口腔乾燥の改善に関する研究 : Capparis属植物配合タブレットの味覚特性と口腔内の潤い感について

本研究では、口腔乾燥を自覚したひとへのCapparis masaikai(マビンロウ)を配合したタブレット(MT)の応用にあたって、MTの嗜好性及び口腔内の潤い感を把握するため、成人を対象に官能評価を行った。その結果、1.MTは、甘味・渋味・苦味・粉っぽさがあり、爽やかさが少ないと評価された。2.MTの若年女性の嗜好性に対する評価が低かった。このことから、MTは味の嗜好性の評価や総合評価を向上させる必要性があると考えられた。3.MTは口腔内での潤い感が60分持続し、その効果が特に高齢者群で高かった。このことから、今後口腔乾燥症を有する成人・高齢者に口腔内の潤い感を付与する有効な手立ての一つとなると考えられた。As the taste characteristic of the tablet which mixed Capparis masaikai, a sensory evaluation was carried out among young panelists (23 men, average age 25.5 and 31 women, average age 22.2) and elderly panelists (15 men, average age 72.1 and 17 women, average age 74.3) in order to grasp the preference of taste and moisture sensation in the oral cavity. The sample of the sensory evaluation was made to be two kinds of the tablets of MT (the tablet including the 15% Capparis masaikai extract) and N-MT (the tablet of the identical composition without the Capparis masaikai extract). The sensory evaluation items were made to be the time until the tablets melted in the oral cavity, and strength and weakness and preference, total evaluation of the taste of the tablet in licking and after the licking. The following results were obtained: 1. MT was evaluated that sweetness, astringent taste and bitterness and powder were stronger than N-MT, but it was evaluated that refreshingness was weaker than N-MT. 2. An evaluation for the preference of the young women of MT was low. From this result, there seemed to be a necessity of improving evaluation and total evaluation of the preference of taste of MT. 3. Moisture sensation in the oral cavity kept 60 minutes on MT, and the effect was especially high in the elderly panelists. From this result, MT seemed to be one of the effective ways that gave moisture sensation in the oral cavity to adult and elderly people who would be conscious of the dry mouth in future

Formative Factors of Membranous Substances on Dorsum of Tongue, Teeth, Buccal Mucosa in Elderly Persons Requiring Nursing Care

要介護者の口腔粘膜にみられる付着物は，痰，痂皮，剥離上皮と呼ばれているが，上皮成分を主体とした付着物を剥離上皮膜と定義づけ，本研究にて，要介護高齢者の口腔内に形成された剥離上皮膜を部位別に形成要因を検討した。調査対象者は，入院中の患者のうち65 歳以上の要介護高齢者70 名であった（81.1±7.7 歳）。入院記録より年齢，疾患，常用薬，寝たきり度を調査し，意識レベル，発語の可否，介助磨きの頻度は担当看護師から聴取した。歯科医師が口腔内診査を行い，膜状物質の形成の有無，Gingival Index などを評価した。形成された膜状物質は，歯科医師がピンセットで採取した。粘膜保湿度（舌背部，舌下粘膜）は，粘膜湿潤度試験紙（キソウエット®）により10秒法で評価した。採取された膜状物質は，通法に従ってパラフィン切片を作製し，HE 染色とサイトケラチン1 による免疫染色で重層扁平上皮か否かについて確認し，重層扁平上皮由来の角質変性物が認められたものを剥離上皮膜と判断した。剥離上皮膜形成の有無を従属変数として，患者背景・口腔内の14 項目，疾患の15 項目，常用薬の32項目，合計61項目を独立変数として部位ごとで決定木分析を行った。すべての部位で剥離上皮膜の形成に最優先される要因は「摂食状況」であり，経口摂取者には，剥離上皮膜がみられなかった。第2 位は舌背部で舌背湿潤度，頰部で開口，歯面の第3 位が開口であり，口腔粘膜の乾燥を示唆する結果であった。以上，剥離上皮膜の形成要因には口腔乾燥があり，保湿の維持が剥離上皮膜の予防につながると考えられた

Association between oral, social, and physical frailty in community -dwelling older adults

Objectives: Oral frailty (OF) has been shown to be a predictor of disability. Therefore, it is important to be able to identify factors associated with OF in order to prevent long-term dependence. The purpose of this study was to clarify the relationships between OF, social frailty (SF), and physical frailty (PF) in community-dwelling older adults, with the overarching aim of informing the future development of effective measures to prevent frailty. Methods: Oral, physical, and social function, nutritional and psychological status, and medical history were examined in 682 community-dwelling individuals (267 men, 415 women) aged ≥ 65 years. Ordinal logistic regression analysis with SF and PF as independent variables was performed with pass analysis to determine the relationship between the different types of frailty. Results: Logistic regression analysis revealed significant associations between OF and decline in social function, physical function, and nutritional status, and an increase in the number of medications used. Path analysis showed that SF was directly related to OF and that OF and SF were directly related to PF. Conclusions: These findings suggest that a decline in social function may directly influence a decline in oral and physical function. The results of this study provide initial evidence, that may guide the future development of measures that aim to prevent and manage OF

Palatal microbiota associated with membranous substances in older Japanese individuals undergoing tube feeding in long-term care: A cross-sectional study

Objective: Tube feeders are prone to membranous substance formation on the palate, and those with membranous substances have a risk of fever, with the probable involvement of their oral bacteria. However, the palatal microbiota of those with membranous substances has not been elucidated. Therefore, we evaluated the differences in palatal microbiota between tube-fed individuals with and without membranous substances to clarify the microbiota. Materials and methods: This study included 19 participants aged 65 years who required tube feeding. The participants’ characteristics were collected from nursing records and oral examinations. If membranous materials were found on the palate, a specimen was collected. Membranous substances were defined as keratotic degeneration observed under a microscope. Additionally, we performed a comprehensive microbiome analysis by extracting DNA from the samples and performing 16 S rRNA gene sequencing. Finally, we compared the participant demographics and oral microbiota between patients with and without membranous substances. Results: A total of 11 participants had membranous substances associated with “mouth dryness” (p < 0.001) and “constant mouth opening” (p = 0.020). Palatal microbiota differed between those with and without membranous substances. Among the bacteria with a relative abundance greater than 1.0%, the abundance of Streptococcus (p = 0.007), Fusobacterium (p = 0.041), Streptococcus agalactiae (p = 0.009), and Fusobacterium nucleatum subsp. vincentii (p = 0.026) was significantly higher in the membranous substance group than in the non-membranous substance group. Conclusions: The palatal microbiota of individuals undergoing tube feeding differed depending on the presence or absence of membranous substances. Membrane substance formation associated with dry mouth purportedly alters the palatal microbiota. Streptococcus, Fusobacterium, S. agalactiae, and F. nucleatum subsp. vincentii were more abundant in the oral microbiota of patients with membranous substances. Thus, preventing this formation may help in controlling the growth of these microbes