Relation between oral health and nutritional condition in the elderly
Identifieur interne : 002F69 ( Pmc/Corpus ); précédent : 002F68; suivant : 002F70Relation between oral health and nutritional condition in the elderly
Auteurs : Humberto Lauro Rodrigues Junior ; Miriam F. Zaccaro Scelza ; Gilson Teles Boaventura ; Silvia Maria Cust Dio ; Emília Addison Machado Moreira ; Diane De Lima OliveiraSource :
- Journal of Applied Oral Science [ 1678-7757 ] ; 2012.
Abstract
Oral health is a prerequisite for a good chewing function, which may have an impact on food choices and nutritional well-being.
This study was designed to evaluate the relationship between oral health status and nutritional status in the elderly.
In this cross-sectional study, 33 elderly people from the Group for the Elderly Interdisciplinary Geriatrics and Gerontology Program, at Fluminense Federal University, Niteroi, RJ, Brazil, completed a questionnaire to collect information on socioeconomic status, eating habits, physical activity and health habits, undertook a clinical oral examination, blood test, and anthropometric measurements, and were allocated into groups according to age. The oral health status was assessed using the index for decayed, missing and filled teeth (DMFT). The nutritional status was assessed using hemoglobin, hematocrit and albumin concentrations in blood, anthropometric values and the body mass index.
Tooth loss was the biggest nuisance to the elderly subjects (57.6%), followed by the use of dentures (30.3%) and ill-fitting dentures (33.3%). 66.6% of patients had difficulty in chewing, and 54.5% reported this to be due to prostheses and 13.6% to the absence of teeth. A significant correlation was found between DMFT and the value of suprailiac skinfold thickness (rho=0.380, p=0.029).
The results support the temporal association between tooth loss and detrimental changes in anthropometry, which could contribute to increased risk of developing chronic diseases.
Url:
DOI: 10.1590/S1678-77572012000100008
PubMed: 22437676
PubMed Central: 3928770
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Relation between oral health and nutritional condition in the
elderly</title><author><name sortKey="Rodrigues Junior, Humberto Lauro" sort="Rodrigues Junior, Humberto Lauro" uniqKey="Rodrigues Junior H" first="Humberto Lauro" last="Rodrigues Junior">Humberto Lauro Rodrigues Junior</name><affiliation><nlm:aff id="aff01"> DDS, Graduate student, Master's degree Program in Dentistry, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Scelza, Miriam F Zaccaro" sort="Scelza, Miriam F Zaccaro" uniqKey="Scelza M" first="Miriam F. Zaccaro" last="Scelza">Miriam F. Zaccaro Scelza</name><affiliation><nlm:aff id="aff02"> DDS, MSD, PhD, Associate Professor, Department of Endodontics and Geriatric Dentistry, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Boaventura, Gilson Teles" sort="Boaventura, Gilson Teles" uniqKey="Boaventura G" first="Gilson Teles" last="Boaventura">Gilson Teles Boaventura</name><affiliation><nlm:aff id="aff03"> PhD, Associate Professor, Department of Nutrition and Dietary, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Cust Dio, Silvia Maria" sort="Cust Dio, Silvia Maria" uniqKey="Cust Dio S" first="Silvia Maria" last="Cust Dio">Silvia Maria Cust Dio</name><affiliation><nlm:aff id="aff03"> PhD, Associate Professor, Department of Nutrition and Dietary, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Moreira, Emilia Addison Machado" sort="Moreira, Emilia Addison Machado" uniqKey="Moreira E" first="Emília Addison Machado" last="Moreira">Emília Addison Machado Moreira</name><affiliation><nlm:aff id="aff04"> PhD, Full Professor, Department of Nutrition and Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, SC, Brazil</nlm:aff></affiliation></author><author><name sortKey="Oliveira, Diane De Lima" sort="Oliveira, Diane De Lima" uniqKey="Oliveira D" first="Diane De Lima" last="Oliveira">Diane De Lima Oliveira</name><affiliation><nlm:aff id="aff05"> Graduate student of Program in Nutrition, Federal University of Santa Catarina, Florianópolis, SC, Brazil.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22437676</idno><idno type="pmc">3928770</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928770</idno><idno type="RBID">PMC:3928770</idno><idno type="doi">10.1590/S1678-77572012000100008</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">002F69</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002F69</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Relation between oral health and nutritional condition in the
elderly</title><author><name sortKey="Rodrigues Junior, Humberto Lauro" sort="Rodrigues Junior, Humberto Lauro" uniqKey="Rodrigues Junior H" first="Humberto Lauro" last="Rodrigues Junior">Humberto Lauro Rodrigues Junior</name><affiliation><nlm:aff id="aff01"> DDS, Graduate student, Master's degree Program in Dentistry, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Scelza, Miriam F Zaccaro" sort="Scelza, Miriam F Zaccaro" uniqKey="Scelza M" first="Miriam F. Zaccaro" last="Scelza">Miriam F. Zaccaro Scelza</name><affiliation><nlm:aff id="aff02"> DDS, MSD, PhD, Associate Professor, Department of Endodontics and Geriatric Dentistry, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Boaventura, Gilson Teles" sort="Boaventura, Gilson Teles" uniqKey="Boaventura G" first="Gilson Teles" last="Boaventura">Gilson Teles Boaventura</name><affiliation><nlm:aff id="aff03"> PhD, Associate Professor, Department of Nutrition and Dietary, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Cust Dio, Silvia Maria" sort="Cust Dio, Silvia Maria" uniqKey="Cust Dio S" first="Silvia Maria" last="Cust Dio">Silvia Maria Cust Dio</name><affiliation><nlm:aff id="aff03"> PhD, Associate Professor, Department of Nutrition and Dietary, Fluminense Federal University, Niterói, RJ, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Moreira, Emilia Addison Machado" sort="Moreira, Emilia Addison Machado" uniqKey="Moreira E" first="Emília Addison Machado" last="Moreira">Emília Addison Machado Moreira</name><affiliation><nlm:aff id="aff04"> PhD, Full Professor, Department of Nutrition and Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, SC, Brazil</nlm:aff></affiliation></author><author><name sortKey="Oliveira, Diane De Lima" sort="Oliveira, Diane De Lima" uniqKey="Oliveira D" first="Diane De Lima" last="Oliveira">Diane De Lima Oliveira</name><affiliation><nlm:aff id="aff05"> Graduate student of Program in Nutrition, Federal University of Santa Catarina, Florianópolis, SC, Brazil.</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Applied Oral Science</title><idno type="ISSN">1678-7757</idno><idno type="eISSN">1678-7765</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Oral health is a prerequisite for a good chewing function, which may have an impact
on food choices and nutritional well-being.</p><sec><title>Objective</title><p>This study was designed to evaluate the relationship between oral health status
and nutritional status in the elderly. </p></sec><sec><title>Material and Methods</title><p>In this cross-sectional study, 33 elderly people from the Group for the Elderly
Interdisciplinary Geriatrics and Gerontology Program, at Fluminense Federal
University, Niteroi, RJ, Brazil, completed a questionnaire to collect information
on socioeconomic status, eating habits, physical activity and health habits,
undertook a clinical oral examination, blood test, and anthropometric
measurements, and were allocated into groups according to age. The oral health
status was assessed using the index for decayed, missing and filled teeth (DMFT).
