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1.
J Oral Rehabil ; 51(5): 840-850, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38186265

RESUMO

BACKGROUND: Aboriginal older adults residing in remote areas have poor oral function due to inadequate access to healthcare services. Lay health advisor (LHA) strategies can fill capacity shortages of healthcare professionals in rural communities and increase population acceptance of health care or healthy behaviours. OBJECTIVE(S): To evaluate the effectiveness the LHA program on oral function and oral health-related quality of life (OHRQoL) among older adults in aboriginal community. METHODS: Participants were randomly assigned to an experimental group (EG; n = 122) and a control group (CG; n = 118). All participants performed oral exercises, and the EG received additional one-on-one 30-min lessons by an LHA over 4 weeks. Data were collected through face-to-face interview and oral examination. The generalized estimating equation model was used to analyse changes in outcomes over time. RESULTS: The EG exhibited significantly greater improvement in swallowing (ß = .63) at the 6-month follow-up and in masticatory performance (ß = .52) and pronunciation of the syllable/pa/ (ß = 2.65) at the 2-week follow-up than the CG did. The EG had a significantly lower plaque control record (ß = -.14) and plaque index (ß = -.30) at the 3-month follow-up than the CG did. Moreover, the OHRQoL was significantly increased at 6-months follow-up in the EG (p = .010). CONCLUSION: The LHA program had positive effects on chewing, swallowing and plaque control in aboriginal older adults. LHA group also experienced positive long-term effect on OHRQoL after intervention.


Assuntos
Promoção da Saúde , Qualidade de Vida , Humanos , Idoso , Assistência Odontológica , Índice de Placa Dentária , Saúde Bucal
2.
Support Care Cancer ; 30(7): 5779-5788, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35344101

RESUMO

PURPOSE: Maintenance of oral feeding is important in terms of maintaining and improving the quality of life in terminal cancer patients receiving palliative care. Although adequate oral health status is essential for oral feeding in hospitalized patients, the relationship between oral health and oral feeding in patients receiving palliative care remains unclear. This cross-sectional study aimed to examine how the general condition and oral health status of these patients relate to decisions regarding their nutritional intake methods. METHODS: This retrospective cross-sectional study included 103 terminal cancer patients (59 men and 44 women; mean age, 73.8 ± 10.9 years) who received palliative care between April 2017 and August 2019. The nutritional method was assessed using the Functional Oral Intake Scale (FOIS). We assessed two types of nutritional methods: (1) the method advised by the attending physician until the initial dental examination (FOIS-I) and (2) the recommended method based on consultation with a palliative care doctor and dentist after the initial oral examination (FOIS-R). Furthermore, the participants' basic information and Dysphagia Severity Scale (DSS) and Oral Health Assessment Tool (OHAT) scores were assessed. RESULTS: There was a divergence between FOIS-I and FOIS-R. FOIS-R was significantly higher than FOIS-I (p < 0.001). Multiple regression analysis revealed that the time until death, DSS score, and OHAT score had a significant impact on determining the food form for oral feeding. CONCLUSIONS: Appropriate oral health assessment is important in determining the food form and indication for oral feeding among patients receiving palliative care.


Assuntos
Transtornos de Deglutição , Neoplasias , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Saúde Bucal , Cuidados Paliativos , Qualidade de Vida , Estudos Retrospectivos
3.
Support Care Cancer ; 30(2): 1463-1471, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34529140

RESUMO

PURPOSE: Patients with terminal cancer undergoing multidisciplinary palliative care often have oral health problems, but these details are still unclear. This cross-sectional study aimed to elucidate the oral health of patients with terminal-stage cancer who are inpatient recipients of acute-phase palliative care, and to unveil the factors affecting their oral health. METHODS: Participants were 121 patients with terminal-stage cancer (68 males, 53 females, mean age: 73.6 ± 11.1 years) and oral health complaints. They received palliative care at Tokyo Medical and Dental University Medical Hospital between April 2017 and August 2019. Their demographic and medical details were extracted, retrospectively, from their medical records, and their oral health status, such as the number of natural teeth, removable denture usage, Oral Health Assessment Tool (OHAT), and Dysphagia Severity Scale, were evaluated. All outcomes were assessed by a dentist from the palliative care team. RESULTS: The problems with soft tissue, saliva, and oral cleanliness were observed. The absence of posterior occlusal support was common, and the use of removable dentures was often inadequate. In contrast, swallowing function was relatively well-conserved and 46.3% of the participants were capable of nutrition intake solely by mouth. Multiple regression analysis revealed a significant association between total OHAT score and age, consciousness level, prognostic level, and method of nutritional intake. CONCLUSION: The results revealed that the oral health of terminal cancer patients under palliative care declined despite receiving routine oral care from nurses, and suggest the importance of including dental professionals in multidisciplinary palliative care.


