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Warren B. Karp, Ph.D., D.M.D.
Professor Emeritus, The Medical College of Georgia , The Dental College of Georgia and The Graduate School at Augusta University
In the United States, today, malnutrition is a major barrier preventing patients from achieving optimal oral health. For the vast majority of your patients, malnutrition is defined as OVERnutrition, not UNDERnutrition with it's nutrient deficiencies.
That is not to say that there aren't subgroups in the US population who are undernourished. There certainly are. Examples are specific people in the "oldest-old" category (over 85 years), patients with cancer cachexia or people with food insecurity. In the general U.S. population, food insecurity and the prevalence of undernourishment in adults and children was reported to be 2.5% in 2021. Contrast this to the prevalence of OVERnutrition in the U.S. (defined as being overweight or obese) which was over 70% of the population in 2022. There is no doubt that the oral health focus needs to be on identifying, counseling and referring over-nourished individuals, not focusing on vitamins, supplements, fad dietary advice or terms like organic, hormone-free, "healthy," natural, gluten-free and many others.
Diseases and conditions associated with being OVER-nourished include increased general morbidity and mortality and increased risks of diabetes, hypertension, cardiovascular diseases such as stroke, heart disease and peripheral vascular disease, cancer, pregnancy complications, depression, osteoarthritis and mobility problems. Many of these diseases and conditions have major impacts on oral health. There are thousands of research publications on the relationship of oral health to systemic disease. The publications, below, were chosen because they are reviews and available as full text, online. They are all from the peer-reviewed medical and dental literature:
The Relationship Between Systemic Diseases and Oral Disease (2021)
Dental Disease and Diabetes (2022)
Dental Disease and Obesity (2023)
Dental Disease and Hypertension (2021)
Dental Disease and Cardiovascular Disease (2020)
There is complete agreement among leading health organizations about what is considered to be optimal nutrition for promoting health and preventing disease, whether it is dental disease, cardiovascular disease, diabetes, hypertension or cancer. If you review the nutrition recommendations from The National Institutes of Health, The American Heart Association, The National Cancer Institute, The American Dental Association, The American Diabetes Association and others, you will find astounding similarities among the recommendations. The two, leading scientifically-supported ways of eating are The Dash Eating Plan and The Mediterranean Eating Plan. Plant-based vegetarian or vegan eating plans may be healthy, as long as they are not overly-restrictive.
In spite of all the overall agreement about ways of eating and nutrition, many patients and health professionals still rely on non-evidenced based sources for advice and approaches to nutrition. Health professionals are human beings and subject to the same, unending nutrition misinformation in public media, social media and infomercials and these low-quality messages do have an impact.
Members of the dental health care team can have important impacts on the nutrition of dental patients in 3 areas....
1) Identifying patients who are at nutrition risk, especially with regards to diabetes, obesity, cardiovascular disease, hypertension and cancer.
2) Referring patients at nutrition risk to qualified nutrition professionals, especially R.D.N.'s (Registered Dietitian Nutritionists) for counseling and monitoring. You can easily identify these individuals in your community. Patients at nutrition risk are also patients at risk for dental diseases and at risk for medical complications from dental procedures.
3) Be a resource for accurate, reliable and evidenced-based information about foods and nutrition for your patients. Nutrition is a science, not a matter-of-opinion or belief.
Nutrition, Food and Oral Health.pptx
In 2024, Are Eggs OK To Eat, Again?
All Dr. Karp's websites and social media posts are in the public domain and are freely shareable, downloadable and can be duplicated...there is no cost associated with sharing any of the information.
If you, your patients or your dental staff would like a source of current evidenced-based nutrition information or have questions or comments, feel free to friend Facebook (AskDrKarp Facebook Page) or contact me via email, or LinkedIn.
Warren B. Karp, Ph.D., D.M.D. is Professor Emeritus of Biochemistry and Molecular Biology, Pediatrics, Oral Biology and Oral Diagnosis at Augusta University in The Medical College of Georgia , The Dental College of Georgia and The Graduate School. He has a Ph.D. in nutritional biochemistry from The Ohio State University and a Doctorate in Dental Medicine from Dental College of Georgia. He is an elected member of The American Institute of Nutrition (Federation of Societies of Experimental Biology), The American Society of Clinical Nutrition and is past president of the Georgia Nutrition Council. He has served as Director of the Nutrition Consult Service for over twenty years, appointed to the Governor's Obesity Taskforce and served as Vice Chair of the Augusta (Columbia County) Board of Health. You can find a biographical sketch at: wbkarp.com
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