The nutritional status was assessed using hemoglobin, hematocrit and albumin
concentrations in blood, anthropometric values and the body mass index. </p></sec><sec><title>Results</title><p>Tooth loss was the biggest nuisance to the elderly subjects (57.6%), followed by
the use of dentures (30.3%) and ill-fitting dentures (33.3%). 66.6% of patients
had difficulty in chewing, and 54.5% reported this to be due to prostheses and
13.6% to the absence of teeth. A significant correlation was found between DMFT
and the value of suprailiac skinfold thickness (rho=0.380, p=0.029). </p></sec><sec><title>Conclusion</title><p>The results support the temporal association between tooth loss and detrimental
changes in anthropometry, which could contribute to increased risk of developing
chronic diseases.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Andrade, Fb" uniqKey="Andrade F">FB Andrade</name></author><author><name sortKey="Franca Caldas, A" uniqKey="Franca Caldas A">A França Caldas</name></author><author><name sortKey="Kitoko, Pm" uniqKey="Kitoko P">PM Kitoko</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barbosa, Ar" uniqKey="Barbosa A">AR Barbosa</name></author><author><name sortKey="Souza, Jmp" uniqKey="Souza J">JMP Souza</name></author><author><name sortKey="Lebrao, Ml" uniqKey="Lebrao M">ML Lebrão</name></author><author><name sortKey="Laurenti, R" uniqKey="Laurenti R">R Laurenti</name></author><author><name sortKey="Marucci, Mfn" uniqKey="Marucci M">MFN Marucci</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Collins, N" uniqKey="Collins N">N 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Appl Oral Sci</journal-id><journal-id journal-id-type="iso-abbrev">J Appl Oral Sci</journal-id><journal-id journal-id-type="publisher-id">J. Appl. Oral. Sci.</journal-id><journal-title-group><journal-title>Journal of Applied Oral Science</journal-title></journal-title-group><issn pub-type="ppub">1678-7757</issn><issn pub-type="epub">1678-7765</issn><publisher><publisher-name>Faculdade de Odontologia de Bauru da Universidade de São
Paulo</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22437676</article-id><article-id pub-id-type="pmc">3928770</article-id><article-id pub-id-type="doi">10.1590/S1678-77572012000100008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Relation between oral health and nutritional condition in the
elderly</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>RODRIGUES JUNIOR</surname><given-names>Humberto Lauro</given-names></name><xref ref-type="aff" rid="aff01">1</xref></contrib><contrib contrib-type="author"><name><surname>SCELZA</surname><given-names>Miriam F. Zaccaro</given-names></name><xref ref-type="aff" rid="aff02">2</xref><xref ref-type="corresp" rid="c01"></xref></contrib><contrib contrib-type="author"><name><surname>BOAVENTURA</surname><given-names>Gilson Teles</given-names></name><xref ref-type="aff" rid="aff03">3</xref></contrib><contrib contrib-type="author"><name><surname>CUSTÓDIO</surname><given-names>Silvia Maria</given-names></name><xref ref-type="aff" rid="aff03">3</xref></contrib><contrib contrib-type="author"><name><surname>MOREIRA</surname><given-names>Emília Addison Machado</given-names></name><xref ref-type="aff" rid="aff04">4</xref></contrib><contrib contrib-type="author"><name><surname>OLIVEIRA</surname><given-names>Diane de Lima</given-names></name><xref ref-type="aff" rid="aff05">5</xref></contrib></contrib-group><aff id="aff01"><label>1</label> DDS, Graduate student, Master's degree Program in Dentistry, Fluminense Federal University, Niterói, RJ, Brazil.</aff><aff id="aff02"><label>2</label> DDS, MSD, PhD, Associate Professor, Department of Endodontics and Geriatric Dentistry, Fluminense Federal University, Niterói, RJ, Brazil.</aff><aff id="aff03"><label>3</label> PhD, Associate Professor, Department of Nutrition and Dietary, Fluminense Federal University, Niterói, RJ, Brazil.</aff><aff id="aff04"><label>4</label> PhD, Full Professor, Department of Nutrition and Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, SC, Brazil</aff><aff id="aff05"><label>5</label> Graduate student of Program in Nutrition, Federal University of Santa Catarina, Florianópolis, SC, Brazil.</aff><author-notes><corresp id="c01"><bold>Corresponding address:</bold> Miriam F. Zaccaro Scelza - Av. 28 de Setembro nº
44 - sala 704 - Vila Isabel - 20551-031 - Rio de Janeiro - Brazil - Phone: 55 21
22340901 - e-mail: <email>scelza@terra.com.br</email></corresp></author-notes><pub-date pub-type="ppub"><season>Jan-Feb</season><year>2012</year></pub-date><volume>20</volume><issue>1</issue><fpage>38</fpage><lpage>44</lpage><history><date date-type="received"><day>02</day><month>11</month><year>2009</year></date><date date-type="rev-recd"><day>21</day><month>2</month><year>2010</year></date><date date-type="accepted"><day>30</day><month>5</month><year>2010</year></date></history><permissions><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative
Commons Attribution Non-Commercial License which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the
original work is properly cited. </license-p></license></permissions><abstract><p>Oral health is a prerequisite for a good chewing function, which may have an impact
on food choices and nutritional well-being.</p><sec><title>Objective</title><p>This study was designed to evaluate the relationship between oral health status
and nutritional status in the elderly. </p></sec><sec><title>Material and Methods</title><p>In this cross-sectional study, 33 elderly people from the Group for the Elderly
Interdisciplinary Geriatrics and Gerontology Program, at Fluminense Federal
University, Niteroi, RJ, Brazil, completed a questionnaire to collect information
on socioeconomic status, eating habits, physical activity and health habits,
undertook a clinical oral examination, blood test, and anthropometric
measurements, and were allocated into groups according to age. The oral health
status was assessed using the index for decayed, missing and filled teeth (DMFT).
The nutritional status was assessed using hemoglobin, hematocrit and albumin
concentrations in blood, anthropometric values and the body mass index. </p></sec><sec><title>Results</title><p>Tooth loss was the biggest nuisance to the elderly subjects (57.6%), followed by
the use of dentures (30.3%) and ill-fitting dentures (33.3%). 66.6% of patients
had difficulty in chewing, and 54.5% reported this to be due to prostheses and
13.6% to the absence of teeth. A significant correlation was found between DMFT
and the value of suprailiac skinfold thickness (rho=0.380, p=0.029). </p></sec><sec><title>Conclusion</title><p>The results support the temporal association between tooth loss and detrimental
changes in anthropometry, which could contribute to increased risk of developing
chronic diseases.</p></sec></abstract><kwd-group><kwd>Oral health</kwd><kwd>Elderly</kwd><kwd>Aging health</kwd><kwd>Nutritional status</kwd><kwd>Geriatric dentistry</kwd></kwd-group></article-meta></front><body><sec><title>INTRODUCTION</title><p>Oral health is a prerequisite for a good chewing function, which may have an impact on
food choice and nutritional well-being<sup><xref rid="r16" ref-type="bibr">16</xref>,<xref rid="r22" ref-type="bibr">22</xref></sup>. A variety of oral
conditions can lead to an inadequate nutritional status, including tooth loss, pain and
discomfort associated with caries, periodontal disease and ill-fitted dentures<sup><xref rid="r22" ref-type="bibr">22</xref></sup>. The absence of teeth in particular can
affect the digestive capacity and nutritional status of the individual. Furthermore, the
selection of food can be impaired due to the reduced masticatory capacity of the
individual, leading to a restricted intake of fiber- and protein-containing
foods<sup><xref rid="r21" ref-type="bibr">21</xref></sup>. The presence of natural
teeth and well-fit dentures has been linked to an increased variety of foods and
nutrient intake, which will contribute to the consumption of a diet rich in
fiber<sup><xref rid="r11" ref-type="bibr">11</xref></sup>.</p><p>Maintaining an adequate nutritional status is important because an inadequate health
status can lead to either underweight, which increases the risk of infections and
mortality<sup><xref rid="r27" ref-type="bibr">27</xref></sup>, or possible
overweight, which increases the risk of chronic diseases such as hypertension and
diabetes<sup><xref rid="r12" ref-type="bibr">12</xref>,<xref rid="r25" ref-type="bibr">25</xref></sup>.</p><p>The relationship between oral health and nutritional health in the elderly is complex
and controversial, and current understanding of it is limited<sup><xref rid="r21" ref-type="bibr">21</xref></sup>. The aim of this study was to evaluate the relationship
between oral health status and nutritional status of non-institutionalized elderly
individuals.</p></sec><sec sec-type="materials|methods"><title>MATERIAL AND METHODS</title><p>This investigation was conducted from May to August 2009 by the Group for the Elderly
Interdisciplinary Geriatrics and Gerontology Program of the Fluminense Federal
University, RJ, Brazil. The study plan had been approved by the Ethics Committee of the
University, in accordance with the World Medical Association's Declaration of
Helsinki<sup><xref rid="r28" ref-type="bibr">28</xref></sup> (2000). Thirty-three
independent elderly subjects of both genders were studied from a total of 100
individuals, aged 60 years old or over, the cut-off point for the definition of
"elderly" recommended by the World Health Organization (WHO)<sup><xref rid="r24" ref-type="bibr">24</xref></sup> (1989). The subjects were previously informed of the
aims of the study, and consent forms were explained, read and signed by all the
participants. For illiterate or low-reading level subjects, consent was obtained through
their legal representatives. Excluded from the study were those individuals that were
not in good enough physical and/or mental condition to participate in the collection of
data, for example: those confined to wheelchairs, amputees, or those with problems of
understanding that would prevent the measurements used in the study from being taken.
