Oral Function Test Research Articles

Oral functions in adult persons with spinal muscular atrophy compared to a healthy control group: a prospective cross-sectional study with a multimodal approach

BackgroundOral function tests have been shown to reliably detect impaired bulbar function in adults with spinal muscular atrophy (SMA). Although not routinely recorded, it is known that persons with SMA are affected to varying degrees. Detecting differences in bite and tongue force, endurance, and maximum mouth opening has become particularly promising since the introduction of causal therapy for SMA. This study aimed to compare oral function among adult persons with SMA with different SMA types, walking abilities, and treatment status to a healthy control group.MethodsData from oral function tests conducted on 58 persons with SMA and 45 healthy individuals were analyzed. Differences in oral function between SMA subgroups were pairwise tested and compared to the healthy control group using Wilcoxon rank sum tests.ResultsIn an overall comparison, three out of five oral function tests revealed lower values for the SMA group compared to the control group. Subgroup analyses indicated lower scores for most oral function tests in non-ambulatory, untreated patients with SMA type 2 compared to controls. Ambulatory, treated patients with SMA type 3 achieved strength and endurance values comparable to those of healthy individuals.ConclusionsThe impairment of oral function varies across persons with SMA. Routine measurement of oral function is warranted to determine individual bulbar involvement stages. Further evaluation should be scheduled if indicators such as restricted maximum mouth opening arise.Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/register/de/trial/DRKS00015842/preview.

Relationships Between Test Results for Oral Hypofunction, Subjective Frailty Symptoms and Oral Health-Related Quality of Life of Japanese Dental Outpatients: A Multicentre, Cross-Sectional Study.

Oral hypofunction is the stage before oral dysfunction. The subjective symptoms of poor oral function and the decline in oral health-related quality of life (OHRQoL) that occur in the oral hypofunction stage can be missed. This multicentre cross-sectional study was performed to examine the relationships between the test results for oral hypofunction, subjective frailty symptoms and OHRQoL of outpatients in dental clinics. The basic characteristics and oral function test results of 637 dental clinic outpatients were evaluated. The subjective symptoms of physical and oral frailty were investigated using a questionnaire. OHRQoL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16) and OHRQoL dimension score. The overall prevalence of oral hypofunction was 37.8%, with no significant difference between men and women. No significant differences in the presence or absence of subjective symptoms of frailty and a high OHIP score were observed based on sex. However, the prevalence of oral hypofunction was significantly different among the age groups and increased with age. The subjective symptoms of frailty score, OHIP score and OHRQoL dimension score were significantly higher in patients with versus without oral hypofunction. Age, number of underlying diseases, total score for subjective symptoms of frailty, total score for OHIP and OHRQoL dimension score were significantly associated with oral hypofunction. Oral hypofunction may affect the subjective symptoms of frailty and OHRQoL in older adults.

Pilot study on the relationship between oral function or subjective symptoms and appetite.

This pilot study evaluated the relationships between appetite and oral function, and between appetite and the subjective symptoms of decreased oral function. Seventy-one adult dental clinic patients (22 males, 66.0 ± 14.0 years) participated in this study. A Council on Nutrition Appetite Questionnaire score of ≤28 indicated anorexia, and the Mini Nutritional Assessment Short-form, body mass index and skeletal muscle mass index were used to define subject characteristics. Seven oral function tests and seven subjective symptoms related to oral function were evaluated. The relationship between subject characteristics, oral function tests, subjective symptoms and anorexia was analysed using the chi-square test and univariate and multivariate logistic regression. There were significant differences between the normal appetite group and the anorexia group for the 10-item Eating Assessment Tool (EAT-10) survey and the question 'Food remains in the oral cavity after eating' (p < .05). Univariate logistic regression found significant differences in the items of masticatory function, the EAT-10 survey and the question 'Food remains in the oral cavity after eating'. Multivariate logistic regression revealed significant differences in masticatory function (AOR 4.35; 95% CI: 1.03-18.35; p = .045) and EAT-10 (AOR 6.27; 95% CI: 1.40-24.02; p = .016). This pilot study investigated the influence of factors related to oral function on appetite. Relationships were found among poor masticatory function, poor swallowing function and anorexia.

