Purpose of Review
Oral functions, which are responsible for feeding and swallowing, play a very important role in obtaining proper nutrition. Therefore, their deterioration could interfere with ...nutritional ingestion. This review investigated previous reports on the relationship between oral function deterioration and malnutrition.
Recent Findings
Reduced occlusal force, decreased tongue–lip motor function, decreased tongue pressure, decreased masticatory function, and deterioration of swallowing function have been found to be associated with malnutrition. On the other hand, consensus does not exist on whether oral dryness is associated with malnutrition. Prosthetic rehabilitation and oral function training are effective interventions for improving oral functions. However, malnutrition could not be addressed by prosthetic rehabilitation alone; it requires simultaneous management with prosthetic rehabilitation and nutritional guidance. Furthermore, it has been reported that data on whether oral function training, such as tongue strengthening training, could improve malnutrition are limited.
Summary
Partial deterioration of oral functions can cause malnutrition. Prosthetic rehabilitation and oral function training could be considered interventions for improving malnutrition, but numerous unclarified points about these methods remain. In the future, detailed research should be conducted to elucidate the causal relationship between deterioration of oral functions and malnutrition and to establish oral function interventions for improving malnutrition.
Oral function deterioration is related to a variety of factors, including aging, decline in activities of daily living, malnutrition, and cognitive decline. This cross-sectional study examined the ...effects of aging on oral function in healthy individuals.
A retrospective study was conducted on 175 healthy, independent patients aged 40-89 years, without dementia and with ≥20 teeth, who visited a local dental clinic in Japan. Patients were compared with 92 university students aged 20-29 years. The seven criteria proposed by the Japanese Society of Gerodontology to diagnose "oral hypofunction" were observed and statistically analyzed.
Compared with those in the control group, the degree of tongue coating was increased in the group aged over 80 years, occlusal force was decreased in the group aged 70-79 years, tongue motor function was decreased in the groups aged 60-69 years and older, and tongue pressure was decreased in the groups aged 70-79 years and older.
Healthy, independent individuals maintained several oral function criteria across aging, including oral mucosal wetness, occlusal force, lip motor function, masticatory function, and swallowing function. Tongue motor function and tongue pressure decreased with aging, indicating that these may be rehabilitation targets.
Abstract Background Isaacs’ syndrome, also known as neuromyotonia or peripheral nerve hyperexcitability, is a rare disorder that affects the peripheral nervous system. Clinical findings include ...cramps, fasciculations, and myokymia; however, there are few reports of dental treatment for trismus. Case presentation A patient with trismus due to Isaacs’ syndrome experienced swelling and pain in the gingiva surrounding his right lower first molar. He was diagnosed with chronic apical periodontitis by a dentist near his home. However, the patient was informed that dental treatment and medication could not be administered because of the presence of Isaacs’ syndrome, and he visited the Geriatric Dentistry and Perioperative Oral Care Center at Kyushu University Hospital 2 weeks later. The patient’s painless mouth-opening distance (between incisors) was 20 mm at that time, and medication, including amoxicillin capsules and acetaminophen, was administered because the dental extraction forceps or endodontic instruments were difficult to insert into the oral cavity for treatment. Two months after his initial visit, the patient visited us complaining of pain in the same area. However, he had recently undergone plasmapheresis treatment in neurology to alleviate limited mouth opening and systemic myalgia, resulting in a pain-free mouth-opening distance of approximately 35 mm. During this temporary period in which he had no restriction in mouth opening, we performed tooth extraction and bridge restoration on the mandibular right first molar and created an oral appliance for sleep bruxism. Conclusions Plasmapheresis therapy transiently reduced trismus, rendering dental interventions feasible, albeit temporarily. This case report underscores the importance of close collaboration between neurologists and dentists who encounter similar cases while furnishing valuable insights to inform dental treatment planning.
Primary central nervous system lymphoma (PCNSL), a relatively rare brain tumor, bears a dire prognosis. On occasion, the rapid progression of the tumor makes immediate diagnosis and initiation of ...therapy imperative. To achieve swift diagnosis, we adopt flow cytometry (FCM) in addition to conventional histopathology. This study aimed to reveal the utility of FCM diagnosis for PCNSL and the cause of false-negative results of FCM diagnosis. We investigated 33 patients with suspected PCNSL on neuroradiological findings and received both FCM and histological diagnosis. The patients' electronic medical records were investigated, and histological findings, results of FCM, and other clinical data were evaluated. Overall, 27 patients (14 males and 13 females) were diagnosed with PCNSL by histological confirmation. The median age at diagnosis was 68 years. FCM analysis showed lymphoma pattern in 24 cases; however, FCM results did not show lymphoma pattern (sensitivity: 88.9%, specificity: 100%) in the other three lymphoma cases (FCM discordant: FCM-D) and six nonlymphomatous tumor cases. Analysis of FCM-D cases showed the infiltration of T lymphocytes or astrocytes into the tumor tissue, indicating tumor microenvironmental reaction; it is assumed that these reactions deceived FCM diagnosis. The survival of FCM-D patients was superior to FCM concordant counterpart, although the difference was not significant (p = 0.459). The diagnosis of PCNSL by FCM is rapid and highly reliable. Some FCM-D cases are PCNSLs with strong tumor microenvironmental reactions.
Background
The relationship between oral and cognitive functions among older people is highly debated.
Objective
To examine whether oral functions are related to changes in the levels of mild ...cognitive impairment (MCI) biomarkers in older Japanese outpatients.
