2012年5月14日月曜日

唾液分泌減少と口腔機能・栄養の関連

タイの在宅高齢者における唾液分泌減少と口腔機能、栄養、口腔健康の関連をみた論文を紹介します。

Samnieng P, Ueno M, Shinada K, Zaitsu T, Wright FA, Kawaguchi Y. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai. Community Dent Health. 2012 Mar;29(1):117-23.

抄録しか読めていませんが、唾液分泌減少は、非刺激時と刺激時の5分間の唾液分泌量で評価しています。口腔機能は味覚、話し、嚥下、咀嚼、栄養状態はMNAで評価しています。

結果ですが、14.4%の高齢者が唾液分泌減少と判定されました。唾液分泌減少は性別、全身疾患、薬物、喫煙と関連していました。唾液分泌減少群では虫歯と歯周病が有意に多く、MNAの平均点が有意に低かったです。多変量解析で唾液分泌減少は口腔機能と独立した関連を認めました。

以上より、唾液分泌減少は虫歯や歯周病だけでなく、口腔機能低下や低栄養のリスク因子であるという結論です。高齢者では唾液分泌量のモニタリングが重要です。

唾液分泌減少や口腔乾燥は低栄養と関連していると思っていましたが、このような研究があることは初めて知りました。口腔機能訓練や栄養介入で口腔機能や栄養改善とともに、唾液分泌減少や口腔乾燥が改善するかどうかも知りたいですね。

Abstract
OBJECTIVES:
This study was to analyze the association of hyposalivation with oral function, nutritional status and oral health in community-dwelling elderly Thai.
METHOD:
The subjects were 612 elderly people (mean age = 68.8, SD 5.9 years). Oral function (tasting, speaking, swallowing and chewing) and Mini Nutritional Assessment (MNA) were evaluated. Oral examination investigated teeth and periodontal status. Both unstimulated and stimulated whole saliva were collected for 5 minutes.
RESULTS:
Among all subjects, 14.4 % were classified within the hyposalivation. Hyposalivation was associated with gender, systemic disease, medication, and smoking. Subjects within the hyposalivation group had a higher number of decayed teeth and a higher prevalence of periodontitis than the normal salivation group (p < 0.05). The hyposalivation group also had a lower number of teeth present and a lower mean MNA score than the normal salivation group (p < 0.05). Logistic regression analysis showed that hyposalivation in both dentate and edentulous subjects was significantly associated with tasting, speaking, swallowing and chewing.
CONCLUSION:
This study suggested that hyposalivation is a risk factor not only for dental caries and periodontal disease but also for taste disturbances, speaking problems, swallowing problems, poor chewing ability and malnutrition. Monitoring salivary flow is an important measure in the care of older people.

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