Nurses' Perceptions of Oral Health Care Provision After the COVID-19 Lockdown.

OBJECTIVE: This study aimed to investigate nurses' perceptions of oral health care provision to inpatients in Japanese hospitals and the infection control measures taken by them after the coronavirus disease 2019 (COVID-19) lockdown to promote collaborative oral health care. METHOD: The participants were 1037 nurses working in inpatient wards at 4 hospitals in Fukuoka Prefecture, Japan. Data were collected through a questionnaire survey approximately 6 months after the first COVID-19 lockdown. RESULTS: More than 90% of the 734 nurses participating in this study positively perceived the preventive effect of oral health care on aspiration pneumonia, ventilator-associated pneumonia, and viral infection. However, approximately half of them had negative perceptions about their knowledge and confidence regarding the control of COVID-19 with oral health care provision, and 84.7% expected to be provided with the necessary information by oral health professionals. Further, 537 nurses (73.2%) provided oral health care to their patients; 9 nurses (1.7%) responded that those patients who received oral health care decreased after the lockdown; and 12 (2.4%) responded that they could no longer collaborate with oral health professionals because of the lockdown. Additionally, 41.7% of them used neither protective glasses nor face shields even after the lockdown began. CONCLUSIONS: This study showed that almost all the nurses perceived the benefcial effect of oral health care for the prevention of viral infection and pneumonia. However, some nurses perceived that their oral health care provision and collaborative oral health care were negatively affected. It also showed that most nurses' knowledge, confidence, and use of infection control measures were insufficient. The results indicate that oral health professionals should support nurses in providing oral health care by providing them with information on COVID-19 infection control measures to prevent infection transmission.

Masticatory performance and other oral functions in community-dwelling elderly patients without posterior occlusal support by natural teeth.

PURPOSE: To evaluate masticatory performance (MP), maximum occlusal force (MOF), maximum tongue pressure (MTP) and oral diadochokinesis (ODK) among community-dwelling elderly patients without posterior occlusal support. METHODS: This study enrolled community-dwelling elderly patients (≥65 years old) who belonged to Eichner A, B4, C1, C2, and C3. Each oral function was statistically compared among groups. Correlations between MP and other variables were examined in Eichner B4 and C patients. RESULTS: MP and MOF values in Eichner B4 and C patients were significantly lower than in Eichner A patients. There were significant differences in MTP values between Eichner "A and C2, C3", and "B4 and C2, C3". ODK in Eichner C patients showed significantly lower values compared to Eichner A patients in general. Although there were statistically significant correlations of MP with age, the number of remaining teeth and all oral functions were identified, and multiple regression analysis indicated that MOF and MTP were independently related to MP. CONCLUSION: Oral functions in Eichner B4 and C patients were lower compared to Eichner A patients. MP was significantly correlated with MOF and MTP in elderly patients without posterior occlusal support, suggesting the importance of rehabilitation of MOF and MTP in MP.

Analyses of Swallowing Function and Its Related Factors in Community-Dwelling Elderly Patients: A Case-Control Study.

This retrospective case-control study evaluated the prevalence of declined swallowing function and the association with oral functions and gender in community-dwelling elderly patients. Their profiles, the results of swallowing function (Eating Assessment Tool: EAT-10) and other oral functions (oral dryness, maximum occlusal force (MOF), tongue-lip motor function (oral diadochokinesis: ODK), maximum tongue pressure (MTP) and masticatory performance (MP)) were extracted for analyses. The patients were categorized into three groups according to EAT-10 score (Group 1: 0, Group 2: 1 and 2, Group 3: ≥3). In total, 242 patients were enrolled and 46 of them (19.0%) were categorized into declined swallowing function (Group 3). In two-group comparisons (Group 1, 2 versus Group 3), significant differences were identified in age and the number of remaining teeth, but they were not identified in three-group comparisons. The patients with declined swallowing function (Group 3) had significantly lower function in ODK and MTP. Multiple logistic regression analyses identified that declined swallowing function was independently associated with declined functions in ODK /ka/ (OR: 5.31, 95% CI: 1.03-27.23, p = 0.04) and in MTP (OR: 2.74, 95% CI: 1.12-6.66, p = 0.03). This study could confirm the critical role of tongue functions in swallowing in community-dwelling elderly patients.

Calcium channel blockers, angiotensin II receptor antagonists and alpha-blockers accentuate blood pressure reducing caused by dental local anesthesia.

