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Aims: To evaluate the perceptions of parents on general health, oral health, and dental care for children with Down syndrome (DS), and to investigate factors related to parents' perceptions of oral health., Methods and Results: An online questionnaire survey was conducted of parents of children with DS. Forty-three percent and 81% of the parents rated their child's oral health and general health as good, respectively. Parent-rated oral health was strongly associated with general health, followed by the parents' satisfaction with their child's dentist, halitosis, difficulty in dental examination, and the number of times they helped their child with toothbrushing. Seventy-seven percent of the parents were satisfied or rather satisfied with their child's dentist. The parents expected the dentist to reassure their child and to be specialized in the treatment of persons with disabilities. Seventy-three percent of the parents brushed their child's teeth at least once a day, and 92% brushed their own teeth at least twice a day. The number of times the parents brushed their own teeth was strongly associated with the frequency of brushing their child's teeth., Conclusion: General health, a trusting relationship with the dentist, and parental perceptions of oral hygiene affect parent-rated oral health of children with DS., (© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)

Background: Previous studies have reported an association between oral hypofunction and normal gait speed as a marker for physical function; however, the association between maximum gait speed as a more sensitive marker for physical function and poor oral function has not been investigated., Objectives: To elucidate associations of oral hypofunction, comprising seven elements, with both normal and maximum gait speeds in an older population., Methods: Participants were recruited in 2018 from a hospital-based health checkup in Kyoto Prefecture. Seven oral function tests (oral hygiene, oral dryness, occlusal force or number of teeth, tongue-lip motor function, tongue pressure, masticatory function and swallowing function) were performed. Oral hypofunction was defined as an abnormality in at least three of these items. Gait speed was measured as normal and maximum gait speeds. The relationship between oral hypofunction and maximum gait speed was analysed using logistic regression., Results: This study included 198 participants (130 men and 68 women; mean age: 75.0 years). Among them, 152 (76.7%) had oral hypofunction. After adjustment for age, sex and body mass index, oral hypofunction was significantly associated with a low maximum gait speed (odds ratio: 2.75, 95% confidence interval: 1.41-5.37)., Conclusion: Oral hypofunction is associated with maximum gait speed in older people. The prevention of oral hypofunction may help maintain walking speed and promote an increase in healthy life expectancy., (© 2024 John Wiley & Sons Ltd.)

Purpose: This prospective cohort study examined the effects of the number of present and functional teeth on mortality among older Japanese adults requiring nursing care in an environment of comprehensive oral hygiene and nutritional management., Methods: The study included 174 older adults (mean age: 84.4 ± 8.3 years; male/female: 49/125) in need of support or long-term care, who resided in either a local specialized healthcare facility or their own homes, and received daily oral hygiene and nutritional support at facilities in Okayama, Japan. The initial clinical oral examination along with assessment of general physical condition and nursing environment of the participants were performed in July 2013 and followed up for one year., Results: All-cause mortality occurred in 28 (mean age: 88.7 ±13.4 years; male/female: 6 /22) individuals during the follow-up period. Cox proportional hazard analysis indicated that older age, low performance in activities of daily living (Barthel Index <40), and underweight status (body mass index <18.5) were significant risk factors for mortality. The number of present and functional teeth were not found to be significant risk factors for mortality., Conclusions: During the one-year follow-up period, the number of present and functional teeth did not have a significant impact on mortality among older Japanese adults requiring nursing care in a well-managed environment of oral hygiene and nutritional status.

Objectives: This study aimed to assess the association between posterior occlusal support (POS) and the risk of tooth loss in older adults aged ≥75 years., Methods: This longitudinal study analyzed 94,422 participants who participated in multiple dental check-ups provided as part of the public healthcare services in Osaka, Japan, from 2018 to 2022. The participants were categorized into nine groups (A1-3, B1-4, and C1 and C2) according to their POS status using the Eichner index at baseline. The dental charts were compared between the initial and final assessments to assess tooth loss. Logistic regression analysis was used to examine the association between POS status and tooth loss, adjusted for several covariates, including age, sex, body mass index, periodontal status, oral hygiene, history of diabetes, history of hypertension, attendance at the annual dental check-up, and observational period. Furthermore, stratified logistic regression analyses were conducted using anterior or posterior tooth loss., Results: After controlling for confounders, POS status was associated with tooth loss. The odds ratios (ORs) with A1 as the reference were 1.74 in A2, 2.55 in A3, 3.40 in B1, 4.74 in B2, 5.79 in B3, 6.00 in B4, 4.44 in C1, and 3.00 in C2, respectively. The ORs for anterior tooth loss were higher than those for posterior tooth loss, with the highest OR observed in B4 (21.4)., Conclusions: This large population-based cohort study showed that a decreased POS was a risk indicator for tooth loss; furthermore, the risk increased even further in the anterior teeth region., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Aspiration pneumonia has a high recurrence rate, and oral care by dentists has been found effective in preventing its onset; however, this has not been evaluated using prospective studies. Therefore, we conducted a prospective study to evaluate the effectiveness of professional oral care by dentists in reducing aspiration pneumonia recurrence in older adult patients., Methods: In this prospective cohort study, we evaluated a dental oral care intervention, using a historical control group (control group). It was conducted at a single-centre regional core hospital in Japan that serves a large number of patients aged older than 80 years. Patients who were hospitalised for aspiration pneumonia were included in this study. During the study period (1 April 2021 to 31 March 2022), the clinical group received weekly professional cleaning by a dentist and the control group received standard oral care by a nurse as usual from 1 April 2020 to 31 March 2021. The dentist oral care group received weekly professional oral care from a dentist and was followed prospectively for 1 year. A Kaplan-Meier analysis was used to evaluate the timing of recurrent aspiration pneumonia or death. A Cox proportional hazards model was used to obtain a hazard ratio and determine the 95% confidence intervals., Results: There were 91 participants in the clinical group and 94 in the control group. The mean age of participants was 85 years, and 75 (40.5%) were female. The recurrence rate was 27.5% in the clinical group and 44.7% in the control group (P = .005). Professional cleaning by a dentist reduced the risk of recurrence of aspiration pneumonia by approximately 50% (adjusted hazard ratio, 0.465; 95% confidence interval, 0.278-0.78)., Conclusions: Professional cleaning by a dentist was associated with a lower rate of aspiration pneumonia recurrence than nurse-provided conventional oral care., Competing Interests: Conflict of interest None disclosed., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim: This study examined the oral status and the presence of teeth requiring treatment among older adults receiving home medical care., Methods: This cross-sectional study was conducted at a Japanese dental clinic specializing in geriatric treatment. We recruited older adults receiving home medical care in the community who had begun to receive domiciliary dental care. The Japanese version of the Oral Health Assessment Tool (OHAT-J), as well as the presence of teeth requiring extraction and the need for assistance in maintaining oral hygiene were used to evaluate the participants' oral health and its association with other items., Results: Ninety-three participants (44 male and 49 female, median age: 87.0 years) were surveyed. The median OHAT-J score was 6. The duration since the previous dental visit was 23 months. Sixty-two (73.8%) of 84 participants with ≥1 natural tooth had severe caries or teeth with severe mobility that required extraction. Logistic analysis revealed that requiring assistance in maintaining oral hygiene, mild dementia, severe dementia, and depression were significantly associated with an OHAT score of ≥6., Conclusions: Older adults receiving home medical care had poor oral health, with approximately 70% of them requiring tooth extraction. The need for assistance in maintaining oral hygiene and poor mental status contribute to poor oral health. Geriatr Gerontol Int 2024; 24: 706-714., (© 2024 Japan Geriatrics Society.)

