• Title/Summary/Keyword: Xerostomia

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Prevalence and influencing factors of dysphagia in elderly patients

  • Son, Hyo-Jin;Park, Yu-Mi;Yim, Sun-Young;Heo, Yu-Ri;Son, Mee-Kyoung
    • Oral Biology Research
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    • v.42 no.4
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    • pp.208-215
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    • 2018
  • The purpose of this study was to identify the risk of dysphagia among patients that visited prosthodontics department, and evaluate the difference in risks arising from oral conditions and disease in order to preliminarily intervene the various influencing factors of dysphagia. A questionnaire was given to patients that were aged 65 years or older who visited the prosthodontics department between September to December 2017. The data was collected and analyzed using the t-test, $x^2-test$ and logistic regression analysis. The mean age of the patients was 75 years. Out of 300 patients, 206 patients (68.7%) had a risk of dysphagia. There were statistically significant differences between the -non-risk and risk groups, which included the number of natural teeth, total number of teeth including prosthesis, denture use, denture discomfort, number of tooth brushing, oral dryness, digestive system diseases, and musculoskeletal diseases. Among these, oral dryness was a risk factor while the total number of teeth, including natural teeth and prostheses, served as a protective factor. More than half of the elderly patients were at risk of dysphagia. Oral dryness is influenced by many factors and it should continuously be managed. Patients should fully recover their masticatory function by preserving the remaining teeth and compensating for the missing teeth. A dental practitioner should be fully aware of the risk of dysphagia in elderly patients and be able to intervene and offer proper patient health care in advance through treatment guidelines and education.

A Correlation Study of the Body Mass Index and the Indicators of Oral Health (체질량지수와 구강건강지표 사이의 상관성에 대한 연구)

  • Shim, Hyeyoon;Park, Jeong Hwan;Lee, Sanghun;Kim, Hojun
    • Journal of Korean Medicine for Obesity Research
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    • v.21 no.1
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    • pp.32-41
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    • 2021
  • Objectives: We aim to observe the relation of body mass index (BMI) and the indicators of oral health. Methods: 400 subjects participated in the study. The BMI values are calculated from the height and weight. For the tongue diagnosis, we used the tongue imaging device to analyze the color, tongue coating, and tooth marks. We measured the concentration of hydrogen sulfide (H2S) and methyl mercaptan (CH3SH) to evaluate the halitosis. The dry mouth was evaluated through the measurement of saliva secretion and with the questionnaire asking the frequency of dry mouth. Results: The BMI values were significantly higher in the group with light-white and blue-purple colored tongue, and significantly lower for lightly-coated tongue. However, the correlation of BMI and the amounts of saliva secretion was not significant as well as in the correlation of BMI and the concentration of H2S, CH3SH. In tongue diagnosis, the subjects who had blue-purple colored tongue also had significantly higher H2S and CH3SH, but tendency of lower saliva secretion. Conclusion: We obtain data showing that BMI value and the indicators of oral health including tongue diagnosis have meaningful correlation.

Usefulness of the Salivary Gland Scan Using $^{99m}Tc$-pertechnetate after Radiotherapy in Patients with Head and Neck Cancer (방사선 치료에 따른 $^{99m}Tc$-pertechnetate를 이용한 이하선과 악하선 기능 검사의 유용성)

  • Kim, Jong-Jin;Hong, In-Soo;Lee, Jong-Young;Kim, Myung-Soon;Sung, Ki-Joon;Park, Jin-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.3
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    • pp.325-331
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    • 1996
  • Purpose : To assess the functional change of salivary gland, recovery of salivary destruction, difference of susceptibility to irradiation between the parotid and sub-mandibular gland, correlation between the xerostomia and excretory rate by irradiation in salivary scan using $^{99m}Tc$-pertechnetate in patients with head and neck cancer. Materials and Methods : We evaluated 19 patients with head and neck cancer who had taken $^{99m}Tc$-pertechnetate salivary gland scan before, during and after radiotherapy. We measured the uptake of radioactivity every 5 minutes for 60 minutes after injection of $^{99m}Tc$-pertechnetate(370MBq). We also evaluated the first excretory function stimulated by 5% citric acid at 30 minutes after injection of $^{99m}Tc$-pertechnetate and then the second excretory function stimulated by 10% citric acid at 45 minutes. Results : The mean uptake curves showed a sharp increase at the 1st week of radiotherapy and then showed a gradual decrease afterwards during radiotherapy. And the mean uptake curves after radiotherapy Persistently decreased on follow up scans without being recovered. The excretory rates decreased gradually as radiation dose increased and were not recovered after radiotherapy. Our study was not satisfactory enough to show the difference of susceptibility to irradiation between the parotid and salivary gland and the correlation between the symptom of xerostomia and the change of the excretory rates. Conclusion : The parotid and submandibular gland scans using $^{99m}Tc$-pertechnetate are useful in the assessment of the functional change of the salivary gland by radiotherapy and predicted the functional change of the salivary gland until 1 year-follow up scan.

