Journal of Oral Rehabilitation 2006 33; 85–93

Individual difference in the number of chewing strokes and its determinant factors
T. UEDA, K. SAKURAI & T. SUGIYAMA
Chiba, Japan Department of Complete Denture Prosthodontics, Tokyo Dental College,

SUMMARY This study was carried out to clarify the distribution and individual variation of the number of chewing strokes before last swallowing (NCS), as well as to assess the factors that affect NCS, when dentulous adults masticate the same type of food. NCS was measured in 75 dentulous adults using gummy candies. Measurements were repeated five times to obtain the average and variation. Moreover, the correlation of NCS with various physiological factors (lateral width and vertical distance of chewing loop, angle of opening and closing path, opening and closing time, occlusal time, masticatory performance, number of occlusal contact points, occlusal contact area, occlusal force, flow rate of whole saliva and viscosity of whole saliva) and 28 personality factors were analysed by both of the single variate analysis and the multivariate analysis. The results showed that the average NCS was 41Æ0 Æ 16Æ0, and the coefficient of variation was 0Æ090 Æ 0Æ040.

Additionally, the correlation between NCS and each factor was investigated, and found that any of these factors did not function as a single determinant for NCS. Following, determinant factors were further examined by the stepwise method of linear multiple regression analysis. From these analysis we found that when opening and closing time and four personality factors were combined, they were significantly involved in determining NCS (P < 0Æ01). Therefore, we conclude that individual NCS until last swallowing is not determined by a sole, specific physiological factor but is affected by multiple factors including personality. KEYWORDS: mastication, the number of chewing strokes, personality, linear multiple regression analysis, food Accepted for publication 2 May 2005

Introduction
Within the food processing (1) during food ingestion, chewing transforms the solid piece of food into a masticated bolus of a suitable size to be transported to the oropharynx for its swallow. Many studies have been advocated to investigate the number of chewing strokes, however in most of these studies subjects were asked to chew a given test food and swallow it in one single swallow. Also previous studies have been advocated to measure the number of chewing strokes until the first swallow motion occurs. However, in recent studies food processing has been referred as a process that continues while tongue pushes a part of bolus of food ready to be swallowed from the oral cavity into the
ª 2006 Blackwell Publishing Ltd

oropharynx (1–3). Thus, in order to clarify the number of chewing strokes all through the food processing it is necessary to measure the number of chewing strokes until the last swallow occurs. But still remains the question, how can be defined the necessary number of chewing strokes involved in food processing? The number of chewing strokes during ordinary meal (daily meal) would be conceivable an intermediate situation with two extreme eating situations. The first extreme is the situation in which a person is chewing and swallowing as fast as possible. The relationship between physiological factors and the number of chewing strokes might be strongest in this situation. The other extreme is a formal dinner situation, where a fast mastication is socially inappropriate

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and personality factors might predominantly determine the number of chewing strokes. Past studies have reported that there is no correlation between the number of chewing strokes and masticatory performance (4, 5). These findings suggested that the number of chewing strokes might not solely be influenced by physiological variables but also by other factors. Thus, we hypothesized that factors involved in determining the number of chewing strokes until last swallowing are not only physiological factors but also personality factors. The present study was conducted to clarify: (i) the distribution of the number of chewing strokes until last swallowing among subjects when the same type of food is masticated, (ii) the variation of the number of chewing strokes until last swallowing when an individual repeatedly masticates an identical food and (iii) factors that affect the number of chewing strokes until last swallowing. each measurement session, one gummy candy was used. Measurements of the number of chewing strokes were performed in the evening, between 4 and 6 h after lunch. The number of chewing strokes was recorded from the beginning of mastication until the last swallowing action by using the mandibular movement analysing device BioPAK 1Æ7R†. For each subject the test food was placed on the tongue and then they were asked to occlude in centric occlusion and restrain from mastication. On a command signal, chewing was initiated and the subjects were allowed to swallow the test food ad libitum. Subjects were asked to signal once all the test food has been swallowed. Chewing side was not indicated. Prior to the experiment, preliminary chewing training was performed at least three times, and subsequently chewing tests were carried out five times. Between measurement sessions, sufficient rest time was given to subjects. Two dummy measurements were randomly inserted between the tests using another type of gummy candy with different physical properties.

