-
Molecular Genetics and Metabolism Jun 2024Information about dysarthria and dysphagia in mitochondrial diseases (MD) is scarce. However, this knowledge is needed to identify speech and swallowing problems early,...
BACKGROUND
Information about dysarthria and dysphagia in mitochondrial diseases (MD) is scarce. However, this knowledge is needed to identify speech and swallowing problems early, to monitor the disease course, and to develop and offer optimal treatment and support. This study therefore aims to examine the prevalence and severity of dysarthria and dysphagia in patients with MD and its relation to clinical phenotype and disease severity. Secondary aim is to determine clinically relevant outcome measures for natural history studies and clinical trials.
METHODS
This retrospective cross-sectional medical record study includes adults (age ≥ 18 years) diagnosed with genetically confirmed MD who participated in a multidisciplinary admission within the Radboud center for mitochondrial medicine between January 2015 and April 2023. Dysarthria and dysphagia were examined by administering the Radboud dysarthria assessment, swallowing speed, dysphagia limit, test of mastication and swallowing solids (TOMASS), and 6-min mastication test (6MMT). The disease severity was assessed using the Newcastle mitochondrial disease scale for adults (NMDAS).
RESULTS
The study included 224 patients with MD with a median age of 42 years of whom 37.5% were male. The pooled prevalence of dysarthria was 33.8% and of dysphagia 35%. Patients with MD showed a negative deviation from the norm on swallowing speed, TOMASS (total time) and the 6MMT. Furthermore, a significant moderate relation was found between the presence of dysarthria and the clinical phenotypes. There was a statistically significant difference in total time on the TOMASS between the clinical phenotypes. Finally, disease severity showed a significant moderate relation with the severity of dysarthria and a significant weak relation with the severity of dysphagia.
CONCLUSION
Dysarthria and dysphagia occur in about one-third of patients with MD. It is important for treating physicians to pay attention to this subject because of the influence of both disorders on social participation and wellbeing. Referral to a speech and language therapist should therefore be considered, especially in patients with a more severe clinical phenotype. The swallowing speed, TOMASS and 6MMT are the most clinically relevant tests to administer.
PubMed: 38843620
DOI: 10.1016/j.ymgme.2024.108510 -
CoDAS 2024To determine the relationship between mastication and malnutrition in community-dwelling older adults. (Meta-Analysis)
Meta-Analysis
PURPOSE
To determine the relationship between mastication and malnutrition in community-dwelling older adults.
RESEARCH STRATEGIES
To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies.
SELECTION CRITERIA
It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity.
DATA ANALYSIS
The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals.
RESULTS
After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool.
CONCLUSION
Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.
Topics: Humans; Mastication; Malnutrition; Aged; Independent Living; Female; Cross-Sectional Studies; Male; Geriatric Assessment; Middle Aged; Aged, 80 and over
PubMed: 38836831
DOI: 10.1590/2317-1782/20242023209en -
Cureus May 2024Introduction Oral submucous fibrosis (OSMF) is a persistent, collagen metabolic disorder distinguished by the presence of fibrosis of the connective tissue stroma in the...
Introduction Oral submucous fibrosis (OSMF) is a persistent, collagen metabolic disorder distinguished by the presence of fibrosis of the connective tissue stroma in the oral mucosa with a higher malignant potential rate for oral cancer. This study aimed to analyze the utility of electromyography (EMG) as the prognostic assessment tool in the management of OSMF with conventional intralesional corticosteroid therapy. Materials and methods This study included 20 OSMF cases of age range 20 to 80 years without systemic comorbidities to assess pre-treatment and post-treatment changes with intralesional corticosteroid therapy as an intervention and to determine if it could be assessed using electromyographic study. Clinical and histopathological grading of OSMF was done. The five clinical parameters were evaluated for measuring treatment prognosis. Among them, mouth opening, tongue protrusion, and burning sensation assessments were quantitative parameters, and palpable fibrotic bands and mucosa colour were qualitative parameters. As OSMF involves changes in muscle plane in moderately advanced and advanced cases, EMG was used as an assessment tool for measuring muscle activity. Among the muscles of mastication, the masseter and temporalis were selected for evaluation. Twenty age and gender-matched healthy controls were required for this study as there are no standardized normal values for amplitude and onset of activity in muscle analysis. The EMG activity of the right and left temporalis and masseter muscles were recorded using surface electrodes and were correlated with five clinical assessment parameters. Results In