The Effect of Subjective Xerostomia and Salivary pH in Salivary Glands Stimulated by Laughter Therapy in Frail Elderly Women

Sun Young Lim; Kyem Ju Lee; Su Jin Kim

doi:10.12799/jkachn.2016.27.1.72

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Lim, Lee, and Kim: The Effect of Subjective Xerostomia and Salivary pH in Salivary Glands Stimulated by Laughter Therapy in Frail Elderly Women

Original Article

Journal of Korean Academy of Community Health Nursing 2016; 27(1): 72-80.

Published online: 31 March 2016

DOI: https://doi.org/10.12799/jkachn.2016.27.1.72

The Effect of Subjective Xerostomia and Salivary pH in Salivary Glands Stimulated by Laughter Therapy in Frail Elderly Women

Sun Young Lim¹, Kyem Ju Lee¹, Su Jin Kim²

¹College of Nursing, Korea University, Seoul, Korea.

²Department of Nursing, Baekseok Culture University, Cheonan, Korea.

Corresponding author: Lee, Kyem Ju. College of Nursing, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Korea. Tel: +82-2-3290-4910, Fax: +82-2-928-9107, kyem74@hanmail.net

Received 26 January 2016 Revised 16 March 2016 Accepted 23 March 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify the effect of subjective xerostomia and salivary pH in salivary glands stimulated by laughter therapy in frail elderly women.

Methods

The research used a one-group pretest-posttest design. Data were collected from July 2, 2015 to September 30, 2015. A sample of 41 frail female elderly patients was recruited at A Nursing Home in K City, Korea. We measured xerostomia and salivary pH using a questionnaire and BCP test paper (pH 5.6~7.2). Laughter therapy was given once a week for four weeks (3 items). Data were analyzed through descriptive statistics, independent t-test, ANOVA, paired t-test and Cronbach's using the SPSS 18.0 program.

Results

There were significant differences in salivary pH according to oral health (t=-2.06, p<.05). There were significant differences in xerostomia (t=4.41, p<.001) and salivary pH (t=-7.94, p<.001) after salivary glands stimulated by laughter therapy.

Conclusion

Salivary glands stimulated by laughter therapy improved xerostomia and salivary pH of the frail elderly. Therefore, salivary glands stimulated by laughter therapy may be useful in promoting and maintaining oral health among the frail elderly in the rapidly increasing population of old people.

Keywords: Frail elder, Xerostomia, Salivary gland

Figures and Tables

Table 1

Contents of Laughter Therapy Program

Stage	Contents		Duration (min)
Introduction Open mind	Self introduction,		10
	Friendship
	Various greeting methods
	Stretch of laughter muscle
Main stage	Part 1: Laughter, what is laughter therapy?		40
		Effects of laughter
	Part 2: Stretch of laughter face muscle
	Part 3: Applause with laughter
	Part 4: Stimulate excercise of salivary gland
		Strengthening exercise (gingiva, tongue, cheek)
		Execute gingiva message
		Execute tongue exercise
		Execute cheek stretching
Finish stage	Deep respiration		10
	Warm-up (neck exercise, shoulder exercise)
	To say feeling

Table 2

The General Characteristics and Oral related Health (N=41)

Characteristics	Categories	n (%) or M±SD
Age (year)		82.12±5.17
	65~69	1 (2.4)
	70~79	13 (31.7)
	80~89	23 (56.1)
	≥90	4 (9.8)
Household type	Alone	18 (43.9)
Household type	Married children living	23 (56.1)
Smoking	Yes	1 (2.4)
Smoking	No	40 (97.6)
Drinking	Yes	6 (14.6)
Drinking	No	35 (85.4)
Chronic illness	Yes	34 (82.9)
Chronic illness	No	7 (17.1)
Current drug medication	Yes	34 (82.9)
Current drug medication	No	7 (17.1)
Water drinking (cups/day)	≤2	2.44±0.89
	3~4	6 (14.6)
	5~6	16 (39.0)
	≥7	14 (34.1)
		5 (12.2)
Stress	A lot of	19 (46.4)
Stress	Less	22 (53.6)
Exercise	Yes	15 (36.6)
Exercise	No	26 (63.4)
Digestion status	Not changed	37 (90.2)
Digestion status	Hard to digest	4 (9.8)
Self-rated oral health (tooth and gum)	Good	16 (39.0)
Self-rated oral health (tooth and gum)	Bad	25 (61.0)
Denture	Present	25 (61.0)
Denture	Absence	16 (39.0)
Natural teeth		2.41±1.22
	Nothing	12 (29.3)
	<10	13 (31.7)
	10~19	3 (7.3)
	≥20	13 (31.7)