Materials and methods
Subjects The subjects were healthy Japanese dentulous young adults. Experience in dental treatment, malpositioned teeth, or malocclusion was not included in the exclusion criteria. Subjects suffering from systemic disease, those during or immediately after dental treatment and removable denture wearers were excluded. Written approval for participation in this study was obtained from 80 people who had agreed with the purpose of this study. Three subjects who had subjective and objective abnormalities in masticatory functions, who did not like gummy, were excluded. Two subjects dropped out due to moving during the test period. A total of 75 subjects (39 males and 36 females, mean age: 24 Æ 3 years) were enroled in this study.

Measurement of physiological factors We measured 12 physiological factors for each subject (see Table 1). Analysis of masticatory movement. The path of mandibular movement was recorded by means of BioPAK while chewing a piece of chewing gum (Xylitol Gum)‡ on the habitual chewing side. After the gum had become softened and the masticatory rhythm had reached a stable state, the path of the mandibular movement was recorded in the frontal projection during 20 strokes to obtain the mean lateral width of chewing loop (mm), mean vertical distance of chewing loop (mm), and mean angle of opening and closing path (°) (Fig. 1). Mean opening and closing time (ms), mean occlusal time (ms) and mean total cycle time (ms) were also calculated. Measurement of masticatory performance. The masticatory performance was measured by the Manly and Braley’s method (6). The subjects were asked to chew a prefixed number of strokes (20 strokes) 3 g of

Measurement of the number of chewing strokes The test food selected in this study was gummy candy in a columnar shape (4Æ2 Æ 0Æ2 g, 20 mm in diameter, 8 mm in height). The hardness of the gummy candy was shown to be 73 N by the texture analyzer* using a V-type plunger* at 20 °C (the angle of the plunger was 30°, crosshead speed 1Æ0 mm.s)1, distance 100%). For

*Stable Micro Systems, Surrey, UK.

BioResearch Associates, Wisconsin, USA. Lotte, Tokyo, Japan.

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DETERMINANT FACTORS OF THE NUMBER OF CHEWING
Table 1. Results of measurements of physiological factors Vertical distance of chewing loop Lateral width of chewing loop Angle of opening and closing path Total cycle time Occlusal time Opening and closing time Masticatory performance The number of occlusal contact point Occlusal contact area Occlusal force Stimulated whole salivary flow rate Viscosity of stimulated whole saliva 75 75 75 75 75 75 75 75 75 75 75 75

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n (unit) (mm) (mm) (°) (ms) (ms) (ms) (%) (points) (mm2) (kN) (mL Æ min)1) (mPa Æ s)

Test materials Chewing Chewing Chewing Chewing Chewing Chewing Peanuts gum gum gum gum gum gum

Mean 15Æ2 4Æ5 24Æ2 725 345 381 79Æ0 24Æ5 116Æ5 0Æ567 1Æ55 1Æ30

s.d. 3Æ1 1Æ4 18Æ4 149 86 83 10Æ2 9Æ0 83Æ2 0Æ221 0Æ67 0Æ06

Paraffin wax Paraffin wax

the image analysing software, Scion Image for Windows**, to calculate the number of occlusal contact points and occlusal contact area (mm2). Within the context of this study, an interocclusal distance of ‡150 lm was considered as an occlusal contact. Measurement of occlusal force. Occlusal force was measured using an occlusal force meter GM-10††. The recording places were the left and right first molars. Measurements were performed five times on each side, and the maximal value was regarded as the occlusal force. Measurement of the flow rate and viscosity of whole saliva. The flow rate of stimulated whole saliva (mL Æ min)1) was measured based on the method described by Heintze et al. (7) which consists of masticatory stimulation method and spitting collection method. Briefly, 1 g of paraffin wax was chewed for about 2 min until the wax became soft. Again, the same material was chewed for 5 min and the whole saliva secreted while chewing was periodically expectorated into measuring tubes. These measurements were carried out just before the measurements of the number of chewing strokes. The viscosity of the collected saliva (mPa Æ s) was measured on the oscillation viscometer (Viscometer VM-1G)‡‡ immediately after saliva was collected. Prior to the measurements, the viscometer

