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Dental caries is the most prevalent of chronic oral conditions. We investigated child and parental factors associated with early childhood caries (ECC) in 17- to 23-month-old children in Aichi Prefecture, Japan. Of the 61,714 children who underwent a health examination at 18 months of age, 54,206 (27,860 males, 26,346 females) were included in the analysis. The parents of the children completed a self-administered questionnaire comprising items related to the child’s eating habits and lifestyle and the parent’s lifestyle and childcare factors. Logistic regression analyses were performed using ECC as the dependent variable, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The prevalence of ECC was 0.8%. In the multivariate analysis, children who consumed sweetened beverages daily and snacked frequently had significantly higher ORs for ECC: 1.29 (95% CI: 1.05–1.59) and 1.49 (95% CI: 1.15–1.91), respectively. Bedtime breastfeeding and bottle-feeding were significantly associated with higher ORs for ECC: 4.88 (95% CI: 4.01–5.94) and 2.31 (95% CI: 1.72–3.10), respectively. Not eating breakfast daily and late bedtime were associated with high ORs for ECC: 1.41 (95% CI: 1.02–1.96) and 1.31 (95% CI: 1.05–1.64), respectively. The OR for ECC was significantly higher in children whose father was a smoker than in those whose father was not: 1.44 (95% CI: 1.18–1.76). The OR for ECC was significantly higher in children with no childcare adviser than in those with a childcare adviser: 1.67 (95% CI: 1.06–2.65). Children who had not been vaccinated had a significantly higher OR for ECC compared to children who had: 1.49 (95% CI: 1.14–1.94). These results imply the importance of enhancing parental guidance on the lifestyle habits of children and creating an environment in which parents can consult with others regarding parenting.

Background This study aimed to examine whether modifiable risk factors can predict tooth loss over 10 years and estimate population attributable risk (PAR) for a combination of modifiable factors. Methods This longitudinal study included 1,466 participants who underwent dental examinations in 2007 and 2017 and were aged 40-79 years at baseline. Periodontal conditions were assessed using the 2018 periodontal classification. Incident tooth loss was defined as ≥4 teeth lost over a 10-year period. We calculated the partial PAR (pPAR%) for tooth loss to estimate the combined effect of modifiable risk factors. Results Incidence of tooth loss was 17.5%. Directed acyclic graphs were used to identify risk factors for tooth loss. A logistic regression model showed that baseline periodontitis, dental caries experience, no regular dental visit, periodontal treatment, smoking, and obesity were associated with tooth loss after adjusting for covariates; pPAR% was 55.5% (95% confidence interval: 31.1-73.0%) in periodontitis stage III-IV and 87.6% (50.4-97.4%) in the combination of all factors, respectively. The sex-stratified analysis showed that smoking and no regular dental visit in men and obesity in women were identified as potential risk factors for tooth loss. Conclusions Modifiable factors accounted for most cases of incident tooth loss. Risk factors for tooth loss might differ by sex, suggesting that the appropriate approach for preventing tooth loss base on sex. This article is protected by copyright. All rights reserved.

Introduction: A relationship between periodontal disease and dementia has been reported. It is important to visit a dentist to maintain healthy periodontal tissue. Few studies have been reported on the association between dental visits and the risk of dementia. This study examined the relationship between the use of dental care among older people and the incidence of dementia based on health insurance claims data. Materials and Methods: We targeted 31,775 people aged 75 or 80 years. Dental utilization was obtained from the health insurance claims data from April 2014 to March 2015. The month when dementia medical costs were first incurred during the 4-year follow-up period was defined as the dementia onset month. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the incidence of dementia for the use of dental care. Results: Regarding the type of dental visit, the adjusted HR of overall dementia was significantly lower (0.89: 95% CI, 0.81–0.98) in those who received periodontal treatment compared with those who did not receive any dental treatment. Regarding the days of periodontal treatment, participants with ≥5 days had significantly lower adjusted HRs for overall dementia, Alzheimer’s disease, and vascular dementia than those with 0 days, and the adjusted HRs were 0.84 (95% CI, 0.75–0.94), 0.88 (95% CI, 0.77–1.00), and 0.82 (95% CI, 0.69–0.99), respectively. Conclusion: Individuals who received periodontal treatment on many days had a low risk of dementia. Regular dental visits to treat or prevent periodontal disease may be important to prevent dementia.