Table 3

Subjective Xerostomia according to Oral related Health Characteristics by Laughter Therapy (N=41)

Variables	Categories	Xerostomia			t or F	p
		Pretest	Posttest	Difference
		M±SD	M±SD	M±SD
Self-rated oral health (tooth and gum)	Good	23.43±11.51	18.75±9.50	-4.68±12.83	1.50	.140
Self-rated oral health (tooth and gum)	Bad	32.84±11.74	22.60±14.34	-10.24±10.62	1.50	.140
Denture	Present	30.64±12.68	26.87±12.01	-8.60±12.80	-0.35	.724
Denture	Absence	26.87±12.01	19.62±11.16	-7.25±10.08	-0.35	.724
Natural teeth	Nothing	29.41±9.85	24.75±13.28	-4.66±11.99	1.95	.138
	<10	31.92±11.48	18.00±7.51	-13.92±12.08
	10~19	28.33±19.50	27.33±19.42	-1.00±3.60
	≥20	26.38±14.56	19.38±14.82	-7.00±10.68

Table 4

Salivary pH according to Oral related Health Characteristics by Laughter Therapy (N=41)

Variables	Categories	Salivary pH			t or F	p
		Pretest	Posttest	Difference
		M±SD	M±SD	M±SD
Self-rated oral health (tooth and gum)	Good	6.44±0.81	7.13±0.50	0.68±0.70	-2.06	<.05
Self-rated oral health (tooth and gum)	Bad	6.12±0.83	7.32±0.47	1.20±0.81	-2.06	<.05
Denture	Present	6.12±0.83	7.20±0.50	1.08±0.86	0.79	.434
Denture	Absence	6.44±0.81	7.31±0.47	0.87±0.71	0.79	.434
Natural teeth	Nothing	6.17±0.83	7.25±0.45	1.08±0.79	0.27	.842
	<10	6.23±0.83	7.15±0.55	0.92±0.95
	10~19	6.00±1.00	7.33±0.57	1.33±0.57
	≥20	6.38±0.87	7.31±0.48	0.92±0.75

Table 5

Xerostomia, Salivary pH by Laughter Therapy (N=41)

Variables	Pretest	Posttest	t	p
Variables	M±SD	M±SD	t	p
Xerostomia	29.17±12.41	21.09±12.07	4.41	<.001
Salivary pH	6.24±0.83	7.24±0.48	-7.94	<.001

References

1. Statistics Korea. Statistics for the elderly [Internet]. Seoul: Statistics Korea;2014. cited 2014 October 29. Available from: http://kosis.kr/.

2. Kim JY, Moon WS, Lee KS, Hwang TY. Effects of oral exercise on oral function and denture satisfaction of the elderly. J Agric Med Community Health. 2015; 40(3):158–170.

3. Kim CO, Lee HY, Ho SH, Park HS, Park CW. Effects of visiting prehabilitation program against functional decline in the frail elderly: A prospective randomized community trial. J Korean Gerontol Soc. 2010; 30(4):1293–1309.

4. Sun WD, Lee SY, Kim DJ, Yoon JL, Kim CW, Nam HJ. Current situations of health care service system for older persons and its policy issues [internet]. Seoul: Korea Institute for Health and Social Affairs;2014. cited 2014 December 31. Available from: https://www.kihasa.re.kr/html/jsp/main.jsp.

5. Noh EM, Baek JU. Subjective oral health status of the elderly and social impact efficacy. J Dent Hyg Sci. 2010; 10(4):233–239.

6. Hebling E, Pereira AC. Oral health-related quality of life: A critical appraisal of assessment tools used in elderly people. Gerodontology. 2007; 24(3):151–161.

7. Jang JH, Baik SH, Kim AJ, Jung SH, Kim OS, Kim SH. The effect of xerostomia on perceived oral health among elderly people wearing dentures. J Korean Acad Dent Health. 2006; 30(4):438–446.

8. Kim JH, Park JH, Kwon JS, Ahn HJ. Effect of pilocarpine mouthwash on xerostomia. Korean J Oral Med. 2011; 36(1):21–24.

