Oral care support system

Abstract

To provide a system for specimen tests and oral care support for maintaining and improving oral health conditions.SOLUTION: A specimen test includes, in test items, a test relating to oral bacteria or Candida, and a blood test relating to saccharometabolism. There is provided an oral care support service capable of maintaining and improving oral health conditions of a subject by analyzing specimen test results including, in test items, the test relating to oral bacteria or Candida, and the blood test relating to saccharometabolism, and various types of information of the subject.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present invention provides a blood test that can estimate the state of glucose metabolism in the body, which is increasingly known to be related to at least oral health, and a test that utilizes an antigen-antibody reaction to identify bacterial species and strains that may affect oral health. By implementing the test of the present invention in a blood test that is commonly performed as part of general health management, maintenance, and improvement, or medical treatment, it is possible to support the maintenance and improvement of the oral health of the general public. Furthermore, the present invention relates to an oral care support system that provides the test results to dental medical institutions and institutions that provide dental health guidance, enabling effective treatment and guidance on maintaining and managing oral health. Furthermore, by providing information on the state of the subject's oral function and information useful for maintaining and improving oral function, it is possible to maintain and improve the subject's oral health and even maintain and improve the subject's quality of life. [Background technology]

[0002] It is becoming increasingly clear that maintaining and improving oral function is essential for maintaining and improving people's quality of life. In particular, with the rapid aging of the population, which leads to a significant decline in oral function, there is an increasing need to maintain and improve oral health for a wide range of age groups, including younger people, in order to maintain and improve future oral function. Maintaining and improving oral health is a prerequisite for maintaining and improving oral function. The Japanese government also states that "periodontal disease does not produce clear subjective symptoms in the early stages, and by the time symptoms such as loose teeth and purulent discharge from the gums appear, it is often difficult to prevent tooth loss, even with dental health guidance and dental treatment. Therefore, periodontal disease screening is essential to prevent tooth loss, and it is important to detect periodontal disease early so that appropriate dental health guidance and dental treatment can be received." Therefore, "maintaining oral health and chewing significantly impacts independence, including speaking, maintaining posture, chewing, and swallowing, and is also expected to have an effect on preventing the need for nursing care." For this reason, the government is currently conducting periodontal disease screening for people aged 40, 50, 60, and 70, based on the idea that "improving and maintaining oral function and oral health can be expected to maintain and improve quality of life in old age." However, the current situation is that dental disease screening has not been widely implemented, with estimated national attendance rates of 1.27% in 2000, 2.74% in 2005, 3.34% in 2010, and 4.30% in 2015, indicating that dental disease screening is almost never implemented. Furthermore, even dental screening, which is simpler than periodontal disease screening, only accounts for approximately half (52.9%) of those aged 20-79. This is particularly true for men, with attendance rates of 43.3% for those aged 20-29, 44.6% for those aged 30-39, and 49.4% for those aged 40-49 (National Health and Nutrition Survey (2016)). In order to resolve the above issues, the government announced in May 2022 that it would begin considering whether to include in its "Basic Policy" for economic and fiscal management a policy to introduce a "universal dental checkup" system that would make annual dental checkups mandatory for all citizens, and measures to make this a reality will be taken in the future.

[0003] Periodontal and dental examinations require at least 20–40 minutes per subject, as they involve professional dentists and dental hygienists assessing the condition of each subject's teeth, gums, and plaque through visual observation and testing with instruments and reagents. To successfully conduct these examinations, it is necessary to secure a sufficient number of specialists to cover the number of subjects, as well as to provide specialized equipment and tools, such as examination chairs equipped with a device capable of irradiating the oral cavity with visible light, an environment allowing for mouth rinsing, and specialized instruments. Accommodating a large number of subjects requires a large examination venue, which contributes to the widespread implementation of these examinations. Furthermore, dental examinations typically cost around 5,000 yen per subject, even for basic examinations. Implementing dental examinations for the entire population would require a huge amount of funding. Furthermore, funding is a major challenge, as examinations are preferably conducted approximately once a year. With regard to the burden of implementation costs, the national budget and health insurance budget are already in a tight spot, making it difficult to raise all the costs. If the costs were to be borne by the subjects, it is unlikely that subjects would be willing to bear the large costs to undergo regular checkups, considering that the test is not directly related to life and that personal incomes below the middle class are declining significantly. Therefore, even if a universal dental checkup system were enacted, it can be predicted that major challenges would be resolving and realizing the shortage of experts, the testing environment (testing locations, equipment, etc.) required to implement universal dental checkups, and finding the large amount of funding required to implement the program.

[0004] Meanwhile, in order to provide information on bacteria that are believed to cause periodontal disease, a test has been proposed that uses markers to identify specific bacteria contained in samples collected from the oral cavity (Patent Documents 1 and 2). This test can accurately determine the presence or absence in the oral cavity of specific bacteria that are said to be the causative bacteria of oral infections in a broad sense, such as periodontal disease. However, because the diagnosis of periodontal disease is carried out by checking the condition of the periodontal tissues and the degree of inflammation based on diagnostic criteria, the test is only carried out by a select few dentists who need to obtain reference information when treating periodontal disease. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] International Publication No. 2004 / 106541 [Patent Document 2] International Publication No. 2000 / 039583 Summary of the Invention [Problem to be solved by the invention]

[0006] In recent years, it has become increasingly known that oral hygiene can have adverse effects on systems other than the oral cavity, such as systemic diseases, and can reduce quality of life, especially in the elderly. Therefore, maintaining and preventing the decline of oral function associated with aging, and improving and maintaining the state of the oral cavity, which is closely related to oral function, to a healthy state are becoming major issues in today's aging society. Meanwhile, due to factors such as the testing environment and the costs involved, examinations to assess oral health, such as periodontal disease checkups and dental checkups, are not widely conducted among the general public. Therefore, it is necessary to regularly assess oral hygiene status using methods that eliminate these obstacles to implementation, and to improve, maintain, and manage oral health. [Means for solving the problem]

[0007] In light of the above-mentioned circumstances, and as a result of extensive research, the present invention aims to provide a specimen test that can assess oral health status and contribute to improving and maintaining the oral health of the general public without imposing significant burdens of effort and expense on subjects and testers. Specifically, the system performs one or more test items selected from the group consisting of nucleic acid tests, antigen tests, and antibody tests for oral bacteria and Candida that may affect oral health status, as well as blood tests such as blood glucose and hemoglobin A1c levels. The results of these specimen tests are used to predict the subject's oral health status and to identify subjects who require dental treatment, periodontal disease screening, dental checkups, and dental health guidance. By communicating these test results and prediction information to subjects and those requesting the tests, it is possible to treat oral disease at an early stage, implement effective preventive measures to prevent oral disease and oral problems, and regularly provide optimal dental treatment and dental health guidance. The present invention provides a specimen test and oral care support system that makes these achievements possible. [Effects of the Invention]

[0008] The present invention can be performed in conjunction with blood tests during health checkups and medical procedures, which have traditionally been widely performed among the general public. This eliminates the need for significant burdens on subjects and test administrators in terms of environmental preparation, labor, and cost, making it highly feasible for widespread implementation. Therefore, implementation of the present invention can contribute to the early improvement and maintenance of the oral health of the general public. Furthermore, because it is possible to predict subjects who require dental examinations, checkups, and dental health guidance, specialized medical treatments can be provided only to a subset of at-risk subjects, rather than to the entire population. This provides benefits equivalent to or greater than those achieved by conducting periodontal disease and dental checkups on all subjects, while achieving simplicity and significant cost savings. Therefore, implementation of the present invention enables the implementation of periodic examinations that are as effective as national dental checkups, enabling accurate and efficient oral hygiene education and medical treatments for subjects who require dental treatment, dental health guidance, and other educational activities to improve dental hygiene. In addition, in the prevention and treatment of oral diseases, etc., various information for each subject that may affect oral health status and oral treatment can be communicated to medical professionals such as dentists, so it can be used as a reference when considering effective treatments and prognosis care methods, and it can enable dental health guidance to be optimal for each subject. Furthermore, because it can easily grasp the oral health status of patients even in medical institutions that do not have an oral care department, it is expected that appropriate measures will be taken in medical fields other than oral care in terms of improving the effectiveness of treatment and postoperative prognosis. [Brief explanation of the drawings]

[0009]

