Feasibility of two-color chewing gum mixing ability test for evaluating masticatory performance in schoolchildren

Mastication plays a major role in a person's life and affects much of their quality of life, from enjoying food to facilitating nutrition. This study aimed to assess the feasibility of evaluating masticatory performance in schoolchildren during routine dental exams using a validated chewing test.

Adolescents aged 11 to 19 from schools in Greifswald, Germany, were recruited. From a population exceeding 3,000, a 40% response rate was expected. A randomization list determined whether consenting participants underwent testing, limited to 50% to avoid selection bias. Data collected included age, sex, and school type. Masticatory performance was assessed using the two-color chewing gum test (Hue-Check Gum), evaluated visually (subjective assessment scale, 1 to 5) and digitally (Viewgum variance of hue, 0 to 1).

In total, 861 participants were recruited (mean age 13.85 ± 2.02 years; 48.55% female). Low masticatory performance (subjective assessment scale 1 or 2) was observed in 14.59% of participants, indicating potential chewing difficulties impacting daily life. Masticatory performance improved with age, reflected by a decrease in the variance of hue value from 0.3 in 11-year-olds to 0.21 in 18- to 19-year-olds. Masticatory performance did not differ significantly between sexes: median subjective assessment scale score 3 (interquartile range 3-4; P = .517). Participants with permanent dentition showed higher masticatory performance than those with mixed dentition: (3 [3-4] vs 3 [3-3]; P .001).

This study confirms that masticatory performance increases with age. Routine implementation of masticatory performance testing during school dental screenings is feasible and may help identify children at risk of impaired chewing function. (Quintessence Int 2026;57:218-228; doi: 10.3290/j.qi.b6689083).