Methods
This observational study included 52 outpatients aged ≥65 years who underwent dental examinations at the Fukuoka Dental College Hospital. The Mini‐Mental State Examination (MMSE) was performed, and MCI blood biomarker levels were assessed at baseline and after 2 years. The present dental and periodontal conditions and the oral functions (tongue pressure and masticatory performance) were evaluated. Changes in parameters from baseline to follow‐up were compared using the Wilcoxon signed‐rank test, McNemar test or chi‐squared test. Associations among changes in the parameters were analysed using Spearman's rank correlation coefficient.
Results
The follow‐up rate in this study was 67%. The masticatory performance was improved (p < 0.001), whereas gingival inflammation was decreased (p < 0.001) over the 2‐year period. A significant increase in the MMSE score (p < 0.001) and a decrease in MCI risk (p < 0.001) were noted. The decrease in MCI risk was correlated with the increase in both masticatory performance (ρ = −0.34; p < 0.05) and MMSE score (ρ = −0.56; p < 0.01).
Conclusion
A decrease in MCI risk, as demonstrated by the levels of the blood biomarkers, was correlated with an increase in the masticatory performance in Japanese outpatients.
Two‐year changes in oral and cognitive functions among older Japanese dental outpatients.
Myeloid sarcoma (MS) is a relatively rare manifestation of myeloid neoplasms at sites other than the bone marrow. The rarity of gastrointestinal (GI) MS is attributed to certain factors, such as ...misdetection due to insufficient endoscopic assessments at the initial presentation with acute myeloid leukemia (AML) as well as the difficulty of making a histologic assessment of leukemic involvement of the GI tract. We herein report a case of AML with gastric involvement and discuss the importance of screening examinations and therapies considering the location of MS and the data of cytogenetic and molecular mutation.
It is known that oral frailty is one of the risk factors for physical frailty. Therefore, early detection, appropriate treatment, and prevention of oral frailty are really important. Tongue lifting ...exercise has been identified as a well-known method for improving decreased tongue pressure, one of the factors for oral frailty. However, few reports have investigated how tongue-strengthening exercises affect physical function and body composition. The aim of this study was to investigate the effects of isometric tongue lifting exercises on oral function, physical function, and body composition.
Participants were 49 elderly people aged 68-79 years, who had previously participated in the "Itoshima Frail Study." Participants performed isometric tongue lift exercises for 3 months. Oral function (tongue pressure and oral diadocokinesis), physical function (grip strength, open-eyed one-leg standing, sit-to-stand motion time, 5-m gait speed, and 3-m Timed up and go TUG), and body composition were measured at baseline and post-intervention, and the extent of changes in each item was statistically analyzed. Furthermore, participants were divided into physical frailty/pre-frailty and robust groups based on the Japanese version of the frail scale proposed by BMC Geriatr. 2015 Apr;15:36 and were compared in terms of the extent of changes in each item baseline and the post-intervention.
After the intervention, oral function increased significantly together with a significant improvement in physical function, open-eyed one-leg standing time, sit-to-stand motion, and 3-m TUG. For body composition, visceral fat level and basal metabolic rate decreased significantly. Although no significant change in body composition was observed in the physical frailty/pre-frailty group after the intervention, significant improvements in several items were observed in the robust group.
Isometric tongue lifting exercise can effectively improve oral function. Furthermore, it might affect physical function and body composition.
Individuals with implantable ventricular assist devices (VADs) are at extremely high risk of bleeding, thromboembolism, and infection after undergoing invasive dental procedures. This study aimed to ...investigate the systemic and local complications of tooth extraction before and after VAD implantation.
This retrospective cohort study was conducted at a single center. Oral surgical procedures were performed in patients before and/or after left VAD implantation for bridge-to-heart transplantation between April 2013 and December 2017. In this study, the medical charts of the patients were retrospectively reviewed. Data about pre-extraction complete blood count, coagulation profile, biochemical profile, and incidence of local and systemic complications were compared in patients undergoing tooth extraction before VAD implantation (b-VAD group) versus after VAD implantation (a-VAD group).
In total, 28 inpatients underwent 36 oral surgical procedures before and/or after VAD implantation. Moreover, 24 tooth extractions were performed in the b-VAD group, and 12 were performed in the a-VAD group. The incidence of post-extraction bleeding was higher in the a-VAD group (P = .001, Mann-Whitney U test), and a significant difference was observed in terms of activated partial thromboplastin time (P = .010, Mann-Whitney U test). Systemic complications associated with VADs included cerebral infarction (n = 2) and driveline infection (n = 1). Post-extraction bleeding was observed within 90 days after VAD implantation in all patients who underwent tooth extraction.
The risk of bleeding after tooth extraction was higher in the a-VAD group (67%) than in the b-VAD group (13%). In 3 cases, VAD-related systemic complications developed within a short period after tooth extraction. The extraction management in the b-VAD group could be controlled without causing any problem. Hence, the opportune time of tooth extraction is before VAD implantation.
Coagulation factor X (FX) deficiency causes severe hemorrhagic symptoms. We herein report a 90-year-old man with hemorrhagic symptoms and prolongation of prothrombin time (PT) and activated partial ...thromboplastin time (APTT). Cross-mixing tests showed a factor deficiency pattern, but administration of plasma products was not effective. Acquired coagulation factor deficiency was suspected, and immunosuppressive therapy was started. After the intervention, his hemorrhagic symptoms improved. A decrease in FX activity was later confirmed, and anti-FX autoantibody was retrospectively detected by an enzyme-linked immunosorbent assay. Immediate intervention is important for patients suspected of having acquired coagulation factor deficiency.
PDF
