Duration of mastication and oral phase of swallowing in the elderly with different dental conditions: a clinical analysis
Duração da mastigação e da fase oral da deglutição em idosos com diferentes condições dentárias: análise clínica
Tatiane Totta Salgado; Marina Gatti; Katia Flores Genaro; Luiz Fernando Pegoraro; Giédre Berretin-Felix
Abstract
Purpose: to measure the total time of mastication and oral phase of swallowing in healthy elderly people, considering different food consistency, the presence of natural teeth, and the type of prosthetic oral rehabilitation, as well to compare dental conditions and consistencies.
Methods: a cross-sectional study with 57 healthy elderly people, aged between 60 and 82 years, divided into: dentate group (D) (n=15); and rehabilitated groups; PD: fixed or removable partial dentures in one or both arches (n=15); CRD: maxillary and mandibular complete removable dentures (n=15); ISCD: complete dentures - maxillary removable denture and mandibular implant-supported dentures (n=12). The duration time (seconds) of chewing and of the oral phase of swallowing was measured in the consistencies: solid (a roll slice), pudding (10 ml) and liquid (10 ml).
Results: healthy dentate elderly subjects had the following intervals: liquid=1.07±0.35 s; pudding=3.48±1.76 s; and solid=27.88±7.11 s. Statistically significant differences were observed between the D and ISCD groups (p=0.0056) and between D and CRD (p=0.0056) for liquid. For all groups, there was a statistically significant increase between liquid and solid consistencies and between pasty and solid ones (p<0.001).
Conclusions: the dentate elderly had shorter oral phase time of swallowing for liquids than the rehabilitated edentulous elderly, but not different from the elderly with partial dentures. Chewing and swallowing time for solid food was longer than that for the other consistencies, regardless of dental condition.
Keywords
Resumo
Objetivo: mensurar o tempo total da mastigação e da fase oral da deglutição em idosos saudáveis, considerando diferentes consistências alimentares, a presença de dentes naturais e o tipo de reabilitação oral protética, bem como realizar comparação entre as condições dentárias e as consistências.
Métodos: estudo transversal com 57 idosos saudáveis, entre 60 e 82 anos, distribuídos em grupo dentado (D) (n=15) e grupos reabilitados: próteses parciais fixas ou removíveis em uma ou ambas as arcadas (PP) (n=15); prótese total removível maxilar e mandibular (PTR) (n=15); prótese total - prótese removível superior e prótese implanto-suportada inferior (PTIS) (n=12). O tempo de duração (segundos) da mastigação e da fase oral da deglutição foi medido nas consistências: sólida (pão francês), pudim (10 ml) e líquida (10 ml).
Resultados: idosos dentados saudáveis apresentaram os intervalos: líquido=1,07±0,35 s; pudim=3,48±1,76 s; e sólido=27,88±7,11 s. Foram observadas diferenças estatisticamente significativas entre os grupos D e PTIS (p=0,0056) e entre D e PTR (p=0,0056) para líquido. Para todos os grupos, houve aumento estatisticamente significante entre as consistências líquida e sólida e entre pastosa e sólida (p<0,001).
Conclusões: idosos dentados apresentaram menor tempo de fase oral da deglutição para líquidos do que idosos edêntulos totais reabilitados, mas não diferente dos idosos com prótese parcial. O tempo de mastigação e deglutição do alimento sólido foi maior que o das demais consistências, independente da condição dentária.
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Referencias
1. United Nations. World Population Ageing 2019: Highlights (ST/ESA/SER.A/430). New York: United Nations, 2019.
2. Instituto Brasileiro de Geografia e Estatística (IBGE). Projeção da população do Brasil e das Unidades da Federação por sexo e idade: 2010-2060. Rio de Janeiro: IBGE, 2018.
3. Teixeira DK, Andrade LM, Santos JLP, Lima CA, Teixeira DK. Autopercepção da saúde bucal e impacto na qualidade de vida de idosos. Rev Rene. 2015;16(1):110-20.
4. Marot J, El Osta N, Hennequin M, Mazevet M, Faulks D. Defining oral health in the elderly: a systematic review. Gerodontology. 2019;36(3):205-15.
5. Gaio EJ, Haas AN, Carrard VC, Oppermann RV, Albandar JM, Susin C. Oral health status of 100-year-old people in Southern Brazil. Gerodontology. 2012;29(2):e1150-e1156.
6. Peyron MA, Woda A, Mioche L, Alvarez-Cascante C, Lassauzay C. Where, how, and how many times do people with a healthy natural dentition chew? Arch Oral Biol. 2004;49(1):45-51.
7. Fontijn-Tekamp FA, Slagter AP, Van der Bilt A, Van 't Hof MA, Witter DJ, Kalk W et al. Biting force and masticatory efficiency in relation to the number of paired teeth and prosthesis wear. J Dent Res. 2000;79(10):1743-9.
8. Hatch JP, Shinkai RS, Sakai S, Rugh JD, Paunovich ED. Determinants of self-reported masticatory ability in dentate and edentulous individuals. J Prosthet Dent. 2001;86(4):417-23.
9. van der Bilt A. Assessment of mastication with implications for oral rehabilitation: a review. J Oral Rehabil. 2011;38(10):754-80.
