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Journal of Oral Rehabilitation 2006 33; 2–7

Chewing-side determination of three food textures


J. PAPHANGKORAKIT*, N. THOTHONGKAM† & N. SUPANONT‡ *Department of Oral Biology,
Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand, †Faculty of Dentistry, Naresuan University, Pitsanulok, Thailand and

HRH Princess Maha Chakri Sirindhorn Medical Centre, Nakorn Nayok, Thailand

SUMMARY Food texture affects chewing movement six and three subjects preferred to chew on right or
but it is not known if it also affects the chewing-side left sides respectively. The chewing-side pattern
pattern. This study determined the chewing sides of remained unchanged between three food types in
three test foods with different textures during about half of the subjects. When the same food was
habitual chewing. Twenty healthy dental students compared between 2 days, the chewing-side pattern
(aged 20–24 years) chewed pieces of pork jerky, of almonds was shown to be most reproducible (18
fresh asparagus and almonds on two separate ses- subjects). Unidentified cycles with little or no lateral
sions (1 week apart). In each session, each subject displacement, labelled as bilateral, were observed
chewed 30 food specimens, 10 of the same food type, more frequently near the end of the chewing
until swallowing while a video camera recorded the sequence with more occurrences in almonds and
displacement of the chin with respect to the other jerky than asparagus (P < 0Æ01). It was suggested that
two reference points vertically marked along the chewing-side preference is not a fixed characteristic.
facial midline. A slow-speed video playback was Food texture seemed to influence the side prefer-
used to identify the chewing side of each cycle. The ence and also the occurrence of bilateral cycles.
chewing-side pattern (right preference, left prefer- KEYWORDS: preferred chewing side, food texture,
ence, no preference) in each individual was deter- chewing pattern, jaw movement, mastication
mined statistically. The results showed that overall,
11 subjects did not have any side preference whereas Accepted for publication 3 May 2005

(8) or the chewing efficiency on that side (9). However,


Introduction
Bourdiol and Mioche (10) found that the number of
Normal chewing is characterized by unilateral cycles cycles used during side-imposed chewing sequences of
with periodic alternation of food between both sides of frankfurters, cheese and toffee was less on the side with
the dentition although less unilateral cycles are larger occlusal contact area. Hannam et al. (11) sugges-
observed with homogenous and soft foods. Once the ted that the preferred chewing side was related to the
food attains the consistency, homogeneity and cohe- ability to move the jaw laterally towards that side. The
siveness ready to be swallowed, bilateral cycles can above variations could be due to the methods used to
occur (1, 2). The study of chewing-side pattern is useful verify the preferred chewing side. In some studies, the
in understanding the neural control of chewing and the chewing side was observed visually (6) while in others
design of dentures. Previous studies have shown that more sophisticated tracking devices were used (5, 8,
most normal persons chew more on either the right or 12). The preferred chewing side was usually deter-
left side, the so-called ‘preferred chewing side’ (3–5). mined simply by the percentage of right- or left-side
What determines the side preferably used during chewing cycles without any statistical analysis except in
chewing is not known. Studies have shown that the the study of Wilding and Lewin (4). Moreover, the
preferred chewing side is not related to handedness texture of test food also varies. Bread and toffee (3),
(6, 7) and not associated with the area of tooth contact meat (5), gum (6), and wine-gums (4) have all been