the right masseter, the rest amplitude of 1.6010 µV of the OSMF was statistically significant (p-value: 0.050) when compared with 4.1275 µV of the control. The clench amplitude of 133.370 µV of the OSMF was statistically significant (p-value: 0.062) when compared with 94.310 µV of the control. In the left masseter, the rest amplitude of 1.6695 µV of the OSMF was statistically significant (p-value 0.066) when compared with 2.5735 µV of the control. In the left masseter, the onset of muscle action of 62.670 ms of the OSMF was statistically significant (p-value: 0.017) when compared with 131.835 ms of the control. The clench amplitude differences in the right masseter of 133.370 µV pre-treatment, and 102.775 µV post-treatment were statistically significant (p-value: 0.007). The clench amplitude in the left masseter of 102.535 µV pre-treatment, and 92.090 µV post-treatment were statistically significant (p-value: 0.036). The correlation was seen between tongue protrusion and rest amplitude in the right masseter in OSMF (r = 0.376, p-value: 0.023). Conclusion There was a correlation between tongue protrusion and rest amplitude in the right masseter muscle in OSMF patients before treatment. In the right and left masseter, during rest, the amplitude of the OSMF group was lesser than that of the control group. During clench, in the right masseter, the amplitude of the OSMF group was higher than that of the control group. During clench in the left masseter, the onset of muscle action was lesser in the OSMF group than in the control group. After treatment, there was a reduction in clench amplitude in OSMF patients from their pretreatment values signifying muscle relaxation and a better onset of muscle action.
PubMed: 38836143
DOI: 10.7759/cureus.59675 -
Nutrition (Burbank, Los Angeles County,... May 2024Maintaining plasma glucose homeostasis is vital for mammalian survival, but the masticatory function, which influences glucose regulation, has, to our knowledge, been...
OBJECTIVE
Maintaining plasma glucose homeostasis is vital for mammalian survival, but the masticatory function, which influences glucose regulation, has, to our knowledge, been overlooked.
RESEARCH METHODS AND PROCEDURES
In this study, we investigated the relationship between the glycemic response curve and chewing performance in a group of 8 individuals who consumed 80 g of apple. A device called "Chewing" utilizing electromyographic (EMG) technology quantitatively assesses chewing pattern, while glycemic response is analyzed using continuous glucose monitoring. We assessed chewing pattern characterizing chewing time (t), number of bites (n), work (w), power (wr), and chewing cycles (t). Moreover, we measured the principal features of the glycemic response curve, including the area under the curve (α) and the mean time to reach the glycemic peak (t). We used linear regression models to examine the correlations between these variables.
RESULTS
t, n, and wr were correlated with α (R = 0.44, P < 0.05 for t and n, P < 0.001 for wr), and t was correlated with t (R = 0.25, P < 0.05). These findings suggest that increasing chewing time and power, while reducing the number of chews, resulted in a wider glycemic curve and an earlier attainment of the glycemic peak.
CONCLUSIONS
These results emphasize the influence of proper chewing techniques on blood sugar levels. Implementing correct chewing habits could serve as an additional approach to managing the glycemic curve, particularly for individuals with diabetes.
PubMed: 38823253
DOI: 10.1016/j.nut.2024.112481 -
Clinical Oral Investigations Jun 2024This cross-sectional pilot study evaluated the impact of age on masticatory performance among individuals aged 65 to 106 years, as part of the Heidelberg Dental...
OBJECTIVE
This cross-sectional pilot study evaluated the impact of age on masticatory performance among individuals aged 65 to 106 years, as part of the Heidelberg Dental Centenarian Study (HD-100Z) conducted in South-Western Germany.
MATERIALS AND METHODS
A total of 31 centenarians were recruited, alongside 31 individuals each from the age groups 75-99 and 65-74, matched based on sex, prosthetic status, and number of teeth. Masticatory performance was assessed using a two-colored chewing gum test and digital image processing. Multiple linear regression analysis was performed to assess the effect of age, sex, number of teeth, type of prosthesis on the masticatory performance.
RESULTS
Masticatory performance, as measured by the standard deviation of hue in the chewing gum test, decreased significantly in centenarians compared to individuals aged 75-99 years (-0.112, p = 0.037) and those aged 65-74 years (-0.274, p < 0.001). The effects of sex, number of teeth, and type of prosthesis on masticatory performance were not significant associations (p ≥ 0.135).
CONCLUSION
The findings suggest that age may have a significant influence on masticatory performance in the studied age groups, challenging previous notions that aging itself has little impact on masticatory ability. The inclusion of centenarians in the study highlights the need for further investigation into masticatory function in age groups reaching up to 100 years or more.
CLINICAL RELEVANCE
This study contributes to the understanding of how ageing affects oral function, which may guide dental treatment approaches for older individuals, and set the stage for more in-depth investigations in this field in the future.
Topics: Humans; Female; Mastication; Cross-Sectional Studies; Male; Aged, 80 and over; Aged; Pilot Projects; Germany; Age Factors; Chewing Gum
PubMed: 38822870
DOI: 10.1007/s00784-024-05742-y -
PloS One 2024Chewing fresh leaves of Catha edulis (khat) is a popular pastime activity among Ethiopians where 12% women chew it. Reports show that khat use has been associated with...
Current khat (Catha edulis F.) use among Ethiopian women and its association with anemia and underweight: A cross-sectional analysis from Ethiopian Demographic and Health Survey.
BACKGROUND
Chewing fresh leaves of Catha edulis (khat) is a popular pastime activity among Ethiopians where 12% women chew it. Reports show that khat use has been associated with poor nutritional status. This study aimed to determine whether khat chewing is linked to underweight and anemia.
METHOD
We analyzed data from the 2016 Ethiopian Demographic and Health Survey (EDHS). The EDHS used two stage stratified cluster sampling to collected data from 16,650 households. We used data from a total of 15,683 respondents and 1904 respondents who chewed ever chewed khat in their lives. We used Pearson's chi-square, and logistic regression while stratifying by residence (urban vs rural) to control for confounders.
RESULT
Our results indicated 10.7% (95%CI: 10.92,11.26) of women chewed khat for an average of 16.5 days in the previous month. A woman's current khat chewing status was significantly associated with age, educational level, region, religion, wealth group, and marital status. Women aged 40-44 were significantly more likely to chew (AOR = 2.89,) compared to those aged 15-19. Compared with Protestant women, Muslim women were 210 times more likely (AOR = 210, 95% CI 102,435.7) to chew and women in the poorest wealth quintile had 73% higher odds (AOR = 1.73, 95% CI 1.22,2.44) of chewing khat when compared with the richest. Anemia was not associated with a woman's chewing status, whereas rural women who chewed khat for more than 26 days in a month had a 78% increased risk (OR = 1.78) of being underweight when compared to non-chewers.
CONCLUSION
Khat chewing is associated with sociodemographic factors and current khat use is associated with a higher risk of underweight among women living in rural areas. Implementing targeted awareness campaigns for women about the risks of khat chewing is recommended.
Topics: Humans; Catha; Female; Adult; Ethiopia; Thinness; Anemia; Cross-Sectional Studies; Adolescent; Young Adult; Middle Aged; Health Surveys; Mastication; Rural Population
PubMed: 38820499
DOI: 10.1371/journal.pone.0297831 -
Clinical and Experimental Dental... Jun 2024This study aimed to clarify the relationship between oral frailty and oral dysbiosis among hospitalized patients aged ≥ 50 years. (Observational Study)
Observational Study
OBJECTIVE
This study aimed to clarify the relationship between oral frailty and oral dysbiosis among hospitalized patients aged ≥ 50 years.
METHODS
A prospective observational study was conducted. Number of teeth, masticatory ability, articulatory oral motor skill, tongue pressure, swallowing pressure, and choking were used to assess oral frailty. Saliva samples were collected from the oral cavity for bacterial culture.
RESULTS
A total 103 in patients enrolled and 53.4% suffered from oral frailty. Oral frailty was found to have a 3.07-fold correlation with the presence of Enterobacterales in the oral cavity (p = 0.037), especially in poor articulatory oral motor skill, which showed at greater risk of Enterobacterales isolated from the oral cavity by 5.58-fold (p = 0.01).
CONCLUSION
Half of hospitalized patients was found to have oral frailty that was related to more Enterobacterales in the oral cavity. This evidence suggests that the enhancement of articulatory oral motor skills may serve as a potential strategy for mitigating the presence of Enterobacterales within the oral cavity.
Topics: Humans; Female; Aged; Male; Prospective Studies; Middle Aged; Dysbiosis; Saliva; Mouth; Hospitalization; Frailty; Aged, 80 and over; Mastication; Enterobacteriaceae
PubMed: 38816943
DOI: 10.1002/cre2.890 -
Cureus Apr 2024In edentulous arches, alveolar ridge atrophy after tooth extraction is a common problem that affects patient comfort and quality of life. Implant-supported fixed...
