Tooth Loss, Occlusal Teeth Support, Salivary Flow Rate, and Food Texture Choice in the Elderly with Cognitive Impairment: A Preliminary Study in Indonesia

Kartika I. Sari1, *, Paulus A. Ong2, Ambrosius Purba3, Sunardhi Widyaputra1
1 Department of Oral Biology, Faculty of Dentistry, Universitas Padjadjaran, Sumedang, Jawa Barat 45363,, Indonesia
2 Department of Neurology, Hasan Sadikin Hospital, Bandung, Indonesia
3 Department of Physiology, Faculty of Medicine Universitas Padjadjaran, Sumedang, Jawa Barat 45363, Indonesia

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© 2021 Sari et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Oral Biology, Faculty of Dentistry, Universitas Padjadjaran, Sumedang, Jawa Barat 45363, Indonesia TeL: +6285263167939; E-mail:



The elderly are at risk of experiencing oral health problems and chewing due to tooth-loss, decreased occlusal teeth support, and decreased salivary flow rate.


This study aimed to compare distribution and comparison tooth loss, the proportion of occlusal teeth support, salivary flow rate, and the choice of food texture between the normal and cognitive impairment groups.


Preliminary study and cross-sectional designed method on community-dwelling elderly in Bandung City, Indonesia. The inclusion criteria were no complaint of orofacial pain, not wearing denture prostheses, good communication skills, reading and writing skills, and good physical health. Demographic data include age, gender, education, and occupation. Tooth loss distribution, the proportion of occlusal contact zone, salivary flow rate, and choice of food texture were determined. Cognitive function was measured using the mini mental short examination (MMSE) form. A Mann-Whitney test was used to compare normal and cognitive impairment groups with a significance level of p-value <0.05.


25 cognitive normals with MMSE score ≥25 and 10 cognitive impairment with MMSE score <25. Mean anterior tooth-loss was 2.16±3.89 vs. 4.90± 4.28 (p<0.05) and posterior tooth loss was 7.12± 5.89 vs 10.40± 4.90, p> 0.05 under normal condition compared with the cognitive impairment groups. Fewer occlusal support zone was found more frequently in cognitive impairment by groups B2, B3, B4, and C according to the Eichner Index classification. Salivary flow rate was 1.2942± 0.5768 vs 1.2755± 0.9811, p> 0.05. The participants in both groups preferred a hard-solid food portion.


The loss of anterior teeth is significantly different. The loss of posterior teeth appeared to be different between the elderly with cognitive impairment compared with the normal groups. The occlusal support zone, salivary flow rate, and the choice of food texture as a meal served were similar between both groups in this study.

Keywords: Tooth loss, Occlusal support zone, Salivary flow rate, Choice of food texture, Cognitive impairment, Fever.