The authors studied the influence of the medecine used for complicated diseases on the course of dental treatment. 20 eldery patients (average age 68.8) taking antiplatelet drugs were selected. The patients needed dental surgery: 33 times tooth extractions, and one time minor resection of a benign tumor on the tongue.2% Xylocaine ® (Lidocaine) (cotaining 1/80, 000 epinephrine) was used for local anesthesia. During surgery, monitoring (using 8 channel polygraph or automatic tonometer) was performed.
The following results were obtained.
1. The complicated diseases for antiplatelet were 8 cerebral infarctions, 5 myocardial infarctions, 5 angina pectoris, 4 atrial fiblilations, and one cardiomyopathy and hypertension. There were some patients with two complicated diseases.
2. Cases of simple use of antiplatelets outnumber the combination use. The quantity of antiplatelet drugs was small.
3. Postoperative bleeding was prevented by suturing and longer Pressure of the wound. Only one patient had postoperative bleeding without suturing.
4. Dentist must be aware of the development of antiplatelet drugs.

View full abstract

Measurement of blood pressure is a routine procedure in dental treatment for elderly patients. Recently, automatic sphygmomanometers have become common, because of the simplicity of handing. To evaluate the practical applicability of automatic sphygmomanometers in dentistry, we examined how the blood pressure measured on a dental chair with automatic sphygmomanometers varied with the types of sphygmomanometers. In addition, we examined to what extent the blood pressure measured by ausculation with a conventional mercury sphygmomanometer correlated to the values obtained with automatic sphygmomanometers .
A total of 100 subjects were used. They consisted of 50 young people (25 males and 25 females) in their twenties and 50 old people (25 males and 25 famales) aged over 65 years. Threetypes of automatic sphygmomanometer were used; upper-arm type, wrist type and finger type. These were oscillometric devices. Blood pressure was measured in two body positions;sitting and supine positions.
The blood Pressure obtained with the finger type was higher than that obtained byausculation with a mercury sphygmomanometer. The value obtained with the upper-armtype was lower than that obtained by ausculation. The value obtained with the wrist type wasalmost the as that obtained by ausculation. Significant positive correlation was found betweenthe values obtained with the three types of automatic sphygmomanometer and the valueobtained with a mercury sphygmomanometer. The scattering of blood pressure values wasslightest when measured with the mercury sphygmomanometer, followed by the upper-armtype and then by the wrist type. The scattering was largest with the finger type .
The above results suggest that in clinical application of automatic sphygmomanometer indentistry, it is necessary to be acquainted with the actual differences in value by the types ofsphygmomanometer, including the mercury type, and to be aware that measurement with thefinger type can hardly be expected to be reliable.

View full abstract

In a hospital or nursing home for the elderly, it is not easy to prove the identity of each person's removable denture. If the denture owner has a mental disability, this may be a very difficult task for the nursing staff. Therefore, some dentists have recommended marking the owner's name on the denture.
In this study, one of the authors interviewed 36 disabled elderly to ask whether they wanted marking on the denture or not. 25 of them preferred to have their name marked. This demand was not related to mental disability.
Markings were then placed inside 44 dentures of the 25 elderly who wished for their name to be marked. The marking method was developed by us with a kanji label writer and light curing translucent resin.
One month later, we were able to check 42 dentures closely. Only one (2.4%) showed a small break of the mark margin.
One year later, we found sligth changes on 4/25 (16.0%) of the dentures. These were small margin exfoliations or surface coloring of the mark. However, the name could be easily identified on all dentures.
Finally, we elicited responses from the nursing staff and guardians of the elderly. All of them appreciated our project and stated that the marking was very usefull for the disabled elderly.

View full abstract

Good oral health contributes to a better quality of life. Close cooperation between dental professionals and public health nurses is essential for successful oral health care of the homebound elderly. The purpose of this study was to investigate the oral status of the homebound elderly and to find which factors in oral health care are judged important by public healthnurses.
A questionnaire was mailed to public health nurses at public health centers and governmental offices in Tokyo and Saitama. Responses were obtained from 161 public health nurses and 155 were analyzed, with 6 incomplete replies being omitted. The results were as follows:
1 . Of 155 public health nurses, 105 (67.7%) thought that most of the homebound elderly had carious teeth.
2. One hundred and thirty-five nurses (87.1%) thought that most of the homebound elderly had periodontal diseases.
3. Ninety-seven nurses (62.6%) thought that most of the homebound elderly suffered from pain in the mouth.
4. One hundred and forty-six (94.2%) thought that the dentures of the homebound elderly were usually ill-fitting.
5. Eighty-three (53.5%) thought that the most significant problem regarding the oral status of the homebound elderly was ill-fitting dentures.
6. One hundred and forty-seven responders (94.8%) thought that the homebound elderly were dissatisfied with their dentures.
7. One hundred and forty-seven (94.8%) thought that the homebound elderly needed dental treatment.
8. The key matters of importance for oral health care in domiciliary care were determined to be: the method of denture cleaning, 126 responses (81.3%); the method of tooth cleaning, 123 responses (79.4%); and careful judgement of the dental treatment needs of the elderly, 107 responses (69.0%).
9. The key factors in poor knowledge of oral health care in domiciliary care were determined to be: removable prosthodontic treatment for the edentulous and the partially edentulous, 118 responses (76.1%); treatment for dental caries and periodontal diseases, 116 responses (74.8%); careful judgement of the dental treatment needs of the elderly, 108 responses (69.7%); and the method of denture cleaning, 104 responses (67.1%). A significantly higher number of public health nurses who had not been trained in oral hygiene than public health nurses with training selected the method of tooth cleaning as matters of poor knowledge. A significantly higher number of public health nurses who had not been trained in oral health for the adult than public health nurses with training selected the methods of both tooth and denture cleaning as matters of poor knowledge.
These findings demonstrated that the greatest problem in the oral health of the homebound elderly is ill-fitting dentures and that training public health nurses in cleaning teeth and dentures by dental professionals is necessary. It is important that public health nurses should be able to evaluate the oral status of the elderly for successful oral health care and careful judgement of the dental treatment needs of the elderly.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract