Nutrition is the science that interprets the nutrients and other substances in food in relation maintenance,growth,reproduction, health and disease of an organism. It includes food intake,  absorption, assimilation, biosynthesis, catabolism and  excretion.

1. NUTRITIONAL CARE
IN
GERIATRICS
1

2. OUTLINE
 Introduction
 Nutritional objectives
 Nutrient requirements of elderly
 Classification of foods
 Factors contributing to the nutritional problems in
elderly
 Oral factors that effect diet and nutrition of elderly
 Optimizing diet and nutrition in older patients
 Conclusion
 Bibliography
2

3. 3

4. INTRODUCTION
4

5. INTRODUCTION
What is health ? : By WHO
Executive board(1998)
Health is a dynamic state of complete
physical, mental, spiritual and social
well being and not merely the absence of
disease or infirmity.
5

6.  Physical Health :
 Good bodily health, result of regular exercise,
proper diet and nutrition and proper rest for physical
recovery.
Mental Health :
 It refers to individual’s emotional and psychological
well-being. Being able to handle normal level of
stress, recover from difficult situation Mind Intellect
Ego.
6

7. Social Health :
 Maintaining satisfying relationship with
everyone around Boss, Subordinate,
Colleague, Customer Wife, children
Neighbours Friends Relatives
7

8.  Nutrition is the science that interprets
the nutrients and other substances in food in relation
maintenance,growth,reproduction, health and
disease of an organism. It includes food
intake, absorption, assimilation, biosynthesis, catabolism
and excretion.
8

9.  Diet is the sum of food consumed by a
person or other organism. .
 A balanced diet is one that
gives your body the nutrients it needs to
function correctly.
9

10. Malnutrition
 Inappropriate amount of, or quality of nutrients comprising
a healthy diet are not consumed for an extended period of
time.
Undernutrition:
 Often thought to be a problem of third world countries
 Inadequate consumption, poor absorption, or excessive loss
of nutrients.
Overnutrition:
 Excessive intake of specific nutrients.
10

11.  Good nutrition enhances quality of life, by
preventing malnutrition and promoting
optimal functioning.
 Poor nutrition compromises quality of life,
reduces longevity ,burdens the health care
system and economy.
11

12. AGING THEORY :
1.Biological theory-- predetermined process
controlled by genes, molecule & cellular theories.
2.Programmed theory or biological clock theory
3.Wear and tear theory- like machines body too
wears
4.Mitochondrial theory etc etc.
There are n numbers of
theories but none explain
Satisfactorily. 12

13. CLASSIFICATION OF FOODS
1. By origin
 Foods of animal origin
 Foods of vegetable origin.
2. By chemical composition
 Proteins
 Fats
 Carbohydrates
 Vitamins
 Minerals
13

14. 3. By predominant function
14

15. NUTRIENT REQUIREMENTS OF ELDERLY
 Energy requirements decrease with age because
of decline in their BASAL METABOLIC RATE.
 Collagen is a major component of our skin.
 It plays a role in strengthening skin, plus may benefit
elasticity and hydration. As you age, your body
produces less collagen, leading to dry skin and the
formation of wrinkles.
 Supplements containing collagen may help slow the
aging of skin by reducing wrinkles and dryness. also
reducing joint pain in conditions like arthritis.
15

16. PROTEINS
 Dietary proteins are composed of amino acids, which have the basic
structure that includes a central carbon atom with hydrogen, an amino
group, and a side group.
 Body functions are quickly distracted from their normal activity when
quality proteins are vomited from the diet
 Protein deficiency results in lower antibody production, reduced
resistance to infection, anaemia,and decrease in muscle volume.
16

17. DIETARY FIBER
 A low intake of fiber is commonly seen in
elderly people especially denture wearers as
fiber rich foods may be difficult to eat.
 A low intake of fiber in diet is associated with
conditions like CONSTIPATION, colon cancer
& diabetes. Such conditions may be alleviated
by recommending foods high in fiber such as
raw vegetables & fruits.
17

18. Dietary Fibre
 Increase dietary fibre intake to 21 g/day for women and
30 g/day for men (51+ years)
 Replace refined cereals and flour products with whole
grain foods
 Increase fibre slowly to prevent excessive bloating,
cramping, flatulence and diarrhea
 Drink adequate amount of fluids
 Examples: oat bran, psyllium, legumes, fruits,
vegetables, wheat bran, flax seeds
18

