口腔機能に関わる高齢者歯科保健施策の変遷と今後の課題

Abstract

高齢期の歯・口腔の健康づくりにおいて，口腔機能の良否は食生活に直結するものであり，全身の健康にも大きな影響を与える．特に咀嚼は代表的な口腔機能として，「健康日本21（第三次）」や「歯・口腔の健康づくりプラン」でも目標項目が設定されている．一方，高齢者の口腔機能については，オーラルフレイルの概念が2015年3月に提唱されて以降，関連施策でも取り上げられるようになった．オーラルフレイルの学術的定義は，しばらく統一されてこなかったが，2024年4月に初めて関連3学会での統一見解が発表された．そこで，本稿では，公的資料等での咀嚼評価の現状を紹介するとともに，オーラルフレイルの新定義に至るまでの口腔機能に関わる高齢者歯科保健施策の変遷を整理する．また，オーラルフレイル評価ツールであるOF-5について，地域での高齢者歯科保健活動への応用性について検討する． In promoting oral health in older adults, satisfactory oral function is directly related to dietary habits and significantly impacts overall health. In particular, mastication is a typical oral function, and targets have been set in “Health Japan 21 (3rd term)” and the “Oral Health Promotion Plan.” On the other hand, the oral functions of older adults have been addressed in policy since the concept of oral frailty was proposed in March 2015. Unfortunately, the academic definition of oral frailty continued to remain ununified for some time. However, in April 2024, three relevant academic societies released a unified definition of “oral frailty” for the first time. Accordingly, this article describes the current status of masticatory assessment in official documents, and summarizes the changes in oral health measures for older adults related to oral function, leading to the new definition of oral frailty. In addition, the applicability of the OF-5, an oral frailty assessment tool, to community oral health interventions for older adults is discussed.

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