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OBJECTIVE: Side-effects of medications cause xerostomia. There have been cases where a medication has been discontinued owing to its severe side-effects. Therefore, the xerostomia must be treated to ensure that the primary disease is managed effectively. This study analyzed the actual status of patients with medication-induced xerostomia and investigates factors associated with its improvement. METHODS: This study assessed 490 patients diagnosed with medication-induced xerostomia who had an unstimulated salivary flow of ≤0.1 mL/min and received treatment for xerostomia at a xerostomia clinic. Patient age, sex, medical history, medications used, disease duration of xerostomia, and psychological disorders were recorded. The anticholinergic burden was assessed using the Anticholinergic Cognitive Burden scale. The unstimulated salivary flow was measured by the spitting method. According to their symptoms and diagnoses, the patients were introduced to oral lubricants, instructed on how to perform massage, and prescribed Japanese herbal medicines, and sialogogues. Factors associated with the subjective improvement of xerostomia and objective changes in the salivary flow rate were recorded at six months. RESULTS: Xerostomia improved in 338 patients (75.3%). The improvement rate was significantly lower in patients with psychiatric disorders (63.6%) (P = 0.009). The improvement rate decreased as more anticholinergics were used (P = 0.018). However, xerostomia improved in approximately 60% of patients receiving three or more anticholinergics. The unstimulated salivary flow increased significantly more in patients who reported an improvement of xerostomia (0.033±0.053 mL/min) than in those who reported no improvement (0.013±0.02 mL/min) (P = 0.025). CONCLUSION: Xerostomia treatment improved oral dryness in 75.3% of patients receiving xerogenic medications in this study. If xerostomia due to side-effects of medications can be improved by treatment, it will greatly contribute to the quality of life of patients with xerogenic medications and may reduce the number of patients who discontinue medications.

DOI： 10.1371/journal.pone.0280224

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INTRODUCTION: Declining oral function may affect subsequent physical frailty in the older population. The aim of this longitudinal study was to summarise data on patients who underwent functional oral examination and evaluate the impact of management on patients with oral hypofunction (OHF). METHODS: Dental outpatients aged over 65 years at their initial visit to the Niigata University Hospital received detailed assessment of seven oral function items to diagnose oral hypofunction using diagnostic criteria defined by the Japanese Society of Gerodontology. Patients with OHF at the first assessment received management including oral health guidance for low function and dental treatment. They were re-evaluated approximately 6 months later and the two assessments were compared. According to the results of the second assessment, the patients were divided into two groups: OHF improved and OHF re-diagnosed. RESULTS: Of the 273 patients who underwent the first assessment, 86 (31.5%) were diagnosed with OHF and received management. Of those, 42 (48.8%) completed the second assessment. Comparing the first and second assessment, significant improvement was observed in oral hygiene, occlusal force, tongue-lip motor function of /pa/, mastication and swallowing. The change in values from the first assessment demonstrated a significant difference between the OHF improved and re-diagnosed groups only in occlusal force. CONCLUSION: Management for patients with OHF can contribute to the improvement of poor oral function, and an increase in occlusal force was notable in the recovery from OHF.

DOI： 10.1111/ger.12655

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PURPOSE: This study aimed to determine whether denture use contributes to maintaining and improving food forms in long-term care facility (LTCFs) residents. METHODS: In 888 residents of 37 LTCFs in Japan, the following were investigated: nutritional intake status, food forms, age, sex, Barthel index (BI), clinical dementia rating (CDR), number of teeth present, number of occlusal supports, swallowing function, and use of dentures. Among all residents, those who were well-nourished and had ≤9 occlusal supports were analyzed. Based on standardized criteria, the food forms consumed by the subjects were divided into two groups: dysphagia and normal diet, which were further classified into four levels. Analysis was performed using a generalized estimation equation with the four levels of food forms as dependent variables and age, sex, BI, CDR, presence of dysphagia, number of teeth present, and use of dentures as independent variables. RESULTS: The final analysis included 622 (70.0%) residents. Of these, 380 (61.1%) used dentures. The analyses revealed that food form was significantly associated with age (adjusted odds ratio [OR], 0.98), BI (OR, 1.04), number of teeth present (OR, 1.03), presence of dysphagia (OR, 0.44), and use of dentures (OR, 2.82). CONCLUSION: Denture use was associated with food forms among Japanese LTCF residents. This indicates that the use of dentures is related to the maintenance of food forms, even in the elderly who participate in few activities of daily living, have reduced cognitive function, and require long-term care.

DOI： 10.2186/jpr.JPR_D_21_00161

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Publishing type：Research paper (scientific journal)   Publisher：Georg Thieme Verlag KG  

Abstract

Introduction The associations of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein (HDL-C) with reduced saliva flow rates have not been previously reported.

Objective The present study aimed to assess the association of cholesterolemia with reduced saliva flow rates in community-dwelling elderly subjects.

Methods The present study analyzed 342 participants (170 males and 172 females aged between 78 and 79 years old). Unstimulated salivary flow rate (USFR) was assessed using a cotton roll method. Low-USFR was defined as 0.10 g/30 seconds. Stimulated salivary flow rate (SSFR) was assessed by having the participants chew tasteless gum for 3 minutes. Low-SSFR was defined as 1.0 mL/minute. Blood samples were collected for the measurement of LDL-C, HDL-C, rheumatoid factor, hemoglobin A1c, and creatinine. To assess depression, the General Health Questionnaire 30 was used. A standardized questionnaire was completed, covering the current and previous medications of the participants and smoking status. We stratified the serum LDL-C levels of the participants as normal, moderate or severe hyper-LDL cholesterolemia and serum HDL-C levels as normal or hypo-HDL cholesterolemia. Multivariate logistic regression models were established and low-USFR or low-SSFR were set as dependent variables in the aforementioned models.

Results After controlling for the effects of the other variables, the odds ratios (ORs) (95% confidence intervals [CIs]) for low-USFR were 2.25 (1.10–4.61) for moderate and 5.69 (1.55–20.8) for severe hyper-LDL cholesterolemia, while that of hypo-HDL cholesterolemia was 3.40 (1.33–8.69). Severe hyper-LDL cholesterolemia was also associated with low-SSFR with an OR of 3.89 (1.39–10.88).

