Food for Thought: The Relationship Between Oral Health and Nutrition
Course Number: 583
Course Contents
Nutritional Screening
Nutritional screening tools are recognized as vital for identifying patients at risk for diet related oral and systemic health issues. Subjective and objective approaches can begin with questions about diet, chewing ability and oral health status, while evaluation of soft tissue health and healing capacity may detect signs of nutritional deficiencies such as oral lesions, glossitis and angular cheilitis.23
The Mini Nutritional Assessment (MNA) tool is ideal for older adults and assesses dietary intake, weight loss, mobility, and psychological stress. The Malnutrition Universal Screening Tool (MUST) focuses on BMI, weight loss and acute disease impact. While the Nutrition Screening Initiative (NSI) includes questions about eating habits, health conditions and functional status. The AAP oral health risk assessment is useful in pediatric settings and includes nutritional and hygiene counseling prompts, and a self management goal sheet for caregivers.24 To choose the best nutritional screen tool, it’s important to match the tool to your patient population, clinical setting and depth of information needed.
Figure 14. Nutritional Screening Tools
Image Source: Generated by AI
Oral health specific tools can be used to assess caries risk based on carbohydrate intake and frequency. Caries Management by Risk Assessment (CAMBRA) is an evidence-based approach for patient-specific caries management at its earliest stages. The first step involves categorizing caries risk based on the clinician's overall assessment of patient's disease indicators, caries protective factors, and caries predisposing factors. The treatment guideline below assesses caries risk as low, moderate, high, or extreme risk categories.25
| Low Risk: | Routine care and fluoride toothpaste are sufficient. |
| Moderate Risk: | Add fluoride varnish and dietary counseling. |
| High Risk: | Requires fluoride + antibacterial therapy (e.g., chlorhexidine), xylitol, and sealants. |
| Extreme Risk: | All of the above plus salivary substitutes and more aggressive management.25 |