Unintentional weight gain may reflect a systemic disease or change in dietary habits.
Weight gain – An unintentional weight gain of 10 lbs or >10% of usual weight in <6 months may reflect reduced physical activity or a shift to a higher caloric diet. Although unlikely without other symptoms, it could be a sign of significant fluid retention.
Weight loss – An unintentional weight loss of 10 lbs or >10% of usual weight in < 6 months is a marker of increased risk for malnutrition and infection, as well as systemic diseases, such as type 2 diabetes mellitus and different neoplasms.
Pain or difficulty with masticatory function, as well as soft tissue lesions or infections interfering with food or beverage intake can lead to a compromised diet with subsequent weight loss and nutrient deficiencies.
Fewer than 18 teeth can impact ability to eat, and has shown to be associated with reduced intake of fresh fruits, vegetables and whole grain.
Frequent consumption of sugar- containing beverages, chewing gum and candy is associated with an increased risk for developing caries.
Dietary supplements include nutrient supplements (vitamins and minerals), botanical or herbal, and other products, such as creatine, caffeine and green tea extracts. In general, multivitamin mineral supplements are safe, but single nutrients in doses exceeding recommended levels may be associated with toxicities and drug interactions, e.g. the effect of coumadin may vary with changes in intake of vitamins E or K, or Ginseng.
Patients with unintentional weight gain/loss of >10 lbs in <6 months should be referred to a physician for evaluation and a registered dietitian for nutrition evaluation and counseling.
Patients with difficulties or pain upon biting, chewing, or swallowing and patients with less than 18 teeth should have a dietary consultation to determine changes in food habits and overall adequacy of caloric and macronutrient intake. Such patients should be given dietary advice according to federal dietary recommendations and be referred to a registered dietitian for evaluation and counseling.
Patients who consume >4 sugar containing foods, snacks, chewing gum or candy should be given advice as to caries risk reduction and alternatives to high sugar-containing fluids, snacks and candies.