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An Analytical Study on Gender Differences in Self-Reported Oral Health Care and Problems of Japanese Employees: Makoto KAWAMURA, et al. Department of Preventive Dentistry, Hiroshima University School of Dentistry—The purpose of this survey was to clarify gender differences in self-reported oral health care and problems of Japanese employees. A 60-item questionnaire named Dental Checker® was used in a project on oral health in the working place. Subjects were 77,845 Japanese employees (males, 52,345; females, 25,500). The Mantel-Haenszel chi-square test was used to clarify gender differences among respondents. Of great significance was a finding that 81.8% of females felt uncomfortable when they slept without brushing their teeth, as contrast with 58.8% of males (P

One hundred and two dentate patients with type II diabetes mellitus and 98 non-diabetic subjects were examined for oral conditions and metabolic state. Self-reported health behaviour was analysed. From factor analysis four factors emerged: general health behaviour (GHB), perceived fatigue (PF), diet control (DC) and regular diet (RD). In diabetics PF, DC and RD were significantly higher than that in non-diabetics. Patients with diabetes were more likely to control their disease through a programme of decreased kilojoule intake leading to weight management. However, they tended to tire. The mean gingivitis index was significantly higher (p

電動歯ブラシは, プラーク除去や歯肉炎の改善に対して手用歯ブラシと同等の効果があることが報告されている。しかし電動歯ブラシを4週間から8週間と, 短期間使用した時の効果についての報告は多いが, 1年以上の長期間にわたって使用した場合の効果についての報告は少ない。そこで今回は, 初期治療およびメインテナンスの期間中も電動歯ブラシを使用した場合の臨床的パラメーターに対する効果について検討する目的で研究を行った。初期治療において電動歯ブラシ (インタープラーク®,IP) によるブラッシング指導を受け, 引き続きメインテナンスの期間中もIPを使用している患者23名をIP群とした。同様に初期治療およびメインテナンスを受けている患者で, 手用歯ブラシを使用している患者 (14名) を手用歯ブラシ群とし, 両群について初期治療終了後, 3ヵ月毎にリコールを行い, 6カ月, 12カ月および24カ月後にPCR, PD, およびBOPなどの臨床診査を行った。その結果, IP群, 手用歯ブラシ群ともに初期治療によりPCR, PDおよびBOPなどの臨床的パラメーターは改善され, メインテナンスの期間中も良好に推移した。以上の結果より, IPは初期治療およびメインテナンスを継続している患者が長期間使用した場合でも, 手用歯ブラシと同等の効果があることが示された。

熱ショック蛋白質 (hsp) と歯周炎との関わりを探る第一歩として, ヒト歯根膜由来線維芽細胞PDL) におけるhsp遺伝子発現をRT-PCR法を用いて検討した。 (Hsp70, hsp60遺伝子ともに無刺激下でもPDLにおける発現が確認された。また, hsp70は, 42℃, 1時間のheatshock処理およびActinoobacillus actinomycetemcomitans, E. coliの破砕液の24時間刺激により, その発現の増強が認められたが, Streptococcus sanguis, Lactobacillus caseiの破砕液刺激では変化は認められなかった。また, hsp60については上記の刺激によっても発現の増強は認められなかった。今回の結果から, 細菌破砕液がhsp70発現を誘導し得るストレスとなり, また歯周病原性細菌による感染の際に歯周組織のhsp70の発現量が増大する可能性が推察された。本論文の要旨は, 第37回秋季日本歯周病学会 (1994年10月6日) において発表した。