Figure 1

Figure 2

Figure 3

[0010] That is, the present invention includes the following inventions. Item 1: Specimen tests that include one or more tests selected from the group consisting of nucleic acid tests, antigen tests, and antibody tests related to oral bacteria and / or Candida, and one or more tests selected from the group consisting of blood glucose level measurement, hemoglobin A1c level measurement, oxidized HDL level measurement, and high-sensitivity CRP test. Item 2: At least one of the oral bacteria 牙龈卟啉单胞菌 The specimen test according to item 1, comprising: Item 3: At least two or more different types of oral bacteria 牙龈卟啉单胞菌 The specimen test according to item 2, wherein the strain is Item 4: A specimen test according to any one of Items 1 to 3, which provides information about the subject's oral cavity in addition to the results of the test items. Item 5: A specimen test according to Item 4, wherein the information about the subject's oral cavity includes information contained in any of information about oral health status, information about risk factors in oral health, information about oral hygiene, and information about recommended oral care products. Item 6: A specimen test according to any one of Items 4 or 5, wherein the information relating to the subject's oral cavity includes information relating to dental health guidance. Item 7: A specimen test according to any one of Items 1 to 6, wherein the test related to oral bacteria and / or Candida includes two tests: an antibody test and either a nucleic acid test or an antigen test. Item 8: An oral care support system that uses the results of one or more tests selected from the group consisting of nucleic acid tests, antigen tests, and antibody tests related to oral bacteria and / or Candida, and either of the information in (i) and (ii) below, to create information useful for improving or maintaining the subject's oral cavity in a healthy state, and provides the results and the created useful information to the subject. (i) Information on the results of specimen tests, including blood tests that include at least one or more of the following test items: blood glucose level measurement, hemoglobin A1c level measurement, oxidized HDL level measurement, and high-sensitivity CRP test. (ii) Subject information including at least one or more of the following: general attribute information such as the subject's own sex, age, height, weight, waist circumference, BMI, waist-to-hip ratio, medical history information of blood relatives, self-awareness of oral and general health conditions, medical history information, oral hygiene habits, actual information on dietary, lifestyle, exercise, drinking, and smoking habits, sleep behavior information, and psychological state information. Item 9: An oral care support system that creates useful information for improving or maintaining a healthy oral cavity of a subject by utilizing specimen test result information from one or more tests selected from the group consisting of nucleic acid tests, antigen tests, and antibody tests related to oral bacteria and / or Candida, and information from one or more of the information items included in (i) and (ii) below, and provides at least the created useful information and specimen test result information to the person requesting the test and / or the subject. (i) Information on the results of specimen tests, including blood tests that include at least one or more of the following test items: blood glucose level measurement, hemoglobin A1c level measurement, oxidized HDL level measurement, and high-sensitivity CRP test. (ii) Subject information including at least one or more of the following: general attribute information such as the subject's own sex, age, height, weight, waist circumference, BMI, waist-to-hip ratio, medical history information of blood relatives, self-awareness of oral and general health conditions, medical history information, oral hygiene habits, actual information on dietary, lifestyle, exercise, drinking, and smoking habits, sleep behavior information, and psychological state information. Item 10: At least one of the oral bacteria 牙龈卟啉单胞菌 Item 10. The oral care support system according to any one of items 8 and 9, comprising: Item 11: At least two different types of oral bacteria or two or more different types of oral bacteria 牙龈卟啉单胞菌 Item 11. The oral care support system according to Item 10, comprising a strain of bacteria. Item 12: The oral care support system according to any one of items 8 to 11, further comprising one or more evaluations from the group consisting of: understanding and evaluation of oral function and oral condition using images and videos of the oral cavity; evaluation of oral function using videos including the head during chewing and / or vocalization and chewing sounds; and oral diadochokinesis. Item 13: An oral care support system according to any one of items 8 to 12, which stores some or all of the test results of the specimen test and information necessary for maintaining and improving the subject's oral cavity in a healthy state, created from the test results of the specimen test, in an electronic medical record or a database used for the subject's health management, and uses it to support medical procedures in the dental and oral surgery fields and to support the subject's oral health management. Item 14: The oral care support system according to any one of items 8 to 13, wherein the information useful for improving or maintaining the subject's oral cavity in a healthy state includes determining whether the subject needs dental health guidance and communicating the results of the determination to the subject.

[0011] The oral bacteria that are the subject of testing in the present invention refer to bacteria present in the oral cavity and throat, which are said to number more than 400 to 800 species. The types of bacteria that constitute the normal oral flora vary from subject to subject, and even within a given subject, they are known to fluctuate depending on age, oral hygiene status, systemic diseases, metabolism, and other factors. While the presence or absence of periodontal disease, caries, and other conditions is determined during dental checkups and dental treatments, the technology of the present invention not only provides a simple method for predicting these conditions, but also provides information that can be used to estimate oral infection risks, such as the risk of oral infection contraction and recurrence, and the likelihood of oral infection becoming severe, as well as the presence and extent of constitutions that make standard oral infection treatments and preventative measures less effective. Therefore, the oral bacteria that are the subject of specimen testing in the present invention are preferably bacteria known to affect oral health, and it is even more preferable to target bacteria that may affect the onset and progression of disease. In addition to bacteria, fungi such as Candida albicans ( 白色念珠菌) is also known as a causative bacterium of oral infections, so it is preferable to test for it. Examples of bacteria that can have a negative impact on oral health include the bacteria known as the red complex, which is associated with periodontal disease. 牙龈卟啉单胞菌 (Porphyromonas gingivalis), 具核梭杆菌 (Treponema denticola), 福赛坦纳菌 In addition to three types of bacteria from Tannerella forsythia, 伴放线聚集杆菌 (Aggregatibacter actinomycetemcomitans: former scientific name is 放线放线杆菌 ), known as the orange complex, 中间普氏菌 (Prevotella intermedia), 结节真杆菌 (Eubacterium nodatum), 具核梭杆菌 (Fusobacterium nucleatum), 多形梭杆菌 (Fusobacterium polymorphum), 变黑普氏菌 (Prevotella nigrescens), 微小消化链球菌 (Peptostreptococcus micros), 直肠弯曲菌 (Campylobacter rectus), 昭和弯曲菌 , 纤细弯曲菌 (Campylobacter gracilis), 星座链球菌 (Streptococcus constellatus), etc. Other bacteria known to have a direct or indirect relationship with dental caries include: 变形链球菌 (Streptococcus mutans), 远缘链球菌 (Streptococcus sobrinus), 内氏放线菌 (Actinomyces naeslundii), 黏性放线菌 (Actinomyces viscosus), 溶齿放线菌 (Actinomyces odontolyticus), 口腔放线菌 (Actinomyces oris), and others known to be associated with dental plaque formation. 马氏棒状杆菌 (Corynebacterium matrcorti), known to be associated with jaw actinomycosis 衣氏放线菌 (Actinomyces israelii), known to be associated with invasive infections in the elderly 无乳链球菌 (Streptococcus agalactiae), etc.

[0012] "Related to oral bacteria or Candida" means that the subject of the specimen test is nucleic acid, antigen, and antibody derived from oral bacteria or Candida, or nucleic acid, antigen, and antibody showing reactivity equivalent to the genes, antigens, and antibodies derived from the above. Specifically, in the case of nucleic acid testing, the subject of the specimen test is nucleic acid corresponding to each of all oral bacteria and Candida to be tested; in the case of antigen testing, the subject of the specimen test is antigen corresponding to each of all oral bacteria and Candida to be tested; in the case of antibody testing, the subject of the specimen test is antibody corresponding to each of all oral bacteria and Candida to be tested, or substance showing reactivity equivalent to those.

[0013] The testing methods that can be used for nucleic acid testing are not particularly limited as long as they utilize nucleic acids, and the optimal method can be adopted depending on the purpose of the test. Examples include conventional PCR, real-time PCR, reverse transcription PCR, nested PCR, hot start PCR, multiplex PCR, quantitative PCR, quantitative real-time PCR, touchdown PCR, inverse PCR, GC-rich PCR, 2-step PCR, loop-mediated isothermal amplification, digital PCR, multiple displacement amplification such as whole genome amplification, strand displacement amplification, nicking enzyme amplification reaction, helicase-dependent amplification, recombinase polymerase amplification, strand-invasion based amplification, nucleic acid sequence based amplification, transcription mediated amplification, etc.

[0014] The antigens tested in antigen tests refer to the bacterial body itself, parts of the bacterial body, and compounds derived from bacteria that have an antigenic structure. When simultaneously testing for antigens related to two or more bacteria, antigen tests are performed using a combination of antibodies corresponding to each bacterium. In this case, it is desirable that the antibodies used for each antigen test do not substantially cross-react with other bacteria contained in the sample. Here, "does not substantially cross-react" means that, as long as it is possible to distinguish the presence of antigens of each of the bacteria being tested, even if some cross-reaction occurs, it is considered to be no cross-reaction.

