Two-color chewing gum mixing ability test for evaluating masticatory performance in children with mixed dentition: Validity and reliability study

Abstract

The unappealing taste of the chewing material and the time-consuming repetitive task in masticatory performance tests using artificial foodstuff may discourage children from performing natural chewing movements. Therefore, the aim was to determine the validity and reliability of a two-color chewing-gum mixing ability test for masticatory performance (MP) assessment in mixed dentition children. Masticatory performance was tested in two groups: systemically healthy fully dentate young adults and children with mixed dentition. Median particle size was assessed using a comminution test, and a two-color chewing gum mixing ability test was applied for MP analysis. Validity was tested with Pearson correlation and reliability was tested with intraclass correlation coefficient, Pearson correlation and Bland Altman plots. Both comminution and two-color chewing gum mixing ability tests revealed statistically significant MP differences between children (n=25) and adults (n=27, both p<0.01). Pearson correlation between comminution and two-color chewing gum mixing ability tests was positive and significant (r=0.418, p=0.002). Correlations for inter- examiner reliability and test-retest values were significant (r=0.990, p=0.0001 and r=0.995, p=0.0001). Although both methods could discriminate MP differences, the comminution test detected these differences generally in a wider range compared to two-color chewing gum mixing ability test. However, considering the high reliability of the results, the two-color chewing gum mixing ability test can be used to assess masticatory performance in children, especially at non-clinical settings.

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