The study aimed to examine the association of self-rated chewing function, the number of teeth and periodontal status with metabolic syndrome.The participants were 11,119 adults aged 40-74 years who underwent specific health checkups, including an oral health examination, in 2018 in Japan. This study used the standard questions of the specific health checkups to obtain information on self-rated chewing function. A multinomial logistic regression analysis was performed with metabolic syndrome status as the dependent variable, and age, sex, lifestyle questions, self-rated chewing function, number of teeth, and periodontal status as the independent variables.Number of teeth and periodontal status were significantly associated with metabolic syndrome after adjusting for confounding variables. Self-rated chewing function was significantly associated with metabolic syndrome in the crude analysis, but not after adjustment for confounding variables. Both number of teeth and periodontal status were significantly associated with self-rated chewing function.There was no significant direct association between self-rated chewing function and metabolic syndrome. Self-rated chewing function may be an indicator of poor oral condition that links to metabolic syndrome.

Background Toothbrushing is a health-related lifestyle habit and has been reported to contribute not only to oral health but also to some parameters of general health; however, little research has been conducted to understand the association of the frequency and timing of toothbrushing with the development of comprehensive metabolic abnormalities, with consideration of oral health condition. In this study, using longitudinal data, we examined this association in Japanese adults, adjusting for periodontal condition. Methods A 5-year longitudinal study was performed with 4,537 participants between 35 and 64 years old who underwent an annual dental examination in both 2003 and 2008. Data about toothbrushing habits and metabolic abnormalities, such as obesity, hyperglycemia, diabetes, hypertension, hypertriglyceridemia, and low levels of high-density lipoprotein-cholesterol, were analyzed using Poisson regression analysis. Results The percentage of participants with a toothbrushing frequency ≤1 time/day was 29.4%, and that for those not brushing their teeth at night was 21.4%. The incidences of obesity and hyperglycemia after 5 years were 5.5% and 28.4%, respectively. A toothbrushing frequency ≤1 time/day was associated with development of obesity (prevalence rate ratio [PRR] 1.77; 95% confidence interval [CI], 1.12-2.80), after adjusting for periodontal condition and potential risk factors. A significant association between not brushing teeth at night and hyperglycemia (PRR 1.30; 95% CI, 1.02-1.66) was observed in participants with toothbrushing frequency of 1 time/day. No association was found between toothbrushing habits and other metabolic abnormalities. Conclusions This study suggests that toothbrushing habits are associated with the development of obesity and hyperglycemia.

Objective To examine the effects of oral health factors related to oral function and their combination on mortality in older people. Background Recent studies have reported that oral factors, including oral function, are associated with mortality. Materials and methods The participants were 4765 community-dwelling individuals aged 75 and 80 years. The follow-up period for survival or death was 3.5 years, and the date of death was defined based on data managed by the insurer. A Cox proportional hazard model was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality as dependent variables for oral health factors, including the number of teeth, swallowing disability, oral dryness and oral hygiene and the combinations of oral health factors as independent variables. Results In univariate analyses, all four oral health factors were significantly associated with mortality. After adjusting for age, sex, smoking, body mass index and medical history, and analysing the oral health factors separately, swallowing difficulty had the highest HR for mortality (adjusted HR, 2.12; 95% CI, 1.35-3.33). In the analysis using combinations of oral health factors as the independent variable, the participants with swallowing disability, oral dryness and poor oral hygiene had the highest HR for mortality (adjusted HR, 8.35; 95% CI, 3.45-21.08). Conclusion Oral health factors related to oral function appear to be associated with mortality risk and an accumulation of oral health factors increases mortality risk among older people.

Background Many studies have reported risk factors for tooth loss. Oral health instruction is considered effective at improving oral health behavior and oral health. However, few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. Here, we conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss. Methods Baseline surveys were conducted at 1216 dental clinics in 46 prefectures in Japan, and 12,399 dental patients aged 20 years and over underwent oral examinations and completed a questionnaire. The dental clinics also completed a questionnaire at baseline. A 3-year follow-up survey included 2488 patients in 585 dental clinics. Multilevel multivariate logistic regression analysis was used to examine the risk of tooth loss at the patient and clinic levels. Results Of the patient variables, older age, higher mean probing pocket depth, current or past smoking, and bleeding during tooth brushing were associated with higher risks of tooth loss. Individuals with many teeth who visited dental clinics for maintenance were at significantly lower risk of tooth loss. Of the clinic variables, patients attending dental clinics with four or more dental hygienists had a significantly lower risk of tooth loss (OR 0.68, 95% CI 0.50–0.99). Patients attending dental clinics that provide oral health instructions for 20 min or more had a significantly lower risk of tooth loss (OR 0.69, 95% CI 0.50–0.96). Conclusions In addition to individual risk factors for tooth loss, dental clinic factors such as length of oral health instruction and number of dental hygienists are associated with tooth loss. In dental clinics, ensuring sufficient time for dental hygienists to provide oral health instructions can help prevent tooth loss in dental patients.

