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Sociomedical and oral factors affecting masticatory performance in an older population

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Abstract

Objectives

To assess the sociomedical and oral factors affecting masticatory performance in a community-dwelling older population.

Materials and methods

Community-dwelling persons over 60 years were investigated using medical and dental oral interviews, oral and denture examination (natural teeth, tooth mobility, number of occluding tooth pairs, and removable dentures’ prevalence and quality), and evaluation of masticatory performance using a mixing ability test.

Results

A total of 130 participants with a mean age of 73.9±8.5 years were recorded. Fifty-eight (44.6%) used various types of removable prostheses. Twenty were edentulous and used a pair of complete dentures. Univariate analyses revealed statistically significant associations (p≤0.05) between masticatory performance and aging, marital status, subjective chewing ability, use of removable dentures, use of various combinations of complete dentures, pain caused by maxillary denture, number of teeth, tooth mobility, posterior chewing pairs, all chewing contacts natural or prosthetic, retention of mandibular partial dentures, and dentures’ occlusion. The multivariable quantile regression analysis revealed that fewer natural teeth (95% CI: −0.02–0.01, p<0.001), being edentulous and using a pair of complete dentures (95% CI: 0.09–0.35, p=0.001), and larger percentage of severely mobile teeth (95% CI: 0.07–0.82, p=0.020) were associated with lower masticatory performance.

Conclusions

Poor masticatory performance in older adults was associated with fewer teeth, being edentulous and using a pair of complete dentures, and increased prevalence of severe tooth mobility.

Clinical relevance

Retaining the natural dentition and preventing and treating periodontal disease are important measures to maintain masticatory performance in older adults.

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References

  1. Peyron MA, Woda A, Bourdiol P, Hennequin M (2017) Age-related changes in mastication. J Oral Rehabil 44:299–312. https://doi.org/10.1111/joor.12478

    Article  PubMed  Google Scholar 

  2. Laguna L, Chen J (2016) The eating capability: constituents and assessments. Food Qual Prefer 48:345–358. https://doi.org/10.1111/1541-4337.12219

    Article  Google Scholar 

  3. Pereira LJ, Duarte Gaviao MB, Van Der Bilt A (2006) Influence of oral characteristics and food products on masticatory function. Acta Odontol Scand 64:193–201. https://doi.org/10.1080/00016350600703459

    Article  PubMed  Google Scholar 

  4. Gonçalves TMSV, Schimmel M, van der Bilt A, Chen J, van der Glas HW, Kohyama K, Hennequin M, Peyron MA, Woda A, Leles CR, José Pereira L (2021) Consensus on the terminologies and methodologies for masticatory assessment. J Oral Rehabil. https://doi.org/10.1111/joor.13161

    Article  PubMed  PubMed Central  Google Scholar 

  5. van der Bilt A (2011) Assessment of mastication with implications for oral rehabilitation: a review. J Oral Rehabil 38:754–80. https://doi.org/10.1111/j.1365-2842.2010.02197.x

    Article  PubMed  Google Scholar 

  6. Müller F, Hernandez M, Grütter L, Aracil-Kessler L, Weingart D, Schimmel M (2012) Masseter muscle thickness, chewing efficiency and bite force in edentulous patients with fixed and removable implant-supported prostheses: a cross-sectional multicenter study. Clin Oral Implants Res 23:144–150. https://doi.org/10.1111/j.1600-0501.2011.02213.x

    Article  PubMed  Google Scholar 

  7. Schimmel M, Ono T, Lam OL, Müller F (2017) Oro-facial impairment in stroke patients. J Oral Rehabil 44:313–326. https://doi.org/10.1111/joor.12486

    Article  PubMed  Google Scholar 

  8. Barbe AG, Javadian S, Rott T, Scharfenberg I, Deutscher H, Noack MJ, Derman S (2020) Objective masticatory efficiency and subjective quality of masticatory function among patients with periodontal disease. J Clin Periodontol 47:1344–1353. https://doi.org/10.1111/jcpe.13364

    Article  PubMed  Google Scholar 

  9. Kosaka T, Ono T, Kida M, Kikui M, Yamamoto M, Yasui S, Nokubi T, Maeda Y, Kokubo Y, Watanabe M, Miyamoto Y (2016) A multifactorial model of masticatory performance: the Suita study. J Oral Rehabil 43:340–347. https://doi.org/10.1111/joor.12371

    Article  PubMed  Google Scholar 

  10. Ikebe K, Matsuda K, Kagawa R, Enoki K, Okada T, Yoshida M, Maeda Y (2012) Masticatory performance in older subjects with varying degrees of tooth loss. J Dent 40:71–76. https://doi.org/10.1016/j.jdent.2011.10.007

