Oral health status of Kiribati pregnant women

Prenatal dental examinations were performed from June 2012 to May 2013 in the Republic of Kiribati as a Japan International Cooperation Agency support program. We analyzed the examination data and compared it with Japanese data retrospectively to clarify the oral health condition of pregnant women in the Republic of Kiribati. We recorded the DMF index, gingival status, and calculus attachment, analyzed data of 512 pregnant women. We also compared the city and the rural group data. The average number of present teeth, decayed teeth, missing teeth and filled teeth was 26.9, 2.5, 1.1, 0.2, respectively. Pregnant Kiribati women had significantly more decayed teeth and fewer filled teeth, more severe periodontal condition, more calculus deposition, and more severe gingival swelling than pregnant Japanese women. No significant difference was found in missing and filled teeth, but pregnant women in the city group had significantly more decayed teeth and tooth stumps than those in the rural group. Our findings indicate that pregnant women in Kiribati have more decayed teeth, more missing teeth, fewer filled teeth, and more severe periodontal problems than their counterparts in Japan. Additionally, the oral health status of pregnant women in Kiribati could be subject to regional variations

チョウコウレイ シャカイ ニオケル シカ ト コウクウ ホケン : ソノ イギ ト ショウライ テンボウ

According of a white paper on aging society in 2011, elderly population was almost 30 million and population aging rate was 23.1% on October 1st, 2010 in Japan. Thus Japan has become ultra-aged society. Year by year, number of dependent elderly is increasing and especially light level one is much more. Consequently public nursing care insurance system has been changed in 2006 to focus on care prevention with main six items; impairment of locomotor system, oral function and nutrition, and prevention of social withdrawal, dementia, and depression. Oral health promotion for elderly must be needed in such the ultra-aged society. In this article, significance and vision about rehabilitation of oral function is considered and mentioned with Japanese social situation, elderly quality of life, dysphagia rehabilitation, brain activities during oral function, cooperation activity between dentistry and nutrition. Finally the followings would be emphasized as consideration; 1. Education of dental hygienists is significant in the ultra-aged society, because they are specialists of maintaining and supporting oral health and function of elderly. 2. Significance of oral health promotion, including rehabilitation of oral function for elderly, and importance of dental hygienists should be spreaded socially and generally. 3. Doing field research and clinical one using an area characteristic of Tokushima would benefit the Japanese society, not only medical field but also welfare one. 4. Making connection and coordination with administrative organ could be one of important strategies to perform the foregoing. 5. Making a model plan with connection of oral health promotion and welfare projects and then sending information about the model widely could benefit Japanese ultra-aged society

Molecular analysis for bacterial contamination

Bacterial contamination in dental unit waterlines (DUWLs) was evaluated by molecular techniques in addition to the conventional culture method. Water samples (n=8) from DUWLs were investigated for heterotrophic bacteria by culture method using R2A agar. The selected bacterial antibiotic-resistance genes and Legionella species-specific 16SrDNA were identified by PCR. The profiles of bacterial contamination in DUWLs were further identified by PCR-DGGE. In this study, no antibiotic-resistant or Legionella genes were detected. Polycyclic aromatic hydrocarbon-degrading bacterium, Novosphingobium sp. was the most prevalent in DUWLs. Conventional PCR and PCR-DGGE were shown to be potentially useful for monitoring of bacterial contamination in DUWLs

超音波断層法を用いた嚥下運動評価法

The aim of this study is to develop an index to assess swallowing function by ultrasonography in order to evaluate the relationship between movements of the hyoid bone and the larynx while swallowing water. Forty-two younger participants (mean age, 20.3 ± 3.4 years) and 42 older participants (mean age, 75.1 ± 10.6 years) with normal swallowing function were included in the study. Movements of the hyoid bone and the larynx while swallowing 5 mL of water were observed using ultrasonography. Two-dimensional distances from the starting points of the hyoid bone and the larynx to their points of maximum movement were measured as displacements. The hyoid bone–laryngeal motion ratio was defined as the hyoid bone displacement divided by the laryngeal displacement. Parameters were compared among four groups: younger male, younger female, older male, and older female. The hyoid bone displacement differed significantly between the younger and older groups, and the laryngeal displacement differed significantly between age groups and sexes. The hyoid bone–laryngeal motion ratio was not significantly correlated with age, height, or body weight, and did not show a significant difference between the four groups. Thus, the hyoid bone–laryngeal motion ratio is an index that evaluates swallowing movement and is independent of physique and physiological changes associated with aging

