Abstract
Healthcare providers are finding it more and more difficult to treat the physiological changes brought on by ageing, especially those that impact oral function, as the world's population continues to age. This essay investigates the consequences of older people's diminished chewing ability, which frequently arises from masseter muscle atrophy. We address the impact of impaired mastication on systemic health, namely gastrointestinal function, emphasising the critical role chewing plays in starting the digestive process. The integration of dental, surgical, and rehabilitative techniques is emphasised in the evidence-based recommendations for the management of mastication impairments in the aged.
Overview
A vital physiological function that is essential to the digestive process is chewing, or mastication. Salivary enzymes initiate the chemical breakdown of food as it breaks down mechanically in the mouth, paving the way for effective digestion and nutritional absorption. The masseter muscle, a vital part of the chewing mechanism, can atrophy in older people, which can seriously hinder this process. Although sarcopenia, or the loss of muscular mass and strength, is a normal aspect of ageing, its effects on mastication have a significant negative influence on older persons' health and quality of life. This study highlights the need for focused interventions to lessen the impacts of impaired chewing by examining the connection between masseter muscle atrophy and digestive health in older populations.
The Physiology of Mastication and its Role in Digestion
The first stage of digestion, mastication, has both enzymatic and mechanical purposes. Together with other masticatory muscles, the masseter muscle provides the force needed to break food into smaller pieces. By increasing the food's surface area, this technique promotes enzymatic activity. The breakdown of carbohydrates and fats in the mouth is initiated by salivary enzymes like lipase and amylase, highlighting the importance of effective mastication. It has been demonstrated that improper chewing causes larger food boluses that are more challenging to swallow and digest, putting more strain on the stomach and oesophagus. Malnutrition in the elderly can be made worse by inadequate mastication, which has been linked to delayed stomach emptying and decreased nutrient absorption (Yamamoto et al., 2022).
Impact of Aging on the Masseter Muscle
Sarcopenia, which affects all skeletal muscles, including the masseter, is brought on by ageing. Research has indicated that as people age, their masseter muscle's cross-sectional area and contractile strength drastically decrease (Shiga et al., 2015). Comorbid conditions including osteoporosis, which weakens the jawbone, edentulism (tooth loss), and ill-fitting dentures all contribute to this decline. Masseter muscle atrophy makes it harder to masticate food since it not only reduces chewing efficiency but also causes jaw instability. A preference for softer, processed foods that are frequently poorer in fibre and vital nutrients might result from the loss of chewing ability, aggravating metabolic and gastrointestinal problems.
Consequences of Impaired Mastication
1. Gastrointestinal Dysfunction
The digestive system is directly impacted by chewing deficiency. Because larger food particles are more difficult to digest and may encourage dysbiosis, improperly chewed food upsets the balance of the gut microbiota (Watanabe et al., 2020). Furthermore, the enzymatic digestion of food is further compromised by the elderly's decreased salivary output.
2. Malnutrition and Weight Loss
A common result of poor chewing is malnutrition. Because they have trouble chewing, elderly people frequently shun nutrient-dense foods including fruits, vegetables, and proteins, which can result in deficits in vital vitamins and minerals (Sheiham & Steele, 2001).
3. Psychosocial Implications
Chewing difficulties can also have an impact on mental health and social interactions. During meals, a lot of senior citizens feel embarrassed or frustrated, which lowers their quality of life and causes social isolation.
A multidisciplinary approach is necessary to address the problem of elderly people's reduced mastication:
1. Dental and Prosthodontic Solutions
Chewing efficiency can be greatly increased by restoring dental occlusion with properly fitted dentures, dental implants, or bridges. Compared to traditional dentures, there is evidence that implant-supported prostheses improve patient satisfaction and masticatory performance (Emami et al., 2013).
2. Nutritional Support
The risk of malnutrition can be reduced by dietary changes, such as the addition of nutrient-dense meals that range from soft to hard. Supplements and nutritional counselling, if required, should be customised for each person.
3. Physical Rehabilitation
Resistance training exercises for the jaw and targeted physical treatment can help restore some of the strength of the masseter muscles. Masticatory muscle training has been demonstrated to increase muscular tone and chewing efficiency in older adults (Okura et al., 2014).
4. Preventive Care
The compounded consequences of tooth loss and jawbone resorption can be avoided with routine dental examinations and early treatments for oral health concerns.
Conclusion
Effective chewing is essential for both general health and digestive health, especially in older adults. When oral and systemic health problems are coupled with masseter muscle atrophy, it presents a serious problem that calls for an all-encompassing, interdisciplinary solution. Healthcare professionals can improve the quality of life for senior citizens by addressing the underlying causes of impaired mastication and putting evidence-based therapies into practice. This will guarantee that the digestive process starts in the mouth, where it should.
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I hereby declare no conflict of interest in this paper.