The purpose of this study was to analyze the relationship between jaw stability and the feeding function of 53 bedridden elderly dysphagic patients. Investigations included a questionnaire on daily life activities and meals, oral examinations, functional tests for feeding ability, and assessments of feeding function during the meal. The results of intraoral examination of this patient population for jaw stability revealed that 34.0% of individuals had posterior support for occlusion regardless of whether they had natural teeth or dentures. Thus, the number classified as having mandibular stability (ST) was 18 and that with no mandibular stability (NST) was 35. In a Repetitive Saliva Swallowing Test (RSST), 83.3% of the NST group and 40.0% of the ST group were unable to swallow more than 3 times within 30 seconds. In a water swallowing test, 91.4% of the NST of group was unable to swallow 15 mL of water by a single swallow, while 40.0% of ST group was capable. The results suggest that jaw stabilization by occlusion with the posterior teeth or dental prosthetics is important to feeding function, particularly swallowing.
In response to new findings and comments from the members and the public, the Dysphagia Diet Committee of the Medical Review Committee of the Japanese Society of Dysphagia Rehabilitation, which was established in April 2010, has discussed and made regular improvements to the Japanese Dysphagia Diet of 2013 (JDD2013) [1,2] since its creation eight years ago. As a result, the JDD2013 was revised and "the Japanese Dysphagia Diet of 2021 by the Japanese Society of Dysphagia Rehabilitation" was drawn up. In the future, the Board of Directors will discuss how to deal with additional opinions and the necessity of reviewing the classification.This article is a translation of "the Japanese Dysphagia Diet of 2021 by the Japanese Society of Dysphagia Rehabilitation [3]" published in Japanese in August 2021. I. Overview and General Remarks NameThe name of the classification is the Japanese Dysphagia Diet of 2021 of the Japanese Society of Dysphagia Rehabilitation (JDD2021). The JDD2021 describes the classification of meals and the classification of thickened liquid and is referred to as the JDD2021 (meal) and the JDD2021 (thickened liquid), respectively. To simplify this, we created a quick reference table for the JDD2021 (meal) and the JDD2021 (thickened liquid); however, this explanation should be read carefully before use (refer to Table 1 and 2). Purpose of establishmentIn Japan, since there was no unified stage of dysphagia diet, such as the National Dysphagia Diet (2002) [4] in the United States, many names and stages of dysphagia diet were used inconsistently in each region and facility. Moreover, the lack of consensus and standard classification contributed to the delay in the listing of medical fees.These factors are disadvantages for patients with dysphagia and people involved in the care of such patients, for example, those involved in the transfer of dysphagia patients from acute hospitals to convalescent hospitals, or from hospitals to facilities or homes. Therefore, the JDD2013 shows the graded classification of meals and thickened liquids that are
Children with Down Syndrome (DS) show developmental retardation of gross motor function including acquisition of oral movements related to eating and swallowing. To characterize the process of development/acquisition of eating/swallowing function of children with DS, interlabial pressure (IP) during taking food into the mouth was assessed. This study included 99 children with DS (birth to 4 year-old), and 112 age-matched control children showing typical development. IP during taking food into the mouth was measured as an objective index of lip closing function. The system for measuring IP during taking food into the mouth consisted of a strain gauge-pressure sensor connected to a strain-measuring device, which sent data to a personal computer installed with electromagnetic oscillograph software to display pressure waveforms. The DS and typically developing children were grouped into each age group and the data were compared between matched-age groups. IP during taking food into the mouth, pressure-time (PT), variation coefficient (VC) of IP during taking food into the mouth and VC of PT were analyzed using the unpaired t-test. Analyses showed a significantly higher IP during taking food into the mouth in the DS population than in the typically developing children in the 2 and 3 year old (P = .042 and .049, respectively) groups. No significant difference was observed between the DS and typically developing groups with respect to PT, VC of IP during taking food into the mouth or VC of PT for any age group. Children with DS showed a process of acquisition of lip closing function during taking food into the mouth similar to the process found in typically developing children, even though children with DS experience developmental retardation in gross motor and cognitive functions.
The purpose of this study was to investigate the distribution of causes of dysphagia and the types of treatments being provided at the Dysphasia/Dysphagia Rehabilitation Clinic of Showa University Dental Hospital. The subjects included 173 dysphagic patients. Fifty-three percent of patients ranged 0-12 age, and 24% of them were over 60 years old. The survey results showed that diseases of the central nervous system, such as cerebral palsy (CP), was a major diagnosis in young patients, and cerebrovascular accident (CVA) was a predominant cause in adult and elderly patients. Diagnosis distribution showed that swallowing dysfunction was the most frequent diagnosis for patients on their first visit when compared to other feeding dysfunctions including malfunction of lips, tongue, and mastication. Almost 40 % of patients still continue to have rehabilitation for their dysphagic symptoms at the end of March 2002. This suggests that dysphagia rehabilitation is needed for a long time for many disabled individuals.
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