9. Jee YJ, Kim JS, Lee JH, Jeon ES. A study on the relationship between halitosis developments and oral environmental. J Dent Hyg Sci. 2010; 10(2):101–107.

10. Brunette DM. Introduction to the proceedings of the fifth international conference on breath odour research. International Dental Journal. 2002; 52:Suppl 3. 177–180.

11. Min BM. Oral biochemistry. Seoul: Daehan Narae Pub Co;2007. p. 73.

12. Jeong SJ, Yoon MS, Im DS, Jeong MS. Dental caries risk can be predicted by simply measuring the pH and buffering capacity of saliva. J Dent Hyg Sci. 2006; 6(3):159–162.

13. Kim YJ, Park KM. Effects on salivation, xerostomia and halitosis in elders after oral function improvement exercises. J Korean Acad Nurs. 2012; 42(6):898–906.

14. Cho EA, Kim KH. Correlation among xerostomia, halitosis, and salivary pH in older adults. J Korean Gerontol Nurs. 2012; 14(1):69–78.

15. Choi ES, Lyu J, Kim HY. Association between oral health status and health related quality of life (EuroQoL-5 Dimension). J Dent Hyg Sci. 2015; 15(4):480–487. DOI: 10.17135/jdhs.2015.15.4.480.

16. Kim JH, Park JH, Kwon JS, Ahn HJ. Effect of pilocarpine mouthwash on xerostomia. Korean J Oral Med. 2011; 36(1):21–24.

17. Takeda M, Hashimoto R, Kudo T, Okochi M, Tagami S, Morihara T, et al. Laughter and humor as complementary and alternative medicines for dementia patients. BMC Complement Altern Med. 2010; 10(1):28. DOI: 10.1186/1472-6882-10-28.

18. Ko YJ, Hyun MY. Effects of laughter therapy on pain, depression, and quality of life of elderly people with osteoarthritis. J Korean Acad Psychiatr Ment Health Nurs. 2013; 22(4):359–367. DOI: 10.12934/jkpmhn.2013.22.4.359.

19. Ministry for Health, Welfare and Family Affairs. Case management for frail elderly [internet]. Seoul: Ministry for Health, Welfare and Family Affairs;2008. cited 2009 January 20. Available from:http://www.mohw.go.kr/front_new/index.jsp.

20. Sun WD, Lee SH, Park JS, Bae SS, Cho YH, Kim CB, et al. Analysis of the effects of muscle strength exercise on physical function and quality of life in the frail elderly. Korean J Health Educ Promot. 2008; 25(1):39–53.

21. Bennett MP, Lengacher C. Humor and laughter may influence health: II. Complementary therapies and humor in a clinical population. Evid Based Complement Alternat Med. 2006; 3(2):187–190.

22. Fox PC. Management of dry mouth. Dent Clin North Am. 1997; 41(4):863–875.

23. Redman RS. Development of the salivary glands. In : Sreebny LM, editor. The salivary system. Boca Raton, FL: CRC Press;1987. p. 2–17.

24. Billings RJ, Proskin HM, Moss ME. Xerostomia and associated factors in a community-dwelling adult population. Community Dent Oral Epidemiol. 1996; 24(5):312–316.

25. Lee JY, Lee YO, Kho HS. Reliability of a questionnaire for evaluation of dry mouth symptoms. Korean J Oral Med. 2005; 30:383–389.

26. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009; 41(4):1149–1160. DOI: 10.3758/BRM.41.4.1149.

27. Sun WD, Kim HR, GO SJ, Lee SY, Kim DJ, Kim CW, et al. The correspondent strategy development of healthcare services for older persons with a view to health status cycle [internet]. Seoul: Korea Institute for Health and Social Affairs;2014. Cited 2015 August 25. Available from: http://www.repository.kihasa.re.kr:8080/handle/201002/13740.

28. Jung YH, Ko S, Kim EJ. Report No: 2013-31-19. A study on the effective chronic disease management. Research report. Seoul: Korea Institute for Health and Social Affairs;2013. 12.

29. Kim MK, Jung HM, Park GJ. Subjective xerostomia and jaw functional limitation related quality of life of the elderly. Korean J Health Serv Manag. 2014; 8(1):87–102.

30. Kim MH, Kim KW, Lee KS. Association between oral health and oral health-related quality of life among the elderly. J Dent Hyg Sci. 2014; 14(4):488–494. DOI: 10.17135/jdhs.2014.14.4.488.

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