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Objectives: There is limited evidence of a temporal relationship between periodontal diseases and self‐perceived general health. To plug this knowledge gap, we aimed to assess how periodontal health affects future self‐rated health (SRH). Methods: We collected data from five waves of an annual nationwide Japanese survey of dental patients from 2015 to 2019. The analysis of repeated measurements included 9306 observations from 4242 patients aged 20 years or older. The clinical periodontitis measurements were bleeding on probing, deepest periodontal pocket depth and most severe clinical attachment loss (CAL). We used a self‐administered questionnaire to collect data on sociodemographic characteristics, diabetes history, health behaviour, SRH and self‐reported periodontitis. We applied 2‐level ordered logistic regression models for repeated measurements to examine the relationships between SRH (time t) and 1‐year‐lagged periodontal health (time t‐1) after adjusting for covariates. Results: The percentage of SRH responses recorded at time t as 'good', 'moderate' and 'poor' were 36.9%, 52.4% and 10.7%, respectively. Multivariate analyses showed that the risk of poorer SRH at time t increased in patients with CAL ≥7 mm (odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.02–1.30), those who reported bleeding gums (OR = 1.33, 95% CI = 1.21–1.46) and those who perceived swollen gums (OR = 1.40, 95% CI = 1.26–1.56) at time t‐1. Sensitivity analyses using the 4‐year follow‐up model and 3‐year‐lagged cohort model also showed consistent results. Conclusion: Periodontitis shows a gradual contribution to future SRH in dental patients, even after adjusting for sociodemographic characteristics, general health and health‐related behaviours. [ABSTRACT FROM AUTHOR]

Background: Although statistical associations between tooth loss and cognitive decline have been reported, there are few previous studies on denture wearing. Additionally, it remains unclear whether nutritional status mediates this association. Objective: Our purpose was to test for the hypothesis that the association between the number of teeth and denture wearing with cognitive function is mediated by nutritional status in residents of nursing homes. Materials and Methods: We enrolled 162 participants who required long‐term care (mean age: 87.7 ± 7.5 years, 26 men and 136 women) and were admitted to eight nursing homes in Fukuoka city, from September 2013 to March 2014. A trained dentist conducted dental and swallowing examinations, and the care‐staff assessed nutritional status, comorbid conditions and cognitive function using the Clinical Dementia Rating (CDR). Results: Poisson regression analysis showed that 0‐19 teeth without dentures were associated with severe cognitive impairment (CDR 3) (prevalence ratio = 2.00; 95% confidence interval: 1.13‐3.55) after adjustment for sex, age, suspected swallowing dysfunction and comorbid conditions. Mediation analysis confirmed that the nutritional status as a mediator of this association (the percentage mediated effect through nutritional status was 23.1%). Conclusion: There is an association between dental status and cognitive impairment in elder individuals, and dentures and poor nutrition are involved in this association. However, due to the cross‐sectional design of this study, there is a possibility that this association is bidirectional. [ABSTRACT FROM AUTHOR]

Fungi compose a minority but a common component of normal oral microbiota and contribute to oral and systemic health by interacting with bacterial inhabitants. This study investigated the relationship of oral fungal profiles to health status and bacterial profiles of 159 elderly adults receiving community support and home care services. Fungal and bacterial densities and compositions were determined based on the fungal ribosomal internal transcribed spacer region and bacterial 16S rRNA gene amplicon analyses, respectively. The total fungal density of 87 individuals exceeded 5,000 copies, and their microbiota was characterized by significantly less dense bacterial populations and lower relative abundances of oral health-associated taxa, such as Neisseria perflava and Porphyromonas pasteri , compared with those with less than 5,000 copies of fungi. These individuals were significantly older, had fewer teeth, had lower physical function, and comprised more denture users and individuals with cognitive decline. Fungal compositions were classified into three profiles ( Candida albicans -dominant, non- albicans Candida -dominant, and non- Candida -dominant), and individuals with a non- albicans Candida -dominant profile exhibited significantly lower physical and cognitive function than those with the Candida albicans -dominant profile. These results demonstrate that a high-density fungal population co-occurs with poor oral and systemic health status of the host and dysbiosis of the bacterial community, and particularly, the overgrowth of non- albicans Candida species may be implicated in worsening systemic conditions., Importance: The interaction between fungal and bacterial components involved in the virulence of oral microbiota has received attention. This study demonstrates that an increase in fungal components is associated with a dysbiotic bacterial community and poor health status in elderly adults. Among individuals with a high-density fungal population, particularly, those with a non- albicans Candida -dominant profile had lower physical and cognitive functions than those with a C. albicans -dominant profile. These findings indicate that the evaluation of fungal components, in addition to the bacterial components, is important to understand the involvement of oral microbiota in oral and systemic diseases in elderly adults., Competing Interests: The authors declare no conflict of interest.