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Purpose: This study aimed to investigate the usefulness of a newly developed oral simulator for nursing students’ oral assessment education on oral diseases and symptoms. Materials and Methods: The participants were first-year students (n=105) at a nursing school in Japan. Ten identical oral simulators with angular cheilitis, missing teeth, dental caries, calculus, periodontitis, hypoglossal induration, food debris, and crust formation were created by a team of dentists. After a 45-minute lecture programme for oral assessment performance with the Oral Health Assessment Tool (OHAT), the ability test with the simulators and the OHAT as well as test feedback were conducted in a 30-minute practical programme. To evaluate the effectiveness of the programmes, questionnaires and ability tests with slides of oral images were conducted at baseline and after the programme. Results: Ninety-nine students (94.3%) participated in this study. The results of the ability test with the simulators and the OHAT in the practical programme showed that the correct answer rates of assessing tongue, gingiva, present teeth, and oral pain were less than 40%. Their levels of confidence, perception, and oral assessment performance were statistically significantly higher after the programmes than they were at baseline. Their level of confidence in assessing the need for dental referral had the largest increase in scores compared to the lowest scores at baseline in the nine post-programme assessment categories. Conclusions: This study identified several problems with nursing students’ oral assessment skills and improvements of their oral assessment confidence, perceptions and performance. [ABSTRACT FROM AUTHOR]

The concept of oral frailty was first proposed in Japan in 2014 by the "Joint Working Committee on Oral Frailty," consisting of three academic societies—the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty—to enhance public understanding of oral frailty. Oral frailty is a state between robust oral function (a "healthy mouth") and its decline, characterized by slight declines in oral function, including tooth loss and difficulties in eating and communicating, which increase the risk of impaired oral functional capacity but can be reversed with proper intervention and treatment. Oral frailty can be assessed using the Oral Frailty 5‐item Checklist (OF‐5) without the need for a dental health professional. Oral frailty is defined as having at least two of the following components: (i) fewer teeth, (ii) difficulty chewing, (iii) difficulty swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Approximately 40% of community‐dwelling older adults have oral frailty. Oral frailty is associated with poor dietary variety, social isolation, physical frailty, disability, and mortality. This statement introduces the concept and definition of oral frailty, a new assessment tool (OF‐5), and concept diagrams for healthcare professionals and the general public. These tools aim to promote public awareness and facilitate collaboration between medical and dental healthcare providers. Geriatr Gerontol Int 2024; 24: 1111–1119. [ABSTRACT FROM AUTHOR]

Objective: This pilot study evaluated the relationships between appetite and oral function, and between appetite and the subjective symptoms of decreased oral function. Methods: Seventy‐one adult dental clinic patients (22 males, 66.0 ± 14.0 years) participated in this study. A Council on Nutrition Appetite Questionnaire score of ≤28 indicated anorexia, and the Mini Nutritional Assessment Short‐form, body mass index and skeletal muscle mass index were used to define subject characteristics. Seven oral function tests and seven subjective symptoms related to oral function were evaluated. The relationship between subject characteristics, oral function tests, subjective symptoms and anorexia was analysed using the chi‐square test and univariate and multivariate logistic regression. Result: There were significant differences between the normal appetite group and the anorexia group for the 10‐item Eating Assessment Tool (EAT‐10) survey and the question 'Food remains in the oral cavity after eating' (p <.05). Univariate logistic regression found significant differences in the items of masticatory function, the EAT‐10 survey and the question 'Food remains in the oral cavity after eating'. Multivariate logistic regression revealed significant differences in masticatory function (AOR 4.35; 95% CI: 1.03–18.35; p =.045) and EAT‐10 (AOR 6.27; 95% CI: 1.40–24.02; p =.016). Conclusion: This pilot study investigated the influence of factors related to oral function on appetite. Relationships were found among poor masticatory function, poor swallowing function and anorexia. [ABSTRACT FROM AUTHOR]

Aim: In Japan's public health system, dentists can assess and intervene in oral hypofunction cases. However, the associations between oral hypofunction and health outcomes and costs remain unclear. This study aimed to identify these associations. Methods: This retrospective cohort study using a Japanese health insurance claims database included 45 916 individuals aged ≥65 years who underwent dental examinations for oral hypofunction. The primary outcomes were incidence rates of aspiration pneumonia, femoral or vertebral fractures and all‐cause mortality. Secondary outcomes were annual medical and dental costs. We used competing risk regression and Cox models to estimate primary outcomes, and gamma regression models for secondary outcomes. Results: The adjusted hazard ratios were 0.84 (95% CI 0.74–0.96) for the incidence of aspiration pneumonia, 1.11 (1.02–1.21) for the incidence of femoral or vertebral fractures and 1.27 (1.07–1.50) for all‐cause mortality in individuals with oral hypofunction compared with those without. The adjusted relative risk was 1.05 (1.01–1.10) for annual medical costs and 0.94 (0.81–1.09) for annual dental costs in individuals with oral hypofunction compared with those without. Conclusions: Individuals with oral hypofunction were at increased risk of femoral or vertebral fractures and all‐cause mortality, and they incurred significantly higher annual medical costs, compared with those without this condition. Notably, they showed a lower risk of aspiration pneumonia, suggesting potential benefits of dental intervention. Integrating dental care into medical strategies might be necessary to improve health outcomes and reduce healthcare costs for those with oral hypofunction. Geriatr Gerontol Int 2024; 24: 1053–1059. [ABSTRACT FROM AUTHOR]

Objective: Although it has been suggested that a decline in oral function is one of the potential risk factors affecting mild cognitive impairment (MCI), evidence is insufficient to draw clear conclusions. This Japanese cross‐sectional study examined the association between tongue pressure (TP) and MCI in middle‐aged and older adults aged 36–84 years. Methods: Study participants were 1019 (368 men and 651 women). TP was evaluated using a TP measurement device. The maximum value of three measurements was used for analysis. MCI was defined as being present if a participant had a Japanese version of the Montreal Cognitive Assessment score of <26. Adjustment was made for age, smoking status, alcohol consumption, leisure‐time physical activity, body mass index, hypertension, dyslipidemia, diabetes mellitus, history of depression, number of teeth, employment, education, and household income. Results: The prevalence of MCI was 45.3%. Among women, compared with the lowest tertile of TP, the second and highest tertiles were significantly associated with a lower prevalence of MCI with a clear dose–response relationship; the adjusted odds ratio (95% confidence intervals) in the second and highest tertiles of TP were 0.54 (0.36–0.83) and 0.55 (0.36–0.84), respectively (p for trend = 0.005). In contrast, no statistically significant association was observed between TP and the prevalence of MCI among men. Conclusions: Our findings suggest that higher TP might be inversely associated with the prevalence of MCI in middle‐aged and older Japanese women. [ABSTRACT FROM AUTHOR]

Background: Prevotella bacteria are associated with inherent diseases of the oral cavity, such as periodontal disease, and systemic diseases. Oral frailty (OF) has been associated with nursing necessity and death. However, the relationship between OF and oral microbiota has not been fully clarified. Objective: This cross‐sectional study investigated the association between OF and Prevotella percentage in the oral microbiota of community‐dwelling older adults. Methods: Oral bacteria species from saliva were identified in 208 community‐dwelling older individuals aged ≥60 years in Japan. The proportion of Prevotella in the oral microbiota was classified into three tertile groups, and its relationship with each test item for OF (number of remaining teeth, masticatory performance, oral diadochokinesis, tongue pressure, difficulties eating tough foods, difficulties swallowing tea or soup, number of applicable OF judgement items, and existence of OF) was examined using ordinal logistic regression analysis. Results: The Prevotella proportions were classified into lower, middle and upper groups, comprising 70, 69 and 69 participants, respectively. The three groups showed a significant relationship between the number of remaining teeth (odds ratio [OR]: 0.946, 95% confidence interval [CI]: 0.915–0.977), masticatory performance (OR: 0.897, 95% CI: 0.844–0.953), number of applicable OF judgement items (OR: 1.477, 95% CI: 1.14–1.915), and existence of OF (OR: 4.194, 95% CI: 1.519–11.576). Conclusion: The proportion of Prevotella in oral microbiota was high in individuals with OF. Among the older adults, the type of oral microbiota and systemic diseases may be related to the examination and management of oral function decline. [ABSTRACT FROM AUTHOR]

