermore, optimizing oral health is important in maximizing older patients' functional capacity to consume a healthful and varied diet.
Publisher: Wiley
Date: 09-09-2015
DOI: 10.1111/JOOR.12226
Abstract: Oro-facial pain (OFP) is known to exert profound impacts on quality of life including functionally and psychosocially mediated changes in dietary intake and thereby nutrition. This commentary explores the evidence base available on chronic oro-facial pain, diet and nutrition and discusses current dietary guidance for in iduals with chronic OFP potential impact of chronic OFP on eating and nutritional status impact of nutritional status on pathophysiology of chronic OFP and potential role of nutrition in the management of chronic OFP.
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.JDENT.2008.12.003
Abstract: Assessment of the impact of dental function on diet and nutritional status requires robust methodologies and a standardised approach to increase accuracy of results and to facilitate cross study comparisons. The objectives of this paper are: to report the outcomes of a consensus workshop that critically reviewed publications reporting on dietary methodologies in relation to the impact of oral health on nutrition to highlight future directions for research and to make recommendations for appropriate use of methodologies for future research. Data relevant to nutrition and dental status published from 1980 to 2005 in English were presented at the consensus workshop for discussion and appraisal. Relevant papers were retrieved through PubMed. Relevant texts were obtained from the library at Newcastle University, UK. A purposive s le of original articles that illustrated the application of a range of nutritional methodologies to the study of oral health impacts was identified. Original flagship texts on nutritional methodologies were reviewed. Numerous studies have shown an association between loss of teeth and inferior diet. Further research is required to elucidate the impact of novel approaches to prosthetic rehabilitation and the impact of contemporaneous dietary and dental intervention on diet, nutritional status, disease progression and quality of life. The recommendation of the consensus workshop was that future studies should adopt a comprehensive approach to the assessment of nutrition that encompasses measurement of diet, body composition, biochemical indices of intake and levels of nutrients, and functional biomarkers of disease.
Publisher: Elsevier BV
Date: 08-2012
DOI: 10.1016/J.JDENT.2012.04.025
Abstract: In order to fully assess the impact of prosthetic rehabilitation and to formulate appropriate dietary advice, in-depth information about patients' experiences of eating with dentures is needed. The objective of this study was to develop and validate a questionnaire that accurately reflected the real concerns of patients with dental prostheses about the aspects of their life related to eating, using detailed information derived from qualitative interviews with patients. Themes around factors related to eating with dentures were derived from interviews with patients (n=66) with either implant-supported mandibular over-dentures or conventional dentures. The themes were used to design a self-completed questionnaire with questions scored on a visual analogue scale and additionally questions answered using free text. The content and face validity of the questionnaire was tested on a different group of patients (n=10) with implant-supported mandibular over-dentures ('implant-supported') or conventional dentures. Test-retest reliability analysis was conducted on a further group of 30 patients (n=15 implant-supported n=15 conventional dentures). A questionnaire has been developed with 33 questions scored on a visual analogue scale and 31 open questions designed to collect further information as free text. Themes identified were around social, emotional and practical issues about eating. The instrument has good internal reliability with a Cronbach alpha values of 0.86-0.95 and good test-retest reliability with intra-class correlation coefficients 0.87-0.92 across the domains. A patient-based instrument has been developed to measure emotional and social issues related to eating with dentures (ESIRE questionnaire). The questionnaire will be a useful tool in future trials of prosthetic rehabilitation.
Publisher: Cambridge University Press (CUP)
Date: 11-2005
DOI: 10.1079/PNS2005431
Abstract: Diet and nutrition impact on many oral diseases, in particular dental caries. Consumption of fluoridated water coupled with a reduction in non-milk extrinsic sugar intake is an effective means of caries prevention. However, studies on the fluoride concentration of bottled waters suggest increased consumption of these waters, in preference to fluoridated tap water, would lead to a marked decrease in caries protection. Concerns have been raised about the bioavailability of fluoride from artificially-fluoridated water compared with naturally-fluoridated water. This issue has been addressed in a human experimental study that has indicated that any differences in fluoride bioavailability are small compared with the naturally-occurring variability in fluoride absorption. Research has unequivocally shown sugars to be the main aetiological factor for dental caries, and information on intakes guides health promotion. Repeat dietary surveys of English children over three decades indicate that levels of sugars intake have remained stable, while sources of sugars have changed considerably, with the contribution from soft drinks more than doubling since 1980. Dental caries eventually leads to tooth loss, which in turn impairs chewing ability causing avoidance of hard and fibrous foods including fruits, vegetables and whole grains. A very low intake ( g/d) of NSP and fruit and vegetables has been found in edentulous subjects. Provision of prostheses alone fails to improve diet. However, initial studies indicate that customised dietary advice at the time of denture provision results in increased consumption of fruits and vegetables, and positive movement through the stages of change. Feasible means of integrating dietary counselling into the dental setting warrants further investigation.
Publisher: SAGE Publications
Date: 19-04-2011
Abstract: Saturated fatty acids (SFAs) produce an inflammatory response. Hyperinflammation is now recognized as one of the key underlying etiologic factors in periodontal disease. The longitudinal relationship between dietary SFAs and periodontal disease in 264 Japanese in iduals, aged 75 years, for whom data were available for the years 2003-2004, was investigated. SFA intake was assessed with a brief self-administered diet history questionnaire. Participants were classified by quartiles of SFA intake. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and follow-up examinations. The number of teeth with a loss of CAL ≥ 3 mm at any site over a year was calculated as ‘periodontal disease events’. Poisson regression analysis was conducted, with dietary SFAs as the primary predictor of interest, to estimate their influence on periodontal disease events. High dietary SFA intake was significantly associated with a greater number of periodontal disease events among non-smokers. The multivariate adjusted relative risk (95% confidence intervals) in the 1st, 2nd, 3rd, and 4th quartiles of dietary SFAs was 1.00, 1.19 (0.72-1.97), 1.55 (0.95-2.52), and 1.92 (1.19-3.11), respectively. These findings suggest an independent association of dietary SFA intake to the progression of periodontal disease in older Japanese non-smokers.Abbreviations: saturated fatty acid (SFA) clinical attachment level (CAL) Toll-like receptor (TLR) lipopolysaccharide (LPS) brief self-administered diet history questionnaire (BDHQ) decayed, missing, and filled teeth (DMFT) clinical attachment level (CAL) body mass index (BMI) relative risk (RR) confidence intervals (CI) nuclear factor-kappa B (NF-κB).
Publisher: Wiley
Date: 22-11-2007
DOI: 10.1111/J.1600-0528.2006.00366.X
Abstract: This study was designed to measure total intake, urinary excretion and estimated retention of fluoride in children under customary fluoride intake conditions, living in either fluoridated or low-fluoride areas of north-east England. Subsidiary aims were to investigate the relationships between the variables measured. Using a randomized cluster design with schools as the s ling units, four schools from a non-fluoridated area and two from a fluoridated area were selected from the schools chosen to participate in the study. Fluoride intake from diet and toothbrushing was assessed using a 3-day food diary and fluoride analysis of expectorated saliva during toothbrushing. S les of all foods and drinks consumed were measured for fluoride content using direct and indirect silicon-facilitated diffusion methods as appropriate. Urinary fluoride excretion and urine volume were measured over 24 h and estimation of fractional urinary fluoride excretion (FUFE) and fluoride retention made from collected data. Following descriptive analysis of variables, Pearson's correlations investigated relationships between fluoride content of home tap water, daily fluoride intake, excretion and retention. Thirty-three children completed the study: 18 receiving non-fluoridated water [mean = 0.08 (+/-0.03) mg F/l], nine sub-optimally fluoridated water [mean = 0.47 (+/-0.09) mg F/l] and six optimally fluoridated water [mean = 0.82 (+/-0.13) mg F/l] at the time of the study. Complete data on F intake, excretion and retention were available for 29 children. Mean fluoride intake from diet and toothpaste ranged from 0.031 (+/-0.025) mg/kg body weight (bw)/day for the low-fluoride area to 0.038 (+/-0.038) and 0.047(+/-0.008) mg/kg bw/day for sub-optimally and optimally fluoridated areas respectively. Contribution of toothpaste to total fluoride intake ranged from 3% to 93% with mean values of 57%, 35% and 47% for children receiving low, sub-optimally and optimally fluoridated water respectively. FUFE ranged from a mean of 32% (+/-13%) for the optimally fluoridated area to 44% (+/-33%) for the low-fluoride area. Fluoride retention was not correlated with the fluoride concentration of home water supply, but was strongly positively correlated (P < 0.001) with total daily fluoride intake. In an industrialized country, total fluoride intake, urinary excretion and consequently fluoride retention no longer reflect residence in a community with a non-fluoridated or fluoridated water supply. Fluoride toothpaste contributes a significant proportion of total ingested fluoride in children, particularly in low-fluoride areas.
Publisher: SAGE Publications
Date: 08-2008
DOI: 10.1177/154405910808700815
Abstract: Edentulous in iduals have reduced chewing ability and lower fruit and vegetable consumption compared with dentate in iduals. It has been suggested that the two are causally related. However, psychosocial factors such as attitude, self-identity, and knowledge of recommendations are predictive of intake in non-edentulous persons. The aims of this study were to: determine if perceived chewing ability was predictive of fruit and vegetable intake explore the predictive ability of knowledge, attitude, and self-identity and compare intake between edentulous and dentate in iduals. Full denture-wearing (N = 79) and dentate persons (N = 52) completed a three-day food diary. Perceived chewing ability, sociodemographic, and psychosocial factors were assessed via self-administered questionnaire. The dentate persons consumed significantly more fruit and vegetables, but differences were not significant when juices were excluded. Perceived chewing ability explained ~ 4% variance in intake. Attitude, self-identity, and knowledge explained a further ~ 20%. If the diet of denture-wearers is to be improved, psychosocial factors, as well as perceived chewing ability, must be addressed.
Publisher: Wiley
Date: 23-04-2012
DOI: 10.1111/J.1600-0528.2012.00688.X
Abstract: To measure the fluoride (F) content of infant foods and drinks requiring reconstitution with liquids prior to consumption and to determine the impact of water F concentration on their F content, as consumed, by measuring F content before and after preparation. In total, 58 infant powdered formula milks, dry foods and concentrated drinks were prepared with deionized water (<0.02 ppm F) nonfluoridated (0.13 ppm F) and fluoridated (0.90 ppmF) water. The F concentrations of drink s les were measured directly using a fluoride-ion-selective electrode after addition of TISAB III, and food s les and formula milks measured indirectly by an acid diffusion method. The overall range of F concentrations of all the nonreconstituted s les, in their prepreparation dry or concentrated forms, was from 0.06 to 2.99 μg/g with the highest F concentration for foods found in the dry 'savoury meals' (a combination of vegetables and chicken or cheese or rice) group. However, when the s les were reconstituted with nonfluoridated water, the mean F concentrations of prepared 'concentrated juices', 'pasta and rice', 'breakfast cereals', 'savoury meals' and 'powdered infant formula milks' were 0.38, 0.26, 0.18, 0.16 and 0.15 μg/g, respectively. The corresponding mean F concentrations were 0.97, 1.21, 0.86, 0.74 and 0.91 μg/g, respectively, when the same s les were prepared with fluoridated water. Although some nonreconstituted infant foods/drinks showed a high F concentration in their dry or concentrated forms, the concentration of F in prepared foods/drinks primarily reflected the F concentration of liquid used for their preparation. Some infant foods/drinks, when reconstituted with fluoridated water, may result in a F intake in infants above the suggested optimum range (0.05-0.07 mg F/kg body weight) and therefore may put infants at risk of developing dental fluorosis. Further research is necessary to determine the actual F intake of infants living in fluoridated and nonfluoridated communities using reconstituted infant foods and drinks.
