Takahiro Mori

Development of a candy-sucking test for evaluating oral function in elderly patients with dementia: A pilot study

To maintain oral intake in elderly patients with dementia, it is important to evaluate their oral function. However, these patients often have difficulties following instructions during oral function tests, especially with the progression of dementia. The task of sucking a lollipop candy is simple for elderly patients with mild or severe dementia. The present study aimed to develop a new oral function test – the “candy sucking test” (CST) – for elderly patients with dementia.

Factors related to masticatory performance in healthy elderly individuals

PURPOSE Maintenance of natural dentition and/or prosthodontic rehabilitation is necessary for good masticatory function. Although other factors such as physical and oral functions are also important for masticatory performance, only a few studies have evaluated their roles. The aim of the current study was to assess factors associated with masticatory performance among elderly individuals, while maintaining and/or reconstructing all occlusal support areas. METHODS The present study was designed and implemented as a cross-sectional study, involving a total of 262 participants (mean age: 74.2±5.9years) who participated in the Kyoto Elders Physical Fitness Measurement Research Project. Individuals with partial or complete edentulousness who did not use dentures were excluded from the study. The predictor variables included physical status (i.e., age, gender, body-mass index, and grip strength), oral conditions (i.e., number of present teeth, temporomandibular joint noise, and denture wearer), and oral functions (i.e., maximum voluntary occlusal force; occlusal contact area; cheek pressure; oral diadochokinesis test /pa/, /ta/, /ka/; and maximum voluntary tongue pressure). The variable outcome was masticatory performance. These variables among the participants using univariate and multivariate analyses were compared. RESULTS Grip strength, number of present teeth, maximum voluntary occlusal force, occlusal contact area, oral diadochokinesis /ka/ /ta/, and maximum voluntary tongue pressure were significant factors for masticatory performance. Stepwise regression analysis showed that grip strength, maximum voluntary occlusal force, and diadochokinesis /ta/ significantly affected masticatory performance. CONCLUSIONS Masticatory performance was closely associated with grip strength, maximum voluntary occlusal force, and diadochokinesis /ta/ among healthy elderly participants.

Candy eating behaviour to improve swallowing function in dementia subjects

OBJECTIVES To develop and assess a dysphagia training method involving lollipop sucking training in older adults with dementia, clarify its effectiveness for improving oral function. METHODS Twenty-five older adults with dementia (5 males and 20 females, mean age 90.8 ± 6.7 years) were participated in this study. Participants were trained in lollipop sucking once a day, 3 times a week for 6 months. Mini-Mental State Examination (MMSE), Barthel Index (BI), Candy Sucking Test (CST), and BMI values were measured before and after the training. Participants were grouped into those who achieved >0.1 g/min increase in CTS value after the training (increase group) and those who did not (nonincrease group). RESULTS No significant change was observed after the training. The increase group contained 4 patients and the non-increase group contained 21 patients. There were no significant differences in MMSE, BI, or BMI between the two groups before and after the training. However, the CST values of the increase group before the training (0.31 ± 0.13 g/min) were significantly lower than non-increase group (0.69 ± 0.27 g/min) (p < 0.01). Respective changes in BMI before and after training were 1.13 ± 0.85 kg/m² and -0.53 ± 1.76 kg/m² in the increase and non-increase, and the difference in these changes was statistically significant (p = 0.04). CONCLUSIONS Our new rehabilitation method was well accepted by older adults with dementia, and there was an improvement in oral function as a result of the rehabilitation, which had some good influence on weight gain.

Change of Oral Conditions after Combined Use of a Tongue Brush and Toothbrush: A Pilot Study

Introduction: This pilot study compared the effect of tongue cleaning by using a tongue brush alone and the one of combined using a tongue brush and toothbrush. Materials and Methods: 20 healthy young men were studied. The effect of tongue cleaning was assessed according to the following three criteria, including a tongue coating index, H2S concentration and oral bacterial count. These criteria were applied after tooth brushing combined with tongue brushing and then compared with the data by using a tongue brush alone. To evaluate the need for ongoing combined oral cleaning, its effect was evaluated on the day after a 7-day cleaning regimen’s completion, and we compared it and the data obtained on the day before the study. Results: After using a tongue brush alone, the tongue coating index improved and the oral bacterial count decreased (p < 0.05). After combined oral cleaning with both a tongue brush and toothbrush, significant improvements were revealed for the three criteria (p < 0.01).While, no significant difference was observed in the tongue coating index, H2S concentration, and oral bacterial count between on the first day before cleaning and on the next day after the 7-day cleaning regimen completion. Conclusion: This study indicated that oral cleaning by using a tongue brush alone resulted in a minimal decrease in the oral bacterial count, but significant improvement was achieved by combined use with a toothbrush. The results also suggested the necessity of daily combined use of a tongue brush and toothbrush for maintenance of a healthy oral cavity. *Corresponding author: Mineka Yoshikawa, DDS PhD, Associate professor, Hiroshima University Institute of Biomedical and Health Sciences, Department of Advanced Prosthodontics, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8553, Japan, Tel: +81-82257-5677; Fax +81-82-257-5679; E-mail: mineka@hiroshima-u.ac.jp