In 1981 the Ministry of Welfare decided to start a national program of health promotion, the object of which was to establish continuous health care from the time of life in the womb, through birth, development, and aging, to the time of death. The purpose of dental health in this program was to prevent loss of teeth caused by dental diseases, especially periodontal disease among middled-aged people. In this program there were 5 experimental areas to investigate health conditions and to try new practices of health administration in the community. In 1986 we did a survey of the dental condition of 119 middle-aged people (between 39 and 44) living in Aoki village, one of 5 experimental areas east of Nagano prefecture.
The results were as follows:
1. The percentage of people treated for dental caries were 81.8% in men and 78.1% in women. The results were higher than those of the national dental survey in 1981.
2. The percentage of people having no inflammation in the gingiva was 54.5% in men and 81.3% in women. The results were higher than those of the national dental survey in 1981.
3. The percentage of people having dental calcules was 54.6% in men and 28.6 % in women. The results indicated the need for of oral prophylaxis, especially in men.
4. The mean number of lost teeth per person was 1.6 in men and 2.7 in women. In particular the loss of the second molar increased in proportion to aging.
5. The percentage of people with lost teeth and no prosthesis was 46.9% in men and 32.6% in women. People having more than 6-8 lost teeth generally suffered from malfunction of mastication.
6. The percentage of people having received treatment for dental diseases within one year prior to the date of survey was 43.6 % in men and 51.6 % in women.

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The coronavirus disease 2019 (COVID-19) is a major public health problem. Dental and oral surgical procedures that generate aerosols are considered to have a high infection risk. However, few studies have reported COVID-19 clusters in dental and oral surgical care settings; therefore, with the aim of understanding the infection situation in actual dental and oral surgical care settings during the COVID-19 epidemic, we conducted a questionnaire survey on infection control measures and infection status in dental and oral surgery practice. The results showed that the risk of spread of COVID-19 infection through dental and oral surgical care is very low. However, there is no doubt that the risk of infection exists in dental and oral surgical procedures involving saliva and other materials. The results of this study indicate that infection risk in dental and oral surgical practice can be avoided if the epidemic situation is correctly judged and appropriate measures (screening, triage, infection control, avoidance of close contact, and health care of medical staff) are taken. Correctly identifying the COVID-19 infection status in this study will be important not only for measures to prevent the spread of new infections in the future, but also to avoid the health consequences of withholding or refusing medical treatment based on inaccurate information.

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特別養護老人ホーム入所者4名に対し3カ月間にわたって口腔衛生指導と, 徹底したプロフェッショナル・オーラル・ヘルス・ケア (POHC) を行なったところ, プログラム開始後1カ月目より歯垢および歯肉炎が減少し, 研究終了時には歯垢付着, 歯肉炎が当初のそれぞれの1/3, 1/9まで著明に改善をした. 一方入所者本人に口腔衛生を任せ, 指導を含む一連の口腔衛生プログラムを行なわなかったグループ5名では, この間歯垢付着, 歯肉炎ともに全く変化が観られなかった. このことから専門職による定期的な口腔衛生プログラムは歯肉炎改善のためにきわめて有効であることが示唆された.

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新型コロナウイルス感染症2019（COVID-19）の世界的流行により，歯科治療におけるエアロゾル感染のリスクに関する懸念が高まった．歯科分野においては，エアロゾルの発生や患者の口腔粘膜および唾液との直接的な接触が避けられないため，感染流行当初はエアロゾルを発生させる歯科治療を極力控えるよう，WHOなどの行政機関からアナウンスがなされた．その後，歯科におけるCOVID-19感染リスクの研究が進み，具体的なガイドラインが提供されたが，過去3年間にわたりCOVID-19によるエアロゾル感染に関する研究者間の見解は一致しなかった．本総説では歯科診療時の感染リスクやその測定手法を中心に概説し，今後の歯科における感染制御のあり方についても考察を行う．COVID-19を含めたさまざまな感染症に対し，本稿を用いて，歯科医療現場で最大限の予防策を講じる一助としたい．

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