Impact of masticatory training on masticatory function: A systematic review and meta-analysis

Abstract

Statement of problem: Abnormal masticatory function has been reported to impact health, but evidence for the efficacy of training is inconsistent, and a systematic review is required.

Purpose: The purpose of this systematic review and meta-analysis was to assess the efficacy of training interventions to enhance masticatory function, including specific protocols and outcomes.

Material and methods: Nine databases (PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, Wanfang, China Science and Technology Database, and China Biomedical Literature Database) were searched from inception to February 2025. Study quality was assessed by using the Cochrane and Joanna Briggs Institute (JBI) evaluation tools. Data were pooled using fixed-effects or random-effects models, with heterogeneity evaluated via the I² statistic.

Results: Of 6750 screened articles, 9 studies were included, covering healthy volunteers, individuals with cognitive impairment, those with oral frailty, and patients after orthognathic surgery. Training methods were categorized as media- or device-based training. Outcome indicators included direct and indirect measures. Meta-analysis showed mastication exercises using chewing gum significantly improved tongue pressure (SMD=2.04, 95% CI [0.63, 3.45], P<.05).

Conclusions: Mastication exercises using chewing gum were the most prevalent method, effectively improving tongue pressure. Mastication exercises using chewing gum and hard media were found unsuitable for edentulous individuals. NoSick Exerciser served as intensive training for healthy people or for patients during recovery from orthognathic surgery. This review also classified masticatory function metrics, guiding clinical tool selection.