1
|
Asahina H, Ogasawara T, Akieda T, Miyahara K, Okada Y, Matsumura K, Taniguchi M, Yoshida A, Kakinoki Y. Palatal microbiota associated with membranous substances in older Japanese individuals undergoing tube feeding in long-term care: A cross-sectional study. Heliyon 2023; 9:e20401. [PMID: 37780754 PMCID: PMC10539663 DOI: 10.1016/j.heliyon.2023.e20401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023] Open
Abstract
Objective Tube feeders are prone to membranous substance formation on the palate, and those with membranous substances have a risk of fever, with the probable involvement of their oral bacteria. However, the palatal microbiota of those with membranous substances has not been elucidated. Therefore, we evaluated the differences in palatal microbiota between tube-fed individuals with and without membranous substances to clarify the microbiota. Materials and methods This study included 19 participants aged 65 years who required tube feeding. The participants' characteristics were collected from nursing records and oral examinations. If membranous materials were found on the palate, a specimen was collected. Membranous substances were defined as keratotic degeneration observed under a microscope. Additionally, we performed a comprehensive microbiome analysis by extracting DNA from the samples and performing 16 S rRNA gene sequencing. Finally, we compared the participant demographics and oral microbiota between patients with and without membranous substances. Results A total of 11 participants had membranous substances associated with "mouth dryness" (p < 0.001) and "constant mouth opening" (p = 0.020). Palatal microbiota differed between those with and without membranous substances. Among the bacteria with a relative abundance greater than 1.0%, the abundance of Streptococcus (p = 0.007), Fusobacterium (p = 0.041), Streptococcus agalactiae (p = 0.009), and Fusobacterium nucleatum subsp. vincentii (p = 0.026) was significantly higher in the membranous substance group than in the non-membranous substance group. Conclusions The palatal microbiota of individuals undergoing tube feeding differed depending on the presence or absence of membranous substances. Membrane substance formation associated with dry mouth purportedly alters the palatal microbiota. Streptococcus, Fusobacterium, S. agalactiae, and F. nucleatum subsp. vincentii were more abundant in the oral microbiota of patients with membranous substances. Thus, preventing this formation may help in controlling the growth of these microbes.
Collapse
Affiliation(s)
- Hironao Asahina
- Department of Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Nagano, 399-0704, Japan
- Department of Special Care Dentistry, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Tadashi Ogasawara
- Matsumoto Dental University, Nagano, 399-0704, Japan
- Yokosuna Dental Clinic, Shizuoka, 424-0035, Japan
| | | | - Kohta Miyahara
- Department of Special Care Dentistry, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Yoshiyuki Okada
- Department of Special Care Dentistry, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | | | | | - Akihiro Yoshida
- Department of Oral Microbiology, Matsumoto Dental University, Nagano, 399-0704, Japan
| | - Yasuaki Kakinoki
- Department of Special Needs and Geriatric Dentistry, Kyushu Dental University, Fukuoka, 803-8580, Japan
| |
Collapse
|
2
|
Evaluation of oral care using MA-T gel for high-risk patients: a pilot study. BMC Oral Health 2023; 23:108. [PMID: 36805677 PMCID: PMC9936488 DOI: 10.1186/s12903-023-02779-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/30/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Oral care with gel is a common method for preventing aspiration in high-risk patients. An oral care gel is used to clean and moisturize the oral cavity. However, the effects of gel care on the oral bacteria remain unclear. In this pilot study, we described a matching transformation system (MA-T) for elderly high-risk patients. MA-T is an on-demand aqueous chlorine dioxide solution that provides excellent safety and has various antimicrobial activities, even in the presence of abundant organic compounds. This study investigated the effects of MA-T gel in patients requiring nursing care. MATERIALS AND METHODS Patients who were hospitalized for nursing care were included in this study. No drugs and foods were administered orally. Oral bacteria and intraoral humidity were examined by daily care using MA-T gel. Moreover, oral membranous substances were analyzed and material from the oral cavity was cultured on selective media for identifying opportunistic organisms. RESULTS Membranous substances were present in the oral cavities of all patients. The number of bacteria decreased, and oral moisture improved, after treatment with MA-T gel. Moreover, oral humidity was also controlled with the continued use of MA-T gel. MA-T gels should be used not only for professional care but also on a daily basis for better oral care. Furthermore, the results of bacterial cultures showed that MA-T controls the propagation of opportunistic bacterial infections. CONCLUSION Membranous substances may be observed in the oral cavity of individuals requiring nursing care for tube feeding. The results of this pilot study suggest that MA-T, a novel disinfectant, can be used for oral care in the elderly to reduce the risk of aspiration-pneumonia.
