In order to study their possible influences on oral calcification, nine kinds of Chinese (indigenous) medicines applicable to dry mouth were tested using a pH drop method that measured in vitro formation of calcium phosphate precipitates. Only jûzentaihoto® showed an inhibitory effect on the rate of amorphous calcium phosphate (ACP) formation. Seven kinds of Chinese (indigenous) medicines except for bakumondoto® and byakkokaninjinto® reduced the rate of hydroxyapatite (HAp) transformation by 20~52% with 2.0~7.1 times increase in time. Both at bakumondoto® and byakkokaninjinto® only increased the time by 1.5~1.7 times. From the comparison with etidronic acid, it was suggested that all nine kinds of Chinese (indigenous) medicines might have potential as anticalculus agents in toothpastes and mouthwash.

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It can be supposed that oral health care might influence the regulation of the cardiovascular system for aged persons, and the change in the system might also be different in accordance with consciousness and/or perioral hypersensitivity. The purpose of the current study is to clarify whether oral health care could influence the cardiovascular system for bedridden aged persons, and, if so, the aspect of the change might be influenced by consciousness and/or perioral hypersensitivity using systolic blood pressure, pulse date, and Rate Pressure Product (RPP) .
Thirty five bedridden aged persons in hospital were selected as subjects. The age of the subjects were ranged from 67 to 101 (86.3±8.7) years. All the subjects were classified as Rank C, in which a person is determined as a disabled person who is regularly bedridden with support for excretion, feeding, and changing clothes. The subjects were classified into three groups as follows ; Group A those who can follow instructions provided by a care-giver, Group B : those without perioral hypersensitivity who cannot follow instructions by a care-giver, and Group C : those with perioral hypersensitivity who cannot follow instructions by a care-giver. Systolic blood pressure, pulse date, and RPP were monitored during oral care at the first visit.
There was no change in the regulation of the cardiovascular system for subjects in Group A. However, significant decreases in both systolic blood pressure and RPP were observed for subjects in Group B, while both measures increased for subjects in Group C.
The results here suggested that oral health care for bedridden aged person, who can follow instructions by a care- giver, had no effect on the regulation of the cardiovascular system. Persons without perioral hypersensitivity who can follow instructions might show a change in the system immediately after the start of oral health care, but the system might settle gradually along with oral health care. However, for persons with both inability to follow instructions and perioral hypersensitivity, desensitization could not be expected, so that undesired changes in the cardiovascular system including an acute increase in blood pressure might take place.

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The purpose of this study was to examine the association between the detection of Candida in the oral cavity and some factors related to oral health in the elderly.
Subjects were 200 patients aged 70 years and over (average age 79.1±6.6 years, 82 men and 118 women) who required general dental treatment or domiciliary dental care. For all subjects a swab was taken from the buccal mucosa and then transferred into a simplified culture for Candida (Stomastat^®). After incubation for 24 hours at 37 °C, the detection of Candida was assessed based on the color of the culture and classified into three categories : negative, pseudo-positive and positive. Factors related to oral health including subjects’ age, gender, residence, work and daily activities, oral status, transferring to clinic, walking ability, and systemic diseases were also recorded.
The results indicated that age and gender were not associated with the detection of Candida. The presence of Candida was significantly related to utilization of institution, no work or reduced daily activities, poor oral hygiene, denture wearing, less present teeth, difficulty in transferring to the clinic and walking, and suffering from dementia or other systemic diseases. However, a multivariate analysis revealed that significant factors affecting detection of Candida were oral hygiene, work and daily activities, and walking ability, whereas denture wearing and systemic diseases including dementia, which had been considered risk factors for oral Candida were not strongly related to the detection of Candida .

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The aim of the current study is to investigate the influence of resting salivary flow and Gum test on Heart Rate Variability (HRV) when two measures of salivary flow and HRV are performed simultaneously. 14 normal adults (9 males and 5 females, average : 30.6±3.8 years of age) participated in this study. 15 minutes of resting salivary flow measurement and 10 minutes of Gum test were performed on each subject. Concomitantly, HRV measurements were performed at the following 4 times : (A) 3 minutes from the start of resting salivary flow measurement, (B) 3 minutes before the completion of resting salivary flow measurement, (C) 3 minutes from the start of Gum test and (D) 3 minutes before the completion of Gum test. Simple linear regression analysis was used to investigate the relations among the parameters : Total Power (TP), Low Frequency (LF), High Frequency (HF) and LF/HF such as salivary flow at rest or Gum test, body weight, body mass index (BMI) and HRV respectively. Multiple linear regression analysis was used to investigate the relations between salivary flow and body weight, BMI or HRV. There was an approximately 5% significant increase in average heart rate when heart rates during Gum test (period C and D) were compared with that of resting salivary flow measurement. The HRV measurement values from times A to D, TP, LF, HF and LF/HF were analyzed. There was a significant correlation between LF/HF and salivary flow at times B and D, which were just before the completion of resting salivary flow measurement and Gum test, respectively. In the current study, it was suggested that HRV measurement during salivary flow measurements could be a way to evaluate the influence of autonomic nerve activity on salivary flow. Furthermore, salivary flow appears to increase during salivary flow measurement in normal adults, when the sympathetic nervous system is more active than the parasympathetic nervous system.

