障害者に対する歯科診療が自律神経機能に及ぼす影響 : 心拍変動解析を用いた評価

autonomic nervous function

北海道歯学会

北海道歯学雑誌

To provide safe dental practices, the monitoring biological reactions is important. The evaluation of autonomic nervous function using heart rate variability analysis is effective to assess a stress status in a non-invasive manner. The purpose of this study was to evaluate changes in autonomic nervous function among patients with severe motor and intellectual disabilities (SMID) during dental practices (ultrasonic scaling and tooth brushing). Subjects comprised of 17 patients with SMID. Heart rate variability analysis and heart rate were measured in 10 patients with SMID during ultrasonic scaling and tooth brushing, using the monitoring system for evaluating autonomic nervous function in real time as follows : R-R intervals of heart rate were divided into high-frequency (HF) and low-frequency (LF) components by power spectrum analysis. HF reflects parasympathetic nervous activity and LF/HF reflects sympathetic nervous activity. The results showed an autonomic nervous function was able to be evaluated in patients with SMID during dental practices in real time. In patients with SMID, the values of LF/HF and HR were higher during dental practices (ultrasonic scaling and tooth brushing). The values of LF/HF during ultrasonic scaling were significantly higher than both before and after treatment. LF/HF is related to stress, and these results suggest that dental practices were a stressor among patients with SMID. It appears possible to easily and non-invasively evaluate changes in autonomic nervous function among patients with SMID during dental practices in real time. The values of LF/HF tended to increase during dental practices.