Introduction:

Diet and nutrition are more interlinked to dental health than one can imagine, and this relationship is due to a multidirectional perspective. Any oral diseases, for instance, whether they occur due to trauma, congenital (present by birth) cause, inflammatory cause, or because of cancers or neoplastic tumors, oral immunity gets considerably impacted due to a malfunction in the oral cavity. Specifically, when oral, dental, or facial corrective surgeries are done to improve the patient's oral status, the direct effect is certainly on the diet the individual takes.

How Poor Nutrition Can Compromise Oral Wound Healing?

• Soon after oral, dental, and maxillofacial surgeries, especially in major cases, the food and fluid intake would be considerably compromised, which subsequently compromises the individual's nutritional status.

• Unlike most surgeries done in other organ systems, the surgeries performed or done, particularly in the oral, orofacial, or jaw regions can directly impair the normal food intake of the individual temporarily. This is because whatever one eats or drinks goes through the mouth and it also harbors a myriad of microorganisms or microbiota that can complicate healing. Therefore, the mouth or the oral cavity is not only the main portal for the entry of food into the body but can also be the portal of defense and the infectious microorganisms to enter the body.

• Oral wound healing is most commonly impacted by the oral microbiota itself when there is a lowered immunity. Hence, after oral surgery, it is natural that oral wound healing may take some time. For instance, soon after a wisdom tooth (third molars) extraction, a patient can take up to seven to 14 days to completely undergo oral wound healing and recovery. During this period, the oral surgeon specifically advises the individual to consume soft foods and avoid any hot or spicy foods. This remains one of the classic examples where further oral infections need to be prevented when the oral cavity is in a state of healing or the recovery phase. Other common oral surgeries include such as those performed in the dentoalveolar region, treatment of maxillofacial fractures, or prosthetic rehabilitation.

• Surgeries performed in patients for maxillofacial trauma, orthognathic jaw surgeries, oral cancers or jaw tumors, cleft lip, and palate corrections are some examples where patients may take a longer time than expected to recover and have their oral wounds healed. Furthermore, the extent of oral surgery or the site of dental implants would influence these post-operative instructions and therefore, care should be continued till oral wound healing takes place completely.

• Hence, nutrition plays one of the major roles in this phase of oral postoperative recovery as well as in the healing process. The pediatric and geriatric population groups would be particularly more prone to compromised nutrition than the other high-risk population groups.

Who Are the High-Risk Groups of Patient Morbidity?

Malnutrition in the field of oral and maxillofacial surgery (OMFS) cases is one of the main reasons behind the patient's postoperative morbidity or even mortality as in the cases of oral cancers, neoplasms, salivary gland tumors, or head and neck cancers.

In healthy patients with no medical history, oral wound healing can indeed take place at a faster pace despite compromise in diet or nutrition, but the same cannot be said for immunocompromised individuals, or those suffering from systemic health issues, or taking systemic medications. The common examples of this would be impaired healing process in the following risk groups:

• Young children.

• Malnourished population groups.

• Individuals or children belonging to lower socioeconomic status or groups (subject to poor nutritional status).

• Critically ill or terminally ill individuals.

• The elderly or the geriatric population.

• Patients who have prolonged stay at the hospital.

• Individuals on multiple systemic medications.

• Immunocompromised individuals.

What Are the Nutritional Interventions and Precautions for Oral Surgeries?

• Nutrition in the high-risk groups is a cause for high morbidity and mortality as their nutritional needs have to be addressed by professional healthcare providers in the form of enteral (through the gut), and parenteral nutrition (infusion of a specialized form of nutrition or food intravenously or through a vein).

• Patients who undergo dental or orofacial surgical procedures would more often require protein sources that are most needed for functions of cellular proliferation (the process of cell growth and division), cellular repair (the process of maintaining and restoring the integrity of the functional unit of the cell), and cellular energy.

• Dental surgeons also do not recommend the consumption of excess glucose post-surgery because it may further result in impaired wound healing or metabolism. Excess glucose is usually linked to reduced leukocyte or white blood cell function, possible dehydration, and even metabolic acidosis (acid buildup in the body due to kidney disease or failure).

• Bone healing is one of the major factors that is given the most value in the field of oral and maxillofacial surgery. This is again possibly accelerated in individuals with a good post-operative intake of protein. Eating protein-rich foods can be of benefit to individuals who have had fracture surgeries done since high protein metabolism would play a crucial role in fracture repair.

Conclusion:

In the fields of dentistry and maxillofacial surgery, the importance of preoperative and perioperative nutrition is slowly being investigated and researched by dental and medical researchers as this would influence the postoperative outcomes or wound healing phases soon after dental or oral and maxillofacial surgeries.

Immunocompromised as well as malnourished patients usually demonstrate much-delayed wound healing in comparison to individuals taking only systemic medications or drug therapies.

Malnourished or immunocompromised patients tend to have a much higher susceptibility towards dental or oral infection that can eventually prolong the rehabilitative period in the individual.