Smartphone-based combined oral and whole-body exercise programme aimed at improving oral functions: A randomized clinical trial.

OBJECTIVES: To investigate the effects of a smartphone-based oral and whole-body exercise programme on oral function in older adults. METHODS: Individuals aged 65 years or above were randomized into three groups (non-app use, app use and control group), and a combined oral and whole-body exercise programme was conducted for 5 weeks. Oral muscle strength, saliva flow rate, Oral Health Impact Profile-14 (OHIP-14), and Geriatric Oral Health Assessment Index (GOHAI) were measured before and after the intervention. The changes in each group were analysed at the end of the programme using paired sample t-tests, and the differences among the groups were analysed using the chi-square test, Fisher's exact test and ANOVA. RESULTS: The anterior tongue strength increased by 2.80 kPa after the intervention in the non-app use group; however, the change was not statistically significant. In the app use group, the anterior tongue strength significantly increased by 4.48 kPa. The saliva flow rate increased by 0.54 and 0.71 g/min in the non-app and app use groups, respectively, after the intervention (p < 0.05), and the change was greater in the app use group than in the other groups (p < 0.01). There were no significant changes in the posterior tongue strength, cheek strength, OHIP-14 or GOHAI scores over the course of the study. CONCLUSIONS: A smartphone-based combined oral and whole-body exercise programme can improve anterior tongue strength and saliva flow rate in older participants. The programme, however, did not result in significant changes in posterior tongue strength, cheek strength and perceived oral health.

Effectiveness of an oral health education programme using a mobile application for older adults: A randomised clinical trial.

OBJECTIVE: To investigate the effectiveness of an oral health education programme using a mobile app for adults aged 65 years or older. METHODS: Participants aged 65 or older were randomly allocated into non-app use (n = 25), app use (n = 22) and control (n = 26) groups. The non-app use group received lecture-based oral health education using PowerPoint presentations and participated in workbook activities twice a week for five weeks, whereas the app use group underwent oral health education using a smartphone app and workbook activities for five weeks. Before and after the intervention, a questionnaire survey and oral health examination were performed to examine changes in oral health-related indices. RESULTS: The non-app use group showed significant changes, with a 2.1 increase in oral health knowledge score, 0.2 decrease in the O'Leary index and 0.6 decrease in tongue coating. The app use group showed significant changes, with a 3.1 increase in oral health knowledge score, a 2.5 increase in oral health perception, a 0.3 decrease in the O'Leary index and a 1.4 decrease in tongue coating. Repeated-measures ANOVA showed that interaction between time and group was significant only in tongue coating variable. CONCLUSION: The smartphone app developed in this study carries the possibility to convey informative content for oral health education among older adults.

Effects of Integrative Cognitive Function Improvement Program on Cognitive Function, Oral Health, and Mental Health in Older People: A Randomized Clinical Trial.

We aimed to investigate the effects of an integrative cognitive function improvement program that combined existing cognitive, emotional, and physical therapies on cognitive function, oral health, and mental health in elder participants. Participants were classified into one of the following groups: cognitively normal (CN; n = 18), mild cognitive impairment (MCI; n = 17), and control (n = 17). An integrative cognitive function improvement program was administered to the CN and MCI groups for six weeks. To measure cognitive function, electroencephalogram (EEG) and cerebral blood flow (CBF) were evaluated, and to measure oral health, the O'Leary index, Löe & Silness index, tongue coating, unstimulated saliva flow rate, and oral muscle strength were measured. To measure mental health status, mental health, happiness and social support were measured. The CN and MCI groups showed a significant change in EEG-based indices for awareness level and physical stress. Regarding oral health, the O'Leary and the Löe & Silness index score decreased significantly in the CN and MCI groups. Saliva flow rate increased significantly in the CN and MCI groups. In regards to mental health, the happiness score increased post-intervention in the CN and MCI groups. In conclusion, the integrative cognitive function improvement program was effective in improving cognitive function, oral health, and mental health of elder people.

Associations between Mental Health and Oral Health among Korean Adolescents: Analysis of the National Surveys (2008-2017).

We aimed to analyze the trends and associations between the oral and mental health of Korean adolescents using the Korea Youth Risk Behavior Web-based Surveys. In total, 713,713 adolescents who participated in the surveys were included. To examine trends in oral and mental health, Pearson's correlation coefficients were calculated between the weighted percentages and years, and the regression line slope was assessed to estimate annual changes. A complex sample logistic regression analysis was also performed. Experiencing oral symptoms and suicide-related factors both showed a gradually decreasing trend from 2008 and slight increases in 2017 and 2016, respectively. Compared with adolescents who had no oral symptoms, those with all six oral symptoms showed an increase in suicide attempts in the last 12 months, suicide ideation, and feelings of sadness and despair. In conclusion, experiencing more oral symptoms is associated with an increased risk of suicide-related factors.

Diversity of Acupuncture Point Selections According to the Acupuncture Styles and Their Relations to Theoretical Elements in Traditional Asian Medicine: A Data-Mining-Based Literature Study.