The sample was divided into two groups, the Young Senior Group (YSG), with age not
exceeding 70 years, and the Elderly Senior Group (ESG), aged over 70 years.</p><p>The evaluation of oral health status included the identification of decayed, missing,
and filled teeth, and the presence of prostheses. The oral examination was conducted in
daylight according to biosecurity standards and the findings reported in an odontogram
as recommended by the WHO<sup><xref rid="r26" ref-type="bibr">26</xref></sup> (1997).
The index of decayed, missing and filled teeth (DMFT) was used due to its recommendation
by the WHO<sup><xref rid="r26" ref-type="bibr">26</xref></sup> (1997) to measure and
compare the experience of dental caries in populations. For comparison and analysis of
results the cut-off values used were those obtained from the Oral Health Survey of 2003
for the elderly age group (65 to 74 years) carried out in the Southeast region of
Brazil<sup><xref rid="r03" ref-type="bibr">3</xref></sup>. The mean DMFT for this
region was 28.61±6.44 which meant that dental health was satisfactory, this being
defined when DMFT ≤22.17, with dental health status considered poor when DMFT
>22.17<sup><xref rid="r03" ref-type="bibr">3</xref></sup>. By transforming the
DMFT index in Decayed (D), Missing (M) and Filled (F) the cut-off point was the average
found in the Southeast where oral health status had satisfactory values of D>0.60,
M>27.05 and F=0.91, and oral health status was poor with D>0.60, M>27.05 and
F>0.91<sup><xref rid="r03" ref-type="bibr">3</xref></sup>. The Kappa test was
used to lend a greater reliability to the data collected, and the value of k was
=0.9129, with a p-value below 0.01%. The importance of this test is that it shows that
the value of K was significantly different from zero and this association is classified
as "excellent". Other data on the oral health status were obtained with direct questions
about intake of types of food and perception of the quality of dental
prostheses<sup><xref rid="r03" ref-type="bibr">3</xref></sup>.</p><p>To assess nutritional status anthropometric measurements such as weight, height, arm
circumference (AC), triceps skinfold thickness (TST), subscapular skinfold thickness
(SST), suprailiac skinfold thickness (SIT), and waist circumference (WC) were measured
by a trained professional according to the techniques recommended by the WHO<sup><xref rid="r27" ref-type="bibr">27 </xref></sup>(1995) for adults and the elderly.
Weight (kg) was measured with a Filizola<sup>®</sup> balance (São Paulo, SP, Brazil),
with the patient wearing minimal clothing and barefoot. The height, in meters, was
measured by a stadiometer attached to the balance. The Body Mass Index (BMI) was
determined by the weight (kg) and height squared (m). The diagnosis of nutritional
status according to BMI was classified according to criteria established by the
WHO<sup><xref rid="r25" ref-type="bibr">25</xref></sup> (2000), used for adults
and elderly individuals, as normal weight (18.5 to 24.9 kg/m<sup>2</sup>), overweight
(25-29.9 kg/m<sup>2</sup>), obesity class I (30-34.9 kg/m<sup>2</sup>), obesity class II
(35-39.9 kg/m<sup>2</sup>) and obesity class III (>40 kg/m<sup>2</sup>). The AC was
measured with the arm extended horizontally to the average level of the arm. The
examiner was positioned to the side and passed the graduated, flexible and inelastic
tape, with an accuracy of 0.1 cm, around the arm. The cut-off indicates as high values
>29.9 mm for women and >30.7 mm for men<sup><xref rid="r06" ref-type="bibr">6</xref></sup>. All skinfolds were measured using the Lange skinfold caliper
(Lange, Beta Technology Incorporated<sup>®</sup>, Santa Cruz, CA, USA), with constant
pressure of 10 g/mm and an accuracy of 1 mm. The triceps skinfold thickness (TST) was
measured in the upper arm 1 cm above the midpoint of a line joining the acromion to the
olecranon. The cut-off values indicate as high those values >24.0 mm for women and
>11.0 mm for males<sup><xref rid="r06" ref-type="bibr">6</xref></sup>. The SST was
measured on the left side with the arm in front of the body. The fold is measured at the
inferior angle of the scapula, separating the muscle tissue. The cut-off point indicates
as high values >19.8 mm for females and >17.4 mm for males<sup><xref rid="r23" ref-type="bibr">23</xref></sup>. The suprailiac skinfold thickness (SIT)
was obtained with the right arm slightly away from the body, moving a fold of skin and
fat away from the mid-axillary line and the iliac crest, in the oblique
direction<sup><xref rid="r10" ref-type="bibr">10</xref></sup>. The cut-off point
indicates as high values >19.8 mm for females and >17.9 mm for males<sup><xref rid="r23" ref-type="bibr">23</xref></sup>. The bicipital skinfold thickness (BST)
was measured by moving a fold of skin and fat over the biceps muscle in a vertical
direction (midline)<sup><xref rid="r10" ref-type="bibr">10</xref></sup>. Values >11.8
mm for women and >6.4 mm for men are considered as high<sup><xref rid="r23" ref-type="bibr">23</xref></sup>. The WC was measured at the edge of the iliac crest, in
centimeters, using a tape measure belt. The cut-off points established by the
WHO<sup><xref rid="r25" ref-type="bibr">25</xref></sup> (2000) both for adults and
for the elderly were employed: men with WC between 94 and 101.9 cm and women with WC
between 80.0 and 87.9 cm are classified as being overweight and at increased risk for
complications associated with obesity, while men with WC>102.0 cm and women with
WC>88.0 cm are classified as obese and presenting a much greater risk for metabolic
complications associated with obesity. The percentage of body fat (%BF) was determined
using the sum of skinfolds: TST, BST, SST, SIT<sup><xref rid="r13" ref-type="bibr">13</xref></sup>, with a cut-off percentage for women of greater than 33% and for
men a percentage above 22%<sup><xref rid="r09" ref-type="bibr">9</xref></sup>.</p><p>The nutritional status was also evaluated through the analysis of albumin, hematocrit
and hemoglobin. The level of albumin in blood was verified by a bromocresol green
colorimetric method using the kit Bioclin<sup>®</sup> (Bioclin, Quibasa Química Básica
Ltda, Belo Horizonte, MG, Brazil), with reference values from 3.5 to 5.5 g/dL
(BIOSPECTRO<sup>®</sup>, SP 220). The hematocrit was measured by the capillary tube
method, with reference values of 37% to 47% for women and 40% to 54% for men (MICROSPIN,
Mod Spin 1000). A colorimetric method was employed to measure hemoglobin
(BIOSPECTRO<sup>®</sup>, SP 220), with reference values of 11.5 g/ dL to 15.5 g/ dL
for women and 12.5 g/dL to 17.5 g/dL for men (Bioclin<sup>®</sup>).</p><p>The data obtained were presented in descriptive form as mean, standard deviation and
percentage. For comparison of continuous variables between the two groups, we used
Student's <italic>t</italic> test for independent samples or the Mann-Whitney test. To
examine the correlations between continuous variables we used Pearson's correlation test
or Spearman's. For the correlations between variables, we used Fischer's exact test.</p></sec><sec sec-type="results"><title>RESULTS</title><p>The elderly patients evaluated had an mean age of 71.7±5.35 years, and were divided into
2 groups: Young Senior Group (YSG), with 13 individuals (39.4%), and the Elderly Senior
Group (ESG) with 20 (60.6%); 97% of subjects were female and 3% were male.</p><p>The average DMFT was calculated for both groups: YSG=20.60±6.17 and ESG=21.44±7.26. On
closer examination of this index it was found that the means for decayed (0.75±1.84,
p=0.274) and missing teeth (20.06±9.27, p=0.808) were higher in the ESG. The mean value
for filled teeth found in the ESG (0.62±1.54, p=0.464) was lower than that found in the
YSG. The average number of teeth in the mouth was higher in the YSG, although there were
no statistically significant differences between the groups (<xref ref-type="table" rid="t01">Table 1</xref>).</p><table-wrap id="t01" orientation="portrait" position="float"><label>Table 1</label><caption><p>Distribution of the sample in the Young Senior Group (YSG), with age equal to or
less than 70 years, and the Elderly Senior Group (ESG), aged more than 70 years,
by the DMFT index. (Results are mean±standard deviation. DMFT=decayed,