19. WATER
 Water deficiency in older people leads to dehydration,
this is partly due to a decrease in extra cellular water
which has been shown to exist from the eighth decade
of life.
 It is seen that dehydration is a major cause of mental
confusion in elderly. An average intake of 6-8 glasses
of water per day is most desirable.
19

20. Fluid Intake
Dietary Reference Intake (DRIs) (51+ years)
 Females: 2.7 L/day total water
 Males: 3.7 L/day total water
 NOTE: these values may be difficult to achieve
for older adults due to reduced food intake. Aim
for 6-8 cups per day.
20

21. VITAMINS
 Vitamins are a group of essential nutrients
which are required in very minute amounts to
participate and regulate chemical reactions
within the body .
21

22. 22

23. VITAMIN A Periodontitis
VITAMIN B COMPLEX Lips:
Cheilosis
VITAMIN B COMPLEX
AND IRON Angular Stomatitis,Anemia.
VITAMIN B COMPLEX
IRON &TRYPTOPHAN
Glossitis, Oedema and atrophy
of the
filiform papillae.
VITAMIN C Tender,edematous,bruising,blee
ding from gums,poor wound
healing
ORAL SIGNS OF DIETARY DEFICIENCIES
23

24. IMPORTANCE OF MINERALS
 Minerals provide structural components for the
body .
 They allow nerve and muscle function, blood
clotting and tissue growth and repair, and-base
balance of body fluids ,and act as a co-factors for
the chemical reactions in the body.
24

25. CALCIUM
 Inadequate ingestion of calcium has been
implicated in disease state of the elderly known
as OSTEOPOROSIS.
 It is characterized by decreased bone density.
The elderly are very often susceptible to
osteoporosis.
 Postmenopausal women are most often
affected.
25

26. CALCIUM AND VIT D INTAKE
AGE CALCIUM VITAMIN D
31-50 yrs 1000 mcg 5mcg
51-70 yrs 1200 mcg 10 mcg
>70 yrs 1200 mcg 15 mcg
26

27. 27
Commercially available calcium and vitamin D
ORAL SUPPLEMENT
INTRAVENOUS INJECTION
OF CALCIUM GLUCONATE
ORAL SUPPLEMENT &
INTRAVENOUS INJECTION
OF VITAMIN D

28. CALCIUM AND BONE HEALTH
 Trabecular bone like alveolar bone, vertebrae, wrist
bone are affected first because they are the main
source of calcium.
 Bone loss is a normal part of aging that affects the
maxilla and mandible, as well as the spine and long
bones.
 Resorption of the alveolar ridge is a widespread
problem among denture wearing patients and results
in unstable dentures.
28

29. 29

30. Causes of osteoporosis
1. Genetic background
2. Hormonal status –menopause
3. Disturbances in the bone remodeling process
4. A low exercise level and life styles
5. Inadequate Nutrition like low calcium intake
6. As collagen in your body deteriorates as you age,
bone mass does too. This may lead to conditions
such as osteoporosis, which is characterized by
low bone density and linked with a higher risk of
bone fractures . 30

31. 31

32.  Similar to bones in other parts of the body the alveolar
bone is also susceptible to osteoporosis. Alveolar bone is
also resorbed with the loss of teeth so much that the
mandibular and maxillary ridges sometimes approach
flatness.
DIAGNOSIS.
There is no simple accurate blood test for calcium
nutrieture since calcium blood level is regulated by the
parathyroid-calcitonin -vitamin D mechanism.
 It is difficult to detect early. Considerable
demineralization can occur before the disease is
diagnosed radiographically.
32

33. PREVENTION
 Calcium rich foods like milk and milk products and
cheese.
 Fluoride supplements.
 Increase the vitamin D supplements to increase the
calcium levels from 400 to1000 units per day.
33

34. 34

35. Chronic illness
Disability
Isolation
Transport, access,
mobility and income
Institutionalisation
Depression
Dentition
Intake, absorption and
utilisation of nutrients
Reduced taste
perception
Factors that affect food choice
35

36. Diabetes
ALS
COPD
Dysphagia
Cancer
Palliative Care
Celiac Disease
Constipation
Superbugs
Congestive
Heart
Failure
Pressure
Ulcers
Multiple
Sclerosis
Parkinson’s
Disease
Malabsorption
Syndromes
Osteoporosis
GERD
Pneumonia
Alcohol
Abuse
Stroke
Osteoarthritis
Anemia
Family Related
Issues
Renal Disease
Nutrition Issues
For Older Adults
System Issues
Dementia
Mental Illness
Obesity
Malnutrition
36

