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[Trends in geriatric dentistry and the future--from the point of view of masticatory function].

In recent years the number of aged persons in developed countries has been steadily increasing. Tooth loss is a typical age-associated stomatognathic change, and edentulism rates in Japan have been reported to be 30%. Dentures are made to restore oral functions after the natural teeth have been lost. However, there are also many stomatognathic changes associated with aging as well as oral manifestations of systemic diseases which can make the wearing dentures difficult in elderly persons. Some of the more significant changes occur in the structure of the mucosa, the function of the oral musculature, the temporomandibular joint, the taste perception, salivary function and the nervous system. Studies on the variety of physical and psychological dynamics associated with the aging process are necessary to provide the latest treatment modalities for the aged. The mastication and dentition status in elderly persons are suggested to be closely related with many kinds of physiological functions. On the other hand, stomatognathic functions are suggested to be influenced by the health of the entire body. They are supposed to have an interdependent relationship. The maintenance and care of occlusion are essential to guarantee the quality of life for the elderly. In future, the relationship between masticatory function and physical activities, such as physical exercise, blood flow, respiration, endocrine function, reproduction etc. require further investigation.

Aged↗

Oral manifestations of menopause.

Menopause is a normal developmental stage in a woman's life, marking the permanent cessation of menstruation. It is the result of irreversible changes in the hormonal and reproductive functions of the ovaries. Menopause is accompanied by a number of characteristic physical changes; some of which occur in the oral cavity. The two most common oral manifestations of menopause are: oral discomfort, including pain, a burning sensation, dryness, and altered taste perception; and alveolar bone loss as a result of osteoporosis. Although menopause has been recognized for centuries, it has only been recently that the study of menopause has gained much attention. The purpose of this article is to review the basic physiology of menopause, and to present the etiology of the oral manifestations associated with menopause.

Alveolar Bone Loss↗

Topical apraclonidine hydrochloride in eyes with poorly controlled glaucoma. The Apraclonidine Maximum Tolerated Medical Therapy Study Group.

OBJECT: We determined whether the addition of topical apraclonidine hydrochloride to eyes receiving maximal medical therapy, with inadequate intraocular pressure (IOP) control, and scheduled to undergo surgery, could adequately lower IOP, postponing the need for surgical intervention. DESIGN: A prospective 90 day, multi-centered, placebo-controlled, doublemasked parallel study. PATIENTS: We enrolled 174 glaucoma patients with inadequate IOP control on maximally tolerated medical therapy. All were candidates for either laser trabeculoplasty or invasive surgical intervention. We enrolled only one eye per patient. INTERVENTIONS: We continued to administer maximum-tolerated medical therapy for glaucoma. Patients took the study medication every eight hours. Study medications were either apraclonidine hydrochloride 0.5% or placebo (apraclonidine's vehicle). MAJOR OUTCOME MEASURES: We evaluated IOP, IOP change from baseline, and the number of eyes requiring surgery after the addition of study medication. RESULTS: Sixty one percent of patients treated with apraclonidine maintained adequate IOP control throughout the study, avoiding additional surgery compared to 33.9% patients treated with placebo (P < .001). Apraclonidine treatment resulted in significantly more patients achieving either an additional > or = 20% reduction in IOP from baseline (resulting in an IOP < or = 20 mm Hg) (P < 0.05). The most common ocular complications were conjunctival hyperemia (12.6%), itching and foreign body sensation (6.8%), and tearing (4.5%). The most frequent non-ocular adverse events related to apraclonidine were dry mouth (4.5%) and unusual taste perception (2.2%). CONCLUSIONS: Apraclonidine appears safe and efficacious. It significantly lowered IOP when used in combination with a patient's maximum tolerated medical therapy. This delayed or prevented further glaucoma surgery for at least 90 days in approximately 60% of treated patients.

Administration, Topical↗

Taste and smell perception affect appetite and immunity in the elderly.

The losses in taste and smell that occur with advancing age can lead to poor appetite, inappropriate food choices, as well as decreased energy consumption. Decreased energy consumption can be associated with impaired protein and micronutrient status and may induce subclinical deficiencies that directly impact function. Most nutritional interventions in the elderly do not compensate for taste and smell losses and complaints. For example, cancer is a medical condition in which conventional nutritional interventions (that do not compensate for taste and smell losses) are ineffective. Evidence is now emerging that suggests compensation for taste and smell losses with flavor-enhanced food can improve palatability and/or intake, increase salivary flow and immunity, reduce chemosensory complaints in both healthy and sick elderly, and lessen the need for table salt.

Aged↗

Taste preferences and sensory perceptions in female varsity swimmers.

Taste preferences and sensory estimates of sweetness and fat content of 16 dairy stimuli with varying levels of fat (0%, 3.5%, 10.5% and 37.6%) and sucrose (0%, 5%, 10% and 20%) were compared in members of a Division I college women's swim team and women who did not engage in any organized sports. No differences in taste preferences or sensory estimates were observed for swimmers across the athletic season. However, swimmers had significantly lower preference ratings for high-sucrose and high-fat stimuli than controls. Controls who reported exercising more than 3 h a week also displayed decreased preference ratings for high-sucrose and high-fat stimuli relative to controls who reported exercising less than 3 h a week. With respect to sensory estimates, swimmers reported that high-sucrose stimuli were sweeter, low-fat stimuli were less fatty, and high-fat stimuli were more fatty than controls. The preference ratings and sensory estimates of these athletes were similar to those previously seen in individuals with anorexia nervosa and bulimia.