Assuntos
Neoplasias , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Cuidados Paliativos , Estudos Retrospectivos
4.
J Clin Periodontol ; 49(10): 988-998, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35713224

RESUMO

AIM: To evaluate the effects of an at-home artificial intelligence (AI)-assisted dental monitoring application on treatment outcomes in patients with periodontitis. MATERIALS AND METHODS: Participants with periodontitis were recruited and randomly assigned to an AI (n = 16), AI and human counselling (AIHC; n = 17), or control (CG; n = 20) group. All participants received non-surgical periodontal treatment. We employed an AI-assisted tool called DENTAL MONITORING® (DM) intervention, a new technological AI monitoring product that utilizes smartphone cameras for intra-oral scanning and assessment. Patients in the AI and AIHC groups received additional (a) DM or (b) DM, respectively, with real-person counselling over 3 months. Periodontal parameters were collected at baseline and follow-ups. A mixed-design model analysed the follow-up effects over time. RESULTS: The AI and AIHC groups, respectively, exhibited greater improvement in probing pocket depth (PPD) (mean diff = -0.9 ± 0.4 and -1.4 ± 0.3, effect size [ES] = 0.76 and 1.98), clinical attachment level (mean diff = -0.8 ± 0.3 and -1.4 ± 0.3, ES = 0.84 and 1.77), and plaque index (mean diff = -0.5 ± 0.2 and - 0.7 ± 0.2, ES = 0.93 and 1.81) at 3-month follow-up than the CG did. The AIHC group had a greater reduction in PPD (ES = 0.46) and clinical attachment level (ES = 0.64) at the 3-month follow-up compared with the AI group. CONCLUSIONS: Using AI monitoring at home had a positive effect on treatment outcomes for patients with periodontitis. Patients who received AI-assisted health counselling exhibited better treatment outcomes than did patients who received AI monitoring alone.


Assuntos
Periodontite Crônica , Periodontite , Inteligência Artificial , Periodontite Crônica/terapia , Raspagem Dentária , Seguimentos , Humanos , Perda da Inserção Periodontal/tratamento farmacológico , Índice Periodontal , Bolsa Periodontal/tratamento farmacológico , Periodontite/tratamento farmacológico
5.
J Oral Rehabil ; 49(12): 1163-1172, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36152018

RESUMO

OBJECTIVE: To evaluate the effectiveness of a clinical-based oral function intervention on oral function and care behaviours in older patients with mild dementia. METHOD: Participants were randomly assigned to the experimental group (EG) and control group (CG). Both groups received a leaflet on oral health-related knowledge, and the EG also received an oral function intervention, which was a brief one-on-one lesson concerning oral exercise and preventive oral care. Oral exercise included turning the head, pouting lips, bulging cheeks, stretching tongue, articulation exercise and salivary gland massages. A reminder phone call was made every 2 weeks. Perceived xerostomia and dysphagia, plaque index (PI), Winkel tongue-coating index (WTCI), repetitive saliva-swallowing test (RSST), oral diadochokinesis (DDK) and oral care behaviours were recorded at baseline and at 3-month follow-up. Generalised Estimating Equations (GEE) were used to analyse the indicated effects. RESULTS: The EG (n = 59) exhibited greater improvement to the CG (n = 55) in RSST [ß = 0.7; effect size (ES) = 0.45], the syllables /pa/ (ß = 3.1; ES = 0.37) and /ka/ (ß = 2.7; ES = 0.40) in oral DDK, PI (ß = -0.2; ES = 0.52) and WTCI (ß = -0.8; ES = 0.38). Moreover, the EG exhibited better preventive behaviours in regular dental visits [adjusted odds ratio (aOR) = 2.2], daily mouth cleaning frequency (aOR = 1.6) and mouth cleaning before sleep (aOR = 1.3). CONCLUSION: The brief clinical-based intervention was effective in improving the swallowing function, oral DDK and plaque control of older patients with mild dementia at 3-month follow-up.


