Language：Japanese   Publisher：日本歯科衛生学会  

本研究の目的は,歯科衛生士養成校学生の臨床実習時のストレス反応の実態と関連要因を把握することである。対象はA歯科衛生士養成学校のの3年生46名とし,初めての学外での臨床実習の終了後に質問紙調査を行った。調査項目は,属性,生活習慣,環境,主観的な健康状態,臨床実習におけるストレスに関する項目,職業性ストレス簡易調査票を一部改変したものである。回答がすべて適切であった44名(女性20.8±0.6歳)の結果の分析を行った。臨床実習においてストレスに思った項目は,「自分の知識不足」,「自分の技術不足」が共に36名(81.8%)で最も多かった。「高い・やや高い」反応があった者は,「不安感」24名(54.5%)が最も多かった。また,実習中の健康状態は,「活気」「イライラ感」,「疲労感」,「不安感」,[抑うつ感」,「身体愁訴」と正の相関(p<0.01)があり,睡眠時間と実習中の「疲労感」には負の相関が認められた(p<0.01)。また,同居家族がいないものほど,「抑うつ感」が高く,「活気」が低かった。学生は,人間関係よりも自身の力量にストレスを感じていることが示唆された。また,実習中は,「不安感」などのネガティブなストレス反応と体調には関連があると憶測された。教員は,知識や技術に不安を持たないように十分サポートする必要があるとともに,生活習慣や環境についても考慮する必要があると考えられた。(著者抄録)

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

While research has explored the risk of periodontal disease in various eye conditions, the link between dry eye and periodontal disease remains underexplored, especially in Japanese adults. This study aims to investigate the association between dry eye and periodontal disease in community-dwelling Japanese adults.

Methods

This study is a subset of the Uonuma cohort study, which includes Japanese adults aged 40 years and older residing in the Uonuma area of Niigata Prefecture, Japan. Participants completed a self-administered, paper-based questionnaire. Statistical analyses, including the chi-square test, independent t test, ANOVA test, and logistic regressions, were employed to assess the association of periodontal disease with independent variables.

Results

Among 36,488 participants (average age 63.3 years, 47.4% men), 39.3% had a history of periodontal disease, and gender differences were statistically significant (p &lt; 0.001). Significant associations were found between periodontal disease and dry eye diagnosis or symptoms. Univariable logistic regression revealed links between periodontal disease and age, gender, living status, alcohol consumption, remaining teeth, bite molar availability, and history of dry eye disease or symptoms. Multiple-adjusted regression found that doctor-diagnosed dry eye was associated with a higher likelihood of periodontal disease (odds ratio, 1.12; 95% confidence interval, 1.03–1.22). Participants who never experienced dryness or foreign body sensation had lower ORs of periodontal disease than those who always experienced such symptoms across all models.

Conclusion

A significant correlation was found between dry eye and periodontal disease in Japanese adults. Regular check-ups, early detection, and effective management of both conditions are strongly recommended.

DOI： 10.1186/s12903-023-03773-7

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Other Link： https://link.springer.com/article/10.1186/s12903-023-03773-7/fulltext.html

Language：Japanese   Publisher：新潟歯学会  

【目的】患者の不安や恐怖は歯科受診行動を阻害する可能性がある。患者の不安や恐怖の関連要因として診療内容や歯科衛生士を含むスタッフの対応,歯科医院の環境などが挙げられる。本研究は,歯科衛生士業務を含む歯科治療に対する不安とその要因を明らかにすることを目的とした。【方法】歯科診療所通院患者に質問紙調査を行い,有効回答が得られた234名を分析対象とした。調査項目は対象者特性,Modified Dental Anxiety Scale日本語版(MDAS-J),不安を感じる場面や歯科衛生士の業務に関するものである。患者の不安と関連する要因を検討するために,従属変数をMDAS-J合計点,独立変数をその他の調査項目としてPoisson分析を行った。【結果および結論】分析の結果,男性は女性に比べてMDAS-J合計点が有意に低かった(Ratios of Means,RM:0.89,p<0.01)。年齢階級では,80-99歳の階級に比べ20-39歳(RM:1.37),40-59歳(1.33),60-79歳(1.27)で,MDAS-J合計点が有意に高かった(p<0.05)。歯科衛生士業務は患者の不安と有意な関連が認められなかった。歯科診療所通院患者234名を対象とし,不安の要因について分析したところ,歯科衛生士業務が与える不安感はMDAS-Jを用いて評価される不安感と有意な関連を示さなかった。(著者抄録)

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Language：Japanese   Publisher：新潟歯学会  

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.

DOI： 10.1038/s41591-023-02610-2

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Other Link： https://www.nature.com/articles/s41591-023-02610-2

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To investigate the association between plasma antibody levels against Porphyromonas gingivalis (PG) and atrial fibrillation (AF) history in community-dwelling older individuals in Japan. MATERIALS AND METHODS: This study was a subset of the Uonuma cohort study, including 3091 participants aged 60-79 years. Data were collected, including AF history as a dependent variable, plasma immunoglobulin G antibody levels against PG as an independent variable, and previously reported AF risk factors and demographic information as covariates. RESULTS: The median age of the participants was 69 years. Of the 3091 participants, 1411 (45.6%) were men, and 56 (1.8%) had an AF history. AF prevalence was significantly higher in participants with higher antibody levels against PG than in those with lower antibody levels (3.0% vs 1.4%; p = 0.005). Multivariable logistic regression analysis showed that participants with higher antibody levels against PG had twofold higher odds of having AF (odds ratio = 2.13; 95% confidence interval = 1.23-3.69). Restricted cubic spline analysis indicated a nonlinear relationship between antibody levels against PG and AF history. CONCLUSION: Plasma antibody levels against PG were associated with AF history in community-dwelling older individuals in Japan.

DOI： 10.3290/j.ohpd.b4528813

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To investigate the changes in oral health status with dental intervention during the acute and subacute stages of stroke and their associations with oral intake status. BACKGROUND: Oral health may deteriorate easily in patients following a stroke. However, data are scarce on the changes in oral health with dental intervention throughout the acute and subacute stages of stroke recovery. MATERIAL AND METHODS: We prospectively recruited 98 stroke patients who were admitted to an acute hospital and referred to a dental team and then could be followed at a subacute rehabilitation unit in the same hospital. Provided dental intervention, including oral health care and other general dental treatments, was recorded. Oral health was assessed with Oral Health Assessment Tool (OHAT), and the changes in OHAT score during the acute and subacute stages were statistically tested. Oral feeding status was examined using Functional Oral Intake Scale (FOIS). The cohort was divided into the non-oral feeding, dysphagia and regular diet groups based on FOIS score. Differences in OHAT among the oral intake groups were statistically tested. RESULTS: Gross OHAT score did not differ among the oral intake groups at the time of admission (mean ± standard deviation score: 6.5 ± 2.8 for non-oral diet, 5.6 ± 2.4 for dysphagia diet and 5.3 ± 2.1 for regular diet), but improved more in the regular diet group (2.4 ± 1.5) than in the other groups (5.8 ± 3.0 for non-oral diet and 4.0 ± 2.1 for dysphagia diet) at the last evaluation. Oral hygiene scores improved significantly in the acute stage, while scores for dentures and natural teeth ameliorated significantly in the subacute stage. CONCLUSION: Our findings suggest that appropriate dental intervention in the acute and subacute stages of stroke may contribute to improved oral health and oral food intake.

DOI： 10.1111/ger.12706

PubMed

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

本研究の目的はアルコール摂取状況と歯の喪失との関連を明らかにすることである.40歳以上の25,216名を分析対象とした.分析では,性別およびアルコール摂取状況[非飲酒者,過去飲酒者,現在飲酒者(週1～149g,週150～299g,週300～449g,週450g以上)]により対象者特性を比較した.その後,アルコール摂取状況と歯の喪失との関連について,ロジスティック回帰分析を行った.従属変数を歯の喪失程度(「現在歯数20本未満」および「無歯顎」)とし,独立変数をアルコール摂取状況とした.その結果,男性で,現在歯数20本未満と非飲酒者,過去飲酒者,週450g以上との間に有意な関連がみられた[週1～149gと比較したオッズ比(95%信頼区間)=1.49(1.29-1.72),1.25(1.05-1.49),1.22(1.07-1.39)].無歯顎は非飲酒者との間に有意な関連がみられた[1.70(1.33-2.18)].一方,女性で,現在歯数20本未満と非飲酒者,週150～299g,週450g以上との間に有意な関連がみられた[1.20(1.08-1.34),1.28(1.04-1.57),1.64(1.12-2.40)].無歯顎は週450g以上との間に有意な関連がみられた[3.18(1.31-7.76)].アルコール摂取状況は歯の喪失と関連し,現在飲酒者においてアルコール摂取量が多いほど関連が強く,その関連の程度には性差がみられた.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00440&link_issn=&doc_id=20230814210002&doc_link_id=%2Fdk1dehea%2F2023%2F007303%2F002%2F0177-0184%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2023%2F007303%2F002%2F0177-0184%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being^1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was &lt;1.1 kg m^–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

DOI： 10.1038/s41586-023-05772-8

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Other Link： https://www.nature.com/articles/s41586-023-05772-8