Background Associations between tooth loss and mortality have been reported in older individuals. However, limited information is available regarding the association between occlusion and mortality in nursing home residents. Objective We investigated the association between posterior occluding pairs (POPs) of teeth or dentures and 1-year mortality in nursing home residents. Methods The subjects of this study were residents from four nursing homes in Aichi prefecture, Japan, who were capable of eating and were enrolled in baseline examinations. We examined the number of present teeth and POPs (0-8 pairs), defined as pairs of occluding natural, restored or fixed prosthetic post-canine teeth. Then, we defined prosthetic POPs (0-8 pairs) as pairs of occluding natural, restored or fixed prosthetic post-canine teeth and removable dentures. Nutritional status, activities of daily living, cognitive function and comorbid conditions were assessed. One year later, we followed up the subjects. Ultimately, we analysed 173 elderly people (mean age ± SD: 87.1 ± 8.6 years; the survival group: N = 145, the deceased group: N = 28). Results In univariate analyses, mortality was significantly associated with age, peripheral vascular disease, nutritional status, diet texture and POPs. In multivariate logistic regression analysis, subjects who had 0 prosthetic POPs had significantly higher odds of a high mortality, compared with 8 prosthetic POPs. Conclusion Lack of properly occluding posterior teeth, whether remaining teeth or dentures, is associated with 1-year mortality. (228 words/250).

Aim Many studies have reported close relationships between oral and systemic health. We explored the association of the number of remaining teeth with medical costs and hospitalization duration in people aged 75 and 80 years. Methods Oral health examinations were carried out at dental clinics in 2014. Medical cost and hospitalization duration data for fiscal year 2015 were obtained from the Mie Prefecture health insurer. We analyzed the data of 4700 individuals who met our inclusion criteria: 2745 75-year-olds and 1955 80-year-olds. The effects of remaining tooth numbers on medical costs and hospitalization days were analyzed using a generalized linear model with log link adjustment for confounders. Results Total medical costs for all diseases were significantly higher in those with 20-27, 10-19 and 1-9 teeth, and in edentulous older individuals, compared with those with 28 teeth. Outpatient medical costs for diabetes were significantly higher in those with 20-27 and 1-9 teeth. Inpatient medical costs for digestive cancers were significantly higher in those with 10-19 and 1-9 teeth, and in edentulous older individuals. Hospitalization for digestive cancer was significantly longer in those with 20-27, 10-19 and 1-9 teeth, and in edentulous older individuals, than in those with 28 teeth. The number of teeth as a continuous variable was significantly inversely associated with medical costs for cerebrovascular disease and digestive cancer, and hospitalization days for digestive cancer. Conclusion Small numbers of teeth were associated with higher medical costs and longer hospital stays for older Japanese. Geriatr Gerontol Int 2019; 19: 335-341.

This nationwide cross-sectional survey investigated the association between periodontal disease and self-reported systemic health in periodontal patients who regularly visited private dental clinics in Japan. Data from 999 patients of 444 dental clinics were analyzed; the patients were aged 40 years or older, regularly visited dentists, and had diagnosed periodontal disease (defined as two or more teeth with a clinical attachment level ≥6 mm). Medical history was collected with a self-reported questionnaire. Number of teeth with a probing pocket depth (PPD) ≥5 mm was used to define periodontal status, and the highest quartile was used as the dependent variable. A Poisson regression model showed that histories of diabetes and hypertension were associated with a larger number of teeth with a PPD ≥5 mm (diabetes: prevalence rate ratio [PRR] 1.36, 95% confidence interval [CI] 1.00-1.85; hypertension: PRR 1.27, 95% CI 1.02-1.58) after adjusting for potential periodontal risk factors. These findings suggest that diabetes and hypertension are associated with worse periodontal disease. Dentists should confirm the diabetes and hypertension status of patients who receive maintenance care, because these conditions could affect periodontal management of patients.