Adolescent↗

Salt taste preferences and perceptions of elderly and young adults.

Current research has yielded both support and refutation for the theory that elderly adults have lower taste acuity. The present study compared the perception of and preference for salt in persons 65 years and over and in persons aged 20 to 35 years. The subjects were free-living, had not been hospitalized in the past 12 months, and had never been on a sodium-restricted diet. Salt was introduced in suprathreshold concentrations of 0.3%, 0.5%, 0.7%, and 0.9% in mashed potatoes and chicken broth. The 48 older adults in our study demonstrated higher preferences for the four salt concentrations in the potatoes (p = .0001) and the broth (p = .0004) than did the 53 younger adults. There were no significant differences in the two age groups' abilities to perceive the saltiness of the four concentrations. There were also no significant differences in salt perception among subgroups identified for age, gender, smoking behavior, and denture use. Both groups correctly ranked the concentrations in ascending order. Our study found that taste acuity for salt in older subjects was not different from that of younger adults when suprathreshold concentrations of salt in mashed potatoes and chicken broth were used as stimuli.

Adult↗

Taste and pheromone perception in mammals and flies.

The olfactory systems of insects and mammals have analogous anatomical features and use similar molecular logic for olfactory coding. The molecular underpinnings of the chemosensory systems that detect taste and pheromone cues have only recently been characterized. Comparison of these systems in Drosophila and mouse uncovers clear differences and a few surprising similarities.

Acids↗

Effect of edible oils and oil emulsions on the perception of basic tastes.

The intensity of sweet, bitter or astringent tastes is reduced by consumption of edible oil or oil emulsions immediately before the ingestion of test solutions. The basic taste substances were dissolved in 30% aqueous ethanol, flavoured with plant extracts. The time-intensity dependence was influenced similarly. The sensitivity of taste receptors returned to the original value within 15-20 min. Intensities of acidic or salty tastes were not affected.

Catechin↗

Taste intensity performance in patients irradiated to the head and neck.

Decrements in taste-detection thresholds during radiotherapy and subsequent recovery in the months after therapy are well documented. However, few studies have explored suprathreshold taste intensity perception in radiation patients. This cross-sectional study compared taste function in 15 men postradiation with a group of 23 healthy, nonirradiated male volunteers. A direct-scaling procedure was used to assess taste intensity perception of the four basic taste qualities. Patients performed nearly as well as control subjects on objective measures of suprathreshold functioning. Postradiation intensity judgments of salty (sodium chloride), sweet (sucrose), and bitter (quinine sulfate) solutions were not significantly reduced. Subtle, age-related taste impairments were identified for sour perception (citric acid) postradiotherapy. Younger patients judged citric acid to be more intense than did age-appropriate control subjects, whereas older patients judged it to be less intense. Moreover, younger patients were likely to be midly dysgeusic, whereas older patients appeared to be hypogeusic for citric acid. This study provides evidence for near normal suprathreshold taste intensity perception in patients who have received head and neck irradiation.

Adult↗

Perception of temporal order and the identification of components in taste mixtures.

The capacity of humans to identify the components of taste mixtures is limited to 3 for most people [D.G. Laing, C. Link, A. Jinks, I. Hutchinson, The limited capacity of humans to identify the components of taste mixtures and taste-odor mixtures. Perception 31 (2002) 617-635]. Here, the hypothesis that temporal processing differences have a major role in limiting capacity is investigated. Thirty two subjects were trained to identify sucrose, sodium chloride and citric acid at FIVE concentration levels and were then required to indicate (1) which tastant was perceived first and (2) the identity of each component, in binary and ternary mixtures. Within each mixture set, e.g. sucrose-citric acid, the concentrations of components were adjusted to provide some conditions where intensities and time differences in processing the individual components were minimized. With binary mixtures, changes in intensity resulted in identification of only one component when the differences were largest, and both being identified when intensities were similar. In contrast, subjects found it difficult to indicate which component was perceived first when the intensities were similar and easy when they were substantially different. The most profound effects occurred with ternary mixtures. With each of the three sets, there were several where subjects could not indicate which component was perceived first, and in 13/18 mixtures not all components were identified above chance. Indeed, the most common number of components identified was 2. However, although perception of order was lost in a number of mixtures, this did not preclude identification of one or all three components. This result contrasts with the finding with odors where total loss of order resulted in loss of identity of all components in ternary mixtures [A. Jinks, D.G. Laing, Temporal processing reveals a mechanism for limiting the capacity of humans to analyze mixtures. Cognitive Brain Res. 8 (1999) 311-325]. Thus, loss of identity with taste mixtures seems to occur to a lesser degree. Indeed suppression rather than temporal effects may be the main cause of the loss of identity of components with ternary taste mixtures.

Adolescent↗