    Article  PubMed  Google Scholar 

  11. Arakawa I, Abou-Ayash S, Genton L, Tsuga K, Leles CR, Schimmel M (2020) Reliability and comparability of methods for assessing oral function: chewing, tongue pressure and lip force. J Oral Rehabil 47:862–871. https://doi.org/10.1111/joor.12976

    Article  PubMed  Google Scholar 

  12. Leles CR, Oliveira TMC, de Araújo SC, Nogueira TE, Schimmel M (2019) Individual factors associated with masticatory performance of complete denture wearers: a cross-sectional study. J Oral Rehabil 46:903–911. https://doi.org/10.1111/joor.12822

    Article  PubMed  Google Scholar 

  13. Schimmel M, Voegeli G, Duvernay E, Leemann B, Müller F (2017) Oral tactile sensitivity and masticatory performance are impaired in stroke patients. J Oral Rehabil 44:163–171. https://doi.org/10.1111/joor.12482

    Article  PubMed  Google Scholar 

  14. Elsig F, Schimmel M, Duvernay E, Giannelli SV, Graf CE, Carlier S, Herrmann FR, Michel JP, Gold G, Zekry D, Müller F (2015) Tooth loss, chewing efficiency and cognitive impairment in geriatric patients. Gerodontology 32:149–156. https://doi.org/10.1111/ger.12079

    Article  PubMed  Google Scholar 

  15. Klotz AL, Ehret J, Zajac M, Schwindling FS, Hassel AJ, Rammelsberg P, Zenthöfer A (2020) The effects of prosthetic status and dementia on the chewing efficiency of seniors in nursing homes. J Oral Rehabil 47:377–385. https://doi.org/10.1111/joor.12912

    Article  PubMed  Google Scholar 

  16. Andrade KM, Alfenas BFM, Rodrigues Garcia RCM (2018) Influence of removable prostheses on mastication in elderly subjects with rheumatoid arthritis. J Oral Rehabil 45:295–30. https://doi.org/10.1111/joor.12592

    Article  PubMed  Google Scholar 

  17. Bousiou A, Konstantopoulou K, Martimianaki G, Peppa E, Trichopoulou A, Polychronopoulou A, Halazonetis D, Schimmel M, Kossioni A (2021) Oral factors and adherence to Mediterranean diet in an older Greek population. Aging Clin Exp Res. https://doi.org/10.1007/s40520-021-01861-8

  18. Schimmel M, Katsoulis J, Genton L, Müller F (2015) Masticatory function and nutrition in old age. Swiss Dent J 125:449–454

    PubMed  Google Scholar 

  19. Watanabe D, Yoshida T, Yokoyama K, Yoshinaka Y, Watanabe Y, Kikutani T, Yoshida M, Yamada Y, Kimura M, Kyoto-Kameoka Study Group (2020) Association between mixing ability of masticatory functions measured using color-changing chewing gum and frailty among Japanese older adults: the Kyoto-Kameoka Study. Int J Environ Res Public Health 17:4555. https://doi.org/10.3390/ijerph17124555

    Article  PubMed Central  Google Scholar 

  20. Murakami M, Hirano H, Watanabe Y, Sakai K, Kim H, Katakura A (2015) Relationship between chewing ability and sarcopenia in Japanese community-dwelling older adults. Geriatr Gerontol Int 15:1007–1012. https://doi.org/10.1111/ggi.12399

    Article  PubMed  Google Scholar 

  21. Kossioni AE, Hajto-Bryk J, Janssens B, Maggi S, Marchini L, McKenna G, Müller F, Petrovic M, Roller-Wirnsberger RE, Schimmel M, van der Putten GJ, Vanobbergen J, Zarzecka J (2018) Practical guidelines for physicians in promoting oral health in frail older adults. J Am Med Dir Assoc 19:1039–1046. https://doi.org/10.1016/j.jamda.2018.10.007

    Article  PubMed  Google Scholar 

  22. Halazonetis DJ, Schimmel M, Antonarakis GS, Christou P (2013) Novel software for quantitative evaluation and graphical representation of masticatory efficiency. J Oral Rehabil 40(329–335):18. https://doi.org/10.1111/joor.12043

    Article  Google Scholar 

  23. Schimmel M, Memedi K, Parga T, Katsoulis J, Müller F (2017) Masticatory performance and maximum bite and lip force depend on the type of prosthesis. Int J Prosthodont 30:565–572. https://doi.org/10.11607/ijp.5289

    Article  PubMed  Google Scholar 

  24. Silva LC, Nogueira TE, Rios LF, Schimmel M, Leles CR (2018) Reliability of a two-colour chewing gum test to assess masticatory performance in complete denture wearers. J Oral Rehabil 45:301–307. https://doi.org/10.1111/joor.12609