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.

Objective: Oral health status may be associated with dementia, which in turn results in higher medical costs among older people. Methods: This STUDY enrolled 4,275 older individuals. Generalized linear models were constructed with the medical costs of dementia as the dependent variable, and number of teeth, Community Periodontal Index (CPI), and other factors as independent variables. Results: Individuals with fewer teeth or with poor periodontal condition had significantly higher medical costs ratios for dementia independent of other confounding variables. The adjusted medical costs ratios of dementia were 4.13 (95% CI [confidence interval]; 1.79–9.56) for those with ≤9 teeth compared with those with ≥20 teeth and 3.48 (95% CI; 1.71–7.08) for those with personal CPI code 4 compared with those with personal CPI code 0–2. Conclusions: Oral health status was associated with the medical costs of dementia. Preventing tooth loss and maintaining periodontal health may contribute to controlling dementia costs.

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.

There is limited information regarding the association between tooth loss and the medications used for the treatment of rheumatoid arthritis (RA). Here, we examined the association between tooth loss, disease severity, and drug treatment regimens in RA patients. Method: This study recruited 94 Japanese patients with RA. The severity of RA was assessed using the Steinbrocker classification of class and stage. Data on RA medications were obtained from medical records. We examined the associations between tooth loss, RA severity, and drug treatment regimens using multinomial logistic regression analyses. Results: Patients with 1–19 teeth had significantly higher odds ratios (ORs) of taking methotrexate (MTX) (OR, 8.74, 95% confidence interval (CI), 1.11–68.8) and biologic disease-modifying antirheumatic drugs (bDMARDs) (OR, 21.0, 95% CI, 1.3–339.1) compared to those with 27–28 teeth when adjusted for RA severity (class). Furthermore, patients with 1–19 teeth had significantly higher ORs of taking MTX (OR, 9.71, 95% CI, 1.22–77.1) and bDMARDs (OR, 50.2, 95% CI, 2.55–990.6) compared to those with 27–28 teeth when adjusted for RA severity (stage). Conclusion: RA patients with fewer teeth were more likely to take stronger RA therapies, independent of RA severity and other factors.

Aim: Students often injure their teeth during participation in school-based sports clubs. This study examined the frequencies and types of dental injuries sustained at school sports clubs and compared the risk of dental injury among different sports. Methods: Based on injury statistics from the Japan Sport Council of the junior high schools and high schools in seven prefectures during fiscal year 2006, the risk of dental injury was estimated using a rate ratio (RR) by calculating the ratio of occurrence of dental injury under various circumstances. Results: The RRs of exercise-related dental injury for boys and girls in junior high school were 0.7 (P < 0.001) and 1.3 (P < 0.05), respectively, and for those in high school were 2.6 (P < 0.001) and 2.7 (P < 0.001), respectively. In junior high school, softball (RR = 7.7) for boys and handball (RR = 3.9) for girls commonly led to dental injuries. In high school, Japanese-style wrestling (RR = 18.5) and rugby (RR = 7.3) for boys and handball (RR = 6.5) for girls had high risks for dental injury. Crown fracture was the predominant dental injury among boys and girls attending both junior high school and high school. The proportion of alveolar fracture was higher in school sports clubs than outside school sports clubs among high school boys. Contact or limited-contact sports had significantly higher risks for dental injuries than did noncontact sports. Conclusion: The results of this study suggest that teachers and administrators at schools should pay attention to the risk of dental injury among students participating in high-risk sports.

This study clarified the oral factors related to swallowing function using the results of dental check-ups among community-dwelling independent elders.Data on oral and medical health check-ups from 4,676 participants aged 75 and 80 years were analysed. Swallowing function was evaluated using the repetitive saliva swallowing test (RSST), which assesses the ability to swallow saliva. Swallowing three or more times during a 30 s period was recorded as normal, while swallowing twice or less in 30 s was considered to indicate swallowing difficulty. Multivariate logistic regression analyses were performed to examine the relationship between oral factors and swallowing function.In all participants, the odds ratio (OR) for swallowing difficulty was 3.42 (95% confidence interval (CI): 1.78-6.55) and 6.68 (95% CI: 1.97-22.64) among those who had 10-19 teeth without dentures and those who had 0-9 teeth without dentures, respectively, compared to individuals with ≥ 20 teeth without dentures. Those with moderate or severe dry mouth had a statistically significantly higher OR (8.01, 95% CI: 4.84-13.27) for swallowing difficulty than those without dry mouth. Among dentate participants, in addition to statistically significant variables in the analysis among all participants, those with abundant dental plaque showed a significantly higher OR (2.58, 95% CI: 1.54-4.32) for swallowing difficulty compared to those with no or slight dental plaque.These results suggest that oral factors such as having few teeth without dentures, dry mouth, and poor oral hygiene are related to swallowing function in elders.

