Dry mouth caused by salivary gland hypofunction is a common disoder in elderly persons.However, there have been no surveys reported of dry mouth of the elderly in Japan. The purpose of this study was to evaluate the prevalence and causes of dry mouth in the elderly. The subjects of the study were 95 elderly persons (men n=31, women n=64), aged 65 to 96 years (mean=78) in 3 homes for senior citizens. We asked them detailed questions about various symptoms related to dry mouth, using a specially designed questionnaire. Then we examined missing tooth, oral mucosal lesions and salivary flow-rate by gum test.
The results were as follows:
1. Twenty-three (24.2%) of the subjects noticed subjective sensation of dry mouth.
2. The gum test demonstrated decreased saliva secretion in 48.3% of 89 persons. Severe decreased salivation was observed only in 4 persons (4.5%).
3. Out of the 95 subjects, 85 (89.5%) had at least one chronic systemic disease and 62 (65.3%) were taking at least one xerostomic medication,(e, g., antihypertensive drugs, antihistemics, anticholinergic drugs, antidepressants, psychotropic drugs, antiparkinsonian medication, and diuretics).
4. Those who taking three kinds of xerostomic medication were found to have significantly diminished salivation or sensation of dry mouth.
5. Atrophic change of tongue (22.1%), lobulated (24.2%) and angular cheilitis (2.1%) were clinically observed. No disease of the oral mucosa, such as Leukoplakia, Candidiasis, Oral lichen planus or Aphthous ulcers, were observed.
6. One woman with dry eye was found with possible Sjogren's syndrome, though other persons were not in need of prompt medical treatment against severe dry mouth.

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Nationwide surveys of dental diseases have been conducted by the Ministry of Health and Welfare every six years since 1957.
The date from those seven surveys give us valuable information on the dental diseases and dental health behavior of the Japanese. In this paper, the proportions of persons having permanent teeth classified by age and period are analyzed using an isometric line map method and Bayesian cohort models to investigate the effects of period, age, and birth cohort.
For all kind of teeth, the age effects are overwhelmingly larger than the period and the cohort effects, which supports our natural belief that a decrease in the proportion of the teeth remaining is mainly due to aging.
Though the age trends decrease almost linearly after the age of eruption for all kind of teeth, the decreasing patterns between 20-40 years vary from tooth to tooth depending on the caries susceptibility.
The period trends decline, but after 1975 increase for almost all kind of teeth. It is found that the cohorts born before the mid 1920s have less and those born after the late 1920s more teeth than the average.
The results suggest that the proportions of the teeth present are affected by the demand and supply of dental treatment and the amount and severity of dental caries.

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The oral health of the homebound elderly in Japan is generally poor. Close cooperation between dental professionals and public health nurses is essential for successful oral health care of this group. The purpose of this study was to investigate the level of knowledge of oral hygiene in public health nurses and their ability to instruct the homebound elderly in oral health care.
A questionnaire was mailed to public health nurses at public health centers and governmental offices in Tokyo and Saitama near Tokyo. 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, 147 (94.8%) thought that the denture hygiene of the homebound elderly was poor.
2. One hundred and fifty-one respondents (97.4%) thought that the dental hygiene of the homebound elderly was poor.
3. The preferred instruments and materials for use in denture cleaning were; the brush (denture brush or toothbrush), 147 responses (94.8%); dentifrice, 26 responses (16.8%); and denture cleanser, 62 responses (40.0%).
4. The preferred instruments and materials for use in tooth cleaning were; the toothbrush, 151 responses (97.4%); and dentifrice, 19 responses (12.3%).
5. One hundred and nine respondents (70.3%) thought that they were unable to adequately instruct the homebound elderly in correct methods of denture cleaning. One hundred and twenty-three (79.4%) believed that they could not properly instruct in the use of denture cleanser.
6. One hundred and fourteen respondents (73.5%) thought that they were unable to adequately teach the correct methods of tooth cleaning. One hundred and twenty-one (78.1%) believed that they could not properly instruct the homebound elderly in the use of the interdental brush.
7. A significantly higher number of public health nurses who had been trained in oral hygiene than those with no training thought that dentifrice was not necessary in tooth cleaning.
8. A significantly higher number of public health nurses who had been trained in oral health for the adult and the homebound elderly than those with no training thought that they were able to instruct the homebound elderly in oral health care.
These findings demonstrated that public health nurses require training by dental professionals in the cleaning of teeth and dentures.

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In this study, we applied “Bakumon-do-to” to 26 patients with dry mouth. The patients included 4 with Sjogren syndrome but none with radiation induced xerostomia. In the 22 patients without Sjogren syndrome, 17 were administered drugs to reduce saliva. After treatment, the subjective symptoms were improved in 19 of the 26 patients (73%) and objective findings were improved in 14 of the 26 patients (54%). In addition, the volumes of unstimulated whole saliva were significantly increased (mean value of increase: 0.04±0.03ml/min) (p>0.05).Most of the improvement in subjective and objective symptoms could be observed within 6 weeks. The efficacy was also investigated with reference to the age, gender, systemic medications and salivary gland funcution. There were no differences in age and gender between the subjectively improved and not improved groups. The efficacy was not affected by the difference in systemic medications and degree of salivary dysfunction.

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[in Japanese]

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[in Japanese]

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The elderly population is increasing at a far more rapid rate in Japan than in Europe and North America. In fact, one Japanese in four will be over the age of 65 by 2020.
At present, many elderly patients have multiple dental defects, even though the 8020 movement has been proposed. It is extremely important for us to provide high-quality medical care. Many teeth can now be preserved through progress in appliances, materials, and technology.
We studied the characteristics of elderly patients and designed dentures with a double structure metal framework, with both the mechanical strength and durabilith. We also developed abutments using a coping telescope system.
1. Overdentures for eldely patients should be designed in accordance with the principles for complete dentures.
2. The denture border should cover the gingivolabial margin of the retainer, without notches at the denture border, and extend to gingivobuccal so far as possible.
3. The, mucosal surface of the denture base should be of the total resin type.
4. Metal base dentures with a double structure are able to withstand long-term use, and so are preferred for permanent dentures.
5. Overdenture retainers should use a coping telescope system.

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[in Japanese]

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[in Japanese]

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