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The effect of need of oral health management to oral health impact profile among elderly over 65 years (65세 이상 노인의 구강건강관리요구도가 구강건강영향지수(OHIP-14)에 미치는 영향)

  • Park, Jung-Ran;Kim, Hye-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.6
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    • pp.961-971
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    • 2011
  • Objectives : The aim of the study was to identify the need of oral health education and prevention? for over 65 years elderly. Methods : his study was to identify the need of oral health management and oral health impact profile among elderly over 65 years. 200 elderly participated in the study, lived in KungBuk and KungNam areas, visited Senior welfare center, from 1st September to 30st December 2008. Results : 1. This majority of respondents are female(74.0%), 75-79 years(29.5%), none education(42.5%), living alone(45.5%), income from children(46.0%), and health insurance(65.5%). 2. In the need of oral health management category, the need of dental treatment are professional toothbrushing, gum treatment, treatment for dental caries, treatment for xerostomia. In the need of prevention and education, the majority participants are 'required'. In oral health impact profile category, the majority participants are 'feel no difficulty during speaking(59.0%)', and 'feel no difficulty during tasting(47.0%)'. In the category, the positive answers are more than negative answers. 3. According to general characteristic with the need of oral health management, famle, obviously income, high level of life are significantly different in the need of prevention and education category. Obviously income is significantly different in the need of dental treatment category. According to general characteristic with the oral health impact profile, getting older, high education are significantly different in disadvantage category. In the case of no spouse, anxiety, physical difficulty, mental difficulty and disadvantage are high score in oral health impact profile. In the case of living alone, pain, anxiety, and disadvantage are high score in oral health impact profile. In the case of no income, limitation of function, pain, anxiety, mental difficulty and disadvantage are high score in oral health impact profile. In the case of no health insurance, anxiety, physical difficulty mental difficulty and lack of sociality are high score in oral health impact profile. 4. The oral health impact profile are positive correlation with the need of dental treatment and the need of prevention education. The effect of oral health impact profile are significantly different with spouse, average of income, the need of prevention education. Conclusions : In Conclusion, the need of prevention education and dental treatment for individual oral health promotion are related with general life condition and life level. Also these are influence of quality of life relate with oral health. These findings are require of development of oral health services program and system from bottom to top.

Comparison of Effects according to Type of Oral Exercise Program for Elderly in Gangneung City (강릉시 일부 노인의 구강근육운동 프로그램 형태별 운영 효과 비교)

  • Lee, Sue-Hyang;Ryu, Jean-A;Yu, Ha-Eun;Lee, Jin-Hee;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.16 no.6
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    • pp.424-431
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    • 2016
  • This study compared the effects of programs according to management type by preparing a manual for oral muscle exercises that integrates oral movement and oral massage. The program was performed on 14 elderly patients in a seniors' college self-practice program group and 28 elderly patients in a social welfare center expert intervention group. In the self-practice group, an expert demonstrated oral muscle exercises and subsequently encouraged self-practice by selecting an oral muscle exercise leader. In the expert intervention group, an expert demonstrated oral exercises on a one-on-one basis and subsequently gave oral muscle massages. In the self-practice group, there was no difference in saliva secretion (p=0.213) or oral dryness (p=0.206), after the intervention, the expert intervention group showed improvements in saliva secretion (p=0.009) and oral dryness (p=0.007). There was no difference in program satisfaction between groups (p=0.143), and both groups reported high satisfaction. As seniors may have difficulty in maintaining oral health behaviors, a certain amount of expert intervention may be needed. The results suggest that both a self-practice oral exercise program and an expert intervention program can be effective elderly patients.