Publisher: Springer Science and Business Media LLC
Date: 03-2000
Abstract: A recent report on diet and oral health by the British Nutrition Foundation reviews the anatomy, microbiology and pathology of a number of oral diseases including dental caries, tooth-wear, oral cancer, periodontal disease and enamel defects. The role of nutritional factors in the aetiology and prevention of these oral diseases is discussed. The report states that improvements in the levels of caries in the UK are halting and remain unacceptably high in some 'at risk groups'--including the socially deprived. It states that a two-pronged attack, i.e. reduced frequency of consumption of sugary foods and use of fluoride is necessary to address the problem. To address the increased prevalence of oral cancer avoiding tobacco, limiting alcohol and increasing fruit and vegetable consumption are recommended. Recommendations for approaches to improve oral health are made for health authorities, industry, schools and health professionals and it is recommended that the Government make adequate resources available to improve oral health preventive strategies.
Publisher: Cambridge University Press (CUP)
Date: 10-2001
DOI: 10.1079/BJN2001425
Abstract: The UK Department of Health recently recommended that flour be fortified with folic acid, at 2400 μg/kg. The objectives of the present paper were: to determine the consequence of this on folic acid intake of adolescents to determine the level of fortification necessary to achieve an intake of 400 μg/d in adolescent girls (the amount recommended periconceptionally) to estimate the consequence of fortification on folic acid intake of high flour consumers and to report on folate intake of adolescents. Dietary intake of folate and flour were determined by analysis of an existing database of the diets of 379 English adolescents. The folic acid intake that would result from white flour fortification with folic acid at 2400 μg/kg was determined and the level of folic acid fortification necessary to achieve an intake of 400 μg/d in girls from this source was also calculated. Without flour fortification, 6·9 % of girls failed to reach the UK lower reference nutrient intake for total folate. Fortification of white flour with folic acid at 2400 μg/kg would result in an additional folic acid intake of 191(SEM 6) μg/d in girls. To ensure 97 % of girls received 400 μg/d from white flour, white flour would need to be fortified at a level of 10 430 μg/kg, resulting in intakes of 1260 μg/d from flour in the highest (97·5 centile) female white flour consumers and 1422 μg/d from flour in the highest (97·5 centile) male white flour consumers.
Publisher: Cambridge University Press (CUP)
Date: 03-04-2013
DOI: 10.1017/S1368980013000645
Abstract: There are few data on the dietary intake of children in Libya, and none on free sugars intake. The present study aimed to report the intake of macronutrients and eating habits of relevance to dental health in a group of Libyan schoolchildren and to investigate any gender differences for these variables. Dietary information was obtained from a randomly selected s le using an estimated 3 d food diary. Dietary data were coded using food composition tables and entered into a Microsoft ® Access database. Intakes of energy, macronutrients, sugars and the amount of acidic items consumed were determined using purpose-written programs. Benghazi, Libya. Schoolchildren aged 12 years. One hundred and eighty children (ninety-two boys and eighty-eight girls) completed the study. Their mean age was 12·3 ( sd 0·29) years. The average daily energy intake was 7·01 ( sd 1·54) MJ/d. The percentage contributions to energy intake from protein, fat and carbohydrate were 16 %, 30 % and 54 %, respectively. Total sugars contributed 20·4 % of the daily energy intake, and free sugars 12·6 %. The median daily intake of acidic items was 203 g/d, and of acidic drinks was 146 g/d. There were no statistically significant differences in nutrient intakes between genders. Intake of acidic items was higher in girls ( P 0·001). The contribution to energy intake from macronutrients was in accordance with global nutrition guidelines. The acidic drinks intake was low compared with other populations, while free sugars intake was above the recommended threshold of 10 % of energy intake.
Publisher: Wiley
Date: 12-2000
DOI: 10.1111/J.1752-7325.2000.TB03339.X
Abstract: The theoretical link between foods choice and masticatory efficiency has long been established. Recent evidence has confirmed this association, demonstrating a progressive alteration in food choice with decreasing numbers of teeth, with the greatest effect being among those who are edentulous. This altered food selection results in significant differences in the hematological status for some key nutrients in the one study in which this association was investigated. This paper summarizes some of the literature relevant to diet as a risk factor for systemic disease and identifies areas where altered food choice as a consequence of reduced masticatory efficiency might be placing in iduals at increased risk of life-threatening conditions, such as atherosclerosis and cancer.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2012
Publisher: SAGE Publications
Date: 04-03-2014
Publisher: SAGE Publications
Date: 14-02-2019
Abstract: A systematic review of evidence on the impact of modifiable risk factors on early childhood caries (ECC) was conducted to inform recommendations in a World Health Organization manual on ECC prevention. To systematically review published evidence pertaining to the effect of modifiable risk factors on ECC. Twelve questions relating to infant feeding, diet, oral hygiene, and fluoride were addressed, as prioritized by a World Health Organization expert panel. Questions pertaining to the use of fluoride toothpaste were excluded due to its proven efficacy. The target population was children aged <72 mo. Data sources included Medline, Embase, CINAHL, and PubMed, and all human epidemiologic studies were included. The highest level of evidence was used for evidence synthesis and, where possible, meta-analysis. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement, with evidence assessed via the GRADE method. Of the 13,831 papers identified, 627 were screened in duplicate of these, 139 were included. The highest-level evidence indicated that breastfeeding ≤24 mo does not increase ECC risk but suggested that longer-duration breastfeeding increases risk (low-quality evidence). Low-quality evidence indicated increased risk associated with consumption of sugars in bottles. Only 1 study had data on the impact of sugars in complementary foods, which increased risk. Moderate-quality evidence showed a benefit of oral health education for caregivers (odds ratio, 0.39 95% CI, 0.19 to 0.80, The best available evidence indicates that breastfeeding up to 2 y of age does not increase ECC risk. Providing access to fluoridated water and educating caregivers are justified approaches to ECC prevention. Limiting sugars in bottles and complementary foods should be part of this education. This research is being used by the World Health Organization in developing a toolkit on the prevention and management of early childhood caries. The information will guide 1) governments in developing national oral health plans and 2) clinicians when providing preventive advice, including that regarding infant feeding practices. It will help ensure that advice is in line with current World Health Organization guidelines and the best available evidence.
Publisher: SAGE Publications
Date: 08-03-2023
DOI: 10.1177/23800844231157259
Abstract: Sarcopenia is loss of both muscle mass and function with age and is associated with inadequate protein intake. However, evidence to suggest an association with oral health is less clear. To scope peer-reviewed published evidence (2000–2022) pertaining to oral function in relation to sarcopenia and/or protein intake in older people. CINAHL, Embase, PubMed, and Scopus were searched. Included were peer-reviewed studies measuring oral function (e.g., tooth loss, salivary flow masticatory function, strength of muscles of mastication, and tongue pressure) and a measure of protein intake and/or a measure of sarcopenia (appendicular muscle mass and function). Full article screening was conducted by 1 reviewer with a random 10% screened in duplicate by a second reviewer. Relevant content pertaining to study type, country of origin, measures of exposure, and outcomes and key findings was mapped and the balance of data showing a positive versus null association of oral health with outcomes charted. Of 376 studies identified, 126 were screened in full, yielding 32 included texts, of which 29 were original articles. Seven reported intake of protein and 22 reported measures of sarcopenia. Nine distinct oral health exposures were identified, with ≤4 studies relating to any one of these measures. Most data were cross-sectional in nature (27 studies) and from Japan (20 studies). The balance of data showed associations between tooth loss and measures of sarcopenia and protein intake. However, the balance of data pertaining to any association between chewing function, tongue pressure, or indices of oral hypofunction and sarcopenia was mixed. A broad range of oral health measures have been studied in relation to sarcopenia. The balance of data suggests that tooth loss is associated with risk, but data pertaining to the oral musculature and indices of oral hypofunction are mixed. The findings of this research will increase awareness among clinicians of the amount and nature of evidence pertaining to the relationship between oral health and risk of compromised muscle mass and function, including data showing that loss of teeth is associated with increased risk of sarcopenia in older people. The findings highlight to researchers the gaps in the evidence and where further research and clarification of the relationship between oral health and risk of sarcopenia is warranted.
Publisher: Springer Science and Business Media LLC
Date: 11-2003
Publisher: Copernicus GmbH
Date: 28-04-2016
Abstract: Abstract. The seasonal climate drivers of the carbon cycle in tropical forests remain poorly known, although these forests account for more carbon assimilation and storage than any other terrestrial ecosystem. Based on a unique combination of seasonal pan-tropical data sets from 89 experimental sites (68 include aboveground wood productivity measurements and 35 litter productivity measurements), their associated canopy photosynthetic capacity (enhanced vegetation index, EVI) and climate, we ask how carbon assimilation and aboveground allocation are related to climate seasonality in tropical forests and how they interact in the seasonal carbon cycle. We found that canopy photosynthetic capacity seasonality responds positively to precipitation when rainfall is 2000 mm yr−1 (water-limited forests) and to radiation otherwise (light-limited forests). On the other hand, independent of climate limitations, wood productivity and litterfall are driven by seasonal variation in precipitation and evapotranspiration, respectively. Consequently, light-limited forests present an asynchronism between canopy photosynthetic capacity and wood productivity. First-order control by precipitation likely indicates a decrease in tropical forest productivity in a drier climate in water-limited forest, and in current light-limited forest with future rainfall 2000 mm yr−1.