Assuntos
Transtornos de Deglutição , Demência , Xerostomia , Idoso , Humanos , Deglutição , Saúde Bucal , Xerostomia/reabilitação , Transtornos de Deglutição/reabilitação
6.
J Oral Rehabil ; 48(7): 817-826, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33624362

RESUMO

Tooth loss is a common problem among older adults that affects masticatory function (MF) and food selection. Financial burden is a reason that some older adults in Taiwan with this condition forgo dental restoration. To identify the number of posterior occlusal support areas (POSAs) associated with MF. Large-scale cross-sectional study included 1100 community-dwelling participants of Taiwan aged ≥65 years. Participants completed dental examination and questionnaires through personal interviews. Masticatory performance was evaluated using a colour-changeable chewing gum. Masticatory ability was evaluated on the basis of how many of 14 common foods the participants were able to eat. Participants were grouped into 10 categories (A1-A3, B1-B4 and C1-C3) according to the Eichner index (EI) of posterior occlusal contacts. Multivariable regression models were used to analyse the association between the EI groups and MF. More than 80% of the participants with two or more POSAs (those in groups A1-B2) could easily eat various foods. Compared with those in groups A1-B2, those in groups in B3, B4, C1, C2 and C3 exhibited a significantly different masticatory performance (all P < .001) and significantly higher difficulty in eating fruits and vegetables. A dose-response effect between POSAs and perceived masticatory ability to eat fruits and vegetables was observed (P < .05 for both trends). Preservation of at least two POSAs is essential for MF. Older adults with tooth loss can undergo the restoration of two POSAs to improve MF and increase food intake.


Assuntos
Oclusão Dentária , Perda de Dente , Idoso , Estudos Transversais , Alimentos , Humanos , Mastigação , Inquéritos e Questionários
7.
J Oral Maxillofac Surg ; 75(9): 1848-1855, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28413149

RESUMO

PURPOSE: This study investigated the associations between magnetic resonance imaging (MRI) findings and pain in the temporomandibular joint (TMJ). MATERIALS AND METHODS: The study included 646 TMJs of 323 consecutive patients with temporomandibular disorders; of these, 222 (34.4%) had TMJ pain whereas 424 (65.6%) had no TMJ pain. MRIs were used to evaluate disc position, osteoarthritis, joint fluid, and bone marrow edema. Internal derangement was classified as normal, anterior disc displacement with reduction, and anterior disc displacement without reduction (ADDWOR); condylar morphology was classified as normal, moderate bony change, and severe bony change. The odds ratio (OR) for each MRI variable for nonpainful versus painful TMJs was computed using logistic regression analysis. RESULTS: Compared with joints with normal disc position, the OR of those with ADDWOR was 2.74 (P < .001) for TMJ pain. Similarly, compared with joints with normal condylar morphology, the OR of those with severe bony change was 4.62 (P = .02) for TMJ pain. In addition, the risk of TMJ pain increased by 2.37 in joints with joint fluid (P < .001) and by 2.34 in joints with bone marrow edema (P = .006). The risk of TMJ pain increased significantly with ADDWOR in combination with severe bony change, joint fluid, and bone marrow edema. CONCLUSIONS: These results suggest an association between TMJ pain and ADDWOR, severe bony change, joint fluid, and bone marrow edema. Thus, combining various MRI variables may improve the diagnostic accuracy of TMJ pain.


Assuntos
Dor Facial/diagnóstico por imagem , Imageamento por Ressonância Magnética , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor
9.
J Oral Maxillofac Surg ; 72(10): 2015-31, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24856954