[0015] The antibodies tested in antibody tests refer to proteins that specifically bind to antigens produced by antigenic stimulation with the bacterial cells themselves, parts of the bacterial cells, and compounds derived from the bacteria. Test antigens that react with antibodies include the bacterial cells themselves, parts of the bacterial cells, and compounds derived from the bacteria, as well as antigen peptides and combinations thereof that have similar reactivity. When testing for antibodies associated with two or more bacteria, an antigen-antibody reaction is used, utilizing antigens with distinct antigenic structures corresponding to each antibody. In this case, it is desirable to have no substantial cross-reactivity between the individual antigen-antibody reactions or with antibodies against other bacteria contained in the sample. Here, "no substantial cross-reactivity" means that, as long as the presence of antibodies to each of the tested bacteria can be distinguished, even if some cross-reactivity occurs, it is considered to be no cross-reaction. Furthermore, while antibody tests can be qualitative tests that determine the presence or absence of antibodies, tests that can measure antibody titers are preferred, as this provides information that can be used to infer the degree and timing of infection.

[0016] One or more tests selected from the group consisting of nucleic acid testing, antigen testing, and antibody testing can be selected appropriately depending on the purpose of the test. Preferably, at least one of nucleic acid testing or antigen testing, along with antibody testing, is performed. Both nucleic acid testing and antigen testing can determine the presence of oral bacteria, Candida, or their fragments in the test sample at the time of testing. Because the former detects the presence of nucleic acids, while the latter detects the presence of antigens, the results of the two tests cannot be said to be completely consistent. Therefore, analysis of test results must take into account the principles of the test being performed and the specific test conditions. Nucleic acid testing and antigen testing also differ in terms of detection accuracy and test time. In nucleic acid testing, methods utilizing EMA (ethidium bromide monoazide) or PMA (propidium monoazide) can identify the possible presence of live bacteria. Therefore, when conducting a test, the optimal method or methods should be selected based on a comprehensive consideration of the test purpose, test costs, and test environment. On the other hand, antibody tests can determine whether a subject has been infected with oral bacteria or Candida in the past, and whether the infection is still ongoing. Even if an antibody test identifies a suspected infection, the site of infection may be outside the oral region, so a simple judgment cannot be made based on the information from these tests alone. However, by combining and considering the information from these tests with other information, it is possible to understand the subject's condition, including their infection history.

[0017] The test samples used for nucleic acid, antigen, and antibody tests can be the same or different, but they must be collected at the same time. While sampling on the same day or even several days apart is considered "same time," sampling on the same day is preferable. Different sampling times are undesirable because they may alter the subject's condition and make it difficult to accurately ascertain the subject's information. It is most preferable to collect all test samples for all test items during health checkups or blood tests at medical institutions. Test samples can be obtained by venous blood collection or collection from the oral cavity, throat, or oral tissue. Of these, blood, blood components, or exudates collected from veins or oral tissue are preferred for antibody testing. On the other hand, the test samples used for nucleic acid and antigen tests can be the same as those used for antibody testing, but samples collected from the oral cavity are preferred. Oral samples include blood (including blood components), gingival crevicular fluid, dental plaque, tongue coating, and saliva. Although specimen test samples containing a mixture of these substances are acceptable, it is preferable to use samples that are as free of contamination as possible, as this may impair the accuracy of the analysis of the test results. Furthermore, if there is a possibility of contamination, it is most preferable to attach as much detailed information as possible to the collected specimen, such as the circumstances at the time of collection and the possibility of contamination, so that the analysis of the test results can be easily performed. Furthermore, specimen test samples can be appropriately selected depending on the purpose of the test, but if information on periodontal tissues is desired, samples containing at least one of gingival crevicular fluid, dental plaque, and saliva are preferred, with gingival crevicular fluid and / or dental plaque being preferred, and gingival crevicular fluid being most preferred.

[0018] The test results for nucleic acid tests and antigen tests include the species and number of bacteria detected, their proportion of the total (ratio to the number of remittances), and the types detected in specific strains, and can be selected appropriately from these to provide the test results, taking into account the purpose of the test.The test results for antibody tests include the presence or absence of antibodies derived from specific species or strains and their antibody titers (neutralizing antibody titers, agglutinating antibody titers, etc.), and can be selected appropriately from these to provide the test results, taking into account the purpose of the test.Furthermore, by comprehensively examining the test results (combinations of bacterial species and their proportions, detected test items and test samples, etc.), inferences can be made regarding the health status of the oral cavity and can be included in the test results. Examples of patent publications that describe technologies related to these include JP 2009-52945 (method for testing or diagnosing periodontal disease using immunochromatography), JP 2022-96817, JP 2022-96815, JP 2022-96814, JP 2022-96812, and JP 2017-111095 (all of which are technical information related to measuring antibody titers against periodontal pathogens), but are not limited to these descriptions.

[0019] Regarding periodontal disease, among the bacteria species called Red Complex, 牙龈卟啉单胞菌By comprehensively assessing the results of the presence or absence of detection of Porphyromonas gingivalis, the number of bacteria, their presence ratio to the total number of bacteria, the test items detected, the type of test sample, etc., it is possible to determine the possibility of disease and the risk of susceptibility to disease. In addition, it is preferable to take into account information about the subject, such as the results of the subject's interview, information obtained from various information collection terminals and their analysis results, and information about the subject, such as past treatment history, as this will allow for more accurate risk assessment. Specifically, judgments can be made by appropriately selecting and taking into account antibody titers, blood glucose levels, hemoglobin A1c levels, oxidized HDL levels (evaluation of caries risk, periodontal disease severity, and oral hygiene status: disclosed in Patent Publication Nos. 2022-171275, 2022-171263, and 2022-171272, etc.), blood test items such as the preference CRP test, BMI (Body Mass Index) values, the presence or absence of live bacteria in oral tissues, information on the subject's oral condition and awareness and consciousness regarding oral care, whether or not dental implants have been performed, intestinal bacterial flora information, information related to the subject's lifestyle (information on actual oral care behavior, dietary patterns, and lifestyle patterns (preferably including information obtained using an information acquisition device and the results of analyzing that information), whether or not the subject has a smoking habit, etc.). In these specific cases, antibody titers can suggest the possibility of trace amounts of live bacteria being present in the oral tissues, blood test items such as blood glucose levels, hemoglobin A1c levels, and oxidized HDL levels can suggest the likelihood of an inflammatory reaction occurring, and since the presence of dental implant sites makes it relatively easy for infection to spread deep into the periodontal tissues, making people more susceptible to severe periodontal disease, and high-sensitivity CRP test results can suggest the possibility of a strong inflammatory reaction in the periodontal tissues, it is most preferable to carry out an appropriate combination of these test items. To further improve test judgment, 牙龈卟啉单胞菌 It is advisable to also consider test information on bacterial species other than Porphyromonas gingivalis. Specifically, among the bacterial species known as the Red Complex, 牙龈卟啉单胞菌 Other than (Porphyromonas gingivalis) 具核梭杆菌 (Treponema denticola), 福赛坦纳菌 Two types of bacteria from Tannerella forsythia, 中间普氏菌(Prevotella intermedia), 伴放线聚集杆菌 It is preferable to appropriately select one or more species selected from Aggregatibacter actinomycetemcomitans, and it is even more preferable to select all of these bacterial species. Furthermore, by considering the above information in addition to the test results information that can obtain specific bacterial strain information, it is possible to provide useful information for selecting an effective and efficient periodontal disease treatment method. Another example is when gingival crevicular exudate is used as a test sample. 中间普氏菌 If a large number of Prevotella intermedia bacteria are detected, it suggests the possibility of periodontal disease. In particular, if the subject is an adolescent, it strongly suggests the possibility of adolescent gingivitis, and if the subject is pregnant, it strongly suggests the possibility of pregnancy gingivitis. 中间普氏菌 In addition to (Prevotella intermedia), 具核梭杆菌 Fusobacteria such as Fusobacterium nucleatum 具核梭杆菌 If spirochetes such as Treponema denticola account for a large proportion of the total number of bacteria detected, it is possible that the patient is suffering from (acute) necrotizing ulcerative gingivitis. (Acute) necrotizing ulcerative gingivitis differs from ordinary gingivitis in that it is accompanied by serious symptoms such as soft tissue necrosis, rapid periodontal destruction, and interproximal bone loss. Therefore, it is preferable to detect it at an early stage using the test of the present invention and take appropriate measures.