Fig. 1. Schematic diagram of masticatory movement. An example of the chewing loop as seen in frontal projection (left) and its magnification around the origin (right). V, vertical distance of turning point; L, lateral width of chewing loop; h, angle of opening and closing path.

peanuts, rinse their mouth and disgorge the chewed peanuts. The particle size distribution of the chewed food was then determined by a sieving procedure in a 10-mesh sieve. The residue was collected on a filter paper. The filters were dried in an oven at 80 °C for 8 h, and weighed. The measurements were repeated three times, and the average rate of the passed peanuts (%) was regarded as the masticatory performance of the subjects. Analysis of occlusion. Interocclusal records in centric occlusion, at which subjects could make light tooth contact, were obtained using an addition-curing vinyl silicone impression material for occlusal registration (Exabite)§. The obtained records were captured by the transmission scanner (GT-9600)¶ and analysed using
§

GC, Tokyo, Japan. ¶ Seiko Epson, Nagano, Japan. ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 85–93

**Scion Corporation, Frederick, MD, USA. †† Nagano Keiki, Tokyo, Japan. ‡‡ Yamaichi Electronics, Osaka, Japan.

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Table 2. Summary of statistical analysis of personality survey Extraversion Activity Sociability Risk-taking Impulsiveness Expressiveness Practicality Irresponsibility Emotional instability Inferiority feeling Depressiveness Anxiety Obsessiveness Dependence Hypochondriasis Guilt Points 30 30 30 30 30 0 0 0 0 30 30 0 30 30 ! ! ! ! ! ! ! ! ! ! ! ! ! ! 0 0 0 0 0 30 30 30 30 0 0 30 0 0 Introversion Inactivity Unsociability Carefulness Control Inhibition Reflectiveness Responsibility Stability adjustment Self-esteem Happiness Calm Casualness Autonomy Sense of health Guilt-freedom

Statistical analysis The average number of chewing strokes, standard deviation (s.d.) and coefficient of variation (CV; CV ¼ s.d./average) were calculated from the five measurements. Correlation between the average number of chewing strokes and each factor was analysed by using Pearson’s correlation coefficient. The stepwise method was used for prediction of the factors that could be closely correlated to the number of chewing strokes. Dependent variables was the average number of chewing strokes, and independent variables were the following three combinations: (i) physiological factors and sex (12 variables; see Table 1), (ii) personality factors and sex (29 variables) and (iii) all factors and sex (40 variables). Among the physiological factors, the total cycle time was excluded from the committed variables as it was expressed as the sum of occlusal time and opening and closing time. Selection of variables was done according to Cp statistic. Statistical analysis was performed using the statistical analysing applications, SPSS for Windows 11Æ0J¶¶ and S-PLUS2000**.

A pair of right and left factors indicates a set of personality type, which is expressed in a scale from 0 to 30 points. For statistical analysis, each type is divided into two factors. When the point of a subject is closer to the left factor, the left factor is regarded as 1 and the right factor, as 0. For example, if the point in the type of activity–inactivity is 28, activity ¼ 1 and inactivity ¼ 0. If the point is 15, which is within the average range, both factors are regarded as 0.

was calibrated by the comparison method using standard liquids§§ for calibration for viscometer.

Experimental ethics This protocol was approved by the Ethics Committee of Tokyo Dental College. All experiments were done in accordance with the Edinburgh Revision of the Helsinki Declaration.

Personality survey A personality survey was carried out by questionnaire method according to Eysenck and Wilson (8). The survey consisted of 210 questions to examine two typologies of temperament, which were extraversionintroversion and emotional instability–stability adjustment. Both the typologies could in turn be further divided into seven component characteristics. Hence, 14 types of characteristics were surveyed. Fifteen questions were assigned to evaluate each type, which was expressed by 0–30 points. For statistical analysis, each type was converted to two factors according to the points, and 28 factors in total were obtained. All factors were binarized (applicable ¼ 1, not applicable ¼ 0) (Table 2), and rating for each factor was achieved based on the method established by Eysenck et al.

