Dentist who experienced the Great Hanshin-Awaji Earthquake tells of oral care to prevent “disaster-related deaths”: “In one or two days, the bacteria count rose to 100 million.

Disaster-Related Deaths” a Concern in Noto Earthquake

The Noto Peninsula was hit by a severe earthquake at the beginning of this year. The Noto earthquake, which registered a maximum intensity of 7 on the Japanese scale at around 4:00 p.m. on New Year’s Day, has prompted an ongoing search for missing persons, but many of the evacuees who survived have been forced to live in poor living and sanitary conditions. Some medical professionals are concerned and praying that no evacuees will suffer disaster-related deaths, as has happened in past earthquakes.

Dr. Ryohei Adachi, a dentist and head of the Department of Dentistry and Oral Surgery at Tokiwa Hospital (Miki City, Hyogo Prefecture), experienced the Great Hanshin-Awaji Earthquake in January 1995. At the time, there was not even a word for ‘disaster-related deaths,'” he said.

His experience at that time made him realize that oral care tends to be neglected during evacuation, and that many people, especially the elderly who are physically weak, die from aspiration pneumonia.

Everyone has bacteria in their mouths, and the number of bacteria differs from person to person, but if you don’t brush your teeth for a day or two, the number of bacteria increases to the power of 10 to the eighth power, or 100 million bacteria. If you don’t brush your teeth, the number of bacteria increases to the power of 10 to the eighth power, or about 100 million bacteria in a day or two.

Mr. Adachi points out that there is concern that the elderly and others with weakened physical strength may aspirate and inhale the bacteria, resulting in pneumonia.

Everyone has had the experience of swallowing tea or other beverages. However, for those who are physically weak, there is a risk of inhaling bacteria and contracting pneumonia. This is aspiration pneumonia.

In the Great Hanshin-Awaji Earthquake, 24 (24%) of the “earthquake-related deaths” in the Great Hanshin-Awaji Earthquake were due to “pneumonia.

The Great Hanshin-Awaji Earthquake killed 6,434 people. Mr. Adachi points out that in May ’04, the Kobe Shimbun analyzed and reported on 927 people who were identified as “earthquake-related deaths.

Its characteristics are,

1. Pneumonia was the most common cause, accounting for 24% of the deaths
2. Many of them were elderly
3. 80% of the deaths occurred within two months of the disaster

and so on. When Mr. Adachi saw this news report, he felt that aspiration pneumonia could be prevented through oral care.

The Great Hanshin-Awaji Earthquake occurred early in the morning. Elderly people with dentures often slept with their dentures removed, and even if they were able to evacuate from the earthquake, many were unable to take their dentures with them. Adachi believes that these elderly people had difficulty eating the rice balls that had become hardened over time and were distributed to them during their subsequent evacuation, making it easy for them to become undernourished.

According to Mr. Adachi, the mechanism of death from aspiration pneumonia, mainly among elderly people who evacuated from disasters, is as follows.

Oral bacteria increase due to inadequate oral care, such as lack of water and dry mouth during evacuation. The body’s resistance decreases due to lack of daily medicines, dehydration, stress, etc. Physical and mental frailty, known as “frailty,” increases due to inactivity in daily life. Low nutritional intake leads to a decline in physical fitness. Aspiration at such times can easily lead to pneumonia, which can often result in death if the patient is not physically strong enough.

Gargling, salivary gland massage, mouthwash with disinfectant effect…

Evacuation centers, including the Noto earthquake, often provide inadequate water, food, light, and heat, making the living and sanitary environment poor. Under such extreme conditions, people tend to neglect oral care, which can be fatal for the elderly and infirm. What should we do?

If you have water, gargle. If there is no water, it is better to massage the salivary glands, because it is better to produce a lot of saliva. But if there is a lack of water, saliva may not come out either.”

Salivary gland massage stimulates the parotid, submandibular, and sublingual glands to stimulate saliva production.

On the other hand, to keep dentures and other teeth clean in extreme situations, Adachi sees that wiping dirt off with a wet tissue may be a good idea. However, he also says, “I don’t know how much it contributes. Still, he says, “Elderly people without teeth eat less. We want them to wipe off the dirt on their dentures. If dentures are left in while they are dirty, bacteria will explode,” he says.

What should be done to prepare for disasters on a regular basis? Mr. Adachi suggests using mouthwash that has a disinfectant effect. However, it is also important to follow the directions on how to use it, as it may also remove the indigenous bacteria needed in the oral cavity.

There is also a liquid type toothpaste called liquid toothpaste. Simply put an appropriate amount in your mouth, rinse it out, and brush it with a toothbrush. There is no need to rinse with water as with toothpaste.

Mr. Adachi stresses the importance of taking good oral care on a regular basis.

It is necessary to take good care of your mouth on a regular basis. When cold, hard rice balls are provided during a disaster evacuation, people with bad teeth have difficulty eating them, and this can lead to a loss of physical strength.