Can tooth loss lead to health problems?

Chewing food is a critical step in the digestion process. People with fewer teeth experience decreased chewing efficiency, especially in situations where the back teeth (see picture) are missing, or if they are struggling with ill-fitting dentures. As a result, people who report difficulty chewing avoid eating foods that are difficult to chew.  The most difficult foods to chew often contain the highest nutritional value. How this problem impacts your overall heath is discussed.

The number and distribution of teeth will influence the ease of chewing. The back molar teeth are designed for breaking up food. These teeth have a larger surface area as compared to the front teeth and include additional cusps for efficiently masticating dense, fibrous foods. The presence of molar teeth is critical for efficient chewing.

For patients with complete dentures, the goal is to learn how to balance the dentures over the ridges while chewing. The cheeks, lips and surrounding jaw musculature must be trained to keep the dentures positioned to chew. A simple piece of food acts like a fulcrum, destabilizing and lifting the dentures away from the ridge on the opposite side of the chewing force. This action can be frustrating for patients as they are trying to enjoy their favorite meal.

Because of the importance of chewing in the digestion of food, the health status of the mouth can influence diet and nutrition and therefore affect overall health.  Evidence suggests that our ability to chew affects our food choice. For example, foods that are difficult to chew such as raw carrot, nuts, fibrous vegetables and some fruits are often neglected from a persons diet. People with fewer teeth become handicapped by their dentition and as a consequence may suffer impaired intakes of key nutrients such as dietary fiber.

Other problems associated with a lack of chewing efficiency:

  • Increases in intakes of saturated fats, cholesterol and calories are reported in people as the number of teeth decline.
  • People are more likely to remove the skin from fruits and vegetables, or overcook fresh foods in an effort to make consumption easier. Many nutrients are affected by these practices.
  • Reduction in dietary fiber and in fruits and vegetable consumption has been shown to be associated with increased risk of cardiovascular disease.
  • Associations have been found between fruit and vegetable intake and reduced risk of esophageal, gastric, colorectal, prostate, cervical, pancreatic and bladder malignancy.

Many micronutrients aid in cellular defense mechanisms against oxidative damage to DNA. These antioxidants include selenium, zinc, and manganese; vitamins A, C, and E; betacoarotene, luteine, lycopene and plant flavonoids. The importance in ingesting of these nutrients for normal cellular function is becoming increasingly apparent in reducing the risk of systemic diseases.

Individuals who have missing teeth experience decreased chewing efficiency. As a result, these people are more likely to choose softer, less fibrous foods that commonly contain higher a higher quantity of saturated fat, cholesterol and calories. Recommended quantities of key nutrients found in fruits and vegetables are often deficient in these individuals leading to malnutrition and increased risk of cardiovascular disease and other disorders. Replacement of missing teeth with bridges, implants, or well-fitting dentures can significantly improve chewing efficiency, nutrition and overall health.

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