Review The association between malnutrition and oral health status in elderly in long-term care facilities: A systematic review Aure ´ lie Van Lancker a, *, Sofie Verhaeghe a , Ann Van Hecke a,b , Katrien Vanderwee a , Joline Goossens a , Dimitri Beeckman a,c,d a Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium b Nursing Science, University Hospital Ghent, Ghent, Belgium c Florence Nightingale School of Nursing & Midwifery, King’s College London, London, UK d Department of Bachelor in Nursing, Artevelde University College Ghent, Ghent, Belgium What is already known about the topic?  Malnutrition is a complex and multi-factorial problem in the elderly.  Especially elderly residing in a long-term care facility are vulnerable to malnutrition.  Oral health status in elderly is poor, resulting in a negative impact on quality of life. What this paper adds  This review suggest an independent association between oral health status and malnutrition. International Journal of Nursing Studies 49 (2012) 1568–1581 A R T I C L E I N F O Article history: Received 22 December 2011 Received in revised form 27 February 2012 Accepted 2 April 2012 Keywords: Malnutrition Oral health status Elderly Long-term care A B S T R A C T Objectives: Malnutrition is a common problem in the elderly. It is not clear if oral health is associated to malnutrition in this population. The aim of this systematic review is to determine whether an association exists between oral health and malnutrition in the elderly in a long-term care facility. Design: Systematic review. Data source: Medline, Cochrane and Cinahl were systematically searched for to identify articles published between January 1985 and May 2011. Reference lists were checked for additional publications. Review methods: Publications were included if they explored the association between oral health status and malnutrition. As no consensus about terminology was found, a sensitive filter was developed. The methodological quality of the studies was assessed. Two independent reviewers performed all methodological steps. Results: Sixteen studies met the criteria for inclusion. Eleven studies used a multivariate approach; nine of these found an association between oral health status and malnutrition. Four studies found a relationship between masticatory problems and malnutrition. Five studies found an association between malnutrition and dental condition, number of oral problems, tongue alteration, problems with saliva flow, and candidiasis. Overall, the methodological quality of the studies was medium. Conclusions: Tentative evidence indicates an independent association between oral health status and malnutrition in the elderly residing in a long-term care facility. Caution is needed for the interpretation of these results because of the absence of a gold standard to define and assess malnutrition and oral health status and the presence of methodological limitations throughout the studies. ß 2012 Elsevier Ltd. All rights reserved. * Corresponding author at: Nursing Science, Ghent University, UZ-2 Block A, De Pintelaan 185, B-9000 Ghent, Belgium. Tel.: +32 9 3323619. E-mail address: Aurelie.VanLancker@ugent.be (A. Van Lancker). Contents lists available at SciVerse ScienceDirect International Journal of Nursing Studies journal homepage: www.elsevier.com/ijns 0020-7489/$ – see front matter ß 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijnurstu.2012.04.001