Publisher: SAGE Publications
Date: 03-01-2018
Abstract: This systematic review aimed to assess the association between food and drink consumption around bedtime-specifically, food and drinks containing free sugars-and the risk of dental caries in children. Five electronic databases were searched (PubMed, Ovid Medline, EMBASE, Web of Science, and Scopus) to identify studies that investigated any relationship between food and drink around bedtime and dental caries in 3- to 16-y-old children. The Agency for Healthcare Research and Quality domain guidelines were used to assess the quality of the in idual studies, while GRADE guidelines assessed the quality of studies based on the body of evidence. From 1,270 retrieved titles, 777 remained after removal of duplicates. Of these, 72 were reviewed in full. Eighteen studies fulfilled the inclusion criteria and were included in the analysis: 13 cross-sectional, 4 cohort, and 1 case-control. Studies were categorized into 3 age groups: 3- to 5-y-old, 6- to 11-y-old, and 12- to 16-y-old children. Based on the Agency for Healthcare Research and Quality criteria, 6 of the 18 studies were rated as providing good-quality evidence 8 were rated as fair and 4 were categorized as being of poor quality. It was not possible to conduct a meta-analysis, because of the considerable variations in the type of bedtime exposure and outcome measures. The studies showed a consistent positive association across the 3 age groups, with all 7 studies on preschool children reporting significant positive associations. However, the quality of the body of evidence pertaining to the consumption of food and drinks at bedtime (specifically, food and drinks containing free sugars) and risk of caries was rated as "very low." The results suggest that restricting free sugars before and at bedtime may reduce the risk of caries, but studies with improved design are needed to confirm this. Knowledge Transfer Statement: This is the first systematic review of the evidence assessing the association between caries risk in children and the consumption of food or drinks at bedtime-specifically, foods and drinks containing free sugars. Although the data showed a consistent positive association, the quality of evidence was very low. This means that the current recommendation to restrict food and drinks containing free sugars before bedtime in children, while based on a sound physiologic premise, is supported only by very low-quality published evidence as measured by GRADE guidelines.
Publisher: Springer Science and Business Media LLC
Date: 30-03-2020
DOI: 10.1186/S12889-020-8422-5
Abstract: The association between Free Sugars intake and non-communicable diseases such as obesity and dental caries is well documented and several countries are taking measures to reduce sugars intakes. Public Health England (PHE) instigated a range of approaches to reduce sugars, including a national health marketing c aign (Sugar Smart). The c aign aimed to raise awareness of the amount of sugars in foods and drinks and to encourage parents to reduce their children’s intake. The aim of this study was to determine whether the c aign was effective in altering dietary behaviour, by assessing any impact of the c aign on sugars intake among children aged 5–11 years. Parental perceptions of the c aign and barriers to reducing sugars intake were also explored. Parents of 873 children aged 5–11 years, identified from an existing PHE database, were invited to take part. Dietary information was collected online using Intake24 before, during, and at 1, 10 and 12 months following the c aign. Change in sugars intake was assessed using mixed effects linear regression models. One-to-one telephone interviews were conducted with a purposive s le of parents to explore perceptions of the c aign and identify barriers and facilitators to reducing children’s sugars intake. Completion rates for dietary assessment ranged from 61 to 72% across the follow up time points. Qualitative telephone interviews were conducted with 20 parents. Total sugars intake decreased on average by ~ 6.2 g/day (SD 43.8) at peak c aign and the percentage of energy from total sugars significantly decreased immediately and 1 year post c aign. The percentage of energy from Free Sugars significantly decreased across all time points with the exception of the long term follow up at 12-months post c aign. The percentage of energy intake from total fat increased. Parents expressed a willingness to reduce sugars intakes, however, identified barriers including time constraints, the normalisation of sugary treats, and confusing information. A health marketing c aign had a positive impact in reducing sugars intake but reductions in sugars were not sustained. Parents want to reduce their child’s sugars intake but societal barriers and confusion over which sources of sugars to avoid h er efforts to change.
Publisher: Springer Science and Business Media LLC
Date: 25-07-2008
Abstract: To determine the opinions and attitudes of general dental practitioners and hygienists towards the role of nutrition in periodontal health. The study was completed by general dental practitioners and dental hygienists throughout the UK. A questionnaire was sent out with the British Dental Journal and BDA News together with explanatory information about the study. Postage was pre-paid for replies. Eight hundred and seventy-nine questionnaires were completed. Sixty-six percent of respondents believed nutrition plays a role in periodontal health. Dietary factors that were considered most important were vitamin C (70%), fruit and vegetables (64%) and antioxidant vitamins (45%). Forty-four percent had recommended nutrition supplements to their patients, with multivitamin and mineral supplements (37%) and vitamin C (30%) the most popular. Eighty-two percent of respondents sourced information from dental journals. Qualitative data highlighted uncertainty amongst respondents about the evidence base around nutrition and periodontal health and a lack of training opportunities. A majority of dentists consider that nutrition and dietary factors play a role in maintaining periodontal health. However, there was a need to increase awareness of the current state of the evidence for a role of nutrition in maintaining periodontal health. Concern regarding lack of an evidence base for the role of nutrition in the treatment of periodontal diseases suggests a need for further research into the therapeutic role of nutrition in periodontal disease management.
Publisher: SAGE Publications
Date: 05-10-2019
Abstract: Despite much research on the impact of edentulism and prosthetic rehabilitation on food and nutrient intake, there is little information on how replacing complete dentures affects social and emotional issues around eating. To investigate, in a cohort study, how replacing conventional complete dentures affects eating-related quality of life (ERQoL). A secondary aim was to test the responsiveness of an Emotional and Social Issues Related to Eating (ESIRE) questionnaire to change in ERQoL. Participants, recruited from the Dental Hospital, Newcastle-upon-Tyne, UK, completed the self-administrated ESIRE questionnaire before and after provision of new conventional complete dentures. Paired t test was used to determine any change between pre- and posttreatment ESIRE scores, which can range from 0 (poor) to 100 (excellent). Cohen’s d effect size was used to measure the magnitude of change in ERQoL. Standardized response mean (SRM) was used to measure the responsiveness of the ESIRE questionnaire to changes in ERQoL. Fifty-five participants aged 52 to 85 y (mean, 72 y), including 21 males (42%) and 29 females (58%), completed the study. A statistically significant improvement in the total ESIRE scores was found, mean (SE) +20.3 (3.30), P 0.001. Equally, all domains of the ESIRE questionnaire showed significant improvements: enjoyment of food/eating, +27.3 (3.63), P 0.001 self-consciousness/embarrassment, +18.1 (3.88), P 0.001 interruption to meals, +13.3 (5.27), P 0.05 confidence when eating, +18.7 (4.84), P 0.001 time for eating reparation of meals, +18.5 (4.85), P 0.001) and functional ability to eat, +18.2 (3.67), P 0.001). Cohen’s d was large (0.95) for the total score and ranged from medium (0.37) to large (1.30) for all domains. Value of SRM was large (0.87) for the total score and ranged from medium (0.36) to large (1.1) for all domains. Denture replacement can directly improve ERQoL. The ESIRE questionnaire was responsive to clinically important changes in ERQoL. The results of this study improve the understanding of the impact of denture replacement on eating-related quality of life (ERQoL). Clinicians are encouraged to pay more attention to the impact of wearing conventional complete dentures on social and emotional issues around eating. The findings should motivate clinicians and inspire specialists in prosthodontics and oral rehabilitation to continue providing conventional complete dentures as a suitable treatment option for edentulous patients.
Publisher: National Institute for Health and Care Research
Date: 11-2010
DOI: 10.3310/HTA14520
Abstract: To investigate the clinical effectiveness and cost-effectiveness of laxatives versus dietary and lifestyle advice, and standardised versus personalised dietary and lifestyle advice. A prospective, pragmatic, three-armed cluster randomised trial with an economic evaluation. General practices in England and Scotland, UK. People aged ≥ 55 years with chronic constipation, living in private households. Participants were identified as those who had been prescribed laxatives three or more times in the previous 12 months, or with a recorded diagnosis of chronic functional constipation. Prescription of laxatives, with class of laxative and dose at the discretion of the GP and patient (standard care control arm) standardised, non-personalised dietary and lifestyle advice and, personalised dietary and lifestyle advice, with reinforcement. The primary outcome was the constipation-specific Patient Assessment of Constipation-Symptoms (PAC-SYM)/Patient Assessment of Constipation-Quality of Life (PAC-QOL). The trial planned to recruit and retain 1425 patients from 57 practices (19 per arm) however, only 154 patients were recruited from 19 practices. Due to these low recruitment rates it was not possible to report the conventional trial findings. Baseline characteristics of the s le from data gathered from both postal self-completion questionnaires and face-to-face interviews suggest that our s le experienced very few symptoms of constipation (PAC-SYM) and that the condition itself did not have a major impact upon their quality of life (PAC-QOL). The low level of symptoms of constipation is most likely explained by 90% of the s le using a laxative in the previous week. Most participants in our s le were satisfied with the performance of their laxatives, and levels of anxiety and depression were low. Their fibre consumption was classified as 'moderate' but their average water consumption fell below the recommended guidelines. Daily diaries, completed each day for a period of 6 months, were analysed primarily in terms of overall response rate and item response rates, and the participants accepted this method of data collection. For the economic evaluation, all of the trial arms experienced a reduction in utility, as measured by EQ-5D. There was no statistical evidence to suggest that either the personalised intervention arm or the standardised intervention arm was associated with significant changes in utility at 3 months compared with the control arm. Data on related health-care costs show a cost saving of £13.34 for those in the personalised arm, compared with the control arm, and a smaller cost saving for the standardised arm. These savings primarily occurred because of reduced hospital costs. There was no significant change measured in utility, so the personalised arm appeared to be the preferred course, producing the greatest cost savings. Due to the low number of participants in the trial, no firm conclusions could be drawn about the effectiveness of the interventions. However, a number of factors that contributed to the conduct and progress of the trial are highlighted, which may be relevant to others conducting research on a similar topic or population. ISRCTN73881345. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment Vol. 14, No. 52. See the HTA programme website for further project information.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-03-2023
Abstract: The objective of this review is to identify the extent and nature of the existing literature on co-design with residents residing in aged care facilities. Involving older people in their own care is a key challenge facing the aged care sector. Co-design is an approach that focuses on involving end users in the design of services. Mapping the evidence on co-design in residential aged care will identify the nature and extent of how older people living in residential care have been engaged in the design and delivery of their care. This scoping review will include peer-reviewed primary studies systematic and scoping reviews and gray literature, including abstracts and reports of governments and non-governmental organizations. Older people residing in aged care homes, including those from culturally and linguistically erse backgrounds and/or living with dementia, who are involved in the co-design, co-creation, participation, involvement, and engagement in their care will be considered for inclusion. This review will be conducted in accordance with the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases to be searched will include AgeLine, Cochrane, CINAHL, Embase, Emcare, MEDLINE, PsycINFO, ProQuest, Scopus, Informit Health Collection, and Web of Science. Gray literature searches will include, GreyMatters, BASE, Google Advanced, and World Wide Science. The search will be limited to articles published after December 31, 1999, and to those written in English or with an English-language abstract or summary. Screening and data extraction will occur independently in duplicate. The review outcomes will be presented in tabular format and supported by a narrative summary. Open Science Framework osf.io/6ukty
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.JDENT.2011.08.018
Abstract: This narrative literature review aims to consider the impact of removable partial dentures (RPDs) on oral and systemic health. A review of the literature was performed using Medline/PubMed database resources up to July 2011 to identify appropriate articles that addressed the objectives of this review. This was followed by extensive hand searching using reference lists from relevant articles. The proportion of partially dentate adults who wear RPDs is increasing in many populations. A major public health challenge is to plan oral healthcare for this group of patients in whom avoidance of further tooth loss is of particular importance. RPDs have the potential to negatively impact on different aspects of oral health. There is clear evidence that RPDs increase plaque and gingivitis. However, RPDs have not clearly been shown to increase the risk for periodontitis. The risk for caries, particularly root caries, appears to be higher in wearers of RPDs. Regular recall is therefore essential to minimise the risk for dental caries, as well as periodontitis. There is no evidence to support a negative impact on nutritional status, though research in this area is particularly deficient. Furthermore, there are very few studies that have investigated whether RPDs have any impact on general health. From the limited literature available, it appears that RPDs can possibly improve quality of life, and this is relevant in the era of patient-centred care. Overall, further research is required to investigate the impact of RPDs on all aspects of oral and general health, nutritional status and quality of life.
