The Relationship Between Measures of Nutritional Status and Masticatory Function in Untreated Patients With Head and Neck Cancer

Friedlander, Arthur H.; Tajima, Tracey; Kawakami, Kyle T.; Wang, Marilene B.; Tomlinson, James

doi:10.1016/j.joms.2007.08.023

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 1 , Pages 85-92, January 2008

The Relationship Between Measures of Nutritional Status and Masticatory Function in Untreated Patients With Head and Neck Cancer

Presented at the American Association of Oral and Maxillofacial Surgeons Annual Meeting, Honolulu, HI, October 12, 2007.

Arthur H. Friedlander, DMD
- Associate Chief of Staff and Director of Graduate Medical Education, Veterans Affairs Greater Los Angeles Healthcare System; Director of Quality Assurance, Hospital Dental Service, Medical Center at the University of California Los Angeles; and Professor-in-Residence, Oral and Maxillofacial Surgery, University of California Los Angeles School of Dentistry, Los Angeles, CA.
- Address correspondence and reprint requests to Dr Friedlander: Graduate Medical Education, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073
Tracey Tajima, DDS
- Director, General Practice Dental Residency, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA.
Kyle T. Kawakami
- Research Associate, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA.
Marilene B. Wang, MD
- Chief, Head and Neck Surgery, Veterans Affairs Greater Los Angeles Healthcare System; and Associate Professor, Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.
James Tomlinson, MD
- Chief, Surgical Oncology, Veterans Affairs Greater Los Angeles Healthcare System; and Assistant Professor-in-Residence, Surgical Oncology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA.

Purpose

Nearly 40% of newly diagnosed patients with head and neck cancer are malnourished before treatment begins with many researchers ascribing the malnutrition to a paucity of teeth. We attempted to determine if inadequate numbers of occluding pairs of teeth, rather than mere numbers of teeth, in newly hospitalized, untreated head and neck cancer patients correlates with nutritional status parameters used to identify those at heightened risk for malnutrition-related complications.

Patients and Methods

Patients and cancer-free, matched controls were evaluated for malnutrition (body mass index ≤20 [weight (kg)/height (m²)]), serum albumin ≤2.7 g/dL, hemoglobin ≤11.9 g/dL, and total lymphocyte count ≤1,449/μL), and inadequate numbers of occluding pairs of teeth variably defined as less than 5 “posterior pairs” of occluding teeth or less than 6 or 7 “total pairs” of occluding teeth.

Results

Head and neck cancer patients had significantly lower body mass index (P = .005) and total lymphocyte count (P = .019) than controls, but there were no significant correlations between the nutritional and dental variables in either group.

Conclusions

Untreated head and neck cancer patients frequently have nutritional status parameters indicating heightened risk for malnutrition-related complications but inadequate masticatory function is not a causative factor.