Covid-19 and Prevention of Malnutrition After Confinement by Dentists

Background. The Covid-19 pandemic reached France in January 2020 and the French government
decreed the confinement of the population for eight weeks, from March 17 to May 10, 2020.
Dental surgeries were closed and only dental emergency services were provided. Dental
surgeries reopened on May 11th, with a limited focus on urgent care, by applying new
occupational hygiene standards to limit the circulation of SARS-Cov-2 coronavirus.
Hypothesis. From May 11th, chronic patients and elderly patients who come to the hospital for
dental consultations will have two risks of malnutrition:

1) because of confinement (loneliness, anorexia, difficulty shopping) and 2) because of the
untreated dental problem (oral pain or untreated edentulism). Main objective. To investigate
whether dentists' recommendation to consult a physician is efficient to prevent or to treat
malnutrition. Secondary objective. Conduct a medico-economic study to assess the health
savings generated by the prevention of malnutrition by dentists. Type of study and population
studied. Prospective cohort study including 100 adults received in hospital dental
consultation, malnourished or at risk of malnutrition. Inclusion criteria. All subjects
answering "yes" to one of these two questions: 1) "Do you eat less?" and/or 2) "Have you lost
weight?" Exclusion criteria. None. Study design and evaluation criteria. At baseline, for all
subjects included, the dentist will check the weight (kg, weighed), the usual weight (kg,
question), height (m, question or from ID card), masticatory ability (score 0%-100%) and oral
pain (score 0-10). Then the dentist will give the patient a note advising him to consult his
doctor for assessment and management of malnutrition. The dentist will call the patient 1
month (M1) and 3 months (M3) after baseline, to ask him for his weight (kg), if he consulted
his doctor (yes/no) and received nutritional supplements (if yes, what prescription). Main
evaluation criterion. Body Mass Index (BMI kg/m²) evolution from baseline to M1 and M3.
Secondary evaluation criteria. Weight changes during confinement, medical consultation,
prescription of nutritional supplements and observance. Individual duration of the study.
Three months. Total duration of the study. One year. Expected fallout. To improve the
nutritional status of malnourished participants, following confinement. To anticipate
malnutrition in exposed populations in the case of a second viral pandemic and confinement.
Educate dentists on the importance of screening and managing malnutrition in at-risk
patients.