The elderly patient is often faced with a variety of challenges that can undermine both oral health and nutritional status. As a result, the elderly are considered particularly susceptible to malnutrition. Compared to younger individuals, elders have a significantly decreased ability to respond to physiologic challenges. Sensory function decreases leading to impaired taste and smell. Changes in the gastrointestinal system can affect the ability to digest, absorb and utilize food properly. Functional problems, such as arthritis or vision difficulties can affect the ability to prepare and eat food. Psychosocial problems such as loneliness, depression, lack of money, and poor access to food can all undermine good eating habits.
Problems in the oral cavity, such as xerostomia (dry mouth) and loose teeth, have been considered major contributors to the poor eating habits of the elderly and may be a major contributor to malnutrition. Several studies have shown that dentate status can affect eating abilityand subsequent diet quality. Individuals with one or two complete dentures had a 20% decline in diet quality compared to those with at least partial dentition in one or both arches. Dentures can affect taste and swallowing ability, especially if they are maxillary dentures. The denture covers those taste buds found on the upper palate. And when the upper palate is covered, it becomes difficult to detect the location of food in the mouth. For this reason, dentures are considered to be the major cause of choking in adults.
Dry mouth (xerostomia) is common in the older population, in part because of xerostomic medications commonly taken. Xerostomia makes eating more difficult and increases the cariogenic potential of the diet due to decreased saliva in the mouth. It has also been associated with burning mouth syndrome and inadequate diet.