Purpose : The aim of this study was to analyze the effectiveness of the Ibaraki Obstructive Sleep Apnea （OSA） Disorder Medical and Dental Cooperation Network, based on a questionnaire survey on dental sleep medicine for general practitioners.
Subjects and methods : A questionnaire survey regarding OSA was performed in 2018 on 1,326 clinics which belonged to the Ibaraki Dental Association. The results were compared between dentists who had attended the certified lecture on OSA on dental sleep medicine by the Ibaraki Dental Association （registered dentists） and those who did not （nonregistered dentists）. The questionnaire results of the registered dentists by region were statistically analyzed, both before and after construction of the network.
Results : The questionnaire results showed that 56 clinics performed oral appliance （OA） treatment, of which 33 had registered dentists and 23 did not. By region, the number of clinics performing OA treatment was statistically significantly higher in regions where certified lectures were held than in regions where they were not held （P＜0.01）. Continuous follow-up after OA treatment was performed in significantly more clinics with registered dentists （48.4%） than in those without registered dentists （8.7%） （P=0.002）. A substantial proportion of clinics （73.2%） used the monoblock type of OA in both groups. Before construction of the network system, the registration rate was 12.7%, and rates were significantly higher in regions where certified lectures were held than in regions where they were not held （P=0.01）. After construction of the network system, the registration rate increased to 17.3%, and there was no difference between the 5 original regions and the 2 regions that newly began to hold lectures, but the rate was significantly higher in these regions than in the 3 regions that did not hold the lectures （P=0.035）.
Conclusion : Our questionnaire survey demonstrated that many of the registered dentists performed continuous follow-up of the patients after OA treatment, and the registration rate increased in the regions that began to hold lectures after construction of the network system.

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フッ化物錠剤咬みくだき法を齲蝕予防の目的で, 茨城県下にある某小学校において実施した。研究対象は男子626名, 女子607名, 合計1,233名の児童で, フッ化ナトリウム錠剤2錠 (フッ素量として0.905mg含有) を咬みくだかせた後, 口腔内に残留するフッ素量, 残留率をオリオン社製イオンメーター (407A型), フッ素イオン電極を用いて求めた。
その結果, フッ素の口腔内残留量 (残留率) は男子で0.319mg (35.2%), 女子では0.295mg (32.6%), 全体では0.307mg (33.9%) であった。対象児童の個々の口腔内残留量 (残留率) の最高値は0.819mg (90.5%) で, 最小値は0.030mg (3.3%) であり, 標準偏差は0.110mg (12.1%) であった。全児童の約60%の789人の口腔内残留率は20～40%の間にあった。
本法によるフッ素の口腔内残留量および残留率は学級別, 学年別, 性別によって有意差が認められた。
しかし, 本法は学校保健関係者の指導によって6年間の実施経験をもっており, フッ素の口腔内残留量, 残留率の規準になりうるものであろう。

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Purpose : We investigated actual treatments for obstructive sleep apnea （OSA） in hospital dentistry to help propose a model for integrating dentistry and medicine intermediated by hospital dentistry.
Method : A questionnaire survey of treatments for OSA was mailed to 35 members of the Ibaraki Association of Hospital Dentistry. Replies to the questionnaire were returned by facsimile, e-mail attachment, or post.
Results : Responses were obtained from 27 institutes （recovery rate 77.1%）. There were 19 institutes （70.4%） performing treatment using an oral appliance （OA）. Regarding the annual number of OA made, 14 institutes （73.7%） made 1-9, 3 institutes made 10-49, and 2 institutes made 50-99. Regarding cooperation, 9 institutes （47.4%） cooperated with other departments in the same hospital, 4 institutes cooperated with departments in other hospitals in addition to within the same hospital, 2 institutes cooperated with other special facilities for OSA besides within the same hospital, 2 institutes cooperated with all medical facilities including within the same hospital, and 2 institutes cooperated with other medical facilities only. Sixteen institutes （84.2%） used a one-piece type, 1 institute used a two-piece type only, and 2 institutes used both types. The number of institutes performing orthognathic surgery for OSA was 2 （7.4%）, which coached oral surgeons serving full-time.
Conclusion : This study showed that treatments for OSA tended to be performed more in hospital dentistry than in dental clinics. Most of the patients in hospital dentistry were treated with oral appliances （OA）, while few patients underwent surgical operation. These results may be helpful for assigning the roles of hospital dentistry in the team approach between dentistry and medicine.

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