Candida has been well known as one of pathogens for opportunistic infections. The incidence andnumber of Candida are higher in the oral cavity of the dependent elderly. Oral health care forthe de-pendent elderly requires the cooperation of both the patients and the care providers. Simple and reli-able oral hygiene for eradication of Candida is needed to maintain oral health for the dependent elderly. The purpose of the study was firstly to establish whether the use of a tongue brush could increase the awareness of oral hygiene and decrease the number of Candida, and secondly, to find how the decreaseof Candida affected the oral cavity and the life style of the dependent elderly.There were 67 subjects: 33 dependent elderly and 34 elderly all of whom were receiving dental care on an outpatient basis. The number of Candida on the tongue was investigated on two occasions before instruction on oral care with tongue brush, and 44 days and 99 days after instruction. Addition-ally, an oral examination was performed before, and 99 days after instruction. The subjects filled out questionnaires after instruction.
The mean number of Candida of the dependent elderly was significantly higher than that of the outpatient group both before, and 44 days and 99 days after instruction. The number of Candida de-creased in both groups after instruction, with a particularly marked decrease in the dependent elderly.
In the dependent elderly, the status of oral hygiene and the sense of taste improved, increased self -awareness of health and the increased saliva flow were obtained, and the content of daily meal waschanged by the decrease of Candida.
The use of a tongue brush was beneficial for the improvement of oral hygiene.The decrease of Candida could improve the living activities of the dependent elderly.

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Recently, the effects of chewing gum on stomatognathic system have been studied, and it was also showed that chewing gum could suppress advance of aging. The purpose of this study was to find a chewing gum with low adhesion to dentures, and which denture wearers could chew easily. First we made trial chewing gums with various hardnesses based on the criterion of viscosity, and measured the penetration stress and adhesion to dental restorative materials of each gum. Then we had complete denture wearers chew the trial chewing gums. Participants scored the texture and the adherence to dentures of each gum. We examined the scores affected by the hardness of chewing gum, and also gathered data on the sex, age, denture using time and occlusal force of each subject. The following re-sults were obtained:
1. Penetration stress
The penetration stress was affected by the hardness of chewing gum. The value was significantly low in soft chewing gum.2. Adhesion to dental restorative materials There was significance in the factors of both gum and restorative material. We found that soft gum would be adhesive, and that all the gums would be adhesive to materials made of resin.
3. Chewing gum texture score
The score of chewing gum texture was not affected by the hardness of the chewing gum. The score significantly correlated only with the occlusal force, and the correlation was a little positive. This showed that subjects could easily chew soft chewing gum when the subject had a low occlusal force.
4. Adherence to dentures score
The hardness of chewing gum significantly affected the score. It showed that soft chewing gum would adhere to dentures. The score significantly correlated also with denture using time, and the cor-relation was a little negative.

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The purpose of this study was to establish an evaluation method of the lower denture foundation, using measurements of volume and area on stone casts made for replacement of the lower complete denture.
On ten lower stone casts of edentulous subjects, the volume (V), surface area (S), basal area (B), and projected area to occlusal plane (P) of the denture foundation were measured after jaw registra-tions were performed. For clinical assessment of the denture foundation, shape of ridge and location of border tissue attachment were evaluated and scored (F). Simple correlation coefficients between the parameters measured and F were calculated. Also multiple regression analysis, in which the parame-ters measured were dependent variable and independent variable was F, was performed.
The following conclusions were drawn from the data:
1. The results of measurement in this study were similar to results reported in previous studies.
2. V, S, V/B and V/P had significant positive correlations to F.
3. The multiple correlation coefficient, using V/P, S/P and B/P as the dependent variable and F as the independent variable, was 0.98 (p<0.001) and so it was concluded that itis possible to evalu-ate denture foundation using these parameters.

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The purpose of this study was to investigate the appropriate management of edentulous patients who use denture adhesives.
160 edentulous volunteers (66 males, 94 females. Average age: 73 years), receiving complete den-ture treatment at the Dental Hospital of Tokyo Medical and Dental School, participated in the study.
The dentures (new and old) and the oral status of each patient were examined and scored. The denture and oral status scores were compared between the adhesive using group and the non-using group.
The results are as follows:
1. 23 male and 21 female patients used denture adhesive
.2. No significant correlation was found between the use of denture adhesive and the condition of the residual ridges.
3. The number of adjustment appointments in the using group was significantly larger than that in the non-using group.
4. Though the using group showed a significantly lower degree of satisfaction with the old den-tures, they showed a higher degree of satisfaction with the new dentures.5. The using group showed a higher degree of masticatory score in the new dentures than in the old dentures.
These results suggested that edentulous patients who use denture adhesives could obtain the high quality new dentures by proper prosthodontics treatment.

