The influence of malocclusion, sucking habits and dental caries in the masticatory function of preschool children

Exploring masticatory performance: a bibliometric analysis of studies published in the Web of Science database from 1950 to 2024

Objectively evaluating an individual's capacity for food fragmentation (masticatory performance) is crucial for understanding oral physiology and dental rehabilitation processes. Our aim was to conduct a bibliometric analysis of the literature focusing on masticatory performance. We conducted a survey in Web of Science up to August 31, 2024, applying specific category filters. Two calibrated reviewers manually tabulated the data, extracting information on title, authorship, keywords, institutions, countries, number of citations, year of publication, journal title, study design, masticatory test, population, and dentition status. VosViewer software generated collaborative network maps, while JAMOVI was used to perform ANOVA and Poisson regression analyses. The selection process resulted in 814 articles published between 1950 and 2024, with a recent increase to at least 50 articles per year. The average impact factor was 3.16, with around 30 citations per article. Citations were significantly influenced by the masticatory performance technique, publication year, and journal impact factor. The comminution test was the most prevalent (n = 411). Most studies focused on adults (n = 420) and older adults (n = 361), in which natural dentition (n = 404) and complete dentures (n = 214) were the most widely assessed parameters. The most frequent study designs were cross-sectional (n=489) and prospective (n = 145). The leading countries were Japan (n=202), Brazil (n=134), and the Netherlands (n = 69), and the Journal of Oral Rehabilitation was the most recurrent journal (n = 162). This study highlights the growing interest in evaluating masticatory performance, with a significant increase in publications over the years. This study highlights the need for further research involving children and longitudinal study designs, as well as studies evaluating rehabilitations with removable partial denture and implant-supported prostheses.

The impact of distraction, masticatory performance and sex on food intake of school children from public and private schools: a randomized trial

Recent research highlights the influence of distraction on caloric intake in adults. This study investigated the impact of smartphone use and reading comic book on food intake of schoolchildren aged 10 to 12 years. One hundred and twenty students from public and private schools participated in experimental meal sessions. Individual parameters such as sex, age, body mass index (BMI), and eating preferences were assessed during the first session. In subsequent appointments, participants consumed standardized meals without distraction, while using a smartphone, or reading comic books in a random order. Child Three-Factor Eating Questionnaire (CTFEQr-21) was administered to assess eating behavior, and total caloric intake (kcal), total amount (g) and medium/high-energy-dense amount (g) were measured in each session. No significant difference was observed in food intake among the three experimental meals (without distractor, using smartphone and reading comic book). Masticatory performance, number of chewing cycles, and time until swallow were similar between sexes and school types (p>0.05). Regression models showed that meal duration was dependent on school type, number of teeth, time until swallow and absence of distractor, while total caloric intake was dependent on school type (public), sex (male), time until swallow, and number of cycles. Besides, total amount ingested, and medium/high-energy-dense amount were dependent on school type (public), sex (male), age, size of the particles and time until swallowing, uncontrolled eating and body mass index (p<0.05). In conclusion, the primary factors affecting food/caloric ingestion were sex, school type, and masticatory parameters, while the absence of distractor had an influence on meal duration.

Can Different Impression Techniques Affect the Chewing Efficiency of Mandibular Implant-Retained Overdentures?

Several impression techniques and theories have been developed for implant-retained overdentures, each with its own set of advantages and limitations. This study aimed to assess the chewing efficiency of mandibular implant-retained overdentures fabricated using three distinct impression techniques (mucofunctional, selective, and minimal pressure impression techniques). Twenty-six patients with complete edentulism free from any oral or systemic disease were selected to participate in the study. Three complete mandibular implant-retained overdentures were constructed for each patient, and grouped into three groups according to the impression technique employed in overdenture construction; Group A: Patients were treated by mandibular implant-retained overdenture fabricated using mucofunctional impression technique; Group B: Patients were treated by mandibular implant-retained overdenture fabricated using selective pressure impression technique; Group C: Patients were treated by mandibular implant-retained overdenture fabricated using minimal pressure impression technique. Chewing efficiency was evaluated for each patient with the implant-retained mandibular overdenture after three months of prosthesis insertion as an adaptation period. The data were collected, tabulated, and statistically analyzed. Results indicated that mandibular implant-retained overdentures made using the mucofunctional impression technique showed higher mean values of chewing efficiency parameters than mandibular overdentures made using selective and minimal pressure impression techniques. Within the limitations of this study, it can be concluded that the mucofunctional impression technique may be effective in improving the chewing efficiency of mandibular implant-retained overdentures more than minimal or selective pressure impression techniques.

