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，由于使用常规牙刷有吸入的风险，通常使用纱布进行清洁，但效果不够充分。目前，在引入的护理保险制度下，迫切需要开发有效的口腔保健方法，使其能够安全和方便地由日常护理提供者进行。然而，老年人的口腔独立程度和口腔状况明显不同于年轻人，因此应根据老年人的状况建立有效的口腔保健方法。我们根据口腔保健的独立性程度(独立、部分依赖、完全依赖)和口腔状况(现有牙齿的数量以及是否戴义齿)将老年人的口腔保健分为9类，并编制了老年人口腔保健需求的分类表。根据不同类别定制口腔保健方法，并主要通过微生物学方法对其效果进行评价。为了对依赖的老年人，甚至是牙科工作人员以外的护理人员进行安全、有效的口腔保健，我们开发了一种结合自动供液/吸液系统(Dent)的电动牙刷。ERAC910，狮子牙科产品)。在这项研究中，牙科卫生员和护士将这种刷牙系统应用于牙齿依赖的老年人，并根据漱口水中厌氧菌数量的变化来评估其效果。牙科卫生员和护士使用该刷牙系统后，口腔微生物明显减少。在口腔保健实践中没有观察到提示吸入的症状。

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.