Obesity and Chewing AbilityTuesday, November 11, 2008
Interestingly, chewing also appears to be impaired in folks with severe obesity (even without the trauma of wisdom tooth extraction).
This, at least, was the finding from a study by Jean-Luc Veyrune and colleagues (faculté d’Odontologie, Clermont-Ferrand, France) published in the latest issue of Obesity Surgery.
Veyrune compared the chewing parameters in a group of 44 obese adult patients (BMI = 49.1 +/- 7.2) scheduled for gastric bypass surgery with those of a control group (BMI=20.9 +/- 2.1). In both groups, the subjects’ dental status was characterized by the number of functional dental units. Kinematic parameters, namely chewing time (CT), number of chewing cycles (CC), and chewing frequency (CF), were video recorded during the mastication of five natural standardized foods (banana, apple, sweet jelly, peanut, and carrot). The particle size distribution of the expectorated bolus from carrot and peanuts was characterized by the 50th percentile (D (50)) (sounds kind of yucky to me).
Even in fully dentate obese patients, chewing time and chewing cycles were higher with lower values for D (50). This was particularly true for carrot and peanut (that obviously require more chewing than banana, apple or jelly).
As restrictive bariatric surgeries (like adjustable gastric banding), require fine mastication of foods, this study is again a reminder to evaluate both dental status and chewing ability in patients scheduled for bariatric surgery.
Obviously, the ability to properly chew healthy foods (which generally require a lot of chewing – try biting into an apple with lose teeth) is a prerequisite for health eating.
Dental assessments can be an important barrier to healthy eating and should be part of the general assessment in bariatric patients.