Does Masticatory Ability Contribute to Nutritional Status in Older Individuals?

Mastication plays a primary role in the process of eating. Hence, compromised masticatory ability may affect the nutrition and quality of life, which are particularly important concerns among older individuals. It remains unclear how is the masticatory ability assessed regarding the nutritional status. We examined the effect of various oral factors on three masticatory ability tests conducted among older individuals. A total of 100 older individuals were enrolled in this study. Body mass index (BMI) as an indicator of nutritional status; and age, sex, and the number of occlusal and molar occlusal supports as clinical attributes were recorded. Three masticatory ability tests (masticatory efficiency, masticatory score, and satisfaction with mastication) were conducted, and tongue pressure, cheek pressure, and occlusal force were assessed as oral functions. A significant but weak correlation was found between masticatory efficiency and the masticatory score, but not between masticatory efficiency and satisfaction score. Objective masticatory efficiency was strongly associated with objective oral factors, whereas subjective assessments of masticatory ability (masticatory score and satisfaction score) were not. Furthermore, BMI was significantly associated with subjective assessments of masticatory ability but not with objective masticatory efficiency. Both subjective and objective assessments of masticatory ability, along with considerations of nutritional formulations, are required for the maintenance and improvement of nutritional status in older individuals

Reliability of Screening Methods to Diagnose Oral Dryness and Evaluate Saliva Secretion

In this study, we evaluated the reliability and reproducibility of widely implemented salivary flow rate and oral dryness tests. In experiment 1, twenty young and healthy Japanese participants volunteered to participate. For each participant, the oral moisture (OM) level, unstimulated whole saliva volume (U-WSV), and stimulated whole saliva volume (S-WSV) were measured at the same time on two separate days. In experiment 2, twenty-seven patients who were over 65 years of age volunteered to participate. The OM level and U-WSV were measured at the same time on two separate days. In Experiment 1, the intra-class correlation coefficients (ICCs) corresponding to the S-WSV, U-WSV, and OM level were 0.23, 0.28, and 0.16, respectively, for the young participants. In Experiment 2, the ICCs corresponding to the U-WSV/spitting and OM level were 0.83 and 0.12, respectively, for the older participants. The results of Bland–Altman analysis confirmed the absence of systematic error, with the exception of the OM level results in Experiment 2, which indicated systematic bias. In conclusion, we believe that there is currently no consistent and reliable screening test for assessing salivary flow rate and oral dryness, although the spitting test was determined to be highly reliable

ホテツ ソウチ ニヨル コジン ニンショウ システム ニ カンスル ブンケンテキ コウサツ

In disasters such as hydraulic bore, earthquakes and fire, the oral structure including the dental prostheses can provide identifying information. Over the years, many different personal identification system of dental prostheses have been reported. This present study analyzes the published literature offering the description of the personal identification system of dental prostheses. Two databases, “PubMed” and “Japana Centra Revuo Medicina” were searched to retrieve research papers referred to the personal identification system of dental prostheses. Twenty four papers were selected from the database with the criteria, and they were reviewed. 　This literature search showed that the personal identifications in three kinds of dental prostheses: removable denture, crown and implant were reported; and more papers on removable dentures were extracted compared to the crown and implant, however there is no high quality paper indicating that the structured methods for personal identification of dental prostheses is effective. 　A new method and common write format for personal identification are required to improve the present problems, and our systems using fluorescent material and ultraviolet light and femtosecond pulse laser-oriented recording system would be effective

舌の厚みとその臨床的意義

Background: The tongue occupies most of the space in the oral cavity and it plays an important role in oral functions such as mastication, swallowing and articulation. The tongue continues to move from the time of intake to swallowing, particularly during masticating. A method for evaluating tongue thickness at rest by ultrasonography has been proposed; however, the association between tongue thickness and various oral functions remains unclear. Objective: The purpose of this study was to investigate the relation between tongue thickness and oral functions, and to clarify the clinical significance of tongue thickness measurements in oral function maintenance. Materials and Methods: Elderly outpatients were serially screened for enrollment and a total of 106 subjects (men, 54; women, 52; mean age, 75.2±6.5 years) were selected. Age, body mass index, and functional teeth number including implant and pontic of fixed partial denture number were recorded as the basic attributes. Tongue thickness, tongue pressure, tongue thrust pressure and tongue motor function were measured as tongue assessments. Cheek pressure, oral moisture and occlusal force were measured as other oral functions. Results: Subjects with thick tongue tended to have higher BMI, stronger muscle strengths and lower diadochokinesis. Diadochokinesis of/ka/, cheek pressure and functional teeth number were extracted as the independent factors affecting tongue thickness. Conclusion: Tongue thickness does not necessarily reflect oral functions in healthy elderly people except for a negative association between tongue thickness and oral diadochokinesis of /ka/. Multiple assessments of tongue would be required to evaluate oral function, and the assessment of tongue thickness might have a different clinical meaning

コウクウ ケア ト シカ イリョウ デバイス

Life expectancy in Japan is among the world's highest and aging population has been increasing. Oral care in the elderly has been focused on many medical facilities for prevention from aspiration pneumonia and hospital infections. Poor oral hygiene of the elderly can cause various problems not only in the mouth but also in general health. We have studied on denture plaque micro flora, saliva and the relationship between oral and systemic conditions for more than 15 years. The results of our studies showed the direct and indirect effects of oral care. This article describes on the inflectious problem by dental devices including denture plaque, and significance of oral care through our studies