Background: Oral hypofunction is the stage before oral dysfunction. The subjective symptoms of poor oral function and the decline in oral health‐related quality of life (OHRQoL) that occur in the oral hypofunction stage can be missed. Objective: This multicentre cross‐sectional study was performed to examine the relationships between the test results for oral hypofunction, subjective frailty symptoms and OHRQoL of outpatients in dental clinics. Methods: The basic characteristics and oral function test results of 637 dental clinic outpatients were evaluated. The subjective symptoms of physical and oral frailty were investigated using a questionnaire. OHRQoL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP‐JP16) and OHRQoL dimension score. Results: The overall prevalence of oral hypofunction was 37.8%, with no significant difference between men and women. No significant differences in the presence or absence of subjective symptoms of frailty and a high OHIP score were observed based on sex. However, the prevalence of oral hypofunction was significantly different among the age groups and increased with age. The subjective symptoms of frailty score, OHIP score and OHRQoL dimension score were significantly higher in patients with versus without oral hypofunction. Age, number of underlying diseases, total score for subjective symptoms of frailty, total score for OHIP and OHRQoL dimension score were significantly associated with oral hypofunction. Conclusion: Oral hypofunction may affect the subjective symptoms of frailty and OHRQoL in older adults. [ABSTRACT FROM AUTHOR]

Background: Poverty negatively impacts beneficial aspects of mental development, such as resilience. Toothbrushing, an oral health behavior, has the potential to protect children's resilience through its anti-inflammatory and self-management effects and may be more effective for children, especially children in poverty. This study investigated whether toothbrushing boosts resilience among children, especially children under poverty, and modifies the association between poverty and resilience using a longitudinal population sample of school children. Methods: Data from the Adachi Child Health Impact of Living Difficulty (A-CHILD Study) were analyzed. A baseline study was conducted in 2015 in which the children were in first grade and followed through fourth grade (N = 3459, response rate: 80%, follow-up rate: 82%). Poverty was assessed by material deprivation (life-related deprivation and child-related deprivation) and annual household income at baseline. Children's toothbrushing frequency was assessed at baseline and classified into less than twice a day or twice or more a day. Children's resilience was assessed at baseline and follow-up using the Children's Resilient Coping Scale (range 0-100). Results: Children who brushed their teeth twice or more a day in first grade had 3.50 points greater resilience scores in fourth grade than those who brushed their teeth less than twice a day in first grade. After adjusting for confounders, including resilience in first grade, among underpoverty children, those who brushed their teeth twice or more a day in first grade had higher resilience scores [2.66 (95% CI = 0.53, 4.79)] than those who brushed their teeth less than twice a day. Among nonpoverished children, toothbrushing frequency in first grade did not significantly correlate with resilience in fourth grade. Conclusions: The beneficial effect of toothbrushing twice or more a day on resilience was more significant among children in poverty than among those without poverty in elementary school in Japan. Health policy focused on frequent toothbrushing may contribute to boosting resilience among children living in poverty. [ABSTRACT FROM AUTHOR]

Objectives: With the increasing number of family caregivers due to the ageing population, physical and mental health problems among caregivers are of concern. However, few studies have evaluated their oral health. This study aimed to evaluate the association between being a family caregiver and recent dental visits for dental symptoms in Japan, with consideration of gender. Methods: A cross‐sectional study was conducted using the 2016 Comprehensive Survey of Living Conditions (CSLC) in Japan. Participants with dental symptoms were included in this study. The primary outcome was recent dental visits. The exposure variable of interest was being a primary caregiver for a family member requiring long‐term care. A logistic regression analysis was conducted adjusting for contributing factors such as age, gender, marital status, working hours per week, education, household expenditure per month, self‐rated health and the interaction between gender and caregiving. A stratified analysis by gender was also performed. Results: Of the 5100 eligible participants, 233 (4.6%) were family caregivers. Of all participants, 2746 (53.8%) reported dental visits. The adjusted odds ratio (aOR) of family caregivers having recent dental visits was 0.83 (95% confidence interval [CI], 0.64–1.09). In a gender stratified analysis, family caregivers were less likely to visit dental clinics than were non‐family caregivers in the male subsample (aOR: 0.56, 95% CI: 0.34–0.92) but not in the female subsample (aOR: 0.99, 95% CI: 0.72–1.38). Conclusions: The findings indicate that family caregivers, especially male caregivers, had fewer dental visits than non‐family caregivers. These findings suggest the need to improve the accessibility of dental clinics to family caregivers with dental symptoms. [ABSTRACT FROM AUTHOR]

Objective: It is presumed that people with nervous tendencies brush their teeth for long durations, and, we aimed to investigate how nervous tendencies affect oral health status and lifestyle habits. Subjects and methods: Three hundred and sixty patients who visited the Senri Dental Clinic, affiliated with the Sunstar Foundation, and were being treated for periodontal diseases between 11 January 2017 and 10 April 2017 were enrolled. A total of 323 respondents (101 men and 222 women) were considered eligible. Nervous tendencies were investigated using the Fujinami neurotic index (FNI) and its derivative, the neurotic index (NI). Patients with NIs of ≥20 were included in the 'needs caution' group, whereas those with NIs of <19 comprised the 'healthy' group. The plaque score; periodontal pocket depth; bleeding on probing degree; gingival recession; crevice defects; oral conditions, such as cervical fillings and lifestyle habits were compared between the groups. Results and discussion: No statistically significant differences in oral status were observed between the groups. On the other hand, the needs caution group had significantly longer brushing durations and lower usage of auxiliary teeth cleaning tools than the healthy group. Sleep duration was significantly shorter in the needs caution group than in the healthy group. Conclusions: Patients with strong nervous tendencies had long oral brushing durations and low usage of auxiliary cleaning tools. However, these factors did not negatively affect oral health status. These results could aid in understanding patients with strong nervous tendencies and in developing appropriate dental health guidance measures. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between adherence to professional oral maintenance visits and tooth loss is generally accepted in periodontal treatment; however, this relationship has not been clarified in general dental practices. We evaluated the effectiveness of adherence to professional maintenance by a retrospective survey in a private practice. Methods: We retrospectively extracted data of 395 patients in a general dental practice who had been followed for more than 20 years. For comparisons, two patient groups were created based on oral maintenance rates: a high‐ (≥75%) and a low‐ (<75%) adherence groups. Additionally, multiple logistic regression analysis for tooth loss was conducted with the same two adherence groups and three adherence groups (<50%, ≥50% and <75% and ≥75%), adjusting with risk factors including sex, age, decayed, missing, and filled teeth (DMFT), periodontal status, smoking status, and diabetes at the beginning of maintenance. Results: The number of teeth lost and increased DMFT over time were significantly lower in the high‐adherence group than in the low‐adherence group. Multiple logistic regression analysis for tooth loss in the two adherence groups yielded an odds ratio (95% confidence interval) of 6.50 (3.73–11.32) in the low‐adherence group relative to the high‐adherence group. Further analysis with the three adherence groups showed highest risk in the low‐adherence group and a higher risk in the moderate‐adherence group than the high‐adherence group. Conclusions: Patients with high adherence to maintenance schedules for more than 20 years demonstrated significantly less tooth loss. Dental practitioners should promote high adherence to professional maintenance in general dental practices. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aim: Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer‐to‐peer learning and assessment can help improve nurses' skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE). Methods: A pre‐ and post‐survey of 97 nursing students from a nursing school in Japan was conducted as a peer‐to‐peer oral health education training program that included an assessment and performance checklist. Results: Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0–25) of the first, second, third, and fourth participants in the four‐student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (p <.01). Fifty‐two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills. Conclusions: This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE‐style delivery. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aim: Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross‐sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity. Methods: The analysis included 2727 late‐stage older adults (mean age 79.9 ± 4.3 years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score. Results: Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1‐point increase 0.88, 95% confidence interval 0.84–0.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92–0.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor. Conclusions: Oral frailty was associated with decreased appetite and dietary variety in late‐stage older adults. Geriatr Gerontol Int 2024; 24: 626–633. [ABSTRACT FROM AUTHOR]

