Journal of Oral Rehabilitation 2006 33; 27

Chewing-side determination of three food textures

J. PAPHANGKORAKIT*, N. THOTHONGKAM & N. SUPANONT

*Department of Oral Biology,

Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand, Faculty of Dentistry, Naresuan University, Pitsanulok, Thailand and

HRH Princess Maha Chakri Sirindhorn Medical Centre, Nakorn Nayok, Thailand

SUMMARY Food texture affects chewing movement

but it is not known if it also affects the chewing-side
pattern. This study determined the chewing sides of
three test foods with different textures during
habitual chewing. Twenty healthy dental students
(aged 2024 years) chewed pieces of pork jerky,
fresh asparagus and almonds on two separate sessions (1 week apart). In each session, each subject
chewed 30 food specimens, 10 of the same food type,
until swallowing while a video camera recorded the
displacement of the chin with respect to the other
two reference points vertically marked along the
facial midline. A slow-speed video playback was
used to identify the chewing side of each cycle. The
chewing-side pattern (right preference, left preference, no preference) in each individual was determined statistically. The results showed that overall,
11 subjects did not have any side preference whereas

Introduction
Normal chewing is characterized by unilateral cycles
with periodic alternation of food between both sides of
the dentition although less unilateral cycles are
observed with homogenous and soft foods. Once the
food attains the consistency, homogeneity and cohesiveness ready to be swallowed, bilateral cycles can
occur (1, 2). The study of chewing-side pattern is useful
in understanding the neural control of chewing and the
design of dentures. Previous studies have shown that
most normal persons chew more on either the right or
left side, the so-called preferred chewing side (35).
What determines the side preferably used during
chewing is not known. Studies have shown that the
preferred chewing side is not related to handedness
(6, 7) and not associated with the area of tooth contact
2006 Blackwell Publishing Ltd

six and three subjects preferred to chew on right or

left sides respectively. The chewing-side pattern
remained unchanged between three food types in
about half of the subjects. When the same food was
compared between 2 days, the chewing-side pattern
of almonds was shown to be most reproducible (18
subjects). Unidentified cycles with little or no lateral
displacement, labelled as bilateral, were observed
more frequently near the end of the chewing
sequence with more occurrences in almonds and
jerky than asparagus (P < 001). It was suggested that
chewing-side preference is not a fixed characteristic.
Food texture seemed to influence the side preference and also the occurrence of bilateral cycles.
KEYWORDS: preferred chewing side, food texture,
chewing pattern, jaw movement, mastication
Accepted for publication 3 May 2005

(8) or the chewing efficiency on that side (9). However,

Bourdiol and Mioche (10) found that the number of
cycles used during side-imposed chewing sequences of
frankfurters, cheese and toffee was less on the side with
larger occlusal contact area. Hannam et al. (11) suggested that the preferred chewing side was related to the
ability to move the jaw laterally towards that side. The
above variations could be due to the methods used to
verify the preferred chewing side. In some studies, the
chewing side was observed visually (6) while in others
more sophisticated tracking devices were used (5, 8,
12). The preferred chewing side was usually determined simply by the percentage of right- or left-side
chewing cycles without any statistical analysis except in
the study of Wilding and Lewin (4). Moreover, the
texture of test food also varies. Bread and toffee (3),
meat (5), gum (6), and wine-gums (4) have all been

CHEWING-SIDE DETERMINATION OF THREE FOOD TEXTURES

used in previous studies. The texture of food can alter
some components of chewing cycle (2, 1315) and
perhaps influence the preferred chewing side. The
present study was aimed to test if an individuals
chewing-side pattern was affected by food texture and
if it differed between days.

Materials and methods

Experimental procedure
The study was approved by the Khon Kaen University
Ethical Committee. Twenty dental students, aged
2024 years, having given informed consent, participated in this study. All subjects had normal masticatory
function with angle class I molar relationship and had
28 natural teeth (excluding third molars). The maximum lateral jaw excursion measured at the midmandibular central incisors in each individual did not
show any apparent difference between right and left
sides. On the first day (day 1), each subject was asked to
chew three test foods, being pork jerky (1 cm long)*,
fresh asparagus (1 cm long selected from the middle
part of the stalk) and almond (approximately 2 cm
long, Blue Diamond) representing tough, soft ductile
and brittle food respectively. As the physical properties
of test foods could be variable, the same foods used in
subjects were tested separately for their ultimate
strength and modulus of elasticity using a universal
testing machine with a head speed of 5 mm min)1 as
follows. For almond, the whole seed was placed
horizontally and compressed between two metal plates.
For asparagus, a piece of 1 cm length selected from the
middle part, was placed horizontally and tested under
compression. For pork jerky, a 4-cm-long specimen was
cut with an orientation similar to that inserted into the
mouth and tested under tension (it was difficult to
recognize the orientation of muscle fibres in order to
test separately the specimens cut parallel and perpendicular to the fibre orientation). Ten specimens of each
food were tested on two different days (7 days apart).
All foods tested were stored in the same way as in the
experimental sessions; almonds and jerky were kept in
a sealed container stored at room temperature whereas
the asparagus was newly bought from the supermarket
*Naem Lub Lae, Khon Kaen, Thailand.