missing and filled teeth. Mann-Whitney test)</p></caption><table frame="hsides" rules="groups"><thead><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"><bold>ALL (n=33)</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>YSG ≤70 years(n=13)</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>ESG >70 years (n=20)</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>P</bold></td></tr></thead><tbody><tr><td align="center" rowspan="1" colspan="1">DMFT</td><td align="center" rowspan="1" colspan="1">20.19±7.97</td><td align="center" rowspan="1" colspan="1">20.60±6.17</td><td align="center" rowspan="1" colspan="1">21.44±7.26</td><td align="center" rowspan="1" colspan="1">0.955</td></tr><tr style="background-color:#CCCCCC"><td align="center" rowspan="1" colspan="1">Decayed</td><td align="center" rowspan="1" colspan="1"> 0.53±1.50</td><td align="center" rowspan="1" colspan="1"> 0.20±0.63</td><td align="center" rowspan="1" colspan="1"> 0.75±1.84</td><td align="center" rowspan="1" colspan="1">0.274</td></tr><tr><td align="center" rowspan="1" colspan="1">Missing</td><td align="center" rowspan="1" colspan="1">19.65±8.75</td><td align="center" rowspan="1" colspan="1">19.00±8.28</td><td align="center" rowspan="1" colspan="1">20.06±9.27</td><td align="center" rowspan="1" colspan="1">0.808</td></tr><tr style="background-color:#CCCCCC"><td align="center" rowspan="1" colspan="1">Filled</td><td align="center" rowspan="1" colspan="1"> 0.92±1.95</td><td align="center" rowspan="1" colspan="1"> 1.40±2.50</td><td align="center" rowspan="1" colspan="1"> 0.62±1.54</td><td align="center" rowspan="1" colspan="1">0.464</td></tr><tr><td align="center" rowspan="1" colspan="1">Nº of teeth</td><td align="center" rowspan="1" colspan="1"> 8.00±8.63</td><td align="center" rowspan="1" colspan="1"> 8.90±8.15</td><td align="center" rowspan="1" colspan="1"> 7.43±9.14</td><td align="center" rowspan="1" colspan="1">0.957</td></tr></tbody></table></table-wrap><p>The mean body mass index (BMI) of 30.17±5.38 kg/m<sup>2</sup> for the YSG classified
them as overweight, while the ESG was of normal weight, with an average BMI of
27.21±4.11 kg/m<sup>2</sup>. The AC and BST values were elevated in both groups, with
average values of 31.64±4.66 cm and 14.55±7.96 mm, respectively. Of the indicators SST
(19.26±6.15 mm) and SIT (19.62±9.85 mm) among individuals classified as overweight in
the YSG, a significant difference was noted in the values of SST compared to the ESG
(p=0.022). According to the WC of the YSG, calculated to be 97.93±14.08 cm, this group
is classified as overweight and at increased risk for complications associated with
obesity. Similarly, the percentage of body fat (% BF) was elevated in the YSG, with a
mean of 37.70±5.95%. On this indicator the ESG also showed a raised value (34.64±6.15%).
The biochemical indicators blood albumin, hematocrit and hemoglobin were within normal
limits, with no differences between groups (<xref ref-type="table" rid="t02">Table
2</xref>).</p><table-wrap id="t02" orientation="portrait" position="float"><label>Table 2</label><caption><p>Distribution of the sample in the Young Senior Group (YSG), aged less than 70
years, and the Elderly Senior Group (ESG), aged more than 70 years, by
anthropometric indicators and clinical evaluation. (Student's Unpaired t test;
Significant with * p<0.05). Results are expressed as means ± standard
deviations</p></caption><table frame="hsides" rules="groups"><thead><tr align="center" style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1"><bold>Variables</bold></td><td valign="top" rowspan="1" colspan="1"><bold>ALL (n=33)</bold></td><td valign="top" rowspan="1" colspan="1"><bold>YSG ≤70 years(n=13)</bold></td><td valign="top" rowspan="1" colspan="1"><bold>ESG >70 years(n=20)</bold></td><td valign="top" rowspan="1" colspan="1"><bold>p</bold></td></tr></thead><tbody><tr><td valign="top" rowspan="1" colspan="1">Weight (kg) </td><td align="center" rowspan="1" colspan="1"> 65.8±12.80</td><td align="center" rowspan="1" colspan="1"> 70.7±14.5</td><td align="center" rowspan="1" colspan="1">62.60±10.8</td><td align="center" rowspan="1" colspan="1">0.176</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Body Mass Index (kg/m<sup>2</sup>) </td><td align="center" rowspan="1" colspan="1">28.8±4.80</td><td align="center" rowspan="1" colspan="1">30.17±5.38</td><td align="center" rowspan="1" colspan="1">27.21±4.11</td><td align="center" rowspan="1" colspan="1">0.142</td></tr><tr><td valign="top" rowspan="1" colspan="1">Arm circumference (cm) </td><td align="center" rowspan="1" colspan="1">31.64±4.66</td><td align="center" rowspan="1" colspan="1">33.23±5.43</td><td align="center" rowspan="1" colspan="1">30.93±3.72</td><td align="center" rowspan="1" colspan="1">0.200</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Triceps skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">20.19±6.26</td><td align="center" rowspan="1" colspan="1">21.23±6.52</td><td align="center" rowspan="1" colspan="1">19.70±6.26</td><td align="center" rowspan="1" colspan="1">0.567</td></tr><tr><td valign="top" rowspan="1" colspan="1">Bicipital skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">14.55±7.96</td><td align="center" rowspan="1" colspan="1">16.58±8.45</td><td align="center" rowspan="1" colspan="1">13.88±7.18</td><td align="center" rowspan="1" colspan="1">0.287</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Subscapular skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">16.29±6.88</td><td align="center" rowspan="1" colspan="1">19.26±6.15</td><td align="center" rowspan="1" colspan="1">15.06±6.17</td><td align="center" rowspan="1" colspan="1"> 0.022*</td></tr><tr><td valign="top" rowspan="1" colspan="1">Suprailiac skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">16.05±8.68</td><td align="center" rowspan="1" colspan="1">19.62±9.85</td><td align="center" rowspan="1" colspan="1">15.21±6.82</td><td align="center" rowspan="1" colspan="1">0.121</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Waist circumference (cm) </td><td align="center" rowspan="1" colspan="1"> 94.50±11.38</td><td align="center" rowspan="1" colspan="1">97.93±14.08</td><td align="center" rowspan="1" colspan="1">93.28±7.91</td><td align="center" rowspan="1" colspan="1">0.228</td></tr><tr><td valign="top" rowspan="1" colspan="1">% Body Fat </td><td align="center" rowspan="1" colspan="1">35.87±6.17</td><td align="center" rowspan="1" colspan="1">37.70±5.95</td><td align="center" rowspan="1" colspan="1">34.64±6.15</td><td align="center" rowspan="1" colspan="1">0.125</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Albumin </td><td align="center" rowspan="1" colspan="1"> 3.80±0.26</td><td align="center" rowspan="1" colspan="1"> 3.83±0.29</td><td align="center" rowspan="1" colspan="1"> 3.78±0.25</td><td align="center" rowspan="1" colspan="1">0.943</td></tr><tr><td valign="top" rowspan="1" colspan="1">Hematocrit (%) </td><td align="center" rowspan="1" colspan="1">40.06±3.15</td><td align="center" rowspan="1" colspan="1">39.61±3.64</td><td align="center" rowspan="1" colspan="1">40.36±2.83</td><td align="center" rowspan="1" colspan="1">0.516</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Hemoglobin (g/dL) </td><td align="center" rowspan="1" colspan="1">12.18±1.12</td><td align="center" rowspan="1" colspan="1">12.20±0.98</td><td align="center" rowspan="1" colspan="1">12.17±1.24</td><td align="center" rowspan="1" colspan="1">0.960</td></tr></tbody></table></table-wrap><p>The DMFT index was not significantly associated with the BMI (χ<sup>2</sup>=0.636,
p=0.364), blood albumin (χ<sup>2</sup>=0.185, p=0.508), hematocrit (χ<sup>2</sup>=1.102;
p=0.182) and hemoglobin (χ<sup>2</sup>=0.016, p=0.714). However, 81.8% of patients were
overweight or obese; of these, 36.4% (n=12) had an unsatisfactory DMFT value (<xref ref-type="table" rid="t03">Table 3</xref>).</p><table-wrap id="t03" orientation="portrait" position="float"><label>Table 3</label><caption><p>Association between Body Mass Index (BMI), albumin, hematocrit, hemoglobin and