超音波検査を用いた嚥下音産生機序の解明

Background: Cervical auscultation is a technique frequently used for the screening of dysphagia. However, this method is difficult to evaluate objectively and it is unclear how sound is generated during the swallowing process. The aim of this study was to analyze the waveform of swallowing sound and clarify the sound production process using recordings of swallowing sounds and ultrasound images (USI), performed simultaneously. Materials and Methods: Commercial natural spring water and natural carbonated water were used in experiments 1 and 2, respectively. In experiment 1, a microphone was attached to the skin of the neck of 20 young participants and swallowing sounds were recorded and analyzed. In experiment 2, swallowing processes in three participants were recorded by a medical ultrasonography apparatus. The ultrasonic probe was placed on the skin over one of the thyroid cartilages or the thyroid gland. Results: The swallowing sound wave (SSW) was divided into three sectional periods. The mean duration of the first, second, and third SSW was 210 ± 147 ms, 458 ± 113 ms, and 91 ± 61 ms, respectively. The mean intensity ratio of the first, second, and third SSW was 7.8 ± 5.2, 29.2 ± 16.5, and 5.8 ± 5.1, respectively. When the ultrasonic probe was placed on the skin over one of the thyroid cartilages, in the phase between the production of the second SSW and the silent period, the USI revealed an accumulation of swallowed material around the valleculae and oropharynx. In the silent period of the second SSW, the swallowed material accumulated around the hypopharynx. When the ultrasonic probe was placed on the skin over the thyroid gland, in the silent period of the second SSW, the USI revealed that the swallowed material had passed through esophagus. Conclusion: Waveform and USI findings from this study suggest that swallowing sound can be divided into three sectional periods: an oral phase, a pharyngeal phase, and a repositioning phase

トウキョウ イカ シカ ダイガク シガクブ シガッカ ノ リンショウ ジッシュウ シサツ ホウコク

In recent years, dental services are subdivided and complicated, moreover the social circumstances change busily. An important object of the dental education is to bring up the dentist who had rich knowledge and rich human nature adaptable to such a change. The dental students can learn knowledge and skills through lectures and phantom practices. However, it is essential to experience dental examination and treatment in the clinical field to bring up dentists such as the above dentists. In the University of Tokushima faculty of dentistry, clinical clerkship has been performed by patients' cooperation, and university students have learned a communicative competence and behavior to contact with the patients as well as the knowledge and skill of dental treatment, and improved the professional ethics. On the other hand, the patients suffering from underlying disease except dental disease such as hypertension, diabetes mellitus and heart disorder increase. When these diseases are particularly serious, scrupulous attention is necessary in the dental treatment, these patients are unsuitable for clinical clerkship if the patients are cooperative. Moreover it becomes difficult to get the patients' cooperation for clinical clerkship year by year. The improvement of dental clinical education is a matter of great urgency corresponding to such situation. Therefore we inspected a clinical clerkship in faculty of dentistry, Tokyo Medical and Dental University and collected information for improvement of clinical clerkship of the University of Tokushima, faculty of dentistry

Hardness, Cohesiveness, and Adhesiveness of Oral Moisturizers and Denture Adhesives : Selection Criteria for Denture Wearers

The mechanical properties of seven denture adhesives and eight oral moisturizers, all of which are commercially available, were evaluated using a texture profile analysis. A new assessment chart is proposed for the selection criteria of denture adhesive and oral moisturizers using a radar chart with three axes: hardness, cohesiveness, and adhesiveness

Characterization of Swallowing Sound : Preliminary Investigation of Normal Subjects

Objective The purpose of this study was to characterize the swallowing sound and identify the process of sound generation during swallowing in young healthy adults. Methods Thirty-three healthy volunteers were enrolled and allocated into three experimental groups. In experiment 1, a microphone was attached to one of eight cervical sites in 20 subjects, participants swallowed 5 ml water, and the sound waveform was recorded. In experiment 2, 10 subjects swallowed either 0, 5, 10, or 15 ml water during audio recording. In addition, participants consumed the 5 ml bolus in two different cervical postures. In experiment 3, the sound waveform and videofluoroscopy were simultaneously recorded while the three participants consumed 5 ml iopamidol solution. The duration and peak intensity ratio of the waveform were analyzed in all experimental groups. Results The acoustic analysis of the waveforms and videofluoroscopy suggested that the swallowing sound could be divided into three periods, each associated with a stage of the swallowing movement: the oral phase comprising posterior tongue and hyoid bone movement; the pharyngeal phase comprising larynx movement, hyoid bone elevation, epiglottis closure, and passage of the bolus through the esophagus orifice; and the repositioning phase comprising the return of the hyoid bone and larynx to their resting positions, and reopening of the epiglottis. Conclusion Acoustic analysis of swallowing sounds and videofluoroscopy suggests that the swallowing sound could be divided into three periods associated with each process of the swallowing movement: the oral phase comprising the posterior movement of the tongue and hyoid bone; the pharyngeal phase comprising the laryngeal movement, hyoid bone elevation, epiglottis closure, and the bolus passage to the esophagus orifice; and the repositioning phase comprising the repositioning of the hyoid bone and larynx, and reopening of the epiglottis