Measurement of the Maximum Occlusal Bite Force and its Relation to the Caries Spectrum of First Permanent Molars in Early Permanent Dentition

Objective: To determine the maximum occlusal bite force (MOBF) of the complete spectrum of dental caries in first permanent molars (FPMs) in children aged 7-9 years. Study design: A cross-sectional study was conducted on 123 children. The evaluation of the caries spectrum of FPMs was carried out using the Caries Assessment Spectrum and Treatment index (CAST). The MOBF was measured in the FPM region using the portable occlusal force gauze. Independent sample t-test and one-way analysis of variance test were performed to compare MOBF with CAST scores of FPMs. Based on the CAST scores, FPMs were categorized into three groups, group 1: healthy (score 0, 1, 2), group 2: premorbid (score 3), group 3: morbid (score 4, 5). Results: A significantly lower MOBF was observed (167.56 N ± 49.77) in the morbid stage (group 3) than in the premorbid stage (group 2: 291.57 N ± 56.64), and healthy (group 1; 320.93 N ± 54.23). Intergroup comparison also revealed that FPMs in the healthy stage was associated with a higher bite force compared to those in the premorbid and morbid stages (p<0.001). Conclusions: The mean MOBF decreased with the progression of the caries spectrum of FPMs in early permanent dentition.

Bite force; Caries spectrum; CAST index; Dental caries; Occlusal force gauze

1. Fontijn-Tekamp FA, van der Bilt A, Abbink JH, Bosman F. Swallowing threshold and masticatory performance in dentate adults. Physiol Behav 83(3): 431-436, 2004.

2. Bonjardim LR, Gaviao MB, Pereira LJ, Castelo PM. Bite force determination in adolescents with and without temporomandibular dysfunction. J Oral Rehabil 32(8): 577-583, 2005.

3. Roldan S, Buschang PH, Isaza Saldarriaga JF, Throckmorton G. Reliability of maximum bite force measurements in age-varying populations. J Oral Rehabil 36(11): 801-807, 2009.

4. Varga S, Spalj S, Lapter Varga M, Anic Milosevic S, Mestrovic S, Slaj M. Maximum voluntary molar bite force in subjects with normal occlusion. Eur J Orthod 33(4): 427-433, 2011.

5. Kogawa EM, Calderon PS, Lauris JR, Araujo CR, Conti PC. Evaluation of maximal bite force in temporomandibular disorders patients. J Oral Rehabil 33(8): 559-565, 2006.

6. Van Der Bilt A, Tekamp A, Van Der Glas H, Abbink J. Bite force and electromyography during maximum unilateral and bilateral clenching. Eur J Oral Sci 116(3): 217-222, 2008.

7. Pereira L, Pastore M, Bonjardim L, Castelo P, Gavião M. Molar bite force and its correlation with signs of temporomandibular dysfunction in mixed and permanent dentition. J Oral Rehabil 34(10): 759-766, 2007.

8. Gavião MB, Raymundo VG, Rentes AM. Masticatory performance and bite force in children with primary dentition. Braz Oral Res 21(2): 146-152, 2007.

9. Kaya MS, Akyuz S, Guclu B, Diracoglu D, Yarat A. Masticatory parameters of children with and without clinically diagnosed caries in permanent dentition. Eur J Paediatr Dent 18(2): 116-120, 2017.

10. Sun KT, Chen SC, Li YF, et al. Bite-force difference among obese adolescents in central Taiwan. J Formos Med Assoc 115(6): 404-410, 2016.

11. N’Gom P I, Woda A. Influence of impaired mastication on nutrition. J Prosthet Dent 87(6): 667-673, 2002.

12. Togoo RA, Yaseen SM, Zakirulla M, Al Garni F, Khoraj AL, Meer A. Prevalence of first permanent molar caries among 7-10 years old school going boys in Abha City, Saudi Arabia. J Int Oral Health 3(5): 29-34, 2011.

13. Gudipaneni RK, Alkuwaykibi AS, Patil SR, Assiry A, Alam MK, Vundavalli S. Assessment of Caries Spectrum of First Permanent Molars in 7-to 8-Year-Old School Children in Northern Saudi Arabia: A Cross-Sectional Study. Pesquisa Brasileira em Odontopediatria e Clínica Integrada 20: 4800, 2019.

14. Aldossary MS, Alamri AA, Alshiha SA, Hattan MA, Alfraih YK, Alwayli HM. Prevalence of Dental Caries and Fissure Sealants in the First Permanent Molars among Male Children in Riyadh, Kingdom of Saudi Arabia. Int J Clin Pediatr Dent 11(5): 365-370, 2018.

15. Su CM, Yang YH, Hsieh TY. Relationship between oral status and maximum bite force in preschool children. J Dent Sci 4(1): 32-39, 2009.

16. Mountain G, Wood D, Toumba J. Bite force measurement in children with primary dentition. Int J PaediatrDent 21(2): 112-118, 2011.

17. Frencken JE, de Amorim RG, Faber J, Leal SC. The Caries Assessment Spectrum and Treatment (CAST) index: rational and development. Int Dent J 61(3): 117-123, 2011.

18. de Souza AL, Leal SC, Bronkhorst EM, Frencken JE. Assessing caries status according to the CAST instrument and WHO criterion in epidemiological studies. BMC Oral Health 14(1): 119, 2014.

