A sample of 221 subjects with a mean age of 62.4 years (121 males and 100 females) from nursing home residents in Jordan were recruited to participate in this study. Oral health status, mini mental state examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB) and disability of arm, shoulder and hand test (DASH) were assessed for all subjects.

The response rate was about 88%. The multivariate analysis showed that the degree of upper limb disabilities, as measured by DASH, and reporting not brushing of teeth were the main risk indicators for severity of periodontal disease. Residents with dentures were found to have significantly higher cognitive abilities scores (MMSE), better upper arm abilities (DASH) and gait and balance score (TAB) in comparison with edentulous adults without dentures. Edentulous residents were found to suffer more from cognitive impairment (MMSE) than dentate residents. There was no predilection of upper limb (DASH) and lower limb (TAB) disabilities or depressive symptoms (GDS) for edentulous over dentate subjects.

Results suggest that nursing home residents with a variety of physical, cognitive and psychological disabilities are at increased risk of deterioration of their oral health. All those associated with the health of residents need to be aware of this issue and take preventive and therapeutic measures as needed.

Conventional denture cleaning methods are unable to completely eliminate micro-organisms from dentures.

Test specimens were prepared using acrylic resin containing three types of TiO₂ powder [FAp-TiO_2, titanium dioxide (TiO₂) and hydroxyapatite-coated TiO₂ (HAp-TiO₂)]; n = 96. In the adhesion assay, test specimens were incubated in a fungal suspension and subjected to UVA irradiation, and the number of attachments of C. albicans on the test specimens was counted. The MB-decomposition test and the three-point bending test were then performed to assess the photocatalytic effects of the FAp-TiO₂-containing acrylic resin.

Fluoridated apatite-coated titanium dioxide-containing acrylic resin demonstrated superior effectiveness in inhibiting C. albicans adherence as well as in decomposing MB. In the three-point bending test, the resin showed a smaller decrease in flexural strength compared with TiO₂- or HAp-TiO₂-containing acrylic resin. Furthermore, UVA irradiation for 360 h did not significantly influence its flexural strength or elasticity modulus as compared with the control; this fulfils the requirements of International Organization for Standardization 1567:1999.

Fluoridated apatite-coated titanium dioxide-containing acrylic resin is a clinically suitable material that promotes proper denture hygiene, particularly for elderly persons requiring nursing care or who have a decreased ability to perform normal activities of daily living.

Clinical oral health indicators do not assess the perceived impact of oral health on people's lives.

The study was performed through small group interviews, pilot studies and a main study with 200 people aged 50 and over. Data were collected through interviews in health centres.

For content validity, ‘eating’ (1.00, p < 0.001) and ‘speaking’ (0.96, p < 0.001) obtained the highest level of agreement among experts. For criterion and construct validity, there was an inverse correlation between self-rated oral health, perceived oral treatment needs and satisfaction with oral health and OIDP score. Cronbach's alpha coefficient varied from 0.69 to 0.67 when ‘work’ and ‘vigorous physical activities’ were deleted. Test–retest reliability was 0.69 (ICC).

The validation process showed that the Brazilian OIDP has the necessary basic psychometric properties to be used in the 50–74 years age group in Brazil. ‘Work’ and ‘vigorous physical activities’ had low impact on oral health. The activity ‘vigorous physical activities’ was not maintained in the instrument because of its low impact, while ‘work’ was maintained due of the increase in the 50–59 years age group in the Brazilian population.

Attitudes of dentists have been shown to influence their willingness to provide dental services to the aged.

A questionnaire was administered to 160 (50 men) dental students at Leipzig University aged 19.2–30.5 (mean, 21.7; SD, 2.3) years before entering (T1) and when completing (T2) a gerodontology course. A definition of being young and old and of hopes and fears associated with age was requested. The semantic ageing differential (SAD) was used to measure the students' attitudes towards the aged in three categories. Statistical analysis comprised mean age definitions by gender and mean scores of the SAD at T1 and T2.

Old age was defined as beginning between 56 and 64 years. Female students at T1 regarded a woman as young up to 35.8 years, for male students a woman was young only up to 33.5 years. Male students consider men as old from 60.1 years and women 4.4 years earlier from 55.7 years. Old age fears related mainly to impairment of health and loss of relatives. Hopes for relaxation, rest and serenity were paramount. The SAD results were near neutral in all three dimensions. Minor changes between T1 and T2 occurred.

Students' attitudes were well balanced. Specific barriers to the provision of dental care to the aged emanating from dental students' negative attitudes or fears were not identified. Changes in attitudes occurring during the course appeared small.

The authors report here two cases of oral lesions of lupus erythematosus, with a discussion of their clinical features and the process of differential diagnosis.

It is crucial to consider in the diagnostic process for lupus erythematosus the whole clinical information as well as haematological tests, histopathological features in HE and direct immunofluorescence, not only at first evaluation but also during patient follow-up.

The subjects of this study were geriatric patients (n = 80) from a nursing home. Katz Index for activities of daily living, handgrip strength and mucosal–plaque score (MPS) was evaluated at baseline and 1 year after intervention. The intervention consisted of an educational programme and specific guidelines for caregivers (to perform oral hygiene for dependent elderly and to supervise the independent elderly during oral hygiene practices). Differences on MPS were evaluated using a paired-sample t-test. A stratified analysis was carried out to identify differences in response to the programme according to the Katz Index and handgrip strength of elderly.

