Interest in home-bound geriatric dental patients has grown during the last ten years. On the other hand, the elderly are still at high risk to circulatory disease.
We studied 34 home-bound dental patients (21 females, 13 males), who live in Toyonaka city. They are from 65 to 94 years of age. We divided them into 2 groups: those with circulatory disease, and those with other chronic diseases.
Both groups of subjects were subdivided into 2 groups: in daily living and under dental treatment. We observed their daily health judged by a basic physical list for a week before dental treatment. We investigated the change (means) and fluctuation (max-min) of hemodynamic parameters (systolic blood pressure, diastolic blood pressure and heart rate).
The results were as follows:
1. The changes of hemodynamic parameters were not significantly different between the group with circulatory disease and the group with other chronic diseases.
2. The fluctuation of systolic blood pressure in circulatory disease slightly increased during dental treatment.
3. The fluctuation of heart rate in the circulatory disease group significantly increased during dental treatment.
These results suggested that the mental stress of dental treatment of the home-bound elderly with circulatory disease markedly influenced their systolic blood pressure and heart rate.

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The purpose of this study was to research an aim for determining whether or not a person who suffers from sever dementia can wear dentures. We studied the relation between the person's ability to wear dentures and their Activities of Daily Living (ADL) as well as their Revised Hasegawa's Dementia Scale (HDS-R). There were 86 subjects, with severe dementia, who all lived in a nursing home. Their average age was 79.6 years. Many of them suffered from Alzheimer's desease.
We divided ADL into 6 categories: walking, going to the bathroom, eating, bathing, getting dressed and washing their faces. We gave each person 1, 2 or 3 points according to their ability, and then calculated the total for each person. We used Akaike's Information Criterion (AIC) to analyze the ADL categorical score as an indicator of each person's ability to wear dentures.
The results were as follows:
1. In each category except walking, the higher the person's ability, the higher the rate of wearing dentures.
2. The average score of a denture-wearing person was 10.9, while the average score for a non-denture wearing person was 7.3.
3. We found persons with a score below 7 did not accept wearing dentures, while the persons with a score over 10 accepted dentures. To determine whether or not a person could wear dentures the “bathing” and “getting dressed” categories were the most indicative.
4. No matter what dementia they suffered from, the average ADL score for denture wearing person was 10, and was 7 for non-denture-wearing persons. However, the HDS-R average scores differed among all dementia subjects. To determine whether or not a person with severe dementia can wear dentures, it is more reliable to use ADL scores than HDS-R scores.

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Changes in blood pressure and pulse rate were measured from 30 minutes before entering the examination room to 10 minutes after entering at 5-minute intervals for the purpose of determining the white-coat effect on blood pressure and pulse rate in aged dental patients at an outpatient clinic.
The results show that the systolic blood pressure and pulse rate significantly increased on entering the examination room (p<0.01). There were marked individual differences in the amounts of increases, and 46.5% were determined to be positive for white-coat effect due to a blood pressure elevation of 10mmHg or more. The frequency of systolic blood pressure elevation by the white-coat effect was higher in patients having a history of hypertension, as compared with those without such a history (p<0.05). The frequency of positive response to the whit-coat effect increased with aging (p<0.01). However, the subjects' sex or the contens of the treatment on that day did not influence the frequency of the occurrence of the white-coat effect. There was no correlation between the number of visits/systolic blood pressure at rest and the amount of blood pressure elevation at the time of entrance to the examination room, whereas the blood pressure at the visit was closely correlated positively with the blood pressure at the entrance (r=0.64; p<0.01), suggesting that the blood pressure would be elevated again by stress in patients with high blood pressure at the visit, even if their blood pressure was lowered by resting.

