Relationship between the jaw-closing force and dietary form in older adults without occlusal support requiring nursing care.

In clinical practice, we encounter cases wherein older adults lacking occlusal support consume foods requiring mastication and adequate swallowing function. This study investigated the relationship between jaw-closing force (JCF) and dietary form in older adults without occlusal support requiring nursing care. This prospective cross-sectional study included 123 older adults requiring nursing care who lost their molar occlusal support and consumed food orally without dentures. JCF was defined as the force required for crushing food with the edentulous ridges or with the tooth and edentulous ridge while closing the mouth. Participants were classified into four groups based on the International Dysphagia Diet Standardization Initiative framework for recommended dietary forms. Basic information was collected, and tongue pressure and JCF were measured. Differences in JCF were analyzed using one-way analysis of variance, while factors related to dietary form were evaluated using ordinal logistic regression analysis. Significant differences in JCF were observed among the four groups. Factors such as the Barthel Index, tongue pressure, and JCF were dietary form-related. Our findings suggest that older adults requiring nursing care tend to have higher JCF when consuming meals requiring mastication. Therefore, JCF could serve as an index for determining appropriate dietary forms in this population.

Usefulness and Validity of a Jaw-Closing Force Meter in Older Adults.

We prototyped a new device with a soft and flexible pressure sensor to measure the force to close the mandible with or without occlusal support (jaw-closing force, JCF). This study aimed to clarify the practicality of this instrument. Healthy young and older adults with occlusal support were recruited. Intra- and inter-rater reliability of the JCF meter was examined using data from younger participants. Data regarding age, sex, body mass index, remaining teeth, and dentures of the older adults were obtained. Furthermore, the right and left JCFs were measured using a JCF meter; occlusal force was measured using an existing occlusal force-measuring device. Intra- and inter-rater correlation coefficients were significantly reproducible (0.691−0.811, p < 0.05). JCF was correlated with occlusal force (p < 0.05). Multiple regression analysis revealed that factors significantly associated with JCF included denture status (p < 0.001), age (p = 0.038), and occlusal force (p = 0.043). The prototyped JCF meter can measure JCF with high reproducibility, reliability, and validity. Further, association with occlusal force, which is an existing index, was observed. This device could be used to measure the JCF with or without occlusal support as a new method of evaluating oral function in older adults.

Swallowing Function Evaluation in a Patient with Gerstmann-Sträussler-Scheinker Disease with Pro105Leu: A Case Report.

Gerstmann-Sträussler-Scheinker disease (GSS) is a genetic prion disease. Swallowing function evaluation in patients with GSS remains unclear. Here, we describe a case of videofluoroscopic examination of swallowing (VF) to facilitate continued oral ingestion in a patient with P105L GSS. A 67-year-old woman developed gait disturbance and Parkinsonism symptoms at the age of 54 years. Since her family wanted her to continue oral ingestion, we performed VF, which revealed impairment and preservation of the oral and pharyngeal phases, respectively. Moreover, the impairment of the oral phase was improved by adjusting the patient's posture and food consistency. A swallowing function evaluation based on the condition of a patient with GSS may facilitate continued oral ingestion.