The MPS was significantly reduced (p = 0.001) at follow-up; however, a separate analysis showed that only the independent elderly (p = 0.002) and those with normal muscle strength (p = 0.006) showed a reduction in MPS during the follow-up examination.

The oral hygiene education programme for caregivers resulted in a positive impact on oral hygiene of the independent and functional elderly.

Brazil's universal public healthcare system is theoretically responsible to provide dental care to Brazilians of all ages. However, as dentists were integrated into public primary care facilities only in 2000, Brazilian seniors have accumulated needs.

Seniors (65–74 years old) were examined and interviewed by calibrated professionals. The association of overall need for oral treatment and component factors were analysed. Associations with socio-demographic factors and self-reported attitudes and behaviours were also calculated.

A total of 85.9% of Brazilian seniors demonstrated a need for some oral treatment, 83.8% of the dentate needed periodontal treatment and 57.3% of all seniors needed full or partial prostheses. Social inequalities were also evident as Brazilians using free oral care services demonstrated a higher degree of need, as did elders who had not previously accessed dental services, nonwhites and males.

Our findings demonstrate that the elderly population in Brazil has a very high degree of need in general and that certain subgroups have been especially vulnerable to oral disease.

In a randomised, evaluator-blinded, controlled trial, 60 subjects with hyposalivation (12 men and 48 women) were randomly assigned to two groups: the control group received basic oral hygiene instruction, while for the study (intervention) group, oral hygiene instruction was based on cognitive behavioural principles and motivational interviewing (MI). Both groups were given oral hygiene instruction once every 15 days, with a total of four sessions over a 2-month period: plaque extension and community periodontal index of treatment needs (CPITN), frequency and duration of brushing, frequency of interdental cleaning and scores based on scale of ‘self-efficacy for brushing of the teeth’. Clinical characteristics were compared between the two groups.

Both control and intervention group patients showed significantly lower plaque indices, bleeding indices and an improvement in probe depth after the 2-month study period. Interproximal brushing was significantly more frequent among the intervention group (p = 0.016).

In patients with hyposalivation, the application of oral hygiene instruction based on cognitive principles and MI offers benefits for periodontal health. Longer-term studies are needed to confirm these results.

Polymethylmethacrylate facial fillers are used to soften the results of the ageing process and to augment tissue. Although considered safe for the most part by advocates, they have been associated with many adverse reactions such as ecchymosis, haematomas, swelling, itching, erythema, hypertrophic scarring, hypersensitivity, palpable nodules, tissue necrosis, blindness and foreign body granuloma.

The articles presented in this review are the result of a search and selection of literature from the National Center for Biotechnology Information (NCBI) database, which met the inclusion criteria for the study.

Polymethylmethacrylate is widely used because it is inexpensive, readily accessible and simple to apply. However, some complications are severe and permanent and can be confused with other types of stomatological lesions.

There is no consensus about the relationship between prosthetic factors and TMD among denture wearers.

The sample was composed of 92 patients wearing both maxillary and mandibular complete dentures. The Research Diagnostic Criteria for TMD (RDC/TMD) were adopted for patient examination. Objective evaluation of denture quality was determined by analysis of retention and stability of mandibular denture, interocclusal distance, articulation and occlusion. Association between denture quality and TMD diagnosis was analysed using chi-square and Fisher's exact tests.

37.4% of the patients presented TMD. Denture quality was not significantly associated with the presence of TMD: mandibular retention (p = 0.466); mandibular stability (p = 0.466); interocclusal distance (p = 0.328); centric relation (p = 0.175); and balanced occlusion (p = 0.56).

Within the scope of this case-controlled cross-sectional study, no robust association between prosthetic factors and TMD was found.

Oral moisture was measured with a moisture-checking device and a saliva wetness tester in 30 subjects with maxillary obturator prostheses. These measurements were performed five times at the lingual mucosa, and mean values of each measurement were calculated. The reference value for moisture measurements with the moisture-checking device was 29%, and that with the saliva wetness tester was 3 mm. Subjects were classified as having dry mouth when their moisture measurements were less than the reference values.

The diagnostic results of the saliva wetness tester were in agreement with those of the moisture-checking device. The respective moisture measurements showed a significant positive correlation (r = 0.88, p < 0.01).

The results of the present study demonstrate that saliva wetness testers are as useful as moisture-checking devices to examine dry mouth in patients with maxillary obturator prostheses.

A pre–post study design was used to assess the impact of the educational intervention. The study sample consisted of 67 older adults, who resided in independent or assisted living apartments (age: M = 84, SD = 7.3). Over the course of the programme, participants received patient education pertaining to oral health and oral hygiene. Oral health literacy was assessed using the Rapid Estimation of Adult Literacy in Dentistry (REALD–30) test at baseline and on the final visit. Oral hygiene was measured on four visits using the O'Leary, Drake and Naylor Plaque Control Record (PI).

REALD-30 scores significantly increased, and PI scores significantly decreased for all subjects following participation in the programme (p < 0.001, and p < 0.01, respectively). Hierarchical multiple regression demonstrated that neither study subjects' individual characteristics nor their health literacy significantly predicted the change in oral hygiene.

