Association Between Masticatory Difficulty and Chronic Cough in a Korean Population

OBJECTIVE

Chronic cough, a common outpatient symptom, has various aetiologies, including upper airway cough syndrome, asthma, and gastroesophagoeal reflux. The potential link between dental issues and respiratory diseases has recently garnered attention. This study aims to investigate the association between masticatory difficulty and chronic cough using data from the 2011-2015 Korean National Health and Nutrition Examination Survey (KNHANES).

METHODS

Analysis included 9706 individuals from KNHANES. Participants self-reported masticatory function and chronic cough. Covariates included age, sex, underlying diseases, socioeconomic status, lifestyle factors, and laboratory markers. Binary logistic regression analysed odds ratios for chronic cough covariates. Multiple logistic regression assessed adjusted odds ratios for masticatory difficulty.

RESULTS

Masticatory difficulty prevalence was 32.2%, with chronic cough higher in this group (4.8%) than in the group without masticatory difficulty (3.0%). After adjusting for socioeconomic status, lifestyle factors, and laboratory markers, masticatory difficulty was significantly associated with greater chronic cough prevalence (odds ratio, 1.137; 95% confidence interval, 1.134-1.140).

CONCLUSIONS

Masticatory difficulty was linked with an elevated chronic cough risk in Korean healthy adults. Further research, including prospective studies and detailed investigations into gastroesophagoeal reflux disease and microbiological studies, is warranted to elucidate the impact of mastication on respiratory health. As masticatory difficulty may serve as a clinical indicator for chronic cough interdisciplinary collaboration between dental and respiratory health professionals can facilitate early intervention and enhance patient care.

What Is the Relationship between the Chewing Ability and Nutritional Status of the Elderly in Korea?

This study aims to determine the relationship between chewing ability and the nutritional status of the elderly in Korea. This study utilized the data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2013-2018 for persons who were ≥65 years of age. Of the 7835 subjects, 43.2% had chewing difficulty. Compared to the normal group, the chewing difficulty group had more stress, lower exercise frequency, less snack intake, a lower frequency of eating out, and a higher proportion of food insecurity. The chewing difficulty group had significantly lower food intake compared to the normal group, including various food groups such as cereals and grain, potatoes, fruits, meat, and milks and dairy products. The intake of fresh fruits was 24.5% lower and the intake of plant food (fresh fruits and nonstarchy vegetables) was 17.8% lower in the chewing difficulty group compared to the normal group. In addition, the intake of most nutrients (carbohydrates, fat, calcium, phosphorus, sodium, potassium, vitamin A, riboflavin, niacin, and vitamin C) was significantly lower in the chewing difficulty group than in the normal group. The chewing difficulty was significantly associated with undernutrition (OR = 1.63). In conclusion, chewing ability is closely related to food and nutrient intake among the elderly, which can decrease the quantity and quality of diet and is also related to undernutrition. Therefore, it is necessary to develop customized nutrition programs and aging-friendly food products that consider the chewing ability of the elderly.

Association Between Changes in Oral Health-Related Quality of Life and Depressive Symptoms in the Korean Elderly Population

Objectives: The aim of this study was to examine the association between changes in oral health related quality of life (OHRQoL) and depressive symptoms in the elderly South Koreans.

Methods: We used the 2018 and 2020 Korean Longitudinal Study of Ageing data. Our study population was a total of 3,604 participants aged over 65 in 2018. The independent variable of interest was the changes in the Geriatric Oral Health Assessment Index as OHRQoL between 2018 and 2022. The dependent variable was depressive symptoms in 2020. Multivariable logistic regression analyzed the associations between changes in OHRQoL and depressive symptoms.

Results: Participants with improvement in OHRQoL over 2-year period were likely to have fewer depressive symptoms in 2020. Especially, changes in the oral pain and discomfort dimension score was associated with depressive symptoms. A decline in oral physical function, such as difficulty in chewing and speaking, was also associated with depressive symptoms.

Conclusion: Negative change in OHRQoL is a risk factor for depression in elderly. This results suggest the importance of maintaining good oral health in later life, as a protective factor against depression.

