Background：Both Germany and Japan have statutory health insurance systems which cover dental care to a large extent. Comparison of the oral health of the general populations as outcome offers the possibility to compare the performance of the systems. Both countries have repeated cross-sectional, representative oral health studies, on which these comparisons can be based.

　Materials and Methods：Deutsche Mundgesundheitsstudie（DMS III, DMS IV, and DMS V）studies are cross-sectional, multi-center, nationwide representative studies to investigate the oral health status of the German resident population. Study participants are adults（35- to 44-year-olds）and seniors（65- to 74-year-olds）. Surveys of Dental Diseases in Japan（SDD）are also cross-sectional, representative studies. We selected the 1999, 2005, 2011 and 2016 SDD waves and restricted our analysis to same age groups as in Germany.

　Results：German adults had 25.3 teeth in 1997 and 27.2 in 2014 and Japanese 27.2 in 1999 and 28.3 in 2016 and in German seniors the mean number of teeth increased from 10.1 to 15.5 and in Japanese seniors from 14.7 to 22.7 including wisdom teeth.

　Conclusion：Adult and senior Japanese citizens have more remaining teeth than their German counterparts. This may be dependent on a more favorable risk profile（education, smoking, metabolic factors）, informed decision making, a 30％ copayment of all treatment costs, a higher dental work force（more hygienists）, incentives for periodontal maintenance visits. For each German the expenditure for dentistry was 216 € in 1997 and 302 € in 2014, whereas for each Japanese the expenditure was 178 € in 1999 and 195 € in 2016. Overall it seems, that Japan uses the dental expenditure resources more efficient than Germany in terms of tooth retention.

　The purpose of this study was to ascertain the prevalence of suspected mild cognitive impairment（MCI）and cognitive decline among elderly patients（65 and over）who visit dental clinics and to investigate the relationship between suspected MCI/cognitive decline and oral health status. The participants were patients who visited 15 dental clinics. Dentists examined the participants and interviewed them about their general health and oral health status. The participants also filled out questionnaires about their general and oral health. Suspected MCI was assessed via the Montreal Cognitive Assessment, Japanese version（MoCA-J）. A total of 181 patients from 65 to 84 years old participated. Of the participants, 44.8％ were assessed as having suspected MCI, and 16.0％ had cognitive decline, and both suspected MCI and cognitive decline were influenced by age（p＜0.001）. The percentage of patients with cognitive decline was 8.5％ among the 65-74 age group, and 26.7％ among the 75-84 age group. Patients with cognitive decline had a lower number of present teeth（p＝0.009）, a higher percentage of subjective oral dryness（OR：4.89；95％CI：1.64-14.5）, and more oral pain than patients without cognitive impairment（OR：3.19；95％CI：1.13-9.04）. However, there were no differences between those with suspected MCI and those without cognitive impairment in terms of general health and oral health status. In order to promote early awareness of cognitive decline in dental outpatients, dentists should consider conducting MCI examinations with elderly patients, even if they do not have any noticeable symptoms. Dental professionals should be particularly alert to symptoms of cognitive impairment in patients with older age, fewer present teeth, subjective oral dryness, and oral pain.

　Purpose：This study aimed to grasp the status of recognition and instruction on oral moisturizer for medical staff.

　Methods：We conducted a questionnaire survey on oral moisturizer for dentists, dental hygienists and nurses.

　Results：Answers were obtained from 102 dentists, 20 dental hygienists and 43 nurses. The breakdown was 60 people with less than 5 years of clinical experience, 39 with 5 up to 10 years, and 66 with 10 years or more. Encouragement of use, instruction on how to use, and changes of moisturizer differed significantly by both occupation and years of clinical experience.

　Conclusion：These items are considered to be important guidance to use moisturizer effectively.

　Purpose：In the national health insurance revision in April 2018, a new disease name “oral hypofunction” was introduced to dentistry；however, examination and management are not so carried out. Therefore, the status of examination and management of oral hypofunction and required time were investigated and the problems were clarified.

　Subjects and methods：Questionnaires were sent to 83 training institutions of the Japanese Society of Gerodontology and the implementation status and problems from April to November 2018 were investigated. The state of implementation in June 2018 was investigated by surveying social medical practices. In addition, the examination time by dentists in our department were studied（time study）.

　Results：88％ of the survey forms were collected；54％ implemented the examination, and 46％ did not. The number of charges to national health insurance for inspections varied（median 3 cases, up to 96 cases）, and the average examination time was 24 minutes. There were many examinations that were not performed, and there were many problems with lack of time（14 cases）and difficult implementation（10 cases）.

　The results of the time study were 13 minutes for regular examination and 10 minutes for an alternative examination. In addition, many respondents found that recording, management, and filling in patient forms were complicated. The number of cases implemented two months after the introduction of insurance was extremely small.

　Discussion：Even at the training institution of the Japanese Society of Gerodontology, the number of implementations by dentists was only half and the volume was small. In the time study, although examinations were completed in a short time, explanation and practice took time for elderly patients. The form to be filled in needs to be improved.

　Conclusion：Although the importance of oral hypofunction examination was confirmed, the state of examination and management was inadequate. The problems to be improved were clarified.