Effects of various prosthetic methods for patients with Kennedy Class I partial edentulism on oral hypofunction, subjective symptoms, and oral health-related quality of life

PurposeThis propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with Kennedy Class I partial edentulism (KCIPE) on oral hypofunction, subjective frailty symptoms, and oral health-related quality of life (QOL).MethodsPatients (n = 348) were classified into the following three groups for analysis: NT, patients with natural dentition providing intermaxillary contact in four occlusal supporting zones; RPD, patients with KCIPE who received removable partial dentures; and ISFP, patients with KCIPE who received implant-supported fixed prostheses. Participants' basic characteristics were recorded, and oral function tests were conducted. Subjective symptoms of physical and oral frailty were investigated via questionnaire. Oral health-related QOL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16). Propensity score matching was performed to adjust for patient background factors that could influence oral hypofunction in each group.ResultsCompared with the ISFP group, the RPD group had significantly higher rates of poor oral hygiene, reduced occlusal force, decreased masticatory function, and declines in swallowing function and oral hypofunction; the odds ratio for oral hypofunction was 4.67. Compared with the ISFP group, the RPD group had significantly greater subjective symptoms of physical frailty and oral frailty, as well as higher OHIP scores.ConclusionsProsthetic treatment of KCIPE affected oral hypofunction, subjective frailty symptoms, and oral health-related QOL in dental clinic outpatients.

Relationship between texture perception and oral function: A preliminary study in young, healthy adults.

Oral frailty, characterised by reduced oral function, is associated with systemic health issues in older adults. Although the criteria for diminished oral function often focus on motor and secretory abilities, texture perception also plays a crucial role in health due to its impact on food intake and palatability. This study aimed to explore the relationship between thickness discrimination ability (TDA) and oral motor and secretory functions in healthy young individuals. Twenty-eight adults were assessed for texture perception using eight concentrations of aqueous xanthan gum solutions to determine TDA scores. Measurements of occlusal force, masticatory performance, tongue pressure, stimulated salivary flow rate and tongue-lip motor function were conducted. Spearman's correlation analysis was used to evaluate the relationship between TDA scores and oral functions. Participants were divided into high-sensitivity and low-sensitivity groups based on their TDA scores to compare oral function test results. The TDA scores varied among the participants, with higher scores correlating with higher masticatory performance (r = 0.41, p < .05). Masticatory performance in the high-sensitivity group was significantly higher than in the low-sensitivity group (211.9 ± 59.2 mg/dL vs. 157.9 ± 43.0 mg/dL, p = .013), with no significant differences in other oral functions. Masticatory performance was correlated with TDA, suggesting a link between the selection function of mastication and thickness discrimination. These findings highlight the potential relevance of texture perception in oral function and indicate the need for further exploration, particularly in older adults with declining oral health.

Association between severity of malocclusion and parameters of oral functions in permanent dentition with various malocclusion: case-control study

ABSTRACT Purpose It has been reported that people with malocclusion have poor masticatory function, including decreased bite force and masticatory efficiency, but the relationship between the severity of malocclusion and oral function remains unclear. The purpose of this study was to clarify the relationship between the severity of malocclusion and various oral function parameters using the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), which quantitatively evaluates the state of malocclusion. Materials and methods A total of 138 permanent dentition patients (39-men, 99-women; aged 15–59 years) who visited Tsurumi University Dental Hospital were included in the study. The severity of malocclusion was determined using IOTN-DHC grading, and patients were classified into three groups. All patients underwent oral function tests before orthodontic treatment, including masticatory efficiency, occlusal force, occlusal contact area, lip pressure and tongue pressure. The relationship between malocclusion severity and oral function was statistically analysed. Results Firstly, we compared the medians of each oral function values among three groups and found statistically significant lower value in group 3, the worst IOTN-DHC grading group, as compared to group 1. Correlation analysis revealed correlations between malocclusion severity and oral functions, such as lip pressure, masticatory efficiency and tongue pressure. In addition, masticatory efficiency was correlated with occlusal contact area, tongue pressure and lip pressure. Conclusions Our results suggest that oral function is lower in patients with severe malocclusion and masticatory efficiency is related not only to dental occlusion but also to the function of surrounding soft tissues, such as the tongue and lips.