Conclusion Elderly patients with cholesterolemia have a risk of reduced salivary flow rate.

DOI： 10.1055/s-0042-1744167

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This one-year multicenter longitudinal study aimed to assess whether older adult residents of long-term care facilities should switch from a normal to a dysphagia diet. Using the results of our previous cross-sectional study as baseline, older adults were subdivided into those who maintained a normal diet and those who switched to a dysphagia diet. The explanatory variables were age, sex, body mass index (BMI), Barthel Index, clinical dementia rating (CDR), and 13 simple and 5 objective oral assessments (remaining teeth, functional teeth, oral diadochokinesis, modified water swallowing test, and repetitive saliva swallowing test), which were used in binomial logistic regression analysis. Between-group comparison showed a significantly different BMI, Barthel Index, and CDR. Significant differences were also observed in simple assessments for language, drooling, tongue movement, perioral muscle function, and rinsing and in objective assessments. In multi-level analysis, switching from a normal to a dysphagia diet was significantly associated with simple assessments of tongue movement, perioral muscle function, and rinsing and with the objective assessment of the number of functional teeth. The results suggest that simple assessments can be performed regularly to screen for early signs of discrepancies between food form and eating/swallowing functions, which could lead to the provision of more appropriate food forms.

DOI： 10.3390/ijerph19116586

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BACKGROUND: Outcome prediction for dysphagia recovery is essential for rehabilitation treatment planning. Several studies have reported various predictors for resuming oral feeding after post-stroke dysphagia. However, evidence on oral health and function, a crucial part of feeding, has rarely been reported. Therefore, the goal of this study was to identify the oral status-related factors that could predict oral intake resumption in acute stroke patients. METHODS: 80 acute stroke patients with dysphagia were included. Clinical data, including the changes of general condition, oral and swallowing functions, were collected once a week until discharge. Patients were divided into two groups based on the outcome of the food intake level scale at discharge, and data were compared between the groups. RESULTS: 60 patients had regained complete oral intake before discharge. Multiple logistic regression showed that posterior tongue pressure could significantly predict complete oral intake recovery. Tongue pressure and modified water swallowing test score also significantly influenced diet forms. In addition, Spearman correlation analysis showed that improvement of other oral status-related factors, such as oral moisture and dentition status, also indicated the improvement of diet forms and swallowing function during the hospital stay. CONCLUSION: Tongue pressure measurement could be a useful oral status-related indicator for predicting complete oral intake and adjusting diet forms for acute stroke patients during hospitalization. Acute stroke patients should receive proper oral status evaluation and implementation to enhance functional recovery.

DOI： 10.1016/j.jstrokecerebrovasdis.2022.106401

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We examined factors related to dietary intake status (food form) of long-term care facility (LTCF) residents to identify factors related to proper food form choice for older individuals requiring nursing care. We surveyed 888 residents from 37 LTCFs in Japan. We evaluated basic information (age, sex, body mass index [BMI]), food form (swallowing-adjusted diet class), Barthel Index (BI), Clinical Dementia Rating (CDR), simply evaluated eating and swallowing functions, the number of present/functional teeth, oral diadochokinesis, repetitive saliva swallowing test (RSST), and modified water swallowing test. To clarify factors associated with food form, participants who had good nutrition by oral intake were categorized into the dysphagic diet (DD) and normal diet (ND) groups. Multi-level analyses were used to detect oral functions associated with food form status. Among objective assessments, BMI (odds ratio [OR] 0.979, 95% confidence interval [CI] - 0.022- to 0.006, p = 0.001), BI (OR 0.993, 95% CI - 0.007 to - 0.004, p < 0.001), CDR 3.0 (OR 1.002, 95% CI 0.002‒0.236, p = 0.046), present teeth (OR 0.993, 95% CI - 0.007 to - 0.001, p = 0.011), functional teeth (OR 0.989, 95% CI - 0.011 to - 0.005, p < 0.001), and RSST (OR 0.960, 95% CI - 0.041 to - 0.007, p = 0.006) were significantly associated with DD vs ND discrimination. Simple evaluations of coughing (OR 1.056, 0.054‒0.198, p = 0.001) and rinsing (OR 1.010, 0.010‒0.174, p = 0.029) could also discriminate food form status. These simple evaluations provide insight into the discrepancies between food form status and eating abilities of LTCF residents. Periodic evaluations by the nursing caregiver may help to prevent aspiration by older individuals with dysphagia.

DOI： 10.1007/s00455-022-10440-6

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PURPOSE: This study aimed to determine the association between home visits by a dentist and regular oral hygiene management by a dental hygienist (regular dental management: RDM) and weight loss among older adults in long-term care facilities. METHODS: A total of 468 older residents from 26 Japanese long-term care facilities participated in two surveys in 2018 and 2019. Participants were divided into two groups based on their diet during the baseline survey (regular diet, n = 256; dysphagia diet, n = 212). Participants with a regular diet were further divided into those who exhibited a weight loss ≥ 5% over 1 year (weight loss group: n = 77) and those with a weight loss < 5% (consistent weight group: n = 179). The explanatory variables were age, sex, baseline weight, Barthel index, and clinical dementia rating, as well as the patients' medical history of pneumonia, stroke, diabetes, and depression (which is reportedly associated with weight). Additionally, a Poisson regression with robust standard error, was carried out to analyze the explanatory variables, namely the prevalence of RDM noted during the study and functional teeth (which seemed to affect weight loss). RESULTS: A multivariate analysis revealed that older residents' lack of RDM, clinical dementia assessment, and their history of pneumonia (prevalence rate ratio: 0.35, 95% confidence interval 0.24-0.95) were all significantly associated with weight loss when on a regular diet. CONCLUSION: Thus, weight loss and RDM were related to each other. Weight loss may be suppressed by incorporating RDMs during the early nursing care for older residents on regular diets.