Bacterial-contamination Monitoring

Bacterial contamination of dental unit waterlines (DUWLs) was evaluated by using ATP-bioluminescence analysis and conventional culture method. Water samples (n=44) from DUWLs were investigated for heterotrophic bacteria by culture on R2A agar, which ranged from 1.4×103 to 2.7×105 CFU/mL. The ATP-bioluminescence results for DUWL samples were ranged from 6 to 1189 RLU and obtained within one minutes. These results were well correlated with the culture results (r=0.727-0.855). We conclude that differences in the bacterial contamination of each water supply were confirmed by the ATP-bioluminescence assay. This method would be potentially useful for rapid and simple monitoring of DUWL bacterial contamination

Use of ATP bioluminescence to survey the spread of aerosol and splatter during dental treatment

Aerosol and splatter produced during dental treatment (ultrasonic scaling and professional mechanical tooth cleaning) are potential sources of infection. Contamination patterns on the operators’ masks, goggles, chests and gowned right arms, and on the patients’ goggles, before and after dental treatment were investigated by using ATP bioluminescence analysis. Contamination on every surface tested increased significantly after dental treatment. Maximum contamination was found on patients’ goggles. Aerosol and splatter produced during dental treatment thus have the potential to spread infection to operators and patients. ATP bioluminescence is a useful tool for monitoring surface contamination

Predictors associated with poor outcomes

This study aimed to determine predictive factors associated with poor outcomes among older adult inpatients in the convalescent rehabilitation ward. We also examined the validity of factors that were identified as predictive of poor outcomes. Study subjects were 104 older adult inpatients in the convalescent rehabilitation ward, divided into two groups based on outcome at discharge. Group I included the outcomes of death or transfer to an acute care hospital and Group II included all other outcomes. Data were retrospectively collected from older adults’ medical records, including: activities of daily living, swallowing grade, nutritional index, and blood biochemistry data. Logistic regression analysis was used to extract predictive factors associated with poor outcomes. Next, we calculated the Stratum-specific likelihood ratio (SSLR) for each extracted factor. Two items were extracted as predictive factors with AUCs ≥ 0.7 : N-terminal pro-brain natriuretic peptide (NT-proBNP) and days from onset to hospitalization. The SSLRs showed the risk for a poor outcome increased when NT-proBNP was ≥ 2500 pg / ml, and when there were ≥ 35 days from onset to hospitalization. Our findings suggest these predictive factors provide a valid index to predict poor outcomes among older adults from the early stage of admission

日本の若年女性における一口量と咀嚼回数の関係

Objective: Modification of eating behavior in Japan is promoted to prevent overweight and obesity, but the effects of such modifications are unclear. This study aimed to clarify the inter- and intra-individual relationship between bite size and number of chews of food. Design and methods: Subjects comprised 50 young healthy Japanese women(mean age 19.5 years).Food materials were boiled rice and apple. First, the average bite size and the number of chews per mouthful of food were calculated across the study cohort. The number of chews was counted by subject’s own self and self-reported. Correlation between the individual one-bite volume and the number of chews per volume was analyzed using Spearman’s rank correlation coefficient. Second, the number of chews for three different sized bites of food (half of one bite, one bite, and one-and-a-half bites) were calculated as a prospective observational study. The number of chews for each of the three volumes of food was compared using one way ANOVA with Bonferroni correction. Results: For both food types, there was a negative correlation between individual mouthful volume and number of chews for both food materials. The number of chews per volume decreased as bite sizes increased. Conclusion: This study demonstrated an inter-and intra-individual relationship between bite size and the number of chews and suggested smaller bite sizes were associated with more chews per volume of food

Effect of Oral Functional Training on Changes in Resting Saliva Secretion in Older Hemodialysis Patients