    Article  PubMed  Google Scholar 

  25. Schimmel M, Leemann B, Herrmann FR, Kiliaridis S, Schnider A, Müller F (2011) Masticatory function and bite force in stroke patients. J Dent Res 90:230–4. https://doi.org/10.1177/0022034510383860

    Article  PubMed  Google Scholar 

  26. Weijenberg RA, Scherder EJ, Visscher CM, Gorissen T, Yoshida E, Lobbezoo F (2013) Two-colour chewing gum mixing ability: digitalisation and spatial heterogeneity analysis. J Oral Rehabil 40:737–743. https://doi.org/10.1111/joor.12090

    Article  PubMed  Google Scholar 

  27. Speksnijder CM, Abbink JH, van der Glas HW, Janssen NG, van der Bilt A (2009) Mixing ability test compared with a comminution test in persons with normal and compromised masticatory performance. Eur J Oral Sci 117:580–6. https://doi.org/10.1111/j.1600-0722.2009.00675.x

    Article  PubMed  Google Scholar 

  28. van der Bilt A, Mojet J, Tekamp FA, Abbink JH (2010) Comparing masticatory performance and mixing ability. J Oral Rehabil 37:79–84. https://doi.org/10.1111/j.1365-2842.2009.02040.x

    Article  PubMed  Google Scholar 

  29. Gkavela G (2019) Survey of the oral health status and oral care habits of independent community-dwelling older adults and association with medical and socio-economic factors. PhD Thesis. Dental School, National and Kapodistrian University of Athens, Athens, Greece

  30. Miller CC, Dyes AB, Hutchinson CA (1950) The estimation of permeability and reservoir pressure from bottom hole pressure build-up characteristics. J Pet Technol 2:91–104. https://doi.org/10.2118/950091-G

    Article  Google Scholar 

  31. Olshan AM, Ross NM, Mankodi S, Melita S (1992) A modified Kapur scale for evaluating denture retention and stability: methodology study. Am J Dent 5:88–90

    PubMed  Google Scholar 

  32. Karkazis HC, Kossioni AE (1993) Oral health status, treatment needs and demands of an elderly institutionalised population in Athens. Eur J Prosthodont Restor Dent. 1:157–63

    PubMed  Google Scholar 

  33. Schimmel M, Christou P, Herrmann F, Muller F (2007) A two-colour chewing gum test for masticatory efficiency: development of different assessment methods. J Oral Rehabil 34:671–678. https://doi.org/10.1111/j.1365-2842.2007.01773.x

    Article  PubMed  Google Scholar 

  34. Buser R, Ziltener V, Samietz S, Fontolliet M, Nef T, Schimmel M (2018) Validation of a purpose-built chewing gum and smartphone application to evaluate chewing efficiency. J Oral Rehabil 45:845–853. https://doi.org/10.1111/joor.12696

    Article  PubMed  Google Scholar 

  35. Greenland S, Pearce N (2015) Statistical foundations for model-based adjustments. Annu Rev Public Health 36:89–108. https://doi.org/10.1146/annurev-publhealth-031914-122559

    Article  PubMed  Google Scholar 

  36. Chowdhury MZI, Turin TC (2020) Variable selection strategies and its importance in clinical prediction modelling. Fam Med Community Health 8:e000262. https://doi.org/10.1136/fmch-2019-000262

    Article  PubMed  PubMed Central  Google Scholar 

  37. Montero J, Leiva LA, Martín-Quintero I, Rosel E, Barrios-Rodriguez R (2021) Determinants of masticatory performance assessed by mixing ability tests. J Prosthet Dent. https://doi.org/10.1016/j.prosdent.2020.08.003

    Article  PubMed  Google Scholar 

  38. Kugimiya Y, Watanabe Y, Igarashi K, Hoshino D, Motokawa K, Edahiro A, Ueda T, Takano T, Sakurai K, Taniguchi Y, Kitamura A, Nasu I, Shinkai S, Hirano H (2020) Factors associated with masticatory performance in community-dwelling older adults: a cross-sectional study. J Am Dent Assoc 151:118–126. https://doi.org/10.1016/j.adaj.2019.10.003

    Article  PubMed  Google Scholar 

  39. Peltzer K, Hewlett S, Yawson AE, Moynihan P, Preet R, Wu F, Guo G, Arokiasamy P, Snodgrass JJ, Chatterji S, Engelstad ME, Kowal P (2014) Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa. Int J Environ Res Public Health 11:11308–11324. https://doi.org/10.3390/ijerph111111308

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, Murray CJL, Marcenes W (2017) Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 96:380–387. https://doi.org/10.1177/0022034517693566