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In the 2010 health promotion project for elderly“A comprehensive research project for the Promotion of improvement of oral function care service for Prevention of Long-Term Care”, we offered the oral function improvement program with two additional programs; the improvement of body movement program and the nutrition improvement program; and verified its’ effect as an independent and compound programs. The result showed that the compound programs have a higher rate in the low-grade need for nursing care and reduces the risk of nursing care caused by accidental fall bone fracture or aspiration pneumonia. This proved that the compound programs have high effect in preventive care compared to the independent programs.
For the efficiency of duties of outpatient preventive Long-Term care support providers, we consolidated the assessment of the oral function improvement offered during the compound programs. We examined the common characteristic assessment of independent and compound programs by information analytical technique of the hypothesis discovery type.
As a result, we were able to find the following common assessments: occlusal pressure, the frequency of oral diadochokinesis/ta/ in one second, the first cumulative time of RSST, and the basic health checklist on oral health and General Oral Health Index. This indicated that in practicing the oral function improvement program, the use of these assessments will efficiently extract the effect of compound programs. Furthermore, the use of these assessments reduced the burden of nurses, which led to an expectation of the dissemination of highly effective compound programs.

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The main symptoms of dementia with Lewy bodies (DLB) are fluctuating cognitive impairment and parkinsonism. To our knowledge, only a few studies have investigated minutely dysphagia in DLB patients. This study aims to demonstrate the relationship between dysphagia and cognitive impairment in patients with DLB.
Twenty-two DLB patients (11 males and 11 females; mean age, 77.9) were recruited and the Revised Version of Hasegawa’s Dementia Scale (HDS-R) was scored. They underwent measurements of tongue pressure using a handy probe and videofluoroscopy (VF) for swallowing using 3 g of barium gelatin jelly as a test food. We scored the functional dysphagia scale (oral stage, 37 points; pharyngeal stage, 60 points) and measured the oral transit time based on the VF images.
The average values of 22 patients of the oral stage score, the pharyngeal stage score, the oral transit time and the HDS-R score were, respectively, 11.7, 13.4, 25.6 s and 12.7. Seven patients could not carry out the measurements of tongue strength and the average tongue pressure of 15 patients was 16.1 kPa. Significant correlation was found between the oral score and the HDS-R score(p = 0.038, R=-0.452), but there was no significant correlation between the pharyngeal score and the HDS-R score (p=0.279, R=-0.236).
These results suggested a relation between dysphagia and cognitive impairment in patients with DLB. In order to adjust the diet of patients with DLB, it is helpful to consider not only the swallowing ability but also the cognitive function.

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Complaints associated with psychiatry, sometime, affect dentistry. Because symptoms occur at the oral lesion, patients consult dentists and so, we dentists are involved. We report two recent cases of suspected Cenesthopathy.
Patient 1 : The patient was a 78-year-old man. He complained that the enamel on the back of his teeth melted and extended like rubber, producing transparent pieces of material that came out one after another. The patient strongly rejected a consultation in the department of psychiatry. We carefully listened to and accepted the patient’s complaints without denying them, and concretely explained about the characteristics of the disease and that this phenomenon may develop even in the oral cavity. As a result, the patient’s anxiety about this disease ceased. We used general psychotherapy with drug therapy, but the symptoms were not totally eradicated. Therefore, we talked about the limitations of the dental treatment, and finally the patient accepted treatment in the department of psychsomatic medicine.
Patient 2 : The patient was a 76-year-old man. He complained that objects resembling a spiral-shaped spring, hair, and bar came out of his mouth. The patient consulted several specialists at departments such as neurosurgery, otorhinolaryngology, and dentistry, but was told that no abnormalities were present. The patient was pleased that his complaints were accepted and requested to be treated in our department. After 3 months, the patient’s understanding improved, and thus the treatment was completed.
The dental strategy for this disease, is to perform dense Liason-therapy with a psychiatrist, or early treatment by a psychiatrist, upon agreement with the patient. Therefore, we conclude that it is important to understand and treat psychological diseases.

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The purpose of this study was to evaluate the status of masticatory function in terms of occlusal force and ability of mastication, as well as the relationship between these factors, in elderly complete denture wearers.
The subjects were all elderly complete denture wearers, 35 males and 90 females, living in hospital and welfare facilities. We investigated data for occlusal force and occlusal contact area using a dental prescale system, and for chewing ability using a questionnaire which consisted of 30 food items with three alternatives. We also asked the subjects about their sense of eating satisfaction and for an evaluation of their own dentures and the term of wearing dentures.
The following conclusion can be drawn from the data.
1. Almost all subjects always wear their dentures. They are satisfied with eating and evaluate their own dentures highly. The average term of wearing dentures is 10.7 years.
2. Average occlusal force for all subjects was 127.8±95.9 N, and occlusal contact area on the whole was 3.7±3 mm² ; these were low. It seemed that occlusal force and occlusal contact area were influenced by the attrition of artificial teeth due to long-term denture wearing. On the other hands, it was shown that occlusal force and occlusal contact area were not influenced by satisfaction of eating and an evaluation of their own dentures.
3. The average number of food items which all subjects were able to chew was about 21 items. It was shown that the more subjects were satisfied eating and higher evaluated of their own dentures, the greater the number of food items and the relationships among them (p<0.05) .

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[in Japanese]

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