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Murakami K, Kasakawa N, Hori K, Kosaka T, Nakano K, Ishihara S, Nakauma M, Funami T, Ikebe K, Ono T. Relationship between maximal isometric tongue pressure and limit of fracture force of gels in tongue squeezing. J Oral Rehabil 2024; 51:574-580. [PMID: 37964441 DOI: 10.1111/joor.13627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/27/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND There is no clear objective indicator for selecting soft foods that are required for food bolus formation in older people with impaired oral function. OBJECTIVE This study aimed to investigate the relationship between maximal isometric tongue pressure (MITP) and the mechanical properties of gels that can be crushed by the tongue. METHODS This study included 65 healthy participants aged 22-96 (young group; 15 males, 15 females; older dentate group; 7 males, 8 females; older edentulous group; 10 males, 10 females). MITP was measured by the balloon-probe device. Agar gel with 10 different kinds of fracture force from 10N to 100N was used. The limit of fracture force of gels (LFFG) that were crushed by the tongue was measured by the up-and-down method. In the older edentulous group, two items were measured with and without dentures. Spearman's rank correlation coefficient was used to evaluate the relationship between MITP and LFFG in each group (p < .05). RESULTS There were positive correlations between MITP and LFFG in all groups (overall groups: rs = .66, young group: rs = .46, older dentate group: rs = .61, older edentulous group with dentures: rs = .60, older edentulous group without dentures: rs = .47). CONCLUSION MITP and LFFG were positively correlated in young, older dentate and older edentulous groups, suggesting that MITP has the potential to be an objective indicator of the range of mechanical properties of soft food that can be crushed by the tongue.
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Affiliation(s)
- Kazuhiro Murakami
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Naohiko Kasakawa
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takayuki Kosaka
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | | | | | | | | | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
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Guo J, Zhang M, Adhikari B, Ma Y, Luo Z. Formulation and characterization of 3D printed chickpea protein isolate-mixed cereal dysphagia diet. Int J Biol Macromol 2023; 253:127251. [PMID: 37804891 DOI: 10.1016/j.ijbiomac.2023.127251] [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: 07/23/2023] [Revised: 09/23/2023] [Accepted: 10/03/2023] [Indexed: 10/09/2023]
Abstract
The feasibility study of making 3D printed dysphagia diet was undertaken. A mixture of corn flour and buckwheat flour was used as the model cereal and chickpea protein isolate (CPI) was used as the model protein. Printing gels (inks) of the mixed cereal (control) and CPI-cereal mixture were produced by heating the formulations at 95 °C for 30 min and then cooling them to room temperature. The results showed that all the ink formulations containing CPI had higher apparent viscosity, preferable shear thinning behavior and shape supporting characteristics than that of the control. The cohesiveness and shape supporting ability of 10%CPI-cereal and 20%CPI-cereal formulations were poor and could not produce stable printing shape. The 30%CPI-cereal and 40%CPI-cereal formulations had suitable apparent viscosity, shear thinning behavior, storage modulus, yield stress and printing accuracy and the 3D printed products were stable. The control ink and 10%CPI-cereal ink had low cohesion and also could not pass the spoon tilt test. The 50%CPI-cereal formulation had high hardness and also could not pass the fork pressing test. The 30 % to 40 % CPI-cereal formulations were found to be suitable as dysphagia products as they could be classified as level 5 dysphagia diet.
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Affiliation(s)
- Jia Guo
- State Key Laboratory of Food Science and Resources, Jiangnan University, 214122 Wuxi, Jiangsu, China; China General Chamber of Commerce Key Laboratory on Fresh Food Processing & Preservation, Jiangnan University, 214122 Wuxi, Jiangsu, China
| | - Min Zhang
- State Key Laboratory of Food Science and Resources, Jiangnan University, 214122 Wuxi, Jiangsu, China; Jiangsu Province International Joint Laboratory on Fresh Food Smart Processing and Quality Monitoring, Jiangnan University, 214122 Wuxi, Jiangsu, China.
| | - Benu Adhikari
- School of Science, RMIT University, Melbourne VIC3083, Australia
| | - Yamei Ma
- Jiangsu Gaode Food Co., 226500 Rugao, Jiangsu, China
| | - Zhenjiang Luo
- R&D center, Haitong Ninghai Foods Co., Ltd., 443000 Yichang, Hubei, China
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Moritoyo R, Nakagawa K, Yoshimi K, Yamaguchi K, Ishii M, Yanagida R, Namiki C, Tohara H. Relationship between the jaw-closing force and dietary form in older adults without occlusal support requiring nursing care. Sci Rep 2023; 13:22551. [PMID: 38110442 PMCID: PMC10728115 DOI: 10.1038/s41598-023-49059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023] Open
Abstract
In clinical practice, we encounter cases wherein older adults lacking occlusal support consume foods requiring mastication and adequate swallowing function. This study investigated the relationship between jaw-closing force (JCF) and dietary form in older adults without occlusal support requiring nursing care. This prospective cross-sectional study included 123 older adults requiring nursing care who lost their molar occlusal support and consumed food orally without dentures. JCF was defined as the force required for crushing food with the edentulous ridges or with the tooth and edentulous ridge while closing the mouth. Participants were classified into four groups based on the International Dysphagia Diet Standardization Initiative framework for recommended dietary forms. Basic information was collected, and tongue pressure and JCF were measured. Differences in JCF were analyzed using one-way analysis of variance, while factors related to dietary form were evaluated using ordinal logistic regression analysis. Significant differences in JCF were observed among the four groups. Factors such as the Barthel Index, tongue pressure, and JCF were dietary form-related. Our findings suggest that older adults requiring nursing care tend to have higher JCF when consuming meals requiring mastication. Therefore, JCF could serve as an index for determining appropriate dietary forms in this population.
