Predicting Nutrition Risk in a Dental Clinic Population

Objective: This research explored factors predictive of nutrition risk. The objective was to identify constructs to use in a nutrition risk screening tool in a dental clinic population. Methods: Data were collected by chart review for health behaviors of tobacco use, frequency of sugar consumption, and physical or financial limitations to optimal dietary intake; physical examination of oral variables including number of decayed and missing teeth, natural occluding tooth surfaces, prostheses, or soft tissue lesions; interview to obtain history of chronic diseases (hypertension, diabetes, and immunosuppressive disorders), 24-hour recall, and weight history; measurement of height and weight for calculation of body mass index and percent weight change. The outcome variable, ‘nutrition risk', was determined by expert clinical opinion by two registered dietitians. A convenience sample of 241 English-speaking adults scheduled for dental care at the dental school clinic was obtained. Descriptive statistics, Pearson's product moment correlation, and logistic regression analyses were conducted with a priori alpha=0.05. Results: Mean age=49.02 (SD=16.05) years; 53.66% (n=132) female. Of 23 variables considered for inclusion in the analysis, 12 were predictive of nutrition risk: immunosuppressive disorder, diabetes, dysphagia, soft tissue lesions, difficulty shopping for or preparing food, financial limitation in purchasing food, new caries, high sugar intake, unintentional weight change, history of eating disorder, difficulty with mastication, and number of natural teeth. The fitted regression model correctly classified 87.55% (n=211) of the participants. This model was converted to a proposed screening tool concept for clinical practice that correctly classified 84.23% with a false positive rate of 14.01% and a false negative rate of 26.47%. Conclusion: Factors predictive of nutrition risk in a dental clinic population identify constructs that may be refined and tested to develop a reliable and valid nutrition risk screening tool for dental practitioners. Funding provided by an American Dietetic Association Foundation fellowship.