decayed (D), missing (M) and filled (F) teeth (DMFT). Fischer's exact test</p></caption><table frame="hsides" rules="groups"><thead><tr style="background-color:#CCCCCC"><td colspan="2" rowspan="3" align="center" valign="top"><bold>Variable</bold></td><td colspan="3" align="center" rowspan="1"><bold>BMI (kg/m<sup>2</sup>)</bold></td><td colspan="3" align="center" rowspan="1"><bold>Albumin (g/dL)</bold></td><td colspan="3" align="center" rowspan="1"><bold>Hematocrit (%)</bold></td><td colspan="3" align="center" rowspan="1"><bold>Hemoglobin (g/dL)</bold></td></tr><tr><td align="center" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td><td align="center" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td><td align="center" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td><td align="center" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td></tr><tr><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n (%)</bold></td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td></tr></thead><tbody><tr><td align="center" valign="top" rowspan="1" colspan="1">D </td><td align="center" valign="top" rowspan="1" colspan="1">Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">5 </td><td align="center" valign="top" rowspan="1" colspan="1">15 </td><td align="center" valign="top" rowspan="1" colspan="1">0.636</td><td align="center" valign="top" rowspan="1" colspan="1">18</td><td align="center" valign="top" rowspan="1" colspan="1">2 </td><td align="center" valign="top" rowspan="1" colspan="1">0.185</td><td align="center" valign="top" rowspan="1" colspan="1">18 </td><td align="center" valign="top" rowspan="1" colspan="1">2 </td><td align="center" valign="top" rowspan="1" colspan="1">1.102</td><td align="center" valign="top" rowspan="1" colspan="1">14 </td><td align="center" valign="top" rowspan="1" colspan="1">6 </td><td align="center" valign="top" rowspan="1" colspan="1">0.016</td></tr><tr><td align="center" valign="top" style="background-color:#FFFFFF" rowspan="1" colspan="1">M</td><td align="center" valign="top" rowspan="1" colspan="1"><22.17</td><td align="center" valign="top" rowspan="1" colspan="1">(15.2)</td><td align="center" valign="top" rowspan="1" colspan="1">(45.5)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> (54.5)</td><td align="center" valign="top" rowspan="1" colspan="1">(6.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(54.5)</td><td align="center" valign="top" rowspan="1" colspan="1">(6.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(42.4)</td><td align="center" valign="top" rowspan="1" colspan="1">(18.2)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td align="center" valign="top" style="background-color:#FFFFFF" rowspan="1" colspan="1">F</td><td align="center" valign="top" rowspan="1" colspan="1">Not Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">1 </td><td align="center" valign="top" rowspan="1" colspan="1">12 </td><td align="center" valign="top" rowspan="1" colspan="1">0.364</td><td align="center" valign="top" rowspan="1" colspan="1">13</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">0.508</td><td align="center" valign="top" rowspan="1" colspan="1">9 </td><td align="center" valign="top" rowspan="1" colspan="1">4 </td><td align="center" valign="top" rowspan="1" colspan="1">0.182</td><td align="center" valign="top" rowspan="1" colspan="1">8 </td><td align="center" valign="top" rowspan="1" colspan="1">5 </td><td align="center" valign="top" rowspan="1" colspan="1">0.714</td></tr><tr style="background-color:#CCCCCC"><td align="center" valign="top" style="background-color:#FFFFFF" rowspan="1" colspan="1">T</td><td align="center" valign="top" rowspan="1" colspan="1">≥22.17</td><td align="center" valign="top" rowspan="1" colspan="1">(3.0)</td><td align="center" valign="top" rowspan="1" colspan="1">(36.4)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> (39.4)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(27.3)</td><td align="center" valign="top" rowspan="1" colspan="1">(12.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(24.2)</td><td align="center" valign="top" rowspan="1" colspan="1">(15.2)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr><td rowspan="2" align="center" valign="top" style="background-color:#FFFFFF" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">2 </td><td align="center" valign="top" rowspan="1" colspan="1">16 </td><td align="center" valign="top" rowspan="1" colspan="1">0.707</td><td align="center" valign="top" rowspan="1" colspan="1">18 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">14 </td><td align="center" valign="top" rowspan="1" colspan="1">4 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">9 </td><td align="center" valign="top" rowspan="1" colspan="1">9 </td><td align="center" valign="top" rowspan="1" colspan="1">0.472</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1"><0.6</td><td align="center" valign="top" rowspan="1" colspan="1">(8.7)</td><td align="center" valign="top" rowspan="1" colspan="1">(69.6)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(78.3)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(60.9)</td><td align="center" valign="top" rowspan="1" colspan="1">(17.4)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(39.1)</td><td align="center" valign="top" rowspan="1" colspan="1">(39.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td rowspan="2" align="center" valign="top" style="background-color:#FFFFFF" colspan="1">D</td><td align="center" valign="top" rowspan="1" colspan="1">Not Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">2 </td><td align="center" valign="top" rowspan="1" colspan="1">3 -13</td><td align="center" valign="top" rowspan="1" colspan="1">0.194</td><td align="center" valign="top" rowspan="1" colspan="1">5 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">4 </td><td align="center" valign="top" rowspan="1" colspan="1">1 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">4 </td><td align="center" valign="top" rowspan="1" colspan="1">1 </td><td align="center" valign="top" rowspan="1" colspan="1">0.339</td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">≥0.6</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(8.7)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(21.7)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(17.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(4.3)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(17.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(4.3)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td></tr><tr><td rowspan="2" align="center" valign="top" style="background-color:#FFFFFF" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">3 </td><td align="center" valign="top" rowspan="1" colspan="1">12 </td><td align="center" valign="top" rowspan="1" colspan="1">0.045</td><td align="center" valign="top" rowspan="1" colspan="1">15</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">12 </td><td align="center" valign="top" rowspan="1" colspan="1">3 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">8 </td><td align="center" valign="top" rowspan="1" colspan="1">7 </td><td align="center" valign="top" rowspan="1" colspan="1">0.015</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1"><27.05</td><td align="center" valign="top" rowspan="1" colspan="1">(11.5)</td><td align="center" valign="top" rowspan="1" colspan="1">(46.2)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> (57.5)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(46.2)</td><td align="center" valign="top" rowspan="1" colspan="1">(11.5)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(30.8)</td><td align="center" valign="top" rowspan="1" colspan="1">(26.9)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td rowspan="2" align="center" valign="top" style="background-color:#FFFFFF" colspan="1">M</td><td align="center" valign="top" rowspan="1" colspan="1">Not Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">1 </td><td align="center" valign="top" rowspan="1" colspan="1">10 </td><td align="center" valign="top" rowspan="1" colspan="1">0.614</td><td align="center" valign="top" rowspan="1" colspan="1">11</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">8</td><td align="center" valign="top" rowspan="1" colspan="1">3 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">7 </td><td align="center" valign="top" rowspan="1" colspan="1">4 </td><td align="center" valign="top" rowspan="1" colspan="1">0.701</td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">≥27.05</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(3.8)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(38.5)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> (42.3)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> (30.8)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(11.5)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(26.9)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(15.