Many studies on toothbrushing have concentrated on clinically diagnosing plaque and measuring periodontal status as indicators of oral health behaviour. From a behavioural point of view, however, the more important objective is the health behaviour itself. To investigate the relationship of oral health behaviour to periodontal status, 517 urban employees in Japan (249 men and 268 women aged 20-59 years) responded to a 20-item dental health behaviour questionnaire, entitled the HU-DBI, and had their periodontal conditions examined using the CPITN. Only 1 per cent were found with a healthy periodontium (Code 0), and 9 per cent had bleeding on probing (Code 1). Calculus (Code 2) was the most prevalent condition with 51 per cent of subjects having this code as the worst condition, followed by shallow pockets (Code 3) in 30 per cent, and deep pockets (Code 4) in 9 per cent of the sample. The mean HU-DBI score was 4.2 (out of 12). Females had somewhat higher scores than males (4.4 vs. 4.0, p < 0.05). CPITN had a negative relationship with the HU-DBI (r = -0.26, p < 0.001), and a positive relationship with age (r = 0.40, p < 0.001). Similar relationships were observed in each gender. These data demonstrate the relationship of age with periodontal status, and periodontal status with oral health behaviour. A two-dimensional matrix of HU-DBI score by CPITN may provide a simple and effective means of identifying low and high risk individuals.

The purpose of this study was to extract the factors which affect the caries increment between 1.5 and 3 years of age by dividing the subjects into two groups, one with and the other without caries at 1.5 years of age.The subjects were 1641 children who received a 3-year-old dental health examination at a public health center in Hiroshima City between April 1990 and November 1991.Eight factors associated with caries prevalence at 3 years of age were examined using multivariate analysis. These factors were ‘Family type’, ‘Order of birth’, ‘Interruption of breast feeding’, ‘Bottle feeding at 1.5 years of age’, ‘Regularity of between-meal snacks’, ‘Drinking sugary beverages’, ‘Watching TV at meals’ and ‘Tooth brushing with mother's help’.The results were as follows.1) The factors related to caries increment from 1.5 to 3 years of age for the children without caries at 1.5 years of age were ‘Drinking sugary beverages’, ‘Interruption of breast feeding’, ‘Watching TV at meals’ and ‘Bottle feeding at 1.5 years of age’, and for the children with caries at 1.5 years of age the factor was ‘Tooth brushing with mother's help’.2) We suggest that more efficient dental health guidance should be given at a 1.5-year-old dental health examination.3) The screening method with the eight variables was valid for prediction of caries increment in the children with caries, but not in the children without caries.

The purpose of this study was to extract the factors which affect the caries increment between 1.5 and 3 years of age by dividing the subjects into two groups, one with and the other without caries at 1.5 years of age.The subjects were 1641 children who received a 3-year-old dental health examination at a public health center in Hiroshima City between April 1990 and November 1991.Eight factors associated with caries prevalence at 3 years of age were examined using multivariate analysis. These factors were ‘Family type’, ‘Order of birth’, ‘Interruption of breast feeding’, ‘Bottle feeding at 1.5 years of age’, ‘Regularity of between-meal snacks’, ‘Drinking sugary beverages’, ‘Watching TV at meals’ and ‘Tooth brushing with mother's help’.The results were as follows.1) The factors related to caries increment from 1.5 to 3 years of age for the children without caries at 1.5 years of age were ‘Drinking sugary beverages’, ‘Interruption of breast feeding’, ‘Watching TV at meals’ and ‘Bottle feeding at 1.5 years of age’, and for the children with caries at 1.5 years of age the factor was ‘Tooth brushing with mother's help’.2) We suggest that more efficient dental health guidance should be given at a 1.5-year-old dental health examination.3) The screening method with the eight variables was valid for prediction of caries increment in the children with caries, but not in the children without caries.

The purpose of the present study was to investigate the effect of the chewing gum containing egg-white lysozyme on gingivitis. Sixteen adults aged 18 to 26 years, who exhibited clinically slight gingivitis, were chosen for the study based on preliminary screening. The volunteers were randomly assigned to two groups of eight. They were directed to chew a piece of chewing gum containing 1% egg-white lysozyme or placebo for 5 minutes after each meal during 2 weeks. The experiments were performed in a double blind method. Oral examinations (probing depth, gingival score, bleeding score and plaque score) were carried out on day 1, day 8, and day 15 of the experimental period. All the subjects were instructed to continue their habitual toothbrushing. At the end of the experimental period, the volunteers answered a questionnaire about their subjective feelings and what they thought of the gum. The results were as follows.1) The probing depth, the bleeding score, and the plaque score in both groups decreased at the end of the period.2) The experimental group had a significantly larger decreace in the probing depth and plaque score than the placebo group, but there was not a significant difference in the gingival score between the two groups.3) Concerning the size, hardness, thickness, and taste of the chewing gum, most of the subjects of both groups judged them appropriate and favorable. With respect to the mouth condition, 6 of the placebo group noticed no change, while 4 of the experimental group answered that they felt a decrease in gingival bleeding.These results indicate that the lysozyme-containing chewing gum may be effective in the maintenance of oral health and that this gum may be acceptable to patients with gingivitis.