Collapse
|
3
|
Suzuki T, Kulvanich S, Tsujimura T, Magara J, Ohnishi Y, Inoue M. Cause of Impairments of Bolus Transport and Epiglottis Inversion. Dysphagia 2022; 37:1858-1860. [PMID: 35166944 DOI: 10.1007/s00455-022-10421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/07/2022] [Indexed: 12/16/2022]
Affiliation(s)
- Taku Suzuki
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.,Minamiuonuma City Hospital, 2643-1 Muika-machi, Minamiuonuma-shi, Niigata, 949-6680, Japan
| | - Sirima Kulvanich
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Yasushi Ohnishi
- Minamiuonuma City Hospital, 2643-1 Muika-machi, Minamiuonuma-shi, Niigata, 949-6680, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
| |
Collapse
|
4
|
Tago M, Hirata R, Katsuki NE, Nakatani E, Oda Y, Yamashita S, Tokushima M, Tokushima Y, Aihara H, Fujiwara M, Yamashita SI. Criterion-related validity of Bedriddenness Rank with other established objective scales of ADLs, and Cognitive Function Score with those of cognitive impairment, both are easy-to-use official Japanese scales: A prospective observational study. PLoS One 2022; 17:e0277540. [PMID: 36355834 PMCID: PMC9648766 DOI: 10.1371/journal.pone.0277540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/29/2022] [Indexed: 11/12/2022] Open
Abstract
Aim Bedriddenness Rank (BR) and Cognitive Function Score (CFS), issued by the Ministry of Health, Labour and Welfare, Japan, are easy-to-use and widely used in the medical and long-term care insurance systems in Japan. This study aims to clarify the criterion-related validity of the CFS with the Mini-Mental State Examination (MMSE) and ABC Dementia Scale (ABC-DS), and to re-evaluate the criterion-related validity of BR with the Barthel Index (BI) or Katz Index (KI) in more appropriate settings and a larger population compared with the previous study. Methods A single-center prospective observational study was conducted in an acute care hospital in a suburban city in Japan. All inpatients aged 20 years or older admitted from October 1, 2018 to September 30, 2019. The relationship between BR and the BI and KI, and the relationship between CFS and the MMSE and ABC-DS were analyzed using Spearman’s correlation coefficients. Results We enrolled 3,003 patients. Of these, 1,664 (56%) patients exhibited normal BR. The median (interquartile range) values of the BI and KI were 100 (65–100) and 6 (2–6), respectively. Spearman’s rank correlation coefficients between BR and the BI and KI were −0.891 (p < 0.001) and −0.877 (p < 0.001), respectively. Of the patients, 1,967 (65.5%) showed normal CFS. The median (interquartile range) MMSE of 951 patients with abnormal CFS and ABC-DS of all patients were 15 (2–21) and 117 (102–117), respectively. Spearman’s rank correlation coefficients between CFS and MMSE and ABC-DS were −0.546 (p < 0.001) and −0.862 (p < 0.001), respectively. Conclusions BR and CFS showed significant criterion-related validity with well-established but complicated objective scales for assessing activities of daily living and cognitive functions, respectively. These two scales, which are easy to assess, are reliable and useful in busy clinical practice or large-scale screening settings.
