Patients in nursing homes and other health-care facilities misplace their dentures, leading to a problem of identification. Some form of denture marking would clearly aid in identification. In foreign countries many articles on denture marking have been published. The need to mark dentures is well documented as an aid to the identification of victims of fatal disasters, of misplaced dentures in hospitals, nursing homes, and instituions, and in cases of unconscio usness and psychiatric, traumatic or senile loss of memory. In Japan, there are few articles on denture marking, and denture marking is not widespread. The purpose of this study was to in vestigate the need for a denture marking system at geriatric institutions in Japan.
Sixty-seven staff members in 12 geriatric institutions (8 nursing homes, 2 specialist nursing homes and 2 geriatric hospitals) participated in this study. Fifty-four of 67 staff members were women, 10 were men and the others were unknown. They included case workers, nurses, care workers and others. They had worked in geriatric institutions on average for 9.9 years.
A questionnaire on experience in the identification of misplaced dentures, the necessity of marking dentures and denturs wearers' consent to marking dentures was answered by staff members.
The results were as follows:
1. Denture marking was carried out at one of 12 institutions. In this nursing home a dentist marked the dentures, but only a few dentures were marked.
2. Of 67 staff members, 55 (82 percent) had experience of identifying misplaced dentures.
3. Fifty-six (84 percent) recognized the necessity of marking dentures at geriatric institu tions.
4. Sixty-two (93 percent) thought that patients should be advised to have their dentures marked.
5. Thirty-seven (55 percent) thought that patients would agree to having their dentures marked.
6. Forty-two (61 percent) thought that many patients wanted to have their dentures marked.
The investigation indicated that a large number of staff members recognized the need to mark dentures and thought denture wearers would accept denture marking.
An ideal denture identifier would be cheap and easy to apply by unskilled personnel to both dentures under construction and those already in use. Marking should also be unaffected by cleansing and disinfecting regimes and fire. It should not weaken the denture by reducing its thickness, by stress concentration, or by solvent action. The mark should be cosmetically acceptable. The identification should be specific. The authors have a method for marking dentures easily, simply and cheaply, as follows:
1. Grind channel (5×10×0.5mm) into the polished surface of a denture.
2. Write a name on the channel with a waterproof marker.
3. Make good the channel with clear autopolymerizing resin.
4. Polish the denture.
The authors have had good results using this system of denture marking.

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A questionnaire was mailed to all 70 nursing home for the aged in Saitama Prefecture, out of which 55 nursing homes replied (78.6%). These 55 nursing homes accommodate 3396 persons in total, of which 44.8% are in ther eighties, and 71.7% are female. The ratio of female residents increases with age and it accounts for 81.8% of those in their nineties.
Among the pesronnel of the facilities, female staff mainly take care of the residents. The average number of staff is less than one person for four residents, which indicates the shortage of staff. Also, for each facility, an averge of 1.3 doctors, but only 0.1 dentist and no dental assistant are on hand.
Concerning ADL conditions of the residents such as moving, eating, and hygiene many of them find it most difficult to look after themselves, including brushing their teeth. Less than 40% can take care of themselves without any assistance.
Up to the present, requests for dental service have been met by dental clinics where dental practice for the aged is available.Residents have dental problems, especially related to false teeth: 6.7 persons per facility complain of ill fitting false teeth, and 1.4 cases per month per facility suffer from toothache. In 8 facilities, the patients had trouble with taking food due to toothache. Dental practice is undertaken only 6 facilities, thus the residents' dental health is not properly managed. Dental practice is undertaken in only 6 facilities; thus the residents' dental health is not properly managed. When the residents complain of a toothache, 61.9% of them receives dental treatment, 28.6% take pain-killing medication at ther facility and 9.5% ask a dentist to visit them.
The respondents to the survey made several suggestions with regard to improving the dental service for ther residents
They would like to have visiting dental services, they would like to have dental clinics in the neighborhood where they can regularly receive dental teatment, special dental institutins for the aged, or the arrangement of transportation to and from dental clinics.Furthermore, they request dental assistants to help them to maintain their oral hygiene conditions. Less than 10% replied that they would prefer the present situation to continue.