[0020] Regarding dental caries, 变形链球菌 Streptococcus mutans is widely known as the causative bacterium, but there are also other bacteria, 远缘链球菌 (Streptococcus sobrinus), 唐氏链球菌 (Streptococcus downei), Streptococcus rattus, Actinomyces naeslundii (Actinomyces naeslundii), Actinomyces viscosus (Actinomyces viscosus), Actinomyces odontolyticus (Actinomyces odontolyticus), Actinomyces oris The presence of Actinomyces oris is also considered to be one of the factors that cause dental caries, and is therefore a factor in risk assessment. In addition, when dental plaque is used as a test sample, the ratio of the total number of bacteria detected in the plaque to the total number of bacteria detected in the plaque is Streptococcus sanguis (Streptococcus sanguinis: former scientific name Streptococcus blood ) and the abundance ratio (A) of the number of bacteria Streptococcus mutans It is said that the relationship between the ratio (B) of the number of bacteria (Streptococcus mutans) present (for example, the B / A ratio) is closely related to the occurrence of caries sites in the oral cavity (for example, if the B / A ratio is around 1-2, it can suggest the possibility of pre-caries, and if it shows a value higher than that, it suggests the possibility of caries occurring). Therefore, although it is not a bacterium that causes caries, Streptococcus sanguis (Streptococcus sanguinis) can also be included in specimen testing when the purpose is to assess caries risk.

[0021] It is known that the types of bacteria adhering to the tooth surface change during the process of dental plaque formation. Therefore, when dental plaque is used as a test sample, the stage of the plaque formation process and the risk of deterioration of oral health and oral disease can be estimated by examining the main bacterial species detected. Specifically, Streptococcus gordonii (Streptococcus gordonii), Oral Streptococcus (Streptococcus oralis), Streptococcus milius (Streptococcus mitis), Actinomyces naeslundii (Actinomyces naeslundii), Fusobacterium nucleatum (Fusobacterium nucleatum), Prevotella nigrescens (Prevotella nigrescens), Porphyromonas pastoris (Porphyromonas pasteuri), Veillonella dispar (Veillonella dispa), Veillonella small (Veillonella parvula), Aggregatibacter actinomycetemcomitans (Aggregatibacter actinomycetemcomitans), Prevotella intermedia (Prevotella intermedia), Porphyromonas gingivalis (Porphyromonas gingivalis), Treponema denticola Based on the presence of bacteria such as Treponema denticola and the ratio of their numbers to the total, it is possible to estimate the maturity of dental plaque, the risk of oral disease, and the presence or absence of unpleasant symptoms such as bad breath. Corynebacterium matruchotiiCorynebacterium mattorkoti is known to be deeply involved in the formation of tartar through the calcification of dental plaque by depositing calcium phosphate within its cells, and can provide useful information from the perspective of tartar adhesion and tartar prevention, making it a suitable target for specimen testing when the purpose includes risk assessment for tartar and tartar-related periodontal disease and caries. Furthermore, plaque adhering to the tooth surface above the edge of the gums (supragingival plaque) can provide useful information for assessing the risk of caries and periodontal disease, while plaque adhering to the tooth surface below the edge of the gums in the area known as the periodontal pocket (supragingival plaque) can provide information useful primarily for assessing the risk of periodontal disease.

[0022] In addition, elderly people, people with dry mouth, people taking steroid medication or chemotherapy, and people who wear dentures may have test samples taken from their mouths. Candida albicans If Candida albicans is detected, it can be inferred that the patient is suffering from oral candidiasis or that they may be suffering from it. In addition, nucleic acid tests, antigen tests, and antibody tests on test samples taken from periodontal tissues can Streptococcus constellatus (Streptococcus constellatus) and Prevotella intermedius If test results suggest a mixed infection with (Prevotella intermedias), it can be inferred that a closed abscess may have occurred in the oral cavity, and therefore specimens can be tested if the purpose is to assess the risk of closed abscess.

[0023] The information about the subject's oral cavity that can be provided in addition to the test item results is not limited to information related to periodontal disease, caries, dental plaque, etc. For example, it may include information on the living body related to tongue coating that causes bad breath, glossitis, taste abnormalities, etc., recommendations for dental treatment when it is suspected that there is a possibility of a disease requiring medical treatment, recommendations for dental health guidance when poor dental hygiene is suspected, and information useful for improving, maintaining, and managing oral health, such as providing various information on maintaining and improving oral health, recommending oral care products, and how to use them correctly.

[0024] The present invention can also provide dentists, dental hygienists, and other professionals with information useful for dental checkups, dental health guidance, and dental treatment. Currently, most people do not visit dental medical institutions unless they experience serious conditions such as oral pain or swelling. Few people regularly visit dental medical institutions for preventive oral health maintenance, which is considered desirable from the perspective of oral care. Tooth and alveolar bone loss, recession, and severe periodontal pocket formation are often difficult to restore to their original state, and medical treatments for these conditions aim to maintain the current state without worsening the condition. In particular, periodontitis, an advanced stage of periodontal disease, often requires a long period of time for treatment to be effective due to chronic inflammation and alveolar bone resorption. Therefore, if a subject's oral condition is severely deteriorated when they first visit a dental medical institution, tooth loss may not be prevented, leading to eating disorders, a decline in quality of life, malnutrition, and the progression of dementia. Therefore, in oral health management, it is important to implement preventive dental measures, and if a person's health condition deteriorates, it is important to receive examination and treatment from a dental specialist as early as possible. The present invention can solve the above-mentioned problems by conducting antibody tests using blood samples collected at medical institutions that conduct health checkups and blood tests, which are commonly performed for the purpose of systemic health management, to select individuals who are suspected of needing examination by a dental specialist and recommend dental visits. In addition, by providing information on bacterial species that may affect oral health status, as well as blood test results such as blood glucose levels, hemoglobin A1c levels, oxidized HDL levels, and high-sensitivity CRP tests that may affect oral inflammation and its treatment effects, it is possible to provide information useful for selecting appropriate and effective treatment methods, etc., during treatment at dental medical institutions. Furthermore, even if periodontal tissues are diagnosed as healthy by visual observation or other tests, if antibodies to bacteria related to oral infections are detected in blood or gingival crevicular fluid samples, it is possible that oral tissues are in an infection state (asymptomatic infection) that does not cause inflammation.In this state, individuals are infected but exhibit no or only very mild symptoms. Therefore, any trigger, such as minor changes in physical condition or deterioration of oral hygiene, can cause the symptoms of oral infection to progress. Because the individual is already infected, symptoms often progress much more quickly than usual. Furthermore, if the individual is in an early stage and has a systemic condition that can affect disease progression, such as abnormal blood glucose metabolism, there is a risk that not only will the symptoms progress further, but treatment may also be prolonged or even difficult. Therefore, it is essential to take medical measures as early as possible before symptoms progress. Understanding the state of asymptomatic infection allows for early disease treatment and regular preventive measures, contributing to the maintenance and improvement of oral health.

[0025] The present invention can also provide an oral care support system that can provide many subjects with the information necessary to maintain and improve their oral health, improve subjects' oral care awareness and behavior, and contribute to subjects' efficient dental care visits.

[0026] The oral care support system of the present invention collects and stores the results of one or more specimen tests selected from the group consisting of nucleic acid tests, antigen tests, and antibody tests related to oral bacteria or Candida, and the results of at least one blood test of blood glucose level, hemoglobin A1C level, oxidized HDL level, and favorable CRP test value, as well as general attribute information such as the subject's own sex, age, height, weight, abdominal circumference, BMI, waist-to-hip ratio, and medical history information of blood relatives, self-awareness information about oral and general health conditions, treatment history information, actual information about oral hygiene habits, dietary habits, lifestyle habits, exercise habits, drinking habits, and smoking habits, and bedtime behavior information. The system has a support server 1 that records one or more pieces of subject information selected from the following: and psychological state information. It estimates the subject's oral health status and risk of impairment using specimen test results such as nucleic acid tests and either or both of blood test results and subject information. It creates information useful for maintaining or improving the oral health of each individual subject based on the estimated information. It then provides the test results, estimated information, and the created information useful for improving or maintaining the oral health of each subject to subjects and healthcare professionals via a network, either directly or via a testing provider or test requester. Note that information useful for maintaining or improving oral health also includes the offer and actual provision of oral care services and products that businesses can provide to subjects. This system not only enables extremely simple and inexpensive information processing for a large number of subjects, but also effectively identifies subjects with potentially poor oral health who require specialist examinations, screenings, and guidance, or subjects with a high likelihood of poor oral hygiene who require oral health guidance. By providing the necessary medical treatment for subjects based on the provided information, it could potentially serve as a testing system to replace universal dental checkups. The examination system of the present invention is extremely superior in that it can be implemented at a much lower cost, more easily, and more quickly than actually conducting dental examinations for all citizens.