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: The aim of this study was to determine whether physical activity (PA) is associated with periodontitis in the Japanese population. BACKGROUND: The potential association between PA and periodontitis has not been thoroughly investigated in the Japanese population. METHODS: We used cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next-Generation Oral Health Study. Periodontitis was determined by a full-mouth periodontal examination. PA was assessed using a validated questionnaire. We performed multivariable ordinal logistic regression analyses to assess the association of total PA (the first quintile was set as the reference category) with periodontitis (three categories: no/mild, moderate, and severe), stratified by sex. The associations of periodontitis with domain- and intensity-specific PA were also studied in separate logistic regression models. RESULTS: This study included 2160 Japanese adults [1414 women and 746 men; mean (standard deviation) age 58.1 (9.6) years]. After adjusting for potential confounders, total PA was inversely associated with the presence and severity of periodontitis in women. The multivariable-adjusted odds ratios (95% confidence intervals) for periodontitis in the second to fifth quintiles (compared with the first quintile) of total PA were 0.81 (0.59-1.12), 0.74 (0.53-1.02), 0.77 (0.55-1.06), and 0.64 (0.46-0.89), respectively (p for trend = .01). We did not find different results when we further investigated the associations of periodontitis with domain- and intensity-specific PA. By contrast, PA was not associated with periodontitis in men. CONCLUSION: Total PA had an inverse, linear association with the presence and severity of periodontitis in Japanese women but not in Japanese men. Further prospective studies are required to determine the association between PA and periodontitis.

DOI： 10.1111/jre.13095

PubMed

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Publishing type：Research paper (scientific journal)  

Objective: In this study, the prevalence and underlying cause of enamel hypoplasia in one-year-old children were examined. Additionally, to determine the association between enamel hypoplasia and exposure to sunlight based on the frequency of the mother’s outings during pregnancy. Methods: A total of 273 kids (139 boys) were involved in this study. Based on questionnaires surveys to mothers, oral examinations, and photographs of children's mouths, we looked at the connection between the circumstances of pregnancy and the occurrence of enamel hypoplasia. The presence of enamel hypoplasia was assessed using logistic regression analysis differed among the results of the questionnaire. Results: The prevalence of enamel hypoplasia was 38.5%. In the medium and low groups, enamel hypoplasia was more common than in the high group at the birth month of the child (adjusted odds ratio: 3.36, 95% confidence interval: 1.65–6.85, p = 0.001 vs. adjusted odds ratio: 3.76, 95% confidence interval: 1.89–7.48, p < 0.001, respectively). Enamel hypoplasia was knowingly higher among the children whose mothers went out less than 1–2 times a week during pregnancy (adjusted odds ratio: 2.41, 95% confidence interval: 1.04–5.61, p = 0.041). Enamel hypoplasia was significantly more prevalent when mothers used painkillers during pregnancy (adjusted odds ratio: 5.45, 95% Confidence interval: 1.74–17.08, p = 0.004). Conclusion: It was suggested that the use of antipyretic analgesics during pregnancy and frequency of outings and variations in sunshine hours according to the child's birth month could affect the occurrence of enamel hypoplasia.

DOI： 10.2174/18742106-v17-230303-2022-93

Scopus

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Language：English   Publishing type：Research paper (scientific journal)  

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 workforce. This study aimed to investigate, at the most recent employment, career outcomes, reasons for 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 the undergraduate education. CONCLUSIONS: A quality four-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 prevalence of hospital and administrative roles were higher than national averages. Long-term studies of graduates' career outcomes are warranted.

DOI： 10.1111/idh.12655

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

The purpose of this study was to determine the effect of walking training "Interval Walking Training (IWT)" on oral health status. Participants were divided into two groups: an exercise intervention group and a non-intervention group (control). The intervention group consisted of 59 subjects (20 males, 39 females) aged 50 years or older who participated in the IWT program in Matsumoto from 2019 to April 2022. The control group consisted of 33 subjects (14 males and 19 females) aged 50 years or older who have visited Niigata University Medical and Dental Hospital and agreed to participate in the study. The intervention group underwent walking training (interval walking training) for at least 5-6 months. The walking training consisted of five sets of fast walking above 70% peak aerobic capacity for walking (VO2peak) for 3 min, followed by 3 min of slow walking at ~40% VO2 peak per day for more than four days/week. The oral health status was evaluated for the number of teeth, occlusal force, salivary occult blood, masticatory performance, and tongue pressure. A total of 57 participants were analyzed in the intervention group (18 males and 39 females, age: 66.7 ± 0.8 (mean ± S.E.) years) and 33 participants in the control group (14 males and 19 females, age: 74.5 ± 1.1 (mean ± S.E.) years). There were no significant differences in gender, salivary occult blood, tongue pressure, masticatory performance, or occlusal force between the two groups at the start of the intervention (p = 0.36, p = 0.48, p = 0.42, p = 0.58, and p = 0.08, respectively by unpaired t-test or χ2 test). On the other hand, there were significant differences in age and BMI, with a trend toward lower age and higher BMI in the intervention group (p &lt; 0.001 and p &lt; 0.001, respectively, by unpaired t-test). In terms of rate of change, the intervention group showed a significant increase in occlusal force (F = 4.5, p = 0.04, ANCOVA) and a significant decrease in BMI (F = 7.3, p = 0.009, ANCOVA). No significant differences were observed in the other measured items. It was found that walking training in both middle-aged and older people does not only affect the physical aspect of weight loss but may help maintain and improve the occlusal force.

DOI： 10.3390/ijerph192114465

PubMed

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Publishing type：Research paper (scientific journal)   Publisher：Georg Thieme Verlag KG  

Abstract

Introduction The associations of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein (HDL-C) with reduced saliva flow rates have not been previously reported.

Objective The present study aimed to assess the association of cholesterolemia with reduced saliva flow rates in community-dwelling elderly subjects.

Methods The present study analyzed 342 participants (170 males and 172 females aged between 78 and 79 years old). Unstimulated salivary flow rate (USFR) was assessed using a cotton roll method. Low-USFR was defined as 0.10 g/30 seconds. Stimulated salivary flow rate (SSFR) was assessed by having the participants chew tasteless gum for 3 minutes. Low-SSFR was defined as 1.0 mL/minute. Blood samples were collected for the measurement of LDL-C, HDL-C, rheumatoid factor, hemoglobin A1c, and creatinine. To assess depression, the General Health Questionnaire 30 was used. A standardized questionnaire was completed, covering the current and previous medications of the participants and smoking status. We stratified the serum LDL-C levels of the participants as normal, moderate or severe hyper-LDL cholesterolemia and serum HDL-C levels as normal or hypo-HDL cholesterolemia. Multivariate logistic regression models were established and low-USFR or low-SSFR were set as dependent variables in the aforementioned models.

Results After controlling for the effects of the other variables, the odds ratios (ORs) (95% confidence intervals [CIs]) for low-USFR were 2.25 (1.10–4.61) for moderate and 5.69 (1.55–20.8) for severe hyper-LDL cholesterolemia, while that of hypo-HDL cholesterolemia was 3.40 (1.33–8.69). Severe hyper-LDL cholesterolemia was also associated with low-SSFR with an OR of 3.89 (1.39–10.88).

Conclusion Elderly patients with cholesterolemia have a risk of reduced salivary flow rate.

DOI： 10.1055/s-0042-1744167

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

根面う蝕は,加齢による歯槽骨の退縮や歯周疾患,不適切なブラッシング,唾液分泌量の減少などで発症および進行リスクが高まる.また,高齢者の現在歯数増加,歯周疾患罹患率の増加によって,今後も増加が予想される.根面う蝕は,視診,触診により活動性と非活動性に分類でき,活動性う蝕はフッ化物の応用など非侵襲的な処置で非活動性う蝕へのコントロールが可能である.フッ化ジアンミン銀(SDF:Silver Diamine Fluoride)は55,000ppmという高濃度のフッ化物を含有するう蝕予防・進行抑制剤である.塗布は年1～2回で,費用対効果が高い.SDFの欠点であるう蝕病変の黒変軽減のため,ヨウ化カリウム(KI)の併用について研究が進んでいる.また,フッ化物バニッシュは22,600ppmNaFを4～6時間停滞させ,う蝕予防効果を発揮する塗布材料である.う蝕予防や進行抑制に関して十分なエビデンスがあることから,欧米諸国では小児から高齢者に至るまで,積極的に応用されている.国内では,象牙質知覚過敏鈍麻剤として認可されているが,有効性を示す調査が複数存在することから今後根面う蝕予防や根面う蝕進行抑制へと使用用途が広がっていくことを期待する.SDF,フッ化物バニッシュは操作が簡便で,介護が必要な高齢者や,訪問診療での利用にも適している.多くの年代に渡り,セルフケアに加え.プロフェッショナルケアを充実させることで.今後必要性が増加することが予想される根面う蝕管理に対応する必要があると考える.(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND OBJECTIVES: Several epidemiological studies have reported that smokers have a higher prevalence and severity of periodontal disease than do nonsmokers, and that smoking negatively affects nutritional status and is associated with a reduced intake of antioxidants, particularly vitamin C. The present investigation aimed to examine the relationship between serum vitamin C levels and smoking and its influence on the periodontal condition in older adults. MATERIALS AND METHODS: A total of 353 respondents met the inclusion criteria and were enrolled in the present study. The periodontal status of the study participants was determined through examinations of one or more residual teeth, which included a measurement of the probing pocket depth (PPD) and clinical attachment level (CAL) at six regions of each tooth. Blood samples were collected during the dental examinations and then sent to a laboratory to evaluate serum vitamin C and cotinine levels. A serum cotinine concentration of 100 ng/ml was considered a relevant threshold for active smoking. After dividing the participants into two groups according to serum cotinine levels, Poisson regression analysis was carried out to compare vitamin C levels with the prevalence rate ratio (PRR) for periodontal condition markers for each group based on serum cotinine levels. RESULTS: We evaluated differences in the PRR of serum vitamin C tertiles between participants with high (≥100 ng/ml) or low (<100 ng/ml) serum cotinine levels after adjusting for sex, the use of interdental brushes or dental floss, and the number of teeth. A negative tendency between the PRR of vitamin C tertiles for the PPD or CAL was seen for both groups. Especially, a bigger difference was observed in the group with high serum cotinine levels. The PRR of the first tertiles in the high serum cotinine group was 5.03, compared with 2.69 in the low serum cotinine group (relative risk: 1.9). CONCLUSION: The results of this study suggest a potential association between vitamin C levels and the periodontal condition, which may be influenced by smoking status.

