It has been twelve years since Nursing Care Insurance was introduced in Japan. The population of Needed Long-Term Care exceeded five million in 2012, which is twice of that in 2000, the year the insurance started. The majority of them are over 85 years old. Care manager supports nursing-care service synthetically by assessing the need of Needed Long-Term Care and preparing plans for care.
At care management, the condition of oral is hard to figure out just by seeing from outside and it is also difficult to let people open their mouths. This is the reason why the observation of oral condition is missed in many assessments of care needs. Most of the time both senior citizens and caregivers do not mention about their oral conditions unless they have pain or problems in biting. The problems of oral are gathered as“consumption ability”.
In the research Hattori did in 2011, which objected care managers, the existence of dentistry in assessments was asked. Thirty-one percent answered that it is barely included and 33 percent answered that 10 percent of the assessments includes it. For the question, which asked about cooperation with dentists in the stage of care planning, 36 percent answered almost none and 52 percent answered that it is carried only for about 10 percent of the total case. It is clear that the cooperation with dentists and care managers is very little in the actual situations.
It is required to not giving up eating by using mouths, to prevent infectious diseases by oral care and to position the management of tooth loss or conformity of artificial tooth.

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The purpose of this study was to examine the influence of aging on tongue movement during mastication by analyzing the tongue pressure against an experimental palatal plate.
The subjects consisted of 11 dentate young (group Y) and 11 dentate elderly (group E) with healthy masticatory function. The tongue pressure during mastication of gummy jelly on the habitual side and swallowing was measured using 5 strain gauges (φ : 6.0 mm, KYOWA) which were placed in an experimental palatal plate (S1: incisive papilla, S2: 10.0 mm from the contact point of maxillary canine and first premolar, S3: 10.0 mm from the contact point of maxillary first and second molar toward midline of palate, S4: middle point of the both side first molar, S5: 4.0 mm from middle point between the feveola palatines). The maximum magnitude, duration and integration values of tongue pressure were analyzed in three masticatory stages (early, middle, late), and we calculated the ratio of total duration time to mastication time (TDT/MT). Statistical analysis was performed using Student’s t-test (p<0.05) .
The results were as follows. There was no difference in maximal magnitude between groups Y and E at all strain gauges in all masticatory stages. The duration and TDT/MT in group E were significantly larger than in group Y at each strain gauge except for S3 in all masticatory stages. The integrated value in group Y was significantly larger than that in group E at S3 in all masticatory stages.
From comparison of the masticatory movement function of the young and elderly dentate, it was suggested that the elderly were coping with the change that took place with aging by supplementing the workload necessary for the formation of the bolus of food by extending the duration of tongue contact over a large area within the palate.

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Eating disorders and dysphagia are pressing issues in Japan, given its super-aging population. While simple assessment methods for eating and swallowing functions have been developed, they have consisted of observing the presence or absence of swallowing or a cough reflex. In other words, there has been no simple test to judge swallowing strength. Noting that the suprahyoid muscles that contract during swallowing are jaw-opening muscles, we created a jaw-opening sthenometer to assess the swallowing function and measured the jaw-opening muscle strength of 64 healthy participants (mean age, 44.7±12.6 years) as basic data. The mean jaw-opening muscle strength was approximately 8 kg (mean strength for men, approximately 10 kg; women, approximately 6 kg) . Muscle strength was significantly higher in men than in women, but no correlation with age was found. This result is consistent with previous studies that have measured jaw-opening muscle strength for different purposes. A significant correlation was found between jaw-opening muscle strength and handgrip strength, which uses different muscles. This indicates that the sthenometer provides meaningful measurements and is valid as a measurement tool. The suprahyoid muscles of healthy participants in their 60’s did not show reduced muscle strength due to age.

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The number of actual recipients of oral function improvement service for people requiring support is low. We conducted several surveys of the staff members of community-inclusive medical centers about the planning of oral function improvement services to clarify its factors. The purpose of the first survey was to determine the important factors in planning the oral function preventive care. The aim of this paper was to examine the disincentive factors in planning in oral function preventive care.
The study utilized mail-in anonymous survey results. The analysis was performed with 447 valid answers.
There was a significantly low number of planners who did not perform plan drafting. However, clients who had oral function problems during care were recognized. The disincentive factors, which were different between a number of abnormalities in the oral cavity and a number of service plans that actually were recommended, were associated with the user’s a lack of knowledge of the oral function, the family (p<0.001) and a lack of recognition of the Program provider (p=0.003) , Planner (p=0.02). These data show there were positive statistical differences. On the other hand, “Absence of demands from potential beneficiaries” (p=0.01), showed a negative statistical difference.
Recognition of the need for oral cavity function improvement service is possible in the community. Improved recognition of the service is necessary, and the role of the planner is expected for this activity to connect these people with necessary services.

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[in Japanese]

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