Collapse
Affiliation(s)
- Masaki Tago
- Department of General Medicine, Saga University Hospital, Saga, Japan
- * E-mail:
| | - Risa Hirata
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Naoko E. Katsuki
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Eiji Nakatani
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Hyogo, Japan
| | - Yoshimasa Oda
- Department of General Medicine, Yuai-Kai Foundation and Oda Hospital, Saga, Japan
| | - Shun Yamashita
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Midori Tokushima
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | | | - Hidetoshi Aihara
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Motoshi Fujiwara
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | | |
Collapse
|
5
|
Hirata R, Tago M, Katsuki NE, Oda Y, Tokushima M, Tokushima Y, Hirakawa Y, Yamashita S, Aihara H, Fujiwara M, Yamashita SI. History of Falls and Bedriddenness Ranks are Useful Predictive Factors for in-Hospital Falls: A Single-Center Retrospective Observational Study Using the Saga Fall Risk Model. Int J Gen Med 2022; 15:8121-8131. [PMID: 36389017 PMCID: PMC9657273 DOI: 10.2147/ijgm.s385168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/21/2022] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION In our former study, we had validated the previously developed predictive model for in-hospital falls (Saga fall risk model) using eight simple factors (age, sex, emergency admission, department of admission, use of hypnotic medications, history of falls, independence of eating, and Bedriddenness ranks [BRs]), proving its high reliability. We found that only admission to the neurosurgery department, history of falls, and BRs had significant relationships with falls. In the present study, we aimed to clarify whether each of these three items had a significant relationship with falls in a different group of patients. METHODS This was a single-center based, retrospective study in an acute care hospital in a rural city of Japan. We enrolled all inpatients aged 20 years or older admitted from April 2015 to March 2018. We randomly selected patients to fulfill the required sample size. We performed multivariable logistic regression analysis using forced entry on the association between falls and each of the eight items in the Saga fall risk model 2. RESULTS A total of 2932 patients were randomly selected, of whom 95 (3.2%) fell. The median age was 79 years, and 49.9% were men. Multivariable analysis showed that female sex (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.39-0.93, p = 0.022), having a history of falls (OR 1.9, 95% CI 1.16-2.99, p = 0.010), requiring help with eating (OR 1.9, 95% CI 1.12-3.35, p = 0.019), BR of A (OR 6.6, 95% CI 2.82-15.30, p < 0.001), BR of B (OR 7.5, 95% CI 2.95-19.06, p < 0.001), and BR of C (OR 4.1, 95% CI 1.53-11.04, p = 0.005) were significantly associated with falls. CONCLUSION History of falls and BRs were independently associated with in-hospital falls.
Collapse
Affiliation(s)
- Risa Hirata
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Masaki Tago
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Naoko E Katsuki
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Yoshimasa Oda
- Department of General Medicine, Yuai-Kai Foundation and Oda Hospital, Saga, Japan
| | - Midori Tokushima
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | | | - Yuka Hirakawa
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Shun Yamashita
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Hidetoshi Aihara
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Motoshi Fujiwara
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | | |
Collapse
|
6
|
Suzuki H, Furuya J, Matsubara C, Aoyagi M, Shirobe M, Sato Y, Tohara H, Minakuchi S. Comparison of the Amount of Used and the Ease of Oral Care between Liquid and Gel-Type Oral Moisturizers Used with an Oral Care Simulators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138158. [PMID: 35805817 PMCID: PMC9266061 DOI: 10.3390/ijerph19138158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 11/19/2022]
Abstract
Oral care involving the removal of dry sputum is effective for older patients who require nursing care or hospitalization. However, safe and efficient oral care methods for such patients remain unclear. We aimed to simulate the oral cavity of older adults with dry mouth and elucidate the differences between two moisturization agents, water and gel-like oral moisturizer, and investigate the effect of occupation and experience on the amount of use and the ease of oral care. Using an oral care simulator (MANABOT®, Nissin Dental Products Inc., Kyoto, Japan), 42 students and 48 dental professionals (13 dentists and 35 dental hygienists) performed oral care using moisturization agents to facilitate dry sputum removal. The time required for oral care, amount of water or gel used, amount of pharyngeal inflow, and ease of oral care when using water or gel were compared. The simulations revealed that the amount of use and pharyngeal inflow for gel (2.9 ± 1.6 and 0.3 ± 0.3, respectively) were significantly lower than those for water (6.8 ± 4.1 and 1.2 ± 1.5, respectively) in all participants. Using a gel-like moisturizer might reduce the aspiration risk in older patients requiring nursing care or hospitalization, regardless of occupation and experience.
Collapse
Affiliation(s)
- Hiroyuki Suzuki
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.S.); (S.M.)