This study demonstrated that a community-based geriatric dentistry rotation involving multiple interactions with dental students can in the short term significantly and positively impact older adults' oral health literacy and oral hygiene status.

To examine the clinical oral health status of dentate older people living in the community and attending dental services.

One hundred and eighty-six dentate adults, aged ≥60 years, underwent clinical examination (DMFS, Plaque and Gingival Indexes), salivary analysis and completed a questionnaire.

Participants had an average of 21.4 (±6.2) teeth present and 1.2 (±3.0) decayed, 51.0 (±28.8) missing and 32.6 (±20.5) restored surfaces. Individuals living in the most deprived areas had significantly lower numbers of teeth than those in the least deprived areas (19.1 ± 7.5 cf 23.8 ± 4.1; p < 0.001). Whilst there were no significant differences in DMFS score, residents in the most deprived areas had significantly more missing and fewer filled surfaces than those in the least deprived areas (p = 0.001 and p < 0.001, respectively). Participants with ≥21 teeth (64%) had lower plaque scores, fewer decayed root surfaces, higher stimulated saliva flow rates and lower salivary lactobacilli and yeast counts than those with <21 teeth (p < 0.05 for all).

The findings highlight differences in clinical oral health by age and deprivation status and underline the importance of saliva and retaining a functional dentition.

Sixteen healthy subjects were enroled in this randomized cross-over clinical investigation. The study was conducted in four phases, in which mouthrinses (chlorhexidine gluconate-based or cetilpiridinium-based) and sterile tap water (control group) were used to individually store used toothbrushes in closed containers during 7 days of toothbrushing. Five toothbrushes were used as negative control for bacterial colonisation before contact with oral cavity. Conventional culture and DNA Checkerboard hybridization were used to detect bacterial contamination on the toothbrushes. Subsequently, the number of bacterial species on the bristles was estimated by the DNA Checkerboard method.

One toothbrush presented bacterial contamination in the negative control test. Both culture and DNA Checkerboard showed positive signals of bacterial contamination in the toothbrushes with no differences in the frequency of detection. The control group showed higher total bacterial counts when compared with the mouthrinse groups. Porphyromonas gingivalis had the highest bacterial count followed by Parvimonas micra.

Culture and DNA Checkerboard showed positive signals of bacterial contamination. Mouthrinses that contains 0.12% of chlorhexidine gluconate were more effective in reducing bacterial colonisation on the toothbrushes.

Initially, we adjusted the English version to Portuguese and then developed a training program for use of ROAG, with the participation of CHWs, in selected districts that had the highest enrolled number of elderly people in the city. The elderly persons were distributed among 10 previously trained CHWs. To assess the validity of the ROAG, a CHW and a dentist (considered as the gold standard) independently evaluated the same individual. The reproducibility of the ROAG was evaluated by each of the CHWs examining 5–6 elderly individuals twice with a 7-day interval.

The sensitivity ranged from 0.17 for evaluation of saliva to 0.80 for voice. The specific ranged from 0.69 for teeth/dentures to 0.98 for saliva using mirror and the accuracy ranged from 0.92 for swallow to 0.64 for mucosa. The intra-rater reproducibility of the ROAG was perfect for evaluation of voice, lips and swallow (κ = 1.000).

When used by trained CHWs, the ROAG is a tool with high sensitivity and specificity to assess voice, swallowing, tongue and teeth/dentures. Moreover, it can efficiently detect patients showing no alteration in lips, saliva, mucosa and gums. High reproducibility was observed in almost all the categories. Trained CHWs can use this tool to improve the access of elderly patients to dental services.

This research took the form of a double-blind, randomized clinical trial. Forty-one individuals (mean age: 78.7 years) with xerostomia were divided into two groups: for the first ‘intervention group’ (21 subjects) a topical sialogogue spray (1% malic acid) was applied, while for the second ‘control group’ (20 subjects), a placebo spray was applied; for both groups, the sprays were applied on demand during 2 weeks. The Xerostomia Inventory (XI) was used to evaluate xerostomia levels before and after product/placebo application. Unstimulated and stimulated salivary flows rates, before and after spray application, were measured.

XI scores decreased significantly (clinically meaningful) from 36.4 ± 7.3 points to 29.1 ± 7.1 (p < 0.05) with an XI difference of 7.2 ± 6.1, after the combination among 1% malic acid with xylitol and fluoride application. After 2 weeks of 1% malic acid application, unstimulated and stimulated salivary flows rates increased significantly (p < 0.05).

A topical sialogogue spray containing 1% malic acid improved xerostomia in an elderly population and increased unstimulated and stimulated salivary flows rates.

Saliva is essential to maintain a healthy oral environment and diminished output can result in dental caries. Although gender and age play a role in the quantity of saliva, little is known about the interaction of age, gender and ethnicity on dental caries and salivary flow rates.

Data from the 1147 participants in the OH: SALSA were analysed. The dependent variables were the number of teeth with untreated coronal caries, number of teeth with root caries and the number of coronal and root surfaces with untreated caries. The independent variables were stimulated and unstimulated glandular salivary flow rates along with the age, sex and ethnicity (e.g. European or Mexican ancestry) of the participants.