Background: This study adopts a novel approach of using single-item surveys to simplify the assessment of oral health status and behaviors among Japanese private sector employees. We aimed to establish the validity of self-reported oral health in relation to clinical dental examinations, and to elucidate the relationship between oral diseases, health behaviors, and self-assessments. A secondary aim was to explore the association of self-rated oral health with oral health behaviors., Materials and Methods: Self-administered questionnaires and dental examinations were obtained from 2262 Japanese private sector employees. Workers self-rated their overall oral health status according to five choices: "very good," "good," "fair," "poor," or "bad." Self-reports were then compared with the results of clinical dental examinations, which included measuring the oral hygiene index (DI-S), the number of decayed teeth, periodontal status (Community Periodontal Index) and number of missing teeth. Convergent validity was also tested by examining the correlations of self-reported oral health status with oral health behaviors., Results: Overall, 30.8% of workers reported their oral health as "poor" or "bad." "Poor" or "bad" oral health status was significantly correlated with missing teeth, periodontitis, and decayed teeth. However, lower correlations were found for gingivitis and the oral hygiene index. Most self-reported oral health behaviors were correlated with self-rated oral health; exceptions were "tooth brushing instructions received in a dental clinic," "having a primary-care dentist," and "habitual snacking between meals.", Conclusions: Self-rated oral health provides reasonably valid data, and correlated well with clinically assessed oral health status, including dental caries, periodontal status, and tooth loss. Convergent validity was also found for oral health behaviors., Trial Registration: Clinical trial registration number: UMIN000023011 (UMIN-CTR). Date of clinical trial registration: 06/07/2016., (© 2024. The Author(s).)

Background: Poor oral hygiene, generally manifesting as dental caries, gingivitis, or periodontitis, is a common chronic condition among both children and adults worldwide and has been reportedly associated with hypertension and arterial stiffness mainly in adult patients. However, these associations have not been well-studied in children and adults in the general population. Therefore, we conducted this cross-sectional study to clarify the associations between oral hygiene indices and high blood pressure (BP)/hypertension and arterial stiffness as assessed by the cardio-ankle vascular index (CAVI) in children along with their mothers. The association between maternal oral hygiene and high BP in children was also examined based on the hypothesis that maternal awareness of oral hygiene is related to their children's oral hygiene., Methods: This study was conducted as an Adjunct Study of the Aichi Regional Sub-Cohort of the Japan Environment and Children's Study. Participating children (n = 220, 85-104 months old) and their mothers (n = 217, 29-52 years old) underwent dental/intra-oral examination and BP and CAVI assessment. High BP in children and hypertension in mothers were diagnosed according to corresponding American guidelines. Logistic regression analysis or analysis of covariance was used to examine the associations of poor oral hygiene indices with BP and CAVI., Results: Maternal dental caries ≥1 was associated with their hypertension (adjusted odds ratio [aOR]: 2.72, 95% confidence interval (CI): 1.12-6.61). Maternal dental plaque ≥1/3 was associated with maternal hypertension and children's high BP (aOR, 95% CI: 4.71, 1.33-16.73 and 5.67, 1.22-25.04, respectively). Maximum pocket depth ≥4 mm was associated with children's high BP (aOR: 6.85, 95% CI: 1.24-38.01). No associations were observed between oral hygiene indices and CAVI in children; however, there was a significant association between dental plaque and CAVI in mothers (F = 5.62, p < 0.01)., Conclusions: The small sample size, especially the case number, made it necessary to refrain from drawing unambiguous conclusion. The hypothesis that warrants further investigation based on the present study results is that poor oral hygiene is associated with high BP in children and hypertension and arterial stiffness in mothers, and maternal oral hygiene is associated with high BP in children.

Background: It is important to understand the career motivations and perceptions of students who intend to become dental health professionals. Both dental and dental hygiene students may have different opinions about the profession and future work prospects. To our knowledge, no study has compared the career motivations and career perceptions of Japanese dental and dental hygiene students after admission to dental or dental hygiene school. This cross-sectional study examined the motivations of dental and dental hygiene students for their future career perceptions.  METHODS: First-year students of dental and dental hygiene schools in the academic years 2021 and 2022 participated in the study. Group 1 comprised 104 female dental hygiene students, Group 2-1 comprised 55 female dental students, and Group 2-2 comprised 61 male dental students. A self-administered questionnaire survey was conducted on opinions of the work and prospects of future work with four-point Likert scales ranging from "strongly agree" to "strongly disagree," according to the items., Results: Dental hygiene students consider that they would like to work as professionals and would also like to earn efficiently. Specifically, female dental students prioritized contributing to society by working long-term in a fulfilling environment rather than earning an income, whereas male dental students would like to work as a professional while also effectively earning income., Conclusions: Small but significant differences were found in opinions of the dental hygienist/dentist profession in terms of attractiveness and credibility. Small but significant differences were found for income and working hours when considering future job prospects. The results of this study revealed differences in the first year students between dental and dental hygiene school in their attitudes toward career motivation and prospects for future work., (© 2023. The Author(s).)

Background: In our previous study, international university students showed a significantly higher dental caries morbidity rate than domestic students. On the other hand, the periodontal health status of international university students has not been clarified yet. In this study, we compared the periodontal health status of international and domestic university students in Japan., Methods: We conducted a retrospective review of the clinical data of the university students that visited a dental clinic in the division for health service promotion at a university in Tokyo for screening between April 2017 and March 2019. Bleeding on probing (BOP), calculus deposition and probing pocket depth (PPD) were investigated., Results: The records of 231 university students (79 international and 152 domestic university students) were analyzed; 84.8% of international students were from Asian countries ( n = 67). The international university students showed a higher percentage of BOP than domestic students (49.4% and 34.2%, respectively: p < 0.05) and they showed more extensive calculus deposition (calculus grading score [CGS]) than domestic university students (1.68 and 1.43, respectively: p < 0.01), despite no significant difference in PPD., Conclusions: The current study shows that international university students have poorer periodontal health than domestic students in Japan, even though the result might include many uncertainties and possible biases. To prevent severe periodontitis in the future, regular checkups and thorough oral health care are essential for the university students, especially those from foreign countries.

Purpose: Preoperative cognitive impairment is a significant factor influencing post-operative delirium. We have been performing routine pre-operative comprehensive assessments, including evaluation of cognitive function, handgrip strength, oral hygiene, and nutritional status, in patients aged ≥ 65 years since April 2021. This study aimed to examine the completion rate of pre-operative comprehensive assessment and assess the prevalence of pre-operative undiagnosed cognitive impairment., Methods: In this prospective observational study including patients aged ≥ 65 years scheduled for elective surgery with general or regional anesthesia, cognitive impairment was defined as a Mini-Cog score ≤ 2, and its associations with handgrip strength, oral hygiene, and nutritional status were evaluated. Oral hygiene and nutritional status were assessed using an oral frailty self-checklist and the Mini Nutritional Assessment-Short Form, respectively. The incidence of pre-operative undiagnosed cognitive impairment was estimated, and its associated factors were explored with multiple logistic regression., Results: Among 331 eligible patients, the completion rate was 97.7% (305/312). The mean age was 74.8 years, and 13.1% (40/305) (95% confidence interval [CI], 9.7-17.3%) of the patients had pre-operative undiagnosed cognitive impairment. Multiple logistic regression revealed that handgrip strength (odds ratio [OR] = 0.94, 95%CI = 0.89-0.99) and oral frailty self-checklist score (OR = 1.19, 95%CI = 1.02-1.40) were associated with pre-operative undiagnosed cognitive impairment, while the Mini Nutritional Assessment-Short Form score was not significantly associated (OR = 0.97, 95%CI = 0.82-1.14)., Conclusions: Preoperative comprehensive assessment was feasible. The prevalence of pre-operative undiagnosed cognitive impairment was 13%, and poor handgrip strength and worse oral hygiene were significantly associated factors., (© 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.)