RESUMO

PURPOSE: The aim of the present study was to evaluate the feasibility of a gelatin hydrogel system to enhance recombinant human fibroblast growth factor-2 (rhFGF-2)-induced osteogenic effects during rat mandibular distraction. MATERIALS AND METHODS: Mandibular distraction was performed in 28 male Wistar rats. Then, the rats were divided into 5 groups in which the designated gel mix was inserted into the distracted area: group 1, rhFGF-2 alone (n = 5); group 2, collagen alone (n = 6); group 3, collagen incorporating rhFGF-2 (n = 6); group 4, gelatin hydrogel alone (n = 5); and group 5, gelatin hydrogel incorporating rhFGF-2 (n = 6). The mandibles were excised 29 days after surgery and the newly formed bone was analyzed radiologically and histologically. The experimental groups were compared using the Fisher post hoc test (95% statistical significance threshold; P < .05). RESULTS: Peripheral quantitative computed tomographic analysis, von Kossa staining, and calcein staining showed that using gelatin hydrogel with rhFGF-2 (group 5) significantly increased cortical bone mineral density, the domain area of hard tissue, the domain area of cortical bone area, total bone mineral content, cortical bone mineral content, the von Kossa-stained area, and the calcein-stained area compared with the collagen carrier (group 3). Group 5 also had a significantly larger number of cells positive for tartrate-resistant acid phosphatase compared with group 3 and radiopaque areas were observed more frequently. CONCLUSIONS: The present findings suggest that gelatin hydrogel is a feasible delivery system for rhFGF-2, and when used together perform better in regard to hard tissue healing and treatment time after surgery.


Assuntos
Fator 2 de Crescimento de Fibroblastos/uso terapêutico , Gelatina/química , Hidrogel de Polietilenoglicol-Dimetacrilato/química , Mandíbula/cirurgia , Osteogênese por Distração/métodos , Proteínas Recombinantes/uso terapêutico , Fosfatase Ácida/análise , Anatomia Transversal , Animais , Biomarcadores/análise , Densidade Óssea/efeitos dos fármacos , Colágeno/química , Corantes , Portadores de Fármacos , Estudos de Viabilidade , Fluoresceínas , Corantes Fluorescentes , Humanos , Isoenzimas/análise , Masculino , Mandíbula/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Ratos Wistar , Fosfatase Ácida Resistente a Tartarato , Tomografia Computadorizada por Raios X/métodos , Microtomografia por Raio-X/métodos
10.
J Oral Pathol Med ; 42(3): 275-80, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22882291

RESUMO

BACKGROUND: Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder and is characterized by tumorigenesis and physical deformity. Keratocystic odontogenic tumors (KCOTs) of the jaws are a common manifestation of this syndrome. This study involved a pooled analysis of Japanese individuals with NBCCS and was performed with the aim of analyzing the clinical features of NBCCS and the patterns of occurrence and recurrence of KCOTs in Japanese individuals. METHODS: This study included 25 patients. The relative frequencies of the major symptoms in these patients were compared with those reported in the literature. We also investigated 11 patients with KCOTs (40 lesions) initially treated at Tokyo Medical and Dental University. RESULTS: KCOTs (100%) and palmar and/or plantar pits (n = 19; 76.0%) were the most frequently observed manifestations. Eleven patients (44.0%) had a radiologically confirmed rib anomaly. Nineteen patients (76.0%) had a family history of the syndrome within first-degree relatives. Japanese patients had a relatively low frequency of basal cell carcinoma (n = 7; 28.0%) and falx calcification (n = 7; 28.0%) compared with that reported in other populations. Twelve of the total 40 KCOTs (30.0%) that were followed up for 6 months or more recurred. All recurrent cases had undergone conservative treatment, whereas no recurrences occurred in cases that had undergone radical treatment. CONCLUSIONS: Recurrence of KCOTs associated with NBCCS is frequently encountered, and further investigations are required to confirm the optimal treatment that will ensure a complete cure improving the patient's quality of life.


Assuntos
Síndrome do Nevo Basocelular/patologia , Tumores Odontogênicos/patologia , Adolescente , Adulto , Idoso , Síndrome do Nevo Basocelular/genética , Carcinoma Basocelular/patologia , Criança , Dura-Máter/patologia , Feminino , Seguimentos , Deformidades do Pé/patologia , Deformidades da Mão/patologia , Humanos , Japão , Masculino , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/cirurgia , Neoplasias Maxilares/patologia , Neoplasias Maxilares/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Tumores Odontogênicos/genética , Tumores Odontogênicos/cirurgia , Ossificação Heterotópica/patologia , Qualidade de Vida , Costelas/anormalidades , Adulto Jovem
11.
Digit Health ; 9: 20552076231203891, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37780060

