Relationship Between the Morphology of Oral Membranous Substances and Oral Wetness in Older Individuals Undergoing Long-Term Tube Feeding in Japan

日本长期管饲老年人口腔膜状物质形态与口腔湿润度的关系

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Abstract

AIMS: Oral membranous substances in tube-fed patients undergo temporal morphological changes, increasing the risk of asphyxiation. While xerostomia is hypothesized to influence these alterations, its precise relationship with oral wetness and specific morphological stages remains unclear. This study aimed to investigate oral wetness as an indicator of xerostomia and predictor of membranous substance formation. METHODS AND RESULTS: This study included 18 older tube-fed patients. Following initial oral care, comprising tooth surface and oral mucosa cleaning, we measured tongue dorsum wetness at 3, 6, 12, 24, and 48 h post-care. Concurrent visual examinations assessed the presence and morphology of palatal membranous substances, categorizing them into four types: none, mucous, viscous, and dry. We analyzed the relationships between morphology, wetness, and elapsed time. Oral wetness levels varied significantly across morphological types (p < 0.001), with dry membranous substances exhibiting the lowest wetness values. Membranous substance morphology significantly correlated with elapsed time (r = 0.513, p < 0.001) and oral wetness (r = -0.390, p < 0.001). CONCLUSIONS: Both temporal progression and xerostomia significantly contribute to the formation and morphological evolution of membranous substances. Timely implementation of oral care and moisturization appears crucial for preventing membranous substance formation and mitigating the associated risks.

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