37. FACTORS CONTRIBUTING TO THE
NUTRITIONAL PROBLEMS IN THE ELDERLY
 ORAL FACTORS
 PHYSIOLOGICAL FACTORS
 FUNCTIONAL FACTORS
 PSYCHOSOCIAL FACTORS
 MEDICAL AND SURGICAL FACTORS
 MISCELLANEOUS FACTORS
37

38. 1.ORAL FACTORS
 Changes in ability to chew food
 Changes in taste and smell
 Drug induced xerostomia
38

39. 2.PHYSIOLOGICAL FACTORS
 Changes in ability to metabolize nutrients due to
digestive enzyme deficiency like lactase-which is
responsible for conversion of lactose which is again
important for calcium absorption.
 Changes in ability to absorb and utilize nutrients due
to hypochlorohydria resulting from atrophic
gastritis.
39

40.  Changes in energy requirements and activity
due to decreased B M R.
 Effects of medication like laxatives and
tranquilizers interfering with absorption and
utilization of nutrients.
40

41. 3.FUCNTIONAL FACTORS
 Functional disabilities such as arthritis, stroke or vision or
hearing impairment can affect nutritional status indirectly.
 The older person may have difficulty in getting to and from
grocery stores ,carrying groceries, reaching to the food on
shelves, opening cans and packages, and preparing meals in
general.
 In ability to handle utensils, see food clearly, or hear others
conversation will affect the nutritional status in geriatrics
person.
41

42. 4.PSYCHOSOCIAL FACTORS
LONELINESS AND ISOLATION Individuals with a
strong social network of family and friends are more
likely to be physically and emotionally fulfilled and tend
to have better nutrition .
LOSS OF APPETITE AND INTEREST IN EATING
Due to loss of eating companion such as spouse can affect
the desire to prepare and eat the food which leads to at
least short term malnutrition.
42

43. DEPRESSION, DEMENTIA, ANXIETY AND
POVERTY
Can undermine the desire to prepare and eat the
food .These factors have been associated with
anorexia ,weight loss, and increase morbidity and
mortality in older people.
43

44. 5.PHARMACOLOGICAL FACTORS
 Most elders take several prescriptions and over-the
counter medications daily .These drugs can
interact with food and diet ,sometimes with serious
side effects .These drugs can affect absorption and
utilization of some nutrients ,and vice versa
44

45.  Alcohol provides calories but of little nutritional
value and can undermine nutritional status by
decreasing appetite. Small amount can enhance
appetite but greater amount can suppress it.
 For older people drugs should be easy to open
with clear instructions and less frequent dose of
interval .
45

46. 6.MEDICAL AND SURGICAL FACTORS
 NEUROMUSCULAR DISORDERS LIKE
STROKE AND PARKINSONS DISEASE.
 CHRONIC BRONCHITIS AND
EMPHYSEMA
 PARTIAL GASTRECTOMY
46

47. 7.MISCELLANEOUS FACTORS
 IGNORANCE
 ALCOHOLISM AND LACK OF
FINANCIAL RESOURCES
 FOOD INTOLERANCES
47

48. ORAL FACTORS AFFECTING DIET AND
NUTRITION IN ELDERLY
 ALTERATIONS IN SENSE OF TASTE AND
SMELL
 XEROSTOMIA
 ORAL INFECTIONS
 DENTATE STATUS
 DENTURE EFFECT ON TASTE AND
SWALLOWING
 DENTURE EFFECT ON CHEWING
48

49. ALTERATIONS IN SENSE OF TASTE AND
SMELL
 Age related changes in taste and smell may alter
the food choice and decrease diet quality in some
people .
 Food palatability influences appetite ,and an
altered gustatory or olfactory ability can contribute
to a poor diet.
 Diminished taste and smell acuity may result from
diseases ,drugs, poor nutrition ,or dental problems
as well as the aging process. 49

50. Suggestions to improve appetite
 Increase the use of condiments, flavourful spices
and herbs.
 Serve food at the desired temperature.
 Providing variety of flour and texture foods.
50

51.  Encourage adequate chewing to release a
maximum of gustatory and olfactory stimuli.
 Check oral hygiene practices ,because
unpleasant taste (dysgeusia) may result from
poor oral hygiene.
51

52. XEROSTOMIA
 Xerostomia is the condition commonly found in
the elderly which is characterized by dry mouth or
hyposalivation .
 Xerostomia can also impair complete denture
retention and associated with increased
periodontal diseases, burning or soreness of the
oral mucosa and difficulties in chewing and
swallowing ,all which adversely affect the
selection of food and contribute to poor nutritional
status. 52