Quality of Life and Radiotherapy Complications of Chinese Nasopharyngeal Carcinoma Patients at Different 3DCRT Stages

  • Gu, Mo-Fa;Su, Yong;Chen, Xin-Lin;He, Wei-Ling;He, Zhen-Yu;Li, Jian-Jun;Chen, Miao-Qiu;Mo, Chuan-Wei;Xu, Qian;Diao, Yuan-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.75-79
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    • 2012
  • Purpose: the study aimed to compare the quality of life (QOL) and radiotherapy complications among Chinese nasopharyngeal carcinoma (NPC) patients at different 3-dimensional conformal radiotherapy (3DCRT) stages adjusting for other variables. Methods: 511 NPC patients at different 3DCRT stages were enrolled. They were interviewed regarding SF-36, complications and socio-demographic variables and cancer- or treatment-related variables. Analysis of covariance (ANCOVA) based on SF-36, complications scores as dependent variables, 3DCRT stages as independent variables, and other variables as covariate were established. Results: The influencing factors of PCS included 3DCRT stages and age group. The influencing factors of MCS included 3DCRT stages and income. Most QOL scores of NPC patients were significantly associated with 3DCRT stage, after accounting for other variables. QOL scores of the patients receiving 3DCRT were the lowest, QOL scores of people after 3DCRT gradually increased. PCS scores of people greater than 5 years after 3DCRT was improved to or even better than the level before 3DCRT. The complications with significantly different scores of patients at different 3DCRT status included xerostomia, throat ache, hypogeusia, caries, hearing loss, snuffles. Conclusions: Clinicians should pay more attention to older NPC patients and patients with lower income. When patients receive 3DCRT, measures should be taken to reduce radiation injury to improve the patients' QOL.

The Effect of Pilocarpine-containing Chewing Gum on Anti-microbial Components in Whole Saliva of Xerostomic Patients (구강건조증 환자에서 필로카핀 함유 껌 사용에 따른 전타액내 항균성분의 변화)

  • Park, Moon-Soo;Lee, Sung-Woo;Chung, Sung-Chang;Kim, Young-Ku;Yum, Kwang-Won
    • Journal of Oral Medicine and Pain
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    • v.24 no.4
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    • pp.347-359
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    • 1999
  • The purpose of this study was to investigate the effect of pilocarpine containing chewing gum on anti-microbial components in whole saliva of xerostomic patients, The objective xerostomic patients were instructed to use 5mg-pilocarpine containing chewing gum for 20minutes three times per day, and the author measured the flow rates of unstimulated whole saliva and stimulated whole saliva at the beginning the treatment, 1,2,3, and 4 weeks after. The concentration and flow rate of anti-microbial components in whole saliva were quantitated by enzyme-linked immunosorbent assay(ELISA). The obtained results were as follows: 1. There were significant increase in the unstimulated and stimulated whole salivary flow rate after using pilocarpine-containing chewing gum in xerostomic patients. 2. The concentrations of IgA in the unstimulated and stimulated whole saliva showed increasing pattern but, no significant changes, arid the flow rates of IgA in the unstimulated and stimulated whole saliva showed significant increase after using pilocarpine-containing chewing gum in xerostomic patients. 3. The concentrations of IgM in the unstimulated and stimulated whole saliva showed increasing pattern but, no significant changes, and the flow rates of IgM in the unstimulated and stimulated whole saliva showed significant increase after using pilocarpine-containing chewing gum in xerostomic patients. 4. The concentrations of lactoferrin in the unstimulated and stimulated whole saliva showed no significant changes, and the flow rates of lactoferrin in the unstimulated and stimulated whole saliva showed significant increase after using pilocarpine-containing chewing gum in xerostomic patients. 5. The concentrations of lysozyme in the unstimulated and stimulated whole saliva showed no significant changes, and the flow rates of lysozyme in the unstimulated whole saliva showed significant increase, but in stimulated whole saliva showed no significant changes after using pilocarpine-containing chewing gum in xerostomic patients.

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Comparison of the Clinical Characteristics of Patients with Burning Mouth Syndrome due to Hyposalivation (타액분비저하에 따른 구강작열감증후군 환자의 임상적 특징 비교)

  • Lee, Ha-nul;Kim, Dong-yoon;Baek, So-young;Jeong, Hae In;Lee, Hyun-Jin;Cho, Yunjae;Ha, Na-yeon;Kim, Jinsung
    • The Journal of Internal Korean Medicine
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    • v.41 no.5
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    • pp.838-847
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    • 2020
  • Objectives: The aim of this study was to investigate the clinical characteristics of patients with Burning Mouth Syndrome (BMS) due to hyposalivation (HS). Methods: We reviewed the clinical records of 39 BMS patients who visited the Department of Digestive Diseases of Kyunghee Korean Medicine Hospital from March 1st, 2020 to July 31st, 2020. The subjects were classified according to the presence or absence of hyposalivation and both groups were compared for the proportion of coated tongue, heart rate variability (HRV), Ryodoraku, and the numeral rating scale (NRS) score of tongue pain results. Results: The BMS with Hyposalivation (HS group) and the BMS without Hyposalivation (Non-HS group) showed a significant difference in the proportion of coated tongue and the NRS score for tongue pain. The NRS score was significantly higher in the Non-HS group and the proportion of coated tongue was lower. However, no significant differences were noted in several HRV parameters between the two groups. The most frequent accompanying symptoms were xerostomia and dyspepsia. Conclusions: The results of this study suggest that hyposalivation might be one of the main causes of tongue pain, the key complaint in BMS patients. Sympathetic/parasympathetic imbalance might not be a main contribution of hyposalivation in BMS. Instead, factors such as the number of medications taken seem to correlate with hyposalivation in BMS. This results could be useful in the management of BMS patients with hyposalivation in clinical practice.

