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Lin CS, Chen YC, Chao LJ, Kao WC, Chen TC. Age-related difference in oral adaptation to masticatory perturbation. Arch Oral Biol 2024; 161:105914. [PMID: 38447352 DOI: 10.1016/j.archoralbio.2024.105914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/26/2023] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Mastication can be influenced by intraoral perturbation (e.g., hard food). We developed the masticatory perturbation task (MPT) to assess the perturbation effect during mastication and quantify the degree of adaptation to masticatory perturbation in younger and older adults. DESIGN Thirty-eight younger and 38 older participants completed the MPT, which consisted of three trials assessing masticatory performance (MP) without perturbation (i.e., the baseline condition) and three trials assessing MP with perturbation (i.e., the perturbation condition). Perturbation was implemented by concurrently chewing test food on the preferred side and a drinking straw on the nonpreferred side. We estimated the perturbation effect as the ΔMP between the baseline and perturbation conditions and the adaptation effect as the ΔMP between the third and the first trials for both age groups. RESULTS We found a significant perturbation effect, i.e., a lower MP in the perturbation condition than in the baseline condition, and an adaptation effect, i.e., a higher MP in the third trial than the first trial, in both groups. Moreover, the older group showed a lower degree of adaptation than the younger group. CONCLUSION The masticatory perturbation task revealed the perturbation effect during mastication and the adaptation to masticatory perturbation. The results revealed an association between age and masticatory adaptation.
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Affiliation(s)
- Chia-Shu Lin
- Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taiwan; Oral Medicine Innovation Center, National Yang Ming Chiao Tung University, Taiwan.
| | - Yi-Chen Chen
- Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan
| | - Li-Jung Chao
- Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan
| | - Wei-Chieh Kao
- Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan
| | - Ta-Chung Chen
- Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taiwan
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Masticatory index for patients wearing dental prosthesis as alternative to conventional masticatory ability measures. PLoS One 2022; 17:e0263048. [PMID: 35081155 PMCID: PMC8791480 DOI: 10.1371/journal.pone.0263048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The study objectives were: 1) to develop a masticatory index for evaluating masticatory ability in patients wearing a dental prosthesis, including complete dentures (CD), removable partial denture (RPD), and fixed partial denture (FPD), 2) to test the reliability and validity of the index, and 3) to determine whether the index better reflected patients' masticatory ability compared with conventional subjective and objective measures. METHODS The present cross-sectional study consisted of 2 phases: 1) developing the Chulalongkorn University masticatory index (CUMI) consisting of 20 food items in 5 masticatory difficulty grades using a 3-point Likert scale, and 2) application of the CUMI in 110 patients wearing a dental prosthesis, including CD, RPD, and FPD (control group). The CUMI test-retest reliability was reevaluated 2 weeks later. The convergent validity was compared with objective masticatory performance evaluated with a standard peanut chewing test, and subjective eating impacts evaluated by the Oral Impacts on Daily Performances Index. Oral and denture status were determined clinically. The associations between CUMI score, peanut particle size, and eating impact score was identified using Spearman's correlation coefficient. To evaluate discriminant validity, the associations between masticatory ability measurements and oral and denture status were analyzed using regression analyses. RESULTS The CUMI's Cronbach's alpha and intraclass correlation coefficient values were 0.89 and 0.95, respectively. The convergent validity was shown by significant associations between the increased CUMI score, smaller peanut particle size and decreased eating impact score. Multivariable analyses found that the CUMI score, peanut particle size, and percentage of having an eating impact were significantly associated with the number of remaining teeth and posterior occluding pairs, and type and quality of dental prosthesis. However, the CUMI demonstrated better discriminant validity because significant dose-response relationships were found only between the decreased CUMI score and increased tooth loss severity, and unacceptable denture quality. Adjusted R2 values of the CUMI models were the highest, followed by those of peanut particle size and eating impact. CONCLUSION CUMI is a reliable and valid tool to evaluate masticatory ability of patients wearing a dental prosthesis, including CD, RPD, and FPD. Due to a better discriminant validity, the CUMI better reflects masticatory ability of patients compared with conventional subjective and objective masticatory ability measures.