Association between declines in objective masticatory performance and salivary stress markers: The Suita study

Dentists often encounter patients suffering from psychological and social stress due to declines in masticatory performance, making this a critical issue to manage. We aimed to clarify the relationships between salivary stress markers as objective indices of chronic stress and objective masticatory performance in a general urban Japanese population. Data from 880 participants (mean age, 65.8 years) in the Suita study were used. Salivary interleukin (IL)-6 and cortisol concentrations were measured by enzyme-linked immunosorbent assay. Objective masticatory performance was determined by measuring the increase in surface area test gummy jelly after 30 times chewing. Participants were divided into two groups based on masticatory performance: a decreased group (lowest quartile) and a non-decreased group (second to fourth quartiles). Odds ratios (ORs) of higher salivary levels of stress markers (highest quartile) according to masticatory performance were estimated using logistic regression analysis adjusting for age, sex, periodontal status, salivary flow rate and smoking habit. Salivary IL-6 level was significantly higher in the decreased group than in the non-decreased group. Logistic regression analysis showed the adjusted OR for higher salivary IL-6 was significantly higher in the decreased group than in the non-decreased group (OR = 1.92; 95% confidence interval = 1.33-2.76; P < .001). No significant associations were found between salivary cortisol and decreased masticatory performance in any analyses. Declines in objective masticatory performance may correlate with higher salivary IL-6 level as an objective index of chronic stress.

Association between Dental Treatment, Quality of Life, and Activity Limitation According to Masticatory Discomfort: Evidence from the Korean National Health and Nutrition Examination Survey (2013-2015)

People with masticatory discomfort are unable to consume a balanced diet, which impacts their general health. We studied the relationship between quality of life and dental care associated with masticatory discomfort. Data from Korea’s representative 6th Korea National Health and Nutrition Examination Survey (KNHANES) were used. Complex sampling analysis with the stratification variable, clustering variable, and weight was applied. Demographic and dental treatment characteristics and activity limitations were compared through chi-square tests. The comparison of quality of life according to masticatory discomfort was performed using linear regression. The risk of masticatory discomfort was high in people who did not undergo regular oral examinations and preventive and definitive caries treatment and in those who received periodontal, surgical, endodontic, or prosthetic treatments. Generally, people with masticatory discomfort engaged in less activity owing to other disorders like arthritis, rheumatism, and back, neck, and oral disease. People with masticatory discomfort scored low on quality of life. People who received regular oral examinations and preventive care had a low level of masticatory discomfort, and the treated persons had high masticatory discomfort. Therefore, in order to reduce masticatory discomfort, more diverse and active care should be provided for prevention, specifically regular oral examinations.

Masticatory efficiency in patients with partially dentate dentitions

OBJECTIVES

To assess associations amongst masticatory performance, dental functional status, and perceived chewing problems with common soft and hard foods.

MATERIALS AND METHODS

387 adult participants with reduced natural dentitions were included and underwent an oral examination, completed a written structured questionnaire and performed a two-color chewing gum test for masticatory efficiency. A multivariate regression model was used to analyze associations between masticatory efficiency and a number of dental conditions, with age, gender and perceived chewing difficulties as background variables. Likelihood ratios were calculated to analyze the relationship between masticatory efficiency and dental conditions within a validated hierarchical dental functional classification system expressed by (1) number of teeth in upper and lower jaw, (2) completeness of anterior regions, (3) number of premolar occluding pairs, and (4) number of molar occluding pairs.

RESULTS

The regression model showed a significant positive association between unmixed ratio and self-reported problems with chewing (p = .004), and age (p < 0.001), and negative associations with having a sufficient premolar region (p < 0.001). In the hierarchical dental functional classification system, the likelihoods of having a high unmixed ratio and chewing problems with hard foods were highest for the predictor 'less than 10 teeth in each jaw' (LRs 4.01, respectively 13.06).

CONCLUSIONS

In partially dentates people, perceived chewing difficulties were associated with lower objective masticatory efficiency. Having fewer than 10 teeth in each jaw and having an impaired premolar region were best predictors for low masticatory efficiency.

CLINICAL SIGNIFICANCE

This study shows that having fewer than 10 teeth in each jaw and having an impaired premolar region are associated with low masticatory efficiency and chewing problems. Preservation of at least 10 teeth in each jaw and 3 to 4 premolars is important for preventing chewing difficulties.