Abstract
This review deals with the frequent wide variability of masticatory capacity/incapacity. Neither researchers nor clinicians have taken sufficient account of this variability despite its implications for nutrition. Mastication in normal healthy oral conditions is first described, followed by a short presentation of the mechanisms of masticatory adaptation in the nervous system. Capacity, incapacity, and successful compensatory adaptation of mastication are then defined, along with the different methods used for their evaluation. Examples of adaptation needs are given, such as those concomitant with dental wear or occlusal changes. Finally, given its vital importance for deeply impaired mastication/deglutition function, the impact of masticatory adaptation processes on nutrition is examined.
Highlights
Each mouthful is analyzed by taste, retro-nasal olfaction and oral receptors of the somatosensory system. If this second checkpoint is successfully crossed, (i) the central pattern generators of mastication located in the cerebral cortex and in the brainstem are activated, and (ii) the required physiological responses are anticipated to prepare digestion of the food in the digestive tract post-esophagus. This cephalic phase occurs during mastication proper (Hiiemae and Palmer’s second step), when the food is transformed into a food bolus by the actions of the teeth through the exertion of lingual, facial and masticatory muscles and with the aid of saliva
Cortical plasticity seems to underlie the adaptation of mastication accompanying evolving conditions such as orthodontic movements, dental wear or aging, and more sudden events such as tooth loss or chance injuries of the orofacial area
A cut-off value for normality of 4 mm has been demonstrated with raw carrots (Woda et al, 2010) or artificial food (Witter et al, 2013). This value corresponds to the Masticatory Normative Indicator (MNI) beyond which the analyzed subject can adapt no further, the upper limit of capacitive adaptation being reached
Summary
Tsouknidas, University of Western Macedonia, Greece Edwin M. Specialty section: This article was submitted to Craniofacial Biology and Dental. This review deals with the frequent wide variability of masticatory capacity/incapacity. Neither researchers nor clinicians have taken sufficient account of this variability despite its implications for nutrition. Mastication in normal healthy oral conditions is first described, followed by a short presentation of the mechanisms of masticatory adaptation in the nervous system. Incapacity, and successful compensatory adaptation of mastication are defined, along with the different methods used for their evaluation. Examples of adaptation needs are given, such as those concomitant with dental wear or occlusal changes. Given its vital importance for deeply impaired mastication/deglutition function, the impact of masticatory adaptation processes on nutrition is examined
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