Initial Experience for 3-D Conformal Boost Treatments in Carcinoma of the Nasopharynx (비인강암환자에서 시행한 3차원 입체조형 방사선치료의 조기 임상결과)

  • Jang Ji-Young;Cho Moon-June;Kim Ki-Hwan;Song Chang-Joon;Kim Byoung-Kook;Kim Jun-Sang;Kim Jae-Sung
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.2
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    • pp.172-176
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    • 2000
  • Objectives: To improve local control and reduce toxicity, 3-D conformal radiotherapy was used as a boost the primary tumor site following fractionated radiotherapy in patients with nasopharyngeal carcinoma. Materials and Methods: Eight patients with previously untreated nasopharyngeal carcinomas were treated with 3-D conformal radiotherapy following fractionated radiotherapy from September 1998 to April 2000. All patients had biopsy confirmation of disease before radiation therapy. Stages were II in 1, III in 5, and IV in 2. Two patients received cisplatin based chemotherapy in addition to radiation therapy; induction chemotherapy in 1, concurrent chemoradiation in 1. 3-D conformal radiotherapy delivered using 6MV Linac as a boost(range 25.2-28.8Gy, median 25.7Gy) following conventionally fractionated radiotherapy(range 50.4Gy). Average total dose ranged from 75.6-79.2Gy(median 76Gy). Follow-up time was 4-21 months(median 9.6 months). Results: Seven of 8 patients were evaluated radiologically within 3 months after completion of radiation therapy. All 7 patients were seen complete remission. One of 7 patients had distant metastasis after 5 months and local failure after 7 months. The tree interval of local recurrence was ranged from 4 - 21 months(median 10.2 months). One patient without radiological evaluation got complete remission clinically. Treatment related toxicity was grade 1-3 xerostomia, dysphagia, and mucositis. During 3-D conformal radiotherapy, there was no aggravation of any toxicity. Conclusion: Although the number of patients was small and follow-up period was short, 3-D conformal radiotherapy following conventional radiotherapy improved tumor control and dose escalation without increased toxicity. Survival and late toxicity should be evaluated through long term follow-up. In addition, it is necessary to confirm the benefits of 3-D conformal radiotherapy in nasopharyngeal carcinoma with randomized trial.

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The role of adjuvant external beam radiation therapy for papillary thyroid carcinoma invading the trachea

  • Kim, Young Suk;Choi, Jae Hyuck;Kim, Kwang Sik;Lim, Gil Chae;Kim, Jeong Hong;Kang, Ju Wan;Song, Hee-Sung;Lee, Sang Ah;Hyun, Chang Lim;Choi, Yunseon;Kim, Gwi Eon
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.112-120
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    • 2017
  • Purpose: To evaluate the effect of adjuvant external beam radiation therapy (EBRT) on local failure-free survival rate (LFFS) for papillary thyroid cancer (PTC) invading the trachea. Materials and Methods: Fifty-six patients with locally advanced PTC invading the trachea were treated with surgical resection. After surgery, 21 patients received adjuvant EBRT and radioactive iodine therapy (EBRT group) and 35 patients were treated with radioactive iodine therapy (control group). Results: The age range was 26-87 years (median, 56 years). The median follow-up period was 43 months (range, 4 to 145 months). EBRT doses ranged from 50.4 to 66 Gy (median, 60 Gy). Esophagus invasion and gross residual disease was more frequent in the EBRT group. In the control group, local recurrence developed in 9 (9/35, 26%) and new distant metastasis in 2 (2/35, 6%) patients, occurring 4 to 68 months (median, 37 months) and 53 to 68 months (median, 60 months) after surgery, respectively. Two patients had simultaneous local recurrence and new distant metastasis. There was one local failure in the EBRT group at 18 months after surgery (1/21, 5%). The 5-year LFFS was 95% in the EBRT group and 63% in the control group (p = 0.103). In the EBRT group, one late grade 2 xerostomia was developed. Conclusion: Although, EBRT group had a higher incidence of esophagus invasion and gross residual disease, EBRT group showed a better 5-year LFFS. Adjuvant EBRT may have contributed to the better LFFS in these patients.