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td></tr><tr><td rowspan="2" align="center" valign="top" style="background-color:#FFFFFF" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">1 </td><td align="center" valign="top" rowspan="1" colspan="1">17 </td><td align="center" valign="top" rowspan="1" colspan="1">2.234</td><td align="center" valign="top" rowspan="1" colspan="1">18 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">13</td><td align="center" valign="top" rowspan="1" colspan="1">5 </td><td align="center" valign="top" rowspan="1" colspan="1">0.122</td><td align="center" valign="top" rowspan="1" colspan="1">10 </td><td align="center" valign="top" rowspan="1" colspan="1">8 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1"><0.91</td><td align="center" valign="top" rowspan="1" colspan="1">(3.8)</td><td align="center" valign="top" rowspan="1" colspan="1">(65.4)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(69.2)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> (50.0)</td><td align="center" valign="top" rowspan="1" colspan="1">(19.2)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(38.5)</td><td align="center" valign="top" rowspan="1" colspan="1">(30.8)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr style="background-color:#CCCCCC"><td rowspan="2" align="center" valign="top" style="background-color:#FFFFFF" colspan="1">F</td><td align="center" valign="top" rowspan="1" colspan="1">Not Satisfactory </td><td align="center" valign="top" rowspan="1" colspan="1">3 </td><td align="center" valign="top" rowspan="1" colspan="1">5 </td><td align="center" valign="top" rowspan="1" colspan="1">0.072</td><td align="center" valign="top" rowspan="1" colspan="1">8 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">7 </td><td align="center" valign="top" rowspan="1" colspan="1">1 </td><td align="center" valign="top" rowspan="1" colspan="1">0.628</td><td align="center" valign="top" rowspan="1" colspan="1">5 </td><td align="center" valign="top" rowspan="1" colspan="1">3 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">≥0.91</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(11.5)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(19.2)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(30.8)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(26.9)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(3.8)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(19.2)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(11.5)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td></tr></tbody></table></table-wrap><p>In the evaluation of the oral health status, considering the use of ill-fitting dentures
(IFP), it was found that 54.5% of the subjects had an altered BMI (overweight or
obesity), therefore without any statistical significance (<xref ref-type="table" rid="t04">Table 4</xref>).</p><table-wrap id="t04" orientation="portrait" position="float"><label>Table 4</label><caption><p>Association between Body Mass Index (BMI), albumin, hematocrit, hemoglobin and
ill-fitting dentures (IFD) (no/yes), prosthesis making chewing difficult (PDC)
(yes/no) and avoidance of foods (AF) (yes/no). Fischer's exact test</p></caption><table frame="hsides" rules="groups"><thead><tr style="background-color:#CCCCCC"><td colspan="2" rowspan="3" align="center" valign="top"><bold>Variable</bold></td><td colspan="3" align="center" valign="top" rowspan="1"><bold>BMI
(kg/m<sup>2</sup>)</bold></td><td colspan="3" align="center" valign="top" rowspan="1"><bold>Albumin (g/dL)</bold></td><td colspan="3" align="center" valign="top" rowspan="1"><bold>Hematocrit (%)</bold></td><td colspan="3" align="center" valign="top" rowspan="1"><bold>Hemoglobin (g/dL)</bold></td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>Normal</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>Altered</bold></td><td align="center" valign="top" rowspan="1" colspan="1"><bold>c<sup>2</sup></bold></td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>n
(%)</bold></td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"><bold>p</bold></td></tr></thead><tbody><tr><td rowspan="2" align="center" valign="top" colspan="1">IFD</td><td rowspan="2" align="center" valign="top" colspan="1">No</td><td align="center" valign="top" rowspan="1" colspan="1">04 </td><td align="center" valign="top" rowspan="1" colspan="1">18</td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">20</td><td align="center" valign="top" rowspan="1" colspan="1">02 </td><td align="center" valign="top" rowspan="1" colspan="1">0.067</td><td align="center" valign="top" rowspan="1" colspan="1">18 </td><td align="center" valign="top" rowspan="1" colspan="1">04 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">12 </td><td align="center" valign="top" rowspan="1" colspan="1">10 </td><td align="center" valign="top" rowspan="1" colspan="1">2.881</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">(12.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> (54.5)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1"> (60.6)</td><td align="center" valign="top" rowspan="1" colspan="1">(6.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(54.5)</td><td align="center" valign="top" rowspan="1" colspan="1">(12.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(36.4)</td><td align="center" valign="top" rowspan="1" colspan="1">(30.3)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr><td rowspan="2" valign="top" colspan="1"> </td><td rowspan="2" align="center" valign="top" style="background-color:#CCCCCC" colspan="1">Yes</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">06 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">09 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">-</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">11 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">-</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">0.542</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">09 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">02</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">-</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">10</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">01 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">0.054</td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(18.2)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(27.3)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(33.3)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(27.3)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> (6.1)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> (30.3)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(3.0)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td></tr><tr><td rowspan="2" align="center" valign="top" colspan="1">PDC</td><td rowspan="2" align="center" valign="top" colspan="1">No</td><td align="center" valign="top" rowspan="1" colspan="1">02 </td><td align="center" valign="top" rowspan="1" colspan="1">14 </td><td align="center" valign="top" rowspan="1" colspan="1">0.136</td><td align="center" valign="top" rowspan="1" colspan="1">15 </td><td align="center" valign="top" rowspan="1" colspan="1">01 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">13 </td><td align="center" valign="top" rowspan="1" colspan="1">03 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">10 </td><td align="center" valign="top" rowspan="1" colspan="1">06 </td><td align="center" valign="top" rowspan="1" colspan="1">0.015</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">(6.1)</td><td align="center" valign="top" rowspan="1" colspan="1">(42.4)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(45.5)</td><td align="center" valign="top" rowspan="1" colspan="1">(3.0)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(39.4)</td><td align="center" valign="top" rowspan="1" colspan="1">(9.1)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(30.3)</td><td align="center" valign="top" rowspan="1" colspan="1">(18.2)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr><td rowspan="2" valign="top" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">Yes</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">04 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">13 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">0.656</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">16 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">01</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">-</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">14 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">03 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">-</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">12 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">05 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">0.721</td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(12.1)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(39.