DOI： 10.1007/s41999-021-00576-3

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OBJECTIVE: To investigate the association between oral health management (OHM) by dental hygienists and the occurrence of pneumonia, and determine the effectiveness of OHM in pneumonia prevention. BACKGROUND: In long-term care facilities in Japan, the need for professional OHM is increasing with an increase in the number of severely debilitated residents. MATERIALS AND METHODS: A 1-year prospective multicentre cohort study was conducted using data from 504 residents (63 men; mean age: 87.4 ± 7.8 years) in Japanese long-term care facilities. Basic information, medical history, willingness to engage in oral hygiene behaviour, need for OHM and oral conditions were investigated at baseline. In addition, information on the occurrence of pneumonia was collected using a follow-up survey after one year. A Poisson regression analysis with robust standard errors was conducted, with pneumonia as the dependent variable, and factors associated with OHM and pneumonia occurrence as explanatory variables. RESULTS: Overall, 349 (69.2%) residents required OHM by dental hygienists during that year of follow-up. Of those, 238 (68.2%) were provided with OHM, and 18 (7.5%) developed pneumonia. Among the 111 patients (31.8%) who were not provided with OHM, 21 (18.9%) developed pneumonia. The OHM group had lower pneumonia rates than the non-OHM group (prevalence rate ratio: 0.374; 95% CI: 0.210-0.665). CONCLUSION: Oral health management by dental hygienists was associated with a lower incidence of pneumonia among residents of long-term care facilities, underlining the importance of professional OHM for such individuals. It is recommended that OHM be practised routinely in long-term care facilities.

DOI： 10.1111/ger.12604

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Changing the food form for older adults requiring nursing care from a regular to dysphagia diet is thought to impact their nutritional status. We assessed the association between changes in food form and weight loss over 1 year in older adults. Older adults residing in long-term care facilities in Japan (n = 455) who participated in the baseline (2018) and follow-up (2019) surveys were divided into two groups (regular diet, n = 284; dysphagia diet, n = 171). The regular diet group was further divided into the weight loss (n = 80; weight loss ≥5% over 1 year) and weight maintenance (n = 204; weight loss <5%) groups. After 1 year, the Barthel Index significantly decreased, and the proportion of participants who switched from a regular diet to a dysphagia diet significantly increased in the weight loss group than in the weight maintenance group. Multivariate logistic regression analysis found that Barthel index variation (odds ratio (OR): 0.97, 95% confidence interval (CI): 0.94‒0.99), change from a regular diet to a dysphagia diet (OR: 4.41, 95% CI: 1.87‒10.41), and body weight at baseline (OR = 1.06, 95% CI: 1.01‒1.11) were significantly associated with weight loss. Our results suggest that maintaining the food form inhibits weight loss and improves health outcomes in older adults.

DOI： 10.3390/ijerph182010776

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BACKGROUND: Oral hypofunction is defined as the reversible stage preceding oral dysfunction. However, its assessment and management need further examination and consideration. OBJECTIVE: The present study aimed to examine the current state of oral hypofunction among outpatients at the university hospital. METHODS: New outpatients underwent medical interviews and detailed assessment of oral hypofunction at their initial visit to our dental department. Oral hypofunction was diagnosed if the results of three of the following seven assessment items were below cut-off values: poor oral hygiene, oral dryness, reduced occlusal force, decreased tongue-lip motor function, decreased tongue pressure, decreased masticatory function and deterioration of swallowing function. The relationships between factors used to diagnose oral hypofunction as well as the distributions of assessment values were clarified. RESULTS: Seventy-five of 209 patients (35.9%) were finally diagnosed with oral hypofunction. Diagnosis of oral hypofunction was significantly related to patient age, Eichner index, a chief complaint of dental or periodontal disease or ill-fitting dentures and a history of neurodegenerative disease. The lowest quintile values for poor oral hygiene, oral dryness and decreased masticatory performance were all above current cut-off values. Reduced occlusal force contributed strongly to the diagnosis of oral hypofunction. CONCLUSION: Oral hypofunction in dental outpatients at a university hospital was associated with patient age, medical history and chief complaint at presentation. Diagnosis of oral hypofunction can be closely related to reduced occlusal force. The validity of cut-off values for assessments of oral hypofunction needs further consideration.

DOI： 10.1111/joor.13237

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OBJECTIVES: Various oral symptoms, including xerostomia and burning mouth syndrome, may occur in menopausal women. These symptoms reduce quality of life (QOL). However, the actual condition of xerostomia after menopause is not clear. The purpose of this study was to reveal the factors associated with xerostomia in perimenopausal women. METHODS: Participants included 118 outpatients (mean age, 49.9 ± 3.2 years; range, 45-55 years) at a department of gynecology in Japan. Information was collected concerning age, medical history, medications, menstrual status, and history of treatment for climacteric symptoms. Oral symptoms, including xerostomia were evaluated with a 3-point scale. The climacteric symptom checklist for Japanese women and 36-Item Short-Form Health were used to evaluate climacteric symptoms and QOL, respectively. In addition, the volume of unstimulated saliva, oral moisture, salivary α-amylase, chromogranin A, and 17-β estradiol were measured. RESULTS: Higher age, the total number of medications, psychotropic drug, hormone replacement therapy, treatment for climacteric symptoms, sticky mouth, burning sensation of tongue, dryness of nose and 14 of the 21 climacteric symptoms significantly affected xerostomia. In addition, treatment for climacteric symptoms, fall asleep but often awake at night, headaches and dryness of nose were significantly associated with xerostomia. In conclusion, xerostomia is closely associated to factors such as treatment for climacteric symptoms and certain menopausal symptoms, and it may be related to QOL in perimenopausal women.

DOI： 10.1111/jog.14963

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J03152&link_issn=&doc_id=20211020030002&doc_link_id=%2Fcb5dvsph%2F2021%2F002502%2F002%2F0090-0101%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb5dvsph%2F2021%2F002502%2F002%2F0090-0101%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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The clinical features of xerostomia induced by immune checkpoint inhibitors (ICI) are similar to those of Sjögren's syndrome (SS), whereas the immunohistological and serological features are known to differ from those of SS. However, the radiologic imaging features of salivary glands are not yet well known. We report a case of a 56-year-old male patient diagnosed with ICI-induced xerostomia. The patient underwent various imaging examinations to investigate the condition of the salivary glands, which indicated the following: (1) less specific findings on contrast-enhanced computed tomography, (2) mixed with intermediate and low signal intensity on both T1-weighted and fat-suppressed T2-weighted magnetic resonance imaging and poor "salt and pepper" appearance on magnetic resonance sialography, and (3) multiple ovoid hypoechoic areas with hyperechoic bands without acute sialadenitis on ultrasound. These radiologic imaging findings suggested remarkable lymphocyte infiltration, which could be a characteristic of ICI-induced xerostomia.