Results
Distribution and variation of the number of chewing strokes The minimal value of the average number of chewing strokes was 10; the maximal, 92; the mean, 41Æ0; the median, 38Æ6; s.e., 1Æ85 and s.d., 16Æ0. The distribution of the number of chewing strokes is represented in the histogram graph shown in Fig. 2. The s.d. and CV for the number of chewing strokes in individual subjects are shown in Figs 3 and 4, respectively. Mean Æ s.d. of CV was 0Æ090 Æ 0Æ040, and the median value was 0Æ086.

¶¶ §§

Nippon Grease, Osaka, Japan.

SPSS, Chicago, IL, USA. **Insightful Corporation, Washington, DC, USA.

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DETERMINANT FACTORS OF THE NUMBER OF CHEWING
30

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Correlation between the number of chewing strokes and various factors and analysis by the linear multiple regression Measurement results for various physiological factors are shown in Table 1. Correlations between the number of chewing strokes and physiological factors and sex are shown in Table 3. Also correlations between the number of chewing strokes and personality factors are shown in Table 4. The results of the stepwise analysis are expressed in Equations 1, 2 and 3 as follows (R2: coefficient of determination, Adj-R2: coefficient of determination adjusted for the degree of freedom, rMSE: root mean square error). Equation 1: Predictive formula obtained by the combination of the physiological factors and sex. Y ¼ 23 Á 345 þ 0 Á 04638 Á X1

Frequency (%)

20

10

0 0 20 40 60 80 100

The number of chewing strokes
Fig. 2. Histogram of the mean number of chewing strokes.

%

20

Frequency (%)

where Y is the number of chewing strokes, X1 is opening and closing time (R2 ¼ 0Æ058, Adj-R2 ¼ 0Æ045, P ¼ 0Æ037, rMSE ¼ 15Æ612). Equation 2: Predictive formula obtained by the combination of the personality factors and sex. Y ¼36 Á 180 À 12 Á 202 Á X1 À 12 Á 237 Á X2 þ 18 Á 431 Á X3 þ 13 Á 181 Á X4 À 6 Á 996 Á X5 þ 5 Á 891 Á X6 where Y is the number of chewing strokes, X1 is selfesteem, X2 is irresponsibility, X3 is guilt, X4 is guiltfreedom, X5 is casualness, X6 is sense of health (R2 ¼ 0Æ299, Adj-R2 ¼ 0Æ237, P ¼ 0Æ000, rMSE ¼ 13Æ961). Equation 3: Predictive formula obtained by the combination of all factors and sex. Y ¼23 Á 582 À 13 Á 434 Á X1 À 14 Á 873 Á X2 þ 0 Á 04634 Á X3 þ 14 Á 352 Á X4 þ 10 Á 279 Á X5

10

0 0 2 4 6 8 10

S.D. of the number of chewing strokes
Fig. 3. Histogram of s.d. of the number of chewing strokes.

%

20

10

0 0 0.05 0.10 0.15 0.20 0.25

C.V. of the number of chewing strokes
Fig. 4. Histogram of coefficient of variation of the number of chewing strokes.
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where Y is the number of chewing strokes, X1 is selfesteem, X2 is irresponsibility, X3 is opening and closing time, X4 is guilt, X5 is guilt-freedom (R2 ¼ 0Æ308, Adj-R2 ¼ 0Æ258, P ¼ 0Æ000, rMSE ¼ 13Æ762). On the contrary, when the correlation between the masticatory performance and both the physiological and personality factors was analysed by the stepwise methods, two physiological variables were selected (number of occlusal contact points and occlusal force) while no personality factors were selected (P ¼ 0Æ000).