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Fan Y, Shu X, Leung KCM, Lo ECM. Patient-reported outcome measures for masticatory function in adults: a systematic review. BMC Oral Health 2021; 21:603. [PMID: 34814903 PMCID: PMC8609720 DOI: 10.1186/s12903-021-01949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022] Open
Abstract
Objective The aim of this systematic review was to critically evaluate the Patient-Reported Outcome Measures (PROMs) for masticatory function in adults. Methods Five electronic databases (Medline, Embase, Web of Science Core Collection, CINAHL Plus and APA PsycINFO) were searched up to March 2021. Studies reporting development or validation of PROMs for masticatory function on adults were identified. Methodological quality of the included studies was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. Psychometric properties of the PROM in each included study were rated against the criteria for good measurement properties based on the COSMIN guideline. Results Twenty-three studies investigating 19 PROMs were included. Methodological qualities of these studies were diverse. Four types of PROMs were identified: questions using food items to assess masticatory function (13 PROMs), questions on chewing problems (3 PROMs), questions using both food items and chewing problems (2 PROMs) and a global question (1 PROM). Only a few of these PROMs, namely chewing function questionnaire-Chinese, Croatian or Albanian, food intake questionnaire-Japanese, new food intake questionnaire-Japanese, screening for masticatory disorders in older adults and perceived difficulty of chewing-Tanzania demonstrated high or moderate level of evidence in several psychometric properties. Conclusions Currently, there is no PROM for masticatory function in adults with high-level evidence for all psychometric properties. There are variations in the psychometric properties among the different reported PROMs. Trial Registration PROSPERO (CRD42020171591). Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01949-7.
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Affiliation(s)
- Yanpin Fan
- Faculty of Dentistry, The University of Hong Kong, 1/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Xin Shu
- Faculty of Dentistry, The University of Hong Kong, 1/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong, 1/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, 1/F, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, China.
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Lin YC, Du JK, Lin PC, Kabasawa Y, Lin PL, Hsiao SY, Huang HL. Association between the dental occlusion and perceived ability to eat foods of Taiwanese older adults. J Oral Rehabil 2021; 48:817-826. [PMID: 33624362 DOI: 10.1111/joor.13160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/04/2021] [Accepted: 02/21/2021] [Indexed: 12/11/2022]
Abstract
Tooth loss is a common problem among older adults that affects masticatory function (MF) and food selection. Financial burden is a reason that some older adults in Taiwan with this condition forgo dental restoration. To identify the number of posterior occlusal support areas (POSAs) associated with MF. Large-scale cross-sectional study included 1100 community-dwelling participants of Taiwan aged ≥65 years. Participants completed dental examination and questionnaires through personal interviews. Masticatory performance was evaluated using a colour-changeable chewing gum. Masticatory ability was evaluated on the basis of how many of 14 common foods the participants were able to eat. Participants were grouped into 10 categories (A1-A3, B1-B4 and C1-C3) according to the Eichner index (EI) of posterior occlusal contacts. Multivariable regression models were used to analyse the association between the EI groups and MF. More than 80% of the participants with two or more POSAs (those in groups A1-B2) could easily eat various foods. Compared with those in groups A1-B2, those in groups in B3, B4, C1, C2 and C3 exhibited a significantly different masticatory performance (all P < .001) and significantly higher difficulty in eating fruits and vegetables. A dose-response effect between POSAs and perceived masticatory ability to eat fruits and vegetables was observed (P < .05 for both trends). Preservation of at least two POSAs is essential for MF. Older adults with tooth loss can undergo the restoration of two POSAs to improve MF and increase food intake.