Aim Non-alcoholic fatty liver (NAFL) is known to develop into liver fibrosis, which increases the risk of liver cirrhosis and liver cancer. The association between periodontal condition and fibrotic progression of NAFL is unclear. This study aimed to clarify this longitudinal association. Materials and methods Among 4812 participants aged 35-64 years undergoing annual health check-ups between 2003 and 2004, and follow-up 5 years later, 392 participants were diagnosed with NAFL. After excluding participants with liver fibrosis at baseline, 341 participants were followed up for 5 years. NAFL disease fibrosis score of ≥-1.455 was used to evaluate the probability of the presence of liver fibrosis. Results During the follow-up period, 10.6% of participants progressed to liver fibrosis. A higher clinical attachment level (CAL) tended to be associated with the incidence of liver fibrosis in the logistic regression analysis (odds ratio [OR] 1.82, 95% confidence interval [CI], 0.94-3.49, p = .074). The stratified analysis by obesity revealed a significant association with higher CAL in obese participants (OR 2.87, 95% CI, 1.23-6.69, p = .015), but not in non-obese participants. Conclusion Higher CAL was associated with an increased probability of liver fibrosis in obese adults with NAFL.

Aim This large epidemiological survey of older people examined oral hypofunction and the relationship between oral hypofunction and frailty. Methods Participants were community-dwelling adults aged 65-85 years in Japan. The oral function evaluation included seven items (oral hygiene, oral dryness, occlusal force, tongue-lip motor function, tongue pressure, masticatory function and swallowing function), and oral hypofunction was defined as having abnormalities in at least three of these items. The frailty status was classified into three categories (robust, pre-frail and frail) according to the total Kihon Checklist score. We analyzed 978 subjects with complete data. The relationship between oral function and frailty status was analyzed using multivariate multinomial logistic regression analyses. Results Approximately 60% of the older adults had oral hypofunction. The multivariate odds ratios (ORs) for a pre-frail or frail status were significantly higher for older people with reduced occlusal force, reduced tongue-lip motor function and deteriorated swallowing function than in those without deterioration of those items. Of the oral function items, swallowing function was most strongly associated with the frailty status, and the ORs (95% confidence interval [CI]) for deteriorated swallowing function in pre-frail and frail patients were 6.4 (3.9-10.8) and 10.2 (5.4-19.1), respectively. Those with oral hypofunction had significantly higher adjusted ORs for pre-frail (OR 1.4, 95% CI 1.1-2.0) and frail (OR 2.1, 95% CI 1.2-3.5) statuses. Conclusion Many community-dwelling older people have reduced oral function or oral hypofunction, which is significantly associated with frailty in older people. Geriatr Gerontol Int 2020; 20: 917-926.

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.

OBJECTIVE Increasing age is a potential risk factor for periodontal tissue breakdown, which may be affected by commensal flora. The aim of this study evaluated age-related changes in CD4+ T cells, C-C chemokine ligand 5 (CCL5), interleukin (IL)-17A, and receptor activator of nuclear factor-kappa B ligand (RANKL) expression using germ-free (GF) and conventionally reared (SPF) mice. DESIGN GF and SPF mice at 8 (n = 6/group) and 22 weeks old (n = 6/group) were used. Immunohistochemical analyses were performed to determine the effects of aging on protein expression in periodontal tissues. Age-related changes in alveolar bone were quantified using micro-CT analysis. RESULTS SPF mice, but not GF mice, showed an age-related increase in alveolar bone loss (P

