Effect of gum-chewing exercise on maintaining and improving oral function in older adults: A pilot randomized controlled trial

Background/purpose

Gum chewing has been found to improve oral function. Nevertheless, few randomized controlled trials have investigated the effects of gum-chewing exercises on oral function in older adults. This study aimed to examine the effect of gum-chewing exercises on oral function in older adults.

Materials and methods

This was a single-blind, randomized controlled trial, conducted from November 2021 to January 2022. A total of 130 participants were divided randomly into the intervention and control groups. The intervention group was told to chew experimental gums for one month, while the control group was instructed to chew experimental tablets for one month. Maximum bite force, occlusal contact areas, oral dryness, tongue pressure, tongue and lip functions (number of times each of the following syllables is pronounced per second:/pa/,/ta/, and/ka/), masticatory function, subjective masticatory function, and gum-chewing time were measured at baseline and one month following intervention to assess outcomes.

Results

One month following the intervention, tongue pressure was significantly higher in the intervention group than in the control group (P = 0.027). In the within-group comparisons, maximum bite force (P < 0.001), unstimulated saliva flow (P < 0.001), tongue and lip functions (/pa/: P < 0.001;/ta/: P < 0.001;/ka/: P < 0.001), color scale value (P = 0.019), and ΔE value (P = 0.024) were significantly increased in the intervention group.

Conclusion

The results suggest that gum-chewing exercises can improve oral functions in older adults, although additional increases in masticatory load may be necessary to establish a more effective oral function training method using gum-chewing exercises in older adults.

Factors related to masticatory performance in junior and senior high school students and young adults: A cross-sectional study

PURPOSE

Maintaining good masticatory function from a young age promotes lifelong health, yet limited studies have explored masticatory performance in young individuals. We investigated the relationship of sex, age, and individual oral functions with masticatory performance among junior and senior high school students and young adults.

METHODS

This cross-sectional study included students aged 12-13, 14-15, and 16-17 years (groups S1, S2, and S3, respectively) and young adults aged 20-40 years (group YA). We assessed oral functions, the number of functional teeth, and anthropometric measurements. Masticatory performance was evaluated using color-changeable chewing gum. We analyzed sex-related differences in each group and age-related differences in each sex. Multiple linear regression analysis was performed using masticatory performance as the dependent variable to investigate related factors.

RESULTS

Among the 522 children and 100 young adults, males exhibited significantly higher masticatory performance than females in groups S1, S3, and YA. Among males, groups S2, S3, and YA exhibited significantly higher masticatory performance than group S1. Among females, group S2 exhibited higher masticatory performance than groups S1 and S3. Male sex, the maximum occlusal force and tongue pressure, and the number of functional teeth were significantly correlated with masticatory performance.

CONCLUSIONS

Masticatory function development differed by sex, with males exhibiting higher masticatory performance than females. We identified that male sex, the maximum occlusal force and tongue pressure, and the number of functional teeth were significantly associated with masticatory performance. Our findings provide a basis for masticatory performance assessment in different age groups.

Influence of age and diet consistency on the oral muscle pressure of orthodontically treated and untreated subjects with normal occlusion and comparison of their 3D facial shape

OBJECTIVES

(1) To investigate the effect of age and diet consistency on maximum lips, tongue and cheek pressure of orthodontically treated and untreated subjects with normal, Class I dental occlusion, (2) to find out whether there is a muscle imbalance between anterior tongue and lip pressure in the same subjects at different ages and (3) to compare the 3D facial shape of treated and untreated individuals.

MATERIAL AND METHODS

Subjects with normal occlusion were prospectively grouped into orthodontically treated/untreated and in children/adolescents/adults. Iowa Oral Performance Instrument was used to record the maximum muscle pressure. Two-way ANOVA and Tukey post hoc test analysed age-specific differences in muscle pressure. Two-way ANCOVA analysed the effect of diet consistency on muscle pressure. Lips and tongue imbalance was analysed using z-scores and 3D faces using a generalized Procrustes analysis.

RESULTS

One hundred thirty-five orthodontically untreated and 114 treated participants were included. Muscle pressure was found to increase with age in both groups, except for the tongue in treated subjects. No differences in the balance between lips and tongue muscle pressure were found, but a higher cheek pressure in untreated adults (p<0.05) was observed. 3D facial shapes showed subtle differences. Untreated subjects with soft diet consistency showed lower lip pressure (p<0.05).

CONCLUSION

Oral muscle pressure of orthodontically treated patients without relapse does not differ from that of untreated patients with Class-I occlusion.

CLINICAL RELEVANCE

This study provides normative lip, tongue and cheek muscle pressure in subjects with normal occlusion, which can be used for diagnosis, treatment planning and stability.

Association between masticatory performance and oral conditions in adults: A systematic review and meta-analysis

OBJECTIVES

To give an overview of the evidence on the associations between oral condition factors and masticatory performance of adults, and to evaluate the direction and level of the associations.