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The rapid aging of the Japanese population as well as advances in medical technology allowing pa-tients with cerebro-vascular disease to rehabilitate into society increase our opportunities to meet such elderly patients in our dental offices, because of the increasing incidence of cerebro-vascular disease later in life. Much attention has been paid to the dependent or bedridden elderly with cerebro-vascular disease. In contrast, there are few studies of elderly outpatients with cerebro-vascular disease. The goal of this study was to clarify the medical and dental conditions of the aged patients with cerebro-vascular disease who can visit dental offices. The subjects of the present study were 282 outpatients who visited the rehabilitation clinic in Seirei Mikatahara Hospital after the acute stage of stroke. They were divided into two groups: the elderly group (E-group) aged over 65 (155 patients) and the non-eldery group (N-group) aged less than 65 (127 patients). We examined their activity of daily living (ADL) and func-tional independence measure (FIM) in addition to their medical history. We also investigated their den-tal conditions including the number of present, sound, treated, untreated, and missing teeth, and the re-maining roots, as well as their gingival index (GI) and plaque index (PLI), in addition to the condition of their dentures. We then consulted them about the dental treatment that they required, before asking whether they wished to receive dental treatment or not. The results were as follows: 1) the outpa-tients included 159 patients with cerebral infarction (56.4%), 116 with cerebral hemorrhage (41.1%), and 19 with subarachnoid hemorrhage (6.7%); 2) the main complications included 163 patients with hypertension (57.8%), 33 with diabetes mellitus (11.7%), 12 with atrial fibrillation (4.3%) and 4 with chronic renal failure (1.4%); 3) the major symptoms of these patients consisted of paralysis including hemiplegia (220, 78.0%), aphasia (77, 27.3%), articulation disorder (70, 24.8%) and ataxia (28, 9.9%); 4) the mean scores of the ADL, FIM in the E-group were lower than those in the N-group; 5) the average number of present, sound and treated teeth decreased with age, while the average number of missing teeth as well as the mean score of GI and PLI increased; 6) the number of pa-tients who required removable dentures exceeded the number of patient who required restorative den-tistry; 7) the mean ADL and FIM scores in the E-group with ariculation disorder were lower than those in the E-group without articulation disorder, and also those in the E-group with paralysis were lower than those in the E-group without paralysis. Accordingly, in treating elderly patients with cerebro-vascular disease-associated risk factors, such as hypertension or diabetes mellitus, the dentist should carefully evaluate these patients' medical condition, and manage their treatment properly. In ad-dition, the patients, even though they can visit a dental office, are often debilitated to some degree in motor function or speech, so that dentist must take care of them when they visit the office, especially the patients with hemiplegia or articulation disorder. Furthermore, the goal of dental care for them should be to fit adequate removable dentures in order to improve their quality of life.

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Candida has been reported as common among those persons who wear dentures. It is related to such generalized diseases as the dysphagic pneumonia of the elderly aswell as such intraoral diseases as denture stomatitis and root surface caries. Therefore it is important to keep dentures as clean as possible. Dentures are now chemically washed with a denture cleanser in order to prevent the accidental misuse and ingestion of denture cleanser.
Ozone is a gas with a distinctive odor and strong oxidization power, and accordingly it is used for oxidization and deodorization. Since ozone disinfects by means of a process of oxidization, it does not produce any drug-resistant bacteria and harmful chemical substance after use. Ozone is thought to be suitable for washing and disinfecting dentures, because if it is dissolved in water or exists in water as tiny bublles (the ozone bubble method), it gains efficiency with low concentration.
We studied the bactericidal effect employing the ozone bubble method, choosing Candida albicans, well known for having a higher detection rate and pathogenicity than any other Candida bacteria existing in the mouth. The following are the results we obtained:
1. This method showed about the same bactericidal effect in both the standard strain and the clinical isolates.
2. 99% inactivation time: Standard strain (23ppm)-26 min.(41ppm)-19 min.(49ppm)-15min. Clinical isolate from dentures (23ppm) 24 min. From periodontal pocket (23ppm) 28 min. The CT value of 99% inactivation was 661±94 (ppm·min).
Therefore, we conclude from this study that the ozone bubble method was effecient against C. albicans.

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[in Japanese]

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The growth in the number of elderly people in Japan is accompanied by a growth in the number of elderly dental patients. At the same time, the number of dependent elderly continues to increase. Consequently, dentists and their co-workers have to understand the problems and current status of eld- erly dependent patients. However, many dental students today have had little contact with elderly peo- ple because of the trend towards the nuclear family.
A group of 5^th-year predoctoral dental students did an internship in anursing home, with a view to changing their stereotyped image of the elderly. Specifically, the internship aimed to help them to understand the lives of the dependent elderly, to teach them how to nurse and help the patients, and to stimulate them to consider the current problems of the dependent elderly. After the practice, students filled out a questionnaire on their understanding of the elderly patients, and we evaluated the internship from the results of the questionnaire. 90% of the students indicated that they had deepened their understanding of the dependent elderly, and 83% answered that this internship was a good experience for them. Moreover, the students could point out various problems of the dependent elderly, had learned how to nurse and help them, and how to rehabilitate them. Therefore, we concluded that this program is effective for predoctoral dental students, and the program should be continued.

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