    Article  PubMed  Google Scholar 

  41. CECDO & EEA database at 17 March 2017. https://cecdo.org/oral-healthcare/cecdo-database/. Accessed 12 April 2021

  42. Kossioni AE (2018) The association of poor oral health parameters with malnutrition in older adults: a review considering the potential implications for cognitive impairment. Nutrients 10:1709. https://doi.org/10.3390/nu10111709

    Article  PubMed Central  Google Scholar 

  43. Kossioni AE (2013) Current status and trends in oral health in community dwelling older adults: a global perspective. Oral Health Prev Dent 11:331–340. https://doi.org/10.3290/j.ohpd.a30171

    Article  PubMed  Google Scholar 

  44. Veyrune JL, Lassauzay C, Nicolas E, Peyron MA, Woda A (2007) Mastication of model products in complete denture wearers. Arch Oral Biol 52:1180–1185. https://doi.org/10.1016/j.archoralbio.2007.04.016

    Article  PubMed  Google Scholar 

  45. Woda A, Mishellany A, Peyron MA (2006) The regulation of masticatory function and food bolus formation. J Oral Rehabil 33:840–849. https://doi.org/10.1111/j.1365-2842.2006.01626.x

    Article  PubMed  Google Scholar 

  46. Elmoula HA, Khalifa N, Alhajj MN (2018) Comparison between masticatory index and mixing index among complete denture wearers and associated factors: a multivariate analysis. J Prosthet Dent 120:35–42. https://doi.org/10.1016/j.prosdent.2017.09.009

    Article  PubMed  Google Scholar 

  47. Müller F, Heath MR, Ott R (2001) Maximum bite force after the replacement of complete dentures. Gerodontology 18:58–62. https://doi.org/10.1111/j.1741-2358.2001.00058.x

    Article  PubMed  Google Scholar 

  48. Eberhard L, Oh K, Eiffler C, Rammelsberg P, Kappel S, Schindler HJ, Giannakopoulos NN (2018) Adaptation to new complete dentures-is the neuromuscular system outcome-oriented or effort-oriented? Clin Oral Investig 22:2309–2317. https://doi.org/10.1007/s00784-017-2331-8

    Article  PubMed  Google Scholar 

  49. López R, Smith PC, Göstemeyer G, Schwendicke F (2017) Ageing, dental caries and periodontal diseases. J Clin Periodontol 44:145–152. https://doi.org/10.1111/jcpe.12683

    Article  Google Scholar 

  50. Palinkas M, Borges TF, Junior MT, Monteiro S, Bottacin FS, Mestriner-Junior W, Regalo IH, Siéssere S, Semprini M, Regalo S (2019) Alterations in masticatory cycle efficiency and bite force in individuals with periodontitis. Int J Health Sci (Qassim) 13:25–29

    Google Scholar 

  51. Gilbert AD, Newton JP (1997) The effect of chronic periodontal disease on human jaw muscles: a pilot study using computed tomography. J Oral Rehabil 24:259–264. https://doi.org/10.1046/j.1365-2842.1997.d01-287.x

    Article  PubMed  Google Scholar 

  52. Takeuchi N, Yamamoto T (2008) Correlation between periodontal status and biting force in patients with chronic periodontitis during the maintenance phase of therapy. J Clin Periodontol 35:215–20. https://doi.org/10.1111/j.1600-051X.2007.01186.x

    Article  PubMed  Google Scholar 

  53. Lamba AK, Tandon S, Faraz F, Garg V, Aggarwal K, Gaba V (2020) Effect of periodontal disease on electromyographic activity of muscles of mastication: a cross-sectional study. J Oral Rehabil 47:599–605. https://doi.org/10.1111/joor.12943

    Article  PubMed  Google Scholar 

  54. Pedroni-Pereira A, Marquezin MCS, Araujo DS, Pereira LJ, Bommarito S, Castelo PM (2018) Lack of agreement between objective and subjective measures in the evaluation of masticatory function: a preliminary study. Physiol Behav 184:220–225. https://doi.org/10.1016/j.physbeh.2017.12.001

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2, 11527, Athens, Greece

    Andrianna Bousiou, Kalliopi Konstantopoulou & Anastassia E. Kossioni

  2. Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece

    Argy Polychronopoulou

  3. Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece

    Demetrios J. Halazonetis

  4. Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland

    Martin Schimmel

  5. Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland

    Martin Schimmel

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  1. Andrianna Bousiou
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  2. Kalliopi Konstantopoulou
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  3. Argy Polychronopoulou
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  4. Demetrios J. Halazonetis
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  5. Martin Schimmel
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  6. Anastassia E. Kossioni
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Correspondence to Anastassia E. Kossioni.

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Bousiou, A., Konstantopoulou, K., Polychronopoulou, A. et al. Sociomedical and oral factors affecting masticatory performance in an older population. Clin Oral Invest 26, 3477–3486 (2022). https://doi.org/10.1007/s00784-021-04316-6

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