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Affiliation(s)
- Rieko Moritoyo
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kazuharu Nakagawa
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Kanako Yoshimi
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kohei Yamaguchi
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Miki Ishii
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Ryosuke Yanagida
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Chizuru Namiki
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Haruka Tohara
- Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Iwai K, Azuma T, Yonenaga T, Nomura T, Sugiura I, Inagawa Y, Matsumoto Y, Nakashima S, Abe Y, Tomofuji T. Relationship between Oral Function and Support/Care-Need Certification in Japanese Older People Aged ≥ 75 Years: A Three-Year Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16959. [PMID: 36554840 PMCID: PMC9779451 DOI: 10.3390/ijerph192416959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
The aim was to examine the relationships between oral functions and support/care-need certification in older people aged ≥ 75 years using the National Health Insurance (NHI) database system and data from Kani City, Gifu, Japan. In total, 732 older Japanese people aged ≥ 75 years who did not have support/care-need certification and underwent dental check-ups in Kani City in 2017 were followed up until 2020. Chewing state, tongue and lip function, and swallowing function were assessed by a self-administered questionnaire, an oral diadochokinesis test, and a repetitive saliva-swallowing test, respectively. The presence or absence of systemic diseases and of support/care-need certification was based on data collected by the NHI database. At follow up, 121 (17%) participants had support/care-need certification. The participants with support/care-need certification included more women (p < 0.001) and older people (p < 0.001); and had more hypertension (p = 0.003), musculoskeletal disorders (p < 0.001), pneumonia (p = 0.044), poor chewing state (p < 0.001), and poor swallowing function (p = 0.003) than those without support/care-need certification. Furthermore, the presence of support/care-need certification at follow up was associated with sex (woman: odds ratio [OR], 2.120; 95% confidence interval [CI], 1.354 to 3.317), age (OR, 1.203; CI, 1.139 to 1.270), chewing state (poor: OR, 2.534; CI, 1.409 to 4.557), and swallowing function (poor: OR, 2.372; CI, 1.248 to 4.510) at baseline. However, tongue and lip function were not associated with support/care-need certification. The results indicate that older Japanese people aged ≥ 75 years with a poor chewing state and poor swallowing function at baseline had a higher risk for support/care-need certification after three years.
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Affiliation(s)
- Komei Iwai
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Tetsuji Azuma
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Takatoshi Yonenaga
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Taketsugu Nomura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Iwane Sugiura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yujo Inagawa
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yusuke Matsumoto
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Seiji Nakashima
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yoshikazu Abe
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Takaaki Tomofuji
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
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Murakami K, Hori K, Uehara F, Salazar SE, Ishihara S, Nakauma M, Funami T, Ono T. Effect of maximal voluntary tongue pressure and mechanical properties of gels on tongue pressure production when squeezing gels. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2021.107323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Matsuo K, Sekimoto Y, Okamoto M, Shibata S, Otaka Y. Association between oral health status and oral food intake level in subacute stroke patients admitted to a convalescent rehabilitation unit. Gerodontology 2021; 39:67-73. [PMID: 34448242 DOI: 10.1111/ger.12586] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stroke patients often suffer from dysphagia during their recovery. We hypothesised that subacute stroke patients with dysphagia had more deteriorated oral health status including muscle strength and motor function. OBJECTIVE Quantitatively investigate oral health status and identify associations with oral feeding status in stroke patients admitted to a convalescent rehabilitation unit. METHODS We prospectively recruited 187 stroke patients admitted to a convalescent rehabilitation unit. Oral feeding status was examined using the Functional Oral Intake Scale (FOIS), and the cohort was divided into three groups based on FOIS score as non-oral feeding (FOIS-123; 22 patients), dysphagic diet (FOIS-45; 74 patients), and regular diet (FOIS-67; 91 patients) groups. Activities of daily living (ADL) were assessed with the Functional Independence Measure (FIM). Oral health status was measured quantitatively in six oral function parameters and Oral Health Assessment Tool (OHAT), and differences according to the FOIS, age and FIM were statistically tested. RESULTS In bivariate analysis, two parameters, tongue pressure and tongue-lip motor functions were significantly higher in the regular diet group than in the other groups (P < .01). Gross OHAT score was also significantly better in the regular diet group than in the other groups (P < .01). These significant associations mostly remained in the multiple model after adjusting for age and FIM. CONCLUSION This study suggests that, amongst oral health status, tongue strength and motor function, as well as OHAT score, may have strong associations with oral feeding status in subacute stroke patients at convalescent rehabilitation units regardless of ADL levels.