Publisher: Wiley
Date: 15-01-2009
DOI: 10.1002/JSFA.3481
Publisher: Wiley
Date: 10-03-2010
DOI: 10.1111/J.1600-0501.2009.01859.X
Abstract: The aim of this study was to compare the impact of customised dietary advice on patients' satisfaction with their dentures and oral health-related quality of life (OHRQoL) in patients wearing implant-supported mandibular overdentures (IOD) or conventional dentures (CD). In this prospective cohort study, 28 IOD (two implant-retained mandibular overdenture) and 26 CD patients completed a denture satisfaction scale and the 20-item oral health impact profile (OHIP-20) before and 6 months following provision of customised dietary advice. At 6 months following provision of in idualised dietary advice, the IOD group showed significantly greater satisfaction than the conventional group for denture comfort (80.6, + or - 15.6, vs. 68.7 + or - 15.6 P=0.001), stability (75.8 + or - 15.9 vs. 59.5 + or - 30.4, P=0.002), and perceived chewing ability (79 + or - 30.4 vs. 59.5 + or - 30.4, P=0.027) + or - when adjusted for baseline scores. Before delivery of the dietary advice there were no significant differences between groups for Satisfaction or OHIP scores. No difference in OHRQoL was seen between groups. The delivery of customised dietary advice to edentulous patients impacts differently on their satisfaction with denture comfort, stability and chewing ability depending on the nature of their prosthesis. This re-evaluation of satisfaction occurs when edentulous patients challenge themselves to consume more fruits, vegetables and fibre-rich foods. The IOD group reported an increased level of satisfaction and perceived chewing ability whereas it appeared that CD wearers may have had their awareness of the shortcomings of this sort of prosthesis reawakened.
Publisher: Elsevier BV
Date: 09-2009
DOI: 10.1016/J.JDENT.2009.05.028
Abstract: The objectives of this study were to obtain in-depth qualitative data from patients on the effect of edentulousness and prosthetic rehabilitation upon issues surrounding eating (emotional, social and functional). 33 patients who had received replacement conventional dentures (CDs) and 33 patients who had received implant-supported mandibular overdentures (ISODs) were interviewed by a researcher outside the clinical team. Interviews focused upon their experience of edentulousness, its management and its impact on their lives. Interviews were transcribed and the qualitative data analysed using NVivo [QSR NVivo v.2.2. Melbourne: QSR International 2002]. Both groups of patients told similar stories about the impact of edentulousness upon eating. A few patients who had received replacement CDs reported significant improvement, but marginal improvements were more common. Most patients who had received ISODs reported a significant positive impact upon eating with very few negative effects reported. The findings suggest that the functional limitations of dentures often impose social restrictions on edentulous patients. Optimising conventional dentures may help, but patients' eating-related quality of life is most likely to be enhanced through the functional improvement and increased social confidence that ISODs bring. In conclusion, issues surrounding eating are a major concern for edentulous patients. The main impacts of edentulousness are limitation of social participation and food choice. The functional improvement and increased social confidence that ISODs can provide, has a beneficial impact on this aspect of patients of quality of life.
Publisher: S. Karger AG
Date: 2013
DOI: 10.1159/000346549
Abstract: Effectiveness of 0.5 mg fluoride (F) milk ingestion in preventing caries has been termed only ‘moderate’. In this 3-arm partial cross-over intervention, 32 children aged 6–7 years in a non-F area were recruited and urinary F excretion (UFE) measured before and after ingestion of 0.5 or 0.9 mg F milk. Maintaining customary dietary and oral hygiene habits, children underwent a 2-week ‘wash-in’ with non-F milk, providing a 24-hour urine s le on day 4 of non-F (baseline) and F milk ingestion containing either (i) 0.5 mg or (ii) 0.9 mg F (intervention). A comparative group of thirteen 6- to 7-year-olds living in fluoridated areas provided a 24-hour urine s le on day 4 of daily non-F milk ingestion, following a 2-week non-F milk wash-in. Valid urine s les were analysed for F and UFE estimated from corrected 24-hour urine volume and F concentration. For the 24 test children providing 2 valid urine s les, mean (95% CI) change in corrected 24-hour UFE was 0.130 (0.049, 0.211) and 0.153 (0.062, 0.245) mg/day for 0.5 mg (p 0.007) and 0.9 mg F (p 0.001) groups, respectively. Post-intervention, mean (SD) corrected 24-hour UFE was 0.437 (0.153) mg/day and 0.420 (0.188) mg/day for the 0.5 and 0.9 mg F groups, respectively, which were lower than the WHO provisional standards (0.48–0.60 mg F/day). F milk consumption significantly increased UFE however, the F content of 0.5 and 0.9 mg F milk may be too low to achieve WHO provisional UFE standards concomitant with optimal F exposure in children aged ≥6 years.
Publisher: Springer Science and Business Media LLC
Date: 05-2004
Publisher: Cambridge University Press (CUP)
Date: 02-2004
DOI: 10.1079/PHN2003589
Abstract: Oral health is related to diet in many ways, for ex le, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association between nutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks. Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride. It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is –20kg/yr (~6–10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.
Publisher: Springer Science and Business Media LLC
Date: 20-02-2016
Publisher: Springer Science and Business Media LLC
Date: 11-1996
Abstract: A dental health survey was included as part of a large scale study of nutrition in preschool children. The survey was carried out in 1992/93 and was published in spring 1995. Information on dental health status and on dietary intake was gathered from a total of 1658 children from 100 geographical sectors in the United Kingdom. This article summarises the main findings and highlights some of the most important findings regarding dental health and its relationship to dietary factors. Seventeen per cent of children had some caries experience and in 83% of cases this was untreated. Dental decay was most strongly related to social background. The factors most strongly related to caries prevalence were: receipt of income benefits, in the 1.5-2.5-year-old children the educational status of the mother in the 2.5-3.5-year-old children and social class of the head of household in the 3.5-4.5-year-old children. Consumption of sugary drinks at bedtime, children being left to brush their teeth themselves, household expenditure on confectionery and geographical region were also strongly associated with caries prevalence.
Publisher: Wiley
Date: 12-2000
Publisher: Springer Science and Business Media LLC
Date: 18-03-2021
DOI: 10.1186/S12877-021-02081-5
Abstract: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old ( 85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan. The Newcastle 85+ Study in England ( n = 853) and the Tokyo Oldest Old Survey on Total Health (TOOTH n = 542) comprise random s les of people aged 85 years. Oral health markers included tooth loss, dryness of mouth, difficulty swallowing and difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression. In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for sex, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26–2.46) 2.52 (1.56–4.08) 2.89 (1.52–5.50) 2.59 (1.44–4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed and complete tooth loss was associated with increased risk of frailty. Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.
Publisher: JMIR Publications Inc.
Date: 03-08-2016
DOI: 10.2196/JMIR.5790
Publisher: SAGE Publications
Date: 06-11-2017
Abstract: Breastfeeding is a powerful health-promoting behavior. A 2016 Lancet global collaboration to review the health implications of breastfeeding was among the first to consider oral health outcomes. While a role was suggested for breastfeeding in preventing malocclusion, caries was the only included disease condition unfavorably associated with breastfeeding. The present critical review examines the evidence connecting breastfeeding practices to these outcomes and discusses the methodological challenges inherent in reaching causal conclusions. Published systematic reviews show some evidence of a protective effect of breastfeeding against primary dentition malocclusion but no supportive evidence for mixed dentition and permanent dentition malocclusions. Regarding caries, well-conducted studies report a benefit with breastfeeding up to 12 mo but a positive association between caries and breastfeeding of longer duration, at times that vary between 12 and 24 mo, as well as nocturnal feeding. Future studies would be methodologically stronger if focused on specific malocclusion traits that are plausibly associated with sucking movements rather than using general malocclusion indices. Studies should use detailed and consistent terminology for breastfeeding definition, including frequency, intensity, and timing. Analytical studies should be carried out to distinguish between confounders (e.g., prematurity) and mediators (e.g., use of pacifier). Regarding a link to caries, standard terminology for exposures (e.g., nocturnal feeding) is recommended. Statistical analyses must account for known confounding factors (e.g., socioeconomic conditions) but avoid inappropriate adjustment for variables on a causal path between exposure and outcome or for variables not associated with breastfeeding (e.g., tooth brushing), as can be guided using tools such as direct acyclic graphs. For dental practice, the potential caries risk of long-duration breastfeeding should be part of in idual patient counseling that incorporates patient values and circumstances. Given the unquestioned overall health benefits of breastfeeding, the dental community should support World Health Organization guidelines that encourage and promote breastfeeding.
Publisher: Elsevier BV
Date: 02-2006
DOI: 10.1016/J.SOCSCIMED.2005.06.032
Abstract: UK health policy is concerned with emphasising nutritional status as a factor in the relationship of social inequalities to health outcomes. This paper examines pupil and parent responses to an after-school 'Food Club' designed to promote food preparation skills and healthier food choices amongst 12-13 year olds in low-income areas in North East England. The rationale for the intervention was a series of distinct but connected premises: food preparation skills are essential to inexpensive healthier eating practical cooking skills are given limited emphasis in the secondary school curriculum children have some choice over what they eat and may serve as a conduit of influence within the family. The qualitative investigation used group discussions and in idual interviews with participating pupils and their parents. Most participating pupils enjoyed the practical emphasis upon food preparation, believed their skills developed, and were aware of the underlying message about healthier eating, but only made limited changes to their diet. Interviews with parents showed most to be positive about their child's involvement in such a club, though they varied in their attitude to its underlying message. There was some evidence of children being more involved in cooking at home and making some specific requests about food, but little to suggest they were influencing family food consumption. The findings suggest that an extra-curricular Food Club is an appropriate and feasible approach to developing food preparation skills with pupils in this age group. These findings raise questions about children's opportunities to exercise food preparation skills and make food choices within families, and the extent to which barriers to dietary change may be lowered through educational initiatives directed at pupils.
