要介護高齢者における口臭とその関連要因及び予防対策に関する研究

One hundred ten elderly with disabilities in institutions or receiving home care were selected and informed. This study focused on oral malodor and discusses consent was obtained the relationship between oral malodor and the state of dental health and oral hygiene in the elderly with disabilities. ADL of the elderly with disabilities (rank J, A, B, C, settled by National Health Administration in Japan) were 8.2% at rank J, 28.2% at rank A, 42.7% at rank B and 20.9% at rank C, respectively. The incident rate of swallowing pneumonitis, fever and bedsores were low. Accordingly, physical and mental conditions were comparatively preferable. Tooth and periodontal conditions were comparablye to nationwide results. 1. The elderly in poor ADL had marked oral malodor compared with those in good health. 2. The elderly who required assistance to eat or had special dietary requirements had marked oral malodor. 3. The elderly who had normal oral functions and the ability to take care of their own oral hygiene had markedly less oral malodor. 4. The elderly who had poor oral hygiene exhibitings thick tongue coating and positive results in a Candida albicans culture test, had marked oral malodor. 5. Using, the multivariate statistical analysis of Hayashi methodsⅡ, the coefficient of correlation between the state of oral malodor and 27 variables was obtained. 1) The study obtained trustworthy values that discriminate analysis 92.7% and correlation ratio is 0.53. 2) The variables related to severe oral malodor, extracted by the multivariate statistical analysis in descending order, were: "low level of ADL in gargling and denture brushing", "cigarette smoking", "speech disabilities", "unsatisfactory mastication", "need for special dietary care", "oral druyness", "gingivitis", "soft diet of side dish", "living in a special institution caring for the elderly", "thick tongue coating", and "a positive Candida albicans culture test", respectively. 3) The items related with comparatively comfortable or bearable oral malodor, extracted by the multivariate statistical analysis in descending order were : "satisfactory mastication", "home care", "healthy or poor eyesight", "difficulty in mastication", "being able to independently remove, dentures", "a negative Candida albicans culture test", "no oral dryness", "independents in selecting diet", "comfortable gingival condition", "being dependent on others for tooth-brushing" and "preferable tongue coating", respectively. 4) For the effective preventive countermeasures of oral malodor, ADL of oral health, caring circumstances and hygiene of gingiva/tongue should be focused on rather than dental hygiene itself.

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