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?

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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?

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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)

11

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,