10. Woda A, Foster K, Mishellany A, Peyron MA. Adaptation of healthy mastication to bolus size and texture. Arch Oral Biol. 2006;51(2):135-49.
11. Felicio CM, Melchior MO, Silva MAMR, Celeghini RMS. Mastigação: o que e como avaliar? V Congresso Internacional e XI Congresso Brasileiro de Fonoaudiologia. 2003.
12. Berretin-Felix G, Genaro KF. Deglutição no envelhecimento. In: Marchesan IQ, Silva HJ, Tomé MC, editors. Tratado de motricidade orofacial. São José dos Campos: Pulso; 2014. p. 411-20.
13. Clave P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015;12(5):259-70.
14. Namasivayam-MacDonald AM, Barbon CEA, Steele CM. A review of swallow-related outcome measures used in prevalence studies of oropharyngeal dysphagia in community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2018;73(3):364-73.
15. Suzuki H, Kanbe K, Yanai S. Evaluation of masticatory efficiency in patients with dental implants using the test food 'Gummy Jelly'. J Nihon Univ Sch Dent. 2007;49(4):241-5.
16. van der Bilt A, Burgers M, van Kampen FM, Cune MS. Mandibular implant-supported overdentures and oral function. Clin Oral Implants Res. 2010;21(11):1209-13.
17. Geckollo S, Bilir H. Masticatory efficiency of different types of removable partial dentures. J Oral Rehabil. 1997;24(12):917-23.
18. Silva MES, Magalhães CS, Ferreira EF. Perda dentária e expectativa de reposição protética em adultos e idosos. Rev Saúde Pública. 2010;44(5):813-21.
19. World Health Organization (WHO). Oral Health Surveys: Basic Methods. 5th ed. Geneva: World Health Organization; 2013.
20. Folstein MF, Folstein SE, McHugh PR. 'Mini-mental state'. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
21. Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral: impacto da escolaridade. Arq Neuropsiquiatr. 1994;52(1):1-7.
22. Beltrame JM. Avaliação fonoaudiológica das funções orofaciais e o índice de eficácia mastigatória em indivíduos idosos desdentados totais. [Dissertation]. Curitiba (PR): Universidade Federal do Paraná; 2009.
23. Genaro KF, Berretin-Felix G, Rehder MIBC, Marchesan IQ. Avaliação Miofuncional Orofacial - Protocolo AMIOFE. Rev. CEFAC. 2009;11(2):237-55.
24. Sordi C, Moda LB, Genaro KF, Berretin-Felix G. Mastication efficiency and its relationship with age and dentition. Audiol Commun Res. 2015;20(2):93-101.
25. World Health Organization (WHO). Guidelines for quality control in mammography. Geneva: WHO; 1993.
26. Lucas BL, Coriolano MGWS, Alves GAS, Silva HJ. Characterization of the chewing and swallowing in patients with Parkinson's disease. Rev. CEFAC. 2016;18(3):575-84.
27. Ferreira Junior AF, Castilho AA, Pegoraro LF, Rodriguez-Chessa JG, de Oliveira GM, Genaro KF et al. Comparison of masticatory function and swallowing between elderly individuals with natural teeth and those with implant-supported fixed prostheses. J Oral Rehabil. 2014;41(12):903-11.
28. van der Bilt A, Olthoff LW, Bosman F, Oosterhaven SP. Masticatory performance and efficiency in humans with natural dentition. J Dent Res. 1987;66(5):955-9.
29. Fontijn-Tekamp FA, van der Bilt A, Abbink JH, Slagter AP, van 't Hof MA, Kalk W. Biting force and masticatory performance in people with various dental conditions. J Dent Res. 2000;79(10):1743-9.
30. Bakke M. Masticatory muscles and biting force. In: Miles TS, Nauntofte B, Svensson P, editors. Clinical oral physiology. Copenhagen: Quintessence Publishing; 2004. p. 115-46.
31. Peyron MA, Mishellany A, Woda A. Particle size distribution of food boluses after mastication and swallowing and subsequent adaptive changes. J Oral Rehabil. 2013;40(10):751-7.
32. Newman R, Vilardell N, Clavé P, Speyer R. Effect of bolus viscosity on the safety and efficacy of swallowing and the kinematics of the swallow response in patients with oropharyngeal dysphagia: white paper by the European Society for Swallowing Disorders (ESSD). Dysphagia. 2016;31(2):232-49.
33. Uram-Tuculescu S, Cooper LF, Foegeding EA, Vinyard CJ, De Kok IJ, Essick G. Electromyographic evaluation of masticatory muscles in dentate patients versus conventional and implant-supported fixed and removable denture wearers a preliminary report comparing model foods. Int J Prosthodon. 2015;28(1):79-92.
34. Van der Bilt A, Burgers M, van Kampen FM, Cune MS. Mandibular implant-supported overdentures and oral function. Clin Oral Implants Res. 2010;21(11):1209-13.
35. Lucena CV, Cunha DA, Oliveira JHP, Silva HJ. Characterization of chewing according to time, prevalence of laterality and number of cycles in the elderly. Rev. CEFAC. 2015;17(4):1140-9.
Submitted date:
15/03/2022
Accepted date:
06/10/2022