Background Regenerating gene (Reg) product, Reg, acts as an autocrine/paracrine growth factor for beta-cell regeneration. The presence of autoimmunity against REG may affect the operative of the regenerative mechanisms in beta cells of Type 1 and Type 2 diabetes patients. We screened sera from Type 1 and Type 2 diabetes subjects for anti-REG autoantibodies, searched for correlations in the general characteristics of the subjects with the presence of anti-REG autoimmunity, and tested the attenuation of REG-induced beta-cell proliferation by the autoanitibodies. Material and methods We examined the occurrence of anti-REG autoantibodies in patients’ sera (265 Type 1, 368 Type 2 diabetes patients, and 75 unrelated control subjects) by Western blot analysis, and evaluated inhibitory effects of the sera on REG-stimulated beta-cell proliferation by a 5′-Bromo-2′-deoxyuridine (BrdU) incorporation assay in vitro. Results Anti-REG autoantibodies were found in 24·9% of Type 1, 14·9% of Type 2 and 2·7% of control subjects (P = 0·0004). There were significant differences between the autoantibody positive and negative groups in the duration of disease in the Type 1 subjects (P = 0·0035), and the age of onset in the Type 2 subjects (P = 0·0274). The patient sera containing anti-REG autoantibodies significantly attenuated the BrdU incorporation by REG (35·6 ± 4·06% of the control), whereas the nondiabetic sera without anti-REG autoantibodies scarcely reduced the incorporation (88·8 ± 5·10%). Conclusion Anti-REG autoantibodies, which retard beta-cell proliferation in vitro, are found in some diabetic patients. Thus, autoimmunity to REG may be associated with the development/acceleration of diabetes in at least some patients.

The purpose of this study was to investigate the validity and reproducibility of an oral rating index (ORI) as a conceptual measurement of “gingival health care” level in adults. The study was conducted on 163 patients who received medical examinations and attended for dental checkups at a hospital. The score of the ORI was recorded as excellent (+2), good (+1), questionable (0), poor (−1) or very poor (−2). The validity of the ORI was investigated by comparing it with: Jackson's gingivitis index (GI); Greene & Vermillion's debris index (DI) and calculus index (CI); probing pocket depth (PPD); and percentage of bleeding on probing (%BOP). The intra- and inter-examiner reproducibility of the ORI was assessed on a flat screen using patients' color transparencies of the mouth. The ORI had significantly negative correlations with the GI, DI, CI, and PPD (p

The aim of this survey was to assess the present state of dental health knowledge, attitudes/behaviour and perceived oral health of Japanese employees. A 60-item questionnaire was used in a dental health project in the work place. The subjects comprised 77,845 employees, 76 per cent of whom reported delaying a dental visit until they had toothache, with about 60 per cent delaying even when they discovered a decayed tooth. The majority did not regard decayed teeth as a disease and only a minority reported regular dental visits. About three quarters reported bleeding gums on brushing, although more than half had never been taught professionally how to clean their teeth and less than 5 per cent flossed daily. More than half believed that false teeth were inevitable in old age, and that their teeth were getting worse despite daily brushing. About 70 per cent of the employees thought that it was impossible to prevent gum disease with toothbrushing alone, and nearly half believed a toothpaste with fluoride was effective in preventing periodontal disease. Reorientation of oral health care in Japan, therefore, is urgently needed and dental services have to be provided for the implementation of systematic oral health promotion for employees in the workplace.