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While previous reports have established the anti-inflammatory effects of hangeshashinto, the intracellular signal transduction pathways involved have yet to be elucidated. We aim to employ an experimental system using oral cancer cells to assess the impact of hangeshashinto on intracellular signal transduction pathways in response to stimulation by Porphyromonas gingivalis pathogen-associated molecular patterns (PAMP). Hangeshashinto demonstrated the ability to inhibit the production of interleukin (IL)-6 and IL-8 induced by P. gingivalis PAMP. Furthermore, hangeshashinto suppressed the activation of the IL-6 promoter stimulated by PAMP. Hangeshashinto, like Toll-like receptor (TLR) signaling inhibitors (resatorvid and C29) and an immunosuppressant (dexamethasone), exhibited the ability to suppress TLR-mediated activation of the transcription factor nuclear factor-κB (NF-κB) in response to PAMP stimulation. This study suggests that the anti-inflammatory effects of hangeshashinto may be attributed to the inhibition of TLR signal transduction pathways including NF-κB activation, thereby suppressing NF-κB-dependent gene expression. [ABSTRACT FROM AUTHOR]

We aimed to reveal interrelationships between alexithymia, catastrophic thinking, sensory processing patterns, and dental anxiety among 460 participants who were registrants of a Japanese research company. Measures used were the Modified Dental Anxiety Scale, the Adult Sensory Profile, the Pain Catastrophizing Scale, and the 20‐item Toronto Alexithymia Scale. The interrelationships among the constructs were analyzed using structural equation modeling, adjusting for age, gender, and negative dental treatment experience. Data from 428 participants were used in the analyses. Sensory sensitivity and pain catastrophizing were independently associated with anticipatory and treatment‐related dental anxiety, while difficulty identifying feelings was not. In the mediation model, sensory sensitivity and pain catastrophizing served as full mediators between difficulty identifying feelings and the dimensions of dental anxiety (indirect effects were between 0.13 and 0.15). The strength of the associations was 0.55 from difficulty identifying feelings to both pain catastrophizing and sensory sensitivity, and between 0.24 and 0.26 to anticipatory and treatment‐related dental anxiety. The association between trait‐like phenomena, such as alexithymia, and dental anxiety may be mediated by neurophysiological and cognitive factors such as sensory sensitivity and pain catastrophizing. These findings could be crucial for new and innovative interventions for managing dental anxiety. [ABSTRACT FROM AUTHOR]

Aim: This study examined the associations between geriatric factors and decreased opportunities for conversation among older adults amid a period of self‐restraint during the COVID‐19 pandemic. Methods: A cross‐sectional questionnaire‐based survey was carried out in October 2020. The participants were 204 residents aged ≥65 years staying at a private care home in Kyoto city, Japan. Logistic regression analysis was carried out with the reduction of conversation opportunities as the dependent variable, and geriatric factors as independent variables after adjusting for age and sex. We compared the decreased frequency of opportunities between residents in the assisted living wing and in the nursing care wing of the private care home. Results: The percentages of respondents who reported a decrease in the opportunities for conversation among themselves were 43.9% for residents in the assisted living wing and 19.7% for those in the nursing care wing. After adjusting for age and sex, the opportunities for conversation was significantly associated with the basic activities of daily living (OR 1.07, 95% CI 1.01–1.12), instrumental self‐maintenance (OR 1.25, 95% CI 1.08–1.46), intellectual activity (OR 1.35, 95% CI 1.09–1.66), depression (OR 1.13, 95% CI 1.04–1.23), depressive mood (OR 3.83, 95% CI 1.98–7.42), decreased motivation (OR 3.11, 95% CI 1.58–6.12), appetite loss (OR 4.32, 95% CI 1.54–12.07), swallowing function (OR 1.05, 95% CI 1.00–1.10), chewing difficulty (OR 2.50, 95% CI 1.31–4.75) and eating alone (OR 2.5, 95% CI 1.35–4.62). Conclusion: Decreased opportunities for conversation was more perceived among older adults with higher daily functioning, suggesting that it is associated with depressed mood, oral function and solitary eating. Geriatr Gerontol Int 2024; 24: 385–391. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the association between the oral health status and appetite in community-dwelling older adults. We enrolled 100 people aged >65 years who had participated in long-term care prevention projects between December 2018 and January 2019. Appetite was assessed using the Council on Nutrition Appetite Questionnaire score. The oral health status was assessed based on the number of teeth, occlusal condition, swallowing function, tongue coating, and the Oral Health Assessment Tool. A multiple linear regression analysis was performed with appetite as the dependent variable and each variable related to oral health status as an independent variable. The analysis was adjusted for sex, age, activities of daily living, cognitive function, smoking habit, and alcohol consumption. Dental pain was associated with poor appetite in community-dwelling older adults. No other oral health status parameter was associated with appetite. Thus, controlling dental pain is critical to prevent appetite loss while considering other factors. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between trypsin‐like protease (TLP) activity in the oral cavity as an indicator of periodontal health status and kidney function in Japanese workers. Materials and Methods: This cross‐sectional study included 1117 Japanese workers (mean age = 43.8 years). Tongue‐swab TLP activity was quantified as a* value (the redness intensity of the matrix disc of the TLP activity assessment kit; a larger value indicates more intense enzymatic activity in the samples and poorer periodontal health status). Kidney function was assessed using the estimated glomerular filtration rate (eGFR; a lower value indicates poorer kidney function). We performed ordinal logistic regression analyses to assess the association of the a* value with three eGFR categories: ≥90, 60–89 and <60 mL/min/1.73 m2. Results: The prevalence for each eGFR category was as follows: ≥90 (31.6%), 60–89 (63.8%) and <60 mL/min/1.73 m2 (4.6%). After adjusting for potential confounders, the a* value was found to be significantly associated with reduced kidney function. The multivariable‐adjusted odds ratio (95% confidence interval) for reduced kidney function was 1.12 (1.02–1.22) per unit increase in the a* value. Conclusions: Higher TLP activity was associated with reduced kidney function in Japanese workers. [ABSTRACT FROM AUTHOR]

Implant therapy for tooth loss in the molar area is challenging due to the anatomical limitations, requiring bone augmentation procedures that are associated with high surgical complexity and long postsurgical recovery. Recently, many studies have demonstrated the usefulness of short implants. However, few studies have been performed in Japanese patients to evaluate peri-implant bone changes, changes in peri-implant epithelial tissue, and patient satisfaction. The present study included 16 patients (5 men, 11 women; mean age: 60 years) who received 26 short (6-mm) implants. Changes in peri-implant bone and epithelial tissue were measured radiographically at superstructure loading and after 2 years. Peri-implant pocket probing depth was measured at the epithelial tissue and compared at both time points. Patient satisfaction was graded using the Oral Health Impact Profile (OHIP-14) before treatment and at follow-up. The mean mesial and distal bone levels were -0.05 mm and 0.37 mm at loading, respectively, and were 0.33 mm and 0.53 mm after 2 years, respectively. Significant peri-implant bone formation for mesial and distal bone levels at both time points were determined by Wilcoxon signed-rank test. Mean probing depth increased slightly, from 3.03 mm at loading to 3.33 mm after 2 years, but no significant difference was found. The OHIP-14 found that patient satisfaction levels increased after 2 years. Using 6-mm short implants in sites with insufficient bone levels can be a highly beneficial treatment option for patients, as it avoids the need for bone augmentation. [ABSTRACT FROM AUTHOR]

