Public Health Nutrition

Monitoring and surveillance

Severe tooth loss in older adults as a key indicator of compromised dietary quality

Margaret R Savocaa1 c1, Thomas A Arcurya2, Xiaoyan Lenga2, Haiying Chena2, Ronny A Bella2, Andrea M Andersona2, Teresa Kohrmana2, Rebecca J Fraziera1, Gregg H Gilberta3 and Sara A Quandta2

a1 Department of Nutrition, University of North Carolina at Greensboro, 309 Stone Building, Greensboro, NC 27402, USA

a2 Wake Forest University School of Medicine, Winston-Salem, NC, USA

a3 School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA


Objective Poor oral health influences the dietary quality of older individuals. The objective of the present study was to relate the number of teeth to adherence to the 2005 Dietary Guidelines for Americans among an ethnically diverse sample of older adults.

Design A block cluster design was used to obtain a sample of older adults. Data were weighted to census data for ethnicity and gender. Dietary intakes were assessed using an FFQ and converted into Healthy Eating Index-2005 (HEI-2005) scores.

Setting Two counties in North Carolina, USA, with large African-American and American Indian populations.

Subjects Community-dwelling older adults (N 635).

Results Three hundred and twenty-six participants had severe tooth loss (0–10 teeth remaining), compared with 305 participants with 11+ teeth. After controlling for socio-economic factors, those with 0–10 teeth had lower total HEI-2005 scores and consumed less Total Fruit, Meat and Beans, and Oils, and more energy from Solid Fat, Alcohol and Added Sugar, compared with those with 11+ teeth. Less than 1 % of those with 0–10 teeth and 4 % of those with 11+ teeth met overall HEI-2005 recommendations. Those with 0–10 teeth were less likely to eat recommended amounts of Total Vegetables, Dark Green and Orange Vegetables, and energy from Solid Fat, Alcohol and Added Sugar.

Conclusions Older adults with severe tooth loss are less likely than those with moderate to low tooth loss to meet current dietary recommendations. Nutrition interventions for older adults should take oral health status into consideration and include strategies that specifically address this as a barrier to healthful eating.

(Received December 18 2008)

(Accepted July 14 2009)

(Online publication August 20 2009)


c1 Corresponding author: Email