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Affiliation(s)
- Koichiro Matsuo
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan.,Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Sekimoto
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Mieko Okamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
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Yoshimi K, Nakagawa K, Hara K, Yamaguchi K, Nakane A, Kubota K, Furuya J, Tohara H. Relationship between tongue pressure and back muscle strength in healthy elderly individuals. Aging Clin Exp Res 2020; 32:2549-2555. [PMID: 32006384 DOI: 10.1007/s40520-020-01484-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/13/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Aging is associated with a decrease in muscle mass and strength in swallowing muscles, as well as in whole-body muscles. A decrease in tongue pressure (TP) is related with whole-body function, and the trunk, including abdominal and back muscles, forms the core of the body. However, the direct relationship between TP and trunk muscle strength remains unclear. AIMS To clarify the association between back muscle strength, an indicator of trunk muscle strength, and TP in healthy elderly individuals. METHODS In all, 112 healthy community-dwelling individuals aged ≥ 60 years (men: 35, median age 74.0; women: 77, median age 69.0) were included. Body mass index (BMI), TP, and back muscle strength (BMS) were measured. Tooth loss pattern was evaluated by the Eichner classification. Participants were divided into two groups based on the median of the BMS and classified into three groups based on the Eichner index (Eichner A, B, and C). The effects of BMS and occlusal support on TP were analyzed. RESULTS In the low BMS group, there was a significant difference in TP between the Eichner B and Eichner C (p = 0.017) groups. However, in the high BMS group, occlusal support did not affect TP. Moreover, the explanatory factors for TP were BMS (β = 0.373, p = 0.001) and the Eichner index (β = 0.190, p = 0.036). CONCLUSIONS TP was correlated more with BMS than aging and occlusal support in healthy elderly individuals. This study indicated that the clinical evaluation of the whole body is important when assessing oral and swallowing function.
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Shimazaki Y, Nonoyama T, Tsushita K, Arai H, Matsushita K, Uchibori N. Oral hypofunction and its association with frailty in community‐dwelling older people. Geriatr Gerontol Int 2020; 20:917-926. [DOI: 10.1111/ggi.14015] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/04/2020] [Accepted: 07/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health School of Dentistry, Aichi Gakuin University Aichi Japan
| | - Toshiya Nonoyama
- Department of Preventive Dentistry and Dental Public Health School of Dentistry, Aichi Gakuin University Aichi Japan
| | - Kazuyo Tsushita
- Comprehensive Health Science Center Aichi Health Promotion Public Interest Foundation Aichi Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology Aichi Japan
| | - Kenji Matsushita
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology Aichi Japan
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Supplied Food Consistency and Oral Functions of Institutionalized Elderly. Int J Dent 2020; 2020:3463056. [PMID: 32148501 PMCID: PMC7031709 DOI: 10.1155/2020/3463056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/14/2020] [Accepted: 01/21/2020] [Indexed: 12/04/2022] Open
Abstract
Background Maintaining good oral function is one of the goals of dental treatment. The Japanese national insurance system newly introduced the concept of management of oral function according to the life stage. For the application of management of oral functions of the elderly, seven kinds of examination is a must for the diagnosis: xerostomia, oral hygiene status, maximum occlusal pressure, tongue and labium function, tongue pressure, chewing ability, and swallowing function. We analyzed the relationship between oral functions and supplied food consistency. Methods Oral functions and supplied food consistency of sixty-nine institutionalized elderly were investigated. There were 13 men and 56 women, and their mean age was 86.23 ± 7.02. Oral functions were measured and evaluated according to the Japanese insurance system. Data were analyzed by item response theory analysis, ROC analysis, and decision analysis. Results By the item response theory analysis, tongue pressure and swallowing functions had high discrimination ability. The subjects who had malfunction of the tongue and labium all had processed food. The subjects with difficulty in swallowing, even without malfunction of the tongue and labium, all had processed food. Conclusion Supplied food consistency may depend on the oral functions. However, as oral function has some dimension, a systematic evaluation system is necessary to decide the supplied food consistency.
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Matsuo K, Kito N, Ogawa K, Izumi A, Masuda Y. Effects of textured foods on masticatory muscle activity in older adults with oral hypofunction. J Oral Rehabil 2019; 47:180-186. [DOI: 10.1111/joor.12901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/15/2019] [Accepted: 10/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Koichiro Matsuo
- Department of Dentistry and Oral‐Maxillofacial Surgery School of Medicine Fujita Health University Aichi Japan
| | - Norie Kito
- Department of Dentistry and Oral‐Maxillofacial Surgery School of Medicine Fujita Health University Aichi Japan
| | | | | | - Yuji Masuda
- Division of Oral and Maxillofacial Biology Institute for Oral Science Matsumoto Dental University Shiojiri Japan
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