Coronal caries experience was greater in younger participants while root surface caries experience was greater in the older participants. Coronal caries was lower in the older age groups while the root caries experience increased. Men had a statistically significant (p < 0.02) higher experience of root caries than women. Values for unstimulated and stimulated parotid salivary flow rates showed no age difference and remained constant with age, whereas the age differences in the unstimulated and stimulated submandibular/sublingual salivary flow rates were significant. The mean number of teeth with coronal and root caries was higher in Mexican-Americans than in European-Americans.

Over one-fourth of the adults between the ages of 60 and 79 have untreated root caries over one-third having untreated coronal caries. Lower salivary flow rates play a significant role in both the number of teeth and the number of surfaces developing caries in these adults. Women and individuals of European-American ancestry experience less caries.

Physical performance parameters such as muscle strength and balance can predict the future onset of disabilities in activities of daily living among older adults. In this context, elucidation of the relationships among oral conditions and physical performance parameters is necessary.

Data on occlusal contact patterns of natural teeth (OPNT), self-assessed masticatory ability (mastication), body mass index (BMI), handgrip strength (HG) and one-leg standing time with eyes open (OLST) were collected from 501 independently living adults aged 65–74 years. The relationships among these parameters were analysed using Spearman's rank correlation coefficients and Amos.

Subjects of both genders showed significant correlations among OPNT, mastication, HG and OLST, evaluated using Spearman's rank correlation coefficients. For each Amos model, the goodness-of-fit statistic indicated a good level of fit. In both men and women, OPNT was significantly related to mastication, and mastication was related to HG but not to OLST. OPNT was related to neither HG nor OLST in women and was related to OLST but not HG in men.

The findings observed in this study present a possible importance of dental status and perceived chewing ability for the onset of disability by influencing physical performance in community-dwelling older adults.

Physical performance parameters are significant predictors of decreased activities of daily living. Previous studies have shown the relationships between oral conditions and these parameters. Here, we focused on complete denture wearers.

Two hundred and ten edentulous adults aged ≥65 years and wearing complete dentures were enrolled. The following oral conditions were examined: masticatory ability measured by colour-changing chewing gum, number of foods considered chewable, pain when using dentures and denture base fit. Handgrip strength (HG) and one-leg standing time with eyes open (OLST) were used to evaluate muscle strength and static balance. Spearman's rank correlation coefficients were calculated to examine the correlations between oral conditions and physical performance. Forward stepwise linear regression models were applied with each physical performance parameters as the dependent variable and oral conditions as the independent variable.

The women did not show significant correlations between oral conditions and the physical performance. In men, significant and positive correlations were found between the number of chewable foods and HG, and between the colour scores and OLST. The significant correlation between the colour scores and OLST was still noted in the stepwise liner regression analysis after adjusting for demographic, social and medical conditions, and other oral conditions.

In Japanese elderly edentulous men wearing complete dentures, masticatory ability evaluated as the mixing ability may be associated with static balance.

Several approaches have been proposed to prevent oral infections, including the incorporation of antimicrobial agents to acrylic resins.

Specimens of an acrylic resin (Lucitone 550) were divided into two groups: 0% (control) and 10% PTBAEMA. Antimicrobial activity was assessed by adherence assay of one of the microorganisms, Staphylococcus aureus, Streptococcus mutans and Candida albicans. Surface topography was characterised by atomic force microscopy and wettability properties determined by contact angle measurements.

Data of viable cells (log (CFU + 1)/ml) for S. aureus (control: 7.9 ± 0.8; 10%: 3.8 ± 3.3) and S. mutans (control: 7.5 ± 0.7; 10%: 5.1 ± 2.7) showed a significant decrease with 10% of PTBAEMA (Mann–Whitney, p < 0.05). For C. albicans (control: 6.6 ± 0.2; 10%: 6.6 ± 0.4), there was no significant difference between control and 10% of PTBAEMA (Kruskal–Wallis, p > 0.05). Incorporating 10% PTBAEMA increased surface roughness and decreased contact angles.

Incorporating 10% PTBAEMA into acrylic resins increases wettability and roughness of acrylic resin surface; and decreases the adhesion of S. mutans and S. aureus on acrylic surface, but did not exhibit antimicrobial effect against C. albicans.

The study aim was to investigate the influence of denture-induced compression on sensory nerve responses to stimulations.

Only partially edentulous patients of maxillary Kennedy class II who wear dentures (WD) or who never wear dentures (ND) were recruited as participants. The WD and ND groups had 15 participants with a mean age of 66.9 years and 22 participants with a mean age of 60.2 years, respectively. Current perception thresholds (CPTs) at 2000, 250 and 5 Hz, corresponding to A-beta, A-delta and C fibres, respectively, were measured by the Neurometer^® NS3000 device and compared between groups. The data were analysed by the t-test, the paired t-test and analysis of covariance adjusted for age, sex and thickness of the mucosa.

The CPTs showed large differences at 2000 Hz but no differences at the other frequencies when the WD and ND groups were compared. Only the CPT of the edentulous side at 2000 Hz was significantly different between groups.

Wearing removable partial dentures contributes to changes of responses to stimulations in the large fibre of the sensory nerve underlying the maxillary alveolar ridge.