[0027] As shown in FIG. 1 , the oral care support system according to this embodiment includes a support server 1, a terminal 2 for inputting test results, and a terminal 5 for outputting information for communicating test results and the like to subjects, all connected via a network N such as the Internet to transmit and receive various information. The support server 1 is also connected to and communicates with the network N to transmit and receive various information. A computing device 3, which, if necessary, estimates the oral health status of a subject based on test results and other necessary information and selects or creates appropriate information for each subject regarding the maintenance and improvement of their oral health status when the support server is unable to process the information, and an external server 4, which obtains various information other than test results necessary to estimate the oral health status of a subject and various information not stored in the support server but necessary for selecting and creating information to provide to subjects regarding the maintenance and improvement of their oral health status, are also connected via the network N such as the Internet. The external server includes databases utilizing the My Number system, electronic health insurance cards, and electronic medical records managed by medical institutions or specialized institutions. Information on subjects, etc., can be obtained from the external server and utilized. Information obtained or created by the oral care support system of the present invention can also be transferred to the external server and utilized within the system.

[0028] In the oral care support system according to the above embodiment, the support server may be composed of two or more computers. In this case, the constituent computers are connected to each other via a connection means not via the Internet, such as a local network, or via a network N such as the Internet. The connection means may be used in combination or may be mixed within the system. When multiple support servers are present, each support server can be assigned to perform tasks such as recording and data processing (calculation), and data and system backup in an optimal manner for operating the system. When multiple support servers are present, at least one support server 1 must have the function of selecting test results and information useful for improving or maintaining oral health and transmitting the information to a designated terminal. Since test results and subject attribute information are personal information, the less frequently such information is transmitted and received, the better from the perspective of confidentiality. If the data input location is geographically distant from the support server, the information can be recorded on a separate support server 1 connected to the input terminal without using a network such as the Internet. This significantly reduces the number of times personal information is transmitted and received via the Internet, thereby reducing the risk of information leakage. Furthermore, if the useful information generating unit of the processing device of the support server 1 cannot process or cannot handle all the data due to reasons such as processing capacity, a computing device outside the system can be used.

[0029] As shown in Figure 2, the support server 1 is composed of one or more computers each having a processing device 10 with a communication control unit 12 and a storage means 11. Specifically, a conventional, widely used computer device can be used, which is centered around the processing device 10 and includes the storage means 11, the communication control unit 12, and a pointing device, keyboard, display, etc. as input operation means (not shown).

[0030] The processing device 10 is mainly composed of a CPU such as a microprocessor, and has a memory unit consisting of RAM and ROM (not shown) in which programs defining the procedures of various processing operations and processing data are stored. The storage means 11 can be selected from memory inside or outside the support server 1, a hard disk drive (HDD), a solid state drive (SSD), a removable disk exchange system (RDX), a redundant array of independent disks (RAID), etc. Part or all of the contents of the storage unit may be stored in the memory or hard disk of another computer communicatively connected to the support server 1.

[0031] The processing device 10 has two main functions: an "information collection and recording function" that acquires information necessary for system operation and stores it in the storage means of a designated support server; and an "information generation and transmission function" that acquires information necessary for generating test result information to be provided to each subject and information useful for improving or maintaining the subject's oral health from the recording means, creates useful information, and transmits it to the terminal 5, which outputs it. Specifically, each piece of information to be recorded is input from the terminal 2 as it is acquired and recorded in the recording means. In this case, for example, if there are multiple support servers, it is possible to specify a recording means for recording information for each information item to be input, or to specify a recording means for recording information on a subject-by-subject basis. It is desirable to adopt the optimal method for the "information generation and transmission function" that utilizes the recorded information from the perspectives of convenience and prevention of information leaks. When providing information to a subject, the information is provided by generating the test results to be provided and, if necessary, information useful for improving or maintaining the subject's oral health, and then compiling and transmitting this information to the terminal 5. The terminal 5 not only displays and prints the information on a display or the like, but also transfers the information to the subject's computer, smartphone, recording medium, etc. In this case, the terminal 5 of the support system is a computer owned by the subject or a terminal for acquiring information, and information can be sent directly from the support server to the terminal 5, that is, the computer owned by the subject.

[0032] The generation of information useful for improving or maintaining a subject's oral health involves the use of one or more of the following test results: a nucleic acid test, an antigen test, and an antibody test related to oral bacteria or Candida; (i) blood test results including blood glucose or hemoglobin A1c, oxidized HDL, and a high-sensitivity CRP test; and / or (ii) one or more of the following subject information: general demographic information such as the subject's gender, age, height, weight, waist circumference, BMI, waist-to-hip ratio, and medical history of blood relatives; subjective awareness of oral and general health status; treatment history; oral hygiene habits; dietary, lifestyle, exercise, drinking, and smoking habits; sleep behavior; and psychological status information. The subject information listed above has been shown to be related to oral health and can be useful information for estimating a subject's oral health. Past knowledge that can be used as reference includes, for example, factors that may differ from those of normal healthy individuals in the onset and treatment of oral disease, as well as factors that theoretically cannot be ruled out as being related to oral health. Based on these, test results are examined by creating unique assessment schemes and criteria. For example, nucleic acid tests and antigen tests can indicate the presence of live bacteria or parts of bacteria, and these are considered in conjunction with the origin of the test sample. For test samples collected from the oral cavity, knowledge of the relationship between the bacteria detected in the test and oral health status can be used to determine the need for prevention or treatment, the possibility of disease onset, and estimate the subject's risk of disease. Furthermore, if the test sample is collected from oral tissue, the possibility of infection can be estimated, although there is a possibility of contamination with oral bacteria due to the sample collection method. On the other hand, antibody test results can be used to estimate the presence of current or past infection. Meanwhile, blood glucose levels, hemoglobin A1c levels, and oxidized HDL levels are blood indicators that can determine the presence and severity of abnormalities in a subject's glucose metabolism, but they are known to affect the incidence of inflammatory oral diseases such as periodontal disease and the effectiveness of treatment. Furthermore, high-sensitivity CRP tests can detect the occurrence of inflammation even in localized areas such as oral tissue.Therefore, this information can also be useful for estimating the oral health of subjects.

[0033] When there is only one support server 1, the support server 1 is equipped with at least a subject attribute information storage unit that stores the subject attribute information acquired by the subject general attribute information acquisition unit, a test information storage unit that stores the test result information acquired by the test result information acquisition unit, a subject information storage unit that stores the subject information acquired by the subject information acquisition unit, and a useful information storage unit that stores information useful for improving or maintaining the subject's oral cavity in a healthy state, generated by the useful information generation unit. On the other hand, when there are multiple support servers 1, the subject attribute information storage unit, test information storage unit, subject information storage unit, and useful information storage unit must be present in one of the support servers 1. However, for example, multiple support servers 1 may be equipped with all of the storage units, and the storage units can be freely designed according to the actual operation.

[0034] Periodontal disease is a typical oral disease, which not only brings about inconveniences such as bad breath and loss of aesthetic visual condition due to gingival recession, but also causes significant tooth loss, impairment of oral functions such as masticatory function, and influences on systemic diseases such as malnutrition and mental disorders due to the occurrence of eating disorders, which are factors that reduce QOL. Therefore, the oral care support system of the present invention includes one or more test items selected from the group consisting of nucleic acid test, antigen test, and antibody test related to oral bacteria or Candida fungi, and at least Porphyromonas gingivalis It is preferable that the test includes one or more test items selected from the group consisting of nucleic acid test, antigen test, and antibody test related to the above. Porphyromonas gingivalis It is possible that these strains are threatening oral health and causing problems. Porphyromonas gingivalisSome strains of bacteria can be highly pathogenic in periodontal disease, have characteristics such as drug resistance that make standard treatments ineffective, or can contribute to the onset of systemic diseases, so information on bacterial strains is also useful for creating more effective subject information. For this reason, it is most desirable to include test items that target as many bacterial strains as possible.