DOI： 10.1111/jre.12988

PubMed

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

本研究の目的は小学生における口唇閉鎖力の年齢による変化を示すともに,口唇閉鎖力に影響を与える要因を明らかにすることである.新潟県内Y小学校に通う1年生から6年生の328名(男児167名,女児161名)についてアンケート調査(同意率80.8%)および口唇閉鎖力の測定を実施した.小学生における口唇閉鎖力の年齢による変化を示すために,年齢による口唇閉鎖力の推移を比較した.さらに,9歳未満と9歳以上の2群に分け,各群における口唇閉鎖力4分位群による対象者の特性について比較し,関連する要因についても検討を加えた.その結果,本研究の対象者における口唇閉鎖力は増齢とともに緩やかな増加がみられた.口唇閉鎖力4分位と対象者の特性との関連について,9歳未満では現在歯数,いびきの有無との関連がみられた(オッズ比[95%信頼区間]=1.28[1.01-1.56],0.45[0.24-0.84]).9歳以上の群では,年齢,ローレル指数との関連がみられた(1.45[1.09-1.93],6.02[2.21-16.39]).結論として,小学生における口唇閉鎖力について9歳前後で口唇閉鎖力に影響する要因が異なることが考えられた.口唇閉鎖力の増加に影響する要因として,9歳未満の対象者では現在歯数が,また,9歳以上の対象者では,年齢,肥満との関連がみられた.口唇閉鎖力が低値であることに影響する要因として,9歳未満でいびきと関連していた.(著者抄録)

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

地域在住高齢者の頸部可動域に対する口腔機能訓練の効果を明らかにすることを目的とした.65歳以上の高齢者を対象に年齢,性別,BMI,ロコモ度テスト,現在歯数,義歯の使用および頸部可動域を調査した.自治会の地域によって運動器機能訓練および口腔機能訓練を実施する複合プログラム群(30名),運動器機能訓練を実施する単一プログラム群(35名)の2群に分けて3ヵ月間訓練を行った後,同一項目の調査を行った.頸部可動域の訓練前後比較はWilcoxonの順位和検定を,変化量の2群間比較はMann-WhitneyのU検定を行った.また,頸部可動域の改善を従属変数として,性別,年齢および口腔機能訓練の介入の有無を独立変数としてロジスティック回帰分析を行った.複合プログラム群ではすべての運動方向において頸部可動域が改善した(p<0.05).前屈を除く運動方向において,単一プログラム群と比べて頸部可動域の変化量が高く(p<0.05),頸部可動域の改善が口腔機能訓練の介入と有意な関連がみられた(オッズ比=7.23～18.52).高齢者における口腔機能訓練は頸部可動域の改善に影響を与えることが明らかとなった.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00440&link_issn=&doc_id=20220210120003&doc_link_id=%2Fdk1dehea%2F2022%2F007201%2F001%2F0011-0017%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2022%2F007201%2F001%2F0011-0017%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

This study aimed to evaluate the effects of an oral function training program and indicators of oral health status on improvements in physical performance induced by physical function training in dependent older adults. The participants were 131 potentially dependent older adults (age: ≥65 years) who were randomly divided into two groups: an oral intervention and a control group. All participants underwent physical function training, but only the intervention group took part in the oral function training program. In total, 106 participants completed all of the survey components (60 and 46 participants from the intervention and control groups, respectively). The measures of physical fitness examined included the one-leg standing time with eyes open (OLST) and the timed up and go test (TUG). Logistic regression analyses were carried out to determine the effects of the oral function intervention and health status on physical fitness. The results revealed that the oral function intervention significantly improved OLST and TUG times. These findings suggest that evaluations of oral health status and interventions aimed at activating oral functions are associated with improvements in physical fitness among potentially dependent older adults.

DOI： 10.3390/ijerph182111348

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/s0140-6736(21)01330-1

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Language：Japanese   Publisher：(公社)日本歯科医師会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

障害児者の歯科保健は,全身の健康管理において大変重要であるが,その取り組みは施設ごとに大きく異なる.本調査では,新潟県における障害者施設利用者の歯科診療受診状況,および歯科保健取組状況について調査することで,実態および課題を把握し,特に歯科専門職の配置による有効性を評価することを目的とした.新潟県内で開設されている全障害児者施設1,021ヶ所を対象に調査を行ったところ,有効回答があった801施設のうち5.1%に歯科専門職(歯科医師,歯科衛生士)が配置されていた.施設における歯科保健管理,歯科医療,および食事介助や摂食機能維持の状況を評価した.ロジスティック回帰分析の結果,歯科専門職の配置がある施設では,歯科健診を受ける機会(調整オッズ比=7.02,95%信頼区間=2.66-18.55),歯科保健指導を受ける機会(調整オッズ比=4.34,95%信頼区間=1.98-9.51),歯科疾患予防の取り組み(調整オッズ比=3.97,95%信頼区間=1.50-10.44),歯科専門職との日常連携(調整オッズ比=5.02,95%信頼区間=2.29-10.99),歯科専門職への相談(調整オッズ比=6.53,95%信頼区間=2.46-17.35),および歯科保健がニーズを満たしている割合(調整オッズ比=3.37,95%信頼区間=1.58-7.15)が有意に高かった.障害児者施設における歯科専門職の配置が,歯科保健に有意に関連していることが示唆された.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J00440&link_issn=&doc_id=20210813270001&doc_link_id=%2Fdk1dehea%2F2021%2F007103%2F001%2F0126-0135%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2021%2F007103%2F001%2F0126-0135%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本口腔衛生学会  

わが国では,年々超高齢者数が増加している.健康度の高い在宅超高齢者の食生活の実態を把握することは健康寿命延伸の有益な知見になると考えられる.そのため著者らは,在宅超高齢者を対象として,食事パターンを同定し,栄養素摂取量,栄養状態および嚥下状態との関連について明らかにすることを目的として本研究を行った.新潟市の91歳在宅高齢者86名を対象として,簡易型自記式食事歴法質問票(BDHQ),簡易栄養状態評価(MNA-SF),簡易嚥下状態評価票(EAT-10)による調査を行った.食品群別摂取量から主成分分析を行い,食事パターンを同定し,それらと栄養素摂取量の関連を検討した.さらに,各食事パターンと食に関連する因子,MNA-SFおよびEAT-10との関連を比較検討した.主成分分析の結果,4つの食事パターンが同定された.それぞれの主成分得点三分位によって栄養素摂取量を比較したところ,肉,魚,野菜類の摂取量が多く,ご飯,パンが少ない「副菜型」では,高得点群ほどたんぱく質やビタミンDなどの栄養素摂取量が多く,栄養状態も良好な者が多かった.また,MNA-SFで低栄養と判定された群では対照群と比べて嚥下機能低下のリスクのある者の割合が有意に高かった.さらに,「副菜型」の食事パターンでは居住形態や共に食事をする人の有無との関連も示唆された.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J00440&link_issn=&doc_id=20210813270002&doc_link_id=%2Fdk1dehea%2F2021%2F007103%2F002%2F0136-0146%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2021%2F007103%2F002%2F0136-0146%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Publishing type：Research paper (scientific journal)   Publisher：eLife Sciences Publications, Ltd  

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

DOI： 10.7554/elife.60060

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Other Link： https://cdn.elifesciences.org/articles/60060/elife-60060-v1.xml

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: In this 5-year cohort study, we aimed to determine whether the intake of natto, a fermented soya bean food product, has an indirect effect on tooth loss incidence through BMD changes among postmenopausal women. BACKGROUND: Evidence indicates (1) that natto has a beneficial effect on bone health and (2) that a decrease in bone mineral density (BMD) is associated with tooth loss. METHODS: The study recruited 435 postmenopausal women (average age = 64.2 years). Natto intake (exposure) was assessed at baseline using a food frequency questionnaire. Lumbar spine BMD and number of teeth were measured at baseline and 5-year follow-up. BMD change (mediator) and the number of teeth lost (outcome) over time were calculated. The mediation model consisted of these 3 variables. Mediation analysis was performed to test the indirect effect of the natto intake measured through BMD change on tooth loss. RESULTS: During the study, the mean number of teeth lost was 1.2 (standard deviation = 1.8), and the mean BMD decline was 2.5% (standard deviation = 7.1). After adjusting for potential confounders, increasing habitual natto intake was significantly indirectly associated with a lower incidence of tooth loss mediated by BMD change (incidence rate ratio of tooth loss among women with "≥1 pack/day" natto intake was 0.90 [95% confidence interval = 0.82-0.99] compared to those with natto consumption of "rarely"). CONCLUSIONS: Dietary natto intake is significantly indirectly associated with a lower incidence of tooth loss among postmenopausal women, and systemic bone density could be a mediator of this association.

DOI： 10.1111/ger.12523

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND OBJECTIVES: Few studies have assessed the possible interaction between and impact of IL-6 variants and serum α-tocopherol levels on periodontal condition in older individuals. Here, we assessed the relationship between IL-6 variants and serum α-tocopherol levels on periodontal condition by considering effect modification. MATERIAL AND METHODS: Among the study participants, 359 who were 71 years of age underwent a dental examination, biochemical analysis, and interview. After dividing the participants into tertiles based on serum α-tocopherol levels, we conducted Poisson regression analysis to compare the prevalence rate ratio (PRR) for periodontal disease markers with the IL-6 genotype (rs1800796) based on each tertile adjusted by the number of teeth present (offset). RESULTS: The PRRs of the IL-6 genotype for periodontal condition (probing pocket depth [PPD], clinical attachment level [CAL], and bleeding on probing [BOP]) which were adjusted by the number of teeth present (offset) were 1.17 (P < .001), 1.37 (P < .001), and 1.08 (P = .048), respectively. In addition, a significant association was found between the reciprocal number of PRRs of the IL-6 genotype and three serum α-tocopherol levels. The adjusted PRRs (± standard error) of the IL-6 genotypes for PPD were 0.48 (0.12) for the first group (P < .001), 1.54 (0.04) for the second group (P < .001), and 2.11 (0.03) for the third group (P < .001); similar tendencies were seen for CAL and BOP. CONCLUSION: The results of this study suggest a potential association between the IL-6 genotype and periodontal condition in relation to serum antioxidant concentrations.

DOI： 10.1111/jre.12802

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Language：English   Publishing type：Research paper (scientific journal)  

AIM: The effect of dentition status on higher-level functional capacity patterns over time remains unclear. We aimed to identify distinct higher-level functional capacity trajectories in individuals aged 70-80 years, and examine whether dentition status at 70 years predicted the trajectory. METHODS: The study included 551 community-dwelling adults aged 70 years at baseline. Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) up to the age of 80 years. A higher TMIG-IC score indicated a higher level of competence. Group-based trajectory modeling was used to identify distinct TMIG-IC trajectories. The number of teeth, use of dentures, sex and education were added as baseline group membership predictors. Dental visits, health behaviors, body mass index and comorbidities during observation were added as time-varying covariates. RESULTS: Three TMIG-IC trajectories were identified: "high/stable" (65.3%), "middle/decline" (24.5%) and "low/decline" (10.2%). A lower number of teeth and non-denture use were associated with increased odds of a low/decline trajectory relative to a high/stable trajectory (odds ratio 1.09, 95% confidence interval 1.04-1.14 [per one decrease] and odds ratio 3.96, 95% confidence interval 1.54-10.16, respectively). CONCLUSIONS: Older adults with fewer teeth and those without dentures at the age of 70 years were more likely to follow a trajectory toward functional decline with low baseline TMIG-IC scores, which further declines by the age of 80 years. These findings suggest that preserving natural teeth later in life, as well as using dentures, could contribute toward maintaining a higher-level functional competence. Geriatr Gerontol Int 2021; 21: 48-53.

DOI： 10.1111/ggi.14099

PubMed

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Root surface caries experience tends to increase with age. The purpose of this longitudinal study was to evaluate the relationship between aspects of dietary intake, including milk and sucrose in coffee or tea (SCT), and root surface caries in older Japanese individuals. METHODS: 303 community-dwelling older individuals (age 75 years) were enrolled for analysis. All participants underwent a dental examination at baseline and then annually from 2003 to 2008 (ie six times over a 5-year period). A disease event was considered to have occurred when root surface caries was detected on a previously sound or nonexposed root surface. Over the observation period, disease events in each year were counted. Dietary habits during the preceding month were evaluated using a brief self-administered diet history questionnaire (BDHQ) in 2003 and 2008. Poisson regression analysis performed crude and adjusted increment-rate ratios (IRRs) for root surface caries and the intake of milk and SCT. RESULTS: The adjusted increment-rate ratio (IRR) of the increment of root surface caries for participants in the highest SCT tertile was 1.72 (95%CI: 1.40-2.14) compared with the referent group. In addition, for the amount of milk intake, the adjusted IRR in the highest tertile was 0.63 (95% CI: 0.51-0.78) compared with the referent group. CONCLUSIONS: Much SCT and low milk intake were associated with the increment of root surface caries in community-dwelling older people in Japan. These findings suggest that to help prevent root surface caries, community-dwelling older people in Japan should consume adequate amounts of milk daily and limit their intake of SCT.

DOI： 10.1111/cdoe.12602

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Language：English   Publishing type：Research paper (scientific journal)  

Background: Previous studies have reported associations between nonalcoholic fatty liver disease, periodontitis, and obesity. Serum immunoglobulin G (IgG) antibody titer against Porphyromonas gingivalis, a major pathogen of periodontitis, is an established indicator of periodontal infection. However, the relationship between the antibody titer and liver enzyme levels has not been clarified yet. A study in the elderly was needed to evaluate the effect of long-term persistent bacterial infection on liver function. The objective of this study was to investigate the association between liver function and infection by P. gingivalis, and the effect of obesity on the association. Methods: A cross-sectional study was conducted in adult outpatients visiting Sado General Hospital, in Niigata Prefecture, Japan, from 2008 to 2010. The final participants included 192 men and 196 women (mean age 68.1 years). Multivariable logistic regression analyses were performed to assess the association between the serum IgG antibody titer and the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamine transferase (GGT) levels. Results: In women, serum IgG antibody titers against P. gingivalis was associated with elevated ALT, but not with AST or GGT, independent of covariates (p = 0.015). No significant association was found between the antibody titer and the elevated liver enzymes in men. The effect of obesity on the relationship between antibody titer and liver enzyme levels was not statistically significant. Conclusions: A cross-sectional analysis of adult outpatients suggested an association between P. gingivalis infection and ALT levels in women. The effect of obesity on this association was not statistically significant.

DOI： 10.1016/j.heliyon.2020.e05531

PubMed

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/s0140-6736(20)31859-6

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Publishing type：Research paper (scientific journal)  

© 2020 by the authors. For a healthy oral cavity, maintaining a healthy microbiome is essential. However, data on healthy microbiomes are not sufficient. To determine the nature of the core microbiome, the oral-microbiome structure was analyzed using pyrosequencing data. Saliva samples were obtained from healthy 90-year-old participants who attended the 20-year follow-up Niigata cohort study. A total of 85 people participated in the health checkups. The study population consisted of 40 male and 45 female participants. Stimulated saliva samples were obtained by chewing paraffin wax for 5 min. The V3-V4 hypervariable regions of the 16S ribosomal RNA (rRNA) gene were amplified by PCR. Pyrosequencing was performed using MiSeq. Operational taxonomic units (OTUs) were assigned on the basis of a 97% identity search in the EzTaxon-e database. Using the threshold of 100% detection on the species level, 13 species were detected: Streptococcus sinensis, Streptococcus pneumoniae, Streptococcus salivarius, KV831974_s, Streptococcus parasanguinis, Veillonella dispar, Granulicatella adiacens, Streptococcus_uc, Streptococcus peroris, KE952139_s, Veillonella parvula, Atopobium parvulum, and AFQU_vs. These species represent potential candidates for the core make-up of the human microbiome.

DOI： 10.3390/APP10186450

Scopus

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nature Research  

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.

DOI： 10.1038/s41586-020-2338-1

Scopus

PubMed

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Language：Japanese   Publisher：(NPO)日本歯科保存学会  

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Language：Japanese   Publisher：(公社)日本小児歯科学会  

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Few studies have examined the effect of sucrose intake in coffee or tea (SCT) on dental caries, especially root caries, in elderly people. The purpose of the present study was to examine the associations between SCT and the prevalence of root or coronal caries in community-dwelling elderly Japanese. METHODS: Participants were 370 elders aged 75 years from a larger cohort study of elders in Niigata City, Japan. Dietary habits during the preceding month were assessed with a validated brief self-administered diet history questionnaire (BDHQ). The caries examination was conducted using mirror and ball-pointed periodontal probes under artificial light. Poisson regression analysis was performed to analyze the prevalence-rate ratios (PRRs) between SCT and the root or coronal caries. The number of root or coronal caries was selected as the dependent variable for the analysis. Then, SCT (tertiles labeled low, medium and high) and other 4 variables were selected as independent variables. RESULTS: The PRRs between the number of root caries lesions and SCT were signifi cantly higher in the second (medium intake, 1.38, p ⟨ 0.001) and third tertiles (high intake, 2.07, p ⟨ 0.001). Similar tendencies were seen for the number of coronal caries lesions (PRRs in the second and third tertiles 1.74 and 2.46, respectively, both p ⟨ 0.001). CONCLUSION: A significant positive relationship was observed between sucrose in coffee and tea and the number of coronal or root caries lesions in community-dwelling elderly Japanese.