Objective measurement of oral function in adults with spinal muscular atrophy

BackgroundImpairment of bulbar function in adult individuals with spinal muscular atrophy (SMA) usually is not assessed by established motor scores. Measurements of oral function including quantitative muscle and endurance tests are able to detect subtle changes. The aim of this study was to systematically evaluate the measurement of maximum bite force and endurance, maximum tongue pressure and endurance, as well as maximum mouth opening in adult individuals with SMA types 2 and 3. MethodsData from oral function tests in 43 individuals were analyzed. Differences in oral function between individuals with different SMA types and numbers of SMN2 copies were tested. Spearman´s rho correlations among oral function measures themselves as well as with established clinical outcome scales were analyzed.ResultsThe absolute maximum measures of oral function (maximum bite force, maximum tongue pressure, maximum mouth opening) were able to discriminate between individuals with different SMA types, individuals with a different number of SMN2 copies and with different walking abilities. The pairwise correlations of the absolute maximum measures of oral function were fair to moderate in size; the same was true for their correlations with the established motor scores. All correlations assessing endurance measures of oral function were weaker and statistically insignificant.ConclusionsAmong the oral function tests maximum tongue pressure and maximum mouth opening are particulary promising as clinical and sensitive outcome measures for clinical trials. Oral function tests may supplement existing motor scores, in particular concerning specific questions about bulbar function or in severely affected non-ambulatory individuals where mild (treatment-related) changes would otherwise remain undetected.Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/search/de/trial/DRKS00015842

Effects of Developmental Failure of Swallowing Threshold on Obesity and Eating Behaviors in Children Aged 5-15 Years.

Background: The aim of the present study was to identify factors related to developmental failure of swallowing threshold in children aged 5–15 years. Methods: A total of 83 children aged 5–15 years were included in this study. A self-administered lifestyle questionnaire was completed, along with hand grip strength and oral function tests. Swallowing threshold was determined based on the concentration of dissolved glucose obtained from gummy jellies when the participants signaled that they wanted to swallow the chewed gummy jellies. Developmental failure of swallowing threshold was defined as glucose concentrations in the lowest 20th percentile. After univariate analysis, multivariate binary logistic regression analysis was used to identify factors associated with developmental failure of swallowing threshold. Results: Hand grip strength was significantly correlated with masticatory performance (r = 0.611, p < 0.01). Logistic regression analysis revealed factors related to developmental failure of swallowing threshold, i.e., overweight/obesity (Odds ratio) (OR) = 5.343, p = 0.031, 95% CI = 1.168–24.437) and eating between meals at least once a day (OR = 4.934, p = 0.049, 95% CI = 1.004–24.244). Conclusions: Developmental failure of swallowing threshold was closely associated with childhood obesity in 5- to 15-year-old children.

Development of a candy-sucking test for evaluating oral function in elderly patients with dementia: A pilot study.

To maintain oral intake in elderly patients with dementia, it is important to evaluate their oral function. However, these patients often have difficulties following instructions during oral function tests, especially with the progression of dementia. The task of sucking a lollipop candy is simple for elderly patients with mild or severe dementia. The present study aimed to develop a new oral function test - the "candy sucking test" (CST) - for elderly patients with dementia. We recruited 23 female elderly patients with dementia (mean age 89.0 ± 6.7 years). First, we determined the number of participants who were able to carry out this new oral function test, compared with other existing tests. Then, swallowing function was evaluated using videofluoroscopy for those who could carry out the CST. More participants were able to perform carry out CST than other function tests (P < 0.05). A significant correlation was observed between the CST value, evaluated as the difference in candy weight, and oral transit time (ρ = -0.62, P < 0.01). The CST could be useful as a new method for evaluating the oral function of elderly patients with dementia. Geriatr Gerontol Int 2017; 17: 1977-1981.

Relationship between swallowing function and the skeletal muscle mass of older adults requiring long-term care.

The present study investigated the risk factors for dysphagia among older adults who require long-term care, and also examined their systemic decrease in skeletal muscle mass. We evaluated 399 people who required long-term care and who were residing in Omori town, Yokote city, Akita prefecture, Japan. We then analyzed data from 255 participants who had complete information available regarding their sex, age, case history (stroke, Parkinson's disease and dementia), Barthel Index, Skeletal Muscle Mass Index, oral function test and modified water swallowing test results. Participants' water swallowing test results were used to create groups with good or poor swallowing function, and a univariate analysis was carried out for each parameter. Parameters with a P-value of <0.25 in the univariate analysis were subsequently included in a multiple logistic regression model as explanatory variables, and good or poor swallowing function were defined as the dependent variables. After adjusting for age and sex, our analysis showed that poor tongue motility (odds ratio 17.23, 95% confidence interval 5.90-50.31, P < 0.001) and decreased Skeletal Muscle Mass Index (odds ratio 3.36, 95% confidence interval 1.41-7.99, P = 0.006) were significantly correlated with decreased swallowing function. Decreased swallowing function was closely correlated with poor tongue motility, and this finding is similar to those of previous studies. However, the present results also show that decreased Skeletal Muscle Mass Index is a novel risk factor for dysphagia among older adults who require long-term care.