DOI： 10.1007/s11282-020-00480-9

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BACKGROUND: Perimenopausal women experience a wide variety of systemic symptoms: hot flashes, sweating, mental health concerns and various oral sensory complaints (OSC). OSC in perimenopausal women include xerostomia, taste disturbance and burning mouth. However, the factors associated with these OSC have not been identified. The purpose of this investigation was to elucidate the factors associated with OSC in perimenopausal women. METHODS: The study cohort comprised 43 perimenopausal women aged 45-55 years. Data on medical history, medications, menstrual status, menopausal symptoms, quality of life, xerostomia, taste disturbance and burning mouth were collected. Volumes of unstimulated and stimulated saliva were measured. Tongue coating was evaluated according to a tongue coating index. Univariate analysis was performed to identify factors significantly associated with having xerostomia, taste disturbance, burning mouth and more than two OSC (2OSC). Next, the factors strongly associated with these symptoms were examined by logistic regression analysis. RESULTS: The number of menopausal symptoms was significantly higher, and volume of unstimulated saliva was significantly lower in participants with xerostomia, taste disturbance, burning mouth or 2OSC than in those without these characteristics. Agents targeting the central nervous system were more frequently taken by participants with burning mouth and 2OSC than by those without these characteristics. According to logistic regression analysis, the number of menopausal symptoms was an explanatory variable for xerostomia, taste disturbance, burning mouth and 2OSC. CONCLUSIONS: Our findings suggested that OSC associated with the number of menopausal symptoms. Management of menopausal symptoms may decrease OSC, leading to improved quality of life of perimenopausal women.

DOI： 10.1186/s12905-021-01401-6

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There is wide variation in chewing behaviours, even among healthy humans. Further, the way in which humans determine swallowing initiation when chewing solid foods remains unclear. The current study sought to investigate how the bolus properties change over time during chewing, and to clarify which factors affect chewing and swallowing behaviours, including swallowing initiation, in healthy humans. Twenty-four healthy volunteers were instructed to chew 8 g of steamed rice and spit it out at 50%, 100% and 150% of their own chewing duration, defined as the time of chewing from onset of the first chewing cycle to onset of the first swallow. Chewing and swallowing behaviours were monitored and determined by visual inspection of video recordings. The physical properties such as hardness, cohesiveness and adhesiveness as well as water content of the bolus were measured. In each subject, maximum bite force, tongue pressure and stimulated salivary flow rate were also measured. Hardness gradually decreased, and the cohesiveness and water content of the bolus did not change up to 50% of chewing duration, followed by a slight but significant increase. The adhesiveness of the bolus rapidly decreased at the beginning of chewing. Chewing duration was significantly related to stimulated salivary flow rate; greater salivary flow rate was associated with shorter chewing duration. Variation of chewing duration and swallowing initiation was not dependent on bolus properties during the chewing of steamed rice, but mainly depended on the surface lubrication of the bolus.

DOI： 10.1111/joor.13151

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Overactive bladder (OAB) occurs idiopathic or secondary to a neurological cause. In addition, OAB may also occur due to xerostomia, because it causes excessive drinking of water. If xerostomia is one of the causes of OAB, treating xerostomia may be effective. This study aimed to investigate the prevalence of xerostomia with or without overactive bladder symptoms. A web-based questionnaire was administered to investigate the prevalence of xerostomia with or without overactive bladder symptoms. The survey included questions concerning age, gender, medical history, medications, OAB symptoms by the Overactive Bladder Symptom Score (OABSS), and xerostomia by the Dry Mouth Scale (DMS). From the analysis, a total of 21 (13.0%) participants were identified as having OAB. The prevalence of xerostomia was six (28.6%) in the OAB group and 14 (10.0%) in the non-OAB group. OABSS and DMS were significantly higher in the OAB group than in the non-OAB group. Urgency score and urgency incontinence score of OABSS were substantially higher in xerostomia participants than non-xerostomia participants. The adjusted odds ratio of OAB showed DMS total score, xerostomia symptoms, accompanying symptoms, and other symptoms that were all significantly associated with OAB. These results suggested that OAB subjects, even untreated subjects, had xerostomia. It may be beneficial for clinicians to perform dry mouth management in parallel with careful choice pharmacotherapy for the wellness of OAB patients.

DOI： 10.1111/luts.12354

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BACKGROUND: To date, there have been few guidelines proposed for adjustment of the food consistency, particularly to match the oral function of older adults, which will guide clinicians and caregivers in appropriately modifying food. OBJECTIVE: We investigated how oral, swallowing, and cognitive conditions of older adults who required daily nursing care in a nursing home were associated with different dietary food consistencies. METHODS: Clinical examinations to record dentition status, swallowing, and cognitive functions were performed, and the feeding status, including the food consistencies and need for assistance at lunchtime, was evaluated in 37 older residents in nursing homes. The swallowing function was assessed by performing a modified water-swallowing test, and food swallowing was tested using pudding and rice crackers. The χ2 test was used to determine the relationships among the parameters. RESULTS: No participants were able to take cooked rice, nor regular and soft side dishes. There was no significant relationship between dentition status and feeding status. Of the participants, 95% ate pudding without any problems and 49% ate rice crackers without any signs of swallowing difficulty such as coughing or stopping chewing. There was a significant relationship between the food test score using a rice cracker and the level of food consistencies, and between the same test score and the level of mealtime assistance, whereby the better the score of the food test using a rice cracker, the better was the level of food consistencies including use of a thickening agent and the better was the level of mealtime assistance. CONCLUSION: The results strongly suggest that the food test using a rice cracker was associated with the level of food consistency and mealtime assistance for older adults in nursing homes.

