The effect of maximum biting force and bone loss upon masticatory function and dietary selection of the elderly

Simple methods are described for measuring masticatory effectiveness--the percentage of sugar chewed out of chewing gum in 20 strokes--and the height of residual mandibular bone using callipers. Both are objective methods, they are acceptable to the elderly, appropriate for denture wearers and practicable for use in domiciliary surveys. Using these and other methods, the masticatory effectiveness of housebound pensioners is shown to relate to maximum biting force, denture quality, remaining mandibular bone and dietary selection. However, opinions on the difficulty of mastication are completely unrelated to any of these measures. The level of compensation for inadequate mastication is indicated by the percentage of difficult foods eaten by geriatric hospital inpatients: there was complete overlap of percentages in those endentulous patients using dentures and those without dentures. Presumably many of these patients had adapted to swallowing very poorly chewed food. The contrasts shown between hospital inpatients and old people still at home indicate the progressive consequences of physical and neurological deterioration.