DOI： 10.1922/CDH_00011Yoshihara05

PubMed

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

<title>Abstract</title>
<sec>
<title>Background</title>
Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries.


</sec>
<sec>
<title>Methods</title>
We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group.


</sec>
<sec>
<title>Results</title>
Since ∼1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at ∼0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ∼0.7 per decade in Swiss men (equivalent to ∼26% decline in coronary heart disease risk per decade). The ratio increased in China.


</sec>
<sec>
<title>Conclusions</title>
HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.


</sec>

DOI： 10.1093/ije/dyz099

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publisher：(一社)日本老年歯科医学会  

日本とドイツには共に診療報酬制の法定健康保険制度があり、しかも口腔健康に関する代表的な調査研究が存在している。ドイツの代表的研究であるDeutsche Mundgesundheitsstudie(DMS III、DMS IV、DMS V研究)と日本の厚生労働省による歯科疾患実態調査のデータを利用し、両国の一般集団にみられる口腔健康と歯科健康保険制度のパフォーマンスを比較した。1997年におけるドイツ人の成人集団(35〜44歳)の平均歯数は25.3本、2014年では27.2本であった。日本の1999年の成人集団では27.2本、2016年では28.3本であった。高齢集団(65〜74歳)に関しては、上記と同じ2時点においてドイツ人の場合には平均歯数は10.1本と15.5本、日本人の場合には14.7本と22.7本であり、両国において歯数は増加していた。上記のように両国間の比較では成人集団、高齢集団のいずれの場合でも日本人の残存歯数の方が多かった。ドイツ人1人当たりの歯科診療医療費は上記と同じ2時点において216ユーロと302ユーロ、日本人では178ユーロと195ユーロであった。残存歯数の観点から総合的に判断するとドイツよりも日本の方が歯科医療費資源を効率的に利用していると考えられた。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02171&link_issn=&doc_id=20200131470001&doc_link_id=10.11259%2Fjsg.34.342&url=https%3A%2F%2Fdoi.org%2F10.11259%2Fjsg.34.342&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(NPO)日本歯周病学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: People with chronic kidney disease (CKD) may have an increased risk of periodontal disease, but longitudinal evidence is sparse. METHODS: This 4-year cohort study assessed the association between CKD and changes in periodontal health status, defined by attachment loss (AL) progression, among older adults. Participants were 388 community-dwelling Japanese adults who were 70 years old at baseline with 7053 teeth. Estimated glomerular filtration rate (eGFR) was calculated by using baseline serum creatinine concentration. AL at six sites for every tooth was recorded at baseline and follow-up examinations. Multilevel logistic regression models estimated the tooth-specific risk of AL progression (≥1 site exhibiting a ≥3 mm increase in AL) with baseline CKD (eGFR < 60 mL/min/1.73 m2 ) as the principal exposure. RESULTS: At baseline, 27.8% of the study population (108/388 participants) had CKD. After 4 years, 21.8% of the studied teeth (1537/7053 teeth) exhibited AL progression. After applying inverse probability weighting and adjusting for potential confounders, including sex, use of devices for interdental cleaning, smoking, diabetes, tooth location, abutment for a removable denture, and highest AL, CKD was associated with significantly higher odds of AL progression (adjusted odds ratio: 1.73; 95% confidence interval: 1.15-2.60). CONCLUSIONS: The results suggest that CKD increases the risk of periodontal disease progression in older community-dwelling Japanese adults. Additional studies with more complete information, as well as in other geographic areas and age groups, are necessary to further generalize the findings.

DOI： 10.1002/JPER.18-0464

PubMed

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Language：Japanese   Publisher：日本歯科衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER  

Aims: To identify more reliable and cost-effective methods to detect gingivitis, such as visual examinations, questionnaires, and salivary occult blood tests (SOBT).Methods: Sixty-five elementary school students in Yahiko Village, Niigata, Japan were recruited. Questionnaire was used to assess subjective gingival status. Hemoglobin (Hb) and lactate dehydrogenase (LDH) levels were measured by SOBT. Bleeding on marginal probing (BOMP) method at three labial sites per tooth for all anterior teeth was used to examine clinical gingiva condition. Occurrence of at least 1 site with BOMP positive was defined as gingivitis. Visual gingival redness examination was done at the same sites examined by probing.Results: Participants with gingivitis had higher numbers of sites with redness than those without [6 (0.25-12) vs 0 (0-2), p < 0.001]. Participants with more sites with redness had a 1.29-fold higher risk of suffering from gingivitis (p = 0.002). The overall model had a 77.3% probability of predicting a gingivitis event by the number of sites with gingival redness (p < 0.001). Highest Youden Index was 1.453, yielded from the cut-off value of 4-5 sites with gingival redness.Conclusion(s): This study found that a predictive model using visual gingival redness examination is a viable non-invasive screening test for gingivitis. (C) 2019 Japanese Society of Pediatric Dentistry. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.pdj.2019.05.001

Web of Science

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

本研究の目的は地域在住高齢者における歯数の加齢に伴う変化の軌跡(加齢変化パターン)を類型化し、生命予後との関連を明らかにすることである。70歳から80歳までの10年間に毎年実施した調査に参加した、ベースライン時点で20歯以上を有する299名(男性154名・女性145名)のデータを用いた。70歳から80歳までの歯数の変化に対して、異なる関数形の軌跡をもつグループに分割することを目的に集団軌跡モデルを適応した。その後、歯数の加齢変化パターンと生命予後の関連を評価することを目的にCox比例ハザードモデルによる生存解析を実施した。追跡期間(70歳から85歳)中の総死亡をアウトカムとし、加齢変化パターンごとのハザード比(HR)を算出した。歯数の加齢変化は3つ(28歯維持群、中間-減少群、少ない-減少群)に類型化された。生存解析の結果、少ない-減少群と比較して28歯維持群は総死亡リスクが有意に低いことがわかった(adjusted HR=0.50、95%信頼区間=0.28-0.89)。結論として70歳で20歯以上を有する地域在住高齢者において、その後10年間の歯数の加齢変化は一様でなく、生命予後の観点からはできる限り多くの歯を維持することが重要であり、28歯を維持できれば最も望ましいことが本研究から示唆された。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND PURPOSES: Osteoporosis and osteopenia are multifactorial diseases characterized by low bone mineral density (BMD) and are susceptible to genetic and environmental risk factors. The macrophage erythroblast attacher (MAEA) was discovered as a protein to mediate the attachment of erythroid cells to macrophages and is essential for bone marrow hematopoiesis. MAEA is expressed in a wide range of cells and tissues including osteoblasts and osteoclasts. Recent studies have shown that a single nucleotide polymorphism (SNP) rs6815464 (C/G) in the MAEA gene increases the susceptibility of type 2 diabetes mellitus. However, the contribution of MAEA to bone metabolism remains unknown. Therefore, we performed this study to evaluate the association between MAEA polymorphism and low BMD. METHODS: In a cross-sectional study with postmenopausal Japanese women living in the Yokogoshi area, Niigata City, we evaluated whether rs6815464 was associated with low BMD. Blood samples were collected from 353 subjects (age 63.8 ± 5.4 years). The MAEA genotype was determined by TaqMan assay. BMD was assessed by dual-energy X-ray absorptiometry at the lumbar spine (L2-L4), hip and femoral neck. Low BMD was defined as a T-score <-1. RESULTS: The percentage of subjects with low BMD in the lumbar spine, total hip and femoral neck were 71%, 75% and 84% respectively. After adjusting age, BMI, HbA1c, smoking and alcohol consumption, the G-allele carriage was found to be associated with low BMD of total hip (odds ratio = 2.11, 95% CI: 1.14-3.91, P = 0.018), but not of the lumbar spine or femoral neck. CONCLUSION: The MAEA gene polymorphism rs6815464 was associated with low hip BMD in postmenopausal Japanese women.

DOI： 10.1016/j.gene.2019.03.027

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Macrophage erythroblast attacher (MAEA) is a membrane protein that regulates the development of mature macrophages by mediating attachment with erythroblasts. A polymorphism rs6815464 (C/G) in MAEA gene was reported to be associated with type II diabetes. Along with diabetes, osteoporosis shows an increased prevalence in postmenopausal females, and both diseases have been reported to be associated with periodontitis. Therefore, we explored the relevance of the MAEA polymorphism to periodontitis, bone mineral density (BMD) and haemoglobin A1c (HbA1c). DESIGN: This was a cross-sectional study with the final sample comprised of 344 postmenopausal Japanese females. Probing pocket depth (PPD) and clinical attachment level (CAL) were measured. Genotype was determined by TaqMan assay. Blood biochemical parameters and BMD of the lumbar spine were evaluated. RESULTS: No differences were found in age, body mass index, HbA1c, BMD, number of teeth, bone metabolism parameters between the genotypes. Mean CAL and percentage of sites with PPD or CAL ≥ 5 mm were higher in the G-allele carriers than in the non-carriers. Multiple logistic regression analyses revealed that G-allele carriage was associated with severe periodontitis (odds ratio = 3.73, 95% CI = 1.36-10.19). CONCLUSION: Our results suggested that the MAEA gene polymorphism was independently associated with severe periodontitis.

