School of Oral Health Sciences, Kyushu Dental University, Fukuoka, Japan.
Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Gerontology. 2023;69(3):282-288. doi: 10.1159/000526227. Epub 2022 Oct 6.
Aspiration pneumonia, an important issue for the older adults, is caused by an increase in pathogenic microorganisms in the saliva, aspiration, and weakened host immunity. Recently, decreased tongue pressure has been reported to be associated with dysphagia. This study aimed to investigate the relationship between decreased tongue pressure and the number of bacteria in the saliva of the older adults requiring long-term care.
This cross-sectional study involved 95 older adults requiring long-term care in a facility or at home, eating orally, and who could understand the instructions for measuring tongue pressure. Sex, age, slowness, weakness, shrinking, exhaustion, low activity, number of teeth, functional teeth unit, denture use, oral hygiene, tongue coating index, dry mouth, tongue pressure, and number of bacteria in the saliva were examined. Bacterial counts were analyzed by real-time PCR for total bacteria, total streptococci, methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Porphyromonas gingivalis, and Candida albicans.
Multiple regression analysis showed that poor oral hygiene and decreased tongue pressure were independent risk factors for increased bacteria in the saliva. Decreased tongue pressure is significantly correlated with an increased number of total bacteria and the presence of P. gingivalis.
DISCUSSION/CONCLUSION: Our results suggest that tongue pressure not only maintains the swallowing function but also prevents the increase of bacteria in the saliva of older adults requiring long-term care.
吸入性肺炎是老年人的一个重要问题，它是由唾液中病原微生物的增加、吸入以及宿主免疫力下降引起的。最近，有研究报道舌压降低与吞咽困难有关。本研究旨在探讨长期需要护理的老年人舌压降低与唾液中细菌数量之间的关系。
这是一项横断面研究，共纳入 95 名长期需要在机构或居家接受护理、能够理解舌压测量指导的口腔进食老年人。检查了性别、年龄、动作缓慢、虚弱、消瘦、疲惫、活动度低、牙齿数量、功能牙单位、义齿使用、口腔卫生、舌涂层指数、口干、舌压和唾液中的细菌数量。采用实时 PCR 分析总细菌、总链球菌、耐甲氧西林金黄色葡萄球菌、肺炎链球菌、铜绿假单胞菌、牙龈卟啉单胞菌和白色念珠菌的细菌计数。
多元回归分析显示，口腔卫生差和舌压降低是唾液中细菌增加的独立危险因素。舌压降低与总细菌数量增加和牙龈卟啉单胞菌的存在显著相关。
讨论/结论：我们的结果表明，舌压不仅维持吞咽功能，还可以防止长期需要护理的老年人唾液中细菌的增加。