Aim: Tongue strength plays an important role in the process of food intake, and low tongue pressure has been associated with aspiration pneumonia, cognitive decline, and mortality. However, special equipment for tongue pressure measurement is uncommon in general practice. Recently, the serum creatinine‐to‐cystatin C (Cr/CysC) ratio has been validated as a marker of muscle volume mass. Thus, we aimed to investigate the association of the serum Cr/CysC ratio with tongue pressure in a cross‐sectional study. Methods: This single‐center, cross‐sectional study enrolled 73 participants (mean age, 71.7 years; men, 49.3%) who regularly attended the hospital for treatment of chronic disease. A tongue pressure of <30 kPa was defined as low tongue pressure. We evaluated the relationships between the serum Cr/CysC ratio and tongue pressure using multiple regression analysis. Results: The serum Cr/CysC ratio was correlated with tongue pressure (R2 = 0.25, P < 0.0001). In multiple regression analyses adjusted for confounders including age, sex, body mass index, and serum albumin, the association remained significant (P = 0.0001). In logistic analyses, the multivariable‐adjusted odds ratios of the Cr/CysC ratio for tertiles 1 and 2 compared with tertile 3 for low tongue pressure were 7.81 (95% confidence interval, 1.45–51.73) and 2.71 (95% confidence interval, 0.60–13.19), respectively. Conclusions: We demonstrated that a decreased serum Cr/CysC ratio was associated with a higher risk of low tongue pressure. Our findings suggest that this simple serum surrogate marker may be a first step toward an intervention for oral function by general practitioners. Geriatr Gerontol Int 2024; 24: 102–108. [ABSTRACT FROM AUTHOR]

Aim: To determine the predictors of physical function (PF) decline among nursing home residents using items from the Long‐term care Information system For Evidence (LIFE), a system launched in 2021 to ensure the quality of long‐term care. Methods: The LIFE data of 1648 residents from 45 nursing homes in Japan were retrospectively collected in July 2021 (T0) and January 2022 (T1), including demographics, PF assessed by the Barthel index (BI), nutrition and oral health, and cognitive function. The Dementia Behavior Disturbance scale was used to assess the frequency of certain behaviors, such as "waking at midnight." The predictors of PF decline, defined as a decrease ≥5 in the BI score at T1 compared with that at T0, were determined using mixed‐effects logistic regression analyses. PF at T0 was classified into high (>60 BI) and low (≤60 BI) groups. Results: The participants' mean age was 87.2 ± 7.1 years, and 45.3% experienced PF decline. The significant predictors of PF decline were age ≥ 90 years, body mass index <18.5 kg/m2, dementia diagnosis, moderate and severe cognitive impairments, not vocalizing reciprocal exchanges at will, always "waking at midnight," and high PF at T0. Conclusions: The LIFE items predicted PF decline among nursing home residents, suggesting that LIFE data can be used to ensure the quality of long‐term care. Geriatr Gerontol Int 2024; 24: 123–132. [ABSTRACT FROM AUTHOR]

Background: Psychological stress can cause various mental and physical health problems. The previous results on stress and oral health are inconsistent, possibly because of the narrow stress measurements. We aimed to examine the association between a broader range of stressful life events and oral health among workers. Methods: This cross-sectional study analyzed anonymous individual data from a national survey in Japan. Data on stressful life events, oral health problems which are one or more of tooth pain, gum swelling/bleeding, and difficulty chewing, and covariates were obtained using a self-reported questionnaire. Covariates used included gender, age group, and disease under treatment. Logistic regression analysis was used to estimate the association between stressful life events and oral health problems. We then estimated the causal treatment effects of stress using the augmented inverse-probability weighting (AIPW) method. Results: Among the 274,881 subjects, 152,850 men (55.6%) and 122,031 women (44.4%) with a mean age of 47.0 (standard deviation, 14.4) years, 4.0% reported oral health problems, with a prevalence of 2.1% among those without any stress. The prevalence increased with stress score, reaching 15.4% for those with the maximum stress score. The adjusted odds ratio of this group compared to those without any stress was 9.2 (95% confidence interval [CI], 8.2-10.3). The estimated prevalence of oral health problems by the AIPW analysis was 2.2% (95% CI, 2.1-2.3%) for those without any stress and 14.4% (95% CI, 12.1-16.7%) for those with the maximum stress scores. Conclusion: There was a clear dose-response association between stressful life events and oral health problems. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to clarify the relationship between the oral assessment guide (OAG), a simple method for assessing oral function and poor nutrition in gastric cancer patients and investigate the reduction of oral mucositis through appropriate oral function management. Subjects and Methods: Gastric cancer patients who underwent chemotherapy at the Nagoya Ekisaikai Hospital between January 2015 and December 2020 were evaluated. The prognostic nutritional index (PNI), as the objective variable, was used to assess nutritional status. The explanatory variables were sex, age, smoking status, body mass index (BMI), number of remaining teeth, cancer stage, albumin level, C‐reactive protein level, white blood cell count and the OAG score. Results: PNI was significantly associated with age, number of remaining teeth, cancer stage and the OAG score (p < 0.05) among the 217 patients. There were significant differences in age, BMI, cancer stage and the OAG score among the patients. An abnormal BMI and an advanced cancer stage were more common in older patients, and abnormal OAG scores were associated with a lower PNI. Conclusions: For gastric cancer patients undergoing postoperative chemotherapy, worse oral functional status is associated with worse PNI and nutritional status. [ABSTRACT FROM AUTHOR]

Background: Although the relationship between oral and physical frailty in older adults has been investigated, few studies have focused on the working-age population. This study examined the relationships of the number of remaining teeth and masticatory ability, i.e., signs of oral frailty, with locomotive syndrome (LS) in the working-age population. Methods: The number of remaining teeth, masticatory ability, and presence of LS in 501 participants from four companies were examined. The relationships between the number of remaining teeth groups (≥ 20 teeth or ≤ 19 teeth) and LS and between the masticatory ability groups (high or low) and LS were examined. A binomial logistic regression analysis was conducted using LS from the stand-up test as the objective variable and the two subgroups based on the number of remaining teeth and potential crossover factors as covariates. Results: The analysis included 495 participants (354 males and 141 females; median age, 43 years). The median number of remaining teeth among the participants was 28, and 10 participants (2.0%) had ≤ 19 teeth. The mean masticatory ability values were 39.9 for males and 37.7 for females, and 31 participants (6.3%) had low masticatory ability. In the stand-up test, those with ≤ 19 teeth had a higher LS rate than those with ≥ 20 teeth. The odds ratio for LS in the group with ≤ 19 remaining teeth was 5.99, and the confidence interval was 1.44–24.95. Conclusions: The results confirmed signs of oral frailty in the working-age population. Further, the number of remaining teeth possibly affects standing movement. Thus, oral frailty is associated with LS in the working-age population. [ABSTRACT FROM AUTHOR]