Despite progress in dentistry, tooth loss in old age is still a reality, even more so in long-term-care residents. However, recent trends indicate that natural teeth are lost later in life. Functional decline and age-related pathologies have to be considered in oral health care for this vulnerable population. Retaining and restoring teeth and oral function in elders is important. Tooth loss significantly impairs masticatory performance, which cannot be fully restored by prosthodontic means. Hence an unconscious change in food intake occurs, often involving malnutrition and withdrawal from common meals. Poor oral appearance and bad breath may further impede social activities. Although a chewing activity may be beneficial for cognitive function, natural teeth can present a considerable risk for fragile elders, in whom aspiration of biofilm can lead to pneumonia and death. The presence of natural teeth is also correlated with higher life expectancy, but socio-economic confounding factors have to be considered. When evaluating oral health in the elderly population, standards and priorities for reporting oral health outcome measures have to be defined. Anatomical indicators such as the number of natural teeth or the presence of prostheses might be one option for reporting. However, functional indicators such as masticatory performance and patient-centred outcome measures may be more relevant. In conclusion, there is an overwhelming body of evidence that maintaining a healthy natural dentition in old age is beneficial from a structural, functional and psycho-social point of view.

Aim There is an association between type 2 diabetes mellitus (T2DM) and periodontitis. We examined the association between the dental visit status and diabetes status in the Japanese elderly population. Materials and methods In total, 14,551 participants, aged 75 or 80 years, who underwent systemic health examinations were analysed. Three independent variables of dental visit status were investigated according to dental claims data, including whether dental treatment was received, type of dental treatment (no visit, periodontal treatment, or other dental treatment), and number of days of periodontal treatment (0, 1–4, or ≥5 days). We performed multivariate logistic and linear regression analyses to examine the relationship between dental visit status and diabetes status. Results The multivariate odds ratio (OR) for T2DM was significantly lower (0.74, 95% confidence interval: 0.66–0.82) for subjects who received periodontal treatment compared with those who did not receive dental treatment. Subjects who received periodontal treatment had a significantly lower OR for T2DM, regardless of the number of days of treatment. In the multivariate linear regression model, receiving periodontal treatment was significantly associated with decrease in A1c (p

Aim Sense of coherence (SOC) is a measurement of ability of an individual to cope with psychological stress and remain in good health. The aim of the present study was to examine the relationships among SOC score, oral health status, nutritional status and care need level of older adults using path analysis. Methods We enrolled 53 older adults (17 men and 36 women) who were attending a day care service (mean age 80.4 ± 6.5 years). SOC was assessed using a 13-item, seven-scale instrument. Oral health status (number of present teeth, denture use) and nutritional status (assessed with Mini-Nutritional Assessment Short-Form) were also evaluated. Path analysis was used to examine the relationship of SOC with other related factors, including care need level. Results The mean SOC score was 57.0 ± 13.9. Mini-Nutritional Assessment Short-Form results showed that one participant (1.8%) was malnourished, 26 (49.1%) were at risk of malnutrition and 26 (49.1%) had normal nutritional status. Participants with high SOC scores showed a strong positive attitude, had a relatively large number of teeth, were in good nutritional condition and showed low care need levels. Conclusions The present results showed that maintaining a high SOC level and good oral health help to reduce care need levels in older adults, and also prevent a worsening of their nutritional condition. Geriatr Gerontol Int 2017; 17: 2083-2088.

Background Development of periodontal disease (PD) may be affected by socioeconomic status. This study examined the relationship between occupational status and PD in a 5-year prospective cohort of Japanese workers. Methods In total, 19,633 participants had initial examinations at the Aichi Health Promotion Foundation, of whom 8210 participants aged 20 years or older did not have PD. Follow-up examinations were conducted for 3757 participants, accounting for 45.8% of baseline participants. Ultimately, 3390 participants were analyzed according to the criterion of job classification at baseline, which was based on the International Standard Classification of Occupations, 1987. Oral examinations were performed using the Community Periodontal Index (CPI). The CPI scores were coded as follows: healthy (score of 0); bleeding after probing (1); dental calculus (2); shallow pockets (3); and deep pockets (4). Participants with one or more sextants with a score >2 were diagnosed with PD. Poisson regression analysis was performed to adjust for age and other potential confounders. Results Overall, 31.6% of men and 23.8% of women had developed PD (CPI scores of 3 or 4). The adjusted relative risk (RR) for PD (CPI scores of 3 or 4) in men was not significant. On the other hand, the adjusted RRs for PD (CPI score of 4) in men were 2.52-, 2.39-, and 2.74-fold higher for skilled workers, sales persons, and drivers, respectively, than for professionals. In contrast, we found no gradient in women. Conclusions We found a gradient related to the risk of developing PD according to occupational status among men in a Japanese worker population.

