Normative Data of Healthy Adults on the Test of Masticating and Swallowing Solids (ToMaSS) with Domestic Crackers

Understanding masticatory performance holds significance in diagnosing dysphagia and monitoring outcomes of interventions targeting primarily the oral preparatory phase of swallowing. The Test of Mastication and Swallowing Solids (ToMaSS) is a validated quantitative tool that clinically evaluates mastication and ingestion of solid food. Previous studies established normative values for commercially available crackers across countries. The current study aimed to provide local normative data using commercially available cracker in the healthy Chinese Asian population. 268 participants (21 to 95 years) participated in the normative data acquisition with the Pacific™ Saltine Cracker. ToMaSS parameters (number of bites, number of masticatory cycles, number of swallows, and ingestion time) were measured via review of video recordings. The study reported the normative data of ToMaSS parameters from 247 participants. Statistically significant main effect of age and gender was found, with males exhibiting fewer number of bites (p < .001), fewer masticatory cycles (p = .003), fewer number of swallows (p = .02) and shorter ingestion time (p < .001) than females; and age effect on all parameters (p < .05) except number of swallows. Although statistically significant, posterior functional tooth units (FTU) demonstrated only weak inverse correlations with most ToMaSS parameters except number of swallows, suggesting that reduced posterior occlusal contact may compromise masticatory performance to a small extent. The findings provided insights into the masticatory performance of healthy Chinese Asian population. The normative data could serve as benchmark values in understanding the ingestion behavior of solid food in this population, and in detecting the functional change in swallowing.