Heritage Snacks and Beverages, Nakorn Pathom, Thailand.

Lloyd, Lloyd Instruments, Hants, UK.

2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 27

(fresh supplies daily), wrapped in plastic and stored at

4
C not more than 2 days before use. During each
chewing session, subjects were seated upright in a
comfortable chair with a headrest and eyes aiming
horizontally while chewing the test food habitually
until they decided to swallow. In random order,
10 pieces of each of the three foods were given to each
subject, thus making a total of 30 food samples (trials)
being tested on each day. All subjects returned for the
second session 7 days later (day 2) and the entire series
was repeated. The technique used to observe the
chewing side is described as follows. Three pencilled
dots were marked on the subjects facial skin, one at the
tip of the nose, one just below the center of the lower
lip and one on the chin. Subjects were asked to move
their head as little as they could during the recording
session so that the three marked dots were aligned
vertically during each chewing trial. A video camera
(Panasonic NV-VX3) was placed 1 m in front of the
subject and the picture zoomed in to cover the tip of the
nose and mouth region. The recorded tapes were played
off-line by another investigator using a slow-speed
playback mode of a video cassette player (Panasonic
NV-SR98) to determine the chewing side of each cycle.
A clear plastic ruler was placed over the subjects midfacial line on the television screen to help distinguish
the path of chin movement. Using this method, most
cycles could be identified as right (R) or left (L) cycles.
Some of the cycles, however, could not be clearly
identified (U) because of indistinguishable transverse
movement. The validity of this visual method in
correctly identifying the right and left cycles was tested
by having three subjects chewing gum according to
any of four different preset sequences (12 cycles per
sequence). Ten chewing sequences (60 right and 60 left
cycles) were tested in total and the cycles were
identified by the same person as in the actual experiments. The cross-tab analysis revealed agreement
cofficients (kappa) ranging from 070 to 083.

Data analysis
The number of right and left cycles was expressed as a
percentage of the total cycle number, i.e. %R and %L
respectively. On each day, the chewing-side pattern of
a given subject chewing a given test food was determined by statistically comparing the %R and %L with

Matsushita Industrial, Osaka, Japan.

J . P A P H A N G K O R A K I T et al.
MannWhitney tests (n 10 trials for each food).
A given subject was considered to have a right
chewing-side preference if %R was significantly
(P < 005) greater than %L or a left side preference if
%L was significantly (P < 005) greater than %R. Those
who did not show any side difference were classified as
no side preference. The percentage of the unidentified
(%U) cycles was not included in the comparison. Their
values were smaller than %R or %L and their inclusion
would not have affected the determination of side
pattern. In order to further investigate the nature of the
unidentified cycles, the percentage of such cycles was
calculated for each food type during the early, middle
and late (one-third) periods of the chewing sequence.
The differences in the number of unidentified cycles for
each period and food type were tested with two-way
ANOVA.

Results
The ultimate strength and the modulus of elasticity of
the test foods are shown in Table 1. The moduli of
elasticity were significantly different for the three food
types, with pork jerky being the greatest, followed by
almond and asparagus (P < 001). The ultimate
strength, however, was greatest in almonds. There
was no significant difference in both properties of the
same food type on two different days. All subjects used
both sides to chew test foods and none of the subjects
chewed exclusively unilaterally. The numbers of cycles
until swallowing (mean
SD) in chewing pork jerky,
asparagus and almonds were 198
64, 109
37 and
151
48 respectively and they were significantly
different (one-way ANOVA; P < 0001). When the cycles
Table 1. Mechanical properties (mean
SD) of food samples
(n 10 in each cell)
Day 1
Modulus of
elasticity
(MPa)

Day 2
Ultimate
strength
(MPa)

Modulus of
elasticity
(MPa)

Ultimate
strength
(MPa)

Almond
157
39
08
04
153
76
09
05
Pork jerky 231
100 040
016 204
104 043
019
Asparagus
11
02
03
01
13
04
03
004
Modulus of elasticity was calculated from the slope of the initial
linear part of the stressstrain curve. Ultimate strength was
determined by the highest stress at which pork jerky and almonds
were broken apart and fresh asparagus yielded under force.