DOI： 10.1016/j.archoralbio.2019.04.008

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Language：English  

OBJECTIVES: The purpose of this longitudinal study was to evaluate the relationship between beta-3 adrenergic receptor polymorphism and environmental factors such as smoking on periodontal disease by considering effect modification. MATERIALS AND METHODS: A total of 294 subjects who participated in all follow-up surveys over the 6-year study period were analysed. After dividing subjects into tertiles according to the number of years exposed to smoking, we conducted Poisson regression analysis to compare the incidence rate ratio (IRR) for periodontal disease events during the 6-year study period with beta-3 adrenergic receptor genotype (1: Arg allele carriers, 2: Arg allele non-carriers) for each tertile adjusted for other four variables. RESULTS: The number of years exposed to smoking (mean ± standard deviation) for the 1st, 2nd and 3rd tertiles was 0 ± 0, 20.1 ± 9.1 and 45.3 ± 7.7 years, respectively. The IRRs ± SE were 0.89 ± 0.08 (p = 0.218) for the 1st tertile, 1.93 ± 0.36 (p < 0.001) for the 2nd tertile and 2.56 ± 0.23 (p < 0.001) for the 3rd tertile. CONCLUSION: There was a clear dose-response relationship between beta-3 adrenergic receptor genotype and periodontal disease progression based on the number of years exposed to smoking.

DOI： 10.1111/jcpe.13115

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nature Publishing Group  

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3–6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.

DOI： 10.1038/s41586-019-1171-x

Scopus

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Perioperative oral health care can prevent postoperative complications, but it is also important to maintain oral health afterward to avoid later adverse events. This study examined (a) the relationship between knowledge and attitude toward oral health (KAOH) and oral/periodontal status (OPS) in patients receiving surgery, and (b) the changes in KAOH by perioperative oral health care and education. METHODS: Patients receiving surgery who visited our hospital's dental clinic beforehand were prospectively recruited. All participants received oral health care and education. In questionnaires assessing KAOH before and after surgery, respondent answers were generally classified as positive or negative. OPS was assessed before surgery. Associations between KAOH and OPS and perioperative changes in KAOH were statistically tested. RESULTS: A total of 507 patients answered the questionnaire before surgery, among whom 324 patients also completed it afterward. Preoperative OPS was significantly worse in the negative than in the positive KAOH group. Positive answers for KAOH increased significantly from 68.6% to 92.2% during the perioperative period. CONCLUSIONS: We found that patients with poor KAOH also had poor OPS, but KAOH could be improved by perioperative oral health care and education, suggesting that perioperative oral health management could improve oral health knowledge and attitudes.

DOI： 10.1111/odi.13048

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本口腔衛生学会  

職域における歯科保健事業として、疾病の早期発見を目的とした歯科健診が主に行われてきた。こうした従来型の歯科健診から、行動・環境リスク発見型・行動変容支援型歯科健診への転換を目的として、日本歯科医師会で「標準的な成人健診プログラム・保健指導マニュアル」(生活歯援プログラム)が策定された。本調査ではこのプログラムに基づいた歯科健診と保健指導が、歯科健診単独に比べてどの程度優れているのか検討を行った。新潟市内の3企業の従業員129名(44.6±11.5歳)を対象としてランダムに2群に分け、介入群には生活歯援プログラムに準じた歯科健診と保健指導を、対照群には歯科健診のみを行った。保健行動を把握するための質問紙調査をベースライン時、3ヵ月後、6ヵ月後および1年後に行い、この間の行動変容を調べた。その結果、介入群と対照群のいずれにおいても「職場や外出先での歯磨き」や「フッ素入りの歯磨剤の使用」、「歯間ブラシ・フロスの使用」が有意に改善していた。ただ、介入群では1年後まですべての時点でベースライン時に比べ有意に改善していたのに対し、対照群では一部の時点で有意な改善がみられたのみであった。したがって、従来型の歯科健診でも保健行動の変容がある程度期待できるが、その期間は限定的であること、歯科健診に加え生活歯援プログラムに準じた保健指導を行うことで行動変容はより確実となり、効果が少なくとも1年間持続することが明らかとなった。(著者抄録)

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

歯肉炎の評価は視診もしくはプロービングによる方法が一般的であり、検診の場で使用可能な非侵襲的で簡便性、客観性、再現性を併せもつ検査方法はないのが現状である。本研究では、歯肉溝滲出液(GCF)中の成分が歯肉炎バイオマーカーとして有用であるかを検討した。対象は北九州市内某小学校5、6年生107名である。ブロッティングブラシ(以下、ブラシ)で採取したGCF中のα-1アンチトリプシン(A1AT)、ラクトフェリン(Lf)他4成分(AST、ALT、ALP、LDH)を定量し、PMA index(PMA)、プラーク付着状態(PlI)との比較を行った。PMA、PlIを低値群と高値群に2値化し、GCF成分との比較を行ったところ、PMAではすべての成分、PlIではLDH以外の成分で有意(p<0.05)に関連していた。さらに、ROC曲線から求めたPMA、PlIに対する各成分のカットオフ値はそれぞれ、A1ATが283.8、248.3、Lfが152.1、114.4、ASTが4.5、2.5、ALTはともに1.5、ALPは2.5、PMAでのLDHが26.0であった。陽性尤度比は1.5から3.0程度となった。以上の結果からGCF中A1AT、Lf、AST、ALTおよびALPは小児を対象とした歯肉炎スクリーニングのバイオマーカーとして有用であることが示唆された。(著者抄録)

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

高齢化が進み、有病者への対応や医療連携体制の必要性が高まる現在、診療所は一次医療機関として、多岐にわたる患者への対応および地域における多職種連携等が求められている。本調査の目的は、新潟県の診療所に勤務する各業種の従事状況と、診療所で担える診療内容の関連について評価することである。平成24年8月1日現在、新潟県で開設されている県内すべての歯科診療所(1,186施設)を対象に調査を行い、平成24年7月の1ヵ月間の実施状況について、質問紙による調査で回答を得た。欠損値のない950施設を分析対象とした。診療所に勤務している歯科医師数あるいは歯科衛生士数を説明変数とし、歯科業務補助者数、技工士数、事務職数を共変量に在宅歯科医療サービスの実施状況についてロジスティック回帰分析、障害者および摂食嚥下指導への対応状況については順序ロジスティック回帰分析を行った。その結果、歯科衛生士数のみと関連がみられたのは在宅歯科医療サービス、施設への歯科訪問診療、訪問歯科衛生指導、障害者への対応(それぞれ調整済オッズ比[95%信頼区間]=1.12[1.03-1.23]、1.11[1.01-1.23]、1.31[1.16-1.47]、1.27[1.16-1.40])であった。一方、摂食嚥下指導への対応については歯科医師数(1.24[1.04-1.48])とのみ関連がみられた。診療所の多岐にわたる患者への対応や病診連携を推進するには、まずは歯科医師の意識向上が前提であり、それを基に診療所における歯科医師および歯科衛生士の人材確保が必要である。(著者抄録)

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：Japanese Society for Oral Health  

<p> With advanced aging, there are growing demands for the management of sick persons and medical liaison systems. In such a situation, clinics are expected to play roles as primary medical institutions, such as dealing with diverse patients and promoting community-based multi-professional collaboration. To clarify the association between the statuses of different types of professionals working in dental clinics and their service contents, a questionnaire survey was conducted, involving all dental clinics in Niigata Prefecture (1,186 as of August 1, 2012), along with examination of their service provision in July of the same year. Among these clinics, 950 that responded to the questionnaire without missing values were analyzed. With the number of dentists or dental hygienists working in the study clinics as an explanatory variable and those of dental assistants and clerks as covariances, logistic regression analysis was performed to analyze the contents of home dental care services. Ordered logistic regression analysis was also used to examine the management of patients with disabilities and the provision of feeding/swallowing guidance.</p><p> The items only associated with the number of dental hygienists were home dental care services, visits to care facilities, dental hygiene guidance for care facilities, and the management of patients with disabilities (adjusted odds ratio [95% confidence interval]=1.12 [1.03-1.23], 1.11 [1.03-1.23], 1.31 [1.16-1.47], and 1.27 [1.16-1.40], respectively). The provision of feeding/swallowing guidance was only associated with the number of dentists (1.24 [1.04-1.48]).</p><p> In order to promote the management of diverse patients in dental clinics and their liaison with hospitals, it may be necessary to enhance dentists' awareness as a premise and basis for ensuring sufficient numbers of dentists and dental hygienists working in such clinics.</p>

DOI： 10.5834/jdh.69.1_10

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DOI： 10.1007/s12603-018-1125-2

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Language：English   Publishing type：Research paper (scientific journal)  

Most studies that have demonstrated an association between number of remaining teeth and cognitive impairment have treated teeth as a continuous variable, although the relationship is nonlinear. The aim of this cross-sectional study was to determine the critical number of remaining teeth in hospital outpatients at which the association with cognitive impairment becomes apparent. Japanese adults living on Sado Island who visited Sado General Hospital were invited to participate in Project in Sado for Total Health. In total, 2,530 adults were interviewed and had their teeth counted; 1,476 of these individuals also completed the Mini-Mental State Examination (MMSE) and underwent measurement of their serum high-sensitivity C-reactive protein (hsCRP) levels. Patients on dialysis and those with hsCRP ≥ 10 mg/L were excluded. The final study group consisted of 565 adults (290 men and 275 women) of mean age 69.8 (range 29-91) years. An MMSE score < 24 was considered to indicate cognitive impairment. The subjects were categorized according to whether they had an edentulous jaw or one to 10, 11-20, 21-27, or ≥28 remaining teeth. One hundred twenty-eight of the 565 study participants were diagnosed to have cognitive impairment. Multiple logistic regression analysis revealed associations of cognitive impairment with older age, ischemic heart disease, smoking, and alcohol consumption. After adjustment for covariates, having one to 10 remaining teeth was significantly associated with cognitive impairment. There is a significant association between having only one to 10 remaining teeth and cognitive impairment in hospital outpatients.