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Affiliation(s)
- Ying-Chun Lin
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Je-Kang Du
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pei-Chen Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yuji Kabasawa
- Oral Care for Systemic Health Support, Faculty of Dentistry, School of Oral Health Care Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Pi-Li Lin
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Szu-Yu Hsiao
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Pediatric and Special Needs, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lin CS. Revisiting the link between cognitive decline and masticatory dysfunction. BMC Geriatr 2018; 18:5. [PMID: 29304748 PMCID: PMC5756393 DOI: 10.1186/s12877-017-0693-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 12/18/2017] [Indexed: 12/17/2022] Open
Abstract
Age-related decline in cognitive functions and dementia are major challenges in geriatric healthcare. Accumulating evidence from clinical, epidemiological and animal research suggests that tooth loss may be a risk factor for the decline of cognitive functions. This issue highlights the role of the brain-stomatognathic axis in geriatric medicine. Whether input from the stomatognathic apparatus can affect the brain remains an open debate. By revisiting the evidence published in the past five years, we argue that the hypothesis regarding the association between cognitive decline and masticatory dysfunction should be carefully interpreted. Most of the available clinical and epidemiological studies present only cross-sectional data. With respect to the prospective studies, important confounding factors, such as nutritional and physical conditions, were not fully controlled for. Animal research has revealed that hippocampal deficits may play key roles in the observed cognitive decline. However, experimental intervention and outcome assessments may not capture the condition of human subjects. Brain neuroimaging research may be suitable for bridging the gap between clinical and animal research, potentially contributing to (a) the clarification of the brain network associated with mastication, (b) the identification of brain imaging markers for exploring the mechanisms underlying long-term changes in masticatory functions, and (c) the elucidation of interactions between mastication and other cognitive-affective processing systems. Three potential models of the brain-stomatognathic axis and relevant hypotheses are summarized, focusing on the sensory feedback mechanisms, the compensation of motor control, and cerebellar deficits. Finally, we highlight four critical aspects of study and experimental design that should be considered in future research: (a) the refinement of the considered behavioral assessments, (b) the inclusion of baseline changes in mental and physical conditions,
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Affiliation(s)
- Chia-Shu Lin
- Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan.
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Lo YTC, Wahlqvist ML, Chang YH, Lee MS. Combined Effects of Chewing Ability and Dietary Diversity on Medical Service Use and Expenditures. J Am Geriatr Soc 2017; 64:1187-94. [PMID: 27321597 DOI: 10.1111/jgs.14150] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To examine whether chewing ability affects healthcare use and expenditure and whether improving dietary quality alleviates any such effects. DESIGN Prospective cohort. SETTING The Elderly Nutrition and Health Survey in Taiwan (1999-2000), a nationwide community-based survey of people aged 65 and older. PARTICIPANTS Individuals aged 65 and older (N = 1,793; 903 men, 890 women). MEASUREMENTS Chewing ability (satisfactory or unsatisfactory) was assessed using a questionnaire, and dietary quality was assessed using a 24-hour dietary recall as a dietary diversity score. Data on annual medical use and expenditures from the interview date until December 31, 2006, were collected from National Health Insurance claims. Generalized linear models were used to assess the associations between chewing ability, dietary quality, and annual medical usage or expenditure. RESULTS After 8 years of follow-up, older adults with unsatisfactory chewing ability had considerably higher emergency, hospitalization, and total medical expenditures. Older adults with unsatisfactory chewing ability and a poor diet used fewer annual preventive care and dental services than those with satisfactory chewing ability but had longer hospital stays and higher expenditures. After adjusting for covariates, unsatisfactory chewing ability resulted in significantly longer hospital stays in participants with a poor diet (β = 2.34, 95% confidence interval = 2.02-2.71, P < .001). CONCLUSION Unsatisfactory chewing ability and a less-diverse diet together are associated with longer hospital stays and higher medical expenditures.