Frequency (%)

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Table 3. Correlations between the number of chewing strokes and physiological factors and sex Correlation coefficient Opening and closing time Angle of opening and closing path Total cycle time Viscosity of stimulated whole saliva Occlusal time Lateral width of chewing loop Occlusal contact area Sex Stimulated whole salivary flow rate Occlusal force Vertical distance of chewing loop The number of occlusal contact point Masticatory performance 0Æ242 0Æ176 0Æ168 0Æ131 0Æ058 0Æ025 )0Æ008 )0Æ011 )0Æ013 )0Æ059 )0Æ071 )0Æ075 )0Æ129

Discussion
Distribution of the number of chewing strokes

P-value 0Æ037 0Æ130 0Æ149 0Æ262 0Æ620 0Æ829 0Æ943 0Æ926 0Æ910 0Æ614 0Æ545 0Æ520 0Æ270

Table 4. Correlations between the number of chewing strokes and personality factors Correlation coefficient Guilt Obsessiveness Anxiety Responsibility Inferiority feeling Control Depressiveness Practicality Dependence Sense of health Impulsiveness Inhibition Carefulness Activity Inactivity Unsociability Reflectiveness Expressiveness Autonomy Hypochondriasis Risk-taking Happiness Sociability Guilt-freedom Calm Irresponsibility Casualness Self-esteem 0Æ220 0Æ179 0Æ167 0Æ119 0Æ111 0Æ101 0Æ064 0Æ061 0Æ051 0Æ049 0Æ043 0Æ042 0Æ003 )0Æ009 )0Æ009 )0Æ009 )0Æ016 )0Æ024 )0Æ027 )0Æ032 )0Æ065 )0Æ065 )0Æ102 )0Æ121 )0Æ187 )0Æ198 )0Æ239 )0Æ246 P-value 0Æ058 0Æ124 0Æ151 0Æ311 0Æ344 0Æ387 0Æ588 0Æ606 0Æ665 0Æ673 0Æ715 0Æ718 0Æ978 0Æ939 0Æ939 0Æ939 0Æ892 0Æ837 0Æ821 0Æ786 0Æ578 0Æ577 0Æ382 0Æ301 0Æ109 0Æ088 0Æ039 0Æ034

From all the available test foods that can be swallowed, gummy candies were chosen as the test food, as few people dislike them and also can be supplied constantly in a stable physical property. The gummy candy used in the present study is usually available at any store in Japan. The criteria to select the appropriate amount of test food was based on previous studies of the number of chewing strokes such as Liao et al. (3Æ6 g or 6Æ9 g of gummy candies) (9), Shiozawa et al. (6 g of gummy candy) (10–12) and Jiffry et al. (2Æ2–3Æ5 g of soya beans) (13). It is known that not only the number of chewing strokes, but also the physiological factors related to mastication are influenced by the type and size of the test food used. This is a limitation of this study. Taking into consideration that the subjects’ degree of hunger might affect the number of chewing strokes, the measurements were therefore carried out between 4 and 6 h after lunchtime in order to keep the degree of hunger almost constant among the subjects. The results clearly demonstrated that there was a marked individual difference in the number of chewing strokes. The subject with the largest number of chewing strokes achieved nine times more of the masticatory movement in comparison with the subject with the smallest number of chewing strokes. Therefore, it was suggested that the number of chewing strokes highly depend on individual differences as we expected.

Variation of the number of chewing strokes As previously mentioned, it has been considered that the number of chewing strokes of same food in an individual is almost constant. However, our results demonstrated that the number of chewing strokes was not constant in all subjects. The rates of the subjects in whom s.d. was ‡5 and CV was ‡0Æ1 were 80 and 70%, respectively. These results may be partly due to the fact that measurement errors resulting from subject’s adaptation to the experimental procedures were reduced by the insertion of dummy measurements between the tests. Correlations of the variation and the number of chewing strokes, sex, physiological factors and personality factors were analysed, but no significant correlation was observed by single variate analysis.
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DETERMINANT FACTORS OF THE NUMBER OF CHEWING
Kawamura and Nobuhara (14) reported that the number of chewing strokes varied with food species but variation did not. Therefore, the similar individual difference in the variation of the number of chewing strokes may also be observed for food species other than gummy candies. the number of chewing strokes on gummy candy. However a recent study showed that significant correlations were not observed between the number of chewing strokes until swallowing and the salivary flow rates (in rest and while chewing test foods and paraffin) (17). Our results concur with this report. The personality survey was performed according to the method described by Eysenck et al. (8). The Maudsley personality inventory developed by Eysenck is well known. In this study a modification of this method which allowed non-professionals to understand their own personality was used. Although the confidence and validity of factors of this method have been confirmed, it does not include any lie scale. However, within the context of this study, where there is not any interest between the investigators and subjects, it was considered that this might not represent a problem, and thus it was selected as the method to evaluate the subject’s personality. In the original method, each type of personality is expressed in points. For statistical analysis it is recommended to perform modifications of the points obtained, because rating for each factor varies with types. In this study, each type was converted into two factors, which were two-valued variables.