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The most common dental diseases, caries and periodontal disease are generally known to be caused by infections due to normal flora in the oral cavity. However, we consider that these is insufficient attention to detail in the management of inpatients' oral hygiene.
Especially, the management of oral hygiene is very important in preventing infections and in avoiding mental hygiene problems for long-term elderly hospitalized patients . Accordingly, the questionnaire study was carried out, in order to find opinions and document practice of oral hygiene management by nursing staff in geriatric institutions and hospitals.
The questionnaire was sent to and collected from the subjects whose cooperation was reques ted in advance. The subjects were the staff of geriatric institution in Tokyo and two geriatric hospitals in Kanagawa and Shizuoka.
Of 120 qustionnaires distributed, 90 were returned. The average age of the subjects was 32 .5 years old and the average years of experience was 7.5 years. Sixty subjects have had oral hygiene education and thirth had not. Most respondents answered about the dental treatment and oral hygiene relating to the general health conditions of the inpatients . But the reasons for their answeres were not very clear, and most subjects did not understand the reasons.
Most nursing staff answered that they need the management of oral hygiene . However we think that both their concern with and understanding of oral hygiene are still low.
We suggest that nursing staff are too busy with the general care of inpatients, so they have insufficient time for oral hygiene management. There is therefore a need for the development of an effective mouth rinse, and oral hygiene education for nursing staff. Moreover, cirums tances in which dental hygienists can manage oral hygiene positively at geriatric institutions and hospital should be created.

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This study was performed as the preliminary investigation for the dental care service center for homebound elderly in Chiba-city which is planned to start in 1993.
General care and oral health status of the selected homebound eldery (n=50, aged 54-93, mean age=78.5, 66% female) living in Chiba-city were assesed, The subjects were selected from the elderly receiving home services from a public health center.
Interviews and oral examinations were performed by a team consisting of a dentist, a health nurse and a dental hygienist.
Data analysis was performed using the statistical package SAS.
Major medical problems for the homebound were cerebral hemorrhage (30%) and cerebral embolus (18%).
Most of subjects (67%) had not received dental care for more than five years.
The Major oral problem was difficulty in Chewing, and 52% of denturers were bound to be needing adjustment or replacement.
The Subjects had a mean of 6.9 teeth/person with 42% edentulous.
While over 40% of the participants wanted dental treatment, 32% of subjects who did not want treatment reported lack of assistance and/or transportation for the dental visit as their reason.
According to the oral examination 79% of subjects needing treatment were indicated to receive dental treatment withot adimission.
These findings indicate that dental care service center and organized transportation systems are essential for the dental treatment of the homebound elderly.

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[in Japanese]

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In spite of the increase in the number of elderly people, the relationship between oral health and general health in this age group is unclear. We studied 80 residents in a home for the elderly (65 females, 15 males) with regard to their state of health and oral circumstances. They were from 65 to 97 years of age and from 23kg to 70kg in weight. We divided them into three groups based on physical factors: senile dementia, physical disease and functional disease. We also grouped them according to the peculiar traits of the diseases: four stages for senile dementia (normal, subnormal, predementia and dementia), two groups for physical disease (heart disease and other disease), and two groups for presence or absence of functional disease caused by cerebral vascular accident (CVA). We used Hasegawa's Simple Inspection Scale for senile dementia. Two subjects (2.5%) were found to have senile dementia. As for physical disease, almost half of them suffered from heart disease. With regard to functional disease, about one-third of them had problems resulting from CVA. Our main concern was for the oral condition of these elderly people. Accordingly, we studied how senile dementia, physical disease and functional disease affected the subjects' vigor for life, masticatory efficiency, oral care and the number of their remaining teeth. Inestimated their masticatory efficiency, we used Yamamoto's table, because many of the subjects had dentures. As for oral care, we classified the subjects into five groups according to our care code which runs from 0 to 4, corresponding to the number of untreated teeth.
The results wers as follows:
1. As senile dementia progrens, subjects tend to lose their interent in living, and their normal efficiency of masticating decreanes.
2. In many cases, those with physical disease, especially heart disease, did not receive any dental treatment, even though they had oral problems. However, many of them were quite efficient at masticating, in spite of their physical disease.
3. Those who had functional disease, especially coused by CVA often did not receiveany dental care when necessary. They also tended to masticate less well. However the numbe of subjects with remaining teeth increased in the functionally-diseased groups.
4. The ratio of those with untreated teeth was highest among subjects with functional disease. In other words, functional disease makes it difficult for elderly people to have dental treatment.
One more point we may add is that the food in the home was specially prepared for elderly people, and accordingly the softness of the food was taken into account in the study. Masticatory abililty may vary according to the cooking methods. Therefore, we feel that further research is neede on elderly people who live under different circumstances from the subjects studied in this report.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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