RESUMO

Objective: Healthcare assistants (HCAs) are frontline caregivers for older adults. This study evaluated the effectiveness of combining augmented reality (AR) and virtual reality (VR) to implement oral healthcare simulation training for HCAs. Methods: An experimental design was adopted. HCAs were recruited and randomly assigned to an AR/VR group (n = 40) or a control group (n = 40). The AR/VR group received 2.5 h of AR/VR training. Participants were trained on the Bass brushing technique through AR and on scenario-based oral care procedures for various physical and oral health conditions in older adults through VR. A self-administered questionnaire was employed to collect data before and after the training. Generalized estimating equations were used to analyze the differences between pretest and posttest results. Results: After the training, the HCAs in the AR/VR group achieved a significantly greater increase in their level of oral care-related knowledge (ß = 2.55, effect size [ES] = 1.62), self-efficacy (ß = 4.23, ES = 0.75), and behavioral intention (ß = 2.10, ES = 0.55) relative to the control group. Conclusion: This study revealed that the application of an AR/VR simulation system can effectively improve the geriatric oral care performance of HCAs.

12.
Heliyon ; 9(6): e15869, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37260888

RESUMO

Objective: Episil® is a bio adhesive barrier-forming oral liquid gel that has been used in recent years to relieve pain of oral mucositis (OM) with radiotherapy (RT) or chemoradiotherapy (CRT) in head and neck cancer (HNC) patients. We conducted a retrospective analysis of the clinical effects of Episil® on OM in these patients. Study design: Between June 2018 and May 2020, 65 patients with HNC were treated with RT or CRT at our hospital. Results: The median total RT dose was 50 Gy (range, 30-70 Gy) and the completion rate was 63/65 (97%). The median time to OM resolution was 47 (6-90) days and was significantly longer (53 [27-90] days) when the total RT dose was ≥51 Gy (P < 0.001). Episil® was used in 26 patients. Among them, 10 discontinued its use due to ineffective pain relief, usage difficulties, and taste intolerance. The median duration of use was 30 days and was significantly longer (34.5 days) (P < 0.001) when patients experienced pain relief at treatment initiation. Conclusion: Although Episil® has been shown to be effective in improving the pain of OM caused by RT for HNC patients, and medical professionals are required to give careful attention to each patient.

13.
J Hum Genet ; 57(7): 422-6, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22572734

RESUMO

Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder characterized by developmental defects and tumorigenesis. The gene responsible for NBCCS is PTCH1. The PTCH1 gene has five alternatively used first exons resulting in the translation of three isoforms of the PTCH1 protein; that is, PTCHL, PTCHM and PTCHS. However, the biological significance of each isoform is unclear. Here we show an individual with NBCCS carrying a nonsense mutation in PTCH1 exon2, c.387G>A (p.W129X). As the mutation lay upstream of the ATG codon used for PTCHS translation, the mutant allele still expressed RNA isoforms that encode PTCHS. These results clearly demonstrate that a selective haploinsufficiency of longer isoforms of the PTCH1 protein, PTCHL and PTCHM, but not PTCHS is sufficient to cause NBCCS. Although mice selectively deficient in PTCHS isoforms are currently unavailable, this study sheds light on the complex in vivo roles of PTCH1 isoforms.


Assuntos
Síndrome do Nevo Basocelular/genética , Haploinsuficiência , Receptores de Superfície Celular/genética , Síndrome do Nevo Basocelular/metabolismo , Síndrome do Nevo Basocelular/patologia , Criança , Códon sem Sentido/genética , Éxons , Células HEK293 , Humanos , Masculino , Receptores Patched , Receptor Patched-1 , Biossíntese de Proteínas , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , RNA Mensageiro/análise , RNA Mensageiro/genética , Receptores de Superfície Celular/metabolismo , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transfecção
14.
Healthcare (Basel) ; 10(11)2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36360588

RESUMO

Oral ulcers caused by herpes zoster virus infection are commonly encountered in daily clinical practice. However, in rare cases, sepsis or viremia can occur with serious outcomes; hence, these must be managed effectively. Here, we report a case of a patient with extensive ulceration caused by varicella zoster virus infection. Antiviral treatment was started early, and oral health management was started simultaneously, with oral hygiene instructions for pain control. As a result, the patient was able to resume oral food intake and was discharged from the hospital within a week. This case suggested that oral health management comprising supportive care, with the assistance of dentists and dental hygienists, as well as antiviral therapy, are important in the treatment of oral ulcers associated with herpes zoster virus infection.