19. Kamegai T, Tatsuki T, Nagano H, et al. A determination of bite force in northern Japanese children. Eur J Orthod 27(1): 53-57, 2005.

20. Sakaguchi M, Ono N, Turuta H, Yoshiike J, Ohhashi T. Development of new handy type occlusal force gauge. Japanese Journal of Medical Electronics and Biological Engineering 34: 53-55, 1996.

21. Dahlberg G. Statistical methods for medical and biological students. Statistical methods for medical and biological students 1940.

22. Houston W. The analysis of errors in orthodontic measurements. Am J Orthod 83(5): 382-390, 1983.

23. Tortopidis D, Lyons M, Baxendale R, Gilmour W. The variability of bite force measurement between sessions, in different positions within the dental arch. J Oral Rehabil 25(9): 681-686, 1998.

24. Abu Alhaija ES, Al Zo’ubi IA, Al Rousan ME, Hammad MM. Maximum occlusal bite forces in Jordanian individuals with different dentofacial vertical skeletal patterns. Eur J Orthod 32(1): 71-77, 2010.

25. Koc D, Dogan A, Bek B. Bite force and influential factors on bite force measurements: a literature review. Eur J Dent 4(2): 223-232, 2010.

26. Koç D, Dogan A, Bek B. Effect of gender, facial dimensions, body mass index, and type of functional occlusion on bite force. J Appl Oral Sci 19(3): 274-279, 2011.

27. Pereira LJ, Pastore MG, Bonjardim LR, Castelo PM, Gaviao MB. Molar bite force and its correlation with signs of temporomandibular dysfunction in mixed and permanent dentition. J Oral Rehabil 34(10): 759-766, 2007.

28. Braun S, Hnat WP, Freudenthaler JW, Marcotte MR, Hönigle K, Johnson BE. A study of maximum bite force during growth and development. Angle Orthod 66(4): 261-264, 1996.

29. Garner L, Kotwal N. Correlation study of incisive biting forces with age, sex, and anterior occlusion. J Dent Res 52(4): 698-702, 1973.

30. Shiau YY, Wang JS, Carlsson GE. The effects of dental condition on hand strength and maximum bite force. CRANIO® 11(1): 48-54, 1993.

31. Owais AI, Shaweesh M, Abu Alhaija ES. Maximum occlusal bite force for children in different dentition stages. Eur J Orthod 35(4): 427-433, 2012.

32. Subramaniam P, Babu KG. Effect of restoring carious teeth on occlusal bite force in children. J Clin Pediatr Dent 40(4): 297-300, 2016.

33. de Souza Barbosa T, de Morais Tureli MC, Nobre-dos-Santos M, Puppin-Rontani RM, Gavião MBD. The relationship between oral conditions, masticatory performance, and oral health-related quality of life in children. Arch Oral Biol 58(9):1070-1077, 2013.

34. Gavião MBD, Raymundo VG, Rentes AM. Masticatory performance and bite force in children with primary dentition. Braz Oral Res 21(2):146-152, 2007.

35. Rentes A, Gavião M, Amaral J. Bite force determination in children with primary dentition. J Oral Rehabil 29(12): 1174-1180, 2002.

36. Owens S, Buschang PH, Throckmorton GS, Palmer L, English J. Masticatory performance and areas of occlusal contact and near contact in subjects with normal occlusion and malocclusion. Am J Orthod Dentofacial Orthop 121(6): 602-609, 2002.

37. Sonnesen L, Bakke M. Molar bite force in relation to occlusion, craniofacial dimensions, and head posture in pre-orthodontic children. Eur J Orthod 27(1): 58-63, 2005.

38. Toro A, Buschang PH, Throckmorton G, Roldán S. Masticatory performance in children and adolescents with Class I and II malocclusions. Eur J Orthod 28(2): 112-119, 2005.

39. Tsai HH. Maximum bite force and related dental status in children with deciduous dentition. J Clin Pediatr Dent 28(2): 139-142, 2004.

40. Leal SC, Ribeiro APD, Frencken JE. Caries Assessment Spectrum and Treatment (CAST): A Novel Epidemiological Instrument. Caries Res 51(5): 500-506, 2017.

41. Frencken JE, Giacaman RA, Leal SC. An assessment of three contemporary dental caries epidemiological instruments: a critical review. Br Dent J 228(1): 25-31, 2020.

42. El Batawi H, Fakhruddin KS. Patterns of dental caries among school children assessed using Caries Assessment Spectrum and Treatment tool. Eur J Dent 11(02): 168-173, 2017.

43. Malik A, Shaukat MS, Qureshi A. Prevalence of dental caries using novel caries assessment index-CAST. J Dow Univ Health Sci 8(1): 7-10, 2014.

44. Nagarajappa R, Naik D, Satyarup D, Dalai RP. Risk factors and patterns related to dental caries evaluated with caries assessment spectrum and treatment (cast) among schoolchildren of Bhubaneswar, India. Rocz Panstw Zakl Hig 71(1): 113-122, 2020.

45. Al Gunaid TH. Bite force-What we should know: A literature review. International Journal of Orthodontic Rehabilitation 10(4): 168, 2019.