"Oral Nutritional Supplements: Sugar Content and Potential Dental Implications".

OBJECTIVES The objectives of this article are to list the most commonly prescribed Oral Nutritional Supplements in the UK and Ireland and their sugar content; and to raise awareness among the dental profession regarding their uses and potential dental risks involved. BACKGROUND Many older patients benefit from Oral Nutritional Supplements. Prescribers may not consider dental implications of these. Patients may not think to disclose these medications to their dentist. MATERIALS AND METHODS A list of commonly prescribed Oral Nutritional Supplements in the UK and Ireland was compiled. Nutritional information was obtained from the manufacturers' website and arranged in order of decreasing sugar content. Potential dental implications are discussed and recommendations made for dental practitioners. RESULTS Pre-formed Oral Nutritional Supplements can contain between 6.6 and 27.2 g of sugar per serving. Powdered Oral Nutritional Supplements, which are to be mixed with 200 ml whole milk, contain between 16.4 and 35.0 g sugar per serving. The "shot"-type Oral Nutritional Supplements contain less sugar, ranging from 0.0 to 4.0 g per serving. CONCLUSIONS The sugar content of frequently prescribed Oral Nutritional Supplements can be high. While they are beneficial in assisting the patient to maintain a healthy BMI, they may increase the risk of dental caries. Dental professionals should enquire specifically about Oral Nutritional Supplements during history taking, particularly in groups who are likely to be prescribed such supplements. Consideration should also be given to increasing caries-preventive measures for patients who take these supplements.

[1]  W. Thomson,et al.  Xerostomia and polypharmacy among dependent older New Zealanders: a national survey. , 2020, Age and ageing.

[2]  Joon Seong Park,et al.  The Effect of Nutrition Intervention with Oral Nutritional Supplements on Pancreatic and Bile Duct Cancer Patients Undergoing Chemotherapy , 2019, Nutrients.

[3]  D. Walsh,et al.  Complete Oral Nutritional Supplements: Dietitian Preferences and Clinical Practice , 2019, Journal of dietary supplements.

[4]  A. Culkin,et al.  Can dietitians prescribe safely? The prescribing practice of a nutrition support dietitian supplementary prescriber , 2018, Clinical Nutrition.

[5]  What role for oral nutritional supplements in primary care? , 2018, Drug and Therapeutics Bulletin.

[6]  Kalin L. Johnson,et al.  A Survey of Dental Patient Attitudes on the Likelihood and Perceived Importance of Disclosing Daily Medications. , 2018, Journal of dental education.

[7]  D. Volkert,et al.  Who receives oral nutritional supplements in nursing homes? Results from the nutritionDay project. , 2017, Clinical nutrition.

[8]  M. Elia,et al.  Oral nutritional supplements in a randomised trial are more effective than dietary advice at improving quality of life in malnourished care home residents. , 2017, Clinical nutrition.

[9]  B. Strandvik,et al.  ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis. , 2016, Clinical nutrition.

[10]  P. Moynihan.  Sugars and Dental Caries: Evidence for Setting a Recommended Threshold for Intake. , 2016, Advances in nutrition.

[11]  S. Sezer,et al.  Long-Term Oral Nutrition Supplementation Improves Outcomes in Malnourished Patients With Chronic Kidney Disease on Hemodialysis , 2014, JPEN. Journal of parenteral and enteral nutrition.

[12]  M. Burke,et al.  Intestinal failure and home parenteral nutrition: implications for oral health and dental care. , 2013, Clinical nutrition.

[13]  C. Baldwin,et al.  Dietary advice with or without oral nutritional supplements for disease-related malnutrition in adults. , 2011, The Cochrane database of systematic reviews.

[14]  M. L. Hunter,et al.  A comparison of the nutritional knowledge of dental, dietetic and nutrition students , 2011, BDJ.

[15]  M. Elia,et al.  Encouraging appropriate, evidence-based use of oral nutritional supplements , 2010, Proceedings of the Nutrition Society.

[16]  R. Grimble,et al.  ESPEN Guidelines on Enteral Nutrition: Wasting in HIV and other chronic infectious diseases. , 2006, Clinical nutrition.

[17]  C. Dejong,et al.  ESPEN Guidelines on Enteral Nutrition: Gastroenterology. , 2006, Clinical nutrition.

[18]  P. Ponikowski,et al.  ESPEN Guidelines on Enteral Nutrition: Cardiology and pulmonology. , 2006, Clinical nutrition.

[19]  M. Hickson,et al.  Malnutrition and ageing , 2006, Postgraduate Medical Journal.

[20]  V. Todorovic.  Evidence-based strategies for the use of oral nutritional supplements. , 2005, British journal of community nursing.

[21]  Hélène Payette,et al.  An approach to the management of unintentional weight loss in elderly people , 2005, Canadian Medical Association Journal.

[22]  D. Silk,et al.  Randomized clinical trial of the effects of preoperative and postoperative oral nutritional supplements on clinical course and cost of care , 2004, The British journal of surgery.

[23]  C. Martyn,et al.  Prevalence of malnutrition in patients in general practice. , 1996, Clinical nutrition.

[24]  C. Lundqvist,et al.  The Vipeholm dental caries study; the effect of different levels of carbohydrate intake on caries activity in 436 individuals observed for five years. , 1954, Acta odontologica Scandinavica.