A Persian translation of Ageing Anxiety Scale (AAS) (Int J Aging Hum Dev, 37, 1993, 247) was administered to the university students of a dentistry school located at northern Iran. The questionnaire consisted of twenty-five-point Likert-scale questions.

The obtained mean score of ageing anxiety was 58.51 (±9.85), (out of a possible 100), and the questionnaire revealed a good level of internal consistency (Cronbach's alpha = 0.76). The results did not differ by gender (p = 0.22), between undergraduate or postgraduate students (p = 0.81), various postgraduate disciplines (p = 0.69), residing with an elder at home (p = 0.18) and length of time living with an elder (p = 0.81).

The Persian translation of AAS showed a good level of internal consistency. The selected population with educational attainment in this research revealed a moderate ageing anxiety level.

One hundred complete dentures belonging to 50 nursing home residents (mean age, 84.6 years) were randomly assigned to five groups according to the cleaning method employed: (A) immersion in Polident^® solution alone, (B) brushing with water, (C) ultrasonic cleaning with water, (D) method (A) followed by method (B) and (E) ultrasonic cleaning combined with immersion in Polident^® solution. Before and after the dentures had been cleaned, denture biofilm was collected from the mucosal surface of each lateral half of the examined dentures. The collected micro-organisms were cultured, presumptively identified by standard methods and quantified. Comparisons between the five cleaning methods were carried out using the Kruskal–Wallis test and Dunn's multiple comparisons test.

The denture cleaning methods involving the use of Polident^® solution (methods A, D and E) were significantly more effective at denture disinfection than the other methods (p < 0.05); in particular, the quantity of Candida spp. was lowest after method E (median, 0.00; significantly lower than those observed after methods A, B and C; p < 0.05).

It was concluded that ultrasonic cleaning combined with immersion in a peroxide-based cleanser solution effectively reduces the quantity of micro-organisms surviving on dentures and is a suitable method for elderly individuals who find brushing their dentures difficult.

Specimens without FRC reinforcement served as control (n = 16). After fiber surfaces were exposed, half of the specimens (n = 8/per group) were treated with saliva, the other half was stored in distilled water prior to C. albicans adhesion. The adhered microorganisms were counted under an optical microscope and the data were analyzed.

When exposed to distilled water or saliva, specimens with unidirectional (5403.4 cells/cm² and 5013.4 cells/cm², respectively) (p = 0.202), woven fibers (4053.5 cells/cm² and 3726.6 cells/cm², respectively) (p = 0.283) and specimens without fibers (2250 cells/cm² and 2006.8 cells/cm², respectively) (p = 0.423) showed C. albicans adhesion, being not significant. In general, all the specimens exposed to saliva showed 3582.2 cells/cm² C. albicans adhesion, while specimens exposed to distilled water showed 3902 cells/cm² C. albicans adhesion, yet being not significant (p = 0.436). Regarding fiber type, C. albicans adhesion was significantly affected by the exposed FRC architecture with more favorable results for woven fibers (p < 0.001).

Polymethylmethacrylate without FRCs collected less C. albicans. The presence of saliva seems to reduce the adhesion.

An observational, cross-sectional survey of adults living independently in rural and urban settings in Nova Scotia, Canada was conducted. Using random digit dialing, calibrated interviewers completed a telephone survey, and clinicians calibrated to WHO standards conducted clinical examinations. Weighting was used to correct for sampling bias.

747 community dwelling adults completed both the clinical exam and the questionnaire (n = 411, age 45–64; n = 336, age 65 or older). Rates of edentulism were low (2.6% aged 45–64; 15.7% aged 65+; p < 0.001). Untreated root caries was greater in the older dentate group (19.7 vs. 10.1%; p < 0.001). Being 65 years of age or older was identified as a predictor of increased decayed, missing, filled teeth, presence of decayed and/or filled roots and presence of attachment loss ≥4 mm, but was not a significant predictor of presence of untreated coronal caries.

A falling rate of edentulism and a higher risk for root caries with increasing age may predict the need for more complex dental care as our population ages.

Membranous substances are sometimes observed in the mouths of elderly persons requiring nursing care, and these can lead to bleeding, infection and asphyxiation.

In April 2007, samples were collected from 70 patients at C Hospital, Aichi Prefecture, Japan, who were 65 years or older (median age, 81.1 ± 7.7 years). Sixteen of the subjects were confirmed to have a membranous substance containing a keratin degeneration product that had been derived from stratified squamous epithelium. The samples were examined microscopically, and the presence of epithelial components was confirmed through immunohistochemical staining with anti-cytokeratin-1 antibodies.

Decision tree analysis and logistic regression suggest that the leading contributors to the formation of the membranous substances were the method of ingesting nutrients, dryness of the tongue dorsum and open mouth. These three factors are related to elderly persons requiring nursing care with impaired oral cavity function, and it was suggested that dryness of the oral mucosa was the major factor behind the membrane formation.

Subjects comprised 406 female subjects (55–74 years old) who agreed to participate in a baseline examination and a follow-up examination after 5 years. Serum cystatin C levels were used to assess renal function. Multiple logistic regression analysis was used to evaluate the relationship between tooth loss and change in serum cystatin C levels over 5 years. Tooth loss over 5 years (0: no, 1: yes) was used as the dependent variable. Seven variables were used as independent variables, including change in serum cystatin C levels over 5 years.