ª 2006 Blackwell Publishing Ltd 2


CHEWING-SIDE DETERMINATION OF THREE FOOD TEXTURES 3

used in previous studies. The texture of food can alter (fresh supplies daily), wrapped in plastic and stored at
some components of chewing cycle (2, 13–15) and 4 C not more than 2 days before use. During each
perhaps influence the preferred chewing side. The chewing session, subjects were seated upright in a
present study was aimed to test if an individual’s comfortable chair with a headrest and eyes aiming
chewing-side pattern was affected by food texture and horizontally while chewing the test food habitually
if it differed between days. until they decided to swallow. In random order,
10 pieces of each of the three foods were given to each
subject, thus making a total of 30 food samples (trials)
Materials and methods
being tested on each day. All subjects returned for the
second session 7 days later (day 2) and the entire series
Experimental procedure
was repeated. The technique used to observe the
The study was approved by the Khon Kaen University chewing side is described as follows. Three pencilled
Ethical Committee. Twenty dental students, aged dots were marked on the subject’s facial skin, one at the
20–24 years, having given informed consent, partici- tip of the nose, one just below the center of the lower
pated in this study. All subjects had normal masticatory lip and one on the chin. Subjects were asked to move
function with angle class I molar relationship and had their head as little as they could during the recording
28 natural teeth (excluding third molars). The maxi- session so that the three marked dots were aligned
mum lateral jaw excursion measured at the mid- vertically during each chewing trial. A video camera
mandibular central incisors in each individual did not (Panasonic NV-VX3)§ was placed 1 m in front of the
show any apparent difference between right and left subject and the picture zoomed in to cover the tip of the
sides. On the first day (day 1), each subject was asked to nose and mouth region. The recorded tapes were played
chew three test foods, being pork jerky (1 cm long)*, off-line by another investigator using a slow-speed
fresh asparagus (1 cm long selected from the middle playback mode of a video cassette player (Panasonic
part of the stalk) and almond (approximately 2 cm NV-SR98)§ to determine the chewing side of each cycle.
long, Blue Diamond)† representing tough, soft ductile A clear plastic ruler was placed over the subject’s mid-
and brittle food respectively. As the physical properties facial line on the television screen to help distinguish
of test foods could be variable, the same foods used in the path of chin movement. Using this method, most
subjects were tested separately for their ultimate cycles could be identified as right (R) or left (L) cycles.
strength and modulus of elasticity using a universal Some of the cycles, however, could not be clearly
testing machine‡ with a head speed of 5 mm min)1 as identified (U) because of indistinguishable transverse
follows. For almond, the whole seed was placed movement. The validity of this visual method in
horizontally and compressed between two metal plates. correctly identifying the right and left cycles was tested
For asparagus, a piece of 1 cm length selected from the by having three subjects’ chewing gum according to
middle part, was placed horizontally and tested under any of four different preset sequences (12 cycles per
compression. For pork jerky, a 4-cm-long specimen was sequence). Ten chewing sequences (60 right and 60 left
cut with an orientation similar to that inserted into the cycles) were tested in total and the cycles were
mouth and tested under tension (it was difficult to identified by the same person as in the actual experi-
recognize the orientation of muscle fibres in order to ments. The cross-tab analysis revealed agreement
test separately the specimens cut parallel and perpen- cofficients (kappa) ranging from 0Æ70 to 0Æ83.
dicular to the fibre orientation). Ten specimens of each
food were tested on two different days (7 days apart).
Data analysis
All foods tested were stored in the same way as in the
experimental sessions; almonds and jerky were kept in The number of right and left cycles was expressed as a
a sealed container stored at room temperature whereas percentage of the total cycle number, i.e. %R and %L
the asparagus was newly bought from the supermarket respectively. On each day, the ‘chewing-side pattern’ of
a given subject chewing a given test food was deter-
*Naem Lub Lae, Khon Kaen, Thailand.
mined by statistically comparing the %R and %L with

Heritage Snacks and Beverages, Nakorn Pathom, Thailand.
‡ §
Lloyd, Lloyd Instruments, Hants, UK. Matsushita Industrial, Osaka, Japan.

ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 2–7


4 J . P A P H A N G K O R A K I T et al.

Mann–Whitney tests (n ¼ 10 trials for each food). Table 2. Side preference determination for each subject from two
A given subject was considered to have a ‘right’ sessions of 30 trials

