International Poster Journal of Dentistry and Oral Medicine



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Int Poster J Dent Oral Med 14 (2012), No. 4     15. Dec. 2012

Int Poster J Dent Oral Med 2012, Vol 14 No 4, Poster 623

Correlation between Dental Status and Nutritional-Blood-Markers in the Elderly

Language: English

Dr. Martha Zenginel, Sebastian Schmidt, Sanja Vanessa Beißner, Dr. Peter Rehmann, Prof. Dr. Bernd Wöstmann,
Justus-Liebig-University Giessen, Department of Prosthodontics, Gießen, Germany
Prof. Dr. Dr. Gerald Kolb,
St. Bonifatius Hospital Lingen, Department of Geriatrics, Lingen, Germany

International Association of Dental Research, 89th General Session and Exhibition 2011
San Diego, CA.


It is long known that the selection of nutritional items is affected by the dental status. However there is little information whether this is also reflected in nutritional-blood-markers due to a change in nutritional habits.


Thus it was the aim of this clinical study to evaluate a potential correlation between the dental status and selected nutritional-blood-markers in elderly patients. The following null hypothesis was tested: The dental status does not affect the blood-markers a) folate, b) albumin, c) lymphocytes and d) cobalamin.

Fig. 1: Mini Nutritional Assessment

Material and Methods

Eighty elderly inpatients of the Department of Geriatrics (Bonifatius Hospital Lingen/Ems, Germany) (minimum age 60 years) were included in the study (approval by the Ethics Committee JLU Giessen, AZ 191/09). The assessment comprised the dental status (score 1: no treatment necessary to 4: treatment obligatory), the Mini Nutritional Assessment (MNA, score 0: normal nutritional status, 1: at risk of malnutrition, 2: malnourished, Fig. 1) and the blood-markers folate, albumin, lymphocytes and cobalamin. Additionally a masticatory function test (comminution of a slice of carrot, diameter 2cm and height 1cm, chewing time 45s, score 1: excellent comminution to 6: comminution impossible, Fig. 2 and Tab. 1) was carried out. For statistical analysis (SPSS 17.0) of normally distributed data Oneway Anova was used; otherwise a Kruskal-Wallis H-test was applied. Additionally a Spearman regression for the dental status and the masticatory function test was calculated.

Fig. 2a-b: Masticatory function test (comminution)
Fig. 2c-d: Masticatory function test (comminution)
Fig. 2e-f: Masticatory function test (comminution)
score comminution
1 excellent
2 good
3 medium
4 moderate
5 poor
6 impossible
Tab. 1: Masticatory function test (scores)


The mean score (Mean ± StD) for the dental status was 3.0 ± 0.8 and 0.8 ± 0.6 for the MNA (Tab. 2). There was a significant correlation (Spearman, p < 0.05) between dental status and the masticatory function test (3.8 ± 1.6) (Fig. 3) as well as albumin.
However, no correlation between dental status and the MNA, folate (7.0 ± 3.7 ng/ml), lymphocytes (2.6 ± 0.7 giga/l) or cobalamin (394.9 ± 270.9 pg/ml) could be observed. Thus only the part b of the null hypothesis could be rejected.

dental status masticatory function test MNA folate [ng/ml] albumin [g/dl] lymphocytes [giga/l] cobalamin [pg/ml]
standard values 4.6-18.7 5.5-6.9 1.0-4.8 197-866
1 1.5±0.7 0±0 5.2±1.1 2.5±1.0 19.0±0 354.6±9.3
2 2.5±1.2 0.7±0.5 7.2±4.2 3.5±0.4 23.7±8.1 412.1±342.7
3 3.6±1.2 0.8±0.6 7.4±3.7 3.3±0.5 26.6±7.6 421.8±279.4
4 5.5±0.7 1.0±0.5 6.5±3.6 3.2±0.4 27.4±7.6 340.0±186.2
overall 3.8±1.6 0.8±0.6 7.0±3.7 3.3±0.5 25.8±7.7 394.9±270.9
Tab. 2: Dental status, masticatory function test, MNA and blood-markers (Mean ± StD)
Fig. 3: Dental status and masticatory function test. The line represents the Spearman regression.


Since all folate, lymphocytes and cobalamin mean values are within the normal range and all albumin mean values were below the normal range regardless of the dental status it complicates the statement of a correlation between dental status and blood-markers.
As multimorbidity and thus multimedication is typical for elderly people our data may be influenced otherwise. Though patients with known problems in their reported history were excluded from the study, probably some were not aware of their status and did not fully report.


  1. Sahyoun NR, Lin CL, Krall E. Nutritional status of the older adult is associated with dentition status. J Am Diet Assoc 2003; 103:61-66.
  2. Mobley C, Dounis G. Evaluating dietary intake in dental practices: doing it right. J Am Dent Assoc 2010; 141:1236-1241.
  3. Moynihan P, Thomason M, Walls A, et al. Researching the impact of oral health on diet and nutritional status: methodological issues. J Dent 2009; 37:237-249.
  4. Sheiham A, Steele JG, Marcenes W, et al. The relationship among dental status, nutrient intake and nutritional status in older people. J Dent Res 2001; 80: 408-413.
  5. Vellas B, Villars H, Abellan G, et al. Overview of MNA® - Its History and Challenges. J Nut Health Aging 2006; 10: 456-465.
  6. Rubenstein LZ, Harker JO, Salva A, et al. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini Nutritional Assessment (MNA-SF). J Geront 2001; 56A: M366-377.
  7. Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature - What does it tell us? J Nutr Health Aging 2006; 10: 466-487.
  8. Musacchio E, Perissinotto E, Binotto P, et al. Tooth loss in the elderly and its association with nutritional status, socio-economic and lifestyle factors. Acta Odontol Scand 2007; 65: 78-86.

This Poster was submitted by Dr. Martha Zenginel.

Correspondence address:
Dr. Martha Zenginel
Justus-Liebig-University Giessen
Department of Prosthodontics
Schlangenzahl 14
35392 Gießen