Making of a dental medical examination and treatment guideline to an old patient heading to a final stage in a life

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K10221
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 57080:Social dentistry-related
• Research Institution: The Nippon Dental University
• Principal Investigator: KIKUTANI TAKESHI 日本歯科大学, 生命歯学部, 教授 (20214744)
• Co-Investigator(Kenkyū-buntansha): 高橋 賢晃 日本歯科大学, 生命歯学部, 講師 (20409246) ; 白野 美和 (丸谷美和) 日本歯科大学, 新潟生命歯学部, 准教授 (60318558)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 人生の最終段階 / 歯科診療 / 診療指針

Outline of Final Research Achievements

In considering what kind of treatment plan should be formulated for patients who are unlikely to recover in the field of dental care for the elderly, a Dental R-map was developed to identify situations that could be expected to cause damage or injury to the whole body and to specify the need for dental intervention.The actual situation of oral management for terminally ill cancer patients was summarised. Depending on the stage of the patient, the interventions varied from dental treatment, feeding support and oral hygiene management. The frequency of interventions increased towards the end of life.
Workshops were held and discussions were held on cases that were considered typical. Problems related to denture production and problems caused by leaving teeth were considered important, and the problems were extracted and used as material for the development of guidelines.

Free Research Field

老年歯科医学

Academic Significance and Societal Importance of the Research Achievements

本邦では、後期高齢者の増加に加えて、これら高齢者の現在歯数が増加している。人生の最終段階に向かう者においては、認知機能や口腔諸器官の運動機能の低下から、咬合の維持や回復は、必ずしも咀嚼機能の維持・向上に繋がらない場合が多い。そればかりか、歯や補綴物が口腔内細菌の温床として存在したり、脱落により誤飲のリスクを持ったり、対顎の歯肉に噛み込んだりといった状態すら多く見受けられる。このため、う蝕や歯周病や歯の欠損に対する咬合の再構築を基本としているこれまでの歯科医療の指針は、人生の最終段階にある高齢者に対しては必ずしも適合しない。本研究では、これらの問題に対する指針作りに一定の情報を提案した。