DATA/SOURCES

Medline (PubMed), Embase (Ovid) and CINAHL Plus (EBSCOhost) were searched up to May 2022 for cross-sectional studies on oral conditions and masticatory performance in adults. Methodological quality of the included studies was independently evaluated based on the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between oral condition factors and masticatory performance were extracted. Meta-analysis was conducted on correlation coefficients.

STUDY SELECTION

Of the 8,035 records identified, 97 articles (88 studies) were included in the qualitative synthesis, and 18 studies were included in the meta-analyses. Among the oral condition factors that had associations with masticatory performance, the number of natural/remaining teeth or functional tooth pairs was reported by the largest number of studies, followed by perioral muscle status, dental prosthetic status, oral moisture status and periodontal status. Results of the meta-analyses showed that the positive association with the number of natural/remaining teeth was the strongest (pooled correlation coefficient: 0.51, 95%CI: 0.48 to 0.54), followed by the number of functional tooth pairs, maximum tongue force/pressure, while the association with the oral moisture status was the weakest.

CONCLUSIONS

Number of natural/remaining teeth and functional tooth pairs, perioral muscle status, oral moisture status, dental prosthetic status and periodontal status are the main oral condition factors influencing masticatory performance. Based on the limited evidence available, among these factors, the number of natural/remaining teeth has the strongest positive association, with a very low quality of evidence.

CLINICAL SIGNIFICANCE

This study provides valuable information on the oral condition factors associated with masticatory performance, which would be important for policymakers and clinical practitioners when deciding on the strategies for improving the masticatory performance of adults. This review highlights the need for standardization of measures and classifications of masticatory performance and oral conditions.

REGISTRATION

PROSPERO (registration number: CRD42021256824).

Tongue Pressure Declines Early on in Patients with Malocclusion

(1) Background: The tongue plays a key role in the stomatognathic system in carrying out oral functions. The aim of this study was to identify the association between tongue pressure and orthodontic parameters. (2) Methods: This study is a cross-sectional multicentered cohort study with IRB approval. During routine orthodontic initial examinations, the following data were recorded: age, sex, angle classification, overjet (OJ), overbite (OB), arch sizes, tongue width, and maximum tongue pressure (MTP). The association between MTP and orthodontic parameters was analyzed using Pearson’s correlation analysis and the Student’s t-test. (3) Results: There is a positive correlation between MTP and age between ages 10 and 20 (R = 0.47, p < 0.01). There is a negative correlation with MTP and age between 20 and 40 (R = −0.30, p < 0.05). There are negative correlations between MTP and OJ (R = −0.278, p < 0.01)) and OB (R = −0.374, p < 0.01). While there is no statistical significance between MTP and tongue width, there is a statistically significant difference between age and tongue width (R = 0.22482, p < 0.05). There is no statistical significance between MTP and sex, angle classification, arch length, intercanine width, and intermolar width. (4) Conclusion: An earlier decline in MTP is observed with patients with malocclusion. This implies that patients with malocclusion should seek early treatment for the malocclusion.

Motor Performance and Skill Acquisition in Oral Motor Training With Exergames: A Pilot Study

Objective

To investigate the effects of oral-motor training with exergames on motor performance and motor skill acquisition in two different age groups.

Methods

Thirty-two healthy participants were recruited in the current pilot study and divided equally into two groups (Gen Z and Baby Boomers) according to their age. A pair of electromyographic (EMG) electrodes were placed on the participants’ masseter muscles. The EMG device communicated via Bluetooth with a mobile video game in response to the electromyographic activity of the masseter muscles during clenching. During the experimental session, participants were asked to play a video game in five blocks of 5 min each, with a 3-min break between each time block. The goal of the game was to collect as many coins (game points) as possible and to dodge/avoid upcoming obstacles (game life). Motor performance was assessed by performance scores and the number of game lives. Skill acquisition was measured by task efficiency (ratio of performance scores and number of game lives) across time blocks.

Results

The results of the study showed significantly lower performance scores (p < 0.001), a higher number of game lives (p < 0.001), and lower task efficiency in the Baby Boomer group compared to the Gen Z group. Specifically, the results showed that there was a significant difference in task efficiency between the first and second, third and fourth, fourth- and fifth-time blocks in the Gen Z group (p < 0.002). However, there was only a significant difference between first- and second-time blocks in the Baby Boomer group (p = 1.012), suggesting that skill acquisition in the Baby Boomer group did not change significantly over the course of the time blocks.

Conclusion

The study showed higher motor performance and superior motor skill acquisition with novel exergame training in the Gen Z group compared to the Baby Boomer group. The results of the study indicate that there is an improvement in oral motor skills with short-term training, yet the differences in oral motor skills between the two groups are still evident. The Baby Boomer group, unlike the Gen Z group, did not show robust improvement in task efficiency over the course of the series.