Acupuncture point (AP) selections can vary depending on clinicians' acupuncture style, and therefore, acupuncture style is an important factor in determining the efficacy of acupuncture treatment. However, few studies have examined the differences in AP selections according to the acupuncture styles and theoretical backgrounds causing the differences. We compared the AP prescriptions used for 14 diseases in three classical medical textbooks, Dongeuibogam (DEBG), Saamdoinchimgooyogyeol (SADI), and Chimgoogyeongheombang (CGGHB), which represent unique acupuncture styles and have affected clinicians during this time. AP prescriptions showed more diversity between textbooks than between types of diseases. Among the three textbooks, AP prescriptions of SADI were most different compared to those of DEBG and CGGHB. Importantly, we found each style can be more clearly explained by AP attributes than by the APs per se. Specifically, SADI, DEBG, and CGGHB preferred five transport points located on the limbs, APs of the extra meridians, and source points, respectively. This suggests the possibility that the theoretical diversity of acupuncture styles results in the heterogeneity of AP selections.

Effects of Professional Oral Health Care Programs for Elderly Residents of Nursing Facilities.

Purpose: The purpose of this study was to investigate the effects of a professional oral health care program on the oral health status and salivary flow of elderly people living in nursing homes.Methods: Elderly residents aged ≥ 65 years, living in a nursing home, were randomly assigned to either a one-week interval, two-week interval, or control group, and received an oral health intervention accordingly over a period of 12 weeks. Plaque index, tongue coating, gingival index, and salivary flow rate were compared before and after the oral health intervention within and between the groups.Results: The plaque, tongue coating, and gingival indices of the participants who received the oral health intervention decreased significantly; while the salivary flow rate significantly increased. Plaque, tongue coating, and gingival indices decreased most significantly in the one-week interval group, followed by the two-week interval group, relative to the control. The salivary flow rate increased most significantly in the one-week interval group, followed by the two-week interval group.Conclusion: A professional oral health care program is effective for improving the oral health and salivation of elderly residents in nursing homes and the effect was found to be greater with interventions provided at one-week intervals. Oral health care professionals, including dentists and dental hygienists, must regularly monitor and manage the oral health of elderly residents.

Effects of lingual exercises on oral muscle strength and salivary flow rate in elderly adults: a randomized clinical trial.

AIM: The present study investigated the effects of two types of lingual exercise (tongue-hold swallowing and tongue-pressure resistance training) on oral muscle strength, salivary flow rate and subjective oral health of the elderly. METHODS: We randomly assigned 74 elderly adults (≥65 years) to three groups (tongue-hold swallowing, tongue-pressure resistance training and control groups). Each group participated in 8 weeks of their appropriately prescribed intervention. We measured anterior tongue strength, posterior tongue strength, lip strength, salivary flow rate and Oral Health Impact Profile-14 score before and after 8 weeks. Differences before and after intervention were observed with a paired sample t-test. Moreover, analyses of covariance and variance were performed to determine the differences in the measured values between the groups. RESULTS: The tongue-hold swallowing group showed improvement in both anterior and posterior tongue strength, while the tongue-pressure resistance training group showed a significant increase in only anterior tongue strength. Both the tongue-hold swallowing and tongue-pressure resistance training groups showed increased salivary secretion, with the tongue-pressure resistance training group showing a higher level of salivary secretion. However, the difference in the subjective oral health scores before and after the intervention was not significant. CONCLUSIONS: The two lingual exercises strengthened some aspects of tongue muscles and increased the salivary flow rate, with more salivary secretion in the tongue-pressure resistance training group than in the tongue-hold swallowing group. Any evidence of the lingual exercises being able to enhance subjective oral health could not be found. Geriatr Gerontol Int 2020; ••: ••-••.

Effectiveness of an oral health education programme for older adults using a workbook.

OBJECTIVE: This study investigated the effects of an oral health education programme utilising a workbook for people aged 65 years or older. MATERIALS AND METHODS: A pre-post quasi-experimental design was used to verify the effectiveness of an oral health education programme using a workbook. Oral health education was provided once a week for 5 weeks from May to June 2019. Intervention group I only received lectures on oral health education, while intervention group II reviewed the content using the workbook immediately after the lecture. Chi-square test, Fisher's exact test and a one-way analysis of variance (ANOVA) were conducted to compare differences among the three groups; a paired t test was also carried out to identify the changes before and after the programme. RESULTS: Intervention group I showed a significant increase of 3.52 on oral health knowledge and 3.47 on oral health recognition, while exhibiting a significant decrease of 0.21 on the O'Leary index and 0.69 on the tongue coating index. Intervention group II depicted a significant increase of 4.48 on oral health knowledge and 3.97 on oral health recognition and a significant decrease of 0.32 on the O'Leary index and 2.10 on the tongue coating index. CONCLUSIONS: The oral health education programme using the workbook increased knowledge and recognition of oral health and lowered the O'Leary and tongue coating indexes. Hence, the use of a workbook may facilitate the effectiveness of oral health education for older people.

Association between oral health status and chronic obstructive pulmonary disease in Korean adults.

