Screening, Diagnosis and Prevention of Oral Hypofunction
Kazuhiro TsugaProfessor, Vice PresidentDepartment of Advanced ProsthodonticsGraduate School of Biomedical and Health SciencesHiroshima University Japan
Aging Population – time to actSymposium 2020 Washington DC
1
Oral Hypofunction?
2
Modified and translated by KT from original reference source web page:http://www.mhlw.go.jp/file/05-Shingikai-12404000-Hokenkyoku-Iryouka/0000030112.pdf
Forecast of demand for oral care service (conceptual scheme)
Dem
and
fo
r d
enta
l tre
atm
ent
Progress of ultra-aged society
traditional demand present and future demandhealthy type
elderly type
caries
filling
pulpectomy
crown
tooth extraction
FPD
RPD
Complete Denture
2nd
caries
2nd
caries
caries
filling
pulpectomy
caries
freerestore tooth form> restore oral function
increasing risk of tooth loss
restore oral function> restore tooth form
ou
tpat
ien
t
ho
meb
ou
nd
/ho
spit
al
pat
ien
t
decrease
decrease
Oral hypofunction with age in position paper of Japanese Society of Gerodontology
Minakuchi S, Tsuga K, Ikebe K, et al. Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016. Gerodontology. 2018;00:1–8. https://doi.org/10.1111/ger.12347
Screening?
5
Poor oral hygiene
Oral dryness
http://www.life-qol.net/gazou/sokuteihouhou2.png
https://www.yoshida-dental.co.jp/wp-content/uploads/2014/12/mucus_img_01.jpg
http://www.life-qol.net/douga/shoukai.mp4
Reduced occlusal force
https://www.gcdental.co.jp/product/videos/prescale2/2min_new.jpg
https://www.gcdental.co.jp/product/videos/prescale2/3min_new.jpg
500 N.
Decreased tongue-lip motor function
https://www.dentalsupply.co.jp/files/photo_kenkou_handy.jpg
Decreased tongue pressure
Tongue Pressure Meter (TPM-01, JMS)
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0
20
40
60
Twenties Thirties Forties Fifties Sixties Seventies
Women Men
(kPa)
Age group (Years)
Utanohara Y, Hayashi R, Yoshikawa M, Yoshida M, Tsuga K, Akagawa Y. Standard values of maximum tongue pressure taken using newly developed disposable tongue pressure measurement device. Dysphagia 2008 Sep;23(3):286-90.
(n = 853)
Maximum Tongue Pressure
Decreased masticatory function
https://www.gcdental.co.jp/product/videos/glucosensorgs-II/glucosensorgs-II_3min.jpg
Deterioration of swallowing function
Deterioration of swallowing function
Diagnosis?
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IfClinical Sighns ≧3,
thenOral hypofunction✔
Minakuchi S, Tsuga K, Ikebe K, et al. Oral hypofuction in the older population: Position paper of the Japanese Society of Gerodontology in 2016. Gerodontology. 2018;00:1–8. https://doi.org/10.1111/ger.12347
✔
✔
✔
Prevention?
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10kPa 20kPa 30kPa15kPa
Tongue Training Device
“Peko-Panda”
Maximum Tongue Pressure improved by Peko-Panda Training
最大舌圧値
18.3
23.8
20.722.5
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
ベースライン 4週間後
新機能訓練群
従来法群
[kPa]
**
**P<0.01
(n=157)
Baseline 4 week
Peko-Pandacontrol
Oral Hypofunctionmust be screened, diagnosed, and preventedby oral health care providersfor good QoL of people around the world!
With emerging tools,
