Masticatory performance in oral function assessment: alternative methods.

Imamura, Yoshiki; Chebib, Najla; Ohta, Midori; Mojon, Philippe; Schulte-Eickhoff, Regina Maria; Schimmel, Martin; Graf, Christophe; Sato, Yuji; Müller, Frauke (2023). Masticatory performance in oral function assessment: alternative methods. Journal of oral rehabilitation, 50(5), pp. 383-391. Wiley 10.1111/joor.13421

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BACKGROUND

Masticatory function declines with age or disease, implicating a poor chewing efficiency and an often-unconscious change for a less healthy, yet easy to chew diet. Timely screening of masticatory function may foster an early-onset diagnosis and potential treatment. The aim of this study was to compare alternative diagnostic tools for masticatory function to a Jelly-scan test.

MATERIALS AND METHODS

Patients aged 70 years and older who were hospitalized for rehabilitation were recruited for this study. A total of four different tests for masticatory function were administered. The Japanese Society of Gerodontology glucose extraction test (Jelly-scan) was used as reference to compare a colour-changing gum test (Gum1-colour) as well as a mixing ability test with a visual (Gum2-visual) and opto-electronical (Gum2-digital) analyses. Receiver operating characteristic (ROC) curves were used to establish the discriminative value, kappa-values were used to estimate individual agreements and correlations were verified using Spearman's tests.

RESULTS

Sixty-one patients (Men n=23, Women n=38) aged 82.4±6.8 years participated in the experiments. The average number of natural teeth was 16.5 ± 10.5, 34.4% of the participants wore removable dentures. For all tests, the sum of sensitivity and specificity was >150%. All test correlated with Jelly-scan (absolute Rho >0.5). With Jelly-scan 51 participants (83.6%) were diagnosed with "masticatory hypofunction". After reducing the cut-off value of the test from 100 mg/dl to 65 mg/dl, only 33 participants (54%) fulfilled the diagnosis. This post-hoc analysis increased the sensitivity of the Gum2-tests and the agreement to kappa >0.5 for all three tests.

CONCLUSION

All three tests can be considered useful screening alternatives. In its original version, Jelly-scan may tend to over-diagnose masticatory hypofunction, hence a novel cut-off with better agreement between tests is suggested.

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