Objectives. The main aim of this study was to investigate the relationship between mothers’ gingival condition (an assumed indicator of their self-care level) and the prevalence and severity of dental caries of their children. Sample and Methods. Subjects comprised 1471 pairs of mothers and their children who attended for the 3-year-old dental check-up at a community health centre in Hiroshima. The mothers’ gingival condition was scored as ‘excellent (+2)’, ‘good (+1)’, ‘questionable (0)’, ‘poor (−1)’ or ‘very poor (−2)’ according to the criteria of the Oral Rating Index (ORI). Caries experience of the children was recorded using the WHO caries diagnostic criteria for dmft. Results. The percentage of caries-free children was 51·3%, and the mean dmft score was 2·61. The percentages of caries-free were higher and the mean dmft level were lower in the children of mothers with better gingival condition compared to the children of mothers with worse gingival condition. Conclusions. Mothers’ gingival condition was associated with the prevalence and severity of dental caries of their children.

“齲蝕予防は育児である”という言葉があるように, 乳幼児期における齲蝕には, 家庭環境, 特に母親が大きな影響力を持っていると言われている. 本研究では, 4～6歳の幼稚園児とその母親153組を対象に, 母子の性格と齲蝕との関連性について検討した。母子の性格検査は, 母親に対しては“YG性格検査用紙”を, 園児に対しては高木・坂本の“幼児・児童性格診断検査用紙”を使用して行った。また, 園児の齲蝕罹患状況については, 厚生省の分類に従い齲蝕罹患型 (O・A・B・C型) に分けたものを用いて以下に示す結果を得た。1) 因子分析法を適用し, 母子の性格特性 (上記性格検査の22項目) が, 4つの共通因子によってほぼ説明しうることがわかった。第1因子は子供安定性の因子, 第2因子は母親消極性の因子, 第3因子は母親不安定・不適応性の因子, 第4因子は子供社会性の因子と名付けられた。2) 母親消極性の因子 (第2因子), 子供社会性の因子 (第4因子) と齲蝕罹患型との関連性は認められなかった。一方子供安定性の因子 (第1因子) については, さらに検討が必要と思われた。3) 性格的にはむしろ問題と思われる不安定・不適応性 (第3因子) の高い母親の場合, かえって齲蝕予防の実践が効果的に行われていることが示唆された。

A caries activity test solution, S-3105 developed by Nakamura et al., was examined in the field.Two hundred and thirty pre-school children, ranging in age from 3 to 5 years, were studied. Three dentists examined decayed, missing, and filled teeth, and debris score. Buccal plaque was sampled by swabbing with cotton, and then incubated in the solution at 37°C for 30 min. The color change was estimated as the test score. Then the relationship between oral status and the test was statistically analyzed.The test score showed positive significant correlations with d ratio, dmf, caries severity index (CSI), and ΔCSI.This solution seemed useful for caries activity tests in the field.

Many caries activity tests have been devised and developed, but they have some disadvantage for routine use. In the present study, we attempted to develop a new caries activity test which everyone could use conveniently and rapidly.Various test solutions which were composed of pH indicators, carbohydrates, and anti-microbial agents were prepared. The test solutions were inoculated with cariogenic microorganisms such as St. mutans and pH change or color change of test solutions were measured.Among the test solutions, S-3105, which was composed of resazurin, sucrose, and sodium azide, could detect the acid production of cariogenic microorganisms clearly in 30 min. Color change and pH change of the test solution S-3105 were parallel and the color changed from bluish violet to reddish violet and then to pink. S-3105 was highly sensitive to St. mutans and L. casei but not to other microoraganisms.In the experiment using human dental pleque, a statistically significant correlation was found between the test results of S-3105 and Cariostat or the Snyder test. Also, in a clinical study with 27 children (3 to 5 years old), significant correlations were found between the test results and caries indices such as def (%) and caries severity index (CSI) as well as the results of Cariostat.From the above results, the test solution S-3105 was found to be able to detect the acid production of cariogenic microorganisms visually in 30 min. This test solution might be useful for diagnosis of caries activity and might also be used advantageously for educational and motivational purposes.

