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Objectives: The increasing medical expenses of elderly persons in Japan's rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date., Materials and Methods: Participants were 259 elderly subjects (range: 65-84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses ('Good', 'Not good' and 'Not at all good') on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman's rank method, the Mann-Whitney U-test and the Kruskal-Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables., Results: A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees., Conclusion: The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors., (© 2011 The Gerodontology Society and John Wiley & Sons A/S.)

Objective: The aim of this study was to investigate the relationships between Geriatric Oral Health Assessment Index (GOHAI) and general physical status among community-dwelling older adults., Background: Geriatric Oral Health Assessment Index is a patient-centred assessment of oral health for older adults. We hypothesised that GOHAI is a significant indicator of general physical status of older adults., Methods: This study included 354 adults (age, ≥65 years) living independently. Body mass index, handgrip strength and one-leg standing time with eyes open were used to evaluate the general physical status. Spearman's rank correlation coefficients were calculated to examine the relationships between the GOHAI scores, its three subdivided categories (physical function, psychological function and pain and discomfort) and each physical status measurement. A stepwise linear regression model was applied with each physical status measurement as the dependent variable and the GOHAI scores and its subdivisions as the principal independent variable., Results: Positive correlations were found between the GOHAI scores, its three subdivided categories and handgrip strength. The physical function category positively correlated with one-leg standing time. The GOHAI and the pain and discomfort category scores were retained in the final models of stepwise regression for handgrip strength, and significant relationships persisted after adjustments for demographic, psychosocial, medical and dental status., Conclusion: The GOHAI scores and its pain and discomfort category score may be significant indicators of body muscle strength., (© 2011 The Gerodontology Society and John Wiley & Sons A/S.)

Objectives: To show relationships between oral conditions and physical performance in the elderly living independently., Methods: A total of 821 persons participated. Data on background factors and self-assessed masticatory ability were collected by means of questionnaires. An intraoral examination was performed to examine the pattern of occluding pairs of natural teeth. Handgrip strength and one-leg standing time with eyes open were measured. Step-wise linear regression models were conducted with muscle strength or one-leg standing time as the dependent variables; the pattern of occluding pairs and self-assessed masticatory ability as the principal independent variables., Results: The self-assessed masticatory ability was retained in the final model of the step-wise regression for the handgrip strength, and significant relationships were established in the participants aged 65-74, but the pattern of occluding pairs was not retained. The pattern of occluding pairs, and the self-assessed masticatory ability were retained in the final models for the one-leg standing time, and significant relationships were shown here., Conclusion: The self-assessed masticatory ability may be significantly related to muscle strength and static balance function, and the pattern of occluding pairs may be significantly related to the static balance function, particularly in the elderly aged 65-74.

Aim: Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer‐to‐peer learning and assessment can help improve nurses' skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE). Methods: A pre‐ and post‐survey of 97 nursing students from a nursing school in Japan was conducted as a peer‐to‐peer oral health education training program that included an assessment and performance checklist. Results: Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0–25) of the first, second, third, and fourth participants in the four‐student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (p <.01). Fifty‐two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills. Conclusions: This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE‐style delivery. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to construct a model for oral assessment using deep learning image recognition technology and to verify its accuracy. Background: The effects of oral care on older people are significant, and the Oral Assessment Guide has been used internationally as an effective oral assessment tool in clinical practice. However, additional training, education, development of user manuals and continuous support from a dental hygienist are needed to improve the inter‐rater reliability of the Oral Assessment Guide. Design: A retrospective observational study. Methods: A total of 3,201 oral images of 114 older people aged >65 years were collected from five dental‐related facilities. These images were divided into six categories (lips, tongue, saliva, mucosa, gingiva, and teeth or dentures) that were evaluated by images, out of the total eight items that comprise components of the Oral Assessment Guide. Each item was classified into a rating of 1, 2 or 3. A convolutional neural network, which is a deep learning method used for image recognition, was used to construct the image recognition model. The study methods comply with the STROBE checklist. Results: We constructed models with a classification accuracy of 98.8% for lips, 94.3% for tongue, 92.8% for saliva, 78.6% for mucous membranes, 93.0% for gingiva and 93.6% for teeth or dentures. Conclusions: Highly accurate diagnostic imaging models using convolutional neural networks were constructed for six items of the Oral Assessment Guide and validated. In particular, for the five items of lips, tongue, saliva, gingiva, and teeth or dentures, models with a high accuracy of over 90% were obtained. Relevance to Clinical Practice: The model built in this study has the potential to contribute to obtain reproducibility and reliability of the ratings, to shorten the time for assessment, to collaborate with dental professionals and to be used as an educational tool. [ABSTRACT FROM AUTHOR]