Many investigations have shown that oral hygiene is inadequate in most nursing homes for the aged. The purpose of this study was to investigate the methods of oral hygiene used by the nursing staff to maintain proper dental and denture hygiene among residents. A questionnaire was mailed to 110 staff in 11 nursing homes for aged (9 in Saitama and 2 in Tokyo), and 100 replied, 15 males and 85 females. They had worked in nursing homes for 5.7 years on average. They answered questions on the time and methods applied by the nursing staff to clean the residents' natural teeth and dentures.
The results were as follows:
1. All staff replied that dentures were cleaned by the nursing staff every day. The most frequent time for denture cleaning was “after supper.”
2. Of 100 staff, 94 used a toothbrush or a denture brush when they cleaned residents' dentures. Sixty-four used a denture cleaner. Fifty-eight used both a denture cleaner and a brush. Forty cleaned residents' dentures with toothpaste and brush.
3. Ninety-six replied that natural teeth were cleaned by the nursing staff every day. The most frequent time for natural teeth cleaning was “after supper.”
4. Ninety-five used a toothbrush when they cleaned residents' natural teeth. Fifty-one cleaned them with a toothbrush and toothpaste. Special equipment, such as interdental brushes and dental floss, was rarely used.
5. Individual denture brushes and individual toothbrushes were not always available for daily oral and denture care. In fact, the same brush was sometimes used for more than one resident's oral hygiene. These findings demonstrate that the staff of nursing homes for the aged need professional training to achieve effective daily oral hygiene. The staff's current oral hygiene habits are liable to lead residents to catching infections such as hepatitis virus, methicillin-resistant Staphylococcus aureus (MRSA). Therefore, the staff should be made aware of therisk ofinfection from daily oral hygiene procedures. Measures for facilitating oral hygiene and methods of improving it are necessary to reduce the burden of providing it.

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The purpose of this study was to evaluate the effects of pulsed Nd: YAG laser treatment on periodontal diseases. The subjects used in this study were 30 periodontal diseased patients aged from 26 to 69 years (mean; 51.6±11.0 years). The samples consisted of 30 vital teeth. Each sample satisfied the following criteria: 1) each sample and the adjacent teeth had periodontal pockets of 4mm or greater in depth; 2) the sample had no restoration or filling at the gingival margin.
The periodontal pockets selected for inclusion in this study were treated with a pulsed Nd: YAG laser fitted with 320 micrometer contact optical fiber (dLase 300, American Dental Laser Inc., USA). The duration of the laser radiation was 20sec on the corner of the teeth, and 30 sec for buccal and lingual portions. The energy level of laser radiation at 20pps. was adjusted at the level of pain subthreshold in each patient. The mean energy level used in this study was 1.47±0.31 watts.
The conditions of the gingival tissue were assessed before and after the laser radiation. For evaluation of the Nd: YAG laser treatment, redness, swelling and pain of gingival tissues and bleeding from pockets after probing were examined and scored (0-3 points) at each assessment. Pocket depths were also measured.
The redness of gingiva improved in 20 cases out of 28 cases (71%). The swelling improved in 24 cases out of 27 cases (89%), and the bleeding in 21 cases out of 26 cases (81%). Periodontal pocket depth was reduced significantly (p<0.001) after the laser radiation. The mean pocket depth before radiation was 3.1±1.2mm (ranged from 1 to 8mm) and that after radiation was 2.1± 1.1mm (ranged from 1 to 7mm). No side effect were observed during or after the laser treatment.
Those results indicate that pulsed Nd: YAG laser radiation into peridontal pockets in periodontal therapy is effective and safe. The clinical application of Nd: YAG laser could have great advantage for periodontal therapy in geriatric patients and compromised patients.

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In the oral care of the elderly by themselves various devices, including the toothbrush, have been utilized but with difficulty due to reduced physical and mental functions. Among these devices, a cotton applicator (Mentip^® Large and small) used widely in Japan, and a shanked sponge (Toothette ^®) used widely in Western countries, were examined and evaluated as to their effects of cleaning the oral mucosa and tooth surface. An upper jaw cast (oral model) or a human oral cavity (palate mucosa and upper and lower front teeth surface), to which adhesive materials were attached, was swabbed with a cotton applicator or shanked sponge, and the volume of swabbed materials was measured macroscopically for the oral model and through image processing for the human oral cavity.
In experiments with the oral model using the large and small cotton applicators and the shanked sponge, the following results were obtained:
1) The cleaning effect of the small cotton applicator was extremely poor.
2) A good cleaning effect could be obtained with the large cotton applicator when adhesive materials were rubbed for more than 15 seconds.
3) The cleaning effect of shanked sponge was good in all of the cleanig procedures examined.
In interoral experiments performend using the large cotton applicator and shanked sponge, the following results were obtained:
1) The cleaning effect on the palate was significantly better with the shanked sponge, compared with the large cotton applicator, in all of cleaning procedures examined.
The removal rate of adhesive materials with the shanked sponge was more than 99%.
2) Although no difference in cleaning effect on the teeth surfaces between cotton applicator and shanked sponge was observed when each device was used without rotation after it was soaked in water and slightly wrung, the shanked sponge showed singificantly better cleaning effects in all other cleaning procedures. The removal rate of adhesive materials with the shanked sponge under the most satisfactory conditions was 98%, and with the cotton applicator, was 81%.

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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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[in Japanese]

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