Publisher: Springer Science and Business Media LLC
Date: 2014
Abstract: Data on fluoride exposure of infants are sparse. This study aimed to estimate total daily fluoride intake (TDFI) of infants aged 1-12 months, living in non-fluoridated and fluoridated areas in north-east England. Daily dietary fluoride intake was assessed using a three-day food diary coupled with analysis of fluoride content of food/drink consumed, using a F-ISE and diffusion method. A questionnaire with an interview was used to collect information on toothbrushing habits. TDFI was estimated from diet, plus fluoride supplements and dentifrice ingestion where used. Thirty-eight infants completed the study 19 receiving fluoridated water (mean 0.97 mgF/l) and 19 receiving non-fluoridated water (mean 0.19 mgF/l). Mean (SD) TDFI for the infants living in fluoridated and non-fluoridated areas was 0.107 (0.054) and 0.024 (0.015) mg/kg body weight per day, respectively. Diet was the only fluoride source for 87% of infants and none used fluoride supplements. For infants for whom mouth/teeth cleaning was undertaken, dentifrice contribution to TDFI ranged from 24 to 78%. Infants living in fluoridated areas, in general, may receive a fluoride intake, from diet only, of more than the suggested optimal range for TDFI. This emphasises the importance of estimating TDFI at an in idual level when recommendations for fluoride use are being considered.
Publisher: Informa UK Limited
Date: 06-2015
Publisher: MDPI AG
Date: 30-10-2014
Publisher: Wiley
Date: 28-01-2014
DOI: 10.1002/JSFA.6522
Publisher: Wiley
Date: 08-04-2015
Abstract: There are potential nutritional and sensory benefits of adding sauces to hospital meals. The aim of this study was to develop nutrient fortified sauces with acceptable sensory properties suitable for older people at risk of undernutrition. Tomato, gravy, and white sauce were fortified with macro- and micronutrients using food ingredients rich in energy and protein as well as vitamin and mineral premixes. Sensory profile was assessed by a trained panel. Hedonic liking of fortified compared with standard sauces was evaluated by healthy older volunteers. The fortified sauces had higher nutritional value than the conventional ones, for ex le the energy content of the fortified tomato, white sauce, and gravy formulations were increased between 2.5- and 4-fold compared to their control formulations. Healthy older consumers preferred the fortified tomato sauce compared with unfortified. There were no significant differences in liking between the fortified and standard option for gravy. There were limitations in the extent of fortification with protein, potassium, and magnesium, as excessive inclusion resulted in bitterness, undesired flavors, or textural issues. This was particularly marked in the white sauce to the extent that their sensory characteristics were not sufficiently optimized for hedonic testing. It is proposed that the development of fortified sauces is a simple approach to improving energy intake for hospitalized older people, both through the nutrient composition of the sauce itself and due to the benefits of increasing sensorial taste and lubrication in the mouth.
Publisher: Cambridge University Press (CUP)
Date: 14-09-2013
DOI: 10.1017/S0007114512003583
Abstract: F is an important trace element for bones and teeth. The protective effect of F against dental caries is well established. Urine is the prime vehicle for the excretion of F from the body however, the relationship between F intake and excretion is complex: the derived fractional urinary F excretion (FUFE) aids understanding of this in different age groups. The present study aimed to investigate the relationships between (1) total daily F intake (TDFI) and daily urinary F excretion (DUFE), and (2) TDFI and FUFE in 6–7-year-olds, recruited in low-F and naturally fluoridated (natural-F) areas in north-east England. TDFI from diet and toothbrushing and DUFE were assessed through F analysis of duplicate dietary plate, toothbrushing expectorate and urine s les using a F-ion-selective electrode. FUFE was calculated as the ratio between DUFE and TDFI. Pearson's correlation and regression analysis were used to investigate the relationship between TDFI and FUFE. A group of thirty-three children completed the study twenty-one receiving low-F water (0·30 mg F/l) and twelve receiving natural-F water (1·06 mg F/l) at school. The mean TDFI was 0·076 ( sd 0·038) and 0·038 ( sd 0·027) mg/kg per d for the natural-F and low-F groups, respectively. The mean DUFE was 0·017 ( sd 0·007) and 0·012 ( sd 0·006) mg/kg per d for the natural-F and low-F groups, respectively. FUFE was lower in the natural-F group (30 %) compared with the low-F group (40 %). Pearson's correlation coefficient for (1) TDFI and DUFE was +0·22 ( P = 0·22) and for (2) TDFI and FUFE was − 0·63 ( P 0·001). In conclusion, there was no correlation between TDFI and DUFE. However, there was a statistically significant negative correlation between FUFE and TDFI.
Publisher: MDPI AG
Date: 21-07-2022
Abstract: Objective: A scoping review of available advice to address eating problems experienced by people who wear dentures was conducted in accordance with the PRISMA statement. The objective was to identify and map type, volume, and content of the available eating advice. Methods: Medline, CINAHL, and grey literature databases and Google were searched. Relevant content pertaining to study type, peer-review vs. grey literature, country of origin, advice content, and methods to evaluate effectiveness was mapped. Results: Of the 4591 records identified from peer-reviewed literature, 56 full papers underwent duplicate screening, resulting in 26 papers (from Germany (n = 1), Europe (n = 1), India (n = 2), Japan (n = 7), UK (n = 6), USA (n = 6), or other (n = 3)) being included in the review. These yielded 18 different items of relevant eating advice. Of the 258 screened websites, 63 were included, yielding 30 different items of eating advice. The most-cited advice was to eat soft food and avoid hard and sticky food, cut food into bite-sized pieces, and chew on both sides of the mouth and chew slowly and thoroughly. The identified advice was not supported by reference to peer-reviewed evidence. Advice included some conflicting messages and some advice was non-compliant with authoritative nutritional advice (e.g., avoid red meat, take a vitamin supplement). Conclusion: There is support for providing eating advice at the time of denture provision. A broad range of advice based on clinical experience to support people who wear dentures to overcome the functional limitations exists. However, the efficacy of this advice in improving diet and eating experience has not been tested.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2014
Publisher: Wiley
Date: 20-12-2017
DOI: 10.1111/JGS.15175
Publisher: Wiley
Date: 30-01-2018
DOI: 10.1111/CDOE.12362
Abstract: Early Childhood Caries (ECC) is prevalent around the world, but in particular the disease is growing rapidly in low- and middle-income countries in parallel with changing diet and lifestyles. In many countries, ECC is often left untreated, a condition which leads to pain and adversely affects general health, growth and development, and quality of life of children, their families and their communities. Importantly, ECC is also a global public health burden, medically, socially and economically. In many countries, a substantial number of children require general anaesthesia for the treatment of caries in their primary teeth (usually extractions), and this has considerable cost and social implications. A WHO Global Consultation with oral health experts on "Public Health Intervention against Early Childhood Caries" was held on 26-28 January 2016 in Bangkok (Thailand) to identify public health solutions and to highlight their applicability to low- and middle-income countries. After a 3-day consultation, participants agreed on specific recommendations for further action. National health authorities should develop strategies and implement interventions aimed at preventing and controlling ECC. These should align with existing international initiatives such as the Sixtieth World Health Assembly Resolution WHA 60.17 Oral health: action plan for promotion and integrated disease prevention, WHO Guideline on Sugars and WHO breastfeeding recommendation. ECC prevention and control interventions should be integrated into existing primary healthcare systems. WHO public health principles must be considered when tackling the effect of social determinants in ECC. Initiatives aimed at modifying behaviour should focus on families and communities. The involvement of communities in health promotion, and population-directed and in idual fluoride administration for the prevention and control of ECC is essential. Surveillance and research, including cost-effectiveness studies, should be conducted to evaluate interventions aimed at preventing ECC in different population groups.
Publisher: Elsevier BV
Date: 04-2010
Publisher: Springer Science and Business Media LLC
Date: 10-1994
Abstract: Compromised masticatory efficiency places edentulous persons at risk of consuming a diet low in non-starch polysaccharide (NSP) ('dietary fibre'). No study has quantified NSP intake in edentulous people using a valid and reliable method of dietary assessment. The aim of this study was to provide quantitative data on NSP intake of edentulous persons, together with information on its dietary sources. Using the dietary history method, habitual intake of NSP was compared between edentulous persons (n = 30) and dentate persons (n = 30) between the ages of 40 and 60. Groups were matched for sex and social class. The edentulous group had a median NSP intake of 73 (31-211) g/week. This was significantly lower than that of the dentate group of 106 (25-225) g/week (P = 0.014). Neither group completely met current UK guidelines. NSP intake of 56% (n = 17) of the edentulous group was below 84 g/week, whilst 17% (n = 5) of the dentate group was below this figure--a level of intake below which increased occurrence of gastrointestinal complaints has been observed. The dentate group obtained significantly more NSP from all rich sources, including wholemeal breads, cereals, vegetables and fruit. Depending on their form and preparation, such foods are not necessarily difficult to chew. Specific advice on food selection is required to ensure the edentulous patient has an adequate intake of NSP. Education of the dentist for this purpose is of paramount importance.
Publisher: SAGE Publications
Date: 20-09-2019
Publisher: Wiley
Date: 09-2006
DOI: 10.1111/J.1752-7325.2006.TB04074.X
Abstract: Due to increased consumption of pre-packaged drinks, tap water may no longer be the principal source of water intake and consequently fluoride intake. Little is known about the importance of solid foods as fluoride sources and how the relative contribution of foods/drinks to fluoride intake is affected by residing in fluoridated or non-fluoridated areas. This study investigated the relative contributions of different dietary sources to dietary fluoride intake and compared this in children residing in optimally artificially fluoridated, sub-optimally artificially fluoridated, and non-fluoridated areas. Thirty-three healthy children aged 6 years were recruited from fluoridated and non-fluoridated communities and categorised into three groups based on fluoride content of home tap water: optimally fluoridated ( or =0.3 to < or =0.7 mgF/L) and non-fluoridated (50.3 mgF/L) drinking water. A 3-day dietary diary collected dietary information. S les of foods/drinks consumed were collected and analyzed for fluoride content. Drinks provided 59%, 55% and 32% of dietary fluoride intake in optimally, sub-optimally and non-fluoridated areas respectively. Tap water, fruit squashes and cordials (extremely sweet non-alcoholic fruit flavoured drink concentrates) prepared with tap water, as well as cooked rice, pasta and vegetables were important sources of fluoride in optimally and sub-optimally fluoridated areas. Carbonated soft drinks and bread were the most important contributors to dietary fluoride intake in the non-fluoridated area. The main contributory sources to dietary fluoride differ between fluoridated and non-fluoridated areas. Estimating total fluoride intake from levels of fluoride in tap water alone is unlikely to provide a reliable quantitative measure of intake. Studies monitoring dietary fluoride exposure should consider intake from all foods and drinks.