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Factors examined for their relation to the number of chewing strokes The number of teeth, tooth position, or malocclusion was not taken into consideration in this study. The reason for this is the difficulty in quantitatively assessing the severity of malposition and/or infraversion. The number of functional teeth is reflected on the area and points which contact when the teeth occlude. Within the context of this study, measurements of the occlusal contact area and the number of occlusal contact points were considered to be sufficient. With regard to the methods for the evaluation of physiological factors, not only those used in the present study, but also other methods have been reported. Hatch et al. (15) reported that occlusal force and functional tooth units (defined as pairs of occluding natural, restored or fixed prosthetic postcanine teeth; molars ¼ 2 units, bicuspids ¼ 1 unit) had strong effects on the determination of masticatory performance in dentulous adults. Also, we chose chewing gum for determining the variables related to mandibular movements, because it has an average constant bolus height and physical properties in contrast to test food that can be crushed into small pieces, which not only affect the masticatory progress but also its properties change. However, chewing gum is a test food that is hardly affected by saliva and has different properties than the gummy candy used to measure the number of chewing strokes. This might lead to some difference in the assessment of the correlation between the number of chewing strokes and the variables related to mandibular movements. As saliva plays an important role in the formation of bolus (16), the flow rate and viscosity of saliva were also investigated in this study. Saliva is not almost absorbed into the gummy candy used in this study. It is known that the number of chewing strokes is also influenced by the type of food to be chewed. Then the number of chewing strokes when masticate foods like cookies (which are greatly influenced by saliva) or carrots (are not influenced by saliva), may differ from
ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 85–93

Factors affecting the number of chewing strokes For the following three factors: opening and closing time, casualness and self-esteem very weak correlations to the number of chewing strokes before last swallowing were found. Also, based on the results obtained through the application of another analysis test, there was found a significant correlation between the mastication of gummy and the mastication of chewing gum in all the factors of masticatory movements (lateral width and vertical distance of chewing loop, angle of opening and closing path, opening and closing time and occlusal time). The opening and closing time in an individual is thought to be determined by the central pattern generator. Thus, based on this fact, we consider that the swallowing central pattern generator, which controls the ingestion behaviour (licking, sucking, mastication), speech, respiration, protective reflexes (emesis, coughing) (18), might also control the cease of mastication and the preparation for swallow. In other words, the swallowing central pattern generator might possibly control the number of chewing strokes. Our results also demonstrated that there was no correlation

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between masticatory performance and the number of chewing strokes, which agree with past studies (4, 5). In the present study, we used the same method explained by Yurkstas (4) which consists in using a single sieve to measure the masticatory performance. Nevertheless, instead of using a single sieve for determining an undersize of small particles, as we did in this study, using multiple sieves for determining median particle size would be a more accurate method to measure the masticatory performance (19). This might lead to an error in the correlation between the number of chewing strokes and the masticatory performance. This study indicates that there is not a specific factor which strongly determines the number of chewing strokes. In the stepwise method, the predictive formula by the combination of the physiological factors and sex (Equation 1) was less applicable, in comparison with the predictive formula by the combination of the personality factors and sex (Equation 2). The predictive formula by the combination of both physiological and personality factors and sex (Equation 3) was found to be the most applicable to predict the number of chewing strokes in young adults. These results suggest that the determination of the number of chewing strokes is not explained solely by physiological factors, although their relation to the number of chewing strokes has been extensively studied to date. In this study, we focused on personality as a candidate for the determinant of the number of chewing strokes among various factors other than physiological ones. We showed that several personality factors are involved in determination of the number of chewing strokes, although the underlying mechanisms could not be clarified in this study. We conclude that the number of individual chewing strokes of single gummy candy in dentulous young adults before last swallowing is not determined by a sole, specific physiological factor but is affected by multiple factors including central inhibition and personality. Japan) and Lotte Co., Ltd. (Tokyo, Japan) are also acknowledged for their kind gifts of measurement materials and test foods. This work was supported by the grant from the Promotion and Mutual Aid Corporation for Private School of Japan.