DOI： 10.1159/000511912

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Language：Japanese   Publisher：日本口腔リハビリテーション学会  

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We investigated how the physical properties of food affect chewing kinematics, and examined the effects of aging on behavior. Twenty young and 21 older volunteers were asked to freely chew rice crackers and spit the food out at their average chewing duration. We compared chewing characteristics among the conditions (age × rice cracker), and examined the area of rectified masseter and suprahyoid electromyographic bursts per chewing cycle. We also evaluated temporal changes in those values. In addition, the bolus properties at the end of chewing were compared. The harder/larger the rice cracker, the longer the chewing duration and the greater the number of chewing cycles. These values also increased with age. Chewing cycle time was not affected by age and rice cracker properties, except in one condition: for the rice cracker with the lowest hardness and density, the chewing cycle time was longer than for the other rice crackers. Chewing cycle time decreased at the middle stage of chewing, followed by an increase, with increasing suprahyoid electromyographic activity at the late stage. The physical properties of the bolus at the end of chewing did not differ between age groups, and depended on the initial properties. The water absorption rate of the bolus was significantly greater for the rice cracker with the lowest hardness and density compared with other rice crackers. The results demonstrated that not only hardness, but also other factors, such as density, significantly affected chewing behaviors.

DOI： 10.1016/j.physbeh.2020.113102

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J03152&link_issn=&doc_id=20200925110007&doc_link_id=10.32136%2Fjsdr.24.2_170&url=https%3A%2F%2Fdoi.org%2F10.32136%2Fjsdr.24.2_170&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

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BACKGROUND: Previous studies have suggested a significant relationship between hyposalivation and inhalation therapy-induced oropharyngeal problems. However, salivary secretion tests are not widely performed in daily clinical practice. In fact, xerostomia, the complaint of dry mouth, may not indicate hyposalivation. Therefore, we determined the clinical factors associated with hyposalivation in patients with asthma. METHODS: This study is a post-hoc analysis of our previous studies. Adult patients with asthma on maintenance inhalation therapy were enrolled. The participants completed questionnaires on oropharyngeal symptoms and underwent a salivary secretion test. Symptom severity was evaluated using a numerical rating scale (NRS), and salivary secretion was measured using the modified cotton roll method. Using logistic regression analysis, we identified the clinical factors associated with hyposalivation. RESULTS: In total, 531 patients completed the questionnaire (43.8 ± 16.9 years and male/female = 171/360), and 234 patients successfully performed a salivary secretion test, of which 126 (53.8%) were diagnosed with hyposalivation (<0.25 g/min). The patients with hyposalivation were significantly older (p < 0.0001) and had severe xerostomia and/or gastroesophageal reflux-like symptoms (GERLS) (p < 0.0001). Many of these patients had also used inhaled long-acting beta agonists (p = 0.012) and high-dose inhaled corticosteroids (p = 0.024). Multivariate analysis revealed that advanced age (odds ratio [OR] 1.05, p < 0.0001), severe xerostomia (OR 1.02, p = 0.0006) and severe GERLS (OR 1.02, p = 0.001) were independently and significantly associated with hyposalivation. CONCLUSIONS: Age, xerostomia, and GERLS were significantly related to hyposalivation in patients with asthma. To identify oropharyngeal problems in these patients, a careful assessment of the suspected symptoms of gastroesophageal reflux may be useful.

DOI： 10.1016/j.resinv.2020.06.004

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BACKGROUND: There is a wide variation of chewing behaviors even in healthy humans. The present study was aimed to clarify how the rheological properties of the bolus during chewing is different among individuals. We also investigated if the swallowing threshold was consistent among the individuals and if the difference in the bolus properties at the swallowing affected swallowing movement. METHODS: Twenty-nine healthy volunteers were asked to ingest 8 g of steamed rice. Based on the chewing duration defined by the time until first swallow, participants were asked to chew the food, then either spit it out, or swallow it, at 50%, 100% and 150% of chewing duration. In seven volunteers, the maximum bite force was measured. RESULTS: The hardness of the bolus gradually decreased throughout recording. Although the chewing duration varied widely, there was a significant negative correlation between time and hardness, regardless of the difference in individual chewing duration. The cohesiveness of the bolus was unchanged at the 100% time point, followed by a slight but significant increase. There was no significant correlation between the chewing duration and adhesiveness of the bolus. Swallowing-related bursts of Supra and Infra EMGs were not related to the chewing duration or bolus properties, and chewing duration did not affect swallowing function. CONCLUSION: The current results suggest that the bolus properties such as the hardness and cohesiveness during chewing is just dependent on the chewing duration and the difference in the bolus properties does not affect the swallowing initiation and movement.

DOI： 10.1111/joor.13044

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We investigated how swallowing behaviors are affected by the temperature and carbonation of water in healthy humans. Twenty-nine healthy volunteers were instructed to drink as much natural water, carbonated water, or cider as they wanted, and we recorded the volume of solution swallowed and electromyographic (EMG) activity of the masseter and suprahyoid muscles. Sensory tests regarding the ease of holding the solution in the mouth and ease of swallowing were also performed. The volume of carbonated water swallowed was significantly lower than that of natural water and cider. The ease of holding and swallowing the solution significantly differed between solution types such that natural water was the easiest solution to hold and swallow, followed by cider and then carbonated water in both tests. EMG activity was also affected by the solution type. Masseter EMG activity was significantly lower when swallowing natural water compared with carbonated water. Suprahyoid EMG activity was significantly lower when swallowing natural water compared with carbonated water and cider. The volume of solution swallowed was significantly correlated with the ease of holding and swallowing the solution, but not with masseter or suprahyoid EMG activities. The ease of holding and swallowing the solution significantly affected masseter and suprahyoid EMG activities. The results suggested that when participants experienced difficulty holding and swallowing the solution, masseter and suprahyoid EMG activity increased. Considering our findings that mechanical stimulation with bubbles decreased the volume of solution swallowed and increased EMG activities, carbonated water swallowing may be useful in treating deglutition disorders.