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan; sato-@dent.showa-u.ac.jp
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
- Correspondence: ; Tel.: +81-3-3783-3971
| | - Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, 2-2-1 Oshika, Suruga-ku, Shizuoka 422-8021, Japan;
| | - Michiyo Aoyagi
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan;
| | - Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan; sato-@dent.showa-u.ac.jp
| | - Haruka Tohara
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.S.); (S.M.)
| |
Collapse
|
7
|
Hihara H, Izumita K, Iwatsu M, Sato T, Tagaino R, Shobara K, Shinohara Y, Hatakeyama T, Kayaba C, Sato M, Tokue A, Sugawara T, Ashino K, Ikeda K, Aida J, Sasaki K. Clinical Trial for Evaluating the Effectiveness and Safety of a New Dental Plaque Removal Device: Microscale Mist Unit. Antibiotics (Basel) 2022; 11:antibiotics11060825. [PMID: 35740231 PMCID: PMC9219637 DOI: 10.3390/antibiotics11060825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 12/10/2022] Open
Abstract
This study evaluates the effectiveness and safety of a microscale mist unit (MSM-UNIT) that sprays high-speed fine water droplets to remove dental plaque adhering to the oral mucosa (tongue and palate) and tooth surface. Fifteen patients who had difficulty self-managing sufficient oral care were included in this study. Effectiveness was evaluated for at least five patients' tongues, palate mucosas, and tooth surfaces, and safety evaluation was conducted at all three sites for all patients. Effectiveness was evaluated using the rate of degree of dental plaque removal. Safety was evaluated using a numerical rating scale (NRS) for pain and symptoms of inflammation. An operator who performed treatment and an evaluator who evaluated effectiveness and safety were designated. In addition, an image judgment committee judged effectiveness. Although evaluation of the tongue varied between the evaluators and the image judgment committee, the rates of degree for all plaque removal increased in all regions. In addition, low pain NRS results and minimal symptoms of inflammation were observed and within an acceptable range. The MSM-UNIT can be used effectively and safely for removing oral plaque not only from teeth, but also from the oral mucosa.
Collapse
Affiliation(s)
- Hiroki Hihara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
- Correspondence: ; Tel.: +81-22-717-8369
| | - Kuniyuki Izumita
- Perioperative Oral Health Management, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan;
| | - Misato Iwatsu
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Tomoya Sato
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Ryo Tagaino
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
- Perioperative Oral Health Management, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan;
| | - Kenta Shobara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Yuta Shinohara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Takanori Hatakeyama
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Chie Kayaba
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Mariko Sato
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Ayako Tokue
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Tomoko Sugawara
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Kanamai Ashino
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Koji Ikeda
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| |
Collapse
|
8
|
A Case of Drastic Reduction of Membranous Substances in the Pharynx by Interprofessional Cooperative Oral Care. Case Rep Dent 2022; 2022:6375915. [PMID: 35386430 PMCID: PMC8977340 DOI: 10.1155/2022/6375915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Membranous substances in the pharynx are occasionally observed in tube feeding patients during the fiberoptic endoscopic evaluation of swallowing. Although the mechanism of the formation of these deposits sometimes causes problems, such as dysphagia, asphyxia, or aspiration pneumonia, a 91-year-old male complained about difficulty of swallowing. He had a history of cerebral infarction and aspiration pneumonitis. There was a large amount of oral desquamated epithelium, dental plaque, and calculus in his mouth. Nurses and care workers administered oral care such as rubbing the tongue and buccal mucosa daily. Dentists and oral hygienists visited and provided special oral care three times per week. At least for 77 days, the patient had no recurrence of pneumonitis. The oral desquamated epithelium and membranous substances in the pharynx decreased drastically. 2 months after the first examination, the patient was able to start rehabilitation with food. Some studies have indicated that pharyngeal deposits are derived from the oral mucosa, and through our case, we realized the importance of daily oral care by interprofessional work to reduce membranous substances in the pharynx.