Publisher: SAGE Publications
Date: 03-03-2020
Publisher: Springer Science and Business Media LLC
Date: 07-10-2014
Publisher: SAGE Publications
Date: 15-02-2021
Abstract: The mouth is pivotal in the generation of flavor, the pleasure of eating, and the selection of food. Flavor—representing the integration of olfaction (smell) with gustation (physiologic taste) and as influenced by oral somatosenses—is rarely afforded attention in oral research and dental practice. This article considers the interrelationship between oral health and flavor and highlights gaps in current knowledge. Altered oral function associated with operative and restorative treatment can feasibly alter the perception of flavor through erse ways. Oral diseases and the generation of biofilms on restorative materials have potential to influence the oral microbiota and the perception of flavor. Alterations in masticatory function (through tooth loss, restorative materials, and prostheses with nonbiological surfaces and shapes) compounded by associated influences in the composition and quantity of saliva can affect the release of odorants and tastants from foods and beverages. Furthermore, changes occur in the perception of flavor throughout life and are significant in the aging and medically compromised population with the potential to affect nutrition and pleasure. Dental research and clinical practice should be at the forefront of biomedical science in understanding and promoting the importance and relevance of flavor in the well-being of patients. However, more research is required to guide clinical practice in consideration of olfactory and gustatory function as a component of total patient care. Knowledge Transfer Statement: This commentary highlights the research gaps in knowledge pertaining to the association between oral health and flavor and the significance of flavor to dental practice.
Publisher: SAGE Publications
Date: 02-04-2021
DOI: 10.1177/23800844211003529
Abstract: A systematic review of the evidence on the impact of dental caries on malnutrition risk in children was conducted. To systematically review published evidence pertaining to the effect of dental caries severity and prevalence on risk of wasting or stunting in children. Four questions relating to caries of the permanent dentition, primary dentition, early childhood caries (ECC), and severe ECC as a risk factor for undernutrition were set. The target population was children aged 0 to 18 y from any country. Data sources included MEDLINE and Embase. All human epidemiological studies were included. Quality assessment excluded lowest-quality studies. Evidence synthesis by vote counting was depicted using harvest plots. A best available evidence approach was applied to narrative synthesis. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Of the 2,690 studies identified, 447 were screened in duplicate of these, 117 underwent quality assessment, resulting in 46 included studies, of which 38 were included in vote counting (3 quasi-experimental, 1 cohort, 1 case control, and 33 cross-sectional studies). For the permanent dentition, findings were mixed the balance of data showed no association between caries prevalence (7/11 studies) or severity (8/17 studies) with wasting. For the primary dentition, the balance of data showed a positive association between caries prevalence (10/15 studies) and severity (12/15 studies) with wasting, as well as between-caries prevalence (4/5 studies) and severity (6/6 studies) with stunting. Considering ECC only did not alter this pattern of findings. The balance of evidence suggests that dental caries in the primary dentition is associated with undernutrition. There is a need for well-designed trials on the impact of caries rehabilitation on growth trajectories of children from low- and middle-income countries and for prospective studies of the impact of caries severity on both stunting and wasting to confirm causality. The results of this study can be used by policy makers when considering the importance of oral health in addressing the United Nations Sustainable Development Goal to end all forms of malnutrition. The findings suggest that dental caries in the primary dentition may impair children’s healthy weight gain. The findings indicate that higher-quality data are required to confirm a causal relationship and thus inform funding bodies of the need for research, especially in low- and middle-income countries, to substantiate the current knowledge and inform clear and accurate policy statements.
Publisher: SAGE Publications
Date: 03-08-2019
Abstract: A systematic review was conducted to update evidence on the effect of total dietary starch and of replacing rapidly digestible starches (RDSs) with slowly digestible starches (SDSs) on oral health outcomes to inform updating of World Health Organization guidance on carbohydrate intake. Data sources included MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, LILACS, and Wanfang. Eligible studies were comparative and reported any intervention with a different starch content of diets or foods and data on oral health outcomes relating to dental caries, periodontal disease, or oral cancer. Studies that reported total dietary starch intake or change in starch intake were included or where comparisons or exposure included diets and foods that compared RDSs and/or SDSs. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statement, and evidence was assessed with the GRADE Working Group guidelines. From 6,080 papers identified, 33 (28 studies) were included in the RDS versus SDS comparison: 15 (14 studies) assessed the relationship between SDS and/or RDS and dental caries 16 (12 studies) considered oral cancer and 2 studied periodontal disease. For total starch, 23 papers (22 studies) were included: 22 assessed the effects on dental caries, and 1 considered oral cancer. GRADE assessment indicated low-quality evidence, suggesting no association between total starch intake and caries risk but that RDS intake may significantly increase caries risk. Very low-quality evidence suggested no association between total starch and oral cancer risk, and low-quality evidence suggested that SDS decreases oral cancer risk. Data on RDS and oral cancer risk were inconclusive. Very low-quality data relating to periodontitis suggested a protective effect of whole grain starches (SDS). The best available evidence suggests that only RDS adversely affects oral health.
Publisher: SAGE Publications
Date: 07-04-2021
DOI: 10.1177/14713012211002041
Abstract: People with dementia who live in care homes often depend on care home staff for help with eating and drinking. It is essential that care home staff have the skills and support they need to provide good care at mealtimes. Good mealtime care may improve quality of life for residents, and reduce hospital admissions. The aim of this systematic review was to identify good practice in mealtime care for people with dementia living in care homes, by focusing on carer-resident interactions at mealtimes. Robust systematic review methods were followed. Seven databases were searched: AgeLine, BNI, CENTRAL, CINAHL, MEDLINE, PsycINFO and Web of Science. Titles, abstracts, and full texts were screened independently by two reviewers, and study quality was assessed with Joanna Briggs Institute tools. Narrative synthesis was used to analyse quantitative and qualitative evidence in parallel. Data were interrogated to identify thematic categories of carer-resident interaction. The synthesis process was undertaken by one reviewer, and discussed throughout with other reviewers for cross-checking. After title/abstract and full-text screening, 18 studies were included. Some studies assessed mealtime care interventions, others investigated factors contributing to oral intake, whilst others explored the mealtime experience. The synthesis identified four categories of carer-resident interaction important to mealtime care: Social connection, Tailored care, Empowering the resident, and Responding to food refusal. Each of the categories has echoes in related literature, and provides promising directions for future research. They merit further consideration, as new interventions are developed to improve mealtime care for this population.
Publisher: Wiley
Date: 17-04-2014
DOI: 10.1111/IPD.12108
Abstract: Children in Gaza Strip suffer from a high prevalence of dental fluorosis. To estimate and compare total daily fluoride (F) intake (TDFI) and investigate the relative contributions of different sources of F to TDFI, in 3- to 4-year-old children in Gaza Strip, exposed to low ( 1.2 mg/litre) F concentrations in tap water. A 3-day food diary and s les of tap water, drinks, foods, toothpastes and toothbrushing expectorate were collected from 216 children receiving low (n = 81), moderate (n = 72) or high (n = 63) F concentrations in tap water. F concentration of s les was analysed using an F-ion-selective electrode. TDFI from all sources was estimated. Data were analysed by anova and Tukey's test. The mean (±SD) F concentration in low, moderate and high F tap waters was 0.21(±0.15), 0.91(±0.13) and 1.71(±0.35) mg/litre, respectively. Mean (±SD) TDFI was 0.02(±0.01), 0.04(±0.01) and 0.05(±0.03) mg/kg bw/day, respectively (P < 0.0001). Foods made the largest contribution (63.9%) to TDFI. Total daily fluoride (F) intake increased as F concentration in tap water increased. Foods were the primary source of F. Programmes for monitoring fluoride expose should consider the fluoride concentration of water used for food preparation and local dietary behaviours.
Publisher: Wiley
Date: 12-1998
Publisher: Springer Science and Business Media LLC
Date: 25-03-2000
Publisher: Springer Science and Business Media LLC
Date: 10-2011
DOI: 10.1007/BF03262814
Publisher: SAGE Publications
Date: 05-2006
DOI: 10.1177/154405910608500513
Abstract: Edentulous denture-wearers eat fewer fruits and vegetables than do comparable dentate in iduals. Improved chewing ability with new dentures has resulted in little dietary improvement, suggesting that dietary intervention is necessary. The objective of this randomized controlled trial was to have a positive impact upon dietary behavior of patients receiving replacement complete dentures through a tailored dietary intervention. Readiness to change diet (Stage of Change), intake of fruits, vegetables, and nutrients, and chewing ability were assessed pre-and 6 weeks post-intervention. The intervention group (n = 30) received two dietary counseling sessions the control group (n = 28) received current standard care. Perceived chewing ability significantly increased in both groups. There was significantly more movement from pre-action into action Stages of Change in the intervention group, who had a greater increase in fruit/vegetable consumption (+209 g/d) than did the control group (+26 g/d) (P = 0.001). Tailored dietary intervention contemporaneous with replacement dentures can positively change dietary behavior.
Publisher: Informa UK Limited
Date: 22-08-2007
Abstract: This study aimed to evaluate the use of peer educators in nutrition interventions with older people. A s le of 22 people aged 60+ were recruited and trained using an accredited course for Community Nutrition Assistants which included basic nutrition and group skills. They were paid to work as peer educators in a 20-week food club intervention which ran in 13 sheltered accommodation schemes for older people in northeast England. Clubs ran for 2 hours each week and included food preparation, food tasting and sharing information and ideas about food and health. This paper reports key findings from qualitative interviews with peer educators on their perspectives on their motivation to participate, their training and their implementation of the food club intervention. It discusses some of the issues involved in the training and use of peer educators and presents lessons learned, particularly the need to target training, according to prior experience and skills.
Publisher: Cambridge University Press (CUP)
Date: 04-2007
DOI: 10.1017/S1368980007249729
Abstract: Dietary surveys of 11- to 12-year-old Northumbrian children in 1980 and 1990 revealed that consumption of non-milk extrinsic sugars (NMES) was 16–17% of energy intake. This study reports dietary sugars consumption in 2000 and compares it with data collected in 1980 and 1990, using identical methods. A repeat cross-sectional dietary survey of children aged 11–12 years attending the same schools as in the 1980 and 1990 surveys. Seven middle schools in south Northumberland. All children aged 11–12 years old attending the seven schools. Food consumption was recorded using two 3-day diet diaries. Food composition tables were used to calculate energy and nutrient intakes. NMES, and milk and intrinsic sugars were calculated using previously described methods. The numbers of children completing the surveys in 1980, 1990 and 2000 were 405, 379 and 424, respectively ~60–70% of eligible children. Total sugars provided 22% of energy consistently over the three surveys. NMES consumption in 2000 provided 16% of energy compared with 16% in 1980 and 17% in 1990. Sources of NMES changed over the three surveys. NMES from soft drinks doubled from 15 to 31 g day − 1 , and from breakfast cereals increased from 2 to 7 g day − 1 over the 20 years. Confectionery and soft drinks provided 61% of NMES. Over 20 years, the proportion of energy from fat decreased by 5% and from starch increased by 4%, creating a welcome tilt in the fat–starch see-saw, without an adverse effect on sugars intake. Consumption of NMES in 2000 was substantially higher than recommended, and there has been little change over 20 years. Continued and coordinated efforts are required at a national, community and in idual level to reduce the intake of NMES.
