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

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          Abstract

          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.

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          Most cited references38

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          Biting and chewing in overdentures, full dentures, and natural dentitions.

          It has been suggested that the provision of dental implants can improve the oral function of subjects with severely resorbed mandibles, possibly restoring function to the level experienced by satisfied wearers of conventional complete dentures. Nevertheless, a quantitative comparison has never been made and can be drawn from the literature only with difficulty, since studies differ greatly in methodology. To make such a comparison, we measured bite force and chewing efficiency by using identical methods in subjects with overdentures, complete full dentures, and natural dentitions. Our results indicated that bite forces achieved with overdentures on dental implants were between those achieved with artificial and natural dentitions. Chewing efficiency was significantly greater than that of subjects with full dentures (low mandible), but was still lower than that of subjects with full dentures (high mandible) and overdentures on bare roots. Differences in the height of the mandible revealed significant differences in chewing efficiency between the two full-denture groups. Furthermore, subjects with a shortened dental arch exerted bite forces similar to those of subjects with a complete-natural dentition, but their chewing efficiency was limited due to the reduced occlusal area. For all groups combined, a significant correlation was found between maximum bite force and chewing efficiency. Nearly half of the variation in chewing efficiency was explained by bite force alone.
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            Standard values of maximum tongue pressure taken using newly developed disposable tongue pressure measurement device.

            It is clinically important to evaluate tongue function in terms of rehabilitation of swallowing and eating ability. We have developed a disposable tongue pressure measurement device designed for clinical use. In this study we used this device to determine standard values of maximum tongue pressure in adult Japanese. Eight hundred fifty-three subjects (408 male, 445 female; 20-79 years) were selected for this study. All participants had no history of dysphagia and maintained occlusal contact in the premolar and molar regions with their own teeth. A balloon-type disposable oral probe was used to measure tongue pressure by asking subjects to compress it onto the palate for 7 s with maximum voluntary effort. Values were recorded three times for each subject, and the mean values were defined as maximum tongue pressure. Although maximum tongue pressure was higher for males than for females in the 20-49-year age groups, there was no significant difference between males and females in the 50-79-year age groups. The maximum tongue pressure of the seventies age group was significantly lower than that of the twenties to fifties age groups. It may be concluded that maximum tongue pressures were reduced with primary aging. Males may become weaker with age at a faster rate than females; however, further decreases in strength were in parallel for male and female subjects.
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              Determinants of masticatory performance in dentate adults.

              Masticatory performance results from a complex interplay of direct and indirect effects, yet most studies employ univariate models. This study tested a multivariate model of masticatory performance for dentate subjects. Explanatory variables included number of functional tooth units, bite force, sex, age, masseter cross-sectional area, presence of temporomandibular disorders, and presence of diabetes mellitus. The population-based sample consisted of 631 dentate subjects aged 37-80 years. Covariance structure analysis showed that 68% of the variability in masticatory performance could be explained by the combined effects of the explanatory variables. Age and sex did not show a strong effect on masticatory performance, either directly or indirectly through masseter cross-sectional area, temporomandibular disorders, and bite force. Number of functional tooth units and bite force were confirmed as the key determinants of masticatory performance, which suggests that their maintenance may be of major importance for promoting healthful functional status.
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                Author and article information

                Contributors
                Journal
                J Dent Sci
                J Dent Sci
                Journal of Dental Sciences
                Association for Dental Sciences of the Republic of China
                1991-7902
                2213-8862
                09 July 2023
                April 2024
                09 July 2023
                : 19
                : 2
                : 1021-1027
                Affiliations
                [a ]Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
                [b ]Digital Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
                Author notes
                []Corresponding author. y.komagamine.gerd@ 123456tmd.ac.jp
                Article
                S1991-7902(23)00204-0
                10.1016/j.jds.2023.06.029
                11010614
                e0ffb9cb-1eec-41b4-b54c-9a739b63f49f
                © 2023 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 3 June 2023
                : 28 June 2023
                Categories
                Original Article

                chewing gum,bite force,aged,randomized controlled trial
                chewing gum, bite force, aged, randomized controlled trial

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