Purpose: We have less understanding of which socioeconomic status (SES) indicators may be reflective of latent socioeconomic inequalities in toothbrushing behaviours, especially finishing-toothbrushing by parents in young children. The aim of this study was to reveal the socioeconomic inequalities in children's toothbrushing and finishing-toothbrushing by parents and if it varies by SES indicators., Methods: We used data from 'Survey on Children's Life' conducted by A city of Okinawa Prefecture, Japan. The multiple imputed data of 902 (boys, 453) included self-reported children's toothbrushing behaviour and finishing-toothbrushing by parents in three-to six-year-old children. SES was assessed using self-reported household income and parental educational attainment. Absolute and relative inequalities in toothbrushing behaviours were quantified using the slope index of inequality (SII) and relative index of inequality (RII), respectively., Results: There were significant absolute and relative inequalities of children's toothbrushing for household income (SII and RII were 0.241 and 2.73, respectively), of finishing-toothbrushing by parents for household income (SII and RII were 0.133 and 3.28, respectively), and educational attainment (SII and RII were 0.166 and 5.55, respectively). The same inequality trends were observed after adjusting for covariates (child's age and sex, family structure, breakfast and dinner frequency, and sleep duration)., Conclusion: Socioeconomic inequalities in children's toothbrushing and finishing-toothbrushing by parents varied according to SES indicators., (© 2022. The Author(s), under exclusive licence to European Academy of Paediatric Dentistry.)

Objectives: Effective daily oral hygiene behaviour will prevent periodontal disease. This study aimed to examine the oral symptoms, oral hygiene behaviours and factors contributing to oral hygiene behaviours among patients with type 2 diabetes in a hospital in Japan., Methods: A cross-sectional survey was conducted with 198 patients with type 2 diabetes. Oral symptoms were assessed using a dichotomous scale based on clinical guidelines. Oral hygiene behaviours were assessed based on the frequency of daily tooth brushing and the use of interdental cleaning aids. Chi-square tests and logistic regression analyses were also performed., Results: Overall, 71.2% of the participants had oral symptoms. Of the participants, 80.3% performed twice daily tooth brushing and 61.1% did not perform interdental cleaning on a daily basis. Logistic regression analysis revealed that tooth brushing behaviour was negatively associated with male patients (odds ratio [OR] = 0.45, 95% confidence interval [CI]: 0.25-0.80), difficulty with mastication (OR = 0.63, CI: 0.43-0.92) and tooth loss (OR = 0.68, CI: 0.46-1.00) and positively associated with periodontal disease (OR = 1.73, CI: 1.10-2.72). There were no significant variables related to the use of interdental cleaning aids., Conclusions: Patients need to learn about the necessity for regular oral hygiene behaviours and the appropriate way. In particular, support for male patients, those who have difficulty with mastication, those who have experienced natural tooth loss, and those who have not been diagnosed with periodontal disease are needed., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status.

Background: Oral health is composed of various oral health indices (OHIs), such as oral self-care habits, oral hygiene, oral function, and mastication ability. Oral self-care habits have frequently been examined for obesity risk. This study aimed to comprehensively clarify the association between OHIs and obesity risk., Methods: We collected data for 15 questions on the four OHIs and measured the body mass index of 3494 men and 2552 women aged 35-79 years. Obesity was defined as a body mass index ≥25 kg/m 2 . The four OHIs were scored by the corresponding questions (good as "reference"), and the summed score was defined as "comprehensive OHI", that is, the fifth OHI. Each lowest tertile score was used as "reference". Using multiple logistic regression analysis, odds ratios (ORs), 95% confidence intervals (CIs), and p-values for trends were estimated., Results: In the men and women, the ORs were 1.37 (1.11-1.67, < 0.01) and 2.48 (1.80-3.42, < 0.01) for oral self-care habits, and 1.78 (1.42-2.24, < 0.01) and 3.06 (2.12-4.43, < 0.01) for tooth brushing frequency, respectively. Moreover, in men, a significant trend was found for "harder rinsing out your mouth", related to "oral function". In women, the ORs were 1.74 (1.28-2.36, < 0.01) and 1.43 (1.00-2.06, < 0.01) for "comprehensive OHI" and "longer meal time" related to "mastication ability", respectively., Conclusions: Our findings showed that obesity risk was associated with poor of oral health, which were comprehensively composed of various OHIs, among middle-aged and older Japanese men and women., (© 2022. The Author(s).)

Objectives: This study aimed to clarify the relationship between the experience of receiving career education among final-year dental hygiene students and their views regarding their work and profession, as part of research on the working style of dental hygienists., Methods: An anonymous, self-administered survey was sent by post to all the 162 dental hygienist schools in Japan with dental hygiene students in their final year in November 2019. The main questions were regarding student attributes, career aspirations, their perspective on work and profession and whether or not they received career education at a dental hygienist training school. Analysis was conducted by cross-tabulation and logistic regression., Results: Completed questionnaires were sent to us by 150 schools (response rate 92.6%), with a response from 6,270 students. The students who had received career education had significantly higher awareness and plans for the profession and a positive attitude towards the work (p < 0.01). Following adjustment for age, sex, educational attainment, length of the course of study and timing of class the results shows that there was a significant relation between the experience of the career education with having future plans (odds ratio = 2.11, 95% confidence interval = 1.88-2.38, p < 0.01)., Conclusions: It was observed that the experience of receiving career education just before graduating from dental hygienist school was related to an increased positive attitude of the students towards their work and profession. Further long-term investigations are necessary to evaluate the effects of career education among dental hygiene students and their attitude towards their profession., (© 2021 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.)

Background: Many physical functions decline with aging, but it is not known whether oral functions vary according to sex or decline with aging, as it occurs with physical functions. The present study aimed to examine the association of sex, age, and elapsed years with occlusal force and tongue pressure using a generalized linear mixed-effect model (GLMM) over a 3-year period among old-old Japanese adults., Methods: Participants were community-dwelling older adults who participated in a survey (June 2014-March 2017) and a follow-up survey (July 2017-December 2019) after 3 years (n = 951: 70-year group, n = 466; 80-year group, n = 391; 90-year group, n = 94). Dental examinations including the number of teeth, occlusal force, and tongue pressure were conducted, and a GLMM was used to estimate the association of sex, age, and elapsed years with occlusal force and tongue pressure, adjusting for the number of teeth., Results: The GLMM showed that occlusal force was significantly associated with sex (reference; male, non-standardized coefficient: B = -66.9 [female], p < 0.001), age (reference; 70-year group, B = -81.7 [80-year group], p < 0.001, B = -87.2 [90-year group], p < 0.001), and the number of teeth (B = 13.8, p < 0.001), but did not significantly decrease with elapsed years. Tongue pressure was significantly associated with sex (reference; male, B = -0.94 [female], p = 0.034) and age (reference; 70-year group, B = -1.78 [80-year group], p < 0.001, B = -5.47 [90-year group], p < 0.001). Tongue pressure decreased significantly with elapsed years (B = -0.82, p < 0.001)., Conclusions: These findings suggest that tongue pressure significantly decreased over time, but occlusal force did not. Tongue-related muscles may be more susceptible to aging than masticatory muscles., (© 2021 The American Geriatrics Society.)

This cross-sectional study aimed to examine the oral hygiene behaviors in the general population and identify factors affecting oral hygiene behaviors and plaque removal efficacy. A survey was distributed to patients through 11 dental practices in Japan, and each patient's plaque index score (PIS) was recorded. In total, 1184 patients participated (521 women and 660 men), with 84.04% using manual toothbrushes (MTBs) and 15.96% using electric toothbrushes (ETBs). ETB users had a significantly lower PIS compared to MTB users ( p = 0.0017). In addition, a statistically significant difference in the PIS was detected in relation to the frequency of brushing per day (≥2 times) and time spent on brushing (≥1 min). Some MTB users spent less than 1 min brushing, while all ETB users spent at least 1 min brushing, and extended brushing periods significantly improved the PIS for the MTB users. MTB users tend to replace brush heads more frequently than ETB users, and the frequency of replacement affected the PIS significantly ( p < 0.01) for the MTB users. The status of dental treatment (first visit, in treatment versus recall) also significantly affected the PIS ( p < 0.01). The ETB was more effective than the MTB in terms of better plaque removal and reduced frequency of brush head replacement.