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Burning mouth syndrome was diagnosed as a burning sensation or pain in the oral region unaccompanied by clinical signs. Most of the patients were postmenopausal women and a close relationship between burning mouth syndrome and aging has been proposed. However there are a limited number of studies from this point of view.
In this study, we examined 40 female patients with burning mouth syndrome at the Department of Oral Surgery, Nagoya University School of Medicine. Accompanying systemic diseases, medications, allergy, sites of pain, blood analysis, volume of unstimulated whole saliva, psychological test, subtyping and efficacy were evaluated with reference to aging. The subjects were divided into three subgroups depending on age, 42-56 years old (climacteric group), 57-64 years old (intermediate group) and over 65 years old (aged group).
Typical features were observed both in the climacteric and aged subgroups . In climacteric period, the patients suffered from a small number of accompanying systemic diseases and medication, had no remarkable xerostomia and presented normal blood data except for high blood cholesterol. From the CMI test, most of the patients in the climacteric period were distributed in class I or II which were considered as almost normal . On the other hand, aged patients suffered from many accompanying systemic diseases with medication, had mental disturbances which were revealed with CMI test, and presented hyposalivation . In aged patients, these factors may contribute to the etiology of the BMS.
It has thus been comfirmed that the aging and related changes could play an important role in the etiology of burning mouth syndrome both in the climacteric period and in the elderly.

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SDM which allows measurement of the thickness of masticatory mucosa easily by ultrasonic waves has been recently introduced commercially. SDM may by a useful diagnostic instrument at dental clinics, if it can be actually applied to the measurement of the thickness of masticatory mucosa. In this study, we examined whether SDM can be used for this purpose or not.
Close correlation was found between the measurement data obtained with SDM and those by the puncturing method. The coefficient of variation was 5.2% on average in measurement at the same part of the mucosa ten times with SDM. By ANOVA, there were no statistically significant differences in the data obtained on different measurement days. The above result may indicate that measurement with SDM is reliable.
The Thickness of masticatory mucosa in edentulous mouth measured with SDM almost agreed with the data reported by other investigator. The thickness of flabby gum measured with SDM was greater than that of normal masticatory mucosa. The masticatory mucosa of a patient in whom pain persisted in spite of frequent adjustment of the denture was thinner, compared to normal masticatory mucosa. Thus, the data obtained with SDM and the clinical condition were well related.
These results support the clinical applicability of SDM to the measurement of masticatory mucosal thickness.

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To elucidate the influence of the diet and teeth loss on the endurance performance in addition to aging, 49 Wistar male rats (30-75 weeks old) were divided into four groups: the pre-feeding group (before experiments had been begun), the control group (solid diet), the soft diet group (powder diet containing the same components as the solid one from the 45 the week) and the molarless group (all molars were removed at 45 weeks and the rats were then fed a powder diet). The powder diet group and molarless group were compared with the control group by the exhaustion time and serum indices after swimming-exercise at 35 weeks, 50 weeks and 75 weeks.
The results obtained are as follows.
1. The weight of the soft diet group at 75 weeks was higher than that of the control group at 75 weeks, showing a statistical significance (P<0.01).
2. In the control group, the exhaustion time in the swimming-exercise decreased with aging, showing a statistical significance (P<0.01).
3. In the molarless group at 75 weeks, the exhaustion time in the swimming-exercise decreased compared to the control group at 75 weeks, showing a statistical significance (P<0.05).
4. In the control, the soft diet and the molarless groups, the value of creatinephosho-kinase (CPK) at 50 weeks was higher than that at 75 weeks.
5. In the control and the soft diet groups, the value of free-fatty acid (FFA) at 50 weeks was higher than that at 75 weeks, but there was no statistical significance. In the molarless group, the values of FFA at 50 and 75 weeks were much lower than those of the control and the soft diet groups.
These findings suggest that the endurance performance of aged rats is considerably influ-enced by occlusal and masticatory alteration in addition to aging.