[0035] In this invention, the "healthy state of the subject's oral cavity" also includes the meaning of "healthy oral function." Therefore, "information necessary to maintain and improve the subject's oral cavity in a healthy state" encompasses "information necessary to maintain and improve the subject's oral function in a healthy state." Oral function involves ingestion (taking food into the mouth), mastication, bolus formation and transport, swallowing, articulation, taste, touch, and saliva secretion, and is a fundamental function necessary for people to live a healthy life in society. Understanding these conditions is extremely useful for the subject. Furthermore, since oral hygiene and diseases such as periodontal disease and dental caries are known to be closely related, understanding both the state of the oral cavity and the state of oral function is extremely important from the perspective of maintaining and improving the subject's quality of life.

[0036] Existing technologies can be used to acquire information about oral function and the condition of the oral cavity. Examples include dedicated terminals for information collection and multipurpose terminals, such as smartphones equipped with dedicated applications and information collection devices. These terminals can transmit acquired information to the terminal 2 used for information input or directly to the support server 1 via a non-Internet connection such as Bluetooth®, infrared communication, or a wired line, or via a network N such as the Internet, and can also acquire information such as instruction information from the network. When collecting information about oral function and the condition of the oral cavity, the information necessary to achieve the purpose of analysis is acquired and stored in digital format, processed as necessary, and then transmitted to the support server 1 or other devices using the aforementioned means. When acquiring information from the subject using the aforementioned terminal, information about the subject's oral function, such as the content and control of the information acquisition operation, may be acquired based on or by utilizing information transmitted from the support server 1 to the terminal for grasping the condition of oral function. The information transmitted from the terminal is finally acquired by the oral function information acquisition unit of the processing device 10, and recorded in the oral function information storage unit of the recording means, as shown in FIG. 3. The information to be recorded may be the information directly acquired by the support server 1 from a terminal for grasping the state of oral function, or secondary information obtained by processing the information acquired from the terminal may be recorded in the oral function information storage unit. Furthermore, the information necessary for maintaining and improving the oral cavity of the subject in a healthy state may be created by the useful information generation unit of the processing device 10 using the information recorded in the oral function information storage unit and the information necessary for information processing, such as information on the subject's oral cavity, subject information, and subject attribute information, and the information created may be recorded in the useful information storage unit of the recording device 11.

[0037] The oral care support system of the present invention can also provide useful information to employees in the health management department of corporations and other organizations whose business is to maintain and promote employee health, as well as to dental healthcare professionals. Currently, dental health guidance is often provided to individuals who dentists or other medical professionals determine are in need of dental hygiene guidance during dental examinations. However, in such cases, oral health is already impaired, which presents a challenge in terms of missed opportunities for preventive dentistry, the primary goal of dental hygiene. Because the present invention facilitates large-scale and regular implementation, by utilizing the oral care support system of the present invention periodically and continuously, such as once a year, it is possible to identify subjects with poor oral health before oral diseases become noticeable. By conducting dental checkups and encouraging selected individuals to visit a medical institution, dental treatment and dental health guidance can be provided at an early stage before their oral health is significantly impaired. Furthermore, in dental medical procedures, detailed information on bacterial infections in the oral cavity and information on the subject's overall condition and behavioral habits that may affect oral health can be provided, allowing dentists and other medical professionals to grasp the above-mentioned reference information before taking necessary measures, enabling them to formulate effective treatment plans and preventive measures for recurrence.

[0038] As described above, subject information in the present invention refers to at least the subject's general attribute information, such as gender, age, height, weight, waist circumference, BMI, waist-to-hip ratio, and medical history information of blood relatives; subjective information regarding oral and general health status; treatment history information; oral hygiene habits; actual information regarding dietary, lifestyle, exercise, drinking, and smoking habits; bedtime behavior information; and psychological state information. This information can be obtained from the subject's self-report, monitoring using a terminal device, or electronic medical records. Self-reporting methods include, for example, subject information from specific health checkups. In specific health checkups, subject information regarding medical history and subjective symptoms is obtained. Since specific health checkups also include blood tests for fasting blood glucose and hemoglobin A1c levels, nucleic acid testing and other tests can be performed using these blood samples, thereby enabling the present invention to be implemented without any additional special measures. Some of the medical history information and subjective symptoms in specific health checkups are obtained through questionnaires or other questionnaires. For example, in addition to medical history, there are generally items such as smoking habits, exercise habits, eating habits, drinking habits, and sleeping habits, and this information can be utilized.

[0039] Methods for understanding and evaluating oral function and the state of the oral cavity are not particularly limited, but examples include the following. Important elements of oral function include chewing and swallowing functions. Examples of methods for understanding and evaluating masticatory function include methods for understanding and estimating jaw and tongue movements from facial video information while the subject is actually chewing, methods for analyzing and understanding the amount of food placed in the mouth, the number of chews from ingestion to swallowing, and chewing speed (number of chews per unit), and methods for understanding and evaluating oral function during eating behavior from video of the movements of the upper body and jaw when putting food into the mouth. Examples of methods for understanding and evaluating swallowing function include analyzing video information around the throat during swallowing to understand the details of the swallowing movement state and evaluate swallowing ability from the displacement of each part of the throat, and methods for understanding and estimating swallowing function by analyzing sound information generated during swallowing. Examples of patent publications that describe related technologies include, but are not limited to, JP 2021-105878, JP 2022-126288, JP 2022-74671, JP 2022-68486, JP 2022-68485, and JP 2022-68483. Another example of a method for understanding and evaluating oral function is oral diadochokinesis. Oral diadochokinesis is a testing method that evaluates the speed and dexterity of movements of the tongue, lips, soft palate, etc. based on pronunciation. For example, by acquiring and analyzing audio information generated when specific sounds such as "pa," "ta," and "ka" are repeatedly pronounced within a certain period of time, this method evaluates the speed and dexterity (skill) of movements of the tongue, lips, soft palate, etc. to understand oral function. Meanwhile, examples of methods for acquiring information to understand and evaluate the condition of the oral cavity include the following. Examples of the condition of the oral cavity include the location and state of plaque, the presence or absence and degree of tongue coating, the presence or absence and degree of tartar, the state of tooth alignment, the state of the gums (surface color; the presence or absence, location and degree of gingival recession; the presence or absence, location and degree of gingival swelling; etc.), the state of dental treatment (treatment location and treatment content, location of missing teeth and dentures, etc.), understanding and estimation of occlusion state, etc. One method of obtaining this information is to obtain and analyze images or videos of the mouth opening.For example, a method can be used in which the photography function of a smartphone is utilized, and images or videos are acquired using photography aids such as an illumination device or an opening device that irradiates the measurement site with light of a specific wavelength, sunlight-like light, ultraviolet light, or other light according to the purpose, as needed.In addition to the above, a method can also be used in which this information is acquired multiple times, and if the information is partially missing at the stage of single information acquisition or if the information is not sufficient for analysis, the insufficient information can be supplemented by comparing it with other information, and then the information can be analyzed. Examples of patent publications that describe technologies related to these include JP 2020-179173, JP 2022-171272, JP 2021-105878, JP 2022-97176, JP 2022-68486, JP 2022-68485, JP 2022-68484, and JP 2022-68483, but are not limited to the contents thereof. Dedicated devices may be used as terminals for acquiring this image information, video information, and audio information, or data collection software may be incorporated into office automation equipment such as smartphones. However, devices that are capable of acquiring the information and have the function of transmitting the acquired information to a support server, etc., are not limited thereto.

[0040] Oral functions other than mastication and swallowing can be understood using the following methods: For example, oral movement information (teeth grinding, chewing, chewing force, swallowing jaw movement range), occlusal force (occlusal pressure) and occlusion condition as occlusal function, masticatory ability, number of chews, and mandibular movement ability as masticatory function, throat movement and swallowing force as swallowing function, tongue movement ability, tongue pressure, blood flow, etc. as tongue function, pH and buffer capacity (ability to maintain pH within a normal range) as saliva condition, saliva secretion amount, dryness of the oral cavity and throat area, calcium ion concentration in saliva, serum antibody titer of oral bacteria, immunoglobulin amount, active oxygen amount, oral stickiness, etc., main gas types and concentrations as halitosis condition, size of interdental embrasure (opening area), tooth surface color, number of remaining teeth as dental condition, color and blood flow as gum condition.