Objective: The aim of this 1-year longitudinal randomised controlled trial was to evaluate the effectiveness of tongue cleaning on the maintenance of respiratory function in older adults requiring care., Methods: The participants included 24 residents of two nursing homes in Kitakyushu, Japan. The participants were randomised to receive tongue cleaning with routine oral care (intervention group, n = 12), or routine oral care alone (control group, n = 12). Among the participants, three in the intervention group and four in the control group had cerebrovascular disease history, four in the intervention group and four in the control group had a history of cardiac disease, and five in the intervention group and four in the control group were without medical history. Respiratory function was assessed on the basis of the peak expiratory flow rate (PEFR). Tongue pressure, swallowing function, oral health status, activities of daily living and nutritional status were also measured at baseline and at the end of the 1-year follow-up period., Results: The number of analysed participants in each group was 12. In the control group, the PEFR (1.6 [0.4-4.2] L s -1 vs 1.4 [0.4-3.2] L s -1 , P = .034) and tongue pressure (16.4 [1.7-35.2] kPa vs 8.0 [1.4-38.6] kPa, P = .032) significantly declined after 1-year. However, the PEFR (1.5 [0.8-2.9] L s -1 vs 1.6 [0.7-4.2] L s -1 , P = .366) and tongue pressure (18.1 [4.2-37.1] kPa vs 16.1 [5.2-41] kPa, P = .307) were maintained in the intervention group. The change in the PEFR was significantly greater in the intervention group compared with the control group (0.130 [-0.45-1.70] L s -1 vs -1.70 [-10.00-10.00] L s -1 , P = .028)., Conclusion: Our findings suggest that tongue cleaning may help maintain tongue and respiratory function in older adults requiring care., (© 2021 John Wiley & Sons Ltd.)

Oral health care by dental hygienists contributes to the maintenance of nutritional and general health for older people in nursing facilities. This study aimed to investigate daily tasks and willingness to work among dental hygienists working in nursing facilities in Japan. In 2019, using a self-administered questionnaire, a postal cross-sectional survey was conducted among members of the Japanese Dental Hygienists' Association. Questionnaires were distributed to all 16,722 Association members (responses, n = 8932; return rate, 53.4%). We analysed data from 368 dental hygienists currently working in nursing facilities. Item response theory and correspondence analyses were performed. In total, >90% of dental hygienists undertook oral examinations and provided oral hygiene instructions to residents and facility staff. In contrast, the implementation rate of tasks related to interprofessional collaboration was relatively low (approximately 50%), and 72.6% of dental hygienists indicated that they wanted to continue working in nursing facilities. Their willingness to work was closely associated with work involving interprofessional collaboration. Our study findings showed that dental hygienists' work content in nursing facilities was diverse, but that there was variation in implemented tasks. Willingness to continue working in nursing facilities was associated with interprofessional collaboration among dental hygienists.

Abstract: The purpose of the present study was to investigate the efficacy of perioperative oral managements (POMs) on perioperative nutritional conditions in patients undergoing surgery with general anesthesia. Medical records were retrospectively reviewed and the effects of POMs were investigated based on a large number of cases using a multicenter analysis. The profile of serum albumin levels was assessed and compared between patients with and without POMs using the multivariate analysis. Seventeen Eleven thousand and one hundred sixty patients (4,873 males and 6,287 females) were reviewed. Of these, 2710 patients (24.3%) had undergone POMs. The results of a multivariate analysis revealed the significant positive effect of POMs on perioperative serum albumin level (change between at admission and discharge, (Estimate: 0.022, standard error: 0.012, P < .0001). Patient gender, age, surgical site, performance status, the American Society of Anesthesiologists (ASA) physical status classification, operation time, amount of blood loss, and serum albumin level at admission were also significant predictors. Adjusted multivariate analysis of the effects of POMs on perioperative change of serum albumin level in all subjects reveled the significance of POMs intervention (estimate: 0.022, standard error: 0.012, P < .0001). These results suggest that POMs exerts significant positive effects on perioperative serum albumin levels in patients underwent surgery under general anesthesia., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Few studies have examined the factors related to dental clinics during dental check-ups. We examined the association between dental-hygienist-related factors and patients' regular dental check-ups. This nationwide cross-sectional study was based on a survey conducted in Japan in 2014. The analyzed population included 12,139 patients from 1181 dental clinics. We used three-level Poisson regression analysis, considering patient‒clinic‒prefecture, to examine the association of dental-hygienist-related factors with dental check-up behavior. Patients attending treatment and regular check-ups constituted 63.0% and 37.0%, respectively. The adjusted prevalence ratios (PRs) for patients undergoing regular dental check-ups at dental clinics with dedicated dental hygienists' units, spending ≥20 min in patient education (compared to 0 min), and with three or more dental hygienists (compared to 0 hygienists) available were 1.17 (95% confidence interval [CI]: 1.06-1.30), 1.25 (95%CI: 1.07-1.46), and 2.05 (95%CI: 1.64-2.56), respectively. The median PR indicates that when a patient randomly moves to another dental clinic with more regular dental check-ups, this prevalence increased 1.69 times. These results suggest that dental check-up behavior is determined not only by individual factors but also dental-clinic-level factors. Improving the dental-hygienist-related factors is necessary to encourage people to visit dentists for regular check-ups.

Although some studies showed that lifestyle was associated with oral health behavior, few studies investigated the association between household type and oral health behavior. The aim of this prospective cohort study was to investigate the association between household type, oral health behavior, and periodontal status among Japanese university students. Data were obtained from 377 students who received oral examinations and self-questionnaires in 2016 and 2019. We assessed periodontal status using the percentage of bleeding on probing (%BOP), probing pocket depth, oral hygiene status, oral health behaviors, and related factors. We used structural equation modeling to determine the association between household type, oral health behaviors, gingivitis, and periodontitis. At follow-up, 252 students did not live with their families. The mean ± standard deviation of %BOP was 35.5 ± 24.7 at baseline and 32.1 ± 25.3 at follow-up. In the final model, students living with their families were significantly more likely to receive regular dental checkup than those living alone. Regular checkup affected the decrease in calculus. The decrease in calculus affected the decrease in %BOP over 3 years. Living with family was directly associated with regular dental checkups and indirectly contributed to gingival status among Japanese university students.

Objective: The need to make sense of coherence in placement support for student dental hygienists has been shown. On this basis, this study investigated the relationship between the sense of coherence of student dental hygienists and their view of the profession and attitude to work in order to clarify how they perceive their prospects for employment., Methods: The subjects were graduation-year students at all of the dental hygienist training institutions in Japan, and anonymous, self-administered questionnaires were sent to the institutions by post in 2019. The results were analyzed by χ 2 tests, as well as one-way analysis of variance and multiple comparisons using Tukey's test, with the level of significance set at 5%., Results: Of 6270 questionnaires that were returned, 6264 were analyzed. The sense of coherence (SOC) component senses were manageability (F(26,221) = 5306.06, p < 0.01), meaningfulness (F(26,222) = 4373.48, p < 0.01), and comprehensibility (F(26,216) = 3986.12, p < 0.01), with meaningfulness scoring significantly higher than the other two ( p < 0.01). Analysis with SOC scores divided into the low, medium, and high groups showed a relationship between the SOC of student dental hygienists and their view of the profession and attitude to work ( p < 0.01), such that higher SOC scores were associated with a better view of the profession and a better attitude to work (F(26,225) = 282.18, p < 0.01)., Conclusions: The results suggest that education that increases SOC in dental hygienist training programs may positively affect future prospects for student dental hygienists.

The aim of this study was to examine the association between toothbrushing frequency and school refusal among elementary school children. We used data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) longitudinal study conducted between 2015 and 2016 in Adachi City, Tokyo, Japan. A questionnaire was distributed to all first-grade children aged 6 to 7 years (N = 3697, follow-up rate: 86.2%). Propensity score (PS) matching was applied to collapse the known covariates on toothbrushing frequency in grade 1 on the association with school refusal in grade 2. Among the followed children, 2.4% showed school refusal in grade 2 (89 children) and 23.5% (870 children) brushed their teeth once or less than once daily in grade 1. After propensity score matching, children with toothbrushing once or less than once daily in grade 1 were 2.25 (95% CI: 1.25-4.05) times more likely to show school refusal in grade 2, compared with those with toothbrushing twice or more a day. Our findings suggest that toothbrushing once or less than once daily is an independent risk factor for school refusal among children. Oral health promotion to recommend toothbrushing more than once a day could prevent school refusal. Further intervention studies investigating the mechanism and causality are warranted.

