Perfect health is a honor that has been the goal of human race through ages. Nutrition provides substrates that are very essential for expression of genetic tradition. It follows therefore, that nutrition might influence the occurrence and severity of degenerative diseases that are associated with aging. Nutritional problems may result from changes associated with aging process itself, from disease or other medical conditions, from interactions with medications and so on. INTRODUCTION Proper nutrition is crucial for the health of oral tissues as healthy tissues enhance the possibility of successful prosthodontic treatment in the elderly. In patients with partial or complete tooth loss, prosthetic therapy may be important to maintain or restore masticatory function. However, many other factors also are vital for the nutritional status of geriatric patients. Thus, many age-related medical problems and diseases have nutritional aspects and the patient’s socioeconomic status and dietary habits have a profound influence on their dietary selection. The dental team should always be aware of these budding harmful effects of dental treatment and provide their remedial dietary guidance. Problems always vary with the patient and their dental condition, so suggestions must be modified to meet the patient’s particular needs. NUTRITIONAL OBJECTIVES
- To establish a balanced diet which is consistent with the physical, social, psychological and economic background of the patient.
- To provide temporary dietary supportive treatment, directed towards specific goals such as carries control, postoperative healing, or soft tissue conditioning.
- To interpret factors peculiar to the denture age group of patients, this may relate to or complicate nutritional therapy.
- With a decline in lean body mass in the elderly, caloric needs decrease .
- Vitamin D deficiency is a major cause of metabolic bone disease in the elderly.
- Many nutrient deficiencies common in the elderly, including zinc and vitamin B6, seem to result in decreased or modified immune responses.
- Dehydration, caused by decline in kidney function and total body water metabolism, is a major concern in the older population.
- Overt deficiency of several vitamins is associated with neurological and/or behavioral impairment B1 (thiamin), B2, niacin, B6 , B12, foliate, pantothenic acid, vitamin C and vitamin E).
- Elders, particularly at risk, include those living alone, the physically handicapped with insufficient care, the isolated, those with chronic disease and/or restrictive diets, reduced economic status and the oldest old.
- Functional disabilities such as arthritis, stroke, vision, or hearing impairment.
- Prescribed drugs are the key cause of anorexia, nausea, vomiting, xerostomia, taste loss and interference with nutrient absorption and their utilization.
- Xerostomia affects almost one in five older adults. Xerostomia is associated with difficulties in chewing and swallowing, which can adversely affect food selection and contribute to poor nutritional status.
- Age-related changes may alter food choice and decrease diet quality in some people
- Sense of smell decreases markedly with age, much more rapidly than the sense of taste.
- Sensory changes may diminish the appeal of some foods (e.g., sensitivity to the bitterness of cruciferous vegetables), limiting their consumption and potential health benefits function.
- Periodontal disease also increases with age and may be exacerbated by nutritional deficiencies.
- As adults age, they tend to use more strokes and chew longer, to prepare food for swallowing.
- Masticatory efficacy in complete denture wearers is approximately 80% less than in people with undamaged natural dentition.
- The consequence of dentures on nutritional status varies among individuals
- Dentate adults tend to eat more fruits and vegetables than full-denture wearers.
- Replacing ill-fitting dentures with new ones does not necessarily result in significant improvements in dietary intake.
- As the patients become older, the amount of protein required increases.
- The RDA for proteins, for persons aged 51 and over, is 0.8-g protein/kg body weight per day.
- The best sources of proteins for the elderly diet are dairy products, poultry, meats and fish in the boiled and not dried form. Nuts, grains, legumes and vegetables contain protein, which if eaten in the proper combination, is of the same quality as animal sources of protein.
- Deficiency of proteins causes edema.
- The elderly consume a large proportion of their calories as carbohydrates.
- The recommended range of intake is 50 to 60 per cent of total calories.
- Food sources include grains and cereals, vegetables, fruits and dairy products.
- Inadequate intake of fluid by the elderly will lead to rapid dehydration and associated problems such as hypotension, elevated body temperature and dryness of the mucosa, decreased urine output and mental confusion.
- Under normal conditions, fluid intake should be at least 30 ml per kg body weight per day.
- The RDA for vitamin A is 800-1000 micrograms RE.
- Vitamin A in food occurs in two forms: retinal, or active Vitamin A in animal foods (liver, milk and milk products) and beta-carotene or pro-vitamin A in deep green and yellow fruits and vegetables (apricots, carrots, spinach).
- Deficiency causes Bitot’s spots (eyes), conjunctival and corneal xerosis (dryness), xerosis of skin, follicular hyperkeratosis, decreased salivary flow, dryness and keratosis of oral mucosa and decreased taste acuity.
- Long standing deficiency may cause hyperplasia of the gums, as well as generalized gingivitis.
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