Purpose：The background of patients who need home-visit dental treatment is complex, and it is difficult for dentists to objectively assess whether or not their patients will be able to wear or tolerate new dentures. The purpose of this study was to determine predictive factors for successful usage of new dentures.

　Methods：We selected new patients（mean age, 79.7±12.2 years）who had requested home-visit dental treatment from our dental department and who required dentures over a 5-year period, from 2013 to 2018. After manufacturing dentures for them, we divided the patients into two groups：those who were able to wear their dentures continuously（denture-tolerant group）, and those who were unable to wear dentures and stopped using them（denture-intolerant group）. We evaluated 294 patients in the denture-tolerant group and 25 in the denture-intolerant group, and examined their intraoral conditions and physical status, as well as relationship among those who requested treatment.

　Results：Compared to the tolerant group, the intolerant group included a higher percentage of patients who had difficulty maintaining the seated position（odds ratio：7.870, 95％ confidence interval：3.098 to 19.992, p＜0.001）. The intolerant group also included a higher percentage of patients who had previously exhibited symptoms of Parkinsonʼs disease（p＝0.048）and who had difficulty gargling（p＝0.012）. We consider that the ability to remain seated is not only a useful criterion for evaluating body function, but is also significant for determining denture wearing suitability among older patients who require them.

　Conclusions：Our results suggest that whether or not patients can maintain a seated position is helpful in assessing their overall suitability for wearing dentures in the case of home-visit dental treatment.

　Purpose：The purpose of this study was to examine the predictors of oral hypofunction in older adults at long-term care insurance facilities. Predictors were examined focusing on rinsing ability and activities of daily living that can be evaluated by care providers.

　Methods：Older adults admitted to nursing homes or using day services were selected. A total of 103 participants（17 males, 86 females, mean age：85.3 ± 6.8）were included in the analysis. Assessment items included base attribute, clinical dementia rating（CDR）, functional independence measure（FIM）, rinsing ability, and seven items for diagnosing oral hypofunction.

　Results：A significant relationship was found between rinsing ability/FIM and each of the following items：occlusal force, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function（p＜0.001）. Logistic regression analysis showed that FIM was extracted as a predictor of decreased tongue pressure（percentage of correct classification：90.3％）and decreased masticatory function（percentage of correct classification：83.5％）, and that both rinsing ability and FIM were extracted as predictors of deteriorated swallowing function（percentage of correct classification：77.7％）.

　Conclusion：This study suggested that both rinsing ability and FIM could be candidates for care providers to predict oral hypofunction in older adults at long-term care insurance facilities.

　Pagetʼs disease of bone is characterized by abnormal bone remodeling, which results in deformity of the micro- and macro-structures of the bone, eventually diminishing the bone strength. This condition is extremely rare in Japan, affecting approximately 2 or 3 people per million. Frequently affected sites include the pelvis and spinal column, whereas the jaw is rarely affected. Here, we report the case of an very old patient with Pagetʼs disease of bone, diagnosed due to extensive osteonecrosis of the jaw. The patient was a 96-year-old male who was found at home and had difficulty in moving. The patient was diagnosed with septic shock due to urinary tract infection and was hospitalized. Since his mouth was filled with clotted blood, he was referred to the dentistry department for investigation of the oral infection. Significant bone exposure was observed in the right incisor and left molar regions of the maxilla. The various imaging findings were as follows：extensive sequestra and periodontal space degradation on panoramic radiography, a mixture of sclerotic and resorptive regions on posteroanterior radiography, a cotton wool-like appearance on computed tomography, and abnormal accumulation in the cranial and facial bones on bone scintigraphy. High alkaline phosphatase activity was detected in peripheral blood tests. The patient was diagnosed with Pagetʼs disease of bone concomitant with osteonecrosis of the maxilla. After sequestra excision and dental treatment, an oroantral fistula was found, which was covered using a denture in order to restore the velopharyngeal and swallowing functions. After instructing family members on the handling of the denture, the patient was discharged. During the 2-year follow-up period as an outpatient, no complications were reported. The patientʼs oral condition improved, which allowed him to consume regular meals. Since older patients with osteonecrosis may have undiagnosed Pagetʼs disease of bone, a careful systematic evaluation should be performed for timely management.

　Older adults with dementia may have difficulty in visiting a dentist due to physical symptoms, behavioral and psychological symptoms of dementia（BPSD）, and the environment of care. In this study, we report a case of infective endocarditis caused by apical periodontitis with odontogenic maxillary sinusitis in an older patient with dementia. The patient, a 97-year-old woman, had Alzheimerʼs disease. She presented to our emergency room with a chief complaint of fever and was admitted as an emergency case of bacteremia. Blood culture revealed Streptococcus anginosus, an oral streptococcus, and transesophageal echocardiography showed a verrucoma on the mitral valve, leading to the diagnosis of infective endocarditis（IE）. She was referred to our department for further investigation of the source of IE. On CT imaging, the left maxillary first molar showed odontogenic maxillary sinusitis with root apical periodontitis spreading to the left maxillary sinus, which was revealed to be the source of the infective endocarditis. Because of her strong refusal of treatment, we extracted the causative tooth, a left maxillary first molar, and other remaining roots under psychosedation. In order to continue dental therapy and perform oral hygiene after discharge from the hospital, we arranged for a home dental visit during the hospitalization and instructed the caregiver on oral care. After administration of penicillin G, her fever quickly resolved, and blood culture tests were negative. However, mitral regurgitation worsened due to mitral valve destruction, and heart failure progressed, resulting in death on the 31st day after first visiting our hospital.