DOI： 10.1007/s00455-020-10147-6

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本歯科衛生学会  

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BACKGROUND: In Japan, day care services for elders include programmes aimed at improving nutrition and oral and motor functions. Few studies have qualitatively assessed these interventions. OBJECTIVE: To qualitatively search for the characteristic words used in the work logs of a preventive programme on oral function and nutrition for elders by intervention period and intervention type． METHODS: We included 83 participants (81.3 ± 8.2 years) from four day care services in Japan and divided them into the following groups randomly: those who received oral function intervention only, nutritional intervention only and those who received combined oral function plus nutritional intervention. The interventions were conducted twice per month for 24 months. Data from handwritten work logs were entered into a computer as text files. Monitoring of frequently appearing words, co-occurrence analysis and cross-tabulation by intervention period and intervention types was conducted using text mining analysis. RESULTS: Correspondence analysis revealed that the words used during 1-6 months and 7-12 months were similar in participants' subjective content, and those used in objective content in 13-18 months and 19-24 months were similar. These results indicate that subjective improvements increased after 13 months, and it was maintained within 24 months. The combined intervention type is ideal for oral and nutrition problems. CONCLUSION: Because this text mining approach revealed the changes in the words used and could be used to monitor any subjective improvement, this approach may help evaluate the effects of preventive care.

DOI： 10.1111/joor.12804

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本口腔・咽頭科学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02661&link_issn=&doc_id=20190404470007&doc_link_id=%2Fei4kouku%2F2019%2F003201%2F007%2F0041-0047%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fei4kouku%2F2019%2F003201%2F007%2F0041-0047%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Munksgaard  

DOI： 10.1111/ger.12319

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Public Library of Science  

DOI： 10.1371/journal.pone.0193082

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J03152&link_issn=&doc_id=20190416130007&doc_link_id=%2Fcb5dvsph%2F2018%2F002202%2F007%2F0153-0160%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb5dvsph%2F2018%2F002202%2F007%2F0153-0160%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本老年歯科医学会  

DOI： 10.11259/jsg.32.305

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Stomatological Society  

DOI： 10.1016/S1348-8643(17)30017-4

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DOI： 10.1111/ger.12255

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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DOI： 10.1111/jog.13290

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

DOI： 10.5834/jdh.67.2_64

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Other Link： http://search.jamas.or.jp/link/ui/2017258671

Language：English   Publishing type：Research paper (scientific journal)   Publisher：The Gerodontology Association and John Wiley & Sons  

DOI： 10.1111/ger.12255

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DOI： 10.1111/ger.12186

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J03152&link_issn=&doc_id=20170524040003&doc_link_id=%2Fcb5dvsph%2F2016%2F002002%2F003%2F0080-0085%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb5dvsph%2F2016%2F002002%2F003%2F0080-0085%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/ggi.12500

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Bentham Science Publishers B.V.  

DOI： 10.2174/1874210601610010079

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DOI： 10.1016/j.physbeh.2015.12.024

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DOI： 10.5466/ijoms.15.85

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DOI： 10.1016/j.physbeh.2015.10.004

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.physbeh.2015.08.003

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Language：Japanese   Publisher：日本歯科衛生学会  

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Other Link： http://search.jamas.or.jp/link/ui/2015199755

Language：Japanese   Publisher：日本歯科医学教育学会  

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DOI： 10.1111/j.1741-2358.2012.00685.x

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本口腔診断学会  

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Language：Japanese   Publisher：新潟歯学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2013&ichushi_jid=J00999&link_issn=&doc_id=20140114540004&doc_link_id=%2Fdj2ngtdt%2F2013%2F004302%2F004%2F0119-0127%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdj2ngtdt%2F2013%2F004302%2F004%2F0119-0127%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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Language：Japanese   Publisher：(一社)日本女性医学学会  

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Other Link： http://search.jamas.or.jp/link/ui/2013376414

Language：Japanese   Publisher：日本歯科衛生学会  

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Other Link： http://search.jamas.or.jp/link/ui/2014003843

Language：Japanese   Publisher：(一社)日本口腔衛生学会  

DOI： 10.5834/jdh.63.4_337

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00440&link_issn=&doc_id=20130808300003&doc_link_id=%2Fdk1dehea%2F2013%2F006304%2F003%2F0337-0343%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2013%2F006304%2F003%2F0337-0343%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publisher：Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo  

Objective: Xerostomia, temporomandibular disorder, and periodontal disease are frequently seen in menopausal women. However, few studies have reported the prevalence of oralsymptoms during menopause or the cooperation between doctors at outpatient clinics for women and dentists. The purpose of this study was to investigate the frequency of oral symptoms and the cooperation between doctors at outpatient clinics for women and dentists. Methods: A questionnaire was sent to 380 outpatient clinics for women in Japan. The questionnaire included characteristics for the person completing it, staff structure,cooperation with medicalspecialists, the existence of oralsymptoms, details of these symptoms, cooperation with dentists, and space for free responses. Results: The survey response rate was 57.9% (220 of 380 institutions). Most respondents (81.6%) thought that female sex hormones influenced the mouth, and 79.4% had encountered oralsymptoms. The most frequently encountered symptoms were oral dryness, taste disorder, and burning sensation of the mouth. The necessity of cooperation between doctors and dentists was recognized by 63.1%. Staff that recognised the influence of female hormones on the mouth were significantly more likely than others to acknowledge the importance of cooperation (p<0.01). However, as only half of the staff had referred patients to a dental clinic, it seems possible that patients whose symptoms could have been alleviated by dentists were not appropriately managed. Conclusion: Although oral symptoms can relate to menopause, the cooperation between doctors and dentists is poor. Improved cooperation may relieve not only oral complaints but also systemic menopausal symptoms.

DOI： 10.5466/ijoms.12.21

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Language：English   Publisher：Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo  

Aim: For the treatment of polydipsia, medication and occupational therapy are implemented. Since polysipsia canʼt be completely intercepted, patients are isolated or restrained in severe case. Determining the predictive factors of polysipsia may lead to decreasing abnormal water consumption. This study aimed to reveal the influence of subjective oral dryness, salivary volume and other factors including medication on polydipsia in patients with schizophrenia. Methods: Fifty-two patients were divided into two groups: a polydipsia patient (PD) group and a non-polydipsia patient (NPD) group. Their age, medical history, age of onset of schizophrenia, duration of suffering, tobacco, frequency of mouth opening, subjective oral dryness, number of medications, number of xerogenic medications, chlorpromazine (CPZ) equivalent dose, salivary volume and salivary spinability were investigated. Results: The number of total medications was significantly higher than that of the NPD group. Subjective oral dryness of the PD group was rated as ʻsevereʼ compared with the NPD group, and the frequency of mouth opening in the PD group was higher than the NPD group, though there were no significant differences. There was no significant difference in salivary volume and spinability between the two groups. Logisticregression analysis that demonstrated the predictors of polydipsia were tobacco and number of medications. Conclusion: It was shown that the predictors of polydipsia were tobacco and number of medications. The polydipsia may reduce by decreasing medications and quitting tobacco.

