The aim of this study was toinvestigate the association of the clinical oral health condition and subjectivefeelings about oral health with the depression scale in community-dwelling middle-aged and elderly population.
The study cohort comprised 208 individuals aged 55 years old and over from the general population of Ohasama, a Japanese rural area. Depressive symptoms were evaluated by using the Zung self-rating depression scale (SDS). The clinical oral health condition data included the number of remaining teeth, presence of decayed teeth and missing teeth without prosthetic treatment, removable denture use, and extent of periodontitis. Subjective oral health data included the score on the Oral Impacts on Daily Performances (OIDP) scale, self-assessed oral health problems, problems during eating and utilization of dental services over the previous year. Possible risk factors for depression were also evaluated, including physical and cognitive functions, feeling of systemic health history of ischemic stroke, social supports, pain, life events in the previous year, and socio-demographic factors.
Multiple regression analyses adjusted for age, gender, physical function, feeling of systemic health, income, social support and life events within a year demonstrated that OIDP scores were significantly associated with SDS scores. In contrast, clinical oral health factors were not associated with SDS scores.
In the middle-aged and elderly population, poor oral health, evaluated subjectively, was associated with the depression scale, independently of physical health, sociodemographic characteristics and environmental factors.

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Objectives: Oral dryness may be caused not only by a decrease in the amount of saliva, but also by abnormality of the saliva. However, the relationship between oral dryness and the properties of saliva has not been not clarified. The purpose of this study, therefore, was to examine the relationship between objective assessment of oral dryness and the properties of saliva.
Methods: The subjects were 20 healthy adults (mean age 28.3±2.7 years). Eating, drinking and smoking were prohibited 30 minutes before measurements so that the effects of a meal and moisture intake could be excluded. To evaluate the oral dryness, the following were measured: 1) mucosal moisture (a moisture checking devise for oral mucosa, Mucus®), 2) saliva wetness (test paper, L-salivo®) and 3) saliva flow (unstimulated whole saliva flow rate). To evaluate the properties of saliva, we measured both 1) viscosity (capillary tube method), and 2) spinnability (a thread-forming property meter, NEVA METER®). Correlation coefficients among the three factors of oral dryness and both factors of saliva properties were calculated.
Results: A decrease in saliva flow led to high viscosity (r=-0.73, p<0.05). A rise of viscosity led to high spinnability (r=0.64, p<0.05). High spinnability led to a decrease in saliva wetness (r=-0.45, p<0.05). There was no other significant correlation in other combinations.
Conclusion: This study clearly showed that oral dryness and the properties of saliva were mutually related, which suggests that saliva abnormality is one of the causes of oral dryness.

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Using functional MRI during cycles of toothbrushing and no brushing, we examined the interaction between brushing and brain regional activity in 16 adult subjects (aged 24-60 years, mean age, 43.7 years). In all subjects, toothbrushing resulted in a bilateral increase in blood oxygenation level-dependent (BOLD) signals in the sensorimotor cortex, insula, cingulate cortex, supplementary motor area, and prefrontal cortex. In addition, in the supplementary motor area and prefrontal cortex, the BOLD signals in the right side were greater than those in the left side, whereas no hemispheric specialization was seen in the first three regions. Furthermore, the amygdale was additionally activated in only the subjects who felt pleasure during the toothbrusing. These results suggest that toothbrusing may produce an enhancing effecton the neurocognitive function in the prefrontal cortex, in addition to an increase in neuronal activities in the sensorimotor system.

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The effectiveness of oral care by professionals hasbeen identified in several studies. However, so far investigations concerning the effects of oral care by nurses and caregivers at elderly-care facilities have not appeared. The purpose of this study was to examine the improvements of oral health through oral care provided by RNs and caregivers.
The study was an intervention study without a control group, comparing pre- and post-intervention measurements. The subjects were 29 elderly people in day-care service, and day-care staff (nurses and care workers). Care was provided once a week for 12 weeks. There was a 12-week control period before the study. Evaluation criteria were investigated at baseline, pre, and post-intervention. Adjusted baselines and covariates were used for statistical analyses of comparisons between pre- and post-intervention.
The results are as follows; the oral care index improved (p<0.001), the oral diadochokinesis improved in rower ADL score (p=0.05), but the moisture oralmucosa did not improve (p=0.2).
The study indicated that oral care once a week was effective for elderly day-care recipients even when implemented by nurses or caregivers.

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[in Japanese]

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[in Japanese]

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