Reference value of masticatory performance by measuring the amount of glucose extraction from chewing gummy jelly

PURPOSE

The purpose of this study was to determine a reference value for masticatory performance (MP) by measuring the amount of glucose extracted(AGE) from chewing gummy jelly.

METHODS

A total of 237 young adults (young group, 20-39 years), 147 middle-aged adults (middle-aged group, 40-59 years), and 177 older adults (old group, 60-87 years) participated in this study. All participants had natural dentition, excluding the third molars. AGE was measured when the participant chewed gummy jelly and used as a parameter of MP. AGE was compared among the three groups. Next, AGE in each group was compared between the habitual chewing side and non-habitual chewing side, and between males and females. The correlation between age and AGE was also investigated.

RESULTS

AGE in the young, middle, and old groups were similar, and no significant differences were observed. AGE was significantly higher in the habitual chewing side compared to the non-habitual chewing side, and in males than that in females. No significant correlations were found between age and AGE. AGE in the habitual chewing side of all ages was 221.9 ± 34.4 mg/dL for males and 206.0 ± 28.7 mg/dL for females. The mean-2SD (standard deviation) value representing the reference value of healthy adults was 153.1 mg/dL for males and 148.6 mg/dL for females, which was close to 150 mg/dL.

CONCLUSION

It was concluded that the reference value of masticatory performance as measured by the amount of glucose extraction after chewing gummy jelly was 150 mg/dL.

Differences in the factors associated with tongue pressure between children with class I and Class II malocclusions

Background

The relationship between tongue pressure and masticatory performance during the mixed dentition period in cases of Class II malocclusion has not been clarified. The aim of this study was to determine differences in tongue pressure-related factors, including maxillofacial morphology and masticatory performance, between Class I and Class II malocclusions during the mixed dentition period.

Methods

A total of 56 children with Class I malocclusion (12 boys, 16 girls) or Class II malocclusion (16 boys, 12 girls) with mixed dentition were included in the present study. Height, body weight, hand grip strength, maximum occlusal force, maximum tongue pressure, masticatory performance, and the number of decayed, missing, and filled teeth were measured in all participants. Their lateral cephalograms were also evaluated. The means of all measurements were compared between Class I and Class II malocclusions. Pearson’s correlation coefficients were used to determine associations between maximum tongue pressure and other variables for each type of malocclusion.

Results

The maximum tongue pressure, hand grip strength, and maximum occlusal force in the Class II malocclusion group were significantly lower than those in the Class I malocclusion group (all, p < 0.05). The maximum tongue pressure was significantly positively correlated with hand grip strength, maximum occlusal force, masticatory performance, and SNB (sella, nasion, B point) angle in the Class I group (all, p < 0.05), and with height, body weight, and labial inclination of the central incisors in the Class II group (all, p < 0.05).

Conclusions

The maxillofacial morphometric factors associated with tongue pressure were clearly different between cases of Class I and Class II malocclusion with mixed dentition. Masticatory performance and tongue pressure were significantly positively correlated in cases of Class I malocclusion, but not in cases of Class II malocclusion.

Age and sex differences in oral functions from junior high school to young adulthood: A cross-sectional study

BACKGROUND

As oral function requires maintenance throughout life, it needs to be understood across age groups; however, few studies have investigated this in young individuals.

OBJECTIVES

To clarify age and sex differences in maximum occlusal force, maximum tongue pressure and tongue-lip motor function; and the relationship among these oral functions in junior high school students and young adults.

METHODS

This cross-sectional study investigated oral functions in students aged 12-13 years, 14-15 years old and 16-17 years old (S1, S2 and S3), and young adults aged 20-40 years (YA). We analysed age group differences in each sex and sex differences in each age group. Multiple linear regression analysis was performed for each sex using the maximum occlusal force as the dependent variable to investigate the associations among different oral functions.

RESULTS

In 522 children and 100 young adults, there were significant increases in oral functions with age in males and a significant decrease in maximum tongue pressure between S2 and S3 in females. Maximum occlusal force and tongue pressure were higher in males than in females in S3 and YA; tongue-lip motor function was higher in females than in males in S1. In multiple linear regression analysis, tongue-lip motor function and age group were significant factors in both sexes and in males, respectively.

CONCLUSION

Maximum occlusal force, maximum tongue pressure and tongue-lip motor function increased with increasing age groups in males. Our findings provide a basis for assessing oral function across age groups.

Changes in tongue pressure and dysphagia at oral cancer patients by palatal augmentation prosthesis

Background

The palatal augmentation prosthesis (PAP) is an intraoral prosthesis used in the treatment of dysphagia.

Aim

The objective of the study is to examine the effect of PAP using tongue pressure and the Videofluoroscopic Dysphagia Scale (VDS) to understand the precise mechanism for improvement in swallowing function with PAP for oral cancer at retrospective survey.

