Jaw-Opening Force as a Useful Index for Dysphagia: A Cross-Sectional and Multi-Institutional Study

Abstract

<b><i>Introduction:</i></b> Jaw-opening force (JOF) can be a potential screening tool for dysphagia. However, confounding variables such as comorbidities or physical and oral functions that are associated with the physiology of swallowing have not previously been examined. Adjusting for these variables could reveal the relationship between JOF and dysphagia and indicate whether JOF is an independent factor associated with dysphagia. We therefore aimed to assess the efficacy of using JOF for dysphagia screening in this multi-institutional study. <b><i>Methods:</i></b> Community-dwelling older adults over the age of 65 years (<i>N</i> = 403) who visited the university dental hospitals and participated in health surveys (mean age ± standard deviation, 77.1 ± 7.0 years; range, 65–96 years) between November 2018 and January 2020 were included in this study. The JOFs of all participants were measured. The measured JOF was compared with the presence of dysphagia, which was defined using the Functional Oral Intake Scale and the Eating Assessment Tool-10. <b><i>Results:</i></b> Multiple logistic regression analysis revealed that the presence of dysphagia was independently associated with JOF, calf circumference, and dependence after adjusting for age and sex. <b><i>Discussion/Conclusion:</i></b> Decreased JOF can be a risk factor for dysphagia in older adults.

Strength and morphology of a suprahyoid muscle and their relationship to forward head posture in healthy older adults

“…A study on patients with dysphagia has reported that jaw‐opening force could be a useful screening tool for detecting pharyngeal residue 7 . Another study showed that jaw‐opening force was independently associated with the presence of dysphagia, after adjusting for dysphagia‐causing diseases and confounding factors 8 . These findings have suggested that jaw‐opening force is useful for assessing swallowing function.…”

“…7 Another study showed that jaw-opening force was independently associated with the presence of dysphagia, after adjusting for dysphagia-causing diseases and confounding factors. 8 These findings have suggested that jaw-opening force is useful for assessing swallowing function. Moreover, jaw-opening force decreases with age and is associated with the cross-sectional area (CSA) of the geniohyoid muscle (GHM) and the position of the hyoid bone at rest.…”

Association between Tongue Pressure and Jaw-Opening Force in Older Adults

“…As the suprahyoid muscle is a jaw-opening muscle, a jaw-opening stenometer has been developed to evaluate the strength of the suprahyoid muscle [ 13 ]. Previous studies have shown that jaw-opening force (JOF) is associated with dysphagia in patients with dysphagia [ 13 , 14 ]. Furthermore, in older adults, JOF is associated with the resting position of the hyoid bone [ 15 ] and CSA of the GH muscle [ 16 ], suggesting that opening force may be a useful indicator of suprahyoid muscle strength.…”