Publisher: Springer New York
Date: 2014
Publisher: Elsevier BV
Date: 02-2002
Publisher: SAGE Publications
Date: 11-2005
DOI: 10.1177/154405910508401104
Abstract: It has been suggested that systemic fluoride absorption from drinking water may be influenced by the type of fluoride compound in the water and by water hardness. Using a human double-blind cross-over trial, we conducted this study to measure c max , T max , and Area Under the Curve (AUC) for plasma F concentration against time, following the ingestion of naturally fluoridated hard and soft waters, artificially fluoridated hard and soft waters, and a reference water. Mean AUC over 0 to 8 hours was 1330, 1440, 1679, 1566, and 1328 ng F•min•mL −1 for naturally fluoridated soft, naturally fluoridated hard, artificially fluoridated soft, artificially fluoridated hard, and reference waters, respectively, with no statistically significant differences among waters for AUC, c max , or T max . Any differences in fluoride bioavailability between drinking waters in which fluoride is present naturally or added artificially, or the waters are hard or soft, were small compared with large within- and between-subject variations in F absorption. Abbreviations used: F, fluoride AUC, Area under the Curve for plasma F concentration against time AUC(0-3), Area under the Curve for plasma F concentration against time for 0 to 3 hours following water ingestion AUC(0-8), Area under the Curve for plasma F concentration against time for 0 to 8 hours following water ingestion c max , maximum plasma F concentration corrected for baseline plasma F and dose ( i.e., F concentration of in idual waters) T max , time of c max .
Publisher: Elsevier BV
Date: 06-2007
DOI: 10.1111/J.1875-595X.2007.TB00119.X
Abstract: To assess the prevalence of dental erosion in a s le of 13- and 14-year-old Brazilian schoolchildren and to assess the relationship of dental erosion and socio-demographic characteristics. A convenience s le of 458 children (190 boys and 268 girls) from 14 schools in Três Corações, south east Brazil, was examined. Socio-demographic data were collected by self-completion questionnaires. Dental erosion was observed in 34.1% of subjects, involving enamel only and showing a symmetrical distribution. The palatal surfaces of the upper incisors were the most commonly affected surfaces. Erosion experience was higher in boys pupils from Government funded schools those resident in rural areas and those from the high economic class, but none of these were statistically significant. These data are the first to show that in a cohort of 13-14-year old Brazilian schoolchildren, approximately one third of those examined showed mild erosion, requiring clinical preventive counselling. No statistically significant association was observed between erosion, gender and socioeconomic factors.
Publisher: Wiley
Date: 10-1993
Publisher: IEEE
Date: 2011
Publisher: Wiley
Date: 03-1996
DOI: 10.1111/J.1365-263X.1996.TB00203.X
Abstract: Glucose polymers are widely used as an energy supplement in dietetic practice and are increasingly being used in commercially available products, such as some infant formulae and dried baby foods. Information on the effect of glucose polymers on dental health does not exist, yet is essential in order to advise how these carbohydrates should be incorporated into the diet with least risk to dental health. This study aimed to investigate whether glucose polymers taken as 10% solutions in water, in cow's milk, or in a solution of a milk substitute (Calogen) are acidogenic and, if so, whether these solutions decrease plaque pH to levels associated with enamel demineralization. The solutions alone and with 10% sucrose served as negative and positive controls, respectively. Plaque was collected from the teeth of 14 adult subjects before and at 3, 7, 11, 15, 23 and 27 minutes after rinsing the mouth with one of the solutions. pH curves were compiled and acidogenicity expressed as: pH area, minimum pH reached, maximum pH decrease and length of time below pH 6.0. Glucose polymers caused a decrease in plaque pH but, for some of the measures of acidogenicity, to a significantly lesser extent than sucrose. Glucose polymers showed equal acidogenicity when given in water, milk or Calogen. In view of their potential cariogenicity, advice for mode of consumption of glucose polymers and products containing glucose polymers should be the same as that for non-milk extrinsic sugars.
Publisher: Wiley
Date: 27-05-2022
DOI: 10.1111/EJE.12822
Abstract: To outline the development and implementation of a food science and nutrition module for dental undergraduate students that provides basic knowledge and clinical skills for improving oral health outcomes and understanding their importance for overall health. Interdisciplinary discussions with professionals with expertise in food science and nutrition, including dentists, dietitians and nutritionists, were held to agree on core subject areas in line with the evidence base. The module was delivered online to 2nd‐year dental students due to COVID‐19 restrictions. Students completed an online evaluation on completing the module. Final examination consisted of one essay question. Subject areas and learning outcomes were derived from current and previous approaches to curriculum development. A total of 14 prerecorded lectures, including healthy eating guidelines, dietary assessment, specific oral effects of diet and food constituents were delivered and tutorials provided. The evaluation survey had a 90% ( n = 39/43) response rate. A majority indicated that the course was “interesting,” “worth doing ” (59%) and “provided a good evidence base to understand nutrition and oral health” (87%). Nearly all students (92%) agreed that the course was “sufficiently structured to allow understanding of the key topics ” and that “a good understanding of nutrition is important for a dentist” (95%). A food science and nutrition module developed by a multidisciplinary team enabled dental students to gain an understanding of the role of diet in oral and overall health. The module facilitated the development of skills that enable students to utilise dietary assessment techniques and promote dietary interventions beneficial to oral health. The approach taken may act as a template for other institutions.
Publisher: Elsevier BV
Date: 09-2002
Publisher: Wiley
Date: 10-08-2007
Publisher: Elsevier BV
Date: 02-2020
Publisher: SAGE Publications
Date: 06-05-2020
Abstract: Limiting free sugars to % of energy intake is a World Health Organization evidence-based recommendation to protect oral health throughout the life course. Achieving this requires a concerted approach with upstream interventions, including legislation underpinning community interventions and health promotion. Global production and trade are the main drivers of sugars consumption, which can be addressed only through prioritization of health impacts in agricultural and trade agreements, including pricing and subsidies. Increasing evidence demonstrates the benefit, including dental benefits, of taxes on sugar-sweetened beverages, a major source of sugars—with taxes based on sugars content being favored due to the dual impact in incentivizing consumers to buy less and encouraging producers to use less through product reformulation. A benefit of product reformulation is that the potential impact on sugars intake occurs independent of consumer behavior change, making the benefits more equitable across social groups. Evidence from meta-analysis indicates that sugars reformulation and portion size reduction could lower energy intake by more than 10% and 16%, respectively. Sophisticated and targeted digital marketing of products high in sugars is another key driver of sugars intake. With the exception of children’s television broadcasting, marketing of products high in sugars is largely unregulated, and increased awareness of modern marketing strategies and more stringent regulation are urgently needed. To ensure a commercial level playing field, mandatory approaches are required. Midstream actions include creating healthier food environments in neighborhoods, community settings (schools, sports centers, hospitals), and workplaces. Only through coalition among authorities responsible for planning and health will “obesogenic and cariogenic” environments be replaced with those that make healthy choices the easiest choice. It is recognized that providing nutrition health education alone is insufficient to achieve necessary sugars reduction however, education has a key role to play in changing social norms and creating drive for change.
Publisher: Cambridge University Press (CUP)
Date: 22-05-2013
DOI: 10.1017/S1368980012002637
Abstract: To investigate the longitudinal relationship between the intake of dietary antioxidants and periodontal disease in community-dwelling older Japanese. A retrospective cohort study, with a follow-up of 2 years (2003–2005). Intakes of dietary antioxidants (vitamin C, vitamin E, α-carotene and β-carotene) were assessed with a validated FFQ. Participants were classified by tertile of antioxidant intake. Full-mouth periodontal status, measured as the clinical attachment level, was recorded at baseline and follow-up examinations. Periodontal disease progression was considered as loss of attachment of 3 mm or greater over the study period at the interproximal site for each tooth. Finally, the number of teeth with periodontal disease progression per person was calculated and was used as the outcome. Poisson regression analysis was conducted, with dietary antioxidants as the main exposure, to estimate their influence on the number of teeth with periodontal disease progression. Niigata City (Japan). Dentate in iduals aged 75 years in 2003, for whom data were available, were included in the analyses ( n 264). A higher intake of dietary antioxidants was inversely associated with the number of teeth with periodontal disease progression, controlling for other variables. The multivariate-adjusted incidence rate ratios in the first, second and third tertiles were 1·00, 0·76 (95 % CI 0·60, 0·97) and 0·72 (95 % CI 0·56, 0·93) for vitamin C 1·00, 0·79 (95 % CI 0·62, 0·99) and 0·55 (95 % CI 0·42, 0·72), for vitamin E and 1·00, 1·02 (95 % CI 0·81, 1·29) and 0·73 (95 % CI 0·56, 0·95) for β-carotene. The study results suggest that higher intake of antioxidants may mitigate periodontal disease in community-dwelling older Japanese.
Publisher: Wiley
Date: 06-08-2011
DOI: 10.1111/J.1600-0528.2011.00632.X
Abstract: The level of Fluoride exposure needed to cause dental fluorosis is not known precisely. An awareness of total F intake from all sources, especially during the critical stages of dental development during infancy and early childhood, is important in preventing the development of dental fluorosis. The aim of the study was to measure F content of ready-to-feed (RTF) infant drinks and foods in the UK. In total, 122 infant foods were analysed for F concentrations, in triplicate, indirectly by an acid diffusion method and 25 infant drinks analysed directly using an F-ion-selective electrode after addition of TISABIII. The median (range) F concentration was 0.110 (0.030-0.221) μg/g for breakfast cereals, 0.112 (0.040-1.200) μg/g for savoury meals, 0.056 (0.030-0.379) μg/g for desserts, 0.044 (0.020-0.191) μg/g for fruits, 0.196 (0.040-0.397) μg/g for baked goods, 0.069 (0.050-0.148) μg/ml for juices, 0.016 (0.009-0.030) μg/ml for milks and 0.041 (0.022-0.069) μg/ml for waters. The median (range) F concentration of all RTF infant foods and drinks by recommended age of consumption was 0.029 (0.010-0.245), 0.088 (0.020-0.500), 0.108 (0.100-0.510) and 0.108 (0.060-1.200) μg/g for infants from birth, 4+ month, 6+ month and 10+ month, respectively. The results suggest that the F concentrations of UK-marketed RTF infant foods, drinks and formula milk are not sufficiently high to be a risk factor for dental fluorosis, if consumption is within the limits recommended for infants and young children.
