Risk factors with intravenous sedation for patients with disabilities.

The purpose of this study was to identify the risk factors associated with low peripheral oxygen saturation (SpO2) and delayed recovery of dental patients with disabilities after intravenous sedation. A total of 1213 patients with disabilities were retrospectively investigated with respect to demographic parameters and sedation conditions. Multivariate logistic analyses were conducted for patients with an SpO2 <90% and a recovery period of >60 minutes to identify the risk factors for poor sedation conditions. A significant odds ratio related to decreased SpO2 was observed for age, sex, midazolam and propofol levels, concurrent use of nitrous oxide, cerebral palsy, Down syndrome, and mental retardation. The most problematic patients were those diagnosed with Down syndrome (odds ratio, 3.003-7.978; 95% confidence interval; P < .001). Decision tree analysis showed an increased risk of decreased SpO2 in males with Down syndrome or after administration of >0.493 mg/kg propofol in combination with midazolam. An increased risk of delayed awakening was seen in patients aged less than 21 years and in males administered >0.032 mg/kg of midazolam. Intravenous sedation for dental patients with disabilities, particularly those with cerebral palsy, Down syndrome, or mental retardation, increases the risk of decreased SpO2. In addition, delayed recovery is expected after midazolam administration.

Factors affecting the motivation for dental check-ups and anxiety in the elderly in Tokyo.

OBJECTIVES: The purpose of this study was to identify factors influencing the motivation for regular dental check-ups and anxiety about future dental problems in the elderly. BACKGROUND: Regular dental check-ups are important to maintain oral health. Anxiety affects the quality of life of the elderly. However, few studies have investigated the factors influencing the motivation for regular dental check-ups and anxiety in the elderly. MATERIALS AND METHODS: Among 452 elderly persons, 215 participants provided useful answers to our questionnaire. The questionnaire consisted of items concerning oral and living conditions of the subjects. Logistic regression analysis was conducted. RESULTS: The mean age of the study sample was 75.7 +/- 5.8 years. The percentage of edentulous subjects was 12.1%. The motivation for regular dental check-ups was significantly positively correlated with the number of teeth present (p < 0.01), using inter-dental brushes (p < 0.01), being on regular prescribed medication (p < 0.05), and having experience of providing oral care for the bedridden (p < 0.05). Anxiety about future oral problems was significantly associated with self-rated health status (p < 0.01) and the presence of dentists who could be counted on to provide domiciliary visits (p < 0.05). CONCLUSION: The participants of this study had a high motivation for regular dental check-ups, but were concerned about the future, particularly if they became bedridden.

[Relationships between application for the School of Oral Health Care Sciences and awareness as a dental hygienist].

The aim of this study was to investigate students' awareness of applying for the School of Oral Health Care Sciences, Tokyo Medical and Dental University and being dental hygienists in the future. Forty-seven students (24 first-year students and 23 second-year students) in the school answered the questionnaire including questions about becoming dental hygienists and certified social workers. We requested them to answer by recalling their thoughts at the time of application. The chi-square test and Fisher's exact test were used for statistical analysis. A significantly larger number of the first-year students thought that a dental hygienist was an attractive occupation compared with the second-year students. The time when first-year students decided to apply for the school was classified into three categories: by August, from September to December of the year preceding admission, and January or February of the admission year. The ratios of the students who decided to apply for the school were 42%, 21%, 38% respectively. The results of analyzing first-year students' questionnaire responses were as follows. A significantly larger number of students who wished or decided to apply for the school by August of the year preceding admission also applied for other dental hygiene programs. The number of students who thought that a dental hygienist was an attractive occupation was significantly greater among the students who wished or decided to apply for the school by August of the year preceding admission than among those who didn't. We consider that these students were highly motivated to become dental hygienists. It is important for the school to recruit students with high motivation.

Factors affecting denture use in some institutionalized elderly people.

This study was conducted to assess which factors were related to the ability of elderly residents of nursing homes to use dentures. For 205 patients in two nursing homes in Chuou-ku, Tokyo, dentists and caregivers examined oral status (caries, status of restoration, missing teeth and occlusal support) as well as denture use, Activities of Daily Living (ADL), ability to rinse the mouth, and degree of dementia. Fifty percent of subjects lacked dentures. Seven items were selected for variance in factor analysis. There was a significant relationship between denture use and all analyzed items except age. The items which proved to be significant, included the number of remaining teeth, the ability to rinse, communication, ability to dress/undress, ability to transfer, and eating (Fisher's exact test). A multiple stepwise logistic regression analysis showed that the nonuse of dentures was significantly related to dressing (p<0.01), the number of remaining crowns (p<0.01) and the ability to rinse the mouth (p<0.0001). The nonuse of dentures was also related to the number of remaining teeth and to the disability of hand and oral functions.