53. CAUSES OF XEROSTOMIA
 COMMON CAUSE IS USE OF MEDICATIONS
 THERAPUETIC RADIATION
 DIABETES AND DEPRESSION
 ALCOHOLISM
 MENOPAUSE 53

54.  PERNICIOUS ANAEMIA
 VITAMIN A AND B’COMPLEX
DEFICIENCY
 HIV INFECTION
 AUTOIMMUNE DESEASES LIKE
SJOGREN’S SYNDROME ETC…….
54

55. XEROSTOMIA AND NUTRITIONAL STATUS
 It hinders the chewing of food as it prevents the
formation of bolus.
 It makes the mouth sore and chewing of food
painful .
 It makes swallowing difficult due to the loss of
saliva’s lubricating effect .
 It can cause changes in taste perception as some
foods must be partially dissolved to be tasted.55

56. XEROSTOMIA
56

57. MANAGEMENT OF XEROSTOMIA
 DEPENDS UPON THE CAUSE OF THE CONDITION
 IF DRUG IS THE CAUSE CONSULT THE PHYSCIAN
TO CHANGE OR ALTER THE PRESCRIPTION
 SALIVA SUBSTITUTES LIKE MILK,JUICE ETC.
57

58.  SIALOGOGUES LIKE SORBITOL,
XYLITOL, LOZENGES,SUGAR FREE GUM
 ADDITIONALLY WATER WITH SLICE OF
LIME
 CHEWING FIBRUOS FOODS AND
 CONSUME 8 GLASSES OF WATER.
58

59. ORAL INFECTIONS AND CONDITIONS
 The process of age related bone loss that occurs
throughout the skeleton may also affect the
alveolar bone that supports the teeth, resulting in
increased risk of tooth loss and edentulism.
 Periodontal diseases also increase with age and
may be exacerbated by nutritional deficiencies.
47% of elderly show root caries and its sequale
leading to edentulism and edentulism leads to
malnutrition.
59

60. DENTATE STATUS AND NUTRITION
 Dentate status can affect diet, nutrition status, and
general health. Conversly,the role of nutritional
factors in the development and prevention of
tooth loss becomes increasingly important.
 Presence of denture and number of teeth are
associated with masticat6ory efficiency and
ability to chew.
 The loss of teeth often leads to select diets that
are lower in nutrient density. 60

61. EFFECTS OF DENTURES ON CHEWING
ABILITY
 Masticatory efficiency in complete dentures
wearers is approximately 80 % lower than in
people with intact natural dentition.
 Other factors that affect chewing ability include
mobile teeth, bone resorption,reduced sensory
perceptions, and motor impairment.
61

62. EFFECT OF DENTURE ON TASTE AND
SWALLOWING
 The taste sensitivity may be reduced when an upper
denture covers the hard palate .
 It also becomes difficult to determine the location of food
in the mouth when the upper palate is covered.
 As a result, swallowing can be poorly coordinated and
dentures can become factor for deaths from choking.
62

63. OPTIMISING DIET AND NUTRITION IN
OLDER ADULTS
Conducting diet screening and assessment.
 The United States Nutrition Initiative has developed
‘Determine Your Nutritional Health Check List'. The
cumulative score for the check list is interpreted as
indicating higher or lower nutritional risk and sets the
stage for further screening and intervention if needed.
 Another rapid nutrition assessment tool, The Mini
Nutritional assessment has been developed and validated .
63

64. NUTRITIONAL ASSESMENTS
 ANTHROPOMETRIC ASSESMENTS
HEIGHT Decrease in height due to
shortening of spinal column loss of bone density
that is osteoporosis
WEIGHT Increase between 35 to 54 yrs for
men and 55 to 65yrs for women ,15 to 20 yrs is
constant.
64

65. BODY MASS INDEX (B.M.I ) Body mass index, or BMI, is
a measure of body size. ... BMI is a screening tool that can
indicate whether a person is underweight or if they have a
healthy weight, excess weight, or obesity.
 It is calculated as weight in kilograms divided by
square of height in metres
B M I = Weight in kgs / (height)2
 Normal B M I is 21,
less than 21 indicates person is undernourished.
65

66.  TRICEPS SKIN FOLD THICKNESS (T S F),
MID ARM CIRCUMFERENCE (M A C) .
Measured by calipers and Provide estimation of
body fat and skeletal muscle mass respectively.
Normal values T S F =22 mm for women
12mm for men
M A C =29.7 mm for women
28.7 mm for men
66

