# Age-Related Diagnostic Accuracy and Patient Acceptance of Two Chewing Efficiency Tests: An Exploratory Field Study

## TL;DR

This study compared two chewing efficiency tests and found that their accuracy and acceptance vary with age, suggesting age-based test selection could improve dental assessments.

## Contribution

The study explores age-related differences in diagnostic accuracy and patient acceptance of two chewing efficiency tests in clinical and nursing home settings.

## Key findings

- Both tests showed good agreement with the clinical reference standard, with AUC values of 0.72 for MDA and 0.78 for CHEW.
- Age significantly influenced diagnostic outcomes and test acceptance, with younger participants preferring MDA and older participants preferring CHEW.
- Misclassifications were most frequent among participants with complete dentures.

## Abstract

Objectives: This study investigated the impact of age on the diagnostic accuracy and patient acceptance of two chewing efficiency tests: the digital Mini Dental Assessment (MDA) using carrots and the CHEW test by Slavicek using fruit gum, applied in both clinical and nursing home settings. Methods: Seventy participants aged 18 to 99 years from dental clinics and nursing homes were included. All participants received a standardized dental examination (reference standard) and performed the MDA and CHEW tests. Sensitivity, specificity, and AUC values were calculated using ROC analysis. Participants rated both tests in terms of taste, consistency, comprehensibility, required time, and subjective chewing sensation. Acceptance was analyzed across age groups and prosthesis types. Results: Both chewing efficiency tests showed good agreement with the clinical reference standard. The AUC was 0.72 for the MDA and 0.78 for the CHEW test (p = 0.192). Sensitivity was higher for the CHEW test (100%) compared to the MDA (83.3%), while the MDA demonstrated slightly higher specificity (59.6% vs. 55.8%). Age significantly influenced both diagnostic outcomes and test acceptance (p < 0.05). Younger participants (<70 years) were more often correctly classified as healthy and tended to prefer the MDA, whereas older participants (≥70 years) preferred the CHEW test, primarily due to taste. Misclassifications occurred most frequently among participants with complete dentures. Conclusions: Both the digital MDA and the CHEW chewing test demonstrated good diagnostic performance in identifying treatment need. Acceptance varied significantly with age, suggesting that test selection may be optimized based on patient characteristics. These simple and rapid assessments may support early detection of dental treatment needs in clinical and nursing home settings.