Aim: To assess the validity of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate (oral diadochokinesis [oral-DDK]) as a gold standard index for articulatory oral motor skill in community-dwelling older Japanese adults. Methods: This cross-sectional study included 607 Japanese adults (mean age = 73.9 years). A single-item self-report questionnaire for articulatory oral motor skill was developed. Study participants completed a 1-month-interval test-retest protocol to assess reliability of the questionnaire, and the protocol was tested by the kappa statistic. Oral-DDK with/ta/(i.e., the number of repetitions of the monosyllable/ta/per second) was measured during the on-site examination. Low oral-DDK performance was defined as <5.2 times/s in men and <5.4 times/s in women. Oral-DDK performance, oral functions other than articulatory oral motor skill, and physical frailty were compared in the groups with and without self-reported low articulatory oral motor skill as determined by the response to the questionnaire. Results: Self-reported low articulatory oral motor skill was identified in 18.5% of the study population. The self-report questionnaire had good test-retest reliability, with a kappa statistic of 0.71. Self-reported low articulatory oral motor skill was significantly associated with a lower value of oral-DDK with/ta/and a higher proportion of low oral-DDK performance, difficulties in chewing and swallowing, dry mouth, and physical frailty. Self-report had high specificity (83.1%) but low sensitivity (42.1%) for detecting low oral-DDK performance. Conclusions: A single-item self-report questionnaire for articulatory oral motor skill had acceptable test-retest reliability and was associated with objectively measured articulatory oral motor skill. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the effects of differences in oral function and depressive tendencies on nutritional status in older adults requiring support or low-level care. Methods: In 106 older adult participants residing in nursing/care homes or participating in community-level preventive care activities, the Mini Nutritional Assessment-Short Form (MNA®-SF) for nutritional status and oral diadochokinesis (ODK), tongue pressure, and repetitive saliva swallowing test (RSST) for oral function, 15-item Geriatric Depression Scale (GDS), Diet-Related Quality of Life Scale-Short Form (DRQOL-SF), and Functional Independence Measure (FIM) were administered. Basic information, including cognitive function, was evaluated. Hierarchical MNA (dependent variable)-based multiple regression analysis was performed, followed by path analysis using factors with significant associations with MNA scores. Results: RSST, ODK, tongue pressure, FIM, and DRQOL were positively correlated with MNA scores and GDS was negatively correlated. Hierarchical multiple regression demonstrated associations with tongue pressure, GDS, FIM, DRQOL scores, and gender. Path analysis confirmed significant paths from tongue pressure to MNA, tongue pressure to FIM, and FIM to MNA (P < .001). Significant paths were confirmed from GDS to MNA (P < .01), from DRQOL to MNA (P < .05), and from gender to MNA (P < .01). Conclusions: Tongue pressure, GDS, FIM, DRQOL scores, and gender were identified as factors that directly affect MNA. Tongue pressure showed the greatest effect and indirectly affected MNA via FIM. These findings emphasize the importance of early detection of low nutritional risk for preventing depression and oral function deterioration, and of evaluation of dietary satisfaction and improvement of quality of life in diets. [ABSTRACT FROM AUTHOR]

Background: Dental caries is one of the most common chronic diseases worldwide, affecting lifelong as well as children. Therefore, it is important to clarify factors related to early childhood caries (ECC) in a younger population in terms of caries prevention. However, the prevalence of ECC is low in developed countries in the twenty-first century and a large-scale survey is needed to clarify the risk factors. Furthermore, earlier tooth eruption is not taken into consideration in most studies of ECC, even though it may be a factor of ECC. The present study investigated the prevalence and risk factors of dental caries in children aged 18 months in a core city of Japan. Methods: Findings from a total of 7351 children aged 18 months were analyzed. Anthropometric measurements of height and weight, as well as an oral examination and a microbiological caries-risk test, were performed. Additionally, a structured interview sheet was provided to the parents or guardians. Findings of dental caries at 18 months of age were evaluated using a logistic regression model. Results: Of the enrolled children, 1.2% had experienced dental caries. Multivariable logistic regression analysis results indicated a significant association with dental caries at 18 months of age for the following factors: second child (OR = 1.78; 95% CI:1.08–2.93, P < 0.05), third and later child (OR = 2.08; 95% CI:1.12–3.89, P < 0.05), 12 or fewer erupted teeth (OR = 0.47; 95% CI:0.24–0.96, P < 0.05), 17 or more erupted teeth (OR = 4.37; 95% CI:1.63–11.7, P < 0.01), Cariostat score (+ + +) (OR = 3.99; 95% CI:1.29–12.31, P < 0.05), daily eating before bed (OR = 2.62; 95% CI: 1.55–4.45, P < 0.001), three or more snacks per day (OR = 2.03; 95% CI:1.15–3.58, P < 0.05), and breastfeeding (OR = 3.30; 95% CI:2.00–5.44, P < 0.001). Conclusions: These results suggest that the number of erupted teeth, as well as birth order, eating habits, and breastfeeding, are significant factors in dental caries occurrence at 18 months of age. [ABSTRACT FROM AUTHOR]

Aim: To enable easy assessment of oral frailty; that is, an overlapping slight decline in multifaceted oral function, in any setting, we developed the oral frailty five‐item checklist (OF‐5), and examined its predictive validity for increased risks of physical frailty, physical disability and mortality among community‐dwelling older adults. Methods: This population‐based cohort study randomly selected 2044 residents in Kashiwa, Japan, with no long‐term care needs. Baseline data were collected in 2012, and follow‐up data were collected in 2013, 2014, 2016, 2018 and 2021. The OF‐5 includes five measures: fewer teeth, difficulty in chewing, difficulty in swallowing, dry mouth and low articulatory oral motor skills. Physical frailty was defined according to the Cardiovascular Health Study criteria. Physical disability and mortality determined from the long‐term care insurance receipt database were followed for 9 years. Results: Of 2031 eligible participants (mean age 73.1 ± 5.6 years; 51.1% women), 39.3% individuals with ≥2 OF‐5 points had significantly increased prevalence and new‐onset rate of physical frailty. After adjusting for potential confounders, oral frailty, defined as ≥2 OF‐5 points, was associated with increased risks of physical disability (adjusted hazard ratio 1.40; 95% confidence interval 1.14–1.72) and mortality (adjusted hazard ratio 1.44; 95% confidence interval 1.11–1.87). The highest adjusted hazard ratios were observed in older adults with coexisting physical and oral frailty. Conclusions: The OF‐5 showed strong predictive validity for physical frailty, physical disability and mortality in Japanese older adults. This assessment tool can be implemented in various settings and foster comprehensive prevention through interprofessional collaboration. Geriatr Gerontol Int 2023; 23: 651–659. [ABSTRACT FROM AUTHOR]

Poor oral health has been linked to an increased risk of mortality. People with good cooking skills may be able to cope with problems caused by oral dysfunction, such as restricted food choice. This study investigated whether cooking skills modified the association between oral health status and mortality. A 3-year follow-up was conducted among participants of the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese adults aged 65–101 years. Oral health assessment comprised number of teeth and three oral functions (awareness of swallowing difficulty, decline in masticatory function, and dry mouth). Cooking skills were assessed using a valid scale adapted for Japanese participants. Mortality from 2016 to 2019 was analysed for 10,121 respondents. Cox regression models were used to estimate hazard ratios for mortality risk adjusting for potential confounders, including sociodemographic factors and health status. During the follow-up, there were 488 deaths (4.8% of all participants). Both fewer teeth and poor oral function were associated with a greater mortality risk. Cooking skills modified the association only for oral function. Stratification by cooking skill score showed that the hazard ratios for ≥2 oral difficulties (vs. none) was 2.06 (95% confidence interval: 1.43–2.96) among those with low cooking skills and 1.25 (95% confidence interval: 0.92–1.71) among those with high cooking skills after adjusting for potential confounders. Improving cooking skills may be key to mitigating health risks owing to poor oral functions. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between vitamin D status and periodontal inflammation as determined by the periodontal inflamed surface area (PISA) in community‐dwelling older adults. Materials and Methods: This cross‐sectional study included 467 Japanese adults (mean age = 73.1 years) who underwent full‐mouth periodontal examinations and measurements of serum levels of 25‐hydroxyvitamin D (25(OH)D). We used linear regression and restricted cubic spline models to analyse the association between exposure (serum 25(OH)D) and outcome (PISA). Results: The linear regression model showed that, after adjusting for potential confounders, participants in the lowest quartile of serum 25(OH)D had 41.0 mm2 more PISA (95% confidence interval [CI]: 4.6–77.5) than the reference group (the highest quartile of serum 25(OH)D). The spline model showed that the association between serum 25(OH)D and PISA was non‐linear and restricted to the low 25(OH)D range. PISA initially sharply decreased as serum 25(OH)D increased, and then the decreasing trend slowed and plateaued. The inflection point with the minimum PISA value was a serum 25(OH)D level of 27.1 ng/mL, above which there was no decreasing trend in PISA with increasing serum 25(OH)D levels. Conclusions: Low vitamin D status had an L‐shaped association with periodontal inflammation in this cohort of Japanese adults. [ABSTRACT FROM AUTHOR]

