Masticatory ability in older individuals: A qualitative interview study.

AIM: To explore older individuals' experienced masticatory ability and the impact of masticatory ability in daily life. MATERIAL AND METHODS: This study applied an open-ended exploratory approach using inductive reasoning. The design was inspired by the qualitative method grounded theory. The final sample consisted of twelve older participants. Seven were men, and five were women. The interviews were audio-recorded and transcribed verbatim. The interviewer successively read the transcribed data and analysed the material in cooperation with the authors. RESULTS: Three categories developed from the data; Deteriorating oral health and functional loss, Eating habits, Prosthetic rehabilitation and function. A core category named Adaptation emerged. Adaptation describes how individuals successfully could adapt to a decreased function and in spite of this develop a positive view of their masticatory ability. DISCUSSION: The participants described an experience of gradually deteriorating oral function that had affected their masticatory ability. By adapting to this functional degradation, some of the participants overcame the functional deficiencies. Most participants perceived their masticatory ability to be good, even though their ability to process some food types was described as inadequate. CONCLUSION: The participants had experienced deteriorating oral health and function throughout life, and they overcame this through adaptation by adjusting their eating habits. Even though prosthetic treatment might be considered successful by the participant, this does not necessarily improve dietary habits. Future research should therefore focus on how dental treatment can be combined with other interventions, such as dietary counselling and physiotherapy to recover physiological function.

Systematic review of measurement properties of methods for objectively assessing masticatory performance.

The objectives of this study is to identify methods for objectively assessing masticatory performance (MP) and to evaluate their measurement properties. A secondary objective was to identify any reported adverse events associated with the methods to assess MP. Bibliographic databases were searched, including MEDLINE, Embase, Web of Science Core Collection, Cochrane, and Cinahl databases. Eligible papers that satisfied predefined inclusion and exclusion criteria were appraised independently by two investigators. Four other investigators independently appraised any measurement properties of the assessment method according to the consensus-based standards for the selection of health measurement instruments checklist. The qualities of the measurement properties were evaluated using predefined criteria. The level of evidence was rated by using data synthesis for each MP assessment method, where the rating was a product of methodological quality and measurement properties quality. All studies were quality assessed separately, initially, and subsequently for each method. Studies that described the use of identical assessment method received an individual score, and the pooled sum score resulted in an overall evidence synthesis. The level of evidence was synthesized across studies with an overall conclusion, that is, unknown, conflicting, limited, moderate, or strong evidence. Forty-six out of 9,908 articles were appraised, and the assessment methods were categorized as comminution (n = 21), mixing ability (n = 23), or other methods (n = 2). Different measurement properties were identified, in decreasing order construct validity (n = 30), reliability (n = 22), measurement error (n = 9), criterion validity (n = 6), and responsiveness (n = 4). No adverse events associated with any assessment methods were reported. In a clinical setting or as a diagnostic method, there are no gold standard methods for assessing MP with a strong level of evidence for all measurement properties. All available assessment methods with variable level of evidence require lab-intensive equipment, such as sieves or digital image software. Clinical trials with sufficient sample size, to infer trueness and precision, are needed for evaluating diagnostic values of available methods for assessing masticatory performance.

Methods for objectively assessing clinical masticatory performance: protocol for a systematic review.

BACKGROUND: Chewing and masticatory function constitutes one of the most important oral health factors that affect quality of life, especially in older individuals. Little consensus currently exists regarding ways to objectively assess clinical masticatory performance (in this context, performance refers an individual's objective ability to mix or comminute food bolus). That said, many methods were developed to assess masticatory performance. Consequently, systematic review of the literature would be of great value when it comes to identifying various methods for objectively assessing clinical masticatory performance and for evaluating these methods. DESIGN: This study protocol describes a systematic review that intends to (i) identify methods to objectively assess clinical masticatory performance and (ii) evaluate psychometric properties (such as validity and reliability) of the identified methods. A systematic literature search is required to do so in these sources: MEDLINE (Ovid), Embase (embase.com), Web of Science Core Collection (Thomson Reuters), Cochrane (Wiley), and Cinahl (Ebsco). INCLUSION CRITERIA: studies in scientific, full-text articles; development articles; validation articles; studies of the general adult population, ages ≥18. EXCLUSION CRITERIA: topics and article types that cover interview methods and self-reported questionnaires; methods/instruments that measure subjective masticatory performance; qualitative studies and case studies; opinion and editorial pieces; animal studies; studies of humans with severe oral health complications. DISCUSSION: This systematic review will result in a comprehensive assessment of various methods designed to objectively measure clinical masticatory performance. This systematic review will rate these methods, assess their reliability and validity, and identify one or more methods that can be recommended for use in clinical and scientific environments. From what is currently known, no systematic evaluation of various methods for objectively assessing clinical masticatory performance has been published. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016037700.