Severe oral mucositis is one of the frequent adverse events in patients with head and neck cancer undergoing radiotherapy. However, a method to prevent oral mucositis has yet to be established. We describe the methods to treat oral stomatitis during head and neck cancer radiotherapy based on the MASCC/ISOO Guideline, and the authors’ findings regarding them. Further, concerning mouthwash use and topical steroid administration, related information and basic ideas of the authors are described.

 We have performed the following management: 1) extraction of infected teeth before the start of radiotherapy; 2) spacer placement; 3) oral care; 4) administration of pilocarpine hydrochloride; 5) topical administration of dexamethasone ointment with olive oil; 6) skin care, consisting of cleaning and moisturizing; and 7) topical application of fluoride. Together, these approaches comprised a preventive bundle against adverse events following radiotherapy. Several years have passed since perioperative oral management become covered by public medical insurance in Japan, and it has become available at many hospitals. The prevention of adverse events during radiotherapy has come to be required for dentistry, but standardization of the management method and validation of evidence on effectiveness are future tasks. We consider it important to establish a method to reduce the severity of radiation oral mucositis by multicenter cooperative clinical research.

 Self-rated health is a simple way of assessing the health status. It is also used for oral health research in general population surveys. However, limited information is available on younger populations aged under 65 years.

 Accordingly, the aim of this cross-sectional study was to investigate the association between the self-rated tooth and gingival health and self-rated general health based on a survey conducted by the 8020 Promotion Foundation in 2015.

 For this survey, questionnaires were mailed to 5,000 people, aged 20 to 79, who were selected by stratified two-stage random sampling from Japanese municipalities, and 2,465 people responded (response rate=49.3%).

 Data without missing responses from 1,972 participants were used for analysis.

 The subjects were divided into three groups according to age: young participants (aged 20-39 years), middle-aged participants (aged 40-59 years), and elderly participants (aged 60-79 years).

 An ordinal logistic regression model was created to evaluate the association between self-rated tooth and gingival health and self-rated general health for each group.

 Multivariable models were adjusted for the number of teeth, sex, employment status, subjective economic status, education, comorbidity, presence of an adviser, and body mass index.

 Based on the ordinal logistic regression analysis, participants with good self-rated tooth and gingival health had significantly better self-rated general health. The adjusted odds ratio (95% confidence interval) was 12.41 (7.22-21.34) for the young participants, 11.77 (7.50-18.48) for the middle-aged participants, and

10.07 (6.55-15.50) for the elderly participants.

 The present study suggests that the self-rated tooth and gingival health is significantly correlated with self-rated general health among general Japanese subjects in all age groups.

 We investigated associations among the oral function, nutritional status, and nutrient intake in elderly individuals living at home and receiving nursing care. The subjects of this study were 63 individuals (25 males, 38 females) aged 65 years or older (average: 83.5±6.8 years). All subjects agreed to undergo a dental examination and answer survey questions regarding their diet. Using the Revised Oral Assessment Guide, we graded 8 intraoral items with a score of 1-3 points to determine the oral function. A total score of 8 points indicated a good function, 9-12 points indicated a mild decrease, and 13 or more indicated a severe decrease in function. The latter 2 groups were combined into a decreased group (oral function decrease of 9 or more points). Age, body mass index, skeletal muscle index, grip strength, and Mini Nutritional Assessment - Short Form results were not significantly different between the good and decreased groups. The good group showed significantly higher values of Alb (≥4.0 g/dL) and tongue pressure (≥35 kPa), and there were also significantly fewer individuals who required nursing care, based on recognition independence, as compared with the decreased group. Date on nutrient intake were extracted from answers to a brief-type self-administered diet history questionnaire, and they were also compared between the groups. The good group contained a significantly higher number of individuals who ate more than the recommended dietary allowance of protein for individuals aged 70 years or older, and had a lower intake of vitamin C. Regarding the nutrient food group intake, subjects in the good group consumed root crops, legumes, and fatty fish significantly more frequently, while those in the decreased group showed a significantly more frequent intake of potatoes, citrus fruits, and confectionery. Associations among a lower oral function, the nutrition status, and food group intake were noted in our results. Our study suggested that the appropriate management of oral care and nutrition can promote a better oral condition, which is important for effective care and living support for elderly individuals. In addition, collaboration between dental and diet professionals is considered helpful.

 The purpose of this study was to assess the knowledge, awareness, and practice of caries prevention and fluoride use in adults and elderly patients, among health care staff at hospitals and identify problems in their oral health care practice.

 A questionnaire regarding caries prevention and fluoride use in adults and elderly patients was distributed to 163 nurses, 68 care staff, and 90 rehabilitation staff in 2 hospitals in Fukuoka Prefecture, Japan.

 Three hundred and twenty-one subjects completed the questionnaire, yielding a response rate of 85.8%. Most subjects understood the importance of caries prevention in adults and elderly patients. However, while more than 80% knew about fluoride toothpaste, only 41.5, 12.8, and 9.4% knew about fluoride mouth rinse, water fluoridation, and silver diamine fluoride application, respectively. Furthermore, only about half of the participants performed caries prevention and collaborated with oral health professionals to achieve this, although their degree of awareness about caries prevention was high. Less than 20% of respondents used fluoride in their oral health care for adults and elderly patients. However, the percentage increased to more than 80% on the inclusion of those who expressed a willingness to use fluoride in the future. The high levels of knowledge and awareness regarding caries prevention, water fluoridation, and silver diamine fluoride application were associated with the performance of caries prevention for adults and elderly patients, collaboration with oral health professionals, and fluoride use when performing oral health care.

 These findings suggest that the provision of information about caries prevention and fluoride use is necessary to promote caries prevention, fluoride use, and collaboration with oral health professionals for caries prevention when providing oral health care for adults and elderly patients.

J Dent Hlth 68: 219-230, 2018