Digital image processing versus visual assessment of chewed two-colour wax in mixing ability tests

Two-colour chewing gum and wax have been widely used as test foods to evaluate the ability to mix and knead a food bolus. The mixing of the colours has been assessed by computer analysis or by visual inspection. Reports contradict each other about whether computer analysis and visual assessment could equally well discriminate between the masticatory performances of groups of participants with different dental status. This study compares the results of computer analysis of digital images of chewed two-colour wax with the results of visual assessment of these images. Sixty healthy subjects participated and chewed on red-blue wax for 5, 10, 15 and 20 chewing strokes. The subjects were divided into three groups of 20, matched for age and gender, according to their dental status: natural dentition, full dentures and maxillary denture plus implant-supported mandibular overdenture. Mixing of the chewed wax was determined by computer analysis of images of the wax and by visual assessment of the images by five examiners. Both the computer method and the observers were able to distinguish the mixing abilities of the dentate subjects from the two denture wearer groups. Computer analysis could also discriminate the mixing abilities of the two denture groups. However, observers were not able to distinguish the mixing abilities of the two denture groups after 5, 10 and 15 chewing strokes. Only after 20 chewing strokes, they could detect a significant difference in mixing ability.