Safe structural food bolus in elderly: the relevant parameters

Abstract

Mastication is essential to prepare food into a bolus ready to be swallowed safely, with no choking risk. Based on food bolus properties, a masticatory normative indicator was developed by Woda et al. (2010) to identify impaired masticatory function within good oral health population. The aim of the present study was to identify relevant parameters of bolus' structure to differentiate safe to unsafe bolus among elderly contrasting by their dental status.93 elderly, 58% with at least 7 posterior dental occlusions and 42% with less than 5 posterior dental occlusions were recruited. They masticated a piece of raw carrot and spit the food bolus ready to be swallowed. Particle size distribution of each individual bolus was evaluated using image analysis.Two parameters derived from the particles size distribution were considered: the median (d50) and the d99 (upper level with only 1% observed values higher). The parameters allowed identifying three groups: one group (n=45) with a food bolus made of many and small particles (d99 = 7.4 mm ± 1.2; d50 = 1.5 mm ± 0.3); one group (n=30) with food boluses containing medium particle size (d99 = 9.0 mm ± 1.4; d50 = 2.4 mm ± 0.4); and one group (n=18) whose food bolus is heterogeneous and contains big particles that seem unsafe to swallow (d99 = 10.3 mm ± 0.9; d50 = 1.7 mm ± 0.4). The links with oral health characteristics of each group were studied