Prevention of systemic diseases caused by oral microbes in dependent elderly

近年来，口腔微生物对各种系统性疾病的影响已被阐明，提示口腔保健的重要性。在依赖的老年人中，由于使用传统牙刷有吸入的风险，因此通常使用纱布进行清洁，但其效果不够。目前，在引进的护理保险制度下，迫切需要开发有效的口腔保健方法，这些方法可以由日常护理提供者安全方便地进行。然而，老年人的独立程度和口腔状况与年轻人有明显的不同，因此，应根据老年人的独立程度和口腔状况制定有效的口腔保健方法。（独立、部分依赖、根据长者的口腔健康需要（包括牙齿数目、是否有假牙）及口腔健康状况（包括牙齿数目、是否有假牙），将长者的口腔健康需要分为9类，并编制长者口腔健康需要分类表。根据每个类别开发了定制的口腔保健方法，并主要通过微生物学方法评估了其效果。为了使依赖老年人的口腔保健安全有效，即使是牙科工作人员以外的护理人员，我们开发了一种电动口腔刷结合自动液体供应/抽吸系统（Dent. ERAC 910，LION牙科产品）。在这项研究中，这个刷系统应用于牙齿依赖的老年人的牙科医生和护士，并评价其效果的基础上的变化，厌氧菌计数漱口水。牙科医生和护士使用该刷系统后，口腔微生物明显减少。在口腔保健实践中未观察到提示误吸的症状。

In recent years, the influences of oral Microbes on various systemic diseases have been clarified, suggesting the importance of oral health care. In dependent elderly people, since the use of conventional tooth brushes has the risk of aspiration, cleaning with gauze is generally performed, but its effects are inadequate. At present, under the introduced care insurance system, it is urgently needed to develop effective oral health care methods that can be safely and readily performed by daily care providers. However, the degree of independence and the oral condition in the elderly markedly differ from those in younger adults, and therefore, effective oral health care methods according to these states should be established.We classified oral health care according to the degree of independence (independent, partially dependent, totally dependent) and the oral condition (number of present teeth and with or without denture) into 9 categories and produced a categorical table of oral health care needs for the elderly. Order-made oral health care methods according to each category were developed, and their effects have been evaluated mainly by microbiological methods.For safe and effective oral health care in the dependent elderly even by care providers other than dental staff, we developed an electrical oral brush combined with automatic liquid supply/suction system (Dent. ERAC910, LION DENTAL PRODUCTS). In this study, this brush system was applied to the dentate dependent elderly by dental hygienists and nurses, and its effects were evaluated based on changes in anaerobe counts in gargling water. Oral microbes markedly decreased after the use of this brush system by dental hygienists and nurses. No symptoms suggesting aspiration were observed in oral health care practice.