The effect of the loss of teeth on diet and nutrition.

Human food selection is dependent on a complex interaction of biological, environmental, cultural and behavioural influences. Numerous studies have provided evidence that food choice is guided neither by physiologic need nor item availability. The widespread prevalence of tooth loss seen in the elderly and the impact of impaired masticatory ability on food selection patterns is often overlooked. Available information suggests that declining masticatory function is, in a large part, responsible for the elderly consuming predominantly soft, easy to chew foods, which, in turn, can induce poor dietary practices and marginal nutritional intakes. It appears that with appreciable tooth loss there is a related decline in masticatory function; significant alterations also take place in certain perceptual and sensory measures. Generally, these perceptual changes reflect alterations in taste and texture preferences; phenomena which persist even after appropriate restorative dental therapy for missing teeth, with either removable partial or complete dentures. It has long been known that full denture wearers experience a reduction in flavour perception after the insertion of their prostheses. In the elderly the generalized decrease in ability to enjoy food has, in part, been attributed to flavour disturbances associated with their dentures. Whether the sensory loss is, to a large degree, due to the prostheses, or primarily reflects age-associated changes in the gustatory and olfactory receptors, is still being explored. The information presented suggests that persons with impaired dentitions , both with and without a dental prosthesis, may impose upon themselves certain dietary restrictions which, in time, can compromise their nutritional status and ultimately place them at health risk.