Lack of Physician-Dentist Collaboration in Aspiration Pneumonia Prevention

Taiju Miyagami,1 Satoshi Teranaka,2 Yuichiro Mine,1 Tomohiro Matsumoto,3 Yuki Yoshimatsu,4,5 Shinichi Matsumoto,6 Kohei Yamaguchi,7 Toru Morikawa8,9 1Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; 2Department of Physical Medicine and Rehabilitation, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan; 3Division of General Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan; 4Elderly Care, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK; 5Centre for Exercise Activity and Rehabilitation, School of Human Sciences, University of Greenwich, London, UK; 6Yushoukai Home Care Clinic Katsushika, Tokyo, Japan; 7Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan; 8Department of General Medicine, Nara City Hospital, Nara, Japan; 9Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, JapanCorrespondence: Taiju Miyagami, Department of General Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo Bunkyo-Ku, Tokyo, 113-8431, Japan, Tel +81-3-3813-3111, Fax +81-3-5802-1190, Email [email protected]: This opinion paper addresses the challenges and future directions for preventing aspiration pneumonia in Japan’s rapidly aging population. It highlights the increasing proportion of elderly individuals and the associated rise in health issues like decreased swallowing function, a risk factor for aspiration pneumonia. The paper emphasizes the effectiveness of dentist-provided oral care in preventing this condition but notes the lack of collaboration between dentists and physicians in Japan’s clinical practice. Key challenges identified include the scarcity of full-time hospital dentists, insufficient communication between physicians and dentists, limited patient understanding and motivation regarding oral care, and a lack of training in geriatric dentistry. The paper advocates for enhanced awareness among healthcare professionals and patients, increased hospital dentists, and improved collaboration mechanisms, particularly in light of recent positive changes in insurance reimbursement policies for elderly oral care.Keywords: dentist, aging, aspiration pneumonia, oral car

The caries-reducing benefit of fluoride-release from dental restorative materials continues after fluoride-release has ended

OBJECTIVE: This study tested the hypothesis that the benefit of fluoride-releasing restorative materials continues even after their reserve of fluoride has been depleted. MATERIALS AND METHODS: Pits in perspex blocks simulating cavities were filled with either a fluoride-releasing or a non-fluoride-releasing restorative material and a dentin single-section was placed 1 mm from the edge of the filled pit. These combinations were exposed to an acid gel system. Each demineralized dentin section was separated from the adjacent material and immersed in fresh demineralizing solutions. Transversal microradiographs were taken following the two experimental periods. This study defined ΔΔZ as the increase of integrated mineral loss (ΔZ) during the second acid attack. RESULTS: The first acid attack substantially demineralized the near-surface region (depth < 40 μm) in all samples. The second acid attack, however, did not cause further demineralization in this near-surface region. Instead, it demineralized dentin deeper than 40-60 μm. The ΔΔZ of the material that did not release fluoride was significantly greater than that of fluoride-releasing materials. Negative correlations were found between ΔΔZ and the mineral volume% of the near-surface region and lesion body of the initial lesions. These results indicate that the dentin mineral in the near-surface region is chemically altered to become acid-resistant fluorapatite. In addition, lesion progression during the second period of demineralization, which was fluoride-free, may have been affected for the materials that have high mineral content of the surface layer and lesion body. CONCLUSIONS: It is concluded that dentin surrounding fluoride-releasing materials is protected against demineralization even after the fluoride release has diminished

Effect of denture base-resin with prereacted glass-ionomer filler on dentin demineralization

The demineralization of dentin was studied when placed adjacent to one of four experimental denture base-resins. These experimental resins contained polymethylmethacrylate (PMMA) and 0, 5, 10, 20 or 30 wt% surface reaction-type prereacted glass-ionomer (S-PRG) filler, respectively. A dentin thin-section was sandwiched between these resins and subjected to demineralization for 1 wk. Microradiographic analyses showed that the mineral vol% of the surface was increased, and lesion formation was inhibited, in a dose-response relationship with the amount of S-PRG filler. Moreover, the mineral loss decreased, by up to 60%, with an increasing amount of filler. These results indicate that denture base-resins containing S-PRG filler possess a substantial inhibition capability against demineralization, and this may thereby assist in preventing root caries of abutment teeth

Development of millimeter and submillimeter wave catheter transmitting a gyrotron output for irradiation of living bodies

The development of a millimeter and submillimeter wave catheter for irradiation of living bodies using a gyrotron as a radiation power source is described. The GYROTRON FU-IV, optimized for such applications was used in the experiments. It was operated in both cw and pulsed regime at TE03 and TE32 modes with frequences 302 GHz and 238GHz respectively. Irradiation tests were made on paper, beef and liver of living rats

Chemical alteration by tooth bleaching of human salivary proteins that infiltrated subsurface enamel lesions: experimental study with bovine lesion model systems

Salivary macromolecules infiltrate white and brown spot enamel lesions and adsorb onto hydroxyapatite. Calcium-binding salivary proteins such as statherin hinder remineralization of these lesions. We assessed whether bleaching agents can remove salivary components that have infiltrated and bound to experimental subsurface lesions in bovine enamel prepared by immersing specimens in acid and then human saliva. Transversal microradiography showed that such demineralized lesions mimicked incipient carious lesions. Bound proteins to the experimental and untreated control specimens were eluted in a stepwise manner with phosphatebuffered saline, 0.4 M phosphate buffer, and 1 M HCl. SDS-PAGE of dialyzed extracts showed that specific salivary proteins bound to the lesions, while virtually no protein bands were detected if the specimens were bleached. Western blotting showed that even statherin, which was more firmly bound than other proteins, was removed. In-office bleaching agent may be useful in treating enamel lesions for removing proteins bound to these lesions