지역사회 거주 노인의 타액선 기능저하 (구강건조) 평가 및 중재
Assessment and intervention of salivary gland hypofunction (dry mouth) in community-dwelling older adults
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Salivary gland hypofunction (dry mouth) is the most common dysfunction in older adults. It causes a deterioration in oral health, mastication, and swallowing functions. It can also lead to systemic frailty. Early diagnosis and intervention are required to prevent oral and systemic frailty. This literature review introduced the salivary gland hypofunction assessment methods and interventions applicable in community-dwelling older adults. The study proposed an oral mucosal wetness test. The test uses an oral moisture-checking device as the primary test for assessment considering logistic aspects in application to the elderly in the community. The clinical oral dryness score (CODS) is an alternative test. The assessment method of oral mucosal wetness showed a significant correlation with salivary secretion rate. The CODS system is also significantly correlated with mucosal wettability, salivary secretion rate, and severity of oral dryness. Therefore, they have proven useful as test tools for assessing salivary gland hypofunction and oral mucosal wetting. The subjective questionnaire (xerostomia inventory) is also a useful tool for determining the severity of dry mouth and can be combined with other examination methods for salivary gland hypofunction such as oral mucosal wetness test or CODS. Essential interventions to salivary gland disfunction include drug coordination, prescription of artificial saliva, expert application of fluoride varnish, and salivary gland stimulation exercises. Careful consideration of other oral functions, such as occlusal force, tongue pressure, tongue movement, and oral hygiene management ability, is also required. Comprehensive intervention must be planned. Many studies have shown that the degradation of one function leads to that of another. Conversely, improving each function can improve other oral and integrated functions, such as masticatory and swallowing functions. The ultimate purpose of the intervention for salivary gland hypofunction in community-dwelling older adults is to improve and maintain oral functions—mastication, swallowing, and pronunciation. Therefore, interventions should include complex interventions such as oral exercise, tongue pressure enhancement training, oral hygiene, and interventions to improve salivary gland function. The intervention for individual salivary gland dysfunction should be planned with a comprehensive perspective for maintaining integrated oral function and contributing to the prevention and management of systemic frailty and its complications.
Abstract
Salivary gland hypofunction (dry mouth) is the most common dysfunction in older adults. It causes a deterioration in oral health, mastication, and swallowing functions. It can also lead to systemic frailty. Early diagnosis and intervention are required to prevent oral and systemic frailty. This literature review introduced the salivary gland hypofunction assessment methods and interventions applicable in community-dwelling older adults. The study proposed an oral mucosal wetness test. The test uses an oral moisture-checking device as the primary test for assessment considering logistic aspects in application to the elderly in the community. The clinical oral dryness score (CODS) is an alternative test. The assessment method of oral mucosal wetness showed a significant correlation with salivary secretion rate. The CODS system is also significantly correlated with mucosal wettability, salivary secretion rate, and severity of oral dryness. Therefore, they have proven useful as test tools for assessing salivary gland hypofunction and oral mucosal wetting. The subjective questionnaire (xerostomia inventory) is also a useful tool for determining the severity of dry mouth and can be combined with other examination methods for salivary gland hypofunction such as oral mucosal wetness test or CODS. Essential interventions to salivary gland disfunction include drug coordination, prescription of artificial saliva, expert application of fluoride varnish, and salivary gland stimulation exercises. Careful consideration of other oral functions, such as occlusal force, tongue pressure, tongue movement, and oral hygiene management ability, is also required. Comprehensive intervention must be planned. Many studies have shown that the degradation of one function leads to that of another. Conversely, improving each function can improve other oral and integrated functions, such as masticatory and swallowing functions. The ultimate purpose of the intervention for salivary gland hypofunction in community-dwelling older adults is to improve and maintain oral functions—mastication, swallowing, and pronunciation. Therefore, interventions should include complex interventions such as oral exercise, tongue pressure enhancement training, oral hygiene, and interventions to improve salivary gland function. The intervention for individual salivary gland dysfunction should be planned with a comprehensive perspective for maintaining integrated oral function and contributing to the prevention and management of systemic frailty and its complications.