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This study was designed to determine whether in the submandibular glands of the rat, subjected to chemical sympathectomy with reserpine administration, a model animal of cystic fibrosis, at a dose of 5mg/kg for one day (Group 1), two days (Group 2) and at a dose of 0.5mg/kg once a day for 6 consecutive days (7 day-Group; Group 3), p-and m-octopamines, and dopamine used at different doses (10, 20, 50 and 100mg/kg) acted completely or partially as false neurotransmitters, as seen in tyramine at all doses used.
Enlargement of the submandibular glands induced by reserpine treatment was completely stopped by pargyline, a monoamine-oxidase inhibitor. The volume of saliva secreted by the submandibular glands of reserpinized rats was significantly reduced in response to m-octopamine at all days and dopamine at almost all days and all doses used, whereas in response to p-octopamine it was significantly reduced only at low doses and in combination with prazosin, but not other blockers. The total output of protein secreted, whether expressed as mg/h or μg/mg/h, by the reserpinized submandibular glands was significantly reduced in response to m-octopamine at all days after reserpine treatment. In contrast, it significantly increased at 7 days after reserpine treatment in response to dopamine and p-octopamine alone, and to p-octopamine with atropine. However, no replacement was observed in the types of proteins in the submandibular saliva of reserpinized rats in response to the three sialogogues used at any dose and with any blockers except prazosin.
These results suggest that two octopamines and dopamine could be partially false neurotransmitters and have dual actions, direct and indirect, to the salivary glands of rats.

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To elucidate the mandibular bone mass changes due to occlusal and masticatory alterations in addition to aging, 66 Donryu male rats (30-74 weeks old) were divided into three groups, a control group (fed with a solid diet), a soft diet group (fed with a powder diet containing the same components as the solid one, from the 43rd week) and a molarless group (all molar were removed at 43 weeks and then fed with a powder diet).
The bone mineral densities (BMDs) were measured by quantitative methods using soft roentgenograms and image analyzing system, and the data were compared with each other. The results obtained are as follows.
1. The BMD of condyles in control increased with age to the 43rd week, and then decreased gradually. The BMD of the same area in soft diet and molarless groups decreased depending on age after the 47th week. There were significant decrease in the BMD of experimental groups (p<0.01).
2. The BMD of the attachment area of the masseter muscle in control increased with age to the 60th week, and then decreased. The BMD of the same area in the soft diet and molarless groups decreased depending on age after the 60th week. There were significant decrease in the BMD of the experimental groups (p<0.05).
3. The BMDs of condyles showed lower values in the experimental groups than in the control group at all ages.
These findings suggested that the bone remodeling in the condyle and the attachment of the masseter muscle in aged rats were considerably influenced by occlusal and masticatory alteration in addition to aging.

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Since the Elderly Health Law was promulgated in February 1983, dental health measures have been put into effect targeting adults and the elderly to deal with the ageing population, and the promotion of lifelong dental health care has been advanced. The city of Osaka has implemented the following 4 programs to promote dental health:
1. Instructions in dental health in prenatal classes
2. Dental checkups of one-and-a-half year old infants
3. Dental checkups of 3 year old children
4. Dental health consultation in accordance with the Elderly Health Law
Based on data obtained through the implementation of dental health consultations in accordance with the Elderly Health Law in all wards of Osaka city, we have conducted the following comparisons:
1. Change in ratio of abnormal teeth by year from 1989 to 1994
2. Status of implementation of dental health consultation
In addition, we have analyzed the most recent data obtained from April 1994 to March 1995 to profile the population seeking consultation as follows:
1. Profile of population seeking consultation (age, sex)
2. Presence/absence of abnormality by age
3. Presence/absence of abnormality by sex
4. Presence/absence of abnormality by sex and age
5. Classification of dental abnormality
The results indicate that 70% of the those seeking consultation were women. Abnormality was observed in about 64% of all those seeking consultation. The rate of dental abnormality was higher in men than in women, and high rates of dental abnormality were observed in the 50's and 60's age group.

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[in Japanese]

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