chewing-side preference if %R was significantly


Subject %R %L Side preference*
(P < 0Æ05) greater than %L or a ‘left’ side preference if
%L was significantly (P < 0Æ05) greater than %R. Those 1 32Æ4 35Æ7 0Æ88
who did not show any side difference were classified as 2 40Æ6 37Æ5 0Æ06
3 39Æ3 44Æ3 0Æ88
‘no side preference’. The percentage of the unidentified
4 33Æ7 43Æ7 L (0Æ001)
(%U) cycles was not included in the comparison. Their 5 37Æ2 38Æ4 0Æ94
values were smaller than %R or %L and their inclusion 6 63Æ9 15Æ5 R (0Æ001)
would not have affected the determination of side 7 42Æ5 44Æ8 0Æ66
pattern. In order to further investigate the nature of the 8 46Æ2 40Æ9 0Æ23
9 38Æ1 43Æ0 0Æ24
unidentified cycles, the percentage of such cycles was
10 59Æ3 29Æ1 R (0Æ001)
calculated for each food type during the early, middle
11 38Æ9 47Æ3 0Æ32
and late (one-third) periods of the chewing sequence. 12 50Æ8 44Æ0 R (0Æ02)
The differences in the number of unidentified cycles for 13 39Æ2 47Æ8 L (0Æ03)
each period and food type were tested with two-way 14 50Æ5 34Æ7 R (0Æ001)
ANOVA. 15 46Æ5 39Æ2 0Æ42
16 43Æ3 28Æ6 R (0Æ001)
17 43Æ0 41Æ3 0Æ76
Results 18 38Æ9 50Æ0 L (0Æ02)
19 70Æ3 12Æ1 R (0Æ001)
The ultimate strength and the modulus of elasticity of 20 48Æ9 44Æ9 0Æ44
the test foods are shown in Table 1. The moduli of
%R and %L represent the percentage of cycles with side
elasticity were significantly different for the three food displacement to the right and left respectively (from 60 trials).
types, with pork jerky being the greatest, followed by *A given subject was considered to be predominantly right sided if
almond and asparagus (P < 0Æ01). The ultimate %R was significantly (P < 0Æ05) greater than %L or left sided if %L
strength, however, was greatest in almonds. There was significantly (P < 0Æ05) greater than %R. Unidentified or
presumed bilateral cycles were not taken into account (see Data
was no significant difference in both properties of the
Analysis). The numbers in brackets are P-values obtained from
same food type on two different days. All subjects used independent t-tests.
both sides to chew test foods and none of the subjects
chewed exclusively unilaterally. The numbers of cycles from all 60 trials were pooled, about half of the subjects
until swallowing (mean  SD) in chewing pork jerky, (11 subjects) did not reveal a preferred chewing side,
asparagus and almonds were 19Æ8  6Æ4, 10Æ9  3Æ7 and whereas six subjects preferred to chew on the right and
15Æ1  4Æ8 respectively and they were significantly three on the left (Table 2).
different (one-way ANOVA; P < 0Æ001). When the cycles Table 3 summarizes significance values for side pref-
erence in all trials for each day. Eleven of 20 subjects on
Table 1. Mechanical properties (mean  SD) of food samples day 1 and 10 of 20 subjects on day 2 changed their
(n ¼ 10 in each cell) chewing-side pattern for different food types. When
compared between 2 days, it was found that only seven
Day 1 Day 2 subjects consistently chewed the same food with the
Modulus of Ultimate Modulus of Ultimate
same side pattern (1, 4, 6, 8, 11, 16, 19). The chewing-
elasticity strength elasticity strength side pattern was most reproducible with almonds (18
(MPa) (MPa) (MPa) (MPa) subjects, excluding 5, 20), asparagus (12 subjects,
excluding 2, 7, 10, 12, 13, 14, 15, 17) and least
Almond 15Æ7  3Æ9 0Æ8  0Æ4 15Æ3  7Æ6 0Æ9  0Æ5
Pork jerky 23Æ1  10Æ0 0Æ40  0Æ16 20Æ4  10Æ4 0Æ43  0Æ19 reproducible with pork jerky (11 subjects, excluding 2,
Asparagus 1Æ1  0Æ2 0Æ3  0Æ1 1Æ3  0Æ4 0Æ3  0Æ04 3, 7, 9, 10, 13, 15, 17, 18). Six subjects (2, 7, 10, 13, 15,
17) changed their chewing-side pattern for both pork
Modulus of elasticity was calculated from the slope of the initial
linear part of the stress–strain curve. Ultimate strength was
jerky and asparagus on the second day.
determined by the highest stress at which pork jerky and almonds Only four subjects (subjects 4, 6, 10, 19) consistently
were broken apart and fresh asparagus yielded under force. showed a right- or left-side preference. 14 subjects did

ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 2–7


CHEWING-SIDE DETERMINATION OF THREE FOOD TEXTURES 5

Table 3. Chewing-side determin-


Day 1 Day 2
ation established during each session
(days 1 and 2), with three different Subject Jerky Asparagus Almond Jerky Asparagus Almond
test foods
1 0Æ06 0Æ19 0Æ1 0Æ15 0Æ76 0Æ59
2 R(0.005) R(0Æ01) 0Æ06 L(0Æ001) L(0Æ02) 0Æ72
3 L(0.02) 0Æ58 0Æ9 0Æ91 0Æ18 0Æ9
4 0Æ06 0Æ25 L(0Æ001) 0Æ97 0Æ76 L(0Æ003)
5 0Æ22 0Æ91 0Æ24 0Æ4 0Æ73 L(0Æ01)
6 R(0Æ001) R(0Æ001) R(0Æ001) R(0Æ001) R(0Æ001) R(0Æ001)
7 L(0.03) 0Æ58 0Æ97 0Æ65 R(0Æ03) 0Æ06
8 0Æ91 0Æ68 0Æ35 0Æ34 0Æ28 0Æ49
9 L(0Æ04) 0Æ97 0Æ07 0Æ32 0Æ44 0Æ09
10 0Æ4 R(0Æ002) R(0Æ001) R(0Æ002) L(0Æ001) R(0Æ001)
11 0Æ22 0Æ53 0Æ25 0Æ72 0Æ35 0Æ64
12 0Æ12 0Æ53 0Æ08 0Æ08 R(0Æ03) 0Æ1
13 0Æ8 0Æ68 0Æ65 L(0Æ02) L(0Æ02) 0Æ56
14 R(0Æ01) 0Æ58 0Æ06 R(0Æ01) R(0Æ01) 1
15 R(0Æ05) R(0Æ02) 0Æ12 0Æ11 0Æ06 0Æ58
16 0Æ07 R(0Æ01) 0Æ06 0Æ06 R(0Æ03) 0Æ06
17 R(0Æ03) R(0Æ02) 0Æ64 0Æ67 0Æ94 0Æ2
18 0Æ07 0Æ44 0Æ07 L(0Æ001) 0Æ44 0Æ93
19 R(0Æ001) R(0Æ05) R(0Æ001) R(0Æ001) R(0Æ001) R(0Æ001)
20 0Æ4 0Æ28 R(0Æ01) 0Æ42 0Æ49 0Æ73

P-values for chewing-side preference obtained from Mann–Whitney tests are indicated for each
subject.
R ¼ right side preference; L ¼ left side preference; No label ¼ no side preference.

Table 4. Percentages (mean  SD)


Day 1 Day 2
of the unidentified cycles during
early, middle, and late periods of a Early Middle Late Early Middle Late
chewing sequence for each test food
(n ¼ 200 sequences in each cell) Jerky 6Æ0  10Æ6 8Æ4  11Æ9 12Æ8  14Æ5 2Æ4  6Æ5 5Æ1  10Æ3 9Æ5  12Æ4
Almond 4Æ8  8Æ5 7Æ7  10Æ1 12Æ2  12Æ2 2Æ0  5Æ9 4Æ6  8Æ8 9Æ4  12Æ0
Asparagus 4Æ0  8Æ1 7Æ3  10Æ3 8Æ8  8Æ7 1Æ5  6Æ2 3Æ2  6Æ9 5Æ1  7Æ7

Each period is obtained by dividing the chewing sequence into three equal intervals. Percentages
of unidentified cycles seen during late periods were, in general, higher than middle periods and
both were significantly higher than during early periods (P < 0Æ01). The percentages seen with
asparagus were always significantly lower than those with jerky and almond (P < 0Æ01).