The aim of this prospective cohort study was to examine whether oral hygiene knowledge, and the source of that knowledge, affect oral hygiene behavior in university students in Japan. An oral exam and questionnaire survey developed to evaluate oral hygiene knowledge, the source of that knowledge, and oral hygiene behavior, such as the frequency of tooth brushing and regular dental checkups and the use of dental floss, was conducted on university student volunteers. In total, 310 students with poor tooth brushing behavior (frequency of tooth brushing per day [≤ once]), 1,963 who did not use dental floss, and 1,882 who did not receive regular dental checkup during the past year were selected. Among these students, 50, 364, and 343 in each respective category were analyzed in over the 3-year study period (follow-up rates: 16.1%, 18.5%, and 18.2%, respectively). The odds ratios (ORs) and 95% confidence intervals (CIs) for oral hygiene behavior were calculated based on oral hygiene knowledge and the source of that knowledge using logistic regression models. The results showed that dental clinics were the most common (> 50%) source of oral hygiene knowledge, and that a more frequent use of dental floss was significantly associated with dental clinics being a source of oral hygiene knowledge (OR, 4.11; 95%CI, 1.871-9.029; p < 0.001). In addition, a significant association was seen between dental clinics being a source of oral hygiene knowledge and more frequent regular dental checkups (OR, 13.626; 95%CI, 5.971-31.095; p < 0.001). These findings suggest the existence of a relationship between dental clinics being the most common source of oral hygiene knowledge and improved oral hygiene behavior in Japanese university students., Competing Interests: The authors have declared that no competing interests exist.

During the Japan International Cooperation Agency (JICA) partnership program in Mongolia, six times between October 2017 and October 2019, education for caries prevention, a questionnaire of daily oral health behavior, and an oral examination for parents and children aged 0-5 years old were done. The target parent population were middle socio-economic class families. In total, there were 2223 participants. The caries prevalence measured in October 2017, January, April, and October 2018, and April and October 2019, was 78.0% (95% CI: 74.2-81.4); 79.4% (73.7-84.4); 80.8% (76.2-84.9); 76.4% (70.1-82.0); 89.3% (85.3-92.6); and 82.6% (79.3-85.6), respectively. Compared to October 2017, in October 2019, the deft of three years old was significantly decreased ( p < 0.01) and that of four years old was also decreased ( p = 0.085). For the prevention of early childhood caries (ECC), daily oral health behaviors are important. In 2019, compared with the percentage of 0-5 years old in 2017, the frequency of tooth cleaning per day, parents cleaning after children, and parents watching during children's tooth cleaning were significantly increased ( p < 0.01). Unfortunately, the frequency of sugary-snack intake per day showed an increased tendency ( p < 0.05). The baby teeth decayed, extracted and filled (deft) index at three and/or four years old in October 2019 was correlated with the childrens' background characteristics, such as parent educational attainment, frequency of sweets intake, frequency of daily tooth cleaning, and parental cleaning of children's teeth. The effects of the JICA program were recognized.

Background : Epidemiologic studies provide broad-based evidence that males are at greater risk of severe periodontal diseases than females. Our recent findings further revealed that male gender was an independent risk factor for gingival bleeding in late adolescents in Japan. Gingival health status has been reported to be affected by oral hygiene behavior. However, gender difference in this regard has not yet been clarified. Methods : We conducted a retrospective review of mandatory medical questionnaires administered as part of a legally required freshman medical checkup between April 2017 and 2019 at the University of Tokyo. Results : Among a total of 9376 sets of responses, chosen subjects were 9098 students aged 17-19. For frequency of daily brushing, males brushed less frequently than females ( p < 0.001): 1 time or less (male: 22.9%, female: 11.2%), twice (65.0%, 69.2%), 3 times or more (12.1%, 19.6%). For the duration of brushing each time, males brushed for a shorter period of time than females ( p = 0.005): 1 min or less (male: 17.2%, female: 14.1%), 2-3 min (46.9%, 49.2%), 4 min or more (35.9%, 36.7%). (1) Male gender, (2) lower frequency of daily brushing and (3) shorter duration of brushing each time, were significantly associated with the presence of gingival bleeding ( p < 0.001 for all). Multivariate regression analysis showed that: (1) male gender (odds ratio 1.29, 95% confidence interval 1.15-1.44); (2) frequency of daily brushing: 1 time or less (2.36, 2.02-2.76), twice (1.45, 1.27-1.67); and (3) brushing duration each time: 1 min or less (1.57, 1.39-1.78), 2-3 min (1.26, 1.14-1.39), were independent risk factors for gingival bleeding ( p < 0.001 for all). Conclusions : Males showed poorer oral hygiene behavior than females in late adolescents in Japan. Male gender was an independent risk factor for gingival bleeding, as well as poor oral hygiene behavior.

Objectives: This study aimed to evaluate the prevalence of, and the factors associated with, periodontal disease in Japanese patients with rheumatoid arthritis (RA). Methods: Patients with RA enrolled in the Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort completed three self-administered questionnaires including questions about recent gingival bleeding during toothbrushing, a recent diagnosis of periodontitis by a dentist, and any history of periodontitis. Logistic regression analyses were used to evaluate associations with clinical variables for each questionnaire. Results: Among 5600 Japanese patients with RA, 31.0%, 18.3%, and 20.4% of patients self-reported recent gingival bleeding during toothbrushing, a recent diagnosis of periodontitis by a dentist, and a history of periodontitis, respectively. In multivariate models, younger age, fracture history, Japanese Health Assessment Questionnaire-Disability Index (JHAQ-DI), and prednisolone dosage were significantly ( p  < .05) associated with recent gingival bleeding during toothbrushing. Older age, female gender, and ever-smoker status were significantly correlated with a recent diagnosis of periodontitis. Conclusion: Many Japanese patients with RA experience gingival bleeding during toothbrushing and are diagnosed with periodontitis. Age, female gender, ever-smoker status, fracture history, JHAQ-DI, and prednisolone dosage appeared to be associated with periodontal disease in Japanese patients with RA.

Aim: We conducted a multicenter study to explore the risk factors of developing pneumonia and the effectiveness of perioperative oral management (POM) for the prevention of pneumonia in postsurgical patients., Methods and Results: A survey covering eight regional hospitals was conducted over 4 years, from April 2010 to March 2014. Using the Diagnosis Procedure Combination database, a target group of 25,554 patients with cancer who underwent surgery was selected and assessed from a population of 346,563 patients without pneumonia on admission (sample population). The study compared the incidence of pneumonia and attempted to identify the significant predictive factors for its occurrence in these patients using multiple logistic regression analysis. Comparative assessment for the occurrence of pneumonia before and after POM implementation showed a significant incidence decrease after POM introduction in the target group, with no such change observed in the sample population. Multiple logistic regression analysis showed that the odds ratio for pneumonia occurrence after POM introduction was 0.44, indicating a reduced risk of pneumonia., Conclusion: POM in cancer patients was indeed effective in reducing the incidence of pneumonia in hospitals and thereby helped in preventing pneumonia during hospitalization., (© 2019 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Background: To date, a few studies have documented the detailed periodontal conditions of a Japanese population. It is important to know if the awareness of Japanese nationals and dentists regarding oral hygiene and prevention of periodontal disease have improved when compared with the past in Japan for the development of future scenarios regarding prevention. The aim of this study was to investigate the severity, prevalence, and extent of periodontal disease in the adult population of the city of Takahagi, Japan. Results were also compared with those of an epidemiological study performed in Japan in the 1980s., Methods: A total of 582 (aged 20 to 89 years) randomly sampled Takahagi residents answered a comprehensive questionnaire and participated in clinical examinations., Results: The mean percentages of tooth surfaces harboring plaque and exhibiting BOP were 59.5 ± 20.9% and 31.1 ± 21.1%, respectively. The mean PPD and CAL were 2.5 ± 0.5 mm and 2.9 ± 1.0 mm, respectively. Compared with results of the 1980s survey, the mean percentages of plaque and bleeding on probing were lower in the current population. The mean CAL and prevalence of attachment loss of ≥5 mm in some age groups were higher in the present study than in the 1980s study. There were no statistically significant differences with respect to mean probing depth between the 1980s and current age groups., Conclusions: Periodontal disease was still prevalent in the current Japanese population, even though some improvement occurred. Proper public health programs therefore need to be established.