67.  For T.S.F Values less than or equal to
11mm in women
05 mm in men
Indicates severe fat energy malnutrition
For M.A.C Values less than 23.1 for women
24.4mm in men
Indicates severe protein malnutrition.
67

68.  ADVANTAGES
Can evaluate nutritional status longitudinally
within short period of time.
DISADVANTAGES
Don't provide exact evidence of under
nutrition because the results are also affected
by physiological processes.
68

69. OTHER ANALYSES
 Measurement of blood urea nitrogen,
creatinin,haemoglobin,hematocrit, iron binding capacity,
sodium potassium and cholesterol.
SERUM ALBUMIN
A serum albumin level greater or equal to
35g/L NO MALNUTRITION
30 - 34g/L MODERATE
< 30 g/L SEVERE MALNUTRITION
69

70. PHYSICAL EXAMINATION
Physical examination is the most important criteria
for assessing the nutritional deficiency disorders in
geriatrics patients.
70

71. 71

72. Questionnaire for assessing the
nutritional health of elderly adults
72

73. 73

74. DIET RECOMMENDATIONS AND SUGGESTIONS
FOR OLDER ADULTS
 A new food pyramid has been designed for people
aged 70 years and above to reflect the unique needs
of older people.
 It should compared with the original food guide
pyramid .
 The modified food pyramid for elders stresses fewer
servings of grain products and more servings of
dairy, and emphasizes adequate water intake. 74

75. 75

76. 76

77. 77

78. DIETARY HISTORY AND EVALUATION
 Mini Nutritional Assessment MNA developed by Guigoz
et.al 1994.composed of simple questions that can be
performed in twenty minutes.
Parameters used are
 Anthropometric mesurements(wt,ht,wt loss).
 Global physical and neurophysiologic status.
 Dietary questions related to number of meals, foods and
fluid intake and masticatory ability.
 Subjective evaluation of health and nutrition. 78

79. 79

80. 80

81. 81

82. 82

83. DIET RECOMMENDATIONS & SUGGESTIONS FOR
OLDER ADULTS
 Initially consume soft diet, gradually increase to
biting and incising food.
 Chew longer, eat slowly and cut fibrous foods such
as apples, carrots into bite sized pieces.
83

84. Reading Food Labels
 Compare the Nutrition Facts Table
on food labels to choose products
that contain less fat, saturated fat,
trans fat, sugar and sodium.
 The calories and nutrients listed
are for the specific amount of food
found at the top of the Nutrition
Facts Table.
84

85. DAIRY(2-4
Servings/Day)
Milk, milk shakes, soft custards, ice
creams, soft cheese.
MEAT&POUTRY
(2 Servings/Day)
Eggs,cheese,soups with tender meat,
fish, tender meat in gravy form.
FRUITS(2-3
Servings/Day)
Fruit juices,ices,nectars,canned fruits,
Popsicles.
VEGETABLES(2-3
Servings/day)
Vegetable juices, strained or pureed
vegetables.
GRAINS(6-11
servings/day)
Cooked cereals, soft bread, mashed
potatoes, rice cracker in soup.
OTHERS wine
FOOD GROUP RECOMMENDATIONS
85

86. Conclusion
 Denture wearers are more vulnerable to
compromised nutritional health.
 The ability of the oral tissues to withstand the
stress of dentures is greater if the patient is well
nourished.
 Dietary guidance is integral part of treatment for
the denture-wearing patient.
86

87. • Dietary guidance is integral part of treatment for
the denture-wearing patient.
• Many denture failures are the result of nutritional
deficiencies. Good health and nutrition of older
patients are necessary for the successful wearing
of dentures.
87

88. REVIEW OF LITERATURE-1
 W. 0. Ramsey et al .The role of nutrition in
conditioning edentulous patients. J Prosthet
Dent1970 Feb;23(2):130-5.
88

89.  A fivefold plan of treatment that may be
used in nutritionally oriented tissue
conditioning consists of:
( 1) examination by physician,
(2) use of physical tissue conditioning agents,
(3) dietary advice,
(4) motivation, and
(5) dietary supplementation.
89

90. Conclusion:
 A clinically applicable approach to the role
of nutrition in preparation of the edentulous
patient for dentures has been presented.
 Immediate improvement and long-term
maintenance of tissue vitality can be
assured only if an optimum biologic and
mechanical environment is assured.
90