참고문헌 (26)
- Kho HS, "Understanding of xerostomia and strategies for the development of artificial saliva", Chin J Dent Res, 17, pp.75~83 (2014)
- Sreebny, L.M, "A reference guide to drugs and dry mouth - 2nd edition", Gerodontology, 14, pp.33~47 (1997)
- So JS, "Dry mouth among the elderly in Korea: a survey of prevalence, severity, and associated factors", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 110(4), pp.475~483 (2010)
- Affoo RH, "Meta-Analysis of Salivary Flow Rates in Young and Older Adults", J Am Geriatr Soc, 63(10), pp.2142~2151 (2015)
- Hoeksema AR, "Elderly with remaining teeth report less frailty and better quality of life than edentulous elderly : a cross-sectional study", Oral Dis, 23, pp.526~536 (2017)
- Ramsay SE, "Influence of poor oral health on physical frailty : a population-based cohort study of older British men", J Am Geriatr Soc, 66, pp.473~479 (2018)
- Plemons JM, "American Dental Association Council on Scientific Affairs. Managing xerostomia and salivary gland hypofunction:executive summary of a report from the American Dental Association Council on Scientific Affairs", J Am Dent Assoc, 145(8), pp.867~873 (2014)
- Walls AWG, "The relationship between oral health and nutrition in older people", Mech Ageing Dev, 125, pp.853~857 (2004)
- Osailan SM, "Clinical assessment of oral dryness : development of a scoring system related to salivary flow and mucosal wetness", Oral Surg Oral Med Oral Pathol Oral Radiol, 114, pp.597~603 (2012)
- Jager DHJ, "Clinical oral dryness score : evaluation of a new screening method for oral dryness", Odontology, 106(4), pp.439~444 (2018)
- Fukushima Y, "Evaluation of oral wetness using an improved moisture-checking device for the diagnosis of dry mouth", Oral Sci Int, 14(2), pp.33~36 (2017)
- Thomson WM, "The Xerostomia Inventory : a multi-item approach to measuring dry mouth", Community Dent Health, 16, pp.12~17 (1999)
- Jennifer Lee, "Translation and Validation of a Korean Version of the Xerostomia Inventory in Patients with Primary Sjögren’s Syndrome", Journal of Korean Medical Science, 31(5), pp.724~728 (2016), 대한의학회
- Thomson WM, "Further testing of the xerostomia inventory", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 89(1), pp.46~50 (2000)
- Sleibi A, "Reversal of Root Caries with Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Varnish in Xerostomia", Caries Res, 55(5), pp.475~484 (2021)
- Patel R, "Refocusing dental care : A risk-based preventative oral health programme for dentate older people in UK care homes", Gerodontology, 39(2), pp.131~138 (2022)
- Ekstrand KR, "A randomized clinical trial of the anti-caries efficacy of 5, 000 compared to 1, 450ppm fluoridated toothpaste on root caries lesions in elderly disabled nursing home residents", Caries Res, 47, pp.391~398 (2013)
- Weyant RJ, "American Dental Association Council on Scientific Affairs Expert Panel on Topical Fluoride Caries Preventive Agents. Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review", J Am Dent Assoc, 144, pp.1279~1291 (2013)
- Persson A, "Buffering effect of a prophylactic gel on dental plaque in institutionalized elderly", Gerodontology, 24, pp.98~104 (2007)
- Seo K, "Effects of oral health programmes on xerostomia in community-dwelling elderly : A systematic review and meta-analysis", Int J Dent Hyg, 18, pp.52~61 (2020)
- Ohara Y, "Effectiveness of an oral health educational program on community-dwelling older people with xerostomia", Geriatr Gerontol Int, 15, pp.481~489 (2015)
- Saleem M, "Improvement of salivary flow and oral wetness by a lip trainer device and sonic toothbrush in older Japanese men and women with dry mouth", J Oral Sci, 61(2), pp.221~228 (2019)
- Ki, J.Y., "Effect of Oral Health Education Using a Mobile App (OHEMA) on the Oral Health and Swallowing-Related Quality of Life in Community-Based Integrated Care of the Elderly: A Randomized Clinical Trial", Int. J. Environ. Res. Public Health, 18, pp.11679~ (2021)
- Kim HJ, "Improvements in oral functions of elderly after simple oral exercise", Clin Interv Aging, 14, pp.915~924 (2019)
- Ibayashi H, "Intervention study of exercise program for oral function in healthy elderly people", Tohoku J Exp Med, 215, pp.237~245 (2008)
- Nakagawa K, "Effects of gum chewing exercises on saliva secretion and occlusal force in community-dwelling elderly individuals : A pilot study", Geriatr Gerontol Int, 17, pp.48~53 (2017)