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LETTER TO THE EDITOR |
Professor, Department of Prosthodontics and Dows Institute for Dental Research University of Iowa 418 Dental Science N Iowa City, IA 52242-1010 E-mail: Ettinger{at}blue.weeg.uiowa.edu
Dear Dr. Noelker:
I read with interest Dr. Joseph Sharkey's article on food insufficiency in diabetics in The Gerontologist (Sharkey, 2005). The article was interesting, but it seems to me that a major variable that influences food intake was missing. Did anybody look in the mouths of these people to assess their dentition? To eat protein or vegetables you need adequate numbers of chewing pairs of teeth. How many of these individuals were wearing dentures, and what was the quality of the dentures? You can ask an older adult, "Are you satisfied with your ability to eat?" and the answer is "Yes." If you ask that same person, especially one with an inadequate denture or numbers of chewing pairs, "Can you eat fresh vegetables?" the answer is "No." "Can you eat fresh fruit?" The answer is "No." "Can you eat meat?" The answer is "No."
I believe the author's conceptual model is missing the oral health status, which either should be in a separate category under Fundamental Factors or could be placed under the Health-Related portion of the article.
The other major factor missing in this article was information regarding the individuals' ability to swallow food. I saw no assessment of that anywhere. To eat effectively you need to be able to chew food and swallow it; otherwise, it has to be put into a blender and turned into a liquid.
Did the North Carolina Nutrition and Function Study not evaluate oral health and swallowing as part of its data gathering?
I would be very interested to hear a response from the author.
Yours sincerely,
References
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