超音波装置を用いた嚥下動態評価

Background : The purpose of this study was to investigate the usefulness of an ultrasonographic method for examination of dysphagia in stroke patients based on evaluation of tongue movement during the swallowing process.Methods : Nineteen patients with acute stroke (13men, 76.1 ± 6.5years) in whom dysphagia was proven by videofluoroscopic examination of swallowing (VF) were eligible for inclusion in the tongue and oral function test with ultrasonography (TOFU) study. Sixteen age- and sex-matched individuals (11men, 73.4 ± 6.1years) served as controls. In the TOFU study, a patient was required to swallow saliva in the 30-degree head-up position. The tongue surface was visible as a bright narrow line on an M-mode image. We recorded the velocity of the tongue downward and upward movement (Vd and Vu) and the distance from the caudally falling to the cranially raised position (D).Results : Vu of patients with dysphagia was significantly slower than that of control subjects (44.7 ± 11.1mm/s vs. 70.4 ± 13.4min/s, p<0.001), and D of patients was shorter than that of control subjects (11.4 ± 3.4mm vs. 14.7 ± 3.0min, p = 0.002). Vd showed no significant association.Conclusions : These preliminary results suggest that TOFU is an accurate method for bedside evaluation of dysphagia in acute stroke patients.

Quality of life and functional status in patients with cancer of the oral cavity and oropharynx: pretreatment values of a prospective study

We assessed the pretreatment health-related quality of life (HRQOL) and functional status of patients with advanced oral and oropharyngeal cancer. Eighty patients were investigated. HRQOL was assessed by EORTC QLQ-C30/QLQ-H&N35 questionnaires. Functional status assessment comprised speech and oral function tests. The results revealed a wide range of HRQOL and functional deficits before treatment. HRQOL appeared to be related to some extent to tumor site (patients with oral tumors reported more pain compared to patients with oropharyngeal tumors) and tumor classification (patients with T3–T4 tumors reported more trouble opening the mouth and felt more ill compared to patients with T2 tumors). Comorbidity appeared to have a major impact. Patients with comorbidity had significantly worse scores on several scales/items on both the EORTC questionnaires. Functional deficits were related to tumor site, classification and comorbidity. Patients with oral cavity tumors (versus oropharyngeal tumors), patients with T3–T4 tumors (versus T2 tumors), and patients with comorbidity (versus without comorbidity) scored significantly worse on several speech and oral function tests. Impaired speech and oral function appeared to be clearly related to global quality of life (QLQ-C30) and self-reported speech (QLQ-H&N35). Many patients with advanced oral and oropharyngeal cancer have compromised HRQOL and functional status before the start of treatment. In addition to tumor site and tumor classification, comorbidity appears to have a major impact on HRQOL and functional status. Knowledge of pretreatment HRQOL and functional status levels is useful for better understanding the impact of treatment on these outcomes over time.

Biochemical tests in the diagnosis of chronic pancreatitis and in the evaluation of pancreatic insufficiency

Chronic pancreatitis (adults) and cystic fibrosis (children) are the most common diseases leading to exocrine pancreatic insufficiency that, when reduced to <5% of normal function, is characterised by steatorrhoea. The pathogenesis of the former condition is outlined, and recent concepts are emphasized. Biochemical tests to detect pancreatic insufficiency and to identify pancreatic disease as the cause of steatorrhea include: serum enzyme tests (lipase, amylase, trypsin); stool chymotrypsin; isotopic tests based upon the assimilation of [ 14C] lipids and starch or excretion of the isotope as breath CO 2, as well as the dual-labelled Schilling test; oral function tests utilising substrates hydrolysed by pancreatic enzymes such as benzoyl tyrosyl- p-aminobebzoic acid and fluorescein dilaurate; and duodenal intubation studies following meal-induced or hormonal stimulation of the pancreas. The rationale for these tests and the cumulative clinical experience of their utility are reviewed. A recommended diagnostic strategy is briefly presented. The role of various biochemical procedures to evaluate the efficacy of pancreatic enzyme replacement therapy is also described.