International Bio-Dental Science Course

Dental treatment and oral care for the elderly with swallowing
disorders in Japan
Associate Professor Mineka Yoshikawa
Hiroshima University

Abstract
Japanese public health insurance system for all citizens was established in 1961, which had
been covering 100–70% of medical/dental treatment expense. The virtue of the system had brought in
increasing life expectancy and number of teeth at the latest decades of the lives. Epidemiologic study
proved the effectiveness of prostheses for improving the quality of lives. However, our super-aged
society without long historical infrastructure had little attention for eating function, and deprived the joy
of eating in more than 260,000 gastrostomy patients. Dysphagia and malnutrition became major issues
in Japanese geriatric medicine. Our disease structure has been changing also in the field of dentistry.
Restorative dentistry is still in major need, but new rehabilitative dentistry is emerging.
Videoendoscopy is getting much attention of Japanese dentists for diagnosing dysphagia and
swallowing rehabilitation. But we –dentists- should be able to evaluate multiple eating functions
quantitatively to help maintaining the joy of eating before doing this controversial examination. Beside
masticatory muscles, tongue and perioral muscles play the important roles in eating, but there were no
numerical standard and evidence-based remedies for their dysfunction.
In this lecture, I would like to review the latest change in disease structure and introduce the
current reality in Japanese super-aged society.
Topics are below;
1: Super -Aged Society in Japan
2: Swallowing disorders and aspiration pneumonia in Japanese elderly
3: The role of dental treatment and oral care for the elderly with swallowing disorders
Lecturer’s message to students:
Japan greets the arrival of “Super-Aged Society", and is on the front-line of the fight against the
elderly's various problems.
Any other county has never had an experience with this situation before in the world.
Let's talk what and how the dentistry and dental treatment can contribute to them.
Keywords: Prosthodontics, Geriatric dentistry, Oral rehabilitation, Super-aged society, Aspiration
pneumonia, Oral care, Frailty

Faculty of Dentistry, Hiroshima University, Department of Global Dental Medicine & Molecular Oncology 1
 International Bio-Dental Science Course

Faculty of Dentistry, Hiroshima University, Department of Global Dental Medicine & Molecular Oncology 2
 International Bio-Dental Science Course

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Faculty of Dentistry, Hiroshima University, Department of Global Dental Medicine & Molecular Oncology 3
 International Bio-Dental Science Course

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Miniquiz
1. “Super Aged Society” is the society that more than ( ) % of the elderly over 65 year - old
are exist in the country’s total population.
a/ 7
b/ 14
c/ 21

2. Average life expectancy includes ( ) life expectancy and care-needed life expectancy.
a/ Healthy
b/ Normal
c/ Disease

3. Pneumonia is the ( ) death cause in Japan, 2015.

a/ 1st
b/ 2nd
c/ 3rd

4. Silent aspiration is caused by deterioration of ( ) and swallowing reflexes.

a/ gag
b/ cough
c/ postural

5. ( ) is the condition that the deterioration of energy in muscle strength, mind and body by
aging.
a/ Dementia
b/ Frailty
c/ Depression

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Faculty of Dentistry, Hiroshima University, Department of Global Dental Medicine & Molecular Oncology 4