Aim: To investigate the existence of a bidirectional temporal relationship between periodontal condition and glycaemic status. Materials and Methods: This longitudinal study included 2198 participants with mean age 43.4 ± 7.7 years, who underwent dental examinations in Yokohama, Japan, at two time points, 2003–2004 and 2008–2009, at an interval of 5 years. Periodontal condition was assessed by the mean value of probing pocket depth (PPD) and clinical attachment level (CAL). Glycaemic status was assessed by fasting glucose and glycated haemoglobin (HbA1c). Results: The cross‐lagged panel models showed the effect of HbA1c at baseline on mean PPD at follow‐up (β = 0.044, p =.039). There was a marginal effect of fasting glucose on the mean PPD (β = 0.037, p =.059). It was similar to the effect of fasting glucose or HbAlc on mean CAL. However, in the opposite direction, no effect of mean PPD or CAL at baseline on fasting glucose or HbAlc at follow‐up was identified. Conclusions: This study demonstrated a unidirectional relationship between glycaemic status and periodontal condition. The study population, however, had mostly mild periodontitis. Future studies are needed to investigate the effect of periodontal condition on glycaemic status in patients with severe periodontitis. [ABSTRACT FROM AUTHOR]

Objectives: Oral health inequalities exist worldwide, and cross‐country comparisons can provide valuable insights into country‐level characteristics contributing to such inequalities. However, comparative studies in Asian countries are limited. This study examined the magnitude of education‐related oral health inequalities in older adults in Singapore and Japan. Methods: Longitudinal data for older adults, aged ≥65 years, from the Panel on Health and Ageing of Singaporean Elderly (PHASE; 2009, 2011–2012, and 2015) and Japan Gerontological Evaluation Study (JAGES; 2010, 2013, and 2016) were used. Dependent variables were being edentate and having a minimal functional dentition (MFD; i.e. ≥20 teeth). The absolute and relative inequalities were calculated using the slope index of inequality (SII) and relative index of inequality (RII) for educational level [low (<6 years); middle (6–12 years); high (>12 years)] in each country. Results: A total of 1032 PHASE participants and 35 717 JAGES participants were included. At baseline among PHASE participants, 35.9% were edentate and 24.4% had MFD, while among JAGES participants, 8.5% were edentate and 42.4% had MFD. The prevalence of low, middle and high educational levels for PHASE was 76.5%, 18.0% and 5.5%, and for JAGES were 0.9%, 78.1% and 19.7%, respectively. Older adults in Japan had lower education‐related inequalities for being edentate [for both SII (−0.53, 95% CI = −0.55 to −0.50) and RII (0.40, 95% CI = 0.33–0.48)] and for not having MFD for both SII (−0.24, 95% CI = −0.27 to −0.20) and RII (0.83, 95% CI = 0.79–0.87) compared to Singapore. Conclusions: Education‐related inequalities for being edentate and not having MFD were higher among older adults in Singapore compared to Japan. [ABSTRACT FROM AUTHOR]

Introduction: Perioperative oral management (POM) was introduced into the Japanese universal health insurance system in 2012. Collaboration with dental clinics is important for hospitals without a dentistry department. A dental hygienist newly assigned as a member of the patient flow management centre led a seminar to promote collaboration via the web. This study represents the first step to explore the possible role of the hospital‐based dental hygienist in the field of regional medical–dental cooperation of POM by assessing their willingness to participate in providing this type of care by a survey. Methods: The rate of attendees' satisfaction and the current problems of the collaboration for POM were evaluated through a questionnaire survey after the web seminar. Results: All respondents reported satisfaction with the web seminar although it was the first experience of an online seminar for half of the respondents. All hospital dentists, but only 47.8% of dentists working at clinics, had participated in POM. Dental hygienist tended to show greater desire to participate in POM than dentists. All respondents appreciated the role played by the dental hygienist as a key manager of medical–dental collaboration between the hospital and local clinics. Conclusion: The hospital‐based dental hygienist can play a role in planning and management of web seminars for POM, to raise awareness and promote regional medical–dental cooperation of POM. [ABSTRACT FROM AUTHOR]

Objective: Globally, baccalaureate programs in dental hygiene are increasingly established. In addition, in Japan, many dental hygienists (DHs) and social workers (SWs) are prematurely leaving the workforce. This study aimed to investigate the most recent employment, career outcomes, reasons for a job change, and satisfaction with the job and undergraduate curriculum among graduates of the baccalaureate program at the Department of Oral Health and Welfare (DOHW), Faculty of Dentistry, Niigata University. Methods: All 262 graduates (graduating classes 1–10) of the DOHW were invited to participate in this survey; an original self‐administered questionnaire was distributed to those who consented. Responses were received from 114 (43.5%) graduates. Results: Almost all respondents (89.5%) had dual licensure as both DH and certified SW. They were employed immediately after graduation (99.1%) and at the time of the survey (96.5%). Over 60% of them worked as DHs, mainly in hospitals. SWs mainly worked in administration. Among the 113 respondents who were employed, 39.8% changed jobs at least once. The main reasons for job selection were 'interest in job content' and 'flexible working hours'. Nearly 90% of the respondents felt satisfied or fairly satisfied with their job and their undergraduate education. Conclusions: A quality 4‐year baccalaureate degree program in dental hygiene and social welfare positively influenced graduates' work continuity. Most graduates felt satisfied or fairly satisfied with their job and the undergraduate curriculum. Employment rates within each profession and the prevalence of hospital and administrative roles were higher than national averages. Long‐term studies of graduates' career outcomes are warranted. [ABSTRACT FROM AUTHOR]

Background: Oral diseases affect quality of life and known to decrease productivity. We examined the impact of oral health status on various types of work problems. Methods: This cross-sectional study used data from an internet-based self-report questionnaire survey administered to workers in Japan. Responses to the questionnaire regarding seven types of oral health-related work problems (1. Stress; 2. Lack of focus; 3. Lack of sleep; 4. Lack of energy; 5. Lack of communication due to halitosis; 6. Lack of communication due to appearance; 7. Lack of ability due to dental-related pain) were investigated and statistically analyzed. Explanatory variables were self-reported oral health status, number of teeth, and gum bleeding. To examine the association of oral health with the presence of work problems, logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI). Age, sex, educational attainment, income, the presence of diabetes, and industrial classifications were used as the covariates. Results: A total of 3,930 workers (mean age: 43.3 (SD = 11.7), 2,057 males and 1,873 females) were included. Overall, a total of 6.2% of workers reported having at least one oral health-related work problem in the past year, whereas 21.8% of those with poor self-reported oral health reported work problems. Workers with poor self-reported oral health were 3.58 (95% CI (1.70–7.56) times higher odds of reporting work problems than those with excellent self-reported oral health. Conclusions: Oral health was found to be associated with various work problems. Oral health promotion policies are needed in the workplace. [ABSTRACT FROM AUTHOR]

