EHR study finds wearing dentures could hurt overall nutrition

A new study from the Regenstrief Institute and the Indiana University School of Dentistry found that people with dentures experienced a decline in certain nutrition markers over two years.

The research recently published in the Journal of Prosthodontics, linked dental records with the lab values ​​of nutritional biomarkers. Researchers believe that it is the first study to do so.

“Dentures are a significant change for a person. They do not provide the same chewing efficiency, which may alter eating habits,” said senior author Dr. Thankam Thyvalikakath, director of the Regenstrief and IU School of Dentistry Dental Informatics program, in a statement.

“Dentists need to be aware of this and provide advice or a referral for nutrition counseling. These patients need support during the transition and possible continued monitoring,” she added.

WHY IT MATTERS

Tooth loss, also known as edentulism, can affect overall health, including raising the risk for malnutrition.

For this study, researchers used electronic health record data and electronic dental record data from more than 10,000 patients to try and longitudinally examine the nutritional status among denture wearers.

They also compared the nutritional profiles of denture and nondenture wearing patients using biomarkers from laboratory reports.

“To the best of our knowledge, studies utilizing laboratory values ​​of nutritional biomarkers in the serum and urine samples present in the EHR and linking with EDR data have not been reported previously,” researchers wrote.

The research team found that serum albumin, calcium and total protein decreased over the course of two years after patients received the dentures when compared to those without dentures.

“Serum albumin, a predominant protein in blood is an indicator for nutritional assessment in healthy individuals and reduced levels indicate poor health outcomes,” noted the researchers. “Reduction in serum calcium could be attributed to reduced dietary calcium intake among denture wearers relative to others,” they added.

Protein, meanwhile, is a biomarker for nutritional status.

“Older adults with reduced protein intake are at risk for sarcopenia which can impact physical activity and lead to poor quality of life,” said the research team.

Although the levels were within normal range, researchers said they could decrease as more time passes.

“Future studies should investigate the significance of screening patients who receive denture treatment (irrespective of the type of prosthesis they receive) for malnutrition risk using simple and easy-to-implement tools such as a questionnaire,” they wrote.

They noted limitations in the study, including potential record inconsistencies and the use of patient data from a single academic institution.

Next steps in the research area will be to investigate other potential influences on nutrition, such as insurance status and dental clinics characteristics. Researchers also said multisite studies would be warranted.

“In addition, it is also crucial that future research investigate the benefit of nutritional diet counseling for patients who receive teeth replacements – dentures as well as implants,” said researchers.

THE LARGER TREND

Electronic dental records are a potential gold mine for data-driven insights – particularly given the link between oral health and other conditions. In 2018, Columbia University College of Dental Medicine announced the establishment of the Center for Precision Dental Medicine, aimed at facilitating deeper understandings of the relationship between dental and overall health.

The College was among the first academic dental institutions to unify dental and medical patient records in the Epic EHR, officials said.

A few months later, Epic signed its first dental support organization, enabling data exchange for improved patient care.

ON THE RECORD

“With the rising awareness to integrate dental and medical care, matched EDR-EHR data is a rich resource to study the effect of oral health and dental treatments on overall health and vice versa,” said researchers in the Journal of Prosthodontics study.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.

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