91. REVIEW OF LITERATURE-2
 Brodeur JM, Laaurin D. Nutrition intake
and gastrointestinal disorders related to
masticatory performance in the edentulous
elderly. J Prosthet Dent 1993;70:468-73.
91

92.  The effects of chewing efficiency on
nutrient intake and the prevalence of
gastrointestinal disorders were determined
in edentulous elderly subjects.
 Three hundred sixty-seven
noninstitutionalized individuals aged 60
years and over were interviewed.
92

93.  Denture masticatory performance and the
collection of dietary information were
assessed with the “Swallowing Threshold
Test Index” and a food-frequency
questionnaire.
93

94. Conclusion:
 Approximately half of the subjects enrolled
in our study exhibited a low masticatory
performance classification.
 Participants with low masticatory
performance took significantly more
medication for gastrointestinal disorders
than those with superior masticatory
performance
94

95. REVIEW OF LITERATURE-3
 N'Gom PI, Woda A. Influence of impaired
mastication on nutrition. J Prosthet Dent
2002;87:667-73
95

96.  It has been suggested that people who suffer
from impaired masticatory function may
adapt food consistency to their oral status
(which may lead to deficient nutrient
intake).
96

97. ASSESSMENT OF MASTICATORY
FUNCTION
 The first heading covers self-assessment of
MF by means of scales and questionnaires,
which are often used in epidemiological
surveys.
 Subjects are asked to score their ability to
chew foods as good, fairly good, or poor or
to rate foods as easy, fairly easy, difficult,
or very difficult to chew.
97

98.  The second heading encompasses methods
that measure the subject’s ability to reduce
food into smaller particles.
 The third heading covers a method that
measures the amount of sugar extracted
from chewing gum.
98

99.  The fourth heading encompasses such
sophisticated techniques as bite force
measurement, electromyography,
kinematics, and video recording.
 The fifth and final heading encompasses
methods based on anatomic criteria.
 Analysis and count of occlusal contact
areas and missing teeth also have served as
variables for the assessment of MF.
99

100. Conclusion:
Poor oral health leads to impaired masticatory
function. Whether MF plays a role in food
selection is still a matter of debate, but
impaired MF may lead to inadequate food
choice and therefore alter nutrient intake.
100

101. REVIEW OF LITERATURE-4
 Kranti Ashoknath Bandodkar et al Nutrition
for geriatric denture patients.J Indian Prosthodont
Soc 2006;6(1):22-28.
101

102. Qualitative dietary assessment
 The purpose of the dietary assessment is to
determine what an individual is eating now,
what he or she has eaten in the past and
recent changes in the diet.
102

103.  A questionnaire has been developed to
identify older individuals with nutritional
problem-
103

104. Conclusion:
Many denture failures are the result of
nutritional deficiencies. Good health and
nutrition of older patients are necessary for
the successful wearing of dentures.
104

105. REVIEW OF LITERATURE-5
 Singh G, Quadri S, Kapoor B, Rathi S.
Effect of nutrition in edentulous geriatric
patients. J Oral Res Rev 2018;10:33-8.
105

106. Nutritional Evaluation
 The first priority while evaluating nutrition
is to understand the differences in metabolic
functioning of an individual and how his
metabolism reacts to a particular diet.
106

107.  To determine the above, the following fields
need to be explored:
 Omics research: this includes such as
nutrigenetics and nutrigenomics (example,
epigenetic, transcriptomics, proteomics, and
metabolomics).
107

108.  Micro biome: The human body is home to
several microorganisms. Research must be
conducted to determine their role in
metabolism, responsiveness of body to
certain nutrients, diet, diseases, etc.
108

109.  Biological networks: This include the study
of an individual's genes, effect of biological
network on food responsiveness, and other
environmental factors such as micro-
organisms, pollution, chemical ingredient,
etc.
109

110. Conclusion:
 On this date, guiding a edentulous patient
through an adequate diet plan should be
implemented into his prosthodontic
treatment.
 Recommending diet after fitting dentures
can help overcome a lot of agonies,
psychological, and well as physiological
issues.
110

111. REFERENCES
 Gerodontic nutrition and dietary
counseling for prosthodontic patients
-Dent Clin N Am 47 [2003] 355-371
 Mayo Clinic-Diet manual-7th edition
 Prosthodontic treatment for
edentulous patient- Boucher 12th
edition
111

112.  Essentials of complete denture
prosthodontics-Winkler 3rd edition.
 Text book of complete denture-
Heartwell -5th edition
 Complete denture prosthodontics
– John J.sharry.
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113. THANK YOU
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