Collapse
|
9
|
Hihara H, Tagaino R, Washio J, Laosuwan K, Wicaksono DP, Izumita K, Koide R, Takahashi N, Sasaki K. Effectiveness and safety of a new dental plaque removal device utilizing micro mist spray for removing oral biofilm in vitro. BMC Oral Health 2021; 21:286. [PMID: 34088301 PMCID: PMC8176685 DOI: 10.1186/s12903-021-01647-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background Removal of oral biofilm from the oral mucosa is essential for preventing risk of respiratory and gastrointestinal infection in elderly people. Currently, no device is available which can remove oral biofilm from oral mucosa effectively and safely. Therefore, the effectiveness and safety of the Micro Scale Mist UNIT (MSM-UNIT), a newly developed dental plaque removal device utilizing high speed sprays of fine water droplets, were evaluated for biofilm removal, including the rate and surface roughness for simulated tooth surface and mucous membrane. Methods Simulated tooth and oral mucosa coated with an artificial biofilm of Streptococcus mutans were used for evaluation of effectiveness, with uncoated substrates as the controls. The MSM-UNIT and a conventional air ablation device were operated under recommended instructions. The effectiveness was evaluated from the rate of removal of the biofilm, and the safety was evaluated from the damage observed by scanning electron microscope and surface roughness. Results The biofilm removal rate of the MSM-UNIT was significantly higher than that of AIRFLOW. Little damage was observed in the area treated by the MSM-UNIT. The surface roughness of the MSM-UNIT treated area on simulated tooth surface and oral mucosa showed no significant difference to the control area. In contrast, cracks and powder were observed in the area treated by AIRFLOW. In particular, the surface roughness of the AIRFLOW treated area for Toughsilon was significantly larger than that of the control. Conclusions The MSM-UNIT could be used safely and effectively for removing biofilm not only on simulated tooth surfaces but also simulated mucous membrane. The MSM-UNIT has no harmful effect on teeth or oral mucosa, and may be used for comprehensive oral care for patients during nursing care and the perioperative period.
Collapse
Affiliation(s)
- Hiroki Hihara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Ryo Tagaino
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Jumpei Washio
- Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Kittipong Laosuwan
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, T. Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Dimas Prasetianto Wicaksono
- Faculty of Dental Medicine, Department of Pediatric Dentistry, Universitas Airlangga, St. Mayjen Prof. Dr. Moestopo No. 47, Surabaya, 60132, Indonesia
| | - Kuniyuki Izumita
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Rie Koide
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Nobuhiro Takahashi
- Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| |
Collapse
|
10
|
Tago M, Katsuki NE, Yaita S, Nakatani E, Yamashita S, Oda Y, Yamashita SI. High inter-rater reliability of Japanese bedriddenness ranks and cognitive function scores: a hospital-based prospective observational study. BMC Geriatr 2021; 21:168. [PMID: 33750305 PMCID: PMC7941919 DOI: 10.1186/s12877-021-02108-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The statistical validities of the official Japanese classifications of activities of daily living (ADLs), including bedriddenness ranks (BR) and cognitive function scores (CFS), have yet to be assessed. To this aim, we evaluated the ability of BR and CFS to assess ADLs using inter-rater reliability and criterion-related validity. METHODS New inpatients aged ≥75 years were enrolled in this hospital-based prospective observational study. BR and CFS were assessed once by an attending nurse, and then by a social worker/medical clerk. We evaluated inter-rater reliability between different professions by calculating the concordance rate, kappa coefficient, Cronbach's α, and intraclass correlation coefficient. We also estimated the relationship of the Barthel Index and Katz Index with the BR and CFS using Spearman's correlation coefficients. RESULTS For the 271 patients enrolled, BR at the first assessment revealed 66 normal, 10 of J1, 15 of J2, 18 of A1, 31 of A2, 37 of B1, 35 of B2, 22 of C1, and 32 of C2. The concordance rate between the two BR assessments was 68.6%, with a kappa coefficient of 0.61, Cronbach's α of 0.91, and an intraclass correlation coefficient of 0.83, thus showing good inter-rater reliability. BR was negatively correlated with the Barthel Index (r = - 0.848, p < 0.001) and Katz Index (r = - 0.820, p < 0.001), showing justifiable criterion-related validity. Meanwhile, CFS at the first assessment revealed 92 normal, 47 of 1, 19 of 2a, 30 of 2b, 60 of 3a, 8 of 3b, 8 of 4, and 0 of M. The concordance rate between the two CFS assessments was 70.1%, with a kappa coefficient of 0.62, Cronbach's α of 0.87, and an intraclass correlation coefficient 0.78, thus also showing good inter-rater reliability. CFS was negatively correlated with the Barthel Index (r = - 0.667, p < 0.001) and Katz Index (r = - 0.661, p < 0.001), showing justifiable criterion-related validity. CONCLUSIONS BR and CFS could be reliable and easy-to-use grading scales of ADLs in acute clinical practice or large-scale screening, with high inter-rater reliabilities among different professions and significant correlations with well-established, though complicated to use, instruments to assess ADLs. TRIAL REGISTRATION UMIN000041051 (2020/7/10).