This study examined the relationship between stimulated salivary flow rate and oral health status in an adult population. Multinomial multivariate logistic regression analysis was used to examine the associations of salivary flow rate with dental caries status and periodontal status at the individual level among 2,110 Japanese adults with ≥10 teeth. Then, a spline model was used to examine the nonlinear relationship between salivary flow rate and teeth with dental caries or periodontal disease in multilevel analysis. Odds ratios were calculated for a 1.0-mL/min reduction in salivary flow rate at a point. After adjusting for confounding variables, participants with a flow rate ≤3.5 mL/min had significantly higher odds ratios for high caries status, and participants with a flow rate ≤1.4 mL/min had a higher odds ratio for broad periodontal disease, than did those with a flow rate >3.5 mL/min. In spline models, the odds ratio for teeth with dental caries or periodontal disease increased with reduced saliva secretion. The present findings suggest that decreased saliva secretion affects both dental caries and general periodontal health status.

Objective To investigate the association between dental consultation and oral health status among male Japanese employees. Methods The participants were 3351 male employees who received a workplace oral health examination conducted at the ages of 35, 40, 45, 50, 55, and 59 years before retirement in conjunction with an annual health checkup. Data on dental expenditures were collected from health insurance claims. The number of dental visits and dental care expenses, alone or in combination, were used as indices of the dental consultation status for the analyses. The effects of dental consultation status on oral health status (number of total teeth, number of decayed teeth, and periodontal status) were analyzed using multivariate multinomial logistic regression analyses adjusted for confounders. Results Multivariate analyses revealed that the odds ratio (OR) for 20‐27 teeth (losing 1‐8 teeth) was significantly higher (OR 1.4, 95% confidence interval (CI) 1.1‐1.7) in those who had a high number of dental visits and high dental care expenses than in those who did not have a dental visit. By contrast, the ORs for ≤19 teeth (losing ≥9 teeth), having ≥3 decayed teeth, or having a periodontal pocket ≥6 mm were significantly lower (OR 0.2, 95% CI 0.1‐0.6; OR 0.5, 95% CI 0.3‐0.6; OR 0.7, 95% CI 0.5‐1.0, respectively) in those who had fewer dental visits and lower dental care expenses. Conclusions These results imply that the dental consultation status is associated with oral health status among male employees.

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of 1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.

Dental caries is caused by acidogenic plaque microbiota formed on saliva-bathed tooth surfaces, in which multiple organisms act collectively to initiate and expand a cavity. We explored bacterial species associated with the salivary microbiome of individuals with low susceptibility to dental caries. The bacterial composition of saliva from 19 young adults was analyzed using barcoded pyrosequencing of the 16S rRNA gene; we compared 10 caries-experienced (CE) and nine caries-free (CF) individuals. A quantitative PCR assay of saliva from 139 orally healthy adults aged 40–59 years was carried out to confirm the result obtained by pyrosequencing analysis. The microbiomes of CF individuals showed more diverse communities with a significantly greater proportion of the genus Porphyromonas. Among operational taxonomic units (OTUs) corresponding to the genus Porphyromonas, the OTU corresponding to P. pasteri was the most predominant and its relative abundance in CF individuals was significantly greater than in CE individuals (P

Objective To clarify the fluoride/mineral kinetics in an oral biofilm following concurrent application of fluoride and other mineral ions released from experimental toothpaste containing S-PRG filler using depth-specific analysis. Study design Twenty subjects wore in situ plaque-generating devices, comprised of a pair of enamel slabs, and a biofilm was allowed to form. The devices were removed after three days, immersed in the toothpaste filtrate containing Al, B, Sr and F ions for 1 min, and then reinserted at the same location. After 30 min, the devices were removed and samples were obtained by sectioning into outer, middle and inner biofilm layers (300-μm thick). Samples treated with filtrate containing F without S-PRG filler extract served as the control. Fluoride and the three other mineral ions extracted from 4-μm sections were quantified using a fluoride electrode and ICP-AES, respectively. The results were corrected for biomass volume, estimated by the area measurement of stained 2-μm sections. Results The mean uptake ratios (S-PRG/control, ng/mm3) of Al, B, Sr and F were 186.6/53.7, 58.4/25.0, 456.9/125.7 and 43.6/12.0, respectively, in the outer layer, indicating that the mineral ions could easily diffuse into the biofilm. F concentrations in the outer biofilm treated using filtrate with S-PRG filler extract were significantly higher than those in controls, although both biofilms were exposed to filtrates containing the same level of F. Conclusions The results suggest that toothpaste containing S-PRG filler promotes fluoride retention in oral biofilms via the uptake of other mineral ions.