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(48.5)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> (3.0)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(42.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(9.1)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(36.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(15.2)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td></tr><tr><td rowspan="4" valign="top" colspan="1">AF </td><td align="center" valign="top" rowspan="1" colspan="1">No</td><td align="center" valign="top" rowspan="1" colspan="1">02 </td><td align="center" valign="top" rowspan="1" colspan="1">14 </td><td align="center" valign="top" rowspan="1" colspan="1">0.136</td><td align="center" valign="top" rowspan="1" colspan="1">15 </td><td align="center" valign="top" rowspan="1" colspan="1">01 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td><td align="center" valign="top" rowspan="1" colspan="1">12 </td><td align="center" valign="top" rowspan="1" colspan="1">04 </td><td align="center" valign="top" rowspan="1" colspan="1">0.285</td><td align="center" valign="top" rowspan="1" colspan="1">10 </td><td align="center" valign="top" rowspan="1" colspan="1">06 </td><td align="center" valign="top" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(6.1)</td><td align="center" valign="top" rowspan="1" colspan="1">(42.4)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(45.5)</td><td align="center" valign="top" rowspan="1" colspan="1">(3.0)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(36.4)</td><td align="center" valign="top" rowspan="1" colspan="1">(12.5)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td><td align="center" valign="top" rowspan="1" colspan="1">(30.3)</td><td align="center" valign="top" rowspan="1" colspan="1">(18.2)</td><td align="center" valign="top" rowspan="1" colspan="1"> </td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">Yes</td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1">04 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">13 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">0.656</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">16 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">01 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">-</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">15</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">02 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">0.398</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">12 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">05 </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" style="background-color:#CCCCCC" rowspan="1" colspan="1">(12.1)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(39.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(48.5)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(3.0)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> (45.5)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(6.1)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(36.4)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1">(15.2)</td><td align="center" valign="top" style="background-color:#CCCCCC" rowspan="1" colspan="1"> </td></tr></tbody></table></table-wrap><p>In relation to prostheses that make it difficult to chew (PDC), 17 patients (51.5%)
proved to be dissatisfied, and 13 (39.4%) had a change in their nutritional status
(χ<sup>2</sup>=0.136, p=0.656). As for the patients who avoided foods (AF), 17
(51.5%) were among those who had altered oral health status (<xref ref-type="table" rid="t04">Table 4</xref>). In evaluating the consistency of the food, it was found
that at least one third of the subjects prefer putty (n=12, 36.40%), soups (n=9,
27.30%), chopped (n=11, 33.30%), ground (n=11, 33.30%), crushed (n=12, 36.4%) or boiled
(n=10, 30.3%) food. Biochemical indicators such as blood albumin, hematocrit and
hemoglobin did not show any association with DMFT and its components decayed, missing
and filled teeth (<xref ref-type="table" rid="t03">Table 3</xref>), IFD, PDC and AF
(<xref ref-type="table" rid="t04">Table 4</xref>).</p><p>In the analysis of the BMI and the anthropometric and biochemical markers, a significant
correlation was found between BMI and the variables AC (r=0.942, p<0.001), TST
(r=0.740, p<0.001), BST (r=0.669, p<0.001), SST (r=0.847, p<0.001), SIT
(r=0.828, p<0.001) and WC (r=0.868, p<0.001). The DMFT index was correlated
significantly only with the variable suprailiac skinfold thickness (SIT) (rho=0.380,
p=0.029) (<xref ref-type="table" rid="t05">Table 5</xref>).</p><table-wrap id="t05" orientation="portrait" position="float"><label>Table 5</label><caption><p>Correlation between Body Mass Index (BMI) and decayed, missing and filled teeth
(DMFT) with anthropometric and clinical data. (<sup>§</sup>Pearson and
<sup>£</sup>Spearman correlation. Significant with * p<0.05)</p></caption><table frame="hsides" rules="groups"><thead><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>BMI<sup>§</sup></bold></td><td colspan="3" align="center" rowspan="1"><bold>DMFT<sup>£</sup></bold></td></tr><tr><td valign="top" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>r</bold></td><td align="center" rowspan="1" colspan="1"><bold>p</bold></td><td align="center" rowspan="1" colspan="1"><bold>rho</bold></td><td align="center" rowspan="1" colspan="1"><bold>p</bold></td></tr></thead><tbody><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Arm circumference (mm) </td><td align="center" rowspan="1" colspan="1">0.942</td><td align="center" rowspan="1" colspan="1"><0.001*</td><td align="center" rowspan="1" colspan="1">0.201</td><td align="center" rowspan="1" colspan="1">0.261</td></tr><tr><td valign="top" rowspan="1" colspan="1">Triceps skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">0.740</td><td align="center" rowspan="1" colspan="1"><0.001*</td><td align="center" rowspan="1" colspan="1">0.303</td><td align="center" rowspan="1" colspan="1">0.080</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Bicipital skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">0.669</td><td align="center" rowspan="1" colspan="1"><0.001*</td><td align="center" rowspan="1" colspan="1">-0.025</td><td align="center" rowspan="1" colspan="1">0.089</td></tr><tr><td valign="top" rowspan="1" colspan="1">Subscapular skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">0.847</td><td align="center" rowspan="1" colspan="1"><0.001*</td><td align="center" rowspan="1" colspan="1">0.177</td><td align="center" rowspan="1" colspan="1">0.323</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Suprailiac skinfold thickness (mm) </td><td align="center" rowspan="1" colspan="1">0.828</td><td align="center" rowspan="1" colspan="1"><0.001*</td><td align="center" rowspan="1" colspan="1">0.380</td><td align="center" rowspan="1" colspan="1"> 0.029*</td></tr><tr><td valign="top" rowspan="1" colspan="1">Waist circumference (mm) </td><td align="center" rowspan="1" colspan="1">0.868</td><td align="center" rowspan="1" colspan="1"><0.001*</td><td align="center" rowspan="1" colspan="1">0.193</td><td align="center" rowspan="1" colspan="1">0.282</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">% body fat </td><td align="center" rowspan="1" colspan="1">0.843</td><td align="center" rowspan="1" colspan="1">0.399</td><td align="center" rowspan="1" colspan="1">0.248</td><td align="center" rowspan="1" colspan="1">0.163</td></tr><tr><td valign="top" rowspan="1" colspan="1">Albumin (g/dL) </td><td align="center" rowspan="1" colspan="1">-0.065</td><td align="center" rowspan="1" colspan="1">0.719</td><td align="center" rowspan="1" colspan="1">0.246</td><td align="center" rowspan="1" colspan="1">0.167</td></tr><tr style="background-color:#CCCCCC"><td valign="top" rowspan="1" colspan="1">Hematocrit (%) </td><td align="center" rowspan="1" colspan="1">0.047</td><td align="center" rowspan="1" colspan="1">0.798</td><td align="center" rowspan="1" colspan="1">-0.244</td><td align="center" rowspan="1" colspan="1">0.178</td></tr><tr><td valign="top" rowspan="1" colspan="1">Hemoglobin (g/dL) </td><td align="center" rowspan="1" colspan="1">0.170</td><td align="center" rowspan="1" colspan="1">0.351</td><td align="center" rowspan="1" colspan="1">-0.154</td><td align="center" rowspan="1" colspan="1">0.400</td></tr></tbody></table></table-wrap></sec><sec sec-type="discussion"><title>DISCUSSION</title><p>In the present study, we found that changes in oral health can influence the diet,
