The Impact of Dietary Intake and Nutritional Status on the Oral Health of Older Adults Living in Care Homes: A Scoping Review

Abstract

Objectives: To review the literature on the relationship between oral health, dietary intake, and nutritional status in older adults in care homes, identifying research gaps.

Background: Many older adults in care homes retain natural teeth but face oral health issues due to challenges in maintaining hygiene and limited dental care access. While the provided diet aims to prevent frailty, it may contain high levels of sugars and fermentable carbohydrates, which can contribute to oral health issues such as dental caries and periodontal disease.

Methods: A scoping review was conducted following PRISMA-ScR guidelines. MEDLINE, CINAHL, Web of Science, and EMBASE were searched to answer, "What is known about the relationship between dietary intake, nutritional status and oral health in older adults in care homes?."

Results: Forty-nine studies (1989-2024) addressed this relationship, with most studies being cross-sectional (n = 43), including two qualitative and one mixed-method study; six were longitudinal, including one interventional. Findings highlighted the negative impact of oral health problems-xerostomia, dysphagia, and chewing issues-on dietary intake and nutritional status, while interventions like denture provision and professional tooth brushing had positive effects. Longitudinal studies emphasised the harm of sugar intake on oral health, with additional factors like dementia, resident dependency, and staffing issues adversely affecting both oral health and nutrition.

Conclusions: This review highlights the complex relationship between oral health, diet, and nutrition in care homes, emphasising gaps in research on the impact of dietary intake, particularly sugar consumption, on oral health, as well as limitations in study designs.

Keywords: care homes; dietary intake; nutritional status; older adults; oral health.