not show a side preference when chewing almonds


Discussion
(1, 2, 3, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18) whereas
with pork jerky and asparagus, more subjects showed a Although the method used to observe the chewing side
side preference (subjects 2, 3, 6, 7, 9, 10, 12, 13, 14, 15, in this study was based on visual inspection, it showed a
16, 17, 18, 19), although with less consistency. The fairly acceptable validity and had the advantage that it
percentages of unidentified cycles during early, middle did not use an intra-oral device that might interfere
and late periods of the chewing sequence are shown in with subjects’ natural jaw movements. The camera
Table 4. The percentage was increasingly larger during might make subjects uneasy but its possible effect on
the middle and late periods of the sequences (P < 0Æ01). chewing behaviour was minimized by randomizing the
When compared between food types, the occurrence of test foods. Movement of the chin as observed in this
such cycles was significantly least with asparagus study has been shown to correlate with that obtained
(P < 0Æ01). The results were not appreciably different from a jaw-tracking device but provides a larger value
between days 1 and 2. of lateral displacement (12) and this was in agreement

ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 2–7


6 J . P A P H A N G K O R A K I T et al.

with the present study. About the same number of our was difficult to break fresh asparagus into pieces before
subjects did or did not have a preferred chewing side. it could be chewed bilaterally. Dried pork jerky and
This did not conform with some previous studies which almonds, on the contrary, are more brittle and easily
showed side preference in most subjects (4–6,16). The broken into separate pieces, resulting in more bilateral
difference could be due to the observation method, cycles. Dealing with natural food products, the present
number of trials, types of test food and the method used study was limited by the difficulty to standardize the
in analysing the preferred chewing side. The determin- rheological properties of the test foods, especially fresh
ation of the preferred chewing side in this study was asparagus and pork jerky. Randomization of food
similar to that used by Wilding and Lewin (4). They, specimens might help to reduce the effect of such
however, found that most subjects had a preferred variability. Some physical properties of the food sam-
chewing side. The results of the present study suggest ples were also tested in this study although more
that chewing-side preference is not a fixed character- comprehensive tests (such as plasticity and toughness
istic, especially when food texture or recording session tests) might give a better picture. In conclusion, the
is different. More subjects (seven to nine subjects) had a present study suggested that chewing-side pattern
preferred chewing side when chewing tough jerky depended on food texture and could change between
compared to hard almonds (five subjects). Cutting days. The determination of preferred chewing side
(grinding) tough food (like jerky) might require a more using natural foods of different textures, therefore, does
comfortable chewing side whereas breaking almonds not seem to be a simple task. Among the three food
might be indifferent between both sides of the jaw, types tested, almond as brittle food seems to be the best
resulting in more frequent chewing-side alternation. choice when food comminution (grinding effect) is
Interestingly, seven to nine subjects also showed a side evaluated or if chewing-side reproducibility is needed
preference when chewing fresh asparagus. Although whereas tough or fibrous food may better reveal the
tender foods are likely to be chewed indifferently on side preference when the cutting effect is at stake. It
either side of the jaw, fresh asparagus might be so should be added that the cohesiveness of the bolus
fibrous that it needed to be chewed on the preferred could play a role in the resultant side preference since
side. Toughness of foods, therefore, might help explain foods with great cohesion (e.g. fibrous food) are not
the choice of chewing side. Wilding and Lewin (4) easily dissociated and tend to be chewed unilaterally.
noticed a similarity of the chewing-side pattern
between two recording sessions in their subjects chew-
Acknowledgments
ing wine-gums. In the present study, almonds showed
the most reproducible chewing-side pattern (18 of The authors would like to thank Prof. J. W. Osborn for
20 subjects), compared with asparagus and jerky. This reading and giving valuable advice on the original
was probably because of the more regular texture of version of this manuscript and Prof. P. W. Lucas who
wine-gums and almonds although the strength and advised on food property testing. This study was
elasticity of pork jerky and asparagus tested on 2 days supported by the Research Fund of Faculty of Dentistry,
was not significantly different. It was also possible that Khon Kaen University.
the breakage of brittle foods like almonds might be
easily reproduced whereas that of jerky and asparagus
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