Aim: To investigate nursing faculty members' perceptions of oral care and to identify the effects of an educational environment on their perceptions., Methods: A cross-sectional questionnaire regarding oral care was conducted at eight nursing schools in Japan. A total of 156 (71.6%) faculty members participated in this study. Their perceptions of oral care practice were compared by using a statistical analysis according to the length of work experience, teaching field, school, and facility setting (defined as whether the school had an affiliated hospital with a dental department)., Results: Almost all of the faculty members were nurses and most were female. Almost all perceived that oral care was effective in the prevention of aspiration pneumonia and frailty. There were significant differences by teaching field in the nurses' perceptions regarding with whom they should collaborate to conduct oral care and there were significant differences by school in the nurses' perceptions regarding who should provide oral care, where it should be provided, and what kinds of knowledge are important for practice. Perceptions of low involvement in oral care were significantly associated with the schools having an affiliated university hospital with a dental department., Conclusion: There were different perceptions regarding oral care among nursing faculty members and their perceptions might have been affected by their educational environment. Therefore, it is suggested that oral care education should be standardized and nursing faculty members should standardize the curriculum regarding oral care for nursing students., (© 2018 Japan Academy of Nursing Science.)

Background: The changed disease landscape in Japan because of an increasing aging population has contributed to an increase in convalescent inpatients, warranting important considerations of their oral care needs. However, information on the oral state of these inpatients is scarce. We evaluated the correlation between the number of residual teeth and tongue hygiene state in these inpatients., Methods: This cross-sectional study included convalescent-ward inpatients, aged 34-100 years. The study was conducted between April 2017 and March 2018 in Kitakyushu, Japan. Data regarding age, sex, number of residual teeth, odontotherapy requirement, medications with oral side effects, and the reason for hospitalization, were collected. Oral hygiene level was assessed using the Oral Health Assessment Tool (OHAT). The correlation between each element of OHAT and the number of residual teeth was analyzed using Pearson's correlation analysis. The risk of a remarkable tongue state was analyzed using binominal logistic regression analysis., Results: Correlations were observed between the number of residual teeth and OHAT subscales, including tongue, saliva, and dentures. A significantly higher percentage of inpatients with ≤19 teeth had a tongue state score of 1 or higher, compared with those with ≥20 teeth. (78.6% vs 57.7%, p = 0.047). In inpatients with ≥20 teeth, the remarkable saliva state significantly increased the risk of the remarkable tongue state by 10.49-fold (95% confidence interval = 2.86-38.51), after adjusting for potential confounders., Conclusion: Poor tongue hygiene is associated with the number of teeth and salivary state in convalescent-ward inpatients. Inpatients with ≤19 teeth had a higher risk of poor tongue hygiene, regardless of the salivary condition, as assessed using OHAT.

Basic activities of daily living (ADL) is a critical indicator of independency in older adults. The purpose of this study is to evaluate impact of ADL decline on coughing ability, as determined by peak expiratory flow rate (PEFR), and to evaluate impact of ADL decline on the ability of tongue cleaning intervention to improve PEFR. Methods: Participants comprised 95 residents of 11 group homes and nursing homes in Kumamoto, Japan. Participants were randomly assigned to cohorts with or without tongue cleaning intervention. Coughing ability was evaluated by measuring PEFR before and after 2 weeks, 4 weeks, and 3 months of intervention. Basic ADL was assessed by Barthel index (BI). Mean BI score among the participants was 59.3 ± 24.2. PEFR in a cohort with ≤ 60 BI score (LB) (1.2, 0.2-4.7 L s -1 ) was significantly lower than that in a cohort with ≥ 61 BI score (HB) (1.8, 0.5-6.5 L s - 1 ; p < 0.001). Multiple regression analysis revealed that BI score significantly correlated with PEFR after adjustment for various confounders (p < 0.004). Although tongue cleaning intervention increased PEFR in both cohorts, BI score only correlated with the amount of change of PEFR in the intervention group (p = 0.048). Basic ADL decline closely correlated with lowered coughing ability, as assessed by PEFR. Additionally, the rehabilitative effect of tongue cleaning on coughing ability was affected by basic ADL in older adults.

Background: The aim of the study is to assess the clinical effect of an antibacterial monomer-containing primer on preventing white spot lesions (WSLs) during fixed orthodontic treatment., Subject and Methods: The study included 35 patients. A split-mouth design was used during bonding of the brackets. In Clearfil (CF) group, adhesive-coated brackets (APC Plus Victory series, 3M Unitek, Monrovia, CA, USA) were bonded with an antibacterial monomer-containing primer (Clearfil Protect Bond, Kuraray Medical, Okayama, Japan). In Transbond (TB) group, the same adhesive-coated brackets were bonded using a conventional primer (Transbond XT Primer; 3M Unitek, Monrovia, CA, USA). The mean duration of orthodontic treatment was 16 months. Digital images of each tooth were used to assess the WSLs. The areas of the WSLs were measured with a software. The bond failures during orthodontic treatment were also recorded., Results: After fixed orthodontic treatment, 23 of the 35 patients showed one or more WSLs. Of the total of 666 teeth, 114 WSLs occurred over the orthodontic treatment time. Rates of WSL in the CF and TB groups were 8.03% and 9.24%, respectively. The difference in WSL rates between the two groups was not statistically significant. No significant difference was observed in the lesion areas between the groups. Moreover, the difference in bracket failure rates between the two groups was also not statistically significant., Conclusion: The results of this long-term clinical study indicated no significant difference between the antibacterial monomer-containing primer group and the control group in the efficacy of reducing demineralization throughout the orthodontic treatment.

Radical esophagectomy for thoracic esophageal cancer is invasive and frequently results in postoperative pulmonary complications. Postoperative pneumonia is the most common such complication and affects hospital mortality and survival rates. Oral care has been very effective in reducing pneumonia. In Japan, preoperative professional oral care is highly recommended. However, there are few studies on the effect of preoperative improvements in oral hygiene as a result of intervention on the incidence of postoperative pneumonia. The primary end-point of this retrospective study was the incidence of postoperative pneumonia after radical esophagectomy. The oral health levels of 46 patients were individually categorized, and then patients were grouped according to whether they maintained or improved their oral hygiene. At the first dental examination, oral health levels were classified as good in 22 patients and bad in 24. Of the 46 patients studied, 39 patients maintained or improved their oral hygiene (good control group), whereas 7 showed no improvement (bad control group). Postoperative pneumonia occurred in eight patients: four in the good control group and four in the bad control group. Statistical analysis with postoperative pneumonia as a dependent variable showed a significant effect of oral hygiene improvement on the incidence of pneumonia. Logistic regression analysis with this factor as an independent variable demonstrated that the risk of postoperative pneumonia was reduced in the good control group (OR 0.086, 95% CI 0.014-0.529). Therefore, preoperative professional oral care may improve oral hygiene and oral health, which may in turn reduce the incidence of postoperative pneumonia.