Significant positive correlations between protease activities in saliva and supragingival/subgingival calculus indices, periodontal pocket depth, or P-M-A index were confirmed. When the partial correlation was calculated, the subgingival calculus index correlated well with the sediment protease at pH 8.5, and the supragingival calculus index showed a significant correlation with the supernate protease at pH 4.5.

The purpose of this study was twofold. The first objective was to measure the periodontal status and perceptions of oral health in adolescents. The second objective was to determine the effects that a program of dental health education would have on their periodontal status and perceptions of oral health. The dental health education with a 90-minute lecture had been given to eleventh-grade students (352) in the previous year. The dental health education program was not carried out in tenth-grade students (442) yet. The oral examination was performed by a dentist for both grades. The examination time was about ten seconds per person. The students' periodontal status was scored as "excellent (+2)," "good (+1)," "questionable (0)," "poor (-1)," or "very poor (-2)" according to the criteria of an Oral Rating Index (ORI) System proposed by the present authors. The level of students' perceptions was assessed by the cognition score of our dental health test (10 items concerning dental attitudes and behavior). Main results were as follows: 1. Only 6% of the 10-th grade students were judged as having "excellent (+2)" oral health. Thirty-six percent were "very poor (-2)" or "poor (-1)" periodontal status. 2. The mean cognition score and the mean ORI score of the 11-th grade students were significantly greater for each sex group than those of the 10-th grade students. 3. The cognition score showed a clear relationship to the ORI score in each grade and in all. The behavioral component of the cognition score was more closely related to the ORI score. These findings suggest that the dental health education contributes to the improvement of periodontal status as well as that of perceptions. Furthermore, the ORI may be utilized for a screening system to evaluate adolescents' periodontal status quickly and effectively.

The present investigation was designed to develop effective dental health practices in adults at their place of work. Their periodontal condition was examined by CPITN, and the relationships between it and their brushing habits, frequency of dental examination, and subjective symptoms of their gingiva were determined in both male and female subjects. The results are as follows:1. Females needed less dental treatment of their periodontal tissues than males; the difference was statistically significant in the age groups of 30-40 and 45-65.2. In all age groups, females brushed their teeth more times daily than males: females brushed an average of over three times daily, and few of them brushed less than once daily. The difference between females and males was statistically significant. The frequency of daily brushing by all of the adults in the present survey was higher than that found by the Ministry of Health and Welfare dental disease survey conducted in 1981.3. In all age groups the periodontal condition was better in subjects who brushed three times a day than in those who brushed only once daily. These results suggest the importance of good tooth-brushing habits for a good periodontal condition.4. Employees in businesses that provided frequent dental examinations had healtheir periodontal tissues than those in businesses that provided only one dental examination. This tendency was the same even when the data were categorized by sex or region.5. There was a relationship between the condition of periodontal tissues and subjective symptoms of gingiva obtained from questionaires. The periodontal tissue of participants who described subjective gingival symptoms was in worse condition than that of those who never felt any gingival abnormality, and the difference in periodontal condition between the two groups was significant.These findings suggest that dental health practices conducted regularly are important for adults.

Although the lierature contains many reports concerning the prevalence of dental caries in Japan, there is little information about the relationship between dental caries in preschool children and dental care by their mothers.Seven hundred and twenty-one children between the ages of 3 and 5 years were examined by three dentists. A mouth mirror and dental explorer were used to detect lesions. Questionnaires were given to thetr mothers concerning toothbrushing, between-meal eating and topical application of fluoride for children. The prevalence rates of clinical caries ranged from 90.4% for 3-year-olds to 97.5% for 5-year-olds. The mean number of decayed teeth was 7.5, 8.8 and 10.2 for 3-, 4- and 5-year-olds children, respectively. In statistic analysis, the group taking one between-meal snack a day showed a lower mean number of decayed teeth than another group (p