ObjectivesReports from national surveys in South Korea and Japan have indicated that the prevalence of periodontal disease is lower in Korea than in Japan. However, these national surveys have not evaluated factors related to periodontal health condition, including diabetes and metabolic syndrome. This study compared periodontal conditions between Korean and Japanese adults, in the context of general health status.DesignCross-sectional study.SettingNational survey in South Korea (Korean National Health and Nutrition Examination Survey, ‘KNHANES’) and a population-based study in Japan (Hisayama study); both were conducted in 2012.ParticipantsThis study included 3574 Korean and 2205 Japanese adults aged 40–79 years.Outcome measuresPeriodontal condition was assessed by using the Community Periodontal Index (CPI). Examiners in Japan underwent clinical calibration training for periodontal examination with a gold-standard examiner from KNHANES, prior to the Hisayama study.ResultsThe age-adjusted prevalences of periodontal disease, defined as CPI score ≥3, were 31.4% and 42.1% in South Korea and Japan, respectively (pConclusionsA higher prevalence of periodontal disease was found in Japanese participants than in Korean participants. Further studies are needed to more clearly elucidate factors underlying the difference in periodontal conditions between the two populations, including those related to the dental healthcare system and dietary intake.

This paper investigates the loss of contactless power transmission in seawater. We developed the antennas without the proximity effect between coils in air to clarify the effect of seawater. The impedance measurement and the experiment of power transmission are conducted with the antennas. From experimental results, it is found that the proximity effect by seawater decreases the power efficiency and increases the loss.

This paper describes a power transmission in a long distance of the contactless power transmission by magnetic resonance method. The efficiency of magnetic resonant coupling method is high, however, the efficiency starts to decrease gradually at certain distance. This is because the increase of leakage flux of the sending coil. In this paper, the leakage flux and transmission performance in a long distance are investigated by simulation and experiment.

This study aimed to determine whether periodontal status is related to a decline in lung function in a general Japanese population. We followed a total of 1,650 community-dwelling individuals (≥40 years) without chronic obstructive pulmonary disease, with at least one teeth, for 3 years. Periodontal status was assessed at baseline by clinical attachment loss (CAL) and probing pocket depth (PPD) at two sites for each tooth, and the mean values were calculated for each subject. Lung function was measured at baseline and follow-up using spirometry, and longitudinal decline in forced expiratory volume in one second (FEV1) was calculated. Multivariate Poisson regression with robust error variance was used to estimate risk ratio (RR). After adjusting for potential confounders including smoking status, there was a tendency for the adjusted RR of developing rapid lung function decline (≥160 mL/3years, the highest quartile of the distribution of FEV1 declines) to increase as mean CAL levels increased (P trend = 0.039). Likewise, a positive association was observed between mean PPD levels and RR of developing rapid lung function decline (P trend = 0.047). Our findings suggest deterioration of periodontal status could be a risk factor for rapid lung function decline in the general Japanese population.

Aim The assessment of the risk of tooth loss in patients visiting a dental clinic is important for managing their oral health. In the present study, we examined the risk factors for tooth loss among dental patients. Methods Data from the 8020 Promotion Foundation Study on the Health Promotion Effects of Dental Care were used in the present study. The study involved 2743 patients who visited a dental clinic in Japan and completed a questionnaire and oral health examination at baseline and at the 2-year follow up. Tooth- and person-level risk factors for tooth loss during 2 years were subjected to a multilevel multivariate logistic regression analysis. Results In both the person- and tooth-level analyses, age, smoking habit, reason for dental visit, economic status, number of remaining teeth, and periodontal status were significantly associated with tooth loss. In the tooth-level analysis, tooth type, tooth status, and periodontal status were significantly related to tooth loss. Persons who visited a dental clinic for periodic maintenance had a significantly lower risk of tooth loss than those who visited only to receive dental treatment. Conclusions Various tooth-level factors and modifiable factors, such as smoking cessation and periodic maintenance, are important for the suppression of tooth loss in dental patients.