DOI： 10.1002/cre2.147

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

健康の評価方法として、歯科保健の分野においても主観的評価による健康度を評価指標にした調査が報告されている。しかし、主観的健康観についての調査対象は高齢者が多く、65歳未満の者を対象とした調査はほとんど行われていない。そのため本研究は、一般地域住民を対象に、歯や歯肉の健康状態と全身健康状態との関連を主観的健康観により明らかにすることを目的とした。全国から20〜79歳の5,000人を抽出し、質問紙による調査で回答を得た2,465人(有効回収率49.3%)の中から、分析に用いる変数に欠損値のない1,972人を分析対象者とした。対象者を年齢によって壮年(20〜39歳)・中年(40〜59歳)・高年(60〜79歳)の3区分に分け、それぞれの群において歯や歯肉の健康状態と全身健康状態の主観的健康観の回答をそれぞれカテゴリー化した後、相互の関連を順序ロジスティック回帰分析を用いて分析した。共変量として、現在歯数、性別、仕事の有無、主観的経済状況、就学年数、治療中の疾患の有無、相談相手の有無、BMIを使用した。その結果、すべての年齢群において歯や歯肉の健康状態が良いと回答した者は全身的な健康状態がより良好であると回答していた(調整済オッズ比[95%信頼区間]=壮年期12.41[7.22-21.34]、中年期11.77[7.50-18.48]、老年期10.07[6.55-15.50])。一般住民において属性や関連要因を調整した分析で、いずれの年代においても主観的な歯や歯肉の健康状態と全身健康状態との間には明確な関連性が認められた。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00440&link_issn=&doc_id=20181113220002&doc_link_id=%2Fdk1dehea%2F2018%2F006804%2F002%2F0198-0206%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2018%2F006804%2F002%2F0198-0206%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Munksgaard  

Objective: To evaluate the association of salivary flow rate with all-cause mortality among older Japanese adults. We hypothesised that hyposalivation would be a marker for mortality. Background: Hyposalivation, which is an objectively measurable decrease in salivary flow, is highly prevalent among older adults. It is associated with malnutrition and poor general health. Methods: The study population comprised 600 community-dwelling Japanese adults (306 men and 294 women), who were 70 years old at baseline. They underwent stimulated salivary flow rate (SSFR) measurements and were followed up during a 10-year study period. After stratification by sex, the hazard ratios of all-cause mortality were estimated using Cox proportional hazards regression analysis comparing groups with and without hyposalivation (ie, SSFR &lt
 0.7 mL/min). Results: The baseline prevalence of hyposalivation was 27.8% (85/306) among men and 47.3% (139/294) among women. During a mean (standard deviation) follow-up period of 104 (27) months, 80 deaths occurred: 60 (75.0%) deaths among men and 20 (25.0%) deaths among women. After adjusting for the number of remaining teeth, smoking status, exercise, hypoalbuminemia, diabetes and cardiovascular disease, hyposalivation at baseline was significantly associated with all-cause mortality among men (adjusted hazard ratio, 1.71
95% confidence interval, 1.01-2.89). In contrast, no association between SSFR and all-cause mortality existed among women. Conclusion: Hyposalivation could be a marker for all-cause mortality among older community-dwelling Japanese men. Future studies investigating the association between SSFR and cause-specific mortality are warranted.

DOI： 10.1111/ger.12319

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Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

DOI： 10.1093/ije/dyy016

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OBJECTIVES: The aim of this study was to investigate the possible correlation between vitamin D receptor (VDR) gene polymorphism and susceptibility to chronic kidney disease (CKD) and periodontal disease. MATERIAL AND METHODS: This study analysed 345 participants, who were all 79 years of age. Kidney function levels were determined based on the estimated glomerular filtration rate (eGFR; non-reduced function: ≥60 and reduced function: <60 ml min-1  1.73 m-2 ). VDR TaqI genotyping was also studied. We calculated the periodontal inflamed surface area (PISA). After classifying participants into quartile groups according to eGFR or PISA values, the subjects were then split into two groups (highest quartile versus the other three groups combined). Multiple logistic regression analysis was performed to evaluate the odds ratios between the eGFR and VDR TaqI genotype with the different PISA groups. The eGFR was set as the dependent variable while the VDR TaqI genotype, HbA1C, gender, smoking habits and body mass index were defined as independent variables. RESULTS: A significant association was observed between the VDR TaqI genotype and eGFR in the PISA high group (odds ratio = 3.97, p = .027). CONCLUSION: Study results suggest that VDR TaqI genotype might be associated with CKD during inflammatory conditions caused by periodontal disease.

DOI： 10.1111/jcpe.12896

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INTRODUCTION: This study evaluated the relationship between serum Rheumatoid Factor (RF) levels and tooth loss in a community-dwelling elderly Japanese women. It was hypothesised that women with high baseline RF levels would experience greater tooth loss over 10 years than age-matched women with lower baseline serum RF levels. MATERIALS AND METHODS: The study population consisted of 197 women aged 70 years with ≥12 teeth at baseline. One hundred and twenty-four participants completed a 10-year follow-up and were divided into 2 groups according to their baseline serum RF levels as follows: RF negative (<15 U/mL; n = 114) and RF positive (>15 U/mL; n = 10). Negative binomial regression was used to investigate the relationship between baseline RFs and tooth lost over the 10-year period. RF and its interaction with the baseline number of teeth were independent variables, with 9 other adjustment covariates. RESULTS: Baseline RFs were significantly associated with tooth loss (P = .035). In addition, a statistical interaction between baseline RFs and baseline number of teeth was identified (P = .023), modifying the association between RFs and tooth loss. The adjusted incidence rate ratio (IRR) for RF-positive participants with 21 baseline teeth was 1.88 (95% confidence interval (95% CI): 0.76, 4.65). IRRs obtained for participants who had 25 baseline teeth (3.02; 95% CI: 1.03, 8.83) or 30 baseline teeth (5.47; 95% CI: 1.29, 23.13) suggested that RF-positive participants with a high number of baseline teeth would exhibit greater tooth loss than RF-negative participants. CONCLUSION: High serum RF levels were associated with a greater IRR for future tooth loss in elderly Japanese women.

DOI： 10.1111/ger.12344

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AIM: To evaluate the longitudinal association of combined healthy lifestyle factors with incidence or progression of periodontitis and tooth loss in older adults. MATERIALS AND METHODS: This 6-year study included 374 Japanese 70-year olds with 7,157 teeth, from a source eligible baseline population of 554 individuals. Four lifestyle factors-cigarette smoking, physical activity, relative weight, and dietary quality-were scored as healthy (1 point) or unhealthy (0 point). Adding the individual scores generated the "healthy lifestyle score" (0-4 points). Multilevel mixed-effects logistic regression models were applied to evaluate tooth-specific associations between the baseline healthy lifestyle score and the incidence or progression of periodontitis (increase in clinical attachment loss ≥3 mm) and tooth loss. RESULTS: After 6 years, 19.0% of the teeth exhibited periodontitis incidence or progression and 8.2% were lost. Compared with a healthy lifestyle score of 0-1 (least healthy), the highest score (4 points) was associated with a significantly lower tooth-specific risk of periodontitis (adjusted odds ratio = 0.32; 95% confidence interval: 0.16-0.62) and tooth loss (adjusted odds ratio = 0.42; 95% confidence interval: 0.23-0.77). CONCLUSIONS: Simultaneous adherence to multiple healthy lifestyle factors significantly lowers the risk of incidence or progression of periodontitis and tooth loss in older adults.