[0041] More specifically, the bite force (bite pressure) of occlusal function can be obtained by measuring myoelectric potential, biting with a piezoelectric sensor, or measuring the myoelectric potential of the jaw or temples. The occlusion state can be obtained by capturing images and analyzing them using AI. Like bite force (bite pressure), chewing ability can be obtained by measuring myoelectric potential, biting with a piezoelectric sensor, or measuring the myoelectric potential of the jaw or temples. The number of chews can be obtained by measuring jaw movement or the myoelectric potential generated during chewing using image analysis, myoelectric potential acceleration, distance sensors, etc. Mandibular movement ability can be obtained from the myoelectric potential when the jaw is moved. Swallowing function and throat movement during swallowing can be evaluated and estimated using the Repetitive Saliva Swallowing Test (RSST), Water Swallowing Test (MWST), Food Test (FT), swallowing sound measurement (cervical auscultation), videofluoroscopic swallowing (VF), endoscopy, electromyography, and photoelectric sensor phase measurement. Swallowing force can be obtained by measuring the electromyography (EMG) generated when the throat moves. Tongue pressure can be measured by holding a probe equipped with a piezoelectric or pressure sensor between the tongue and jaw. Tongue blood flow can be measured by pressing a probe equipped with an SpO2 photoelectric sensor against the tongue. Examples of patent publications that describe related technologies include, but are not limited to, JP 2021-105878 A and JP 2017-515565 A.

[0042] The pH and buffering capacity of saliva can be measured by holding a sensor device equipped with a probe equipped with a pH sensor in the oral cavity, while the amount of saliva secreted and the dryness of the oral cavity and throat can be measured by holding a sensor device equipped with a probe equipped with a capacitance sensor (impedance measurement) in the oral cavity.

[0043] Additionally, the types and concentrations of the main gases that cause bad breath can be obtained by the user blowing their breath into a sensor device equipped with a gas and breath sensor nozzle. The size of the interdental space (opening area), tooth surface color, number of remaining teeth, and gum color can be obtained by color discrimination and image analysis when the user holds a sensor device equipped with a sensor that spectrally analyzes the light absorption pattern of near-infrared light in their mouth. Gum blood flow can be obtained by the user placing a sensor device equipped with an SpO2 sensor in their mouth.

[0044] In addition, the information that the subject information acquisition unit acquires from the user's sensor-equipped terminal (sensor device) that can grasp the actual care status includes tooth brushing patterns, such as the date and time of toothbrushing acquired by a switch signal, brushing time acquired by a timer, brushing area acquired by a gyro sensor, brushing speed acquired by an acceleration sensor, and brushing pressure acquired by a strain gauge or pressure sensor.

[0045] Examples of such sensor devices include terminals equipped with sensors that monitor tissue function levels related to chewing, swallowing, saliva secretion, and tongue movement, occlusion status, chewing or swallowing behavior during eating, or behavior during sleep, toothbrush attachment terminals for the oral care support system described in JP 2017-60661 A, and various oral devices equipped with sensors, such as the GrindCare (registered trademark) terminal for sensor-equipped bruxism (teeth grinding and clenching) prevention products (related patents manufactured by Sunstar Suisse SA; European Patent No. 1610862, U.S. Patent No. 8160689, U.S. Patent No. 9149226, etc.).

[0046] The sensor device can be configured, for example, with a processing device at its core, memory means, input / output unit, image input unit, display / notification unit, and wireless / wired communication unit, and can be a device that obtains biological information, behavioral information, and care behavior information inside and outside the oral cavity and pharynx using the sensors in the input / output unit and the image input unit.

[0047] A device with the following configuration can be used as a means of accurately understanding dental hygiene behaviors such as tooth brushing. Specifically, the device is powered on when the switch is turned on, when the device is removed from the docking station, or when motion is detected by an acceleration or biosensor. Information acquired from the input / output sensors, along with the status of the sensor device (e.g., remaining battery level, usage time, and wearing status), is transmitted from each device to an information terminal, such as a computer or smartphone, owned by the subject via short-range wireless communication (e.g., ANT+, Bluetooth, ZigBee, IrDA, etc.) via a wireless or wired communication unit. When used online, the sensor information is transmitted to the information terminal via short-range wireless communication, and subject information such as tooth brushing behavior, teeth grinding behavior, and heart rate status is transmitted to the information terminal.

[0048] The information acquired by the devices can be sent to the support server 1 or the information input terminal 2 via direct transmission of information from each device equipped with information transmission and reception functions, or via the subject's own computer or smartphone. The system displays biometric information, behavioral information, care behavior information, advice information, and product information from inside and outside the oral cavity and pharynx, as well as information on the subject's attributes, overall health status, and behavioral diary. It also allows for image capture of customer and product information from an image input unit using a built-in camera or barcode reader. Interactive information transmission with the sensor device instantly displays care behaviors and the current condition of the oral cavity and pharynx, and the support server 1 also displays the results of analysis and evaluation based on the information from the device. The system also aims to increase convenience for subjects by appropriately recommending related products based on analysis data and actual usage.

[0049] In addition, information on the device's status (e.g., remaining battery level, usage time, and wearing status) along with sensor information from the sensor device can be received using short-range wireless communication (e.g., ANT+, Bluetooth (registered trademark), ZigBee, IrDA). When used online, for example, sensor information is transferred from the sensor device via short-range wireless communication, and subject information such as tooth brushing behavior, teeth grinding behavior, and heart rate status is sent to an information terminal. Information that requires immediate notification regarding tooth brushing behavior, such as high brushing pressure or fast brushing speed, can be transferred from the information terminal to the sensor device using short-range wireless communication. Data on the analysis and evaluation results displayed after oral care behavior is transmitted to the support server 1 via an internet connection via wireless LAN such as Wi-Fi or wired LAN.

[0050] For example, subjective symptoms of oral conditions acquired through user input include tooth sensitivity, sticky mouth, dry mouth, difficulty swallowing, bleeding gums, poor gum color, misaligned teeth, poor tooth surface color, noticeable gaps between teeth, noticeable bad breath, difficulty chewing, poor bite, and jerky jaw. Institutions that hold information on the function, health status, and actual care status of biological tissues in the oral and pharyngeal regions of the user include medical institutions such as dental clinics, institutions that manage electronic medical record systems, and analytical evaluation institutions that analyze user specimen samples, and such information can be obtained by partnering with these institutions in advance to exchange information.

[0051] The oral care-related information provided includes problems that can arise when using improper toothpaste, toothbrushes, and other products, as well as criteria and methods for selecting appropriate products, information on various oral care products (ingredients information, problems that can arise when used incorrectly and correct methods, etc.), specific optimal oral care methods for a set period of time (for example, one week), oral problems that arise due to differences in age and gender, and those who require care, and how to prevent and deal with them, an introduction to the latest oral-related research, basic knowledge about dentures and implants, common problems that can occur with dentures and how to prevent them, etc.

[0052] In addition, information provided about the relationship between dietary habits and care includes examples of problems caused by eating habits or imbalances, the intake or use of luxury items, and how to deal with them, information about the importance of mastication and problems that tend to arise when masticatory disorders occur, preventive methods to make masticatory disorders less likely to occur, information about the importance of occlusion and problems that tend to arise when occlusion disorders occur, etc. It is also preferable to provide information about the relationship between overall health and oral hygiene.

[0053] In exchange for providing this information, the subject will obtain information on the subject's awareness and actual knowledge status without the user being aware of it as much as possible. Specifically, information is obtained from the user's selection history from a list of free services, or by the user inputting the information required for each service provided. If monitoring information is input in conjunction with product use, a data storage directory will be created for each subject. It is also preferable to perform user registration after product purchase and provide product after-sales service.

[0054] The general attributes of the user that the subject general attribute information acquisition unit acquires from individual terminals 2 or an external server 4 that holds information about the subject include, for example, gender, age, date of birth, height, weight, area of ​​residence, and occupation.

[0055] The health condition acquired by the subject information acquisition unit includes information acquired from the sensor device serving as terminal 2, such as the frequency and number of times of teeth grinding, which is obtained from an electromyography sensor attached to the temples or chin, which indicates the state of the jaw, and information on the body condition, such as height, weight, body fat percentage, electrocardiogram, pulse wave, pulse rate, SpO2 (transcutaneous arterial oxygen saturation), hemoglobin concentration, body temperature, activity level, blood pressure, blood sugar level, bone density, etc., which are obtained from dedicated sensors, and information on intake calories, etc. Information acquired from institutional computers 3, such as those of medical institutions, health insurance institutions, labor unions, and institutions that manage electronic medical record systems, includes the subject's health checkup results, blood donation eligibility and specimen test information, the type and frequency of health foods consumed, information on diseases currently being treated, the presence and type of allergies, and medication information.