Collapse
Affiliation(s)
- Masaki Tago
- Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Naoko E Katsuki
- Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Shizuka Yaita
- Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Eiji Nakatani
- Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Shizuoka, Japan.,Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Shun Yamashita
- Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Yoshimasa Oda
- Department of General Medicine, Yuai-Kai Foundation and Oda Hospital, Kashima, Japan
| | - Shu-Ichi Yamashita
- Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| |
Collapse
|
11
|
Miyahara K, Ogasawara T, Hasegawa H, Shinotsuka K, Shimada K, Ochiai T, Shen FC, Kakinoki Y. Pharyngeal Deposits Comprising Salivary Mucin in Tube-fed Elderly Patients: MUC2 and MUC7 Immunoreactivity. Dysphagia 2020; 36:875-881. [PMID: 33145634 DOI: 10.1007/s00455-020-10202-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 10/19/2020] [Indexed: 12/15/2022]
Abstract
Several investigators have reported that oral membranous and pharyngeal viscous deposits developed in bedridden elderly persons requiring nursing care without oral intake. Therefore, this study aimed to clarify the origin of viscous deposits on the pharyngeal mucosa based on characteristics of salivary and tracheal secretory mucin. The participants were 35 elderly people who required nursing care. All 46 collected specimens, including 30 intraoral and 16 pharyngeal specimens, were stained against specific mucins secreted from the respiratory tract and saliva gland using antibodies anti-MUC2 and anti-MUC7, respectively. Out of 35 participants, the intraoral membranous deposits and deposits on the pharyngeal mucosa developed in 17 (48.6%) and 10 persons (28.6%), respectively. The pharyngeal deposits developed in 58.8% of participants who developed intraoral deposits. All pathological specimens shared microscopic findings of various combinations of eosinophilic lamellar structure and a pale-basophilic amorphous substance. Immunohistochemically, both the 30 oral and the 16 pharyngeal specimens obtained from 17 participants were consistently positive for MUC7 but negative for MUC2. In conclusion, we clarified that the mucoid component of both oral and pharyngeal deposits comprised MUC7 salivary mucin, which revealed that both deposits originated from the oral cavity. This result strongly suggests that oral care is intimately related to oral and pharyngeal conditions.
Collapse
Affiliation(s)
- Kohta Miyahara
- Department of Special Care Dentistry, Hiroshima University, Hiroshima, Japan
| | - Tadashi Ogasawara
- Department of Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, 1780 Hirooka-Gobara, Shiojiri, Nagano, 399-0781, Japan.
| | - Hiromasa Hasegawa
- Hard Tissue Pathology Unit, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri, Japan
| | | | - Katsumitsu Shimada
- Department of Oral Pathology, Matsumoto Dental University, Shiojiri, Japan
| | - Takanaga Ochiai
- Department of Oral Pathology, Matsumoto Dental University, Shiojiri, Japan.,Department of Oral Pathology, Division of Oral Pathognesis & Disease Control, Asahi University School of Dentistry, Mizuho, Japan
| | - Fa-Chih Shen
- Dental Department, Sijhih Cathay General Hospital, New Taipei, Taiwan
| | - Yasuaki Kakinoki
- Department of Special Needs and Geriatric Dentistry, Kyushu Dental University, Kitakyushu, Japan
| |
Collapse
|
12
|
Shen FC, Ogasawara T, Shinotsuka K, Miyahara K, Isono K, Mochiduki N, Matsumura K, Shimada K, Ochiai T, Kakinoki Y, Hasegawa H. Histopathological evaluation of oral membranous substance in bedridden elderly persons without oral intake in Japan. Gerodontology 2018; 36:63-70. [PMID: 30461050 DOI: 10.1111/ger.12379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/10/2018] [Accepted: 10/13/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study was to clarify by histopathological examination the origin of oral membranous substances deposited on the palate, tongue, buccal mucosa and teeth. BACKGROUND Several investigators have reported membranous substances deposited in the mouths of bedridden elderly persons requiring nursing care without oral intake. However, the precise nature and origin of the substances are poorly understood. METHODS Sixty-nine specimens were taken from the oral cavity of bedridden patients, that is, the palate, dorsum of the tongue, the cheek and teeth. Sections were stained with haematoxylin and eosin stain, alcian-blue and periodic acid-Schiff stain (AB-PAS) and antibodies for pankeratin (AE1AE3) and leukocyte common antigen (LCA). RESULTS All specimens showed a film-like nature coloured from tan to white, accompanied by a mucous substance. Histologically, specimens of all sites had a similar feature of the combination of basophilic amorphous and eosinophilic lamellar features. The basophilic substance was positive for AB-PAS, and PAS-positive glycogen granules were also noted in the lamellar structure. Immunochemistry revealed various degrees of pankeratin positive substance and LCA-positive inflammatory cell infiltration. CONCLUSION The oral membranous substance was composed of keratin and mucin with inflammation. These results suggest that the deposition of the oral membranous substance is a pathological condition or oral mucositis caused by dry mouth.