Background: Many studies have reported that oral health status is associated with various systemic health issues. This study examined the correlations among oral health, lifestyle factors, and metabolic syndrome (MetS) in aged participants., Methods: We analyzed cross-sectional oral and medical health checkup data from 2,379 participants aged 75 and 80 years. MetS was diagnosed according to the Harmonization criteria, with the exception of the criterion for central obesity, and body mass index was used instead of waist circumference. Logistic regression analyses were performed to evaluate the correlation between oral health status and lifestyle factors and MetS in both sexes and by sex., Results: In both sexes, the odds ratio (OR) for MetS was 1.54 (95% confidence interval [CI], 1.10-2.17) among those who had 0-9 teeth compared with those with 20-28 teeth. MetS was significantly more likely for those eating quickly than those eating slowly (OR 2.06; 95% CI, 1.35-3.16). Participants using secondary oral hygiene products every day had a significantly lower OR (0.71; 95% CI, 0.55-0.92) for MetS than did those who did not. Participants with 0-9 teeth who ate quickly had a significantly higher OR (2.48; 95% CI, 1.06-5.78) for MetS compared with those with 20-28 teeth who ate slowly., Conclusion: These results suggest that maintaining teeth, eating slowly, and using secondary oral hygiene products every day are associated with a lower likelihood of MetS in the aged population.

Purpose: New methods of public education in oral care must be developed, because the public understanding of the importance of oral care is insufficient. This questionnaire study examined the parameters 'awareness and attitude relevant to teeth and mouth' and 'consciousness and attitude of daily life' in order to clarify what kind of information is needed for public education in oral care., Materials and Methods: Data gathered in a survey of oral care behaviours and lifestyle among the elderly were analysed for oral care awareness and health of the teeth using the factor analysis method. The respondents were divided into four groups according to two factors relating to oral health condition and oral care awareness., Results: The high oral-care-consciousness group had a greater awareness of general health and sociability as well as life satisfaction than did the low oral-care-consciousness group. However, the respondents' economic situation had a larger effect on life satisfaction. The respondents were then divided into higher, middle, and lower economic status groups, and the relation between oral care awareness and life satisfaction was analysed for each group. As a result, the correlation between life satisfaction and oral care consciousness was observed by excluding the economic factors., Conclusion: The present data suggest that oral care awareness may contribute to improvement of lifestyle and life satisfaction.

Objectives: The aim of this study was to clarify the current status of stockpiling of oral care hygiene materials in case of a disaster and to determine methods to support stockpiling during disaster preparation., Methods: We conducted an Internet questionnaire survey on stockpiling and disaster prevention measures among 300 adults. For statistical analysis, the χ² test, Mann-Whitney U-test and Spearman rank test were employed. Logistic regression analysis was conducted to review factors related to stockpiling., Results: Among the questions on stockpiling and disaster prevention (14 of 15 items), seven items on disaster prevention measures and two on disaster prevention experiences significantly differed. Analysis of disaster prevention knowledge revealed that disaster prevention measures and disaster experiences significantly differed in terms of the presence or absence of stockpiling, albeit a positive correlation was noted with stockpiling. Logistic regression analysis was conducted with stockpiling as a dependent variable. As a result, the items 'I am aware about the hazard map of the residential area', 'I am aware about the type of oral care hygiene materials prepared for emergency' and 'Devising the living environment such that large furnitures and cupboards do not collapse during disasters' were effective., Conclusions: Stockpiling at home is considered necessary for self-sufficiency during a disaster on the basis of the experiences in disaster management, disaster prevention knowledge and disaster prevention measures. Hence, stockpiling is a strong measure against disaster prevention along with provision of appropriate knowledge about the necessity of oral care in daily life. Disaster prevention education that empowers a population to prepare itself by implementing disaster prevention measures, such as improving the home environment, is considered effective. In addition, considering that relying on stockpiling at an individual level is ineffective, it is necessary to create mechanisms and systems that jointly manage disaster situations according to local circumstances.

Background: There is growing international interest in identifying the effects of ageing on oral health and on appropriate strategies for managing oral disorders. The Japanese Society of Gerodontology (JSG), as the official representative of researchers and clinicians interested in geriatric dentistry in Japan, makes several recommendations on the concept of "oral hypofunction.", Aims: This study proposes diagnostic criteria and management strategies to reduce the risk of oral hypofunction among older people., Conceptual Framework: We define oral hypofunction as a presentation of 7 oral signs or symptoms: oral uncleanness; oral dryness; decline in occlusal force; decline in motor function of tongue and lips; decline in tongue pressure; decline in chewing function; and decline in swallowing function. The criteria of each symptom were determined based on the data of previous studies, and oral hypofunction was diagnosed if the criteria for 3 or more signs or symptoms were met., Conclusions: We recommend that more evidence should be gathered from clinical studies and trials to clarify our diagnostic criteria and management strategies., (© 2018 The Authors Gerodontology published by Gerodontology Association and John Wiley & Sons Ltd.)

Background: Functional disability of the finger joints in rheumatoid arthritis (RA) patients could affect their oral hygiene and periodontal status because of poor plaque control. We examined the influence of plaque control on the relationship between the severity of RA and periodontal status in RA patients., Methods: This study recruited 89 Japanese RA patients who reported no difficulty in performing oral hygiene. We assessed RA severity using four indices: the Steinbrocker stage and class, the Health Assessment Questionnaire (HAQ) and the Disease Activity Score (DAS). Probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were taken as parameters of periodontal status. Oral hygiene status was assessed using the plaque index (PlI). We examined the association between the severity of RA and periodontal parameters using multivariable linear regression analyses., Results: In multivariable linear regression analyses not including PlI, Steinbrocker stage III-IV patients had significantly higher PlI scores and greater PD compared with those of stage I. The class III-IV patients had significantly higher PlI scores and greater PD. Patients with an HAQ score ≥0.5 had a significantly higher PlI score than those with an HAQ score of 0. However, when PlI was added to each multivariable model as an independent variable, no significant relationship between RA severity and periodontal status was observed., Conclusions: This study suggests that it is important to consider the influence of plaque control when assessing the relationship between RA severity and periodontal health status in RA patients., (© 2018 American Academy of Periodontology.)

