Self‐reported chewing side preference and its associations with occlusal, temporomandibular and prosthodontic factors: results from the population‐based Study of Health in Pomerania (SHIP‐0)

Abstract

This study investigated the prevalence of a preferred chewing side (PCS) and associations between a PCS and signs of temporomandibular disorders (TMD), antagonist contact and prosthetic restoration. A population representative sample of 4086 adults of the cross-sectional epidemiologic 'Study of Health in Pomerania' (SHIP-0) (age range 20-80 years, female 50.2%) was divided in two groups by the presence or absence of a PCS. PCS was evaluated by a questionnaire. Chi-squared tests and multiple logistic regression were used to determine the impact of the relation between a PCS and signs and symptoms of TMD as well as dental factors. The prevalence of a PCS was 45.4%. Women between 40 and 69 years reported more frequently a PCS. There was a preference for the right side (64%). The following independent variables were significantly associated with a PCS: subjective unilateral pain in the temporomandibular joint (TMJ), odds ratio (OR) 2.4; subjective unilateral joint clicking, OR 1.7; unilateral TMJ/muscle pain on palpation, OR 1.6/OR 1.3; loss of one supporting zone (Eichner-Classification), OR 1.9; loss of both supporting zones on one side, OR 2.2, one supporting zone left, OR 1.4; presence of a removable partial denture, OR 1.6; presence of an attachment restoration, OR 1.5. A PCS was found in almost half the study population and was associated with unilateral signs of TMD, most of all TMJ pain and asymmetrical loss of antagonist contact. Despite replacement of lost teeth not all restorations seemed to support bilateral mastication.

Is the side with the best masticatory performance selected for chewing?

“…These discrepancies in the literature can be explained by differences in the study population, in the definition of PCS, and consequently, in the methods used to determine the PCS. 7,10 New research should focus on finding new factors than can explain the high variability of the PCS and on comparing the reliability of different methods to determine PCS.…”

“…they have a preferred chewing side (PCS). [5][6][7] The proportion of children or adults with a PCS ranges from 45% to 98%, [7][8][9][10][11] and there is no agreement on whether the right side is used more frequently than the left side. [8][9][10]12,13 Furthermore, it still unknown whether the PCS is centrally determined or related to peripheral factors, nor which peripheral factors are most closely related to the PCS.…”

“…[8][9][10]12,13 Furthermore, it still unknown whether the PCS is centrally determined or related to peripheral factors, nor which peripheral factors are most closely related to the PCS. 7,10,11 Although natural foods can be used to assess masticatory function, artificial test food can be easily standardised and its physical properties remain the same over time. 14 Consequently, the use of artificial test foods such as silicon impression material is Page 5 of 20 A c c e p t e d M a n u s c r i p t 5 reliable.…”

A comparison of methods used to determine chewing side preference in deciduous, mixed and permanent dentitions

“…Furthermore, Hoogmartens and Caubergh [11] stated that chewing preference could be determined from the peripheral reflex system, which is often proposed to explain other lateral preferences. Diernberger et al [22] believe that how the right side is generally chosen, irrespective of peripheral factors, indicates that chewing preference may be determined by central nervous system mechanisms, because there is higher frequency of right-sidedness in the population.…”

Trastornos temporomandibulares: algunas consideraciones de su etiología y diagnóstico

“…Otro de los factores oclusales identificado es el síndrome de masticación habitual de un lado [28], para el cual existe la hipótesis de que el ser humano tiene un lado preferido para realizar la masticación y este es el lado que presenta mayor alteración de la atm [29,30]. Esto constituye un factor nervioso central [36], de modo que la regulación y el control del dolor se remontan a niveles superiores e incluso a factores genéticos.…”