DOI： 10.1111/jcpe.12920

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DOI： 10.1922/CDH_4200Hanindriyo07

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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OBJECTIVES: To examine the associations among alcohol consumption level, dietary intake and other lifestyle factors, and periodontal condition, in community-dwelling elderly Japanese of a specific age. BACKGROUND: The relationship between alcohol consumption level and periodontitis is a controversial issue. METHODS: Participants were 438 dentate elders aged 73 years from a larger cohort survey of elders in Niigata City, Japan. Data collected from oral examination of each participant, including number of the existing teeth, mean probing pocket depth and mean clinical attachment level (CAL) were used for the analyses. A semiquantitative food frequency questionnaire and a lifestyle habit questionnaire were used to assess food and alcohol consumption, smoking experience, frequency of tooth brushing, interdental brush use, and visits to a dental clinic during the previous year. Blood glucose control was assessed by the glycated haemoglobin (HbA1c) level. Body mass index was calculated from height and weight measurements. The relationships between each variable and the individual mean CAL were analysed by univariate and multivariate analyses. RESULTS: According to logistic regression

DOI： 10.1111/ger.12335

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Munksgaard  

Aims: An association between periodontal disease and liver enzymes has been reported previously. This study examined the relationship between clinical periodontal parameters and changes in liver enzymes levels in 265 non-institutionalized Japanese elderly aged 72 years over 8 years. Materials and methods: The number of sites with probing pocket depth (PPD) ≥ 6 mm and clinical attachment level (CAL) ≥ 6 mm were measured. Changes in liver enzymes (alanine transaminase [ALT] and aspartate transaminase [AST]) was grouped based on any elevation of concentrations. The relationship was determined by logistic regression with adjustment for confounders. Interaction test and stratified analysis were then performed according to smoking status and alcohol drinking habits, separately. Results: Elevation in ALT, but not AST, was significantly associated with PPD (odds ratio [OR] = 1.10) and CAL (OR = 1.03). A significant interaction of periodontal parameters on ALT was observed with smoking status, but not with alcohol drinking habit. The stratified analysis suggested that ALT was found to be significantly correlated with PPD (OR = 1.20) and CAL (OR = 1.04) to those who were smoker. Conclusion: The elevation in ALT levels might be associated with clinical periodontal parameters among non-institutionalized Japanese elderly, and this association was modified by smoking status.

DOI： 10.1111/jcpe.12861

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Publishing  

Aim: To examine the longitudinal association between dentition status and incidence of frailty in older adults. Methods: The present prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Dental examinations, biochemical blood examinations, physical performance and anthropometric measurements, and structured questionnaires were carried out at baseline. The presence of ≥20 teeth with nine or more occluding pairs of teeth was defined as functional dentition. Annual follow-up examinations, including physical performance, anthropometric measurements and structured questionnaires, were carried out over a 5-year period to determine the incidence of frailty, defined as three or more of the following five components derived from the Cardiovascular Health Study: weight loss, weakness, slowness, poor energy and low physical activity level. Adjusted hazard ratios of frailty incidence according to dentition status were calculated from Cox proportional hazards regression analyses. Results: At baseline, 118 participants (36.6%) were defined as having functional dentition. During the follow up, 48 participants (14.9%) developed frailty. The adjusted hazard ratio for frailty in participants with functional dentition was 0.50 (95% confidence interval 0.25–0.98) compared with participants without functional dentition, after adjusting for sex, income, education, smoking status, body mass index, serum biomarkers and comorbidities. Conclusions: Functional dentition was significantly associated with a lower risk of frailty defined by the Cardiovascular Health Study frailty index in older Japanese adults. These results suggest that maintaining healthy and functional dentition into later life is important for frailty prevention. Geriatr Gerontol Int 2018
18: 256–262.

DOI： 10.1111/ggi.13170

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Background: The interaction of periodontopathic bacteria with host immune system induces the production of inflammatory mediators which leads to alveolar bone loss (ABL), the essential feature of periodontitis. Concurrently, periodontal diseases cause the elevation of blood cytokine levels, the alteration of gut microbiota and the dissemination of enterobacteria to the liver. Owing to these mechanisms, periodontal disease might be a risk for liver dysfunction. Several epidemiological studies have reported associations between periodontal diseases and liver dysfunction, although the association between ABL and liver dysfunction has not been investigated. This cross-sectional study determined if elevated serum liver enzyme levels were associated with ABL in Japanese adults. Material and Methods: Japanese adults living on Sado Island who visited Sado General Hospital were invited to participate in the study. Participants over 40 years of age who underwent dental panoramic radiography and blood tests were included. Drinking and smoking habits were self-administered. After excluding patients with edentulous jaw, diagnosed liver diseases, and those on dialysis, data from 44 men and 66 women with a mean age of 73 years were analyzed. The average percentage of ABL for each participant was calculated for mesial and distal sites of all remaining teeth. The levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) were determined. Univariate analyses were performed to select covariates to be put in multivariate analyses. The association between elevated serum liver enzyme levels and the highest quartile of ABL were assessed by multiple logistic regression analysis. Results: After adjusting for covariates, no significant association was found between elevated serum AST, ALT, or GGT levels as dependent variables and the highest quartile of ABL as an explanatory variable. Conclusions: There was no significant association between the elevation of serum liver enzyme levels and ABL in Japanese adults. Key words:Liver enzymes, dental panoramic radiography, alveolar bone loss, Japanese adults.

DOI： 10.4317/jced.54555

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

To determine whether maximum bite force (MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75years at baseline (n=322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios (HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively (P for trend=.01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women.

DOI： 10.1111/joor.12578

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Oral Health  

The aim of this cross-sectional study was to evaluate the associations of tooth loss, denture use, and self-perceived denture fit with frailty in community-dwelling older Japanese adults. The subjects were 344 Japanese adults (177 men and 167 women) aged 79 years in Niigata City (Japan), who participated in an oral and general health examination and a questionnaire survey in 2007. Frailty was defined as the presence of ≥ 2 of the following 3 factors derived and modified from the Study of Osteoporotic Fracture Criteria for Frailty: 1) weight loss ≥ 5% over 2 years, 2) inability to do chair stands, and 3) answer of “no” to the question “Do you feel full of energy?”. Associations between frailty and tooth loss, denture use, and self-perceived denture fit were evaluated using logistic regression analysis. The multivariable models were adjusted for sex, body mass index, and mental health. The frequency of frailty in this study was 8.4%. Multivariable logistic regression indicated that tooth loss (per each additional tooth present, adjusted odds ratio [OR]=0.94; 95% confidence interval [CI]=0.90–0.99), the presence of 20 teeth or more (compared with the presence of less than 20 teeth, adjusted OR=0.39, 95% CI=0.15–0.97), denture non-use (compared with denture use, adjusted OR=17.89, 95% CI=5.00–64.32), and self-perceived ill-fitting denture (compared with well-fitting denture, adjusted OR=3.38, 95% CI=1.01–11.27) were significantly correlated with frailty. Our results suggest that tooth loss, denture non-use, and self-perceived ill-fitting denture were associated with frailty in community-dwelling older Japanese adults.

DOI： 10.5834/jdh.68.2_68

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Other Link： https://search.jamas.or.jp/link/ui/2018250455

Language：Japanese   Publisher：Japanese Society for Oral Health  

<p> Self-rated health is a simple way of assessing the health status. It is also used for oral health research in general population surveys. However, limited information is available on younger populations aged under 65 years.</p><p> Accordingly, the aim of this cross-sectional study was to investigate the association between the self-rated tooth and gingival health and self-rated general health based on a survey conducted by the 8020 Promotion Foundation in 2015.</p><p> For this survey, questionnaires were mailed to 5,000 people, aged 20 to 79, who were selected by stratified two-stage random sampling from Japanese municipalities, and 2,465 people responded (response rate=49.3%). </p><p> Data without missing responses from 1,972 participants were used for analysis.</p><p> The subjects were divided into three groups according to age: young participants (aged 20-39 years), middle-aged participants (aged 40-59 years), and elderly participants (aged 60-79 years).</p><p> An ordinal logistic regression model was created to evaluate the association between self-rated tooth and gingival health and self-rated general health for each group.</p><p> Multivariable models were adjusted for the number of teeth, sex, employment status, subjective economic status, education, comorbidity, presence of an adviser, and body mass index.</p><p> Based on the ordinal logistic regression analysis, participants with good self-rated tooth and gingival health had significantly better self-rated general health. The adjusted odds ratio (95% confidence interval) was 12.41 (7.22-21.34) for the young participants, 11.77 (7.50-18.48) for the middle-aged participants, and </p><p>10.07 (6.55-15.50) for the elderly participants.</p><p> The present study suggests that the self-rated tooth and gingival health is significantly correlated with self-rated general health among general Japanese subjects in all age groups.</p>

DOI： 10.5834/jdh.68.4_198

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Other Link： http://search.jamas.or.jp/link/ui/2019038143

Language：Japanese   Publisher：Japanese Society for Oral Health  

<p> This study investigated the relationship between dysphagia and the nutritional status of elderly individuals living at home when screened with Eating Assessment Tool-10 (EAT-10). A total of 129 participants (62 males, 67 females, aged 85 years) were surveyed. Participants were sent a questionnaire by mail and asked to complete and return it to the authors. Assessments included in the questionnaire were EAT-10, the self-reported number of teeth, Short-form Mini Nutritional Assessment (MNA-SF), a subjective health evaluation, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-Index of Competence), Oral Health Impact Profile-49 (OHIP), and number of foods that can be masticated. To evaluate variation in the study's variables, the analysis was based on established scores of EAT-10: those suspected of having dysphagia score above three; those with no suspicion of dysphagia score below two.</p><p> When screened with EAT-10, 52.7% of the participants were classified as being suspected of having dysphagia. There were significant