OBJECTIVE: The primary aim of this study was to investigate the effect associated with patients' factor such as systemic disease on the blood pressure of patients in dental procedure. The secondary aim of this study was to investigate the effect associated with systemic disease and antihypertensive on the blood pressure changes with local anesthesia. METHODS: The blood pressure was measured before and after local anesthesia injection for dental treatment. The effect associated with patients' factor such as systemic disease on the blood pressure and the effect on blood pressure changes of the type of antihypertensive drugs and the systemic disease were analyzed using a multivariate analysis of variance test. RESULTS: We analyzed 1306 patients scheduled for the dental procedure. Age and some systemic diseases such as hypertension and angina pectoris affected blood pressure before local anesthesia. On the other hand, age and systemic diseases did not affect blood pressure changes. And, some antihypertensive affected systolic blood pressure changes. CONCLUSIONS: The blood pressure change with local anesthesia was not associated with systemic diseases and age but was associated with antihypertensive agents. In particular, calcium channel blockers, angiotensin II receptor antagonists and alpha-blockers accentuate blood pressure reducing caused by local anesthesia. CLINICAL RELEVANCE: The blood pressure change with local anesthesia was associated with antihypertensive agents. This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (number UMIN000030695).

Relationship between Maximum Tongue Pressure Value and Age, Occlusal Status, or Body Mass Index among the Community-Dwelling Elderly.

Background and objectives: In an aging society, the maintenance of the oral function of the elderly is of importance for the delay or prevention of frailty and long-term care. In the present study, we focused on the maximum tongue pressure (MTP) value and analyzed the relationship between MTP and age, occlusal status, or body mass index (BMI). Materials and Methods: This one-center observatory study was conducted using a cohort consisting of 205 community-dwelling outpatients over 65 years old. The MTP values of all subjects were measured using a commercially available tongue pressure measurement device and statistically analyzed. In addition, the correlation between MTP value and BMI was analyzed. Results: The MTP value decreased with age, especially in subjects classified as Eichner B and C. The difference in occlusal status did not show any statistically significant influence on MTP value. The correlation between BMI and MTP value was indicated in the tested groups other than an age of 65-74 and Eichner A groups. Conclusions: Although MTP value decreased with age, the difference in occlusal status did not have an impact on MTP value. The correlation between BMI and MTP value was not shown in the youngest group or a group with sufficient occlusal units. The results presented in the present study may imply that, even if MTP is low, younger age and/or better occlusal status compensate for the inferior MTP value in the cohort studied.

Local anesthetics inhibit priming of neutrophils by lipopolysaccharide for enhanced release of superoxide: suppression of cytochrome b558 expression by disparate mechanisms.

Local anesthetics have anti-inflammatory effects in vivo and inhibit neutrophil functions in vitro, but how these agents act on neutrophils remains unclear. Phagocytosis and bactericidal activity of neutrophils are enhanced by exposure to bacterial components such as lipopolysaccharide (LPS); this process is termed priming, which for enhanced release of superoxide (O2-) causes mobilization of intracellular granules that contain cytochrome b558, a component of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. We studied whether local anesthetics affected LPS priming for enhanced release of O2- in response to triggering by the chemotactic peptide N-formyl-methionyl-leucyl-phenylalanine (fMLP), and we investigated which element in the LPS signaling pathway might be the target of local anesthetics. Neutrophils were incubated with 10 ng/ml LPS and 1% plasma+/-local anesthetics, washed, and triggered with fMLP. Local anesthetics all inhibited LPS priming, and 50% inhibition was at 0.1 mM tetracaine, 0.5 mM bupivacaine, 3.0 mM lidocaine, or 4.0 mM procaine. Local anesthetics inhibited LPS-induced mobilization of specific granules and secretory vesicles. Local anesthetics inhibited LPS-induced up-regulation of cytochrome b558 but not LPS-induced translocation of p47phox. Inhibition of priming by local anesthetics was reversed by washing and incubating for 5 min. Tetracaine alone, but not the other local anesthetics, inhibited LPS activation of p38 mitogen-activated protein kinase (MAPK) and MAPK kinase 3 (kinases in the LPS signaling pathway). The p38 MAPK inhibitors SB203580 and PD169316 also blocked LPS priming. Thus, tetracaine and the other local anesthetics inhibit by disparate mechanisms, but all the local anesthetics impaired up-regulation of cytochrome b558 and all impaired priming of NADPH oxidase by LPS.