Methods and results

Fifteen patients were provided PAPs. Tongue pressure and VDS were evaluated with and without PAP. After intervention with PAP, tongue pressure significantly increased as compared to when without PAP (p < .05). The total mean VDS score with PAP was found to have significantly improved (p < .05). The mean VDS score of the oral phase also significantly improved with the PAP compared to without the PAP group (p < .05). Significant differences (p < .01) were found in each category, such as tongue to palate contact and pyriform sinus residue.

Conclusion

PAP can improve tongue pressure, tongue to palate contact, and pyriform sinus residue.

Inter-measurement variation of masticatory performance test using gummy jelly

The purpose of this study was to clarify the inter-measurement variation of the masticatory performance test. Forty healthy adults were divided into group A (10 males and 10 females), who did not chew the test food before experiment, and group B (10 males and 10 females) who chewed the test food before the experiment. Subjects were asked to chew a gummy jelly for 20 s on the habitual chewing side, and the amount of glucose extraction was measured. The test was repeated three times with an interval of 1 min in both groups (Group A: A1, A2, A3; Group B: B1, B2, B3). In both groups A and B, the difference between the measured values was compared and the reliability between measurements was investigated. In group A, the value of A1 was small, and a statistically significant difference was observed between A1 and other measured values. In group B, the three measured values were similar and no significant difference was observed among the measured values. The intraclass correlation coefficient (ICC) values for determining inter-measurement reliability in group A were 0.758 for A1-A2-A3, 0.708 for A1-A2, and 0.901 for A2-A3. The ICCs in group B were 0.924 for B1-B2-B3, 0.945 for B1-B2, and 0.926 for B2-B3. Based on these results, it can be suggested that high reliability between the measurements can be obtained if the subjects are accustomed to chewing the test food before the experiment, and that the measured values were similar whether it was performed two or three times. Consequently, one measurement was sufficient if subjects were accustomed to chewing the test food before the experiment.

Gender differences in masticatory function in elderly adults with natural dentition

The purpose of this study was to clarify the presence or absence of gender differences in masticatory function in elderly adults with completely natural dentition. Fifty-six elderly adults aged 65 years and older (elderly group) and 60 young adults in their 20-40 s (young group) with natural dentition participated in this study. The maximum occlusal force on the habitual chewing side was measured using dental prescale. Next, the amount of glucose extraction when subjects chewed a gummy jelly on their habitual chewing side for 20 s was measured. The maximum occlusal force and masticatory performance in the elderly and young groups were compared between males and females. The relationship between the maximum occlusal force and masticatory performance was also investigated. The maximum occlusal force in the elderly and young groups was larger in males than in females, and the difference was significant. The amount of glucose extraction in the elderly and young groups was higher in males than in females, and the difference was significant. Regarding the relationship between the maximum occlusal force and the amount of glucose extraction, there was a significant positive correlation. These results suggest that there are gender differences in the masticatory function of the elderly adults with completely natural dentition, and these differences need to be noted in the evaluation of masticatory function.

Oral function in amyotrophic lateral sclerosis patients: A matched case-control study

BACKGROUND & AIMS

Patients with amyotrophic lateral sclerosis (ALS) develop swallowing difficulties with the progression of the disease. The present study aimed at comparing oral function and body composition between ALS patients and healthy controls, and at evaluating which parameters are the most discriminant between both groups.

METHODS

We included ALS patients at the start of their multidisciplinary follow-up at the Geneva University Hospitals and healthy age-, gender-, and dental status-matched adults. We assessed the severity of the disease through the ALS Functional Rating Scale and the swallowing difficulties through the EAT-10 score. We performed an intraoral examination of the dental status, and measured chewing performance, bite, lip and tongue force, saliva weight, and body composition. Group comparisons were performed with t-tests or Mann-Whitney tests as appropriate. Linear discriminant analysis was used to determine the most discriminant parameters between groups.

RESULTS

Twenty-six ALS patients (bulbar onset: n = 7, median (IQR) ALS Functional Rating Scale: 37 (11)) were included. The ALS patients had a significantly lower chewing performance (p < 0.001), lip force (p < 0.001), tongue force (p = 0.002), saliva weight (p < 0.004) and fat-free mass index (p < 0.001) as compared to the healthy individuals, and a higher EAT-10 score (p < 0.001). In ALS patients, a low chewing performance was correlated with a low bite (r = -0.45, p < 0.05)) and tongue force (r = -0.59, p < 0.05). The most discriminant parameters between both groups, by order of importance, were chewing performance, fat-free mass index and saliva weight and allowed the calculation of a discriminant function.

CONCLUSION

Compared to healthy controls, ALS patients have significant alterations of oral function and body composition. The most discriminant parameters between both groups were chewing performance, fat-free mass index and saliva volume. It remains to be demonstrated whether oral parameters predict outcome. CLINICAL TRIAL REGISTRY: clinicaltrials.gov, identifier: NCT01772888.