Prevalence of Malocclusion Traits in Primary Dentition, 2010-2024: A Systematic Review

The present review was aimed to describe the prevalence and the regional distribution of malocclusion among preschool children worldwide. Two independent reviewers performed a systematic literature search to identify English publications from January 2010 to May 2024 using PubMed, ISI Web of Science and Embase. Search MeSH key words were "malocclusion", "primary dentition" and "child, preschool". The reporting quality was assessed by the modified Newcastle-Ottawa Quality Assessment Scale. We identified 2599 publications and recruited 47 articles. Fourteen of the included studies were conducted in Asia, four in Europe, twenty-eight in South America and one in Africa. The prevalence of malocclusion ranged from 28.4% to 83.9%, and half of the reported prevalences were higher than 50%. The highest percentage was in Asia (61.81%), followed by Europe (61.50%), South America (52.69%) and Africa (32.50%). Statistically significant differences existed in deep overbite, anterior open bite, posterior crossbite, edge-to-edge incisor relationship and distal step between continents (p < 0.05). Europe showed the highest prevalence (33.08%) of deep overbite. Africa showed the highest prevalence (18.60%) of anterior open bite. Europe showed the highest prevalence (15.38%) of posterior crossbite. The most common malocclusion traits were increased overjet and deep overbite. To conclude, malocclusion remained prevalent in the primary dentition and varied between countries.

Early Childhood Caries, Masticatory Function, Child Early Cognitive, and Psychomotor Development: A Narrative Review

Dental caries is known as a global public health issue that has been affecting general health apart from its painful nature. Hence, it is undeniable that caries affecting young children or known as early childhood caries, also have an effect on children's general health. One of the interesting findings about caries is that it can also affect child growth and development, specifically on their cognitive and psychomotor ability. Untreated caries are linked to cognitive development through both neural and vascular pathways, with masticatory function as the key. Meanwhile, its effect on psychomotor development might be related to nutritional intake, which might slightly decline on those with caries. This review is aimed to describe the current findings of caries effect on early child development, from masticatory disturbance to further impacts on cognitive and psychomotor development. The overall conclusion of this review is that untreated severe caries in children are potentially associated negatively with their growth and development.

Association between occlusal features and masticatory function in Hong Kong preschool children: a survey with one-year longitudinal follow-up

BACKGROUND

Mastication is important for breaking down food, aiding swallowing and nutrients absorption, and is therefore fundamental to a child's development. Studies have shown poor masticatory function to be associated with younger age and presence of caries. However, studies of the association between masticatory function and malocclusion yielded contradictory results. The aim of this study is therefore to investigate the association between three-dimensional occlusal features with masticatory function, among preschool children in Hong Kong.

METHODS

Self-administered questionnaires on masticatory function in three domains, namely general chewing difficulty, requiring help when eating different food types and increased preference for soft food were completed by parents. Information on non-nutritive sucking habits and basic demographics were also collected in the questionnaire. Clinical examinations were conducted to record three-dimensional occlusal features and presence of caries. Baseline investigations and one-year follow-ups were undertaken for 1,566 and 996 preschool children. Association of poor masticatory function with occlusal features, sucking habits and caries was investigated using chi-squared tests. Binomial logistic regressions were then carried out incorporating any significant factors identified. Longitudinal analysis of the one-year follow-up data was carried out to investigate whether improved occlusal features, sucking habits and caries resulted in better masticatory function.

RESULTS

In the cross-sectional study, the first domain of general chewing difficulty was associated with caries and thumb/digit sucking. The second domain of requiring help when eating different food types was associated with the male sex, younger age, caries and pacifier use. The last domain of increased preference for soft foods was associated with caries and thumb/digit sucking. Occlusal features, including abnormal overjet and unilateral permanent molars not in contact, were significantly associated with poor masticatory function in the bivariate analyses, but were not significant in the logistic regressions. In the longitudinal analysis, general chewing difficulty was found to improve in those of older age and those with resolved anterior crossbite. Less help was required to eat meat in those with fewer caries. Similarly, less help was required to eat food containing bones in those with reduced pacifier use. Preferences for eating soft foods was reduced in those who developed a normal overjet.

CONCLUSIONS

The study identified significant relationships between masticatory difficulties and factors associated with age, gender, active caries, and non-nutritive oral habits such as thumb/digit sucking and pacifier use. Younger children and males required more assistance with certain food types. Active caries and thumb/digit sucking habits contributed to general masticatory difficulties and preference for soft foods. The one-year follow-up indicated that improvement in masticatory function varies across age cohorts and were associated with improved occlusal features, such as resolution of anterior crossbite and normalized overjet, reduced pacifier use, and a decrease in the number of decayed teeth.