Social participation prevents social isolation and loneliness among older adults while having numerous positive effects on their health and well-being in rapidly aging societies. We aimed to estimate the effect of retaining more natural teeth on social participation among older adults in Japan. The analysis used longitudinal data from 24,872 participants in the Japan Gerontological Evaluation Study (2010, 2013, and 2016). We employed a longitudinal modified treatment policy approach to determine the effect of several hypothetical scenarios (preventive scenarios and tooth loss scenarios) on frequent social participation (1 = at least once a week/0 = less than once a week) after a 6-y follow-up. The corresponding statistical parameters were estimated using targeted minimum loss-based estimation (TMLE) method. Number of teeth category (edentate/1–9/10–19/≥20) was treated as a time-varying exposure, and the outcome estimates were adjusted for time-varying (income, self-rated health, marital status, instrumental activities of daily living, vision loss, hearing loss, major comorbidities, and number of household members) and time-invariant covariates (age, sex, education, baseline social participation). Less frequent social participation was associated with older age, male sex, lower income, low educational attainment, and poor self-rated health at the baseline. Social participation improved when tooth loss prevention scenarios were emulated. The best preventive scenario (i.e., maintaining ≥20 teeth among each participant) improved social participation by 8% (risk ratio [RR] = 1.08; 95% confidence interval [CI], 1.05–1.11). Emulated tooth loss scenarios gradually decreased social participation. A hypothetical scenario in which all the participants were edentate throughout the follow-up period resulted in a 11% (RR = 0.89; 95% CI, 0.84–0.94) reduction in social participation. Subsequent tooth loss scenarios showed 8% (RR = 0.92; 95% CI, 0.88–0.95), 6% (RR = 0.94; 95% CI, 0.91–0.97), and 4% (RR = 0.96; 95% CI, 0.93–0.98) reductions, respectively. Thus, among Japanese older adults, retaining a higher number of teeth positively affects their social participation, whereas being edentate or having a relatively lower number of teeth negatively affects their social participation. [ABSTRACT FROM AUTHOR]

Oral health screening is important for maintaining and improving quality of life. The present study aimed to determine whether patients with a certain level of alveolar bone resorption could be screened by salivary bacterial test along with their background information. Saliva samples were collected from 977 Japanese patients, and the counts of each red-complex, that is, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, were measured using quantitative polymerase chain reaction analysis. Mean bone crest levels (BCLs) were measured using a full-mouth periapical radiograph. Multiple logistic regression analysis was used to determine associations between BCLs (1.5–4.0 mm in 0.5 mm increments) and explanatory variables, such as the number of each red-complex bacteria and the patients' age, sex, number of teeth, stimulated saliva volume, and smoking habits. When the cutoff BCL value was set at 3.0 mm, the area under the curve, sensitivity, and specificity values were optimal at 0.86, 0.82, and 0.76, respectively. In addition, all tested explanatory variables, except sex and T. denticola count, were significantly associated with BCLs according to a likelihood ratio test (p < 0.05). Additionally, the odds ratio (OR) was substantially increased when a patient was >40 years old and the bacterial count of P. gingivalis was >107 cells/µL (OR: >6). Thus, P. gingivalis count and patients' background information were significantly associated with the presence of a certain amount of bone resorption, suggesting that it may be possible to screen bone resorption without the need for radiography or oral examination. [ABSTRACT FROM AUTHOR]

Background: The concept of health literacy has gained prominence in the context of oral health. In Japan, curative dental care is generally under universal health coverage, while preventive dental care requires effort. We used this situation to test the hypothesis that high health literacy is associated with preventive dental care use and good oral health status, but not with curative dental care use, in Japan. Methods: A questionnaire survey was conducted from 2010 to 2011 among residents aged 25–50 years in Japanese metropolitan areas. Data from 3767 participants were used. Health literacy was measured using the Communicative and Critical Health Literacy Scale, and the total score was categorized into quartiles. Poisson regression analyses with robust variance estimators were conducted to examine the associations of health literacy with curative dental care use, preventive dental care use, and good oral health, adjusted for covariates. Results: The percentages of curative dental care use, preventive dental care use, and good oral health were 40.2%, 28.8%, and 74.0%, respectively. Health literacy was not associated with curative dental care use; the prevalence ratio (PR) of the highest relative to the lowest quartile of health literacy was 1.04 (95% confidence interval [CI], 0.93–1.18). High health literacy was associated with preventive dental care use and good oral health; the corresponding PRs were 1.17 (95% CI, 1.00–1.36) and 1.09 (95% CI, 1.03–1.15), respectively. Conclusions: These findings may provide clues for the design of effective interventions to promote preventive dental care use and improve oral health status. [ABSTRACT FROM AUTHOR]

Background: Frailty increases the risk of negative health‐related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross‐sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community‐dwelling older adults. Methods: Psychological frailty was defined as a World Health Organization‐5 scale (WHO‐5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA‐J) score of <23, and psychological robustness was defined as a WHO‐5 score of ≥13 and a MoCA‐J score of ≥23. We used a cross‐sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth. Results: After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = −72.7, 95% confidence interval: −126.3 to −19.1). Conclusions: Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community‐dwelling older adults participating in our study. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationship between periodontitis as an independent effect of smoking and the development of chronic obstructive pulmonary disease (COPD) in Japanese people based on longitudinal data. Materials and Methods: We targeted 4745 people who underwent pulmonary function tests and dental check‐ups at baseline and 8 years later. The Community Periodontal Index was used to assess periodontal status. A Cox proportional hazard model was used to examine the relationship between the incidence of COPD and periodontitis and smoking. To clarify the interaction between smoking and periodontitis, interaction analysis was performed. Results: In a multivariable analysis, both periodontitis and heavy smoking had significant effects on COPD development. When periodontitis was analysed as a continuous value (number of sextants with periodontitis) and as a category (presence or absence of periodontitis) in the multivariable analyses after adjusting for smoking, pulmonary function and other variables, periodontitis had significantly higher hazard ratios (HRs) for the incidence of COPD; the HRs were 1.09 (1.01–1.17) and 1.48 (1.09–2.02), respectively. Interaction analysis showed no significant interaction between heavy smoking and periodontitis on COPD. Conclusions: These results suggest that periodontitis has no interaction with smoking but has an independent effect on developing COPD. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association between dental health and incident cardiovascular disease (CVD) in secondary prevention setting. Materials and Methods: A total of 888 patients with known CVD hospitalized in the cardiology unit were prospectively enrolled. We assessed the association between missing teeth and three variables of periodontitis and major adverse cardiovascular events (MACE), defined as a composite of cardiac death, acute myocardial infarction, stroke and hospital re‐admission for congestive heart failure. Results: During a median (Q1, Q3) follow‐up of 4.6 (1.4, 6.7) years, an additional missing tooth was associated with a 3% (95% confidence interval [CI]: 1%–5%) higher hazard of MACE (p =.004). Compared with patients with 0 to ≤4 missing teeth, periods free from MACE (95% CI) by 5 years of follow‐up were, on average, shorter by 0.17 (−0.04 to 0.37) years, 0.26 (0.04–0.49) years and 0.59 (0.34–0.85) years in patients with 5 to ≤7, 8 to ≤13 and >13 missing teeth, respectively. No significant associations were observed between periodontal measures and MACE incidence. Conclusions: In hospitalized patients with existing CVD, the total number of missing teeth was associated with incident MACE. [ABSTRACT FROM AUTHOR]

