Assessment of masticatory efficiency based on glucose concentration in orthodontic patients: A methodological study

BACKGROUND: Treatment for malocclusion can cause discomfort and pain in the teeth and periodontium, which may impair masticatory efficiency. The glucose concentration method is widely used to assess masticatory efficiency for its convenience in the clinical situation, although its validity has not been shown. OBJECTIVES: The aims were to determine the validity of the glucose concentration method and investigate if this method can be applicable to orthodontic patients with braces. METHOD: Sixteen healthy individuals (7 men, 9 women, and 26 ± 5 years old) and 16 patients with malocclusions needing orthodontic treatment (5 men, 11 women, and 26 ± 4 years old) participated. Glucose concentration was measured after 5‐, 10‐, and 15‐s mastication of gummy jelly and compared to Hue values obtained from the color‐changing gum method (reference method). In addition, all participants were asked to fill out the Oral Health Impact Profile questionnaire (OHIP) to assess differences in perception related to the mouth before and after the placement of braces. RESULTS: Glucose concentrations were strongly correlated to measures of the two‐color chewing gum methods (R (2) = 0.965). Both the glucose extraction and chewing gum hue value were the smallest for 5 s chewing cycles and increased as the number of chewing strokes increased for the 15 s chewing cycles. (Hue: R² = 0.510, p < 0.001; glucose: R² = 0.711, p < 0.001) Masticatory efficiency assessed by both methods was significantly lower in orthodontic patients compared to controls (p < 0.05), even though it was not affected by bonding (p > 0.09). In addition, OHIP scores in physical pain dimension and psychological disability were higher in orthodontic patients than in the control group (p < 0.005). CONCLUSION: Measurement of glucose concentration was confirmed as a reliable and convenient method for assessing masticatory efficiency. Furthermore, it appears that this method is applicable to patients with braces whose perception in the oral cavity could change.