DOI： 10.5466/ijoms.12.29

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Language：Japanese   Publisher：(一社)日本女性医学学会  

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Other Link： http://search.jamas.or.jp/link/ui/2013257758

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/j.1745-4603.2012.00364.x

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Language：Japanese   Publisher：日本歯科衛生学会  

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Other Link： http://search.jamas.or.jp/link/ui/2013191354

Language：English   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s11282-012-0102-4

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Language：Japanese   Publisher：日本歯科医学教育学会  

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Language：Japanese   Publisher：新潟歯学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2012&ichushi_jid=J00999&link_issn=&doc_id=20130111530002&doc_link_id=%2Fdj2ngtdt%2F2012%2F004202%2F002%2F0089-0096%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdj2ngtdt%2F2012%2F004202%2F002%2F0089-0096%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本口腔衛生学会  

DOI： 10.5834/jdh.62.5_445

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Other Link： http://search.jamas.or.jp/link/ui/2013097159

Language：English   Publisher：Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo  

<b>Aim</b>: In dental treatment, to remove an instrument, such as dental mirror or to remove a dental cotton roll inserted in the gingivobuccal fold, often brings the patient discomfort or pain. To prevent these uncomfortable conditions, dental instruments or dental cotton rolls are moistened based on an empirical basis. However, there has been no research done evaluating whether discomfort is reduced by these techniques. The purpose of this study was to evaluate the effects of moistened techniques on the patientsʼ discomfort and the operatorsʼ ease. <b>Materials and Methods</b>: Thirty eight subjects without hyposalivation were studied. Two procedures were implemented. One was that a dry or moistened dental mirror was removed after exclusion of the buccal mucosa. The other was removal of a dental cotton roll from the gingivobuccal fold after either moistening it or leaving it dry. The subjectsʼcomfort and the operatorsʼ treatment ease were evaluated on five point scales. <b>Results</b>: During these procedures, the subjectsʼ comfort was significantly increased by moistening of both the dental mirror and the cotton roll. The ease of performing both procedures was also significantly increased for operators in the moistened condition. In addition, there was a significant positive correlation between the subjectsʼ comfort and the operatorsʼ ease. <b>Conclusion</b>: When using dental instruments and removing cotton rolls, moistening increases both the subjectsʼ comfort and operatorsʼ treatment ease.

DOI： 10.5466/ijoms.11.85

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Language：Japanese   Publisher：(一社)日本女性医学学会  

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Language：Japanese   Publisher：新潟歯学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J00999&link_issn=&doc_id=20120725420005&doc_link_id=%2Fdj2ngtdt%2F2012%2F004201%2F005%2F0037-0040%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdj2ngtdt%2F2012%2F004201%2F005%2F0037-0040%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：更年期と加齢のヘルスケア学会((NPO)更年期と加齢のヘルスケア)  

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Language：Japanese   Publisher：(一社)日本女性医学学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

DOI： 10.11259/jsg.26.327

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02171&link_issn=&doc_id=20120124400008&doc_link_id=10.11259%2Fjsg.26.327&url=https%3A%2F%2Fdoi.org%2F10.11259%2Fjsg.26.327&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：医学図書出版(株)  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/j.1741-2358.2009.00358.x

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

DOI： 10.5834/jdh.60.5_575

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2010&ichushi_jid=J00440&link_issn=&doc_id=20101109220004&doc_link_id=%2Fdk1dehea%2F2010%2F006005%2F005%2F0575-0583%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2010%2F006005%2F005%2F0575-0583%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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DOI： 10.1016/j.cca.2009.11.032

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2009&ichushi_jid=J03152&link_issn=&doc_id=20091006220001&doc_link_id=%2Fcb5dvsph%2F2009%2F001302%2F002%2F0077-0087%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb5dvsph%2F2009%2F001302%2F002%2F0077-0087%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本老年歯科医学会  

DOI： 10.11259/jsg.24.48

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2009&ichushi_jid=J02171&link_issn=&doc_id=20090709390006&doc_link_id=10.11259%2Fjsg.24.48&url=https%3A%2F%2Fdoi.org%2F10.11259%2Fjsg.24.48&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Language：English   Publisher：新潟歯学会  

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DOI： 10.1016/j.cca.2009.03.018

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

DOI： 10.5834/jdh.59.1_26

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Other Link： http://search.jamas.or.jp/link/ui/2009113193

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.archoralbio.2008.05.009

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DOI： 10.1016/j.cca.2007.09.025

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Language：English   Publisher：Japan Prosthodontic Society  

<B>Purpose:</B> Our research aimed at shedding light on the effective frequency of professional oral care for those who require nursing care from oral health specialists.<BR><B>Methods:</B> Thirty-eight residents (average age, 80.0±9.4 years) of Niigata Prefecture who required nursing care agreed to participate in our study. They were divided into 3 groups; a control group (13 persons), provided with no professional oral health care: Group A (15 persons), provided with professional oral care once or twice per month: and Group B (10 persons), provided with professional oral care 4 times per month (once a week). Three dentists investigated the general health status and oral conditions such as dental formula, gingivitis index (GI), gingival bleeding index (GBI), degree of coating of on the tongue, and the type of pneumonia-causing pathogens on the pharyngeal mucosa. Professional oral care was provided by 14 dental hygienists for 3 months.<BR><B>Results:</B> Multiple comparison tests revealed that subjects in Group B showed a statistically significant improvement in GI and GBI compared to the controls. Although there was a trend showing some improvement associated with care frequency between pre- and post-intervention, no statistically significant difference was found eventually. Further, no significant difference was found before intervention with regard to the types of pneumonia-causing pathogens on the pharyngeal mucosa. Only Group B manifested a tendency of decreasing number pathogens when compared to the pre-intervention numbers, although it was not statistically significant.<BR><B>Conclusion:</B> Considering the limited time, cost, and manpower, a frequency of 4 times per month may be the most effective, but a higher frequency is recommended to prevent inflammations of the respiratory system.