Collapse
Affiliation(s)
- Fa-Chih Shen
- Department of Dentistry, Cathay General Hospital, Sijhih, Taiwan
| | - Tadashi Ogasawara
- Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Koichi Shinotsuka
- Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Kohta Miyahara
- Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Kazushige Isono
- Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Noriyasu Mochiduki
- Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Kouhei Matsumura
- Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Katsumitsu Shimada
- Department of Oral Pathology, Matsumoto Dental University, Shiojiri, Japan
| | - Takanaga Ochiai
- Department of Oral Pathology, Matsumoto Dental University, Shiojiri, Japan
| | - Yasuaki Kakinoki
- Department of Special Needs and Geriatric Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | - Hiromasa Hasegawa
- Hard Tissue Pathology Unit, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri, Japan
| |
Collapse
|
13
|
Tajima S, Ryu M, Ogami K, Ueda T, Sakurai K. Time-dependent effects of tongue cleaning with mouthwash or mouth moisturising gel on the number of microbes on the tongue surface of elders with care needs. Gerodontology 2017; 34:427-433. [DOI: 10.1111/ger.12283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Sayaka Tajima
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Masahiro Ryu
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Koichiro Ogami
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| |
Collapse
|
14
|
Ohno T, Heshiki Y, Kogure M, Sumi Y, Miura H. Comparison of Oral Assessment Results Between Non-Oral and Oral Feeding Patients: A Preliminary Study. J Gerontol Nurs 2017; 43:23-28. [PMID: 27845809 DOI: 10.3928/00989134-20161109-05] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/30/2016] [Indexed: 01/14/2023]
Abstract
In the current study, evaluation and comparison of oral status was performed to confirm the necessity of oral care for non-oral feeding patients. The study involved patients consulting an attending physician in one hospital's Department of Dentistry for oral care. Based on the feeding method, participants were divided into two groups: (a) non-oral (n = 66) and (b) oral (n = 66) feeding. Characteristics and Oral Assessment Guide scores were compared between groups. The non-oral feeding group had significantly worse scores than the oral feeding group. The non-oral feeding group also showed significantly lower voice-, swallowing-, saliva-, and tongue-related scores. The poor oral status of non-oral feeding patients was clarified. The results suggest the importance of oral care for non-oral feeding patients. [Journal of Gerontological Nursing, 43(4), 23-28.].
Collapse
|
15
|
Kobayashi K, Ryu M, Izumi S, Ueda T, Sakurai K. Effect of oral cleaning using mouthwash and a mouth moisturizing gel on bacterial number and moisture level of the tongue surface of older adults requiring nursing care. Geriatr Gerontol Int 2015; 17:116-121. [DOI: 10.1111/ggi.12684] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Kenichiro Kobayashi
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Masahiro Ryu
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Sachi Izumi
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology; Tokyo Dental College; Tokyo Japan
| |
Collapse
|
16
|
Affiliation(s)
- Yasuaki Kakinoki
- Division of Special Needs and geriatric dentistry, Department of physical functions, Kyushu Dental University
| |
Collapse
|