2016 Volume 37 Issue 4 Pages 407-413
In dependent elderly people receiving enteral nutrition, oral self-care is often inadequate and their oral environment tends to be poor. Thus, it is common for dental professionals to wipe the oral mucosa with a sponge brush in these patients. However, there may still be the risk of a medical emergency associated with dental treatment that is considered to place a minimal burden on the patient. Meanwhile, little is known about the effect of this method of oral care on autonomic activity in dependent elderly people. Therefore, the present study aimed to investigate changes in autonomic nervous system activity during oral care （i.e., wiping the oral mucosa with a sponge brush） in this cohort.
The oral mucosa was wiped with a sponge brush for 5 minutes in 12 dependent elderly people receiving enteral nutrition （3 men and 9 women, aged 83.9±7.0 years） and 13 independent community-dwelling elderly people （1 man and 12 women, aged 73.5±5.1 years）. Changes in the autonomic nervous activity were examined by performing heart rate variability frequency analysis before and during oral care. To measure changes in the heart rate, we used a memory heart rate meter with an improved probe. The heart rate variability measurement values （high frequency [HF], low frequency [LF], and LF/HF ratio） were analyzed. In the independent elderly group, we administered a questionnaire about the change in how these individuals felt after the measurement was conducted.
The LF was significantly lower in the dependent elderly group than in the independent group at each examination period. In the dependent elderly group, significant increases in the HF, LF, and LF/HF ratio were observed during oral care. According to the multiple logistic regression analysis, the dependency was not significantly associated with the increase of LF/HF.
In conclusion, sympathetic nerve activity may increase during oral care （i.e., wiping the oral mucosa with a sponge brush） in the dependent elderly, however, this is not associated with the dependency of the elderly.