In edentulous arches, alveolar ridge atrophy after tooth extraction is a common problem that affects patient comfort and quality of life. Implant-supported fixed restorations are a well-proven treatment option for edentulism. The concepts of implant dentistry have developed over time to produce better aesthetics and functional results. To reduce cantilever length and enable prostheses with 12 teeth, the all-on-four technique entails inserting two anterior implants axially and distally orienting two posterior implants. Compared to conventional loading, immediate loading offers various benefits without compromising quality. An instantaneous fixed provisional allows patients immediate function and preserves their quality of life while also promoting a high degree of patient satisfaction in terms of aesthetics, phonetics, mastication, and psychological comfort.
PubMed: 38800271
DOI: 10.7759/cureus.58919 -
Biofilm Jun 2024Restorative dental materials can frequently extend below the gingival margin, serving as a potential haven for microbial colonization, and altering the local oral...
Restorative dental materials can frequently extend below the gingival margin, serving as a potential haven for microbial colonization, and altering the local oral microbiome to ignite infection. However, the contribution of dental materials on driving changes of the composition of the subgingival microbiome is under-investigated. This study evaluated the microbiome-modulating properties of three biomaterials, namely resin dental composites (COM), antimicrobial piezoelectric composites (BTO), and hydroxyapatite (HA), using an optimized subgingival microbiome model derived from patients with periodontal disease. Dental materials were subjected to static or cyclic loading (mastication forces) during biofilm growth. Microbiome composition was assessed by 16S rRNA gene sequencing. Dysbiosis was measured in terms of subgingival microbial dysbiosis index (SMDI). Biomaterials subjected to cyclic masticatory loads were associated with enhanced biofilm viability except on the antibacterial composite. Biomaterials held static were associated with increased biofilm biomass, especially on HA surfaces. Overall, the microbiome richness (Chao index) was similar for all the biomaterials and loading conditions. However, the microbiome diversity (Shannon index) for the HA beams was significantly different than both composites. In addition, beta diversity analysis revealed significant differences between composites and HA biomaterials, and between both loading conditions (static and cyclic). Under static conditions, microbiomes formed over HA surfaces resulted in increased dysbiosis compared to composites through the enrichment of periopathogens, including , , and spp., and depletion of commensals such as and spp. Interestingly, cyclic loading reversed the dysbiosis of microbiomes formed over HA (depletion of periopathogenes) but increased the dysbiosis of microbiomes formed over composites (enrichment of and ). Comparison of species formed on both composites (control and antibacterial) showed some differences. Commercial composites enriched spp. and depleted . Piezoelectric composites effectively controlled the microbiome viability without significantly impacting the species abundance. Findings of this work open new understandings of the effects of different biomaterials on the modulation of oral biofilms and the relationship with oral subgingival infections.
PubMed: 38800100
DOI: 10.1016/j.bioflm.2024.100199 -
Nutrients May 2024This study aimed to develop the Food Acceptance Questionnaire (FAQ) to assess the masticatory ability of Thai older adults (≥60 years). Fifty participants were...
This study aimed to develop the Food Acceptance Questionnaire (FAQ) to assess the masticatory ability of Thai older adults (≥60 years). Fifty participants were interviewed using open-ended questions about food they regularly consumed and avoided due to difficulty chewing. From a list of 140 items, 100 were recruited for a trial version of the FAQ. A total of 154 participants responded to the 5-point Likert scale on their chewing perception of each food item (1, impossible to chew; 5, most easily eaten). The average response of each food item was used as the chewing index (CI). The 100 food items were ranked and divided into five grades based on their CIs. Masticatory performance (MP) was objectively assessed by a visual scoring method using gummy jelly (UHA Mikakuto). Two foods from each grade that demonstrated the highest correlation with MP were selected to form the final 10-item FAQ. The FAQ score was calculated by summarizing the responses of 10 items. MP correlated strongly with the FAQ score (r = 0.57, < 0.001), indicating its predictive validity. Furthermore, the FAQ indicates strong internal consistency (Cronbach's alpha coefficient = 0.90), indicating high reliability. In conclusion, this newly developed 10-item FAQ is valid and reliable for assessing the masticatory ability of Thai older adults.
Topics: Humans; Mastication; Female; Male; Thailand; Aged; Surveys and Questionnaires; Middle Aged; Reproducibility of Results; Mouth, Edentulous; Aged, 80 and over; Southeast Asian People
PubMed: 38794670
DOI: 10.3390/nu16101432