Results of multiple logistic regression analysis showed that cystatin C change over 5 years, age, number of remaining teeth at baseline, number of sites with ≥4 mm clinical attachment level at baseline and serum 25-hydroxyvitamin D levels at baseline were significantly associated with tooth loss. The odds ratio for tooth loss with cystatin C change over 5 years was 7.70 (p = 0.029).

This study indicates a relationship between serum cystatin C levels and number of missing teeth, and thus suggests that low renal function is associated with tooth loss.

A descriptive cross-sectional study was conducted using a self-administered postal questionnaire targeting government dentists working in the Ministry of Health in Peninsular Malaysia.

Seven hundred and eleven out of 962 dentists responded with a response rate of 74.0%. Only 36.1% of the dentists had experience in providing domiciliary care for elderly people in the past 2 years with mean number of visit per year of 1. Younger dentists below the age of 30 and those with confidence in providing the service were the most willing to undertake domiciliary care for elderly patients (OR = 13.5, p < 0.05). The 3 most reported barriers were patient's complex medical history (74.1%), patient's poor attitude towards oral health service (67.5%), and dentist's unfavourable working condition (64.4%).

The majority of Malaysian government dentists had not been involved in providing domiciliary care for elderly patients. Apart from overcoming the barriers, other recommendations include improving undergraduate dental education, education for elderly people and carers, improving dentist's working condition, and introducing domiciliary financial incentive for dentist.

Tooth loss is associated with functional impairment regarding chewing ability, depending on the number and the location of the remaining teeth.

A search of the English literature was undertaken using the appropriate electronic databases and keywords in order to answer the question of this review. Independent extraction of the related articles was carried out by two authors using predefined eligibility criteria.

Full-text analysis was performed for 51 articles of possible relevance. Finally, data were extracted from 18 studies, published in 20 articles that met the inclusion criteria.

Although there was a conflict between the studies relevant to the number of functional tooth units needed to maintain adequate oral function, it was revealed that chewing ability was closely related to the number and distribution of teeth remaining. Treatment plan should focus on the preservation of the strategic parts of the dental arch that are critical for adequate oral function. Long-term prospective studies, comprising well-defined criteria, clinical variables, methods and utilising comprehensive questionnaires, should be preferred to obtain a clearer picture on the association between masticatory ability and functional tooth units.

There is little information regarding the pH of contemporary adhesives and their influences on S. mutans growth.

The adhesives tested were Polident^® cream, Protefix^® cream and Protefix^® powder. Samples of each adhesive were added to deionized water to produce solutions of 10.0, 5.0, 2.5 and 1.0% w/v (cream formulations) or 5.0, 2.5,1.0 and 0.5% (powder formulation). The pH values were measured immediately after preparation and at 1-, 2-, 3-, 6-, 12-, and 24-h intervals using a digital pH meter. Streptococcus mutans UA159 was inoculated in the Brain Heart Infusion medium with or without the adhesive extracts (control). Bacterial growth was observed by measuring absorption at 600 nm every 1 h for 12 h using a spectrophotometer.

The tested adhesives generally remained relatively pH-stable over 24 h, ranging from 5.5 to 7.0. There were no statistically significant differences in S. mutans growth rates between the extract-treated and control cultures (p > 0.5).

Some adhesives produce a pH below the critical pH of hydroxyapatite and may not be suitable for patients with natural teeth. None of the tested adhesives significantly affect S. mutans growth.

A total of 664 Japanese adults over age 60 were studied by means of a questionnaire and clinical examination.

In all, 197 subjects (29.7%) had TM. We found a significant association between the presence of TM and torus palatinus (TP; 45.1% vs. 26.5%, p < 0.001). Moreover, occlusal force with TM was significantly higher than without TM (p < 0.05). Logistic regression adjusted for age and occlusal force revealed a significant relationship between TM and occlusal force and TP [p = 0.005, odds ratio (OR) = 2.44; p < 0.001, OR = 2.66, respectively].

This study suggests that there is a relationship between TM and factors related to occlusal factor.

Thirty patients with resorbed ridges, fifteen each in the diabetic and non-diabetic group, were selected. The mandibular denture of each patient was lined with heat-polymerised silicone resilient liner. Patients were instructed to clean the dentures with soap water and brush. Samples from the fitting surface of mandibular dentures were collected at 15, 21 and 30 days. Subsequently, samples were collected at 15, 21 and 30 days, after cleaning the dentures with a detergent solution of 4% chlorhexidine gluconate, and incubated for the evaluation of Candida growth. These data were subjected to statistical analysis by Mann–Whitney U-test.

Normal oral flora in diabetics and non-diabetics showed no difference (p > 0.05). The density of colonies increased after 21 and 30 days in diabetic patients (p < 0.05). Number of Candida colonies significantly reduced in both the groups after 21 and 30 days of cleaning the dentures with 4% chlorhexidine gluconate (p < 0.05).

Dentures with silicone resilient liner exhibit increased Candida growth in diabetic patients. Four per cent chlorhexidine gluconate solution effectively disinfects these dentures.

The population comprised the caregivers (n = 27) at an LTC in Porto Alegre, Brazil. Participants answered a questionnaire assessing the time of work at the LTC, number of elderly under their responsibility, their previous training to perform general and oral healthcare, availability of oral hygiene supplies and oral hygiene tasks they performed.