Factors Affecting Masticatory Satisfaction in Patients with Removable Partial Dentures

(1) Background: The degree of satisfaction with dental treatment varies among patients, and the discrepancy may exist between the patient's subjective evaluation and the objective assessment. Further, the optimal methods for increasing patient satisfaction with mastication remain unclear. This study aimed to identify factors affecting masticatory satisfaction in patients with removable partial dentures. (2) Methods: A total of 132 participants (71.0 ± 9.0 years) were included. Masticatory satisfaction was assessed on a visual analog scale. An oral health survey was conducted to assess the number of functional teeth, missing tooth classification: Kennedy classification, occlusal support: Eichner classification, and removable partial dentures wearing jaw. Objective masticatory performance was assessed using gummy jelly, while subjective masticatory ability was assessed using food acceptance status and oral health-related quality of life. The associations of these factors with masticatory satisfaction were assessed. (3) Results: Masticatory satisfaction among removable partial denture wearers was not significantly associated with gender, age, denture wearing jaw, Kennedy classification, and occlusal support. The degree of masticatory satisfaction was significantly greater with higher levels of masticatory function: masticatory performance, food acceptance score, and OHIP-14 score. The OHIP-14 score was the only significant explanatory variable for masticatory satisfaction in the multiple regression analysis; the strongest associations were with the "psychological discomfort" and "physical disability" subscales (p = 0.02 and p = 0.005, respectively). (4) Conclusions: Masticatory satisfaction among removable partial denture wearers was strongly associated with oral health-related quality of life, in which the ability to eat meals comfortably with removable partial dentures is the most important determinant of masticatory satisfaction.

The Mass of Geniohyoid Muscle Is Associated with Maximum Tongue Pressure and Tongue Area in Patients with Sarcopenic Dysphagia

OBJECTIVES

We investigated the associations about the mass of geniohyoid and tongue muscle and the maximum tongue pressure in patients with sarcopenic dysphagia using ultrasonography.

DESIGN

Cross sectional study.

SETTING

5 hospitals including 3 acute and 2 rehabilitation hospitals and 1 older facility.

PARTICIPANTS

36 inpatients with sarcopenic dysphagia.

MEASUREMENTS

Ultrasonography was performed for geniohyoid muscle and tongue. The area for geniohyoid and tongue muscles in sagittal plane and the mean brightness level (0-255) in the muscle area were calculated. Maximum tongue pressure as strength of swallowing muscle were investigated. Partial correlation coefficient and multiple regression analysis adjusting for age and sex were performed.

RESULTS

The mean age was 81.1 ± 7.9. Men were 23. The mean BMI was 19.0 ± 4.1. The mean maximum tongue pressure was 21.3 ± 9.3 kPa. The mean cross sectional area for geniohyoid muscles was 140 ± 47 mm2. The mean brightness for geniohyoid muscle was 18.6 ± 9.0. The mean cross sectional area for tongue muscles was 1664.1 ± 386.0 mm2. The mean brightness for tongue muscles was 34.1 ± 10.6. There was a significant positive correlation between area of geniohyoid muscle and maximum tongue pressure (r = 0.38, p = 0.04). Geniohyoid muscle area was an explanatory factor for maximum tongue pressure (p = 0.012) and tongue muscle area (p = 0.031) in multivariate analysis.

CONCLUSIONS

Geniohyoid muscle mass was an independent explanatory factor for maximum tongue pressure and tongue muscle mass.

Variability in tongue pressure among elderly and young healthy cohorts: A systematic review and meta-analysis

OBJECTIVES

Tongue pressure (TP) is used for the diagnosis of oral hypofunction; however, the impact of several variables on TP is unclear. Therefore, the current systematic review and meta-analysis aimed to analyse the variability in tongue pressure among healthy individuals aged ≥60 years vs <60 years. Secondary outcomes were the influence of gender and the type of measuring device (Iowa Oral Performance Instrument (IOPI) vs JMS tongue pressure measurement device (JMS)).

METHODS

PubMed and the Japanese database Ichushi-Web were searched systematically by two independent reviewers for studies reporting TP values in healthy populations. Clinical studies published between 1959 and June 2020 with more than 10 participants, written in English, German or Japanese, were included. A random-effects meta-regression for aggregate-level data was applied (α < 0.05).

RESULTS

Sixty-eight studies reported TP for a total of 13 773 subjects aged <60 years (n = 3265) and ≥60 years (n = 10 508). TP was significantly higher in subjects <60 years (estimated weighted mean (EWM) ± standard error = 51.9 ± 1.28 kPa; 95% CI = 49.4-54.4) relative to those ≥60 (EWM = 34.7 ± 0.94 kPa; 95% CI = 32.8-36.5) (P < .001), men (EWM = 45.9 ± 2.09 kPa; 95% CI = 41.8-50.0) relative to women (EWM = 39.3 ± 1.68 kPa; 95% CI = 36.0-42.6) (P = .015) and when assessed with the IOPI (EWM = 51.9 ± 1.32 kPa; 95% CI = 49.3-54.5) compared to the JMS (EWM = 33.5 ± 0.63 kPa; 95% CI = 32.2-34.7) (P < .001). In terms of gender, there was no significant difference in TP among subjects ≥60 years (P = .282). However, in subjects younger than 60, a significant difference was observed (P = .004).

