In this study, the authors try to identify the effects of the hardness of barium containing jelly (hereinafter called Ba-Jelly) on mastication and swallow. Ba-Jelly was prepared by mixing and heating barium solution, water and gelatin to dissolve followed by cooling. Ba-Jelly thus prepared was ingested and swallowed by healthy young adult volunteers without any abnormality in mastication and swallowing. Their mastication and swallowing were studied using videofluorography (VF) and gnathohexagraph respectively.
1. The VF study showed that the food bolus stayed long in the mouth (oral phase) but passed from the mouth, oropharynx to hypopharynx and from hypopharynx to esophagus rapidly. The transit rate reduced as the gelatin content increased. The maximum rate of transit to oropharynx was greater than that to hypopharynx.
2. The gnathohexagraph showed that the higher the gelatin content, the greater the number of chewing. It also showed that the higher the gelatin content, the greater the time lag between the occlusal sound recorded at the end of the chewing and the swallowing sound.
The above-mentioned results indicate that hardness of Ba-Jelly affects mastication and swallowing. Hardness of Ba-Jelly seem to affect food bolus formation, which then af-fects pharyngeal transit.

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As aged population grows rapidly in Japan, the number of dental patients with dementia is increasing at an unprecedented rate. This study examined the relationship between senile dementia, dental health and ingestive habits. The survey was conducted for 3 years and 7 months starting in January 1998. 426 elderly dental patients aged 65 years or older participated. Either the patient or his/her caregiver was asked whether the patient performed the activiey independently or with assistance in the following areas:
1) frequency of tooth brushing,
2) ability to brush one's teeth,
3) ability to wash one's mouth,
4) ability to fit and remove dentures,
5) keeping dentures safe,
6) type of meals and assistance needed for eating.
The patients were divided into groups according to the scale developed by the Japanese Ministry of Health, Labour and Welfare. The results showed that the oral health habits of elderly patients declined as their dementia became severe. Furthermore their denture management abilities declined as dementia increased.
In order to provide elderly patients with adequate oral care, trained professionals need to be aware of patients' condition. For example, the such as type of meals provided should reflect patients' dementia level. It is imperative to create an oral care system that deals effectively with demented patients in order to improve their Quality of Life.

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The object of the present study was to investigate whether or not improved oral function by dental treatment leads to improvement of the type of diet and activity of daily living (ADL) among aged patients. One hundred and seventeen aged patients over the age of 64, who received dental treatment from January 1999 to December 2001, participated in this study. The type of diet was classified as ordinary diet, ordinary rice with chopped side diet, semi-fluid rice with ordinary side diet, semi-fluid rice with chopped side diet, fluid diet and tube feeding. ADL was graded as self-supported, semiselfsupported and totally supported among the five categories of eating, bathing, excretion, wearing of clothes and moving.
The type of diet improved in 59 (50.4%) patients after the dental treatment, whereas no change in the type of diet was seen among 53 (45.3%) patients. Five (4.3%) patients showed a decline of the type of diet. Cases of the ordinary diet markedly increased and those of semi-fluid rice with chopped side diet obviously decreased after the dental treatment. In addition, about 40-60 percent of patients showed the improvement of the type of diet after the dental treatment, regardless of ADL. On the other hand, only four (3.4%) patients showed the improvement of ADL with regard to, at least, one of these five categories. Four (3.4%) patients showed a decline of ADL, and no change in ADL was seen in the remaining 109 (93.2%) patients. There was no obvious change in ADL after the dental treatment.

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[in Japanese]

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[in Japanese]

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The purpose of this study was to determine the effectiveness of an enzyme-containing denture cleanser on in vivo plaque deposits.
The denture bacterial flora before and after denture cleansing of 20 dependent elderly were exam-ined for microorganisms by the culture method.
Although hardly any bacteria were detected after denture cleansing, Candida spp.cannot be re-moved by an enzyme-containing denture cleanser.
Microbiologically, Candida spp.in denture plaque are recognized to be the most important microor-ganisms of denture stomatitis etiologically. However, the results of this study showed that Candida spp.could not be removed by an enzyme-containing denture cleanser. High antifungal activity is considered a desirable property of a denture-cleansing agent for prevention of denture stomatitis. In light of the well-recognized relationship between denture cleanliness and the oral health of the denture patient, the importance of plaque removal from a denture cannot be overemphasized.

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Twenty-three patients who received in-patient dental treatment in our department over the last5 years were studied. Based on the results, we established a framework for a critical path for dental treatment in hospital as shown below, and created by path sheet.
1. Patient criteria: Those with impaired ADL who have a chronic (stable) condition of thedis-ease that caused the low ADL and who do not require additional in-patient medical treatment.
2. Treatment parameters: minor surgery (e. g. tooth extraction) and conservative treatment (e. g. caries and root canal treatments).
Prosthetic treatment will be provided on an outpatient basis, at a local dental office, or by home visits.
3. Treatment will be performed twice a day.
4. The number of treatment days: Two timetables were established: 14 days and 7 days. They can be modified depending on the number of teeth to be treated and treatment details.
5. Variances: A variance was defined as an occurrence of incidences such as a prolonged hospitalstay or actions not planned in the path.
6. Path drop-outs: A path drop-out was defined as incompletion of planned dental treatment for some reasons.

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We performed a Critical Path study at Dental Treatment under Hospitalization on patients (28 in total: 14 males, 14 females. Average age 75.1±9.0) who were in our hospital between February 2000 and May 2001.
The Results obtained were as follows:
(1) Patients have 6.8 diseases on average. The most important disease and sequela that brought low levels of ADL were cranial nerve diseases. The rate was 53.6%.
(2) The length of hospital stay reduced to 4.8 days after we introduced the Critical Path System at Dental Treatment under Hospitalization.
(3) Of the 28 cases, there were 9 variant cases and 3 dropped out cases.
(4) Dentists, dental hygeinists and nurses understand their duty, details of treatment, and progress of treatment. We achieved the standardization of medical treatment because of the indications from dentists to nurses and nurses' records, which we simplified.
(5) We analyzed patient satisfaction for the patients and their helpers after the introduction of the Critical Path System. According to the results, they were satisfied with Dental Treatment under Hospitalization, and we understood their treatment.

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[in Japanese]

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[in Japanese]

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