15.
Int Dent J ; 72(4S): S5-S11, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36031325

RESUMO

OBJECTIVE: The total years lived with disability among older people, and the concomitant burden of tooth loss in ageing societies have increased. This study is an overview of the burden of oral diseases and access to oral care in an ageing society. METHODS: We selected key issues related to the burden of oral diseases and access to oral care and reviewed the relevant literature. RESULTS: The rising number of older people with teeth increases their oral health care needs. To improve access to oral care, affordability of care is a great concern with respect to universal health coverage. In addition, accessibility is a crucial issue, particularly for vulnerable older adults. To improve oral care access, attempts to integrate oral health care into general care are being made in ageing countries. For this purpose, provision of professional oral care at home through domiciliary visits and provision of daily oral health care by non-dental professional caregivers are important. Oral health care for older people reduces general diseases such as pneumonia and malnutrition, which in turn could reduce further healthcare costs. CONCLUSIONS: To address the growing burden of oral care in ageing societies, special provision of oral health care to vulnerable older people, and integration of oral care with primary care will be required.


Assuntos
Doenças da Boca , Perda de Dente , Idoso , Envelhecimento , Humanos , Saúde Bucal
16.
J Pers Med ; 12(2)2022 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-35207706

RESUMO

(1) Background: Virtual reality (VR) technology is a widely used training tool in medical education. The present study aimed to evaluate the effectiveness of VR training of oral hygiene students on providing oral healthcare to disabled elderly persons. (2) Methods: A randomized controlled trial was conducted. In 2021, oral hygiene students were randomly assigned to a VR experimental group (EG; n = 11) and a control group (CG; n = 12). The EG received two-hour, thrice-repeated VR-based training interventions at 2-week, 4-week, and 6-week follow-ups. The CG received no VR-based interventions. Data were collected using a self-administered questionnaire before and immediately after each intervention. We performed generalized estimating equations to compare the responses. (3) Results: The EG exhibited a more significant improvement in oral care-related knowledge, attitude, self-efficacy, and intention at the 6-week follow-up than the CG. The students' intention to assist the elderly in using interdental brushes (ß = 0.91), with soft tissue cleaning (ß = 0.53), and with oral desensitization (ß = 0.53), and to have regular dental visits (ß = 0.61) improved significantly at the 6-week follow-up. (4) Conclusions: VR training positively affected students' knowledge, attitude, self-efficacy, and intentions on providing oral healthcare to disabled elderly persons.

17.
J Dent Sci ; 17(1): 535-544, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35028081

RESUMO

BACKGROUND/PURPOSE: Global networking and e-learning courses are an effective strategy for sharing educational content and there is potential scope to use e-learning technology in dental education. Therefore, this study aimed to explicate the challenges encountered in international e-learning use and decipher optimum solutions for disseminating course/systems on an international scale. MATERIALS AND METHODS: An e-learning course with four computer-assisted simulation materials developed among international faculties was provided to dental undergraduates at dental schools in Japan and Vietnam in 2020. A post-questionnaire survey plus pre- and post-tests were conducted to obtain learners' feedback and assess the success of the course's implementation. RESULTS: Altogether, 41 students participated, with a response rate of 78.8%. The mean post-test score was significantly higher than that of the pre-test (p < 0.001). Students from both groups felt that e-learning was beneficial, useful for their future, and should be continued. CONCLUSION: This study showed that e-learning/course provision could be achieved at an international level by using a common online system, which is beneficial for students to gain a wider perspective and global dental education. Learners indicated that they learned without any major problems in learning operations. This type of educational material creation and course implementation is extremely important in global networking and dental education in the present era; and communication and cooperation between the faculties was important for course provision. More countries should be included in future studies to ensure that it has global application.