References
1. Hiiemae KM, Palmer JB. Food transport and bolus formation during complete feeding sequences on foods of different initial consistency. Dysphagia. 1999;14:31–42. 2. Kahrilas PJ, Logemann JA, Lin S, Ergun GA. Pharyngeal clearance during swallowing: a combined manometric and videofluoroscopic study. Gastroenterology. 1992;103:128– 136. 3. Palmer JB, Tanaka E, Siebens AA. Motions of the posterior pharyngeal wall in swallowing. Laryngoscope. 1988;98:414– 417. 4. Yurkstas A. Compensation for inadequate mastication. Br Dent J. 1951;20:261–262. 5. Fontijn-Tekamp FA, van der Bilt A, Abbink JH, Bosman F. Swallowing threshold and masticatory performance in dentate adults. Physiol Behav. 2004;83:431–436. 6. Manly RS, Braley LC. Masticatory performance and efficiency. J Dent Res. 1950;29:448–462. 7. Heintze U, Birkhed D, Bjorn H. Secretion rate and buffer effect ¨ of resting and stimulated whole saliva as a function of age and sex. Swed Dent J. 1983;7:227–238. 8. Eysenck HJ, Wilson G. Know your own personality. London, England: Maurice Temple Smith; 1975. 9. Liao FG, Shiozawa K, Yanagisawa K. Effects of changes in the physical property of test foods on the masseteric EMG, grindinability of foods and the number of chewing strokes. Tsurumi Univ Dent J. 1990;16:407–413. 10. Shiozawa K, Yanagisawa K, Yoshino S et al. Effect of physical property changes of the chewing materials on the masseter muscle activity and the number of chewing strokes. Tsurumi Univ Dent J. 1990;16:63–69, in Japanese. 11. Shiozawa K, Sakanishi K, Yanagisawa K. Effect of food size on the number of chewing strokes until swallowing. Journal of Japanese Society for Mastication Science and Health Promotion. 1991;1:39–44, in Japanese. 12. Shiozawa K, Yanagisawa K, Yoshino S et al. Influence of taste and physical property of the chewing materials on the amount of masseteric activities and the number of chewing strokes until swallowing. Tsurumi Univ Dent J. 1991;17:301–311, in Japanese. 13. Jiffry MT, Molligoda A. Development of the swallowable composition of food in normal dentate subject. J Oral Rehabil. 1983;10:415–420. 14. Kawamura Y, Nobuhara M. Studies on masticatory function. II The swallowing threshold of persons with normal occlusion and malocclusion. Med J Osaka Univ. 1957;8:241–246. 15. Hatch JP, Shinkai RSA, Sakai S, Rugh JD, Paunovich ED. Determinants of masticatory performance in dentate adults. Arch Oral Biol. 2001;46:641–648.

Acknowledgments
We are grateful to the subjects for their kind cooperation in this study. We also thank Dr Mutsumi Takagiwa (Associate Professor, Mathematics Laboratory, Tokyo Dental College) for his instruction of statistical analysis, and Department of Oral Medicine (Tokyo Dental College) for allowing us to use their viscometer. Shofu Inc. (Kyoto, Japan), Lion Dental Products Co., Ltd. (Tokyo,

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16. Prinz JF, Lucas PW. An optimization model for mastication and swallowing in mammals. Proc R Soc Lond B Biol Sci. 1997;264:1715–1721. 17. Gaviao MB, Engelen L, van der Bilt A. Chewing behavior and salivary secretion. Eur J Oral Sci. 2004;112:19–24. 18. Jean A. Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiol Rev. 2001;81:929– 969. 19. van der Bilt A, Fontijn-Tekamp FA. Comparison of single and multiple sieve methods for the determination of masticatory performance. Arch Oral Biol. 2004;49:193–198.
Correspondence: Dr Takayuki Ueda, Department of Complete Denture Prosthodontics, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba city, Chiba, 261-8502, Japan. E-mail: uedat@tdc.ac.jp

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