The Symbiotic Relationship between Oral Health, Nutrition, and Aging

Though aging is a continuous process that occurs in humans even in the absence of disease, disease processes, whether chronic or acute, may hasten aging. Many factors contribute to the variant aging processes in humans: they are subject to an uncontrolled genetic pool; existing medical and dental knowledge, changing interventions from one generation to the next; and advances in science that affect quality of life (i.e., access to adequate food supply and security; refrigeration and climate control; transportation systems; and advances in, and access to, new medications).Even if older adults have good general and oral health, aging cells become more susceptible to dysfunction or disease-organisms may experience a decrease in fat-free cell mass because of inefficient cell replacement. An organism's ability to adequately replace lost cells is partly related to ingesting the adequate protein, energy, vitamins, and minerals needed to generate new tissue. There are two interrelated factors involved in tissue regeneration: that of an adequate food supply and the ability to ingest, process, and absorb sources of required nutrients.Oral Health Status and NutritionIt is important to recognize that poor nutrition consumption contributes to poor oral health and, conversely, poor oral health leads to poor nutrition. This interdependent relationship between nutrition and oral health is particularly important for older adults. Oral health-as defined by the health of perioral tissues (i.e., relating to, occurring in, or referring to the tissues around the mouth), dentition status, masticatory efficiency, biting force, and tongue movement-is a key factor in an individual's ability to adequately consume a varied diet with a nutritionally dense dietary intake.Perioral tissue health significantly influences ingestion of a diet sufficient to sustain life and health. The presence of inflammation, sores, or other lesions around the mouth or oral mucosa hinders consumption of a varied diet, and foods that are acidic, fibrous, or have husks or seeds may be painful or difficult to eat. Healthy lip tissue and facial muscles are crucial to safe ingestion of food in the oral cavity; teeth then prepare the food for its first level of digestion.Tooth function and the digestive processFood often needs mechanical actions that take place when we eat, such as tearing, shredding, or grinding, to break down membranes and allow them to be exposed to digestive enzymes. Smaller pieces of food are easier to swallow and offer a greater surface area for exposure to these enzymes. Saliva is the first interface between food and digestive enzymes and advancing age affects its production, quantity, and composition (Cousson et al., 2012). The mouth actions mentioned above all require healthy teeth, and any edentulous person will have difficulty with them.Breaking down food before swallowing also enhances the hedonic senses of taste and smell that contribute to the enjoyment of a meal. Often, taking pleasure in food is not considered when addressing nutritional concerns, however, loss of taste or smell reduces the enjoyment and appeal of food and contributes to loss of appetite. The chewing surface of teeth may flatten with age, making chewing less effective in breaking down food. Innervation and tooth pulp may be reduced with advanced age and teeth may break, making chewing more difficult.Gums, bone health, and nutritionAging is associated with a loss of lean body mass (gum tissue) and a reduction of skeletal mass (bone). If the mouth's structure is altered by the reduction of gum tissue and a decrease in the bone structure that secures teeth, individuals may experience difficulty with chewing due to loose or missing teeth.Any lesions or sores in gum tissue, soft or hard palate, oral mucosa, infection, or inflammation are barriers to adequate nutritional intake. Inflammation and infection have been linked to disability, poor nutritional status, and cognitive function in older adults (Yu et al. …