[Career history and perceptions of dental hygiene education programs--questionnaire mail-in survey of alumni of the School of Dental Hygiene in Tokyo Medical and Dental University].

This study was conducted to investigate the career history and perceptions about dental hygiene education programs among the alumni (1952-1999 graduates) of the School of Dental Hygiene in Tokyo Medical and Dental University. A questionnaire containing demographic, practice characteristics and views on the programs was mailed to 997 alumni in 1999, and 576 alumni (57.8%) responded. Three hundred and forty-one respondents worked as dental hygienists. The majority who responded were in clinical practice. One hundred and thirty-one of the respondents worked in private clinics, 76 in public health centers, and 72 in clinics in companies. The rate of them who worked in public health centers was much higher than the national average cited in the Statistical Report on Public Health Administration and Services. Two hundred and ninety-one respondents reported inadequate programs. The rate of them who reported inadequate programs was significantly higher in alumni who were working than in alumni who were not. The items cited as insufficiently taught at the school were clinical practice, instrumentation, foreign language, psychology, counseling, and nursing related subjects. Thus, many alumni suggested the need for better programs and continuing education. From these results, it was suggested that dental hygienists need to change their education programs in order to meet the present and future needs of more diversified society. This view was particularly prevalent among alumni who were working. The result showed that dental hygiene educators and dental hygienists urgently need to reconsider the professionalism of their field.

[A study of oral status of adults who received regular checkups and professional care].

The purpose of this study was to investigate the effect of regular professional care on oral health status. We examined the oral health status of 255 adults (76 males, 179 females; 61.8 +/- 7.8 yrs) who received professional dental care at the Dental Hospital of Tokyo Medical and Dental University at least once a year. The oral health care included checkups and prevention (oral health education, scaling, polishing, topical application of fluoride). We compared the oral health status of adults who received regular professional care with the status of subjects of similar age reported in national and Tokyo surveys of dental diseases in 1999. The following results were obtained. 1. The number of teeth present among adults who received regular oral health care was greater than that reported in the national and Tokyo surveys of dental diseases in 1999. 2. The number of untreated decayed teeth among adults who received regular oral health care was smaller than that reported in the national and Tokyo surveys of dental diseases in 1999. The results show that the oral health status of adults who received regular oral health care was better than the oral health condition of those reported in the national and Tokyo surveys of dental diseases in 1999. Therefore, it is suggested that regular professional care by a dentist or dental hygienist will assist in achieving the objective of the 8020 movement (20 healthy teeth at age 80).

Effects of rehydration and food consumption on salivary flow, pH and buffering capacity in young adult volunteers during ergometer exercise.

BACKGROUND: The aim of this study was to investigate the influences of rehydration and food consumption on salivary flow, pH, and buffering capacity during bicycle ergometer exercise in participants. METHODS: Ten healthy volunteers exercised on a bicycle ergometer at 80% of their maximal heart rate. These sessions lasted for two periods of 20 min separated by 5-min rest intervals. Volunteers were subjected to one of the following conditions: (1) no water (mineral water) or food consumption, (2) only water for rehydration, (3) water and food consumption, (4) a sports drink only for rehydration, and (5) rehydration with a sports drink and food. Statistical significance was assessed using one-way analysis of variance and Dunnett's test (p < 0.05). RESULTS: The salivary pH decreased significantly during and after exercise in conditions 4 and 5. The salivary buffering capacity decreased significantly during exercise and/or after the exercise in conditions 1, 3, 4, and 5. CONCLUSIONS: The results showed that salivary pH and buffering capacity decreased greatly depending on the combination of a sports drink and food.

The effect of awareness on the outcome of oral health performed by home care service providers.

OBJECTIVES: The purpose of this study was to investigate the correlations amongst factors, such as knowledge, attitude, practice and oral health behaviour, in caregiver managers so as to improve the oral health of the dependent elderly. METHODS: Data were collected from a sample of 102 caregiver managers from home care service providers using a questionnaire. The respondents were divided into two groups: the group who were aware of effective oral care (A group) and the group who were unaware of effective oral care (U group). The evaluations were frequency distribution tables followed by chi-squared tests of independence and Fisher's exact test. RESULTS: Ninety percent of the respondents thought that dependent elderly needed to be provided with oral care and 77% had been trained in oral care. However, only 44% thought that they could provide appropriate oral care and only 52% had experienced its effect on oral health and general health. There was a significant difference in training by dental hygienists between the A group (36%) and the U group (11%). There was also a significant difference in learning of oral care skills. CONCLUSION: The results suggested a high oral care awareness amongst caregiver managers and an inadequate oral care training system. To improve oral health of the dependent elderly, theoretical teaching alone is not sufficient when providing oral health education and a positive contact with the dental team, especially dental hygienists, is an important factor which supports oral care provided by caregivers.