The Effect of Caries on the Chewing Ability of Children: A Scoping Review

Childhood caries might have several effects on the children's general health and growth, including chewing ability. This study aims to identify the evidences found regarding the effect of caries on the chewing ability of children through a scoping review. A scoping review literature search was performed in three databases (Scopus, PUBMED, and Web of Science) without restricting the publicized year. The selected articles were using human as its subjects and aiming to analyze the effects of caries on mastication ability in children. Ten articles matched the inclusion criteria of this review. All the articles suggested a deleterious effect of caries on masticatory performance, maximum bite force, swallowing threshold, and even masticatory behavior. Two of them stated that the effect was reversible by giving dental treatment. This scoping review concludes a negative effect of caries on the children's chewing ability.

Vitamin D Supplementation, Characteristics of Mastication, and Parent-Supervised Toothbrushing as Crucial Factors in the Prevention of Caries in 12- to 36-Month-Old Children

Severe early childhood caries (S-ECC), defined as any sign of smooth-surface caries in a child younger than three years of age, remains a serious health issue. The aim of this study was to indicate oral health behaviours related to S-ECC. The study surveyed parents (socio-economic and medical factors, oral health behaviours) and clinically examined children including non-cavitated d1,2/cavitated d ≥ 3 lesions. %S-ECC, and caries indices (d1,2 d ≥ 3 mft and d1,2 d ≥ 3 mfs) were calculated. Spearman’s correlation and simple and multiple logistic regression were used to assess the relationships between various factors and S-ECC. A total of 496 children were examined. S-ECC occurred in 44.8%: d1,2 d ≥ 3 mft = 2.62 ± 3.88, d1,2 d ≥ 3 mfs = 4.46 ± 8.42. S-ECC was correlated with socio-economic factors, vitamin D supplementation, breastfeeding and using formula after the 18th month, and toothbrushing. Supplementation of vitamin D and toothbrushing tended to decrease the odds of S-ECC (OR = 0.49 (0.27−0.87); p = 0.016, OR = 0.46 (0.24−0.86) p = 0.015, respectively). Feeding exclusively with formula was observed to increase the odds of S-ECC (OR = 2.20 (1.29−3.76); p = 0.004). Consuming > three snacks daily (OR = 1.39 (0.97−1.98); p = 0.072) and the reluctance to eat resilient foods (OR = 1.63 (1.05−2.51); p = 0.028) were nullified by the confounding factors. Vitamin D supplementation, mastication of resilient food, breastfeeding in the first six months of a baby’s life, and parent-supervised toothbrushing are factors in the prevention of caries in toddlers. Breast- and bottle-feeding after the 18th month of life, the reluctance to eat solids, lack of vitamin D supplementation, hygienic neglect, and delay in introducing oral health behaviours may contribute to the development of caries in toddlers.

[Health relevance of malocclusions and their treatment]

Zahn- und Kieferfehlstellungen gehören zu den häufigsten Mundgesundheitsbeeinträchtigungen beim Menschen. Der vorliegende Beitrag gibt eine Übersicht zu deren Ursachen, Häufigkeit und Folgen. Er zeigt die präventiven und kurativen Möglichkeiten kieferorthopädischer Behandlungen auf und gibt Informationen zu deren rechtlichen Rahmenbedingungen in Deutschland. Inanspruchnahme und Qualität der kieferorthopädischen Versorgung werden im internationalen Vergleich dargestellt.

Bei den Ursachen für Zahn- und Kieferfehlstellungen spielen genetische, epigenetische, funktionelle und umweltbedingte Faktoren eine Rolle, die individuell meist nicht eindeutig feststellbar sind. Bisher zeigen nur kleinere Querschnittsstudien, dass bis zu 80 % der Kinder in Deutschland betroffen sind. Essen, Trinken, Kauen, Sprechen und Atmen können beeinträchtigt sein, die Neigung zu Parodontalerkrankungen sowie Überlastungsschäden von Kiefergelenk und Kaumuskulatur sind erhöht. Bei einer Proklination der oberen Schneidezähne steigt die Gefahr von Frontzahntraumata. Fehlstellungen können zudem negative psychosoziale Folgen oder Einschränkungen der Lebensqualität zur Folge haben. Kieferorthopädische Behandlungen leisten in Kooperation mit anderen (zahn-)medizinischen Fachdisziplinen einen wichtigen präventiven bzw. kurativen Beitrag zur Verbesserung der Mundgesundheit, der Allgemeingesundheit und der Lebensqualität.

Die Kieferorthopädie bietet ein erhebliches Potenzial für die Stärkung der zahnärztlichen Prävention im Gesundheitswesen, zumal die gesetzliche Krankenversicherung (GKV) eine breitflächige Versorgung der Bevölkerung mit kieferorthopädischen Leistungen auf international anerkanntem, hohem Niveau ermöglicht. Um die Prävention weiter zu verbessern, wird die Einführung eines kieferorthopädischen Screenings im 7.–8. Lebensjahr als systematische Vorsorge empfohlen.