Improved physical performance was not observed for the entire study population following dental

treatment; however, times for one-leg standing with eyes open increased significantly in subjects with improved masticatory ability in a intervention study for community-dwelling Protease Inhibitor Library screening older adults [43]. Therefore, it is possible that dental treatment to maintain occlusal contact, good masticatory ability, and functional occlusion may contribute to maintaining balance and further prevent incident falls or accidents in older adults. The important findings from those studies are concisely shown in Fig. 2. A number of cross-sectional studies have shown relationships among functioning in ADL, higher-level functional capacity, and masticatory ability. Perceived chewing ability AZD6244 clinical trial was positively associated with independence level (evaluated as independent, home-bound, or bedridden) and total Tokyo Metropolitan Institute of Gerontology (TMIG) index scores [44]. Logistic regression analysis revealed that functional dependency was 7.5 times more prevalent in individuals capable of chewing four or fewer foods, and 3.3 times more prevalent in those chewing five to nine foods

than in those able to chew all 15 items, suggesting that chewing ability may be independently related to functional status in 80-year-olds [45]. High-level functional capacity including intellectual activity and social role in middle-old elderly individuals was associated with the ability to chew hard foods [46]. Significant differences were found in the total score and sub-scores of intellectual activity and social role on the TMIG index among the three groups of self-assessed masticatory ability [47]. Multivariate logistic regression analysis showed that severely impaired masticatory ability (the ability to chew only soft and pureed food) was significantly related to a loss of three or more points from the total score, and the loss of one point or more for intellectual

activity and social role after adjustment for age, gender, household, educational background, and medical condition [47]. Therefore, masticatory ability may be a significant indicator of functional capacity, i.e. basic ADL and high-level functional capacity, especially intellectual activity and social Oxymatrine role. The relationship between masticatory ability and functioning in basic ADL could be explained by a possible mechanism through which masticatory ability positively influences physical performance. Regarding the relationship between masticatory ability and high-level functional capacity (i.e. intellectual activity and social role), it is possible that dental health behaviours may contribute to maintaining good oral health and the resulting good masticatory ability, and higher-level functional capacity may be an accurate indicator of dental health behaviours in community-dwelling older adults [48].