高齢血液透析患者の口腔乾燥には，日常的な水分摂取の制限と唾液腺自体の加齢性変化が関係していると考えられる．高齢血液透析患者の口腔乾燥改善には，まず十分な安静時唾液の分泌が必要と考え，それを促す手法の一つとして口腔機能訓練に着目した．本研究は，高齢血液透析患者に対して継続的な口腔機能訓練を行い，安静時唾液量の変化から訓練の効果を検証することを目的とした． 研究参加の同意が得られた軽度以上の口腔乾燥を有する高齢血液透析患者を，無作為に2群に分けた．歯科衛生士による口腔機能訓練（唾液腺マッサージ，舌運動訓練）を透析中（週3回）に12週間行った群を介入群，行わなかった群を対照群とした．研究開始前，2週後，4週後，8週後および12週後に，口腔内湿潤度と安静時唾液量を測定した．研究を完了した54名（介入群28名，対照群26名）について，群内および群間の比較には二元配置分散分析を，計測回ごとの多重比較にはBonfferoni法を用いて，統計解析を行った． 口腔機能訓練の実施による変化を検証した結果，口腔内湿潤度は，介入群の主効果および対照群との交互作用も有意であった（F（1,52）＝22.3，p＝0.03，F（4）＝3.5，p＝0.008）．群内の多重比較の結果，介入群は研究開始時と比較して，4週後以降で有意差が認められた（p＜0.05，p＜0.001，p＜0.05）が，対照群は有意差が認められなかった．安静時唾液は，介入群の主効果および対照群との交互作用も有意（F（1,52）＝18.6，p＜0.001，F（3）＝5.3，p＝0.002）であった．群内の多重比較の結果，介入群において，研究開始前と比較して4週後以降（p＜0.05，p＜0.001，p＜0.001）に有意な増加が認められた．一方，対照群において，2週後と12週後，4週後と12週後に有意な増加が認められた（p＜0.05，p＜0.05）．以上より，高齢血液透析患者に対する長期間（4週間以上）の唾液腺マッサージや舌運動訓練による口腔機能訓練は，安静時唾液分泌量を増加させる可能性が示唆された．Introduction:　Daily fluid restriction and aging-related atrophy of saliva glands might cause dry mouth in older hemodialysis patients. We hypothesized that greater saliva secretion is needed to relieve dry mouth and that this could be achieved by providing oral functional training to patients. The aim of this study was to investigate changes in resting saliva secretion after performing oral functional training for older hemodialysis patients with mild dry mouth. Materials and Methods:　Hemodialysis patients with mild dry mouth at Kawashima Hospital gave informed consent to participate in the study. They were then randomly divided into an intervention group (n＝31) and a control group (n＝30). The intervention group was provided oral functional training by a dental hygienist, including saliva gland massage for 30 s and tongue lateral movement for 12 weeks during dialysis treatment. The control group did not receive the training. Overall, 54 participants completed the experiment. Oral wetness was measured using a KISO-WeT Tester, and the amount of resting saliva secreted in 30 s was collected in a cotton roll and weighed. Measurements were implemented at baseline and at 2, 4, 8, and 12 weeks after starting the regimen. Results and Discussion:　In the intervention group, oral wetness at 4, 8, and 12 weeks was significantly higher than that at baseline (p＜0.05, p＜0.001, p＜0.05, respectively). No statistically significant differences were found in the control group. In the intervention group, the amounts of saliva secreted at 4, 8, and 12 weeks were significantly greater than that at baseline (p＜0.05, p＜0.001, p＜0.001, respectively). In the control group, the amount of saliva secreted at 12 weeks was significantly more than that at 2 and 4 weeks (p＜0.05, p＜0.05, respectively). Conclusion:　We concluded that performing oral functional training, which included salivary gland massage and tongue movement training for 4 or more weeks, could increase the amount of resting saliva secretion in older hemodialysis patients with mild dry mouth

ダウン症候群児の咀嚼機能獲得に関連する要因の検討

Down syndrome (DS) has the highest prevalence of any chromosomal abnormality identified in newborns. DS children have specific eating and swallowing difficulties such as poor tongue control, mouth opening, swallowing food without chewing, and both facial and occlusal abnormalities. DS children are also at high risk of aspiration, and swallowing food without chewing is considered to be a factor associated with increased risk of aspiration and eating problems. This study aimed to identify factors preventing the acquisition of masticatory function in DS children. The subjects were 75 outpatient DS children (44 males, age range 12 to 36 month-old, mean age 33.0 ± 7.0 month­-old; 31 females, age 12 to 36 month-old, mean age 20.8 ± 8.0 month-old), who had not yet acquired masticatory function, out of 319 who visited the clinic between October 2012 and October 2017. The information necessary for assessment was retrospectively extracted from the medical records of the subjects. The items examined included age, birth weight, nutritional intake, picky eating, tactile hyperesthesia, cognitive development assessed by Ohta stage, gross motor function, occlusal condition by Hellman's dental age, and tongue thrust/lip closure/mastication while eating. The relationships between the acquisition of masticatory function and these items were investigated after one year of rehabilitation. The revealed age, low birth weight, picky eating, and gross motor function to be relevant factors. Among these, gross motor function was found to be the factor most strongly associated with acquisition of masticatory function