We investigated the relationship between the status of oral flora and the oral and general health of 89 elderly patients living in a nursing home located in Sapporo city. There were 23 males and 66 females, and the mean age was 81. 3 years. Specimens were obtained by swabbing the dorsum of tongue, and they were cultured arobically and the number of the colonies were counted. We calculated the number of colonies of streptococci, staphylococci and candida as well as the total number of these bacterias.
The rate of candida-positive cases was significantly (p<0.05) higher in the denturewearing patients (68/73, 79.5%) than in those without dentures (4/11, 36.4%). However, there were no significant relationships of the number of the colonies to the age and sex of patients, the body mass index (BMI), the activity of daily living (ADL), the presence or absence of xerostomia, and the number of remaining teeth.

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The aging of society in Japan has rapidly progressed and the number of aged persons who consult dentists is increasing. It is necessary for dentists to consider the mental and physical problems specific to aged patients undergoing dental treatment. Tokyo Medical and Dental University has a gerodontic course run by the Department of Geriatric Dentistry. A simulated age program has been introduced into the gerodontic course so that student may learn from experience. In the program dental students experience various difficulties in seeing, hearing and moving by items such as wearing cataract glasses, weights, and supporters. As a result the students act and feel as if they were elderly. The purpose of this study was to examine the effect of the simulated age program on dental students. The subjects were 644^th-year dental students in Faculty of Dentistry, Tokyo Medical and Dental University. They were divided into groups of two. The student whose function was restricted carried out one or two of 7 assignments, e.g., reading, ascending and descending stairs. The other who played a role of caregiver observed how his/her partner acted in the program. After finishing the program, the effect of the program was investigated using questionnaires. Many of the students who played the role of the aged patient answered that they felt disabled beyond their expectations. Many of the students who played the role of caregiver were aware of their partners' difficulty in ascending and descending stairs and doing manual tasks. Therefore, we concluded that the program is effective in raising students' awareness of aged patients' needs.

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Because of lack of the long-term follow up study for the patients with glossodynia, we do not have enough evidence to decide the time of treatment termination as well as the appropriate follow up period. 177 patients with glossodynia at the Department of Oral Surgery, Nagoya University School of Medicine, during the 5-year period between 1988 and 1992, were asked to answer a questionnaire by telephone. Except for twenty-nine of them who had died or who could not be contacted because of moving. 148 patients answered the questionnaire.
We investigated the long-term follow up after the treatment with reference to the results of the treatment, sexuality and the age at the treatment. Ten percent of the patients, who had no symptoms by the end of the treatment, did not complain of glossodynia at the time of the interview.
Sixty-eight percent of the patients reported alleviated symptoms after the treatment, and seventy one percent of them were free from the previous symptoms. twenty percent of the patients still had their symptoms after the treatment, but 29% of them were alleviated and 29% were free from the symptoms. The male group had berrer results than the female group.In the female glossldynia pafients group over 55-years, the present symptoms are more severe than those of the under 54 year old group.During the long-term follow up of patients with glossldynia, most of them were now free or alleviated from the previous symptoms.

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Maintenance of oral health is essential for the elderly to improve their quality of life. It has been reported that removable prosthodontic treatment for dependent elderly patients plays an important role in their QOL. On the other hand, dental treatment of the elderly including prosthidontic treatment should be performed very carefully because of the possibility of cardiac disease, carebrovascular disease and other types of vascular impairments.
The purpose of the study was to verify the risk of removable prosthodontic treatment for dependent elderly patients in our university's home-based dental treatment system. 88 dependent elderly patients (average age 74.6±11.1 years old) were investigated as to their systemic disease, the type of treatment, the place of treatment and number of visits for treatment. Moreover, a sample group of fourteen of the 88 patients were measured for heart rate, systolic blood pressure and diastolic blood pressure by sphygmomanometer at pre-, inter-and post treatments. RPP (rate pressure product) and SpO₂ (hemoglobin saturation of oxygen) were measured by Blood Pressure Monitor BP-88 (COLIN, Japan).
As for the type of treatment, removable prosthodontic treatment accounted for 83% of all dental treatment. 49% of procedures involved repair and relining of existing dentures, and 34% involved construction and insertion of new dentures.
As for systemic desease, cerebrovascular disease was found in 51 patients, and cardiac disease was found in 15 patients. These two diseases affected 67% of all the patients.
As for hemodynamic changes, systolic blood pressure and RPP were increased remarkably in denture adjustment for the patients with pain of residual mucous membrane.
From this investigation, it was suggested that the check and monitoring vital signs are necessary to those in need of denture adjustment and for patients with pain of residual mucous membrane in dependent elderly patients as well those receiving surgical treatment.

