A Comparison of Oral Function in Older In- and Outpatients: An Observational Study

Abstract

(1) Background: Insufficient data exist regarding oral function among older adults in Europe. Therefore, we aimed to assess and compare oral function between older in- and outpatients and identify predictors of low masticatory performance. (2) Methods: Patients were consecutively recruited from the outpatient center (n = 31) and the inpatient geriatric department (n = 31) at a tertiary University Hospital in Switzerland in 2023. Assessments on oral function included the total number of intraoral eruptive teeth, number of supporting zones with dentures, maximal bite force (Dental Prescale II, Fuji Film Corp., Tokyo, Japan), and masticatory performance (Hue-Check Gum©, University of Bern, Bern, Switzerland) using a visual (SA1-SA5) and a digital (SD_Hue) scale. The visual and digital assessment of masticatory performance showed a strong correlation (Kendall tau = 0.83). Low masticatory performance was defined as SA-Grade 1-2 (vs. SA3-SA5 as reference). In a multivariate model adjusting for age, sex, and clinical setting, we investigated associations of maximal bite force, few eruptive teeth, and few supporting zones with low masticatory performance. (3) Results: Mean age was 81.9 (standard deviation (sd) 5.2) years, and 62.9% were female. Overall, maximal bite force was 247 N (sd 261). A total of 39 patients (63.9%) had a low masticatory performance, 62.9% a low maximal bite force, and 50% a low number of eruptive teeth (<10). Masticatory performance, number of eruptive teeth, and maximal bite force did not significantly differ between in- and outpatients. The number of supporting zones was significantly higher in outpatients compared to inpatients (median 4, interquartile range (IQR) 4-4; vs. 4, IQR 2-4; p = 0.03). In the multivariate model, maximal bite force and a low number of eruptive teeth were independently associated with low masticatory performance (adjusted odds ratio 7.4 (95% CI, 1.8-30.4; p < 0.01), and OR 7.8 (95% CI, 1.7-36.4; p < 0.01), respectively). (4) Conclusions: Impaired oral function is highly prevalent in both European older in- and outpatients to a similar degree. The association of low masticatory performance with maximal bite force and with a low number of eruptive teeth may indicate that a basic screening should include either of these parameters to identify impaired oral function.

Keywords: bite force; geriatric; masticatory performance; oral screening; supporting zones.

Figure 1

(A) Visual assessment of masticatory performance displaying pictures of patients by subjective assessment categories (SA1–SA5). (B) Masticatory performance based on visual grading (SA) stratified by clinical setting. Abbreviations: SA; Orophys subjective assessment scale.

Figure 1

(A) Visual assessment of masticatory performance displaying pictures of patients by subjective assessment categories (SA1–SA5). (B) Masticatory performance based on visual grading (SA) stratified by clinical setting. Abbreviations: SA; Orophys subjective assessment scale.

Figure 2

(A) Correlation of masticatory performance based on digital scan scale and visual scale among older outpatients (n = 31) r = 0.83 (Kendall’s tau-b correlation). (B) Correlation of masticatory performance based on digital scan scale and visual scale among older inpatients (n = 30) r = 0.83 (Kendall’s tau-b correlation).