More Teeth and Posterior Balanced Occlusion Are a Key Determinant for Cognitive Function in the Elderly

Abstract

Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability and cognitive function in the elderly. A total of 563 participants aged 65 years or over residing in urban and rural areas of South Korea were surveyed. The chewing ability was measured by objectively measurable indications such as the number of remaining teeth, denture status, color-changeable gum, and occlusal balance using T-Scan III®. The cognitive function was measured by the Korean version of Mini-Mental State Examination-Dementia Screening (MMSE-DS) and a score of 24 or more (out of 30) indicates a normal cognition, below 23 indicates cognitive impairment. The association between socio-demographic factors, chewing ability factors, and cognitive function demonstrated statistically significant results. When comparing the denture status and chewing ability, the proportion of need denture group had fewer remaining teeth and anterior balanced occlusion. The average number of remaining teeth in anterior balanced occlusion with cognitive impairment was 11.2 compared to posterior balanced occlusion with the normal cognition 19.2. A multiple linear regression analysis declared a significant correlation between number of remaining teeth, denture status, occlusal balance, and cognitive function. Results of the present study revealed objectively measurable indications are suitable for chewing ability assessment and correlated with cognitive function.

Chewing and Swallowing Abilities of Persons Living With Dementia: A Systematic Review of Psychometric Properties of Instruments

“…A total of eight instruments assessing chewing ability were reported in 11 scholarly records. Only one instrument, the two-color chewing gum mixing ability test ( Park et al, 2021 ; Shin et al, 2020 ; Weijenberg et al, 2015 ; Zenthöfer et al, 2021 ), was originally developed for use in the dementia population. Five instruments were originally developed for other populations and later used with the dementia population.…”

“…The scoring methods are: (1) frequency, rate, and binary scoring (PMMT, subjective mastication comfort analysis, subjective five food mastication ability, and chewing capacity assessment), (2) rate of good and poor masticatory performance (subjective masticatory index), (3) weight percentage of comminuted test material (masticatory efficiency), and (4) maximum magnitude of bite force (maximum occlusal force). The two-color chewing gum mixing ability test was scored in two different formats across four studies: (1) frequency, rate, and binary scoring ( Park et al, 2021 ; Zenthöfer et al, 2021 ), and (2) 5-points Likert for the changed gum color and/or Diffix score that indicates the amount of mixing ( Shin et al, 2020 ; Weijenberg et al, 2015 ).…”

La masticación, su relación con la disfunción cognitiva y la rehabilitación oral como una medida preventiva

“…La rehabilitación oral es un potencial tratamiento en caso resulte ser beneficioso para la salud oral, siendo una nueva vía para la prevención del deterioro cognitivo y demencia, los estudios realizados demuestran que los diferentes tratamientos protésicos son mejores que una prótesis removible parcial o total, ( 14), las perdida de dientes funcionales es irreversible, esto puede reflejar la salud oral, las dentaduras mal posicionadas, flojas o mal ajustadas pueden disminuir la presión oclusal, estomatitis protésica y causar trastornos nutricionales (15).…”

“…La relación causa-efecto entre la masticación y DC aún no ha sido del todo aclarada, principalmente esta se basa en los datos obtenidos de las investigaciones hechas en animales (1,4,5,(14)(15)(16)(17)(18), y se ha relacionado en la población adulta con la pérdida de las piezas dentarias y edentulismo (19), el sustento de dicho enunciado se basa en que la perdida de dientes, afecta la capacidad masticatoria, la dificultad para llevar el acto de la masticación estaría relacionada con el flujo de sangre al cerebro, siendo de importancia para una amplia gama de funciones cognitivas cerebrales (20), también la capacidad masticatoria es importante para la nutrición del individuo (21), una persona que no puede masticar bien consume menos fibra, micronutrientes y a su vez opta por el consumo de alimentos blandos, fáciles de masticar, que pueden estar relacionados con el deterioro cognitivo (22).…”

Impact of Masticatory Discomfort on Daily Living Difficulties in Korean Elderly with Cognitive Decline

“…Older adults with difficulty chewing tend to eat soft foods, causing a gradual decline in masticatory function. Longterm accumulation of these problems can lead to neuro-degeneration due to nutritional imbalances, as well as a decline in memory and learning, neuroendocrine changes, and hippocampal degeneration 3) .…”