[0056] Similarly, the treatment history acquired by the subject information acquisition unit can include information declared by the subject, as well as information acquired from an external system server 4 used by medical institutions, health insurance and labor unions, and institutions that manage electronic medical record systems. Examples of information that can be obtained include past dental checkup history, past history of tartar removal, whether or not fluoride application treatment was performed and the date of treatment, whether or not scaling or root planing treatment was performed and the date of treatment, whether or not dentures are worn and the location where they are worn, the date they were first worn, whether or not implants are worn and the location where they were treated, treatment information (caries treatment, periodontal disease treatment, etc.), oral bacterial serum antibody titer measurement information, occlusion status information, whether or not brushing instruction was given and the date of instruction, the presence of specific oral bacteria (for example, tests that utilize immune response), whether or not occult blood is present (for example, tests that apply the catalytic action of hemoglobin or immune response), the state of the user's oral flora, the type and amount of immunoglobulin in saliva, DNA / RNA analysis of oral mucosa and saliva, quantification of heparanase in saliva, quantification of female hormones in saliva, quantification of ammonia in saliva, quantification of leukocytes in saliva, quantification of tissue destruction markers such as LDH and MMP in saliva, and the type and amount of oxidative stress markers in saliva.

[0057] Similarly, the information on dietary habits acquired by the subject information acquisition unit includes, for example, the number of usual meals, the start and duration of usual meals, and the contents of the meals. It is preferable that this information can be acquired automatically without the subject's declaration using a dedicated device. For example, for information on meal contents that is difficult to provide, it is preferable to use a method such as capturing and sending photos of the meals, which are then analyzed by AI and converted into information on the meal contents. It is also more preferable to acquire as much information as possible about the subject's eating and drinking habits, such as the number of times they eat out, the contents of meals when they eat out, whether or not they have snacks and their contents, and the contents and times of ingestion of beverages consumed.

[0058] Similarly, the lifestyle habits acquired by the subject information acquisition unit are preferably automatically input from various information acquisition devices via an information terminal owned by the subject to the support server 1. Examples of information transmitted from the information terminal to the support server 1 include lifestyle (smoking, drinking, preferences (eating a lot of sweets, etc.)), daily activity diary, types of daily exercise, average exercise time for daily exercise, average bedtime and average wake-up time, and information related to sleep quality.

[0059] The useful information generation unit analyzes the latest and past information stored in the test information storage unit, the subject information storage unit, and the oral function information storage unit, which can grasp the function and health status of biological tissues in the oral cavity and pharyngeal region, the current state of care, and the current state of awareness and knowledge, based on the subject information stored in the subject information storage unit, and selects and generates information useful for maintaining and improving the insurer's oral health at the time the analyzed information is provided. The analysis can be performed based on a predetermined formula, such as multivariate analysis. Preferably, the above information is analyzed using machine learning to analyze past information and useful information provided in the past, and then generated based on inference. This machine learning can be performed using any method, such as deep learning using neural networks.

[0060] The useful information generated by the useful information generating unit preferably includes one or more pieces of information selected from the following pieces of information (i) to (vi): (i) Evaluation information and improvement proposals regarding the subject's oral care status; (ii) General information on the level of functioning of the tissues in the oral and pharyngeal region, the state of oral hygiene, and the possible impact of the presence or absence of oral diseases and their severity on physical and mental health; (iii) Information about the subject's current oral and pharyngeal condition and other possible risks to future oral health status, as well as methods for preventing and improving such risks; (iv) Information about services to maintain or improve the subject's oral function; (v) An assessment of the subject's lifestyle, diet, and exercise habits, and the risks to future oral health that can be predicted from those habits, as well as information on how to improve those habits and support suggestions for maintaining and improving those habits; (vi) Information about sleep behaviors or remedial services that may adversely affect the function or condition of the subject's oral and pharyngeal area.

[0061] Although the embodiments of the present invention have been described above, the present invention is not limited to these examples, and it goes without saying that the present invention can be embodied in various forms without departing from the spirit of the present invention. [Explanation of symbols]

[0062] 1 Support Server 2. Terminal 3. External computing device 4. External servers 5. Terminal 10 Processing equipment 11 Memory means 12 Communication control section

Claims

1. A specimen test to estimate the oral health status of a subject, which includes a nucleic acid test related to bacteria and / or Candida present in the oral cavity and throat, and one or more tests selected from the group consisting of blood glucose level measurement, hemoglobin A1c level measurement, oxidized HDL level measurement, and high-sensitivity CRP test.

2. Bacteria present in the oral cavity and throat include at least Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Streptococcus mutans, Streptococcus sobrinus, Streptococcus downei, and Streptococcus. rattus, Actinomyces naeslundii, Actinomyces viscosus, Actinomyces odontolyticus, Actinomyces oris, Streptococcus sanguinis, Streptococcus gordonii, Streptococcus oralis, Streptococcus mitis, Prevotella nigrescens, Porphyromonas pasteri, Veillonella dispar, Veillonella parvula, Aggregatibacter The sample test of claim 1, wherein the sample contains one or more bacteria selected from the group consisting of actinomycetemcomitans, Corynebacterium matruchotii, and Streptococcus constellatus.

3. The sample test according to claim 2, wherein the bacteria present in the oral cavity or throat include at least Porphyromonas gingivalis.

4. The specimen test according to any one of claims 1 to 3, which provides information about the subject's oral cavity in addition to the results of the specimen test.

5. The specimen test of claim 4, wherein the information regarding the subject's oral cavity includes at least information regarding oral health status, information regarding risk factors in oral health, information regarding oral hygiene, and information regarding recommended oral care products.

6. The specimen test according to claim 4, wherein the information about the subject's oral cavity includes information about dental health guidance.

7. The specimen test according to claim 1, wherein the test sample to be subjected to nucleic acid testing is a blood sample drawn from a vein or a specimen test sample obtained by collection from the oral cavity, the throat, or tissues within the oral cavity.

8. An oral care support system that uses nucleic acid test results information related to bacteria and / or Candida present in the oral cavity and throat and the information in (i) below to create information useful for improving or maintaining the subject's oral cavity in a healthy state, and provides the nucleic acid test results information and the created useful information to the person requesting the test and / or the subject. (i) Blood test results including at least one or more of the following test items: blood glucose level measurement, hemoglobin A1c level measurement, oxidized HDL level measurement, and high-sensitivity CRP test

9. An oral care support system that uses nucleic acid test result information related to bacteria and / or Candida present in the oral cavity and throat and the information in (i) and (ii) below to create information useful for improving or maintaining the oral cavity of a subject in a healthy state, and provides some or all of the nucleic acid test result information and the created useful information to the person requesting the test and / or the subject. (i) Blood test results including at least one or more of the following test items: blood glucose level measurement, hemoglobin A1c level measurement, oxidized HDL level measurement, and high-sensitivity CRP test (ii) Subject information including at least one or more of the following: the subject's own gender, age, height, weight, waist circumference, BMI, waist-to-hip ratio, general attribute information on the medical history of blood relatives, subjective information on oral and general health status, treatment history information, actual information on oral hygiene habits, dietary habits, lifestyle habits, exercise habits, drinking habits, and smoking habits, bedtime behavior information, and psychological state information.

10. Bacteria present in the oral cavity and throat include at least Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Streptococcus mutans, Streptococcus sobrinus, Streptococcus downei, and Streptococcus. rattus, Actinomyces naeslundii, Actinomyces viscosus, Actinomyces odontolyticus, Actinomyces oris, Streptococcus sanguinis, Streptococcus gordonii, Streptococcus oralis, Streptococcus mitis, Prevotella nigrescens, Porphyromonas pasteri, Veillonella dispar, Veillonella parvula, Aggregatibacter 10. The oral care support system according to claim 8, comprising one or more bacteria selected from the group consisting of Actinobacterium actinomycetemcomitans, Corynebacterium matruchotii, and Streptococcus constellatus.

11. 10. The oral care support system according to claim 8 or 9, wherein the bacteria present in the oral cavity or throat include at least two or more different strains of Porphyromonas gingivalis.

12. The oral care support system according to claim 8 or 9, further comprising one or more evaluations from the group consisting of: understanding and evaluation of oral function and oral condition using images or videos of the oral cavity; evaluation of oral function using videos including the head during chewing and / or vocalization and chewing sounds; and oral diadochokinesis.

13. The oral care support system according to claim 8 or 9, wherein the test items further include one or more pieces of information about the oral cavity obtained using the sensor device.

14. An oral care support system as described in claim 8 or 9, in which some or all of the test results of the specimen test and information necessary to maintain and improve the subject's oral cavity in a healthy state, created from the test results of the specimen test, are stored in an electronic medical record or a database used for the subject's health management, and are used to support medical procedures in the dental and oral surgery fields and oral health management of the subject.

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