DOI： 10.2186/prp.6.225

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DOI： 10.1016/j.jdent.2006.01.001

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Language：Japanese   Publisher：日本味と匂学会  

DOI： 10.18965/tasteandsmell.13.2_175

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Other Link： http://search.jamas.or.jp/link/ui/2007008756

Language：English   Publisher：(一社)日本老年歯科医学会  

DOI： 10.11259/jsg1987.21.35

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DOI： 10.11259/jsg1987.20.63

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Other Link： http://search.jamas.or.jp/link/ui/2005290855

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DOI： 10.1016/S0003-9969(01)00084-X

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DOI： 10.1016/S0304-3940(01)01862-6

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DOI： 10.1016/S0003-9969(00)00124-2

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Language：Japanese   Publisher：九州歯科学会  

DOI： 10.2504/kds.54.313

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Language：Japanese   Publisher：クインテッセンス出版(株)  

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Language：Japanese   Publisher：クインテッセンス出版(株)  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：Japanese Society of Gerodontology  

DOI： 10.11259/jsg.36.supplement_1

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Language：Japanese   Publisher：(株)診断と治療社  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00525&link_issn=&doc_id=20220404180071&doc_link_id=%2Fae4sanke%2F2022%2F0089s1%2F072%2F0420-0424%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae4sanke%2F2022%2F0089s1%2F072%2F0420-0424%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：Japanese Society of Gerodontology  

DOI： 10.11259/jsg.35.supplement_40

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Language：Japanese   Publisher：Japanese Society of Gerodontology  

DOI： 10.11259/jsg.36.supplement_51

CiNii Article

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Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J04897&link_issn=&doc_id=20211222120003&doc_link_id=%2Fch7remed%2F2021%2F005812%2F005%2F1361-1366%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fch7remed%2F2021%2F005812%2F005%2F1361-1366%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(株)診断と治療社  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：医歯薬出版(株)  

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Language：Japanese   Publisher：医歯薬出版(株)  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J07344&link_issn=&doc_id=20200902390006&doc_link_id=%2Faa7tonyd%2F2020%2F003705%2F007%2F0565-0569%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faa7tonyd%2F2020%2F003705%2F007%2F0565-0569%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(株)デンタルダイヤモンド社  

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Language：Japanese   Publisher：クインテッセンス出版(株)  

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Language：Japanese   Publisher：医歯薬出版(株)  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2019&ichushi_jid=J00060&link_issn=&doc_id=20190408030008&doc_link_id=%2Faa7ayuma%2F2019%2F026901%2F009%2F0045-0049%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faa7ayuma%2F2019%2F026901%2F009%2F0045-0049%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：クインテッセンス出版(株)  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

DOI： 10.11259/jsg.32.457

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02171&link_issn=&doc_id=20180426520009&doc_link_id=10.11259%2Fjsg.32.457&url=https%3A%2F%2Fdoi.org%2F10.11259%2Fjsg.32.457&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(株)診断と治療社  

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：日本口腔衛生学会  

CiNii Article

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：更年期と加齢のヘルスケア学会((NPO)更年期と加齢のヘルスケア)  

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Language：Japanese   Publisher：クインテッセンス出版(株)  

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Language：Japanese   Publisher：更年期と加齢のヘルスケア学会((NPO)更年期と加齢のヘルスケア)  

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Language：Japanese   Publisher：神戸常盤大学・神戸常盤大学短期大学部  

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Language：Japanese   Publisher：(株)デンタルダイヤモンド社  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2015000456

Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(株)デンタルダイヤモンド社  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2014315087

Language：Japanese   Publisher：(株)デンタルダイヤモンド社  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2014310472

Language：Japanese   Publisher：(一社)日本老年歯科医学会  

J-GLOBAL

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Language：Japanese   Publisher：更年期と加齢のヘルスケア学会((NPO)更年期と加齢のヘルスケア)  

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Language：Japanese   Publisher：深井保健科学研究所  

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Language：Japanese   Publisher：新潟歯学会  

J-GLOBAL

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Language：Japanese   Publisher：日本歯科衛生学会  

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Language：Japanese   Publisher：(株)全日本病院出版会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publishing type：Meeting report   Publisher：日本歯科衛生学会  

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Language：Japanese   Publisher：(公社)日本歯科医師会  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(株)医学書院  

DOI： 10.11477/mf.1542102570

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2011117031

Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：医歯薬出版(株)  

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Language：Japanese   Publisher：医歯薬出版(株)  

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Language：Japanese  

CiNii Article

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Language：Japanese   Publisher：(株)東京法規出版  

CiNii Article

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Language：Japanese   Publisher：エルゼビア・ジャパン(株)  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2007136812

Language：Japanese   Publisher：(株)ヒョーロン・パブリッシャーズ  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2006246198

Language：Japanese   Publisher：(株)ヒョーロン・パブリッシャーズ  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2006246176

Language：Japanese   Publisher：(株)デンタルダイヤモンド社  

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Language：Japanese   Publisher：(株)日本プランニングセンター  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2006041548

Language：Japanese   Publisher：更年期と加齢のヘルスケア学会((NPO)更年期と加齢のヘルスケア)  

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Language：Japanese   Publisher：医歯薬出版(株)  

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Language：Japanese   Publisher：(株)じほう  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2005135897

Language：Japanese   Publisher：(株)照林社  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2005114513

Language：Japanese   Publisher：(株)じほう  

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Language：Japanese   Publisher：Niigata University  

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2005098923

Language：Japanese   Publisher：(株)医学書院  

DOI： 10.11477/mf.1661100838

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2004112966

Language：Japanese   Publisher：(株)医学書院  

DOI： 10.11477/mf.1661100838

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Event date： 2023

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Event date： 2022.12

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Event date： 2017.9

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Event date： 1999

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Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Presentation type：Symposium, workshop panel (nominated)  

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Presentation type：Symposium, workshop panel (nominated)  

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Presentation type：Symposium, workshop panel (nominated)  

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Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Presentation type：Symposium, workshop panel (nominated)  

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