Since Japan has implemented Universal Health Coverage (UHC), most dental treatments are covered by public health insurance. Therefore, when receiving fixed dental restoration/prosthesis (FDRP) treatment, such as inlays, crowns, and bridges, the patient can choose whether or not it is covered by insurance. This study aimed to evaluate whether those who receive dental check-ups regularly chose uninsured FDRP treatment. Data were collected from 2088 participants, who had undergone FDRP treatment, via a web-based survey and analyzed. Among them, 1233 (59.1%) had received regular dental check-ups (RDC group) and 855 (40.9%) had not (non-RDC group). The multivariate logistic regression model showed that compared to the non-RDC group, those in the RDC group were statistically significantly associated with higher rates of good oral health behaviors (brushing teeth ≥ 3 times daily, odds ratios (OR):1.46; practiced interdental cleaning habitually, OR: 2.22) and received uninsured FDRP treatment more often (OR: 1.59), adjusted for socioeconomic factors. These results suggest that health policy interventions to promote access to RDC among individuals may improve the oral health of people and reduce the financial burden on the public health insurance system. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about the association between oral status and homebound status, and there is a possibility of a bidirectional relationship between them. In this exploratory prospective cohort study, we examined the association between four oral status measurements and being homebound bidirectionally. Methods: We used 2010–2016 panel data gathered from the Japan Gerontological Evaluation Study. All functionally independent participants aged 65 years or older (n = 26,579) were included in this study. Multiple imputation and Poisson regression were used for analyses. We adjusted for age, sex, education, comorbidity, and depressive symptoms. Results: In the fully adjusted model, the prevalence ratio (PR) of being homebound at follow‐up was 1.42 for having <20 remaining teeth, 1.28 for having chewing difficulty, 0.99 for having choking experience, and 0.94 for having dry mouth at baseline. Reversely, being homebound at baseline predicted having chewing difficulty at follow‐up (PR = 1.17), while no significant association was demonstrated with having <20 teeth (PR = 1.00), choking experience (PR = 1.06), and dry mouth (PR = 1.02). Conclusion: Chewing difficulty and having <20 remaining teeth predicted homebound status after 6 years. Reversely, homebound status at baseline only predicted having chewing difficulty at follow‐up. These findings may help to determine the oral frailty assessment measures for older people. [ABSTRACT FROM AUTHOR]

Objectives: Social isolation was associated with increased mortality and numerous adverse health outcomes. However, the longitudinal association between oral health and social isolation has not been studied. In this longitudinal prospective cohort study, the association between the number of remaining teeth and dental prosthesis use with social isolation after 6‐years follow‐up was examined. Methods: Functionally independent adults aged 65 years or older, who were not socially isolated in 2010, were followed up until 2016 in the Japan Gerontological Evaluation Study. Data from 26 417 participants were analysed after random forest imputation to address missing data. Logistic regression models were used to calculate the odds ratio (OR) for incident social isolation in 2016 after adjusting for age, sex, educational attainment, income, activities of daily living, living area and having depressive symptoms. Results: The mean age of the participants at baseline was 72.3 (SD = 5.0). A total of 1,127 (4.3%) participants were socially isolated at follow‐up. Of these, 338 (3.2%) had ≥20 teeth (with or without using dental prosthesis), 171 (3.9%) had 10–19 teeth and used dental prosthesis, 112 (4.2%) had 10–19 teeth and did not use the dental prosthesis, 338 (5.1%) had 0–9 teeth and used dental prosthesis, and 168 (7.6%) had 0–9 teeth and did not use the dental prosthesis. Fully adjusted logistic regression models showed that the OR of incident social isolation was higher for those with fewer teeth; OR = 1.13 (95%CI = 0.96–1.33) for those with 10–19 teeth and OR = 1.36 (95%CI = 1.17–1.58) for those with 0–9 teeth, compared to those with ≥20 teeth. The OR of incident social isolation was lower for those who used a dental prosthesis [OR = 0.90, 95%CI = 0.80–1.02)] compared to those who did not use a dental prosthesis. The interaction between the number of teeth and dental prosthesis use demonstrated that the latter mitigated the incidence of social isolation for participants with tooth loss. Compared to those with ≥20 teeth (with or without prosthesis use), participants with 0–9 teeth that did not use a dental prosthesis were 79% [OR = 1.79, 95%CI = 1.49–2.19] more likely to be socially isolated, whereas participants with 0–9 teeth that used a dental prosthesis were only 23% [OR = 1.23, 95%CI = 1.05–1.45] more likely to be socially isolated. Conclusion: Tooth loss was the main predictor for social isolation at follow‐up, while no dental prostheses use was an additional risk factor. Dental prosthesis use may reduce the risk of social isolation especially in those with severe tooth loss. [ABSTRACT FROM AUTHOR]

This study examines the cross-cultural validity of the Japanese version of the Food Frequency Questionnaire (FFQ), designed for studies on dental caries to assess dietary intake in Japanese children. Parent-reported dietary data were collected (274 children, 3–6 years old) using the 38-item FFQ, whose reliability and validity have been demonstrated in adults. Factor analysis was used to determine dimensionality. Dietary cariogenicity scores were compared with the levels of plaque mutans streptococci, and the decayed, missing, and filled teeth (dmft) index to evaluate the criterion validity using Pearson's correlation coefficient (r) and the Kruskal–Wallis test. The FFQ showed good criterion validity, assessed through its relationship with the dmft index (r = 0.119; p = 0.05) and Dentocult SM score (r = 0.124; p = 0.04). Factor analysis revealed six questionnaire subscales. Internal consistency was from low to acceptable (Cronbach's alpha = 0.64 for the total scale, 0.39–0.53 for each subscale). Children with a higher SM score were more likely to have higher dietary cariogenicity scores (p = 0.01; Kruskal–Wallis test). These results confirm the validity of the Japanese version of the FFQ for children, which can be used to track dietary structure dynamics regarding cariogenicity from childhood to adulthood. [ABSTRACT FROM AUTHOR]

The environments of nursing home staff and residents have dramatically changed since the onset of the COVID-19 pandemic, with greater demand for infection control. This study aimed to clarify the changes and regional differences in the surrounding environment of nursing home residents as well as the working environment of staff, including oral health care, after the spread of SARS-CoV-2. A self-administered questionnaire survey was sent to nursing staff at about 40 nursing homes in different areas of Japan in September and October 2021. The questionnaire consisted of items centered around: (1) the surrounding environment of nursing home residents, (2) awareness and attitudes towards daily work among staff, and (3) attitudes to and procedures for oral health care among staff. A total of 929 respondents included 618 (66.5%) nursing care workers and 134 (14.4%) nurses. Regarding changes in resident daily life, 60% of staff perceived decreases in psychosocial and physical function after the start of the pandemic due to limited family communication and recreational activities, especially in urban areas. Concerning infection control, most respondents adopted routines of disinfecting hands before and after their duties. Oral health care was part of the regular duties of over 80% of respondents. Many participants answered that the frequency and time of oral health care only slightly changed after the onset of COVID-19, but many also reported disinfecting hands both before and after oral health care, particularly in rural areas. Our findings suggested that the COVID-19 pandemic decreased the daily living activities of residents, leading to psychosocial and physical decline, especially in urban areas. The results also indicated that the spread of SARS-CoV-2 triggered improvements in the awareness and attitudes towards infection control in daily work, including oral health care, among nursing care staff, notably in rural areas. Such an effect may contribute to a more positive perception of oral health care infection measures after the pandemic. [ABSTRACT FROM AUTHOR]

Objective: The number of teeth has been shown to affect mortality. However, it is unclear why the number of teeth is associated with mortality. We focused on the number of teeth and malnutrition and examined whether these differences affect 3‐year all‐cause mortality among very elderly individuals. Methods: This analysis was conducted using data from the Tokyo Oldest Old Survey on Total Health study. Altogether 513 participants ≥85 years were categorized based on remaining teeth (0, 1–7, 8–18, ≥19). All‐cause mortality was determined by calculating the cumulative 3‐year survival rate according to the remaining number of teeth and the presence/absence of malnutrition. Further, hazard ratios (HRs) were analyzed using Cox regression analyses. Results: No difference was observed according to the number of teeth (p = 0.638), but the presence/absence of malnutrition was significantly associated with mortality (p < 0.001). Malnutrition was independently associated with higher HRs, even after adjusting for confounding factors associated with mortality. (HR: 2.315, 95% CI: 1.431–3.746). Additionally, adjusting for the number of teeth, HR remained significant (HR: 2.365, 95% CI: 1.449–3.853). Conclusion: In the very elderly, malnutrition—but not the number of teeth—was independently associated with 3‐year all‐cause mortality after adjusting for various health issues. [ABSTRACT FROM AUTHOR]