OBJECTIVES: This study aimed to elucidate the association between oral health status and chronic obstructive pulmonary disease (COPD) in Korean adults (≥ 40 years old) using a representative national dataset from the 6th Korea National Health and Nutrition Examination Survey (6th KNHANES, 2013-2015). METHODS: Participants aged ≥ 40 years from the 6th KNHANES who had received an oral and pulmonary function tests (N = 7719) were included in this study. The participant characteristics according to COPD were compared using t-test and chi-squared test. Logistic regression analysis was used to estimate the association between oral health status and COPD. RESULTS: Participants with poor periodontal status exhibited a higher prevalence of COPD. Moreover, patients with COPD had a greater number of missing teeth than those without COPD. The logistic regression model adjusted for demographic, socioeconomic, health- and oral health-related factors showed that the periodontal status was not significantly associated with COPD, while participants with more missing teeth had a significantly increased possibility of having COPD. CONCLUSIONS: This study revealed that loss of teeth in adults aged ≥ 40 years was associated with COPD.

Association of oral health and activities of daily living with cognitive impairment.

OBJECTIVES: This study compared the oral health status between elderly individuals with and without cognitive impairment and explored the association of oral health and activities of daily living (ADL) with cognitive impairment. METHODS: We conducted convenience sampling on patients aged more than 65 years and analysed data from 630 participants. Data were collected and analysed via a survey evaluating general characteristics, oral health behaviour, subjective oral health status, Oral Health Impact Profile (OHIP-14), Geriatric Oral Health Assessment Index (GOHAI) and ADL. RESULTS: The path analysis and regression analysis of the association of oral health and ADL with cognitive impairment showed that the OHIP-14 was not significantly associated with cognitive impairment, whereas the GOHAI and ADL had significant associations with cognitive impairment. A 1-point increase in the GOHAI was associated with a 0.024-point increase in the cognitive impairment score, and a 1-point increase in the ADL was associated with a 0.006-point decrease in the cognitive impairment score (normal = 0, cognitive impairment = 1). CONCLUSIONS: Poor oral health and ADL were associated with cognitive impairment. Therefore, oral hygiene management is important in maintaining oral health in elderly individuals with cognitive impairment.

Relationship between rheumatoid arthritis and periodontal disease in Korean adults: Data from the Sixth Korea National Health and Nutrition Examination Survey, 2013 to 2015.

BACKGROUND: This study aims to investigate the relationship between rheumatoid arthritis and periodontal disease using data from the Sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2013 to 2015). METHODS: Of 22,948 KNHANES participants, 14,264 who were aged ≥19 years and responded to questions pertaining to periodontal disease and rheumatoid arthritis were analyzed. Periodontal status was measured using the Community Periodontal Index. The authors used a complex sampling analysis by applying an individual sampling weighting to maintain the rolling survey sampling method. To determine the prevalence of rheumatoid arthritis and periodontal disease, a Chi-squared test was performed. Logistic regression analysis was performed after controlling for selected variables to determine relevance. RESULTS: The prevalence of rheumatoid arthritis in patients with periodontal disease was 1.6%, which was higher than in individuals without periodontal disease (1.5%). The prevalence of periodontal disease in individuals with rheumatoid arthritis was 28.4%, which was higher than in subjects without rheumatoid arthritis (27.9%). The risk for periodontal disease was 1.64 times higher in individuals with rheumatoid arthritis than in those without rheumatoid arthritis. Regardless of age or sex, the risk for periodontal disease was 1.97 times higher in the presence of rheumatoid arthritis. However, other logistic regression analysis models, when adjusted for socioeconomic-, health-, and oral health-related factors, did not yield statistically significant findings. CONCLUSIONS: The study results suggest a possible relationship between rheumatoid arthritis and periodontal disease. Further large cohort studies investigating causal relationships between rheumatoid arthritis and periodontal disease are needed.

Efficacy of hyaluronan-rich transfer medium on implantation and pregnancy rates in fresh and frozen-thawed blastocyst transfers in Korean women with previous implantation failure

OBJECTIVE: To evaluate the effect of hyaluronan-rich transfer medium on pregnancy and implantation rates in fresh and frozen-thawed embryo transfers in Korean women with previous implantation failure. METHODS: This retrospective study included 283 blastocyst transfers in patients with previous embryo transfer failure at a private fertility clinic. In the study group (n=88), blastocyst transfers were performed using an hyaluronan-rich transfer medium prior to transfer, whereas blastocyst transfers without any treatment served as controls (n=195). According to the type of transfer (fresh elective or frozen-thawed), all the blastocyst transfers were divided into two study and two control groups. RESULTS: The patient's mean age, serum anti-Müllerian hormone level, causes of infertility, embryo quality, and the number of transferred embryos were comparable between the study and control groups. There were no significant differences in clinical pregnancy rate (45.5% vs. 43.1%), implantation rate (28.9% vs. 28.8%), and clinical abortion rate (10.0% vs. 8.3%) between the two groups, and these findings were not changed after subgroup analysis according to the type of transfer. CONCLUSION: The use of hyaluronan-rich transfer medium in the blastocyst transfer does not appear to have any significant effect on the implantation and pregnancy rates in patients with previous implantation failure.