CONCLUSIONS

Healthy populations aged <60 years showed significantly higher TP than those aged ≥60 years. TP values ascertained by the IOPI are significantly higher than those obtained with the JMS.

Orofacial functions and forces in male and female healthy young and adults

ABSTRACT Purpose: To determine reference values of orofacial myofunctional condition and orofacial forces in healthy young and adults. Methods: Fifty young and adults were selected from a total of 316 voluntaries. Participants were assessed with the Orofacial Myofunctional Evaluation with Scores (OMES) for the investigation of orofacial myofunctional condition. The maximum forces of bite, cheeks, tongue (anterior and posterior regions), and lips were assessed with an electronic dynamometer (values expressed in Newtons). Force values were obtained by average of three repeated measurement. The technical error of measurements was calculated for all variables. Results: There were no differences in orofacial myofunctional condition between men and women. Men presented higher values of orofacial forces compared to women. Conclusion: The normal values of orofacial myofunctional condition and orofacial forces were determined in healthy and adults Brazilian men and women. The values obtained in this study from healthy Brazilian may help in the diagnosis of alterations in orofacial motor function and contribute for their therapeutic management.

Association between tongue and lip motor functions and mixing ability in complete denture wearers

BACKGROUND

Masticatory performance of elderly complete denture wearers is low, which may lead to restriction on intakes of several foods such as fresh fruit or raw vegetables.

AIM

The aim of this study was to investigate the relationship between tongue motor function, lip motor function, and mixing ability in complete denture wearers.

MATERIALS AND METHODS

Participants comprised 54 complete denture wearers with a mean age of 77.1 years. Maximum tongue pressure and oral diadochokinesis were measured to evaluate tongue and lip motor functions. A color-changeable, chewing gum was used to evaluate mixing ability. The relationship between tongue and lip motor functions and mixing ability was assessed using stepwise multiple regression analysis.

RESULTS

The stepwise multiple regression analysis identified maximum tongue pressure, the number of repetitions of the syllable "ka", and gender as significant predictors for mixing ability among complete denture wearers.

DISCUSSION

The elderly edentulous individuals mainly used tongue motor function in oral motor functions for mixing color-changeable chewing gums, which might be ascribable to wearing complete dentures.

CONCLUSIONS

Under the limited conditions of this study, factors relating to tongue motor function, tongue pressure and the number of repetitions of the syllable "/ka"/ significantly contributed to the mixing ability of complete denture wearers. It was suggested that tongue motor function had positive effect on the mixing ability of complete denture wearers.

Tongue function and its influence on masticatory performance in patients treated for oral cancer: a five-year prospective study

Purpose

The purpose of this study was to observe the impact of oral oncological treatment, including the recovery of several tongue functions (force, mobility, and sensory functions), and to determine the influence of these functions on masticatory performance.

Materials and methods

Masticatory performance and tongue force, mobility, and sensory functions were determined in 123 patients with oral cavity cancer. The assessments were performed 4 weeks before treatment and 4 to 6 weeks, 6 months, 1 year, and 5 years after treatment. Generalized estimation equations and mixed model analyses were performed, correcting for previously identified factors in the same population.

Results

A significant deterioration in tongue mobility and sensory function was observed in patients with mandible and tongue and/or floor-of-mouth tumors. Better tongue force and sensory function (thermal and tactile) positively influenced masticatory performance, and this effect was stronger where fewer occlusal units were present. The effect of both the tongue force and maximum bite force was weaker in dentate patients in comparison with patients with full dentures. A web-based application was developed to enable readers to explore our results and provide insight into the coherence between the found factors in the mixed model.

Conclusions

Tongue function deteriorates after oral oncological treatment, without statistically significant recovery. Adequate bite and tongue forces are especially important for patients with a poor prosthetic state. Patients with sensory tongue function deficits especially benefit from the presence of more occluding pairs.

Change in tongue pressure and the related factors after esophagectomy: a short-term, longitudinal study

BACKGROUND

Dysphagia is a prominent symptom after esophagectomy and may cause aspiration pneumonia. Swallowing evaluation after esophagectomy can predict and help control the incidence of postoperative pneumonia. The aim of this study was to clarify whether the change in tongue pressure was associated with any related factor and postoperative dysphagia/pneumonia in patients with esophageal cancer after esophagectomy.

METHODS

Fifty-nine inpatients (41 males and 18 females; 33-77 years old) who underwent esophagectomy participated in this study. Measurement of tongue pressure and the repetitive saliva swallowing test (RSST) was performed before esophagectomy (baseline) and at 2 weeks postoperatively. The general data were collected from patients' medical records, including sex, age, type of cancer, cancer stage, location of cancer, operative approach, history of previous chemotherapy, surgical duration, amount of bleeding during surgery, incidences of postoperative complications, intubation period, period between surgery and initiation of oral alimentation, and intensive care unit (ICU) stay, blood chemical analysis, and lifestyle.