reflecting in the nutritional status of the individual<sup><xref rid="r22" ref-type="bibr">22</xref></sup>. Review of the literature has shown that patients who
have marked loss of teeth may be prone to a decrease in the intake of foods with a heavy
consistency, which are a major source of vitamins, minerals, fiber and protein<sup><xref rid="r19" ref-type="bibr">19</xref>,<xref rid="r21" ref-type="bibr">21</xref></sup>. However, it is important to note that there are several factors
other than oral health status that influence food choice, such as personal preferences,
available food sources and dietary habits, as well as psychosocial and economic
factors<sup><xref rid="r19" ref-type="bibr">19</xref></sup>.</p><p>In relation to DMFT, the reference was to the southeast of the country, given that the
subjects were residents of the state of Rio de Janeiro. In the sample studied it was
found that both the YSG and ESG had DMFT values that were inferior to that observed in
the survey SB Brazil for Southeast, which was 28.61±6.44<sup><xref rid="r03" ref-type="bibr">3</xref></sup>. When stratifying the DMFT, the comparison of these
averages with the average value observed in the Southeast showed that only YSG presented
a lower value for decayed teeth. Regarding missing teeth, both the ESG and YSG had mean
values below that of the region. It was found that in the YSG the number of filled teeth
was not satisfactory. Although there was no significant difference in relation to filled
teeth between the YSG and ESG, it was found that the number of healthy teeth in the
mouth decreased with age. Similar findings were reported from a study involving elderly
individuals aged between 65 and 74, the youngest of whom (65 to 69 years) had a greater
number of teeth. On the other hand, the DMFT in that study was 26.2 and the missing
component accounted for 20.7 teeth<sup><xref rid="r17" ref-type="bibr">17</xref></sup>,
both values being higher than those found in the present study, where the DMFT of the
sample was 20.19 and the missing component accounted for 19.65.</p><p>The reduced number of healthy teeth and the presence of filled teeth in the mouth can
also contribute to the choice of foods. Considering complaints of difficulty in chewing
from the use of dentures, either partial or complete, and the influence on food choice,
our findings are similar to those that mentioned that users of dentures have a reduced
ability to chew compared with those patients with at least 20 teeth in the dental
arch<sup><xref rid="r15" ref-type="bibr">15</xref>,<xref rid="r21" ref-type="bibr">21</xref></sup>.</p><p>In agreement with the conclusions of Esfandiari, et al.<sup><xref rid="r05" ref-type="bibr">5</xref></sup> (2009), the psychological condition of the elderly person
should be considered when choosing the diet, which justifies the option of implants for
use of the overdenture. Chewing ability is associated with not only oral health status
but also the physical constitution of the elderly, since it may contribute to the
regulation of the nutritional status in the elderly<sup><xref rid="r14" ref-type="bibr">14</xref></sup>.</p><p>In the present study, there was no significant difference between the groups in the
values found for DMFT, BMI and albumin. In relation to BMI, Sadamori, Hayashi and
Hamada<sup><xref rid="r18" ref-type="bibr">18</xref></sup> (2008) reported no
significant difference between users and nonusers of dentures. However, a difference was
observed in the amount of albumin present in the blood of the two groups (94 elderly
women, mean age 89.6±5.6), being lower for users of prostheses. According to
Collins<sup><xref rid="r04" ref-type="bibr">4</xref></sup> (2001), the monitoring
of albumin levels can provide a measure of the long-term condition of the patient's
protein levels.</p><p>In the analysis of hemoglobin and hematocrit, there was no statistically significant
difference between the DMFT and BMI. However, it was observed that 36.4% of subjects did
not have an ill-fitting prosthesis and had adequate hemoglobin (χ<sup><xref rid="r02" ref-type="bibr">2</xref></sup>=2.881, p=0.054). In relation to BMI, it
was found that the mean indicated overweight in the YSG while in the ESG the value was
normal. The difference between the groups on BMI values was similar to that found in a
study which reported a lower BMI in older individuals<sup><xref rid="r02" ref-type="bibr">2</xref></sup>. The reason for the ESG having a mean value for BMI below
that found in the YSG is probably the reduction in the number of teeth present and the
reporting of dentures that cause discomfort, leading the research subjects to specific
choices over foods<sup><xref rid="r19" ref-type="bibr">19</xref></sup>. Similarly, other
authors have reported that edentulousness in the elderly, with an average age of 71
years, while not related to BMI was linked to a lower intake of nutrients, indicating
that nutrient intake is associated with oral health status when defined by clinical
indicators<sup><xref rid="r01" ref-type="bibr">1</xref></sup>. On the other hand,
another study did find an association between poorer oral health status and obesity in
elderly subjects aged between 60 and 90 years<sup><xref rid="r07" ref-type="bibr">7</xref></sup>.</p><p>Cutaneous skinfolds, although not the single most accurate form for assessing body fat
percentage, are better indicators of the amount of body fat than the body mass index
(BMI)<sup><xref rid="r08" ref-type="bibr">8</xref>,<xref rid="r27" ref-type="bibr">27</xref></sup>. When comparing DMFT with anthropometric indices, there was a
positive and statistically significant correlation only with the indicator of central
adiposity, the suprailiac skinfold thickness<sup><xref rid="r08" ref-type="bibr">8</xref></sup>.</p><p>In this study the indicators arm circumference and bicipital skinfold thickness (AC and
BST) were altered in the YSG and ESG. Although the BMI value was 27.2 in the ESG, the
SST and SIT indicators classified the subjects of YSG and ESG as overweight (19.26±6.15
mm, 19.62±9.85 mm respectively). Significant differences were found in SST values
between the YSG and ESG. This difference suggests a trend of nutritional changes that
may also be related to tooth loss and the use of removable dentures in the elderly
senior. Other indicators such as waist circumference (WC), triceps skinfold thickness
(TST), and body fat percentage (%BF) presented values that were not statistically
significant compared with DMFT and BMI. Similar to the BMI, waist circumference (WC),
with a mean value of 94.5±11.38 cm classified the sample as being overweight and at
increased risk for complications associated with obesity, especially in the
YSG<sup><xref rid="r27" ref-type="bibr">27</xref></sup>. However, it should be
recalled that values of BMI used to identify overweight in the general adult population
may lead to an overestimation in the number of overweight elderly. Similar problems
appear to exist when assessing waist circumference values<sup><xref rid="r20" ref-type="bibr">20</xref></sup>.</p><p>Overall, the findings obtained and discussed in this work are relevant to ongoing
research linking oral health and nutritional status in order to reach an optimal quality
of life for the elderly.</p></sec><sec sec-type="conclusions"><title>CONCLUSION</title><p>According to the number of elderly participants in this pilot study, it may be concluded
that the DMFT index was satisfactory in 60.7% of the patients. Tooth loss was the
biggest concern of the elderly in accordance with the high percentage of ill-fitting
dentures (45.5%) and prostheses that make it difficult to chew (51.5%). There was a
significant correlation between DMFT and the thickness of the suprailiac skinfold
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