In the older population, denture condition and oral discomfort or pains were considered to relate closely to chewing ability. The attitude towards diet including dietary habits might bealso affected by chewing ability.
The present survey was conducted to elucidate the interrelationships between chewing ability, oral condition and dietary attitudes.
The subjects were residents over 60 years old living in private facilities for the elderly.
The results obtained were the following:
1) Chewing ability was evaluated by the test jelly method. The subjects were categorized into 3 groups (I, II, III) according to the highest level of their chewing ability.
2) There was a close correlation between chewing ability and the number of remaining teeth.(p<0.001)
3) In group I and II, over 80% identified the improvement in their chewing ability as denturewear, against only 44.4% in group III. Instead of masticatory benefit from dentures, some of group III mentioned an improvement in speech (11.1%) or appearance (11.1%).
4) Group III had more oral discomfort or pain than groups I and II.
5) Group III had a higher intake of bread, meat especially processed, oils and fats, and foods between meals than group I and II.
6) As for the concerns about diet, most of group I (75.6%) selected the category of what theyeat, while about half of group II (46.2%) and III (50.0%) selected that of with whom they eat.

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Patients with glossodynia at the Department of Oral Surgery, Nagoya University School of Medicine, during the 5-year period between 1988 and 1992, were requested to answer a questionnaire. Fifteen of them had died or could not be contacted because of a change of address. Finally, 119 patients completed the questionnaire. The age of the patients ranged from 28 to 80, and the average age was 61. The period from the first examination was 2 to 3 years in 40 patients, 4 to 5 years in 46 patients, and over 6 years in 33 patients. The long-term prognosis after treatment was assessed in different subgroups.
In the subgroup of 31 patients who had been free from symptoms, only two patients experienced recurrence of symptoms. In another subgroup of 29 patients whose symptoms were alleviated during treatment, 2 patients reported that their symptoms were becoming worse. Of the 59 patients who had not changed or even worsened during treatment, 6 patients complained or further worsening of their symptoms. Further worsening after treatment was rare in the patients aged 45 to 54 years, which is considered as a climacteric age. The glossodynia patientsaged 55 to 64, which was the most frequent period of glossodynia, experienced little spontaneous improvement in their symptoms after treatment.
From this study, the efficacy of primary treatment and age were considered important factors influencing the long-term prognosis of glossodynia in females.

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Dental anxiety is defined as fear of dental treatment or of a certain aspect of dental treat-ment. It has been an important subject in behavioral dentistry. There have been many studiesabout dental fear and anxiety in several industrial countries, but there has been no empiricalstudy about dental anxiety among older adults in Japan.
The purpose of this study was to estimate levels of dental anxiety and find out its relation-ship to dental status and sociodemographic variables among Japanese older adults. Corah'sDental Anxiety Scale (DAS) was used to measure levels of dental anxiety. To our knowledge, this is the first study to use the Dental Anxiety Scale to measure dental anxiety among olderadults in Japan. A total of 293 patients aged 40 years and over who visited the ProsthodonticClinic of Showa University Dental Hospital were selected as subjects. One dentist interviewedthe subjects to investigate their dental anxiety before the dental examination. Their educational level and marital status are also examined. The subjects were first classified as dentate and edentulous groups. The dentate group was further subdivided into those who had partially edentulous areas and those who had no edentulous areas. Results are presented separately for two older cohorts, respondents ages 40-64 and those 65 and older. No significant correlation was found between dental anxiety and educational level. But Age and dental status wer significantly correlated with dental anxiety. Older subjects had lower dental anxiety than younger subjects. The edentulous group had lower dental anxiety than the dentate group. Among the dentate group those who had partially edentulous areas had higher dental anxiety than those who had no edentulous areas.
The most striking finding from this study was that sex was significantly correlated with dental anxiety among those who did not have spouses.
Males who did not have a spouse had significantly higher dental anxiety than females whodid not have a spouse.

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To study the age-related morphological changes of the normal maxillary sinus, 70 images by computed tomography (CT) were selected from 1500 clinical cases. These 70 cases (36 males and 34 females, mean: 45.4 years) include each ten cases from the second to seventh decade, six cases in the eighth and four cases in the ninth decades. The postero-anterior, medial-lateral diameters and the area were measured and the shapes of the frontal and posterior bony walls of the maxillary sinus were observed at the buccal arch level of the axial CT image. These data were analysed in relation to age and tooth loss. The diameters and area peaked between the third and fifth decade and thereafter declined with age. There were significant differences in the mean values of these three parameters between the cases over the sixth decade and those under the fifth decade (p<0.05). The mean values of the males were all greater than those of the females. There were significant sex differences in the points of postero-anterior and medial-lateral diameters in the groups under the sixth decade (p<0.05). These data were reexamined according to whether the patient was dentulous or edentulous. Every value was smaller in the edentulous group than those for the dentulous group. There was a significant difference bet ween the two groups in the point of medial-lateral diameter (p<0.05). The shape of the bony walls increased the hollowed and straight type and decreased protruded type in the edentulous group. It appears that the size of the maxillary sinus decreases with age and is related to tooth loss.