Background and Objective: Salivary lactate dehydrogenase (LDH) was reported to be a useful parameter for the screening of periodontal disease. We performed a cross-sectional study to verify the usefulness of salivary LDH as a biomarker of periodontitis and to investigate the association of severity of periodontitis with systemic inflammation by measuring salivary LDH and serum high sensitive C-reactive protein (hs-CRP) levels in a community-based middle-aged and elderly population in Japan., Material and Methods: We recruited 644 men and 1171 women, aged 30-79 years, who participated in the Toon Health Study during 2011-15. Periodontal condition was assessed by full-mouth examination including mean value of probing depth, percentage of probing depth of ≥4 mm and ≥6 mm, and bleeding on probing. Saliva and blood serum samples were collected for measurement of salivary LDH level and hs-CRP, respectively. A linear trend across quartiles of salivary LDH was calculated using linear regression. Interaction of salivary LDH and overweight status (body mass index of ≥25 kg/m 2 ) was tested using the cross-product term of log-transformed continuous salivary LDH and overweight status., Results: Analysis of covariance adjusted for potential confounders revealed strong associations between salivary LDH level and the indicators of periodontal condition (P < .01) in both men and women. Sex- and age-adjusted mean values of hs-CRP according to salivary LDH quartiles were 0.40, 0.45, 0.45 and 0.50 mg/L (P for trend <.01). Although the association was attenuated after further adjustment for body mass index, hypertension, diabetes mellitus, dyslipidemia, alcohol intake, smoking status and physical activity. When stratified by overweight status, the association remained significant in overweight individuals (P = .03). The multivariable adjusted odds ratio of hs-CRP level of ≥1 mg/L for the highest vs lowest quartile of salivary LDH was 1.93 (95% CI, 1.01-3.69) in overweight individuals, but not significant in non-overweight individuals., Conclusion: Salivary LDH appears to be a promising biomarker for the mass screening of periodontitis in local community health settings. High salivary LDH levels, particularly in overweight individuals might contribute to prevention of cardiovascular disease, through measuring systemic inflammatory burdens as well as traditional cardiovascular risk factors., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To examine whether late bedtime and short nighttime sleep duration at age 18 months are associated with risk of caries in deciduous teeth., Study Design: Population-based cohort study using health check-up data of 71 069 children born in Kobe City, Japan, who were free of caries at age 18 months and had information on sleep variables at age 18 months and records of dental examinations at age 3 years. Sleep variables were assessed by standardized parent-reported questionnaires, and the incidence of caries in deciduous teeth was defined as the occurrence of at least 1 decayed, missing, or filled tooth assessed by qualified dentists without radiographs. Logistic regression was used to estimate the effects of late bedtime and short sleep duration on dental caries with adjustment for clinical and lifestyle characteristics., Results: Overall, 11 343 (16.0%) cases of caries were observed at age 3 years. aORs for children with late or irregular bedtimes compared with those with bedtimes before 21:00 were 1.26 (95% CI 1.19-1.33), 1.48 (1.38-1.58), 1.74 (1.58-1.92), 1.90 (1.58-2.29), and 1.66 (1.53-1.81) for bedtimes at 21:00, 22:00, 23:00, 0:00, and irregular bedtime, respectively. aORs for children with short or irregular sleep duration compared with those with sleep duration of ≥11 hours were 1.30 (95% CI 1.15-1.47), 1.16 (1.09-1.24), 1.11 (1.05-1.18), and 1.35 (1.25-1.46) for sleep duration of ≤ 8, 9, 10 hours, and irregular sleep duration, respectively., Conclusions: In this exploratory study, late bedtime and short sleep duration were both consistently associated with increased risk of caries in deciduous teeth., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Aim: To examine the effect of toothbrushing on the development of metabolic syndrome (MetS), including assessment of periodontal status, in middle-aged adults., Methods: This 5-year follow-up retrospective study was performed in 3,722 participants (2,897 males and 825 females) aged 35-64 years who underwent both medical check-ups and dental examinations. Metabolic components included obesity, elevated triglycerides, blood pressure, fasting glucose and reduced high-density lipoprotein. Toothbrushing frequency was assessed using a questionnaire. Periodontal disease was defined as having at least one site with a pocket depth of ≥4 mm. Logistic regression analysis was performed to evaluate the relationship between toothbrushing frequency at the baseline examination and the development of MetS (≥3 components)., Results: During follow-up, 11.1% of participants developed MetS. After adjusting for potential confounders including periodontal disease, participants with more frequent daily toothbrushing tended to have significantly lower odds of developing MetS (p for trend = .01). The risk of development of MetS was significantly lower in participants brushing teeth ≥3 times/day than in those brushing teeth ≤1 time/day (odds ratio = 0.64, 95% confidence interval = 0.45-0.92)., Conclusions: Frequent daily toothbrushing was associated with lower risk of development of MetS., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The oral hygiene of patients with a mental illness is an important concern in psychiatric care, and it is necessary to increase the level of self-care among these patients. In this study, we administered an oral care questionnaire to people with mental illness in Japan and compared their answers before (baseline) and at 1 week and 1, 3 and 6 months after they participated in an educational program., Methods: The questionnaire was distributed to 390 patients. It included questions about age, education, income, between-meal snacks, number of teeth, frequency of tooth brushing, and other items. The educational program was developed for the purposes of improving self-care., Results: Before the program, the proportion of male patients who had had a mental illness for ≥ 10 years was significantly higher among those patients who did not brush their teeth before bed. In addition, such patients did not have primary care dentists, and a significantly higher proportion of male patients, compared with female patients, did not undergo routine dental checkups more than once per year. The educational program resulted in an improvement in the use of fluoride toothpaste from baseline to 6 months after the intervention (p = 0.001). The daily use of interdental brushes or floss was significantly different 6 months after the intervention., Conclusions: Male and long-term inpatients need oral hygiene instructions. Our educational program showed the effects of using oral hygiene tools. Future studies should include a control group to measure the impact of the educational program.

Objective: The aim of this study was to evaluate the inhibitory effects of oral moisturising gel containing egg yolk antibody against Candida albicans (anti-CA IgY) in older people. Therefore, we measured the number of Candia CFU present on oral swabs at baseline and after using the gel., Methods: A randomised, double-blind, placebo-controlled trial was conducted among volunteers living in a nursing home in Japan. The participants were divided into two groups. The group 1 participants received oral care using an experimental oral moisturising gel with anti-CA IgY, and those in group 2 received oral care using a placebo oral moisturising gel without anti-CA IgY. The oral care was performed by care workers three times a day for 4 weeks. The participants' tongues were sampled using a swab method at baseline and after 2 and 4 weeks of using the oral gel, and the number of C. albicans, Candida tropicalis and Candida krusei colonies was counted., Results: The baseline oral condition of the participants in the two groups did not differ significantly. The experimental gel significantly reduced the number of C. albicans colonies from baseline to after 4 weeks of using the oral gel; however, no significant reductions were observed in the number of C. tropicalis or C. krusei colonies., Conclusion: The use of oral moisturising gel containing anti-CA IgY for 1 month significantly reduces the number of C. albicans CFU present on swabs in older people., (© 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

A comparison of national surveys on oral health suggested that the population of South Korea has a better periodontal health status than that of Japan, despite their similar inherent backgrounds. Here, we investigated differences in oral bacterial assemblages between individuals from those two countries. To exclude potential effects of oral health condition on the microbiota, we selected 52 Korean and 88 Japanese orally healthy adults (aged 40-79 years) from the participants of two cohort studies, the Yangpyeong study in South Korea and the Hisayama study in Japan, and compared the salivary microbiomes. The microbiota of the Japanese individuals comprised a more diverse community, with greater proportions of 17 bacterial genera, including Veillonella, Prevotella, and Fusobacterium, compared to the microbiota of the Korean individuals. Conversely, Neisseria and Haemophilus species were present in much lower proportions in the microbiota of the Japanese individuals than the Korean individuals. Because higher proportions of Prevotella and Veillonella and lower proportions of Neisseria and Haemophilus in the salivary microbiome were implicated in periodontitis, the results of this study suggest that the greater proportion of dysbiotic oral microbiota in the Japanese individuals is associated with their higher susceptibility to periodontitis compared to the Korean individuals.

Aim: The purpose of this study was to analyze the improvement in oral function and environment in high-risk elderly persons participating in a program to improve oral function organized by their local government., Methods: Participants comprised 36 high-risk elderly and the mean age was 77.11 ± 7.24 years. The program involved training sessions carried out five or six times every 2-3 weeks for 3 months. Oral function and environment was evaluated before and after the program. The research period extended from 2008 to 2010., Results: The effects of intervention were clearly observed in oral diadochokinesis score in the high-risk elderly. Persons with a lower repetitive saliva swallowing test (RSST) and oral diadochokinesis score before intervention showed a tendency toward even greater improvement. No significant changes were observed in saliva secretion or total amounts of Streptococcus mutans, Lactobacilli, Candida or total microorganisms., Conclusions: The effects of intervention were clearly recognized in regards to oral diadochokinesis. Improvement in RSST and oral diadochokinesis scores was marked in those persons showing a lower number of articulations before intervention., (© 2012 Japan Geriatrics Society.)

Background: In recent years, disasters that overwhelm the capacity of humans have been frequent. However, international cooperation has been swift as a result of advances in transportation, enabling the more prompt administration of First Aid., Methods: We have had two opportunities to observe outcomes in oral hygiene immediately after and 10 months after two different major disasters., Results: The types of food provided to survivors altered their sense of taste and resulted in the occurrence of dental caries several months after an earthquake. In addition, it is difficult to practise good oral hygiene in the aftermath of a disaster., Conclusions: We observed the occurrence of previously undocumented problems related to dental issues, such as changes in children's sense of taste caused by unfamiliar types of food provided in relief shelters. Dentists and dental hygienists who are involved in the relief of survivors in the immediate aftermath of a natural disaster should focus on maintaining good oral health in order to prevent the occurrence of dental caries., (© 2012 FDI World Dental Federation.)