Table 2. Side preference determination for each subject from two

sessions of 30 trials
Subject

%R

%L

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

324
406
393
337
372
639
425
462
381
593
389
508
392
505
465
433
430
389
703
489

357
375
443
437
384
155
448
409
430
291
473
440
478
347
392
286
413
500
121
449

Side preference*

L
R

R
R
L
R
R
L
R

088
006
088
(0001)
094
(0001)
066
023
024
(0001)
032
(002)
(003)
(0001)
042
(0001)
076
(002)
(0001)
044

%R and %L represent the percentage of cycles with side

displacement to the right and left respectively (from 60 trials).
*A given subject was considered to be predominantly right sided if
%R was significantly (P < 005) greater than %L or left sided if %L
was significantly (P < 005) greater than %R. Unidentified or
presumed bilateral cycles were not taken into account (see Data
Analysis). The numbers in brackets are P-values obtained from
independent t-tests.

from all 60 trials were pooled, about half of the subjects

(11 subjects) did not reveal a preferred chewing side,
whereas six subjects preferred to chew on the right and
three on the left (Table 2).
Table 3 summarizes significance values for side preference in all trials for each day. Eleven of 20 subjects on
day 1 and 10 of 20 subjects on day 2 changed their
chewing-side pattern for different food types. When
compared between 2 days, it was found that only seven
subjects consistently chewed the same food with the
same side pattern (1, 4, 6, 8, 11, 16, 19). The chewingside pattern was most reproducible with almonds (18
subjects, excluding 5, 20), asparagus (12 subjects,
excluding 2, 7, 10, 12, 13, 14, 15, 17) and least
reproducible with pork jerky (11 subjects, excluding 2,
3, 7, 9, 10, 13, 15, 17, 18). Six subjects (2, 7, 10, 13, 15,
17) changed their chewing-side pattern for both pork
jerky and asparagus on the second day.
Only four subjects (subjects 4, 6, 10, 19) consistently
showed a right- or left-side preference. 14 subjects did
2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 27

CHEWING-SIDE DETERMINATION OF THREE FOOD TEXTURES

Table 3. Chewing-side determination established during each session
(days 1 and 2), with three different
test foods

Day 1
Subject
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Jerky
006
R(0.005)
L(0.02)
006
022
R(0001)
L(0.03)
091
L(004)
04
022
012
08
R(001)
R(005)
007
R(003)
007
R(0001)
04

Day 2
Asparagus

Almond

Jerky

019
R(001)
058
025
091
R(0001)
058
068
097
R(0002)
053
053
068
058
R(002)
R(001)
R(002)
044
R(005)
028

01
006
09
L(0001)
024
R(0001)
097
035
007
R(0001)
025
008
065
006
012
006
064
007
R(0001)
R(001)

015
L(0001)
091
097
04
R(0001)
065
034
032
R(0002)
072
008
L(002)
R(001)
011
006
067
L(0001)
R(0001)
042

Asparagus

Almond

076
L(002)
018
076
073
R(0001)
R(003)
028
044
L(0001)
035
R(003)
L(002)
R(001)
006
R(003)
094
044
R(0001)
049

059
072
09
L(0003)
L(001)
R(0001)
006
049
009
R(0001)
064
01
056
1
058
006
02
093
R(0001)
073

P-values for chewing-side preference obtained from MannWhitney tests are indicated for each
subject.
R right side preference; L left side preference; No label no side preference.

Table 4. Percentages (mean
SD)

of the unidentified cycles during
early, middle, and late periods of a
chewing sequence for each test food
(n 200 sequences in each cell)

Day 1

Jerky
Almond
Asparagus

Day 2

Early

Middle

Late

Early

Middle

Late

60
106
48
85
40
81

84
119
77
101
73
103

128
145
122
122
88
87

24
65
20
59
15
62

51
103
46
88
32
69

95
124
94
120
51
77

Each period is obtained by dividing the chewing sequence into three equal intervals. Percentages
of unidentified cycles seen during late periods were, in general, higher than middle periods and
both were significantly higher than during early periods (P < 001). The percentages seen with
asparagus were always significantly lower than those with jerky and almond (P < 001).