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We made a quantitative inspection for paresthesia around the oral cavity of patients withapoplectic hemiplegia.
The inspection was performed on 34 patients with apoplectic hemiplegia and on 24 healthypeople: the former consisted of 30 males and 4 females with ages in the range of 45.6±9.8years old (from 18 through 63) while the latter consisted of 22 males and 2 females with agesin the range of 44.6±10.6 years old (from 23 through 63).
There were no differences in age between the two groups.
We made a measurement instrument to make a tactile sensation inspection, following the von Frey test.
We measured the upper lip and upward cheek in the second branch area, and furthermore, the lower lip and the downward cheek in the third branch area of the trigeminal nerve; with the total on both right and left sides, each of which we measured on the skin surface.
The tactile sensation inspection began at 250mg and ended at 2g. The inspection was evaluated at five grades; we evaluated it as Grade 1 when 250mg is sensed, Grade 2 when 500 mg is sensed, Grade 3 when 1g is sensed, Grade 4 when 2g is sensed and Grade 5 when 2g is not sensed.
The result was as follows; among the healthy people, all the cases were evaluated as Grade 1, except that two cases of the upward cheek and one case of the downward cheek were evaluated as Grade 2, the normanl value could be assumed to be less than 250mg and no difference was found between the right and the left sides. However among the patients with apolectic hemiplegia, there were significant differences in the second and the third branch areas between the focal and the healthy side. As for the result by measured pats, there was less increase of the tactile sensation threshold.
No clear relation was found between the focal portion and the tactile sensation. We could not predict a tactile sensation defect from a CT-scanned focal picture nor presume, conversely, the focus from the degree of tactile sensation.

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The purpose of this study was to investigate the conservative treatment by the home dental care team of the Nippon Dental University at Niigata. The main subject of this investigation was the dental home and hospital care performed by the team in the first semester between September 1, 1987 and December 31, 1993. The yearly mean rate of each dental home care was 54.1% in prosthetics, 12.8% in oral surgery, 10.7% in conservative treatment and 17.3% in others. In the case of treatment included hospital care, 38.7% was in prosthetics, 32.1% in oral surgery, 16.0% in conservative treatment and 8.9% in others. Due to the level of general care for the patients in the hospital, the rate of oral surgery and conservative treatment under local anesthesia by hospital care was greater than by home care.
Concerning treatment for patients of 70 years and older, the rate of prosthetics was the highest and the rate of conservative treatment was low. On the other hand, in regard to patients less than 70 years old, the rate of oral surgery and conservative treatment was high and the rate of prosthetics was low. Since patients who were at least 70 years old accounted for about 70% of the total, the low rate of conservative treatment might be affected by the patient/age factor.
In order to investigate home care conservative tre atment in more detail, 39 patients were selected on the condition of having 10 or more teeth at the first oral examination and requiring conservative treatment. According to the investigation of the conservative treatment performed on these patients, the following results were obtained: the total number of teeth requiring treatment was 194 and the mean was 5.0. The total number of teeth treated by December 31, 1993 was 87 and the mean was 2.2. Consequently, the treatment rate required was 44.9%. The total number of teeth treated by home care was 45 (51.7%) and that by hospital care was 42 (48.3%). Composite resin and glassionomer cement restorations accounted for 80% of all operative treatment performed on 81 teeth. In endodontic treatment (24 teeth), 10 were treated by pulpectomy and the others by infected root canal treatment. On the basis of this investigation, it is recommended that the conservative treatment system should be reevaluted to improve home dental care.

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While ideal prosthetics can be achieved for a dental defect, is some care no improvement in diet is observed.
The decrease in desire for consciousness of eating is thought to be a cause of no improve-ment. Thus we devised and tentatively prepared questionnaires, in order to understand and evaluate the desire for and consciousness of eating in aged people.
The questionnaires, which we prepared and clinically applied, were composed of 8 items concerning the desire to eat, 4 items concerning the consciousness, 5 items concerning the oral cavity in relation to the QOL, and 4 items concerning the state of the oral cavity and others.
A total of 122 patients (56 men and 66 women with a mean age of 70.0), visiting our geriatric dental clinic, were asked to fill out the research from for the desire for and conscio-usness meal for 3 days. Many of the patients reported a slightly increased desire to eat and the same consciousness of eating, as compared with their usual states.
Patients with strong desire for consciousness of eating often had highly nutritine food, exceeding the required nutrient intake, whereas those with poor desire and consciousness had less nutrient intake than the required amount. From these results, the questionnaires prepared in this study were thought to be practically useful.

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Early detection and early treatment are considered most important approaches to improving cancer cure rates.
The Dental Association of Chiba City, in the belief that conducting mass screening for oral cancer would improve its cure rate, has held “Healthy Come-Come” educational sessions on oral health since 1992, and it includes an oral cancer screening booth.
In this paper we repoet on the methods used to implement the screening, the results, the problems encountered in implementing it, etc.
Methods; The subjects of the screening were persons who applied to participate in response to the appeal in the city's official bulletin.
The screening centered on an interview, inspection, and palpation, and whenever a thorough examination was required, the subject was referred to the appropiate secondary facility.
Even when no abnormal findings were detected, thorough oral health consultation, guidance, counselling, etc, were provided.
Results and Discussion; The number of subjects has been tending to increased year by year, from 52 in 1992, to 207 in 1993, and 262 in 1994.
As a result of screening an abnormality was confirmed in a total of 137 lesions over the 3-year period. All of the patients were referred to appropriate secondary institutions, but no malignancies were found in any of them.
Discussion In order to conduct early detection and early treatment of oral cancer it seems advisable to increase awareness among local residents concerning the oral cavity and to continue to conduct screening in cooperation with loacal organizations.
These oral screnings need to be widely and generally recognized, and implemented on a nationwide scale.

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[in Japanese]

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