18.
J Pers Med ; 12(3)2022 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-35330459

RESUMO

Late-life depression is a major mental health problem and constitutes a heavy public health burden. Frailty, an aging-related syndrome, is reciprocally related to depressive symptoms. This study investigated the associations of physical frailty and oral frailty with depression in older adults. This large-scale cross-sectional study included 1100 community-dwelling older adults in Taiwan. The participants completed a dental examination and questionnaires answered during personal interviews. The 15-item Geriatric Depression Scale was used to assess depression, and information on physical conditions and oral conditions was collected. Multivariable logistical regression analysis was conducted to examine associations of interest. Significant factors associated with depression were pre-physical frailty (adjusted odds ratio (aOR) = 3.61), physical frailty (aOR = 53.74), sarcopenia (aOR = 4.25), insomnia (aOR = 2.56), pre-oral frailty (aOR = 2.56), oral frailty (aOR = 4.89), dysphagia (aOR = 2.85), and xerostomia (aOR = 1.10). Depression exerted a combined effect on physical frailty and oral frailty (aOR = 36.81). Physical frailty and oral frailty were significantly associated with late-life depression in community-dwelling older adults in a dose-response manner. Developing physical and oral function interventions to prevent depression among older adults is essential.

19.
Artigo em Inglês | MEDLINE | ID: mdl-34444121

RESUMO

Interventions engaging community health workers (CHW) for diabetes management aim to improve diabetes care and self-management behaviors among patients. We evaluated the effects of nonsurgical periodontal treatment (NSPT) with the CHW strategy on oral self-care behaviors, periodontal status and oral health-related quality of life (OHQoL) in patients with type 2 diabetes mellitus (T2DM). The participants were randomly assigned to experimental (EG; n = 35) and control (CG; n = 33) groups. All participants received NSPT, whereas the patients in the EG also received one-on-one 30 min lessons from a CHW over 4 weeks. The EG exhibited greater improvement in the probing pocket depth (ß = -0.2, effect size [ES] = 0.61) and clinical attachment level (ß = -0.2, ES = 0.59) at 1-month follow-up than the CG did. The ES increased over the 1-, 3- and 6-month follow-ups, indicating an increase in OHQoL (ES = 0.19, 0.60, and 0.62, respectively) in the EG. The patients in the EG were more likely to change their oral self-care behaviors than patients in the CG were. The NSPT with CHW strategy had a positive effect on 1-month periodontal treatment outcomes, long-term OHQoL and oral self-care behaviors in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Autogestão , Agentes Comunitários de Saúde , Diabetes Mellitus Tipo 2/terapia , Humanos , Qualidade de Vida , Resultado do Tratamento
20.
Clin Interv Aging ; 15: 1-7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32021128

RESUMO

PURPOSE: There are few studies about sarcopenia before and after surgery for oral cancer. Therefore, we examined body composition during hospitalization and factors affecting weight loss, skeletal muscle mass index (SMI) reduction, and swallowing function at discharge in this patient group. PATIENTS AND METHODS: A prospective survey was conducted at Tokyo Medical and Dental University Dental Hospital for patients who underwent primary surgery for oral cancer and reconstruction using free flaps. We compared body weight, SMI, grip strength, and walking speed at admission and discharge. We also examined factors affecting weight loss and SMI reduction and the functional oral intake scale (FOIS) score at discharge. RESULTS: There were 26 patients that we could survey during the period. As a result of Wilcoxon's signed-rank test, body weight, SMI, and grip strength were significantly reduced during hospitalization, but no reduction was noted for sarcopenia. As a result of multiple regression analysis, postoperative chemoradiotherapy was a risk factor for weight loss, reduced SMI, and low FOIS score at discharge. CONCLUSION: Postoperative chemoradiotherapy is a risk factor for weight loss, muscle mass loss, and dysphagia at discharge, and chemoradiotherapy may affect rather than an invasion of surgery. After surgery, besides follow-ups for cancer, oral cancer patients should be followed up to assess dysphagia, undernutrition, and sarcopenia.


Assuntos
Composição Corporal , Quimiorradioterapia , Transtornos de Deglutição , Avaliação Geriátrica/métodos , Neoplasias Bucais , Complicações Pós-Operatórias/diagnóstico , Sarcopenia , Idoso , Pesos e Medidas Corporais , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/métodos , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Japão/epidemiologia , Masculino , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/fisiopatologia , Neoplasias Bucais/terapia , Músculo Esquelético/fisiopatologia , Estudos Prospectivos , Fatores de Risco , Sarcopenia/epidemiologia , Sarcopenia/fisiopatologia , Sarcopenia/prevenção & controle , Velocidade de Caminhada
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