RESULTS

Tongue pressure decreased significantly after esophagectomy (p = 0.011). The decrease of tongue pressure was significantly associated with length of ICU stay and preoperative tongue pressure on multiple regression analysis (p < 0.05). The decrease of tongue pressure in the RSST < 3 or postoperative pneumonia (+) group was significantly greater than in the RSST ≥ 3 (p = 0.003) or pneumonia (-) group (p = 0.021).

CONCLUSIONS

The decrease in tongue pressure was significantly associated with the length of ICU stay, preoperative tongue pressure, and the incidence of dysphagia and pneumonia among inpatient after esophagectomy.

Effects of gum chewing training on oral function in normal adults: Part 1 investigation of perioral muscle pressure

Background/purpose

The strength of the intraoral and extraoral muscles that assist the function of tooth and jaw movement during mastication is important for performing oral function. The aim of this study was to investigate the usefulness of gum chewing training to improve the swallowing and feeding function.

Materials and methods

In experiment 1, the differences in maximum tongue pressure (TP) and cheek pressure (CP) at the measurement time point for both groups with and without training were examined. We instructed subjects to perform gum chewing training 3 times daily for 3 months. TP and CP were measured before training and at 1, 2, and 3 months after starting training. In experiment 2, the changes of TP and CP based on the sex and duration of training were examined. The effect of the training was evaluated before training, at 2 weeks and 1, 2, and 3 months after starting training, and at 1 and 3 months after cessation of training.

Results

Experiment 1 showed TP and CP increased with the progress of continuous training. In experiment 2, TP and CP were higher in men than in women and markedly increased at 2 weeks and 1 month in both sexes. After cessation of training, TP and CP tended to decrease, but there was no significant difference between 3 months after starting training, and also significantly higher than before training.

Conclusion

This study suggested that gum chewing training is a useful to improve the swallowing and feeding function.

Association of feeding behavior with jaw bone metabolism and tongue pressure

In recent decades, the eating habits of children and adolescents have undergone many changes due to the diversification of lifestyles worldwide. Reduced masticatory function in growing animals results in changes in the mandible, including a decrease in bone mass. However, the influence of different eating behaviors on jaw bone metabolism (e.g., the palatal palate) during the growth period is not fully understood. In addition, recent clinical studies reported that masticatory performance is positively related to tongue pressure in adults, but no consensus has been reached regarding whether tongue pressure is related to masticatory performance in children. This review summarizes current findings related to these issues, focusing on the influence of different feeding behaviors on jaw bone metabolism, including the development of tongue pressure. Consumption of a soft diet had a negative impact on jaw bone metabolism in the maxilla and mandible of rats; however, mastication of a hard diet recovered the collapsed equilibrium of bone turnover caused by a soft diet during growth. Tongue pressure is closely associated with an increase in masticatory performance in children. Peak maximum tongue pressure is reached earlier in women than in men. Before reaching adulthood, women require intervention to increase their peak tongue pressure.

Relationship between tongue pressure and maxillofacial morphology in Japanese children based on skeletal classification

During childhood, perioral muscle function is closely associated with malocclusion. To clarify the effects of tongue function on maxillofacial morphology in children, tongue pressure and maximum lip-closing force (LCF) were measured and the relationship between perioral muscle function and maxillofacial morphology was evaluated according to the skeletal classification. Maximum tongue pressure (MTP) and swallowing tongue pressure (STP) were measured on the anterior palatine rugae in 100 children (Hellman's dental stages IIIA-IIIC) using a balloon-type tongue pressure measurement device. Lip-closing force was measured using an LCF measurement device. Lateral cephalograms were examined to classify subjects into skeletal (S)-I, S-II and S-III groups. Correlations of skeletal classification with tongue pressure and LCF were examined. Correlations of lateral cephalometric measurements with palatal volume (PV), measured using a three-dimensional optical scanner, were evaluated. Maximum tongue pressure was significantly lower in the S-II group than in other groups. Swallowing tongue pressure was significantly lower in the S-II group than in the S-III group. Lip-closing force was significantly higher in the S-III group than in other groups. Swallowing tongue pressure was positively correlated with MTP and PV. Correlations between tongue pressure and anteroposterior skeletal classification indicated the importance of quantitative tongue function assessment.