not show a side preference when chewing almonds

(1, 2, 3, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18) whereas
with pork jerky and asparagus, more subjects showed a
side preference (subjects 2, 3, 6, 7, 9, 10, 12, 13, 14, 15,
16, 17, 18, 19), although with less consistency. The
percentages of unidentified cycles during early, middle
and late periods of the chewing sequence are shown in
Table 4. The percentage was increasingly larger during
the middle and late periods of the sequences (P < 001).
When compared between food types, the occurrence of
such cycles was significantly least with asparagus
(P < 001). The results were not appreciably different
between days 1 and 2.
2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 27

Discussion
Although the method used to observe the chewing side
in this study was based on visual inspection, it showed a
fairly acceptable validity and had the advantage that it
did not use an intra-oral device that might interfere
with subjects natural jaw movements. The camera
might make subjects uneasy but its possible effect on
chewing behaviour was minimized by randomizing the
test foods. Movement of the chin as observed in this
study has been shown to correlate with that obtained
from a jaw-tracking device but provides a larger value
of lateral displacement (12) and this was in agreement

J . P A P H A N G K O R A K I T et al.
with the present study. About the same number of our
subjects did or did not have a preferred chewing side.
This did not conform with some previous studies which
showed side preference in most subjects (46,16). The
difference could be due to the observation method,
number of trials, types of test food and the method used
in analysing the preferred chewing side. The determination of the preferred chewing side in this study was
similar to that used by Wilding and Lewin (4). They,
however, found that most subjects had a preferred
chewing side. The results of the present study suggest
that chewing-side preference is not a fixed characteristic, especially when food texture or recording session
is different. More subjects (seven to nine subjects) had a
preferred chewing side when chewing tough jerky
compared to hard almonds (five subjects). Cutting
(grinding) tough food (like jerky) might require a more
comfortable chewing side whereas breaking almonds
might be indifferent between both sides of the jaw,
resulting in more frequent chewing-side alternation.
Interestingly, seven to nine subjects also showed a side
preference when chewing fresh asparagus. Although
tender foods are likely to be chewed indifferently on
either side of the jaw, fresh asparagus might be so
fibrous that it needed to be chewed on the preferred
side. Toughness of foods, therefore, might help explain
the choice of chewing side. Wilding and Lewin (4)
noticed a similarity of the chewing-side pattern
between two recording sessions in their subjects chewing wine-gums. In the present study, almonds showed
the most reproducible chewing-side pattern (18 of
20 subjects), compared with asparagus and jerky. This
was probably because of the more regular texture of
wine-gums and almonds although the strength and
elasticity of pork jerky and asparagus tested on 2 days
was not significantly different. It was also possible that
the breakage of brittle foods like almonds might be
easily reproduced whereas that of jerky and asparagus
was less predictable. The unidentified cycles have never
been reported in previous preferred chewing-side
studies (46). These cycles could be true bilateral cycles
or those with such small lateral movements that the
current visual method was not able to detect them. This
type of cycle was more often observed during the later
parts of each chewing sequence (Table 4). The explanation could be that as the chewing unfolded, the foods
became softer and more dissociated. Subjects tended
thus to use less lateral movement or even chew
bilaterally. Probably because of its fibrous texture, it

was difficult to break fresh asparagus into pieces before

it could be chewed bilaterally. Dried pork jerky and
almonds, on the contrary, are more brittle and easily
broken into separate pieces, resulting in more bilateral
cycles. Dealing with natural food products, the present
study was limited by the difficulty to standardize the
rheological properties of the test foods, especially fresh
asparagus and pork jerky. Randomization of food
specimens might help to reduce the effect of such
variability. Some physical properties of the food samples were also tested in this study although more
comprehensive tests (such as plasticity and toughness
tests) might give a better picture. In conclusion, the
present study suggested that chewing-side pattern
depended on food texture and could change between
days. The determination of preferred chewing side
using natural foods of different textures, therefore, does
not seem to be a simple task. Among the three food
types tested, almond as brittle food seems to be the best
choice when food comminution (grinding effect) is
evaluated or if chewing-side reproducibility is needed
whereas tough or fibrous food may better reveal the
side preference when the cutting effect is at stake. It
should be added that the cohesiveness of the bolus
could play a role in the resultant side preference since
foods with great cohesion (e.g. fibrous food) are not
easily dissociated and tend to be chewed unilaterally.

Acknowledgments
The authors would like to thank Prof. J. W. Osborn for
reading and giving valuable advice on the original
version of this manuscript and Prof. P. W. Lucas who
advised on food property testing. This study was
supported by the Research Fund of Faculty of Dentistry,
Khon Kaen University.

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Correspondence: Dr Jarin Paphangkorakit, Faculty of Dentistry, Khon

Kaen University, Khon Kaen 40002, Thailand.
E-mail: jarin@kku.ac.th