The Oral Biomechanical Functions of Hong Kong Healthy Adults
Condition: Oral Manifestations
MeSH terms: Oral Manifestations
Study type: Interventional

Summary: 
      Hong Kong and Japan are similar in terms of facing the super-ageing society. Maintaining oral
      function in elderly is particularly important because it affects social, physical and mental
      health to the people and to the society. By using technology seems to be one of the solutions
      in dealing with this. Thus, this project aims at using state-of-the-art Age-tech that have
      been used in Japan to implement "Oral Frailty" concept in Hong Kong. Through identifying oral
      biomechanical in elderly population, the investigators expect the situation can be improved,
      and the data analysed and collected can be useful and impactful that can influence the dental
      communities around Southeast Asia and the globe.
    

Detailed description: 
      In 2020, this is not only a year of pandemic but also the year that the number of
      "super-aged" countries - where more than one in five of the population is 65 or older - reach
      to 13 including Japan, Germany, Italy, Netherlands, France, Sweden, Portugal, Slovenia and
      Croatia. By 2030, the number of countries would increase to 34 including Hong Kong, Korea,
      the US, the UK and New Zealand [1]. These countries are currently generating 80% of global
      GDP [2]. So, this 10-15% of super-aged global population is expected to create economic
      burden around 13-20% of GDP depending on the countries and policies [3], that will indeed
      severely affect global economy in the future if the ageing problem is not properly treated.

      Hong Kong and Japan ranks number 1 and 2, respectively, lowest in 0-14 children population in
      the high income countries/region [2]. Facing to this low birth rate, according to the "Hong
      Kong Population Forecast 2020-2069", by 2069, the number of elderly people aged 65 or over in
      Hong Kong will reach 2.6 million, accounting for about 35.9% of the total population. The
      labor force between the ages of 15 and 64 will shrink to 3.9 million, accounting for 54.6% of
      the population [4].

      In particular to dentistry, maintaining the oral function in elderly is very important, due
      to:

        1. food nutrients - when you eat you can obtain the nutrients from food, this provides you
           the essential energy for daily life. Loss of teeth or misfit of artificial teeth
           positively correlated with the risk of development in general chronic diseases [5].

        2. self-esteem - oral appearance and communication are significant factors contributing to
           elderly's psychological well-being and social life, impacting to the oral health related
           quality of life (OHRQoL) [6].

        3. neurological disorder - oral health was shown to related with strokes [7] and
           Alzheimer's disease [8] due to the invasion of oral bacteria such as Aggregatibacter
           actinomycetemcomitans, Prevotella intermedia, and Porphyromonas gingivalis. Only these
           two neurological disorders have accounted 0.08-0.52% loss of GDP in 47 prefectures in
           Japan in 2012, and the GDP lost is forecasted to be increasing continuously [9]. Tooth
           lost is a key factor.

      Apparently, oral health is important to have healthy aging. The dental personnel play a key
      role in oral health, in terms of prevention, intervention, and education. In particular,
      prevention and education are comparatively low-cost strategies while intervention bears the
      higher cost, as shown in our previous study that countries/regions with better economic
      status had fewer severe impacts on diet-related aspects of OHRQoL [10]. Besides, our study
      also showed social and physiological factors "trouble pronouncing words" ranks significantly
      high similarly as other dietary factors, i.e., "uncomfortable to eat", "diet unsatisfactory"
      and "interrupt meals" among the developed countries with high economy. Indeed, the loss of
      teeth, new dental prostheses, and oral muscle dysfunction due to aging are the major
      contributing factors of pronunciation trouble. This physiological "oral frailty" declines the
      elder's mental and social health, and should be identified and addressed before the need for
      long-term care [11].

      Utilizing technology to understand this situation deemed possible and "Age-tech" becomes an
      essential part of health technologies which means applying technology to identify, improve
      and treat oral frailty situations. The technology can also be useful to monitor and evaluate
      the efficiency of oral health conditions during this pandemic when the patients have limited
      mobility around the society.
    

Intervention name(s): Home oral excrise
Intervention type(s): Other
Intervention description(s): The current study aimed to evaluate the efficacy and user experience of mobile phone APP, a mobile application with AI component in facial movement tracking, in improving oral functions of elderly people
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: oral frailty; oral muscle; home oral exercise