Publisher: Wiley
Date: 03-03-2006
DOI: 10.1111/J.1600-0528.2006.00269.X
Abstract: The main aim of this study was to determine how representative the fluoride/creatinine (F/Cr) ratio of a spot urinary s le is of the fluoride content of a 24-h urine s le in young children aged 12-36 months. Subsidiary objectives were to: (a) evaluate the use of 24-h urine s les in monitoring fluoride exposure and (b) estimate the retention of fluoride in very young children. Seven healthy children residing in a fluoridated area completed the study. Dietary information was obtained using a 3-day estimated food diary followed by an interview on the fourth day. S les of foods and drinks were analysed for fluoride content. Ingestion of fluoride from toothpaste was also measured. A 24-h urine s le and a morning spot urine s le were collected from each child. The mean age of the children was 32 months (range: 16-36 months). The mean total daily intake of fluoride was 0.71 (+/-0.41) mg or 0.05 (+/-0.02) mg/kg bodyweight, of which 37% came from the diet, the remainder being from toothpaste ingestion. None of the children used any other sources of fluoride such as fluoride tablets or fluoridated salt. The mean F/Cr ratio was 1.49 (+/-0.63) mg F/g creatinine. A positive correlation (Pearson's correlation=0.76, P=0.05) between fluoride excretion estimated using the F/Cr ratio in a morning spot urine s le and fluoride excretion in a 24-h urine s le was found. There was also a positive correlation (Pearson's correlation=0.83, P=0.02) between total daily fluoride intake and 24-h urinary fluoride excretion. Less than half (43%) of the total daily fluoride intake was retained in the body. The F/Cr ratio of a morning spot urine s le may be used to estimate mean 24-h urinary excretion of fluoride and therefore has potential application for larger-scale epidemiological studies where 24-h s les are impractical. Estimates of 24-h urinary fluoride excretion can be used to gauge fluoride exposure.
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.APPET.2011.03.010
Abstract: Impaired sensorial perception is very common in older people and low sensorial quality of foods is associated with decreased appetite and dietary intake. Hospital undernutrition in older patients could be linked to sensorial quality of hospital food if the quality were low or inappropriate for older people. The aim of this study was to examine changes in the sensorial quality of different foods that occur as a result of the food journey (i.e. freezing, regeneration, etc.) in the most common hospital catering systems in the UK. A trained sensory panel assessed sensorial descriptors of certain foods with and without the hospital food journey as it occurs in the in-house and cook/freeze systems. The results showed effects of the food journey on a small number of sensorial descriptors related to flavour, appearance and mouthfeel. The majority of these effects were due to temperature changes, which caused accumulation of condensation. A daily variation in sensorial descriptors was also detected and in some cases it was greater than the effect of the food journey. This study has shown that changes occur in the sensory quality of meals due to hospital food journeys, however these changes were small and are not expected to substantially contribute to acceptability or have a major role in hospital malnutrition.
Publisher: Elsevier BV
Date: 11-2000
DOI: 10.1016/S0300-5712(00)00044-0
Abstract: The objectives of this study were to investigate the impact of prosthetic rehabilitation of the shortened dental arch on the intake of nutrients, non-starch polysaccharide (NSP) fruits and vegetables (dietary fibre), and to compare dietary intakes between patients receiving bilateral resin-bonded bridges with patients receiving conventional partial dentures. As part of an ongoing randomised clinical trial to compare the effectiveness of bilateral resin bonded bridges with conventional partial dentures, the diets of 40 partially dentate patients were assessed prior to and at 3 and 12 months following treatment with bilateral resin-bonded bridge-work or a lower partial denture. At baseline, three months post treatment and one year post treatment there were no significant differences in the intake of nutrients between groups. A significant increase in the percentage of energy from fat was observed in the patients fitted with a lower partial denture. Apart from this, prosthetic rehabilitation did not result in any other change in the intake of nutrients or in the amount of fruits and vegetables consumed. Levels of intake of NSP, fruits and vegetables were low in both groups of patients on all occasions measured. Prosthetic rehabilitation of the severely shortened dental arch does not result in dietary improvements. Dietary advice that takes into account all the factors that influence food choice (such as taste, cost and cooking skills) needs to be considered in this at risk group.
Publisher: Wiley
Date: 08-08-2008
Publisher: Wiley
Date: 09-1996
DOI: 10.1111/J.1365-263X.1996.TB00238.X
Abstract: Soya infant formulas contain glucose syrups instead of lactose, which has led to concern that they are potentially more cariogenic than standard infant milk formulas, which contain lactose. However, the cariogenic potential of soya infant formulas has not been tested. The aim of this study was, therefore, to compare the effect of a soya infant formula and an infant milk on the pH of dental plaque. The study group consisted of 19 adults in whom plaque pH was measured before, and 3, 7, 11, 15, 19, 23 and 27 minutes after, rinsing the mouth with each of the formulas. pH curves were compiled and acidogenicity expressed as 'pH area', minimum pH reached, and maximum pH decrease. No statistically significant differences were observed between the acidogenicity of the soya infant formula and the infant milk.
Publisher: Springer Science and Business Media LLC
Date: 08-2001
Abstract: Removable partial dentures used to restore the shortened lower dental arch may adversely affect the remaining natural teeth and are associated with a low prevalence of use. To report the findings for caries incidence 2 years after restoration of lower shortened arches with bilateral cantilever resin-bonded bridges (RBBs) and conventional partial dentures (RPDs). Randomised controlled trial. Secondary care 25 male and 35 female subjects of median age 67 years. were randomly allocated to 'bridge' and 'denture' treatment groups of 30 patients each matched for age and sex. Caries incidence was recorded during dental examinations 3 months, 1 and 2 years after insertion of new lower prostheses. Cantilever RBBs and conventional RPDs with cast metal frameworks. There was a highly significant difference in the frequency of new caries lesions, 11 and 51 in the bridge and denture groups respectively (P < 0.01). 20 out of 27 bridge patients and 9 of 23 denture patients had no caries experience. Multivariate modeling identified treatment group as the only significant predictor of caries occurrence. Two years after restoration of lower shortened arches for an elderly s le of patients, there was a significantly greater incidence of new and recurrent caries lesions in subjects restored with RPDs compared with cantilever RBBs.
Publisher: Cambridge University Press (CUP)
Date: 03-2008
DOI: 10.1017/S0007114507803989
Abstract: The WHO recommends limiting non-milk extrinsic sugars (NMES) consumption to ≤ 10 % energy to reduce the risk of unhealthy weight gain and dental caries, and to restrict frequency of intake to ≤ 4 times/d to reduce risk of dental caries. Older adults, especially those from low-income backgrounds, are at increased risk of dental caries, yet there is little information on sugars intake (frequency of intake and food sources) in this age group. The aim of this report is to present baseline data from a community-based dietary intervention study of older adults from socially deprived areas of North East England, on the quantity and sources of total sugars, NMES, and intrinsic and milk sugars, and on frequency of NMES intake. Dietary intake was assessed using two 3-d estimated food diaries, completed by 201 participants (170 female, thirty-one male) aged 65–85 years (mean 76·7 ( sd 5·5) years) recruited from sheltered housing schemes. Total sugars represented 19·6 %, NMES 9·3 %, and intrinsic and milk sugars 10·3 % of daily energy intake. Eighty-one (40·3 %) exceeded the NMES intake recommendation. Mean frequency of NMES intake was 3·4 times/d. The fifty-three participants (26·4 %) who exceeded the frequency recommendation ( ≤ 4 times/d) obtained a significantly greater percentage of energy from NMES compared with those participants who met the recommendation. The food groups ‘biscuits and cakes’ (18·9 %), ‘soft drinks’ (13·1 %) and ‘table sugar’ (11·1 %) made the greatest contributions to intakes of NMES. Interventions to reduce NMES intake should focus on limiting quantity and frequency of intake of these food groups.
Publisher: SAGE Publications
Date: 02-07-2022
DOI: 10.1177/23800844211026608
Abstract: A key purpose of denture provision is to enable eating, yet the body of evidence pertaining to the impact of dentures on wide-ranging nutritional outcomes has not been systematically reviewed. To systematically review published evidence pertaining to the effect of wearing removable dental prosthesis on dietary intake, nutritional status, eating function, and eating related–quality of life (ERQoL). Eight questions relating to the impact of wearing dentures on nutritional outcomes were addressed. The target population was healthy adults aged ≥18 y. Data sources included Medline, Embase, CINAHL, and PubMed. Included were all human epidemiologic studies. The Newcastle-Ottawa score was used for appraisal of study quality. Harvest plots, vote counting, and accompanying narrative provided the basis for synthesis. Of the 1,245 records identified, 134 were retrieved and eligibility assessed by 2 reviewers, and 41 studies were included in the synthesis (14 rated good quality, 20 fair, and 7 poor). The balance of data supported a positive impact of wearing full (5/7 studies) or partial (3/3 studies) dentures (vs. no dentures) on nutritional status, though no clear direction of effect was detected for the impact of dentures on dietary intake. The balance of data clearly showed that objective measures of eating function were compromised in full (14/15 studies) and partial (6/7 studies) denture wearers as compared with the dentate. Data showed that ERQoL was also compromised in denture wearers as compared with the dentate (3/3 studies). However, data showed a positive impact of wearing dentures on ERQoL (5/5 studies) as opposed to wearing no dentures. The balance of evidence shows that despite no clear pattern on impact of wearing dentures on measured dietary intake, in those with tooth loss, wearing dentures can have a positive impact on nutritional status and enjoyment of eating. The results of this systematic review can be used to advocate for health care services to address prosthodontic need to benefit nutritional outcomes. The findings will be of use in educating health care professionals on the impact of wearing dentures and not addressing prosthodontic need on nutritional outcomes.
Publisher: Cambridge University Press (CUP)
Date: 03-1996
DOI: 10.1079/BJN19960150
Abstract: Abstract Increased Ca intake by adolescents is desirable. In order to achieve this, information on the current dietary sources of Ca by this age group is essential to enable change to build on existing habits. This paper addresses two issues: first, the dietary sources of Ca for adolescents are reported and, second, the importance of fortification of flour with Ca to present-day Ca intakes was determined. In 1990 the diets of 379 children aged 12 years were assessed using the 3 d dietary diary and interview method. Computerized food tables were used to calculate the contributions of different food groups to total Ca intake. The Ca content of eachfood was sub ided into naturally occurring Ca and Ca from fortification, and data were analysed to give the daily intake of each. The four most important sources of Ca were milk (25%), beverages (12%), puddings (10%) and bread (9%). Fortification of flour accounted for 13% of total Ca intake. When the contribution of fortification was removed, the proportion of subjects with intakes of Ca below the lower reference nutrient intake (Department of Health, 1991) increased more than fourfold, to 10% of girls and 12% of boys. Milk is contributing less to Ca intake than in the past and increased consumption should be encouraged. Ca fortification of flour remains an important source of Ca. Therefore, unless dietary habits are modified to ensure adequate Ca from other sources, increased consumption of unfortified products from outside the UK will lead to a further reduction in Ca intake.
No related grants have been discovered for Paula Moynihan.