Biting force and tongue muscle strength as useful indicators for eating and swallowing capability assessment among elderly patients

Weakened capability of eating and swallowing is common among elderly population,affecting negatively on their health and well-being.This work measured occlusal force and tongue muscle strength of elderly patients and then assessed whether correlations existed between oral physiological properties and the eating and swallowing capability.A total of 26 elderly patients with potential swallow disorder were recruited in this work.Participants’denture status and daily diet texture were determined by a pre-questionnaire analysis.Their swallowing capability was assessed and rated by water drinking test.Maximum tongue pressure,incisor occlusal force and hand gripping force were measured for each subject.It was observed that participating subjects have on average a significantly lower biting force and maximum tongue pressure than that of normal adults.The swallowing grades assessed by water drinking test showed significant correlations with both the biting force(r=−0.498,P<0.05)and the tongue muscle strength(r=−0.544,P<0.05).The biting force of dysphagia participants correlates significantly with dental conditions(P<0.05).The observed correlation between tongue pressure and diet texture indicates that tongue muscle strength could be used as a reliable indicator of the eating and swallowing capability for elderly people.

Tongue dysfunction in neurological and neuromuscular disorders: A narrative literature review

Evaluation of oral function is useful for tracking longitudinal changes in swallowing function. Using videofluoroscopic(VF) images, we can evaluate swallowing function, but it is extremely difficult to quantitatively evaluate the oral phase. Recently, several studies have tried to quantitatively assess tongue function by analyzing tongue movement on VF images, to measure tongue thickness by ultrasonography, and to measure tongue pressure as surrogate for tongue strength. In this review article,the current state of quantitative assessments of tongue function for identification and management of dysphagia in patients with neuromuscular and other neurological disorders(NNMD) has been outlined. Disturbed bolus transport in patients with NNMD has been quantitatively measured on VF images by analyzing tongue base movement and bolus transport from the mouth to the pharynx. Enlarged tongue in Duchenne muscular dystrophy patients were observed by measuring the transverse width of the tongue on ultrasound. Tongue pressures that were measured using a handheld probe in NNMD patients were less than half of those in healthy subjects. More studies are needed to develop guidelines what types of tongue dysfunction give an indication of adjusting diet and introducing tube feeding to NNMD patients.