Comparison of masticatory performance and tongue pressure between children and young adults

The aims of the present study were to evaluate whether there are significant differences in masticatory performance by gender and dental stage. We also determined the factors directly associated with the masticatory performance in children, and those directly associated with masticatory performance in young adults. The study included 180 subjects, ranging in age from 6 to 12 years or 20 to 33 years. The subjects were divided into three groups according to the Hellman developmental stage (III A, III B, or VA); the groups were the subdivided according to gender. The body mass index (BMI), maximum tongue pressure, and sum of decayed, missing, and filled teeth (DMFT) were determined in all subjects. To investigate masticatory performance, the total number and maximum projected area of chewed particles of the jelly materials were measured. Masticatory performance had the highest values at Stage VA in both males and females. Regarding the maximum tongue pressure in females, Stage III B had the highest value of all stages. Multiple regression analysis showed that masticatory performance was associated with DMFT index, maximum tongue pressure, and BMI in children. Among young adults, masticatory performance was associated with DMFT index and maximum tongue pressure. Better masticatory performance is directly associated with better dental status, a higher BMI, and tongue pressure in schoolchildren. Additionally, masticatory performance was well-correlated with tongue pressure in young adults, although maximum tongue pressure reached its peak before Stage VA in females. We suggest that females need training with respect to tongue pressure, by the mixed dentition stage.

Association between buccal mucosa ridging and oral or occlusal status among older people

OBJECTIVES

This study aimed to evaluate the association between buccal mucosa ridging and oral or occlusal statuses among older people.

SUBJECTS AND METHODS

This cross-sectional study examined 262 independent older people (mean age, 74.2 ± 5.9 years) who participated in the Kyoto Elderly Physical Fitness Measurement Research Project. The predictor variables were oral statuses (number of present teeth and torus palatinus, torus mandibularis, temporomandibular joint noise, clenching, or grinding) and oral functions (occlusal pressure, cheek pressure, oral diadochokinesis, and tongue pressure). The outcome variable was the buccal mucosa ridging status (presence or absence). Additional variables were age, sex, body mass index, grip strength, and wearing dentures. We compared these variables between participants with and without buccal mucosa ridging using a univariate analysis and multiple logistic regression analysis.

RESULTS

Buccal mucosa ridging was present in 177 (67.6%) people. Multiple logistic regression analysis revealed a close association of buccal mucosa ridging with torus mandibularis, tooth clenching and grinding and occlusal pressure, and cheek pressure.

CONCLUSIONS

Over 50% of the participants showed buccal mucosa ridging; this was significantly associated with higher cheek pressure, lower occlusal pressure, torus mandibularis, and tooth clenching and grinding.

A multifactorial model of masticatory performance: the Suita study

Previous studies have identified various factors related to masticatory performance. This study was aimed to investigate variations and impacts of factors related to masticatory performance among different occlusal support areas in general urban population in Japan. A total of 1875 Japanese subjects (mean age: 66·7 years) were included in the Suita study. Periodontal status was evaluated using the Community Periodontal Index (CPI). The number of functional teeth and occlusal support areas (OSA) were recorded, and the latter divided into three categories of perfect, decreased and lost OSA based on the Eichner Index. Masticatory performance was determined by means of test gummy jelly. For denture wearers, masticatory performance was measured with the dentures in place. The multiple linear regression analysis showed that, when controlling for other variables, masticatory performance was significantly associated with sex, number of functional teeth, maximum bite force and periodontal status in perfect OSA. Masticatory performance was significantly associated with number of functional teeth, maximum bite force and periodontal status in decreased OSA. In lost OSA, masticatory performance was significantly associated with maximum bite force. Maximum bite force was a factor significantly influencing masticatory performance that was common to all OSA groups. After controlling for possible confounding factors, the number of functional teeth and periodontal status were common factors in the perfect and decreased OSA groups, and only sex was significant in the perfect OSA group. These findings may help in providing dietary guidance to elderly people with tooth loss or periodontal disease.

Association between tongue and lip functions and masticatory performance in young dentate adults

Motor functions of masticatory organs such as the tongue, lips, cheeks and mandible are known to deteriorate with age, thereby influencing masticatory performance. However, there are few reports on the relationships between tongue and lip functions and masticatory performance. To investigate the relationship between tongue and lip functions and comprehensive masticatory performance, by evaluating crushing, mixing and shearing abilities in young dentate adults. Participants comprised 51 dentate adults with a mean age of 25 years. Maximum tongue pressure and oral diadochokinesis were measured to evaluate tongue and lip functions. A multiple sieving method using peanuts was performed to evaluate crushing ability. A colour-changeable chewing gum was performed to evaluate mixing ability. A test gummy jelly was performed to evaluate shearing ability. The relationship between tongue and lip functions and each masticatory performance was assessed using Pearson's correlation coefficients. In addition, stepwise multiple regression analysis was performed to identify predictors of crushing ability. Crushing ability was significantly correlated with maximum tongue pressure and the number of repetitions of the syllables /pa/, /ta/ and /ka/. Maximum tongue pressure and number of repetitions of the syllable /pa/ were identified as significant predictors for crushing ability. Mixing ability was significantly correlated with the number of repetitions of the syllable /pa/. Shearing ability was not significantly correlated with tongue and lip functions. Masticatory performance during the chewing of brittle foods such as peanuts and solid foods such as chewing gum appears to be correlated with tongue and lip functions.