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Affiliation(s)
- Yuan-Ting C Lo
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Mark L Wahlqvist
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.,Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, Australia
| | - Yu-Hung Chang
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, Australia
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Laudisio A, Gemma A, Fontana DO, Rivera C, Bandinelli S, Ferrucci L, Incalzi RA. Self-Reported Masticatory Dysfunction and Mortality in Community Dwelling Elderly Adults: A 9-Year Follow-Up. J Am Geriatr Soc 2016; 64:2503-2510. [PMID: 27889908 DOI: 10.1111/jgs.14331] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the association, if any, between masticatory dysfunction (MD) and mortality in older adults. DESIGN The Invecchiare in Chianti (InCHIANTI) Study, a cohort study with 9-year follow-up. SETTING Tuscany, Italy. PARTICIPANTS Individuals aged 65 and older (N = 1,155). MEASUREMENTS MD was self-reported; Cox regression was used to assess the association between self-reported MD and 9-year all-cause mortality. This association was also evaluated after stratifying according to use of dentures. Analyses were adjusted for potential confounders, including demographic characteristics, lifestyle habits, comorbidities, nutrient intake, medications, and objective parameters. RESULTS Four hundred five (35%) participants reported MD. Over the 9-year follow-up, 475 (41%) subjects died. According to Cox regression analysis, self-reported MD was associated with higher mortality (relative risk (RR) = 1.23, 95% confidence interval (CI) = 1.02-1.48), after adjusting for potential confounders. In participants with self-reported MD, uncorrected edentulism was the condition associated with the greatest risk of mortality (RR = 2.10, 95% CI = 1.07-4.14); use of dentures seemed to blunt this association (RR = 1.12, 95% CI = 0.87-1.44). CONCLUSION Self-reported MD, chiefly when due to uncorrected edentulism, is associated with 9-year all-cause mortality in community-dwelling elderly adults. Further studies are needed to evaluate whether the timely correction of MD using adequate dentures can increase the survival of older adults.
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Affiliation(s)
- Alice Laudisio
- Unit of Geriatrics, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Antonella Gemma
- UOS Accesso e Presa in Carico Assistenziale, Azienda Sanitaria Locale Roma E, Rome, Italy
| | - Davide O Fontana
- Unit of Geriatrics, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Chiara Rivera
- Unit of Geriatrics, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Stefania Bandinelli
- Geriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, Italy
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
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Huang YC, Chu CL, Ho CS, Lan SJ, Chen WY, Liang YW, Hsieh YP. Factors affecting institutionalized older peoples' self-perceived dry mouth. Qual Life Res 2014; 24:685-91. [PMID: 25150709 PMCID: PMC4349962 DOI: 10.1007/s11136-014-0792-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2014] [Indexed: 11/29/2022]
Abstract
Purpose The purpose of this study was to determine the factors affecting institutionalized older peoples’ self-perceived dry mouth. Methods This cross-sectional study was conducted on elderly residents at 22 long-term care facilities. A total of 165 questionnaires were returned from 13 senior citizen welfare institutions (SCWIs) and nine nursing homes. Multiple logistic regression analysis was used to analyze the data obtained. Results The results showed that the type of long-term care (LTC) facility, regular oral examinations, wearing dentures, and the ability to chew sticky foods affected self-perceived dry mouth. This study determined an association between the type of LTC facility where the participants lived and self-perceived dry mouth. Conclusions The results indicated the importance of providing oral care in order to improve and prevent dry mouth among institutionalized older people living in SCWIs who do not undergo regular oral examinations, wear dentures, and have difficulty chewing sticky foods.
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Affiliation(s)
- Ying-Chia Huang
- Department of Healthcare Administration, Asia University, Taichung City, Taiwan, ROC,
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Hsu KJ, Lee HE, Wu YM, Lan SJ, Huang ST, Yen YY. Masticatory factors as predictors of oral health-related quality of life among elderly people in Kaohsiung City, Taiwan. Qual Life Res 2013; 23:1395-405. [DOI: 10.1007/s11136-013-0574-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2013] [Indexed: 11/29/2022]
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