지역사회 거주 노인의 타액선 기능저하 (구강건조) 평가 및 중재

Abstract

Salivary gland hypofunction (dry mouth) is the most common dysfunction in older adults. It causes a deterioration in oral health, mastication, and swallowing functions. It can also lead to systemic frailty. Early diagnosis and intervention are required to prevent oral and systemic frailty. This literature review introduced the salivary gland hypofunction assessment methods and interventions applicable in community-dwelling older adults. The study proposed an oral mucosal wetness test. The test uses an oral moisture-checking device as the primary test for as sessment considering logistic aspects in application to the elderly in the community. The clinical oral dryness score (CODS) is an alternative test. The assessment method of oral mucosal wetness showed a significant correlation with salivary secretion rate. The CODS system is also significantly correlated with mucosal wettability, salivary secretion rate, and severity of oral dry ness. Therefore, they have proven useful as test tools for assessing salivary gland hypofunction and oral mucosal wetting. The subjective questionnaire (xerostomia inventory) is also a useful tool for determining the severity of dry mouth and can be com bined with other examination methods for salivary gland hypofunction such as oral mucosal wetness test or CODS. Essential interventions to salivary gland disfunction include drug coordination, prescription of artificial saliva, expert applica tion of fluoride varnish, and salivary gland stimulation exercises. Careful consideration of other oral functions, such as occlusal force, tongue pressure, tongue movement, and oral hygiene management ability, is also required. Comprehensive intervention must be planned. Many studies have shown that the degradation of one function leads to that of another. Conversely, improv ing each function can improve other oral and integrated functions, such as masticatory and swallowing functions. The ultimate purpose of the intervention for salivary gland hypofunction in community-dwelling older adults is to improve and maintain oral functions—mastication, swallowing, and pronunciation. Therefore, interventions should include complex interventions such as oral exercise, tongue pressure enhancement training, oral hygiene, and interventions to improve salivary gland function. The intervention for individual salivary gland dysfunction should be planned with a comprehensive perspective for maintaining inte grated oral function and contributing to the prevention and management of systemic frailty and its complications.