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Recently, the relationship between stomatognathic functions and general health in the elderly has been observed with keen interst. Especially, there are some reports on the imfluence of the occlusal-masticatory function on the brain function. In order to verify the relationship between the masticatory function and the general function of the whole body, 36 dependent elderly persons in a geriatric hospital were investigated. The “Denture Score” was obtained by evaluating denture retention, stability, occlusion and satisfaction. Moreover all the subjects were divided into two groups, the low Denture Score group and the high Denture Score group.The degree of dementia was judged by Hasegawa's Dementia Rating Scale. The “Autonomy Score” was evaluated by using the Criteria of Bed-Ridden Elderly issued by the Ministry of Welfare in Japan. The Voluntary maximal clenching force was measured using the Prescale system^®. The “Chewing Score” indicating the masticatory ability was calculated by a food intake questionnaire developed by the authors. The Elderly Nursing Care Plan (MDS/RAPs) developed by the national project in the United States in 1990 was used in this investigation.
The results obtained are as foollows.
The subjects judged to be dementia accounted for 62.4% of all the subjects.
The subjects judged to be pre-bedridden elderly accounted for 38.7% and to be bed-ridden accounted for 61.3% of all the subjects.
In the low Denture Score group, 75% of the subjects were judged to be dementia. On the other hand, in the high Denture Score group, 45% of the subjects were judged to be dementia.
There was a significant correlation between the “Denture Score” and “Autonomy Score” (p<0.01). There was also a significant correlation between the “Denture Score” and the “Voluntary Maximal Clenching Force” (p<0.05). There was also a significant correlation between the “Denture Score” and the “Chewing Score” (p<0.05).
In MDS/RAPs, “Examination of dementia and cognitive loss”, “Examination of psychological well-being”, “Examination of mood state”, “Examination of dental care” and “pressure ulcers” were selected as Resident Assessment Protocols (RAPs).
The results of this study suggest that a close relationship exsts between the masticatory function and some measures of physical and mental activity in this group of elderly subjects.

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Some indigenous microorganisms may cause host opportunistic infections owing to breaking down the balance between the host and the normal microbial flora. Aging is one of the major factors of the relations in this imbalance.
The purpose of this study was to investigate oral microbial flora of elderly people. Subjects consisted of the following two groups: a nursing home group which included people living in 3 different nursing homes (n=110) and a control group consisting of those living in the community (n=72).
We performed general oral examinations, investigated salivary flow rate, buffering capacity, the number of lactobacilli and the level of mutans streptococci in saliva, the numbers of staphylococci and Candida on the tongue, and CH₃SH.
We obtained the following results: the nursing home group showed significantly lower buffering capacity, and higher numbers of Candida and staphylococci on the tongue when compared with the control group.There were no significant differences in the other results. We also gave oral health care to people in one of the nursing homes, and investigated the results of post-treatment. After the care, the salivary flow rate, the level of mutans streptococci, and CH₃SH were improved when compared with pre-treatment, and there was little change of Candida.
The results suggest that the number of opportunistic pathogens, such as Candida or staphyococci, is extremely high in the nursing home group when compared to the control group.However, it was difficult to reduce the number of Candida with the oral health care.

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