A total of eighteen (75%) and 23 (95.8%) of the caregivers answered they performed teeth and denture brushing as part of their routine. When asked about performing hygiene of the mucosa with gauze, 21 (87.5%) participants stated that they did so. However, when asked if they would motivate the independent elderly to perform oral hygiene, only 10 (41.7%) of the caregivers responded positively.

Caregivers’ oral health practices are in accordance with good oral health methods and are not associated with difficulties in performing oral hygiene. However, the high number of elderly people in their care could possibly overwhelm caregivers’ practices. Future qualitative assessment of these issues is needed.

A retrospective review study of clinical records was conducted of 92 patients diagnosed with TN.

The mean age[± standard deviation (SD)] of the patients was 67.3 ± 12.7 years with an average TN duration of 7.1 ± 6 years and a female predominance (M:F = 1:2.5). The maxillary branch was the most involved nerve (in 45% of patients). Twelve patients underwent CT scans, while thirty-six patients had MRIs. Carbamazepine used by 92.4% of patients was the most commonly used drug in the management of the disorder. Twenty-two patients had microvascular decompression (MVD). TN symptoms were completely relieved following surgery in 73% of patients who underwent neurosurgery.

MRI is highly sensitive in the exclusion of central intracranial lesions and recommended as a routine consideration during the assessment of TN patients. Despite the side effects, carbamazepine is the drug therapy of choice. MVD produces satisfactory relief of TN symptoms in the majority of cases and should be offered to young healthy patients.

We analysed the expressions of myosin heavy chain (MyHC) mRNAs and proteins as indicators of the contractile properties in these muscles obtained from rats at 6, 12, 18 and 24 months of age using real-time PCR and SDS-PAGE.

We found no marked age-related changes in the expressions of MyHC mRNAs and proteins in rat masseter and geniohyoid muscles, suggesting that the biological ageing process does not affect contractile properties in these muscles. However, we found a decrease in the expression of MyHC IIb mRNA with ageing in the rat genioglossus muscle, suggesting that biological ageing process induces at least some fast-to-slow myofibre phenotype transition.

The biological ageing process from adult to middle age appears to differentially affect different types of craniofacial muscles.

Proper gustatory function in older people is important for quality of life and enjoyment of food. Impaired taste may contribute to weight loss in elderly.

Cross- sectional study. The participants comprised two groups with age ≥ 70 years. Older people hospitalised for acute disease, home-living prior to hospital admission and with adequate cognitive function (n = 174 with mean age = 84 years). The controls (n = 63, mean age 82 years) were home-living, and healthy by their own judgement. Whole mouth gustatory function was assessed with taste strips impregnated with sweet, sour, bitter and salty taste solutions in four different concentrations each. Correct identifications were summarized, and maximum total score was 16.

Total taste score was reduced in the hospitalised group compared with the control group (p = 0.035). The difference was mainly due to reduced ability to detect sour and bitter taste qualities (p < 0.001 and p = 0.003).

Acutely hospitalised older people had significantly reduced taste ability compared with non-hospitalised controls. Sour and bitter taste qualities were mostly affected. Hospital staff should pay attention to these findings when preparing food for hospitalised older people.

The prevalence and impact of Xerostomia as a cofactor in causing denture problems in Jordanians have not been previously investigated.

This study included 455 participants (253 men and 202 women). Perception of dry mouth was measured by a pilot-tested questionnaire. Xerostomic status was confirmed clinically. Complete denture function was also assessed.

One hundred and thirty six subjects (29.9%) had reported a subjective feeling of dry mouth with a prevalence of 24.9% in men (n = 63) and 36.1% in women (n = 73) (p < 0.01). 136 of the 145 subjects with satisfactory dentures showed one or more signs suggestive of Xerostomia. The majority of xerostomic participants with different sets of complete dentures were dissatisfied with oral functions (p < 0.05). There was a significant association between dry mouth and increasing age, female gender and smoking status (p < 0.05).

Among complete denture wearers, Xerostomia is significantly more prevalent in women and associated with increased age and smoking. Xerostomia adversely affects oral functions and overall satisfaction with dentures.

To investigate the viscosity of yam tuber mucilage (YTM) and its effects on lysozyme and peroxidase activities in solution phase and on surface phase.

Two kinds of YTM were extracted, one containing both protein and carbohydrate and the other containing mainly carbohydrate. Hen egg-white lysozyme and bovine lactoperoxidase were used as lysozyme and peroxidase sources, respectively. Viscosity was measured with a cone-and-plate digital viscometer. Lysozyme activity was determined using the turbidimetric method, and peroxidase activity was determined using the NbsSCN assay. Hydroxyapatite beads were used as a solid phase.

The viscosity values of YTM followed a pattern of a non-Newtonian fluid. The carbohydrate concentration affected the viscosity values at all shear rates, while the protein concentration affected the viscosity values at low shear rates. It could be suggested that YTM composed of 1.0 mg/ml protein and 1.0 mg/ml carbohydrate has viscosity values similar to those of unstimulated whole saliva at shear rates present at routine oral functions. Hydroxyapatite-adsorbed YTM significantly increased the adsorption and subsequent enzymatic activities of lysozyme, but not those of peroxidase.

Yam tuber mucilage has viscoelastic properties similar to those of human saliva and enhances the enzymatic activity of lysozyme on hydroxyapatite surfaces.

Disc-shaped samples (n = 468) were fabricated with rough or smooth surfaces. The samples did not receive any surface treatment (control) or were coated with one of the following experimental coatings (2-hydroxyethyl methacrylate – HE; 3-hydroxypropyl methacrylate – HP; and 2-trimethylammonium ethyl methacrylate chloride – T; and sulfobetaine methacrylate – S). The concentrations of the constituent monomers were 25, 30 or 35%. The water contact angles of the samples were measured, and half of the samples were exposed to saliva. The adherent yeast cells were counted after crystal violet staining.

For the smooth samples, the groups S35, HP35 and HE35 showed significantly lower number of adhered Candida than control, in the absence of saliva. There were no significant differences among the experimental and control groups for the rough samples, but the saliva decreased the cell numbers for groups S25, S30 and HP30. The photoelectron spectroscopy analysis confirmed the changes in the chemical compositions of the experimental samples.

The experimental photopolymerised coatings changed the chemical composition and decreased C. albicans adhesion in the groups S35, HP35 and HE35, suggesting that they should be further investigated.

A total of 46 complete denture wearers were included in this study. Respiratory functions of the subjects were evaluated by spirometric tests that were performed in four different oral conditions: without dentures (WOD), with dentures, lower denture only and upper denture only. Forced vital capacity (FVC), peak expiratory flow, forced expiratory volume in 1 s and forced expiratory flow between 25% and 75% were evaluated. The data were analyzed with Friedman, Wilcoxon and paired-samples t tests (α = 0.05).

Significant differences were found between spirometric parameters in different oral conditions (p < 0.05). In all spirometric parameters, the most important significant differences were found between conditions WOD, FVC and with lower dentures (FVC), and WOD (forced expiratory volume in 1 s) and with upper dentures (forced expiratory volume in 1 s) (p < 0.001).

It was observed that complete dentures may unfavourably affect spirometric values of edentulous subjects. However, current findings need to be confirmed with advanced respiratory function tests.

Dry mouth adversely affects oropharyngeal health, particularly in elderly, and can lead to pneumonia. A better understanding of the epidemiology of dry mouth is therefore important in improving treatment strategies and oral health in high-risk elderly patients.

We conducted a cross-sectional study involving 383 dependent Japanese elderly individuals (65–84 [n = 167] and ≥85 [n = 216] years) at eight long-term care facilities and hospitals. Thirty-four potential factors associated with dry mouth were examined by multiple logistic regression analysis. The primary outcome was dry mouth, as diagnosed by tongue dorsum moisture.

We identified that body mass index and severity of physical disability were identified as a potential factors associated with dry mouth in the super-elderly (≥85 years) group, whereas severity of physical disability, outcome measurement time, high daily water consumption, mouth breathing, use of antidepressants and diuretics, and high frequency of daily brushing (≥2 times per day; Odds ratio: 5.56; 95% Confidence Interval: 1.52–20.00) were associated with dry mouth in the 65- to 84-year-old group.

To our knowledge, this is the first study to identify a link between frequency of daily brushing and dry mouth and suggests that tooth brushing should be encouraged in high-risk dependent Japanese elderly (65–84 years), particularly those taking antidepressants and/or diuretics.

Cross-sectional research conducted with 262 elders aged 60–93 years (mean 69.84, SD ± 6.212) from the Dende community in Northeast, Brazil. Data were collected through an identification questionnaire and the Community Indicator in Oral Health. Data were computed by the Software SPSS, version 15.

There was a predominance of female gender (64.1%), retired, low schooling and income of up to one minimum wage. It was detected a prevalence of soft-tissue injuries in 38.4% (n = 101) of the elders, distributed as follows: red spots 60(57.7%), blisters 20(19.2%), lesions and/or wound 16(15.4%), and white spot 8(7.7%). Among the elders, 40(15.3%) smoked and 20(7.6%) used alcohol. It was verified a statistical association between injuries and using prosthesis (p = 0.039), medicine (p = 0.023) and calculus (p = 0.016).

The oral health of this population is precarious, and there is a high prevalence of oral lesions.

To determine the cytotoxicity of three denture adhesives on primary human oral keratinocytes (HOKs), fibroblasts (HOFs) and permanent mouse fibroblasts cell lines (L929).

Three commercial denture adhesives (two creams and one powder) were prepared for indirect contact using the agar diffusion test, as well as extracts in MTT assay. The results of the MTT assay were statistically analysed by one-way anova and Tukey's test (p < 0.05).

All of the tested denture adhesives showed mild to moderate cytotoxicity to primary HOKs (p < 0.001), whereas none of three was toxic to L929 cells (p > 0.05) in both assays. For primary HOFs cultures, slight cytotoxicity was observed for one of the products from the agar diffusion test and undiluted eluates of all tested adhesives with MTT assay (p < 0.01).

Denture adhesives are toxic to the primary HOKs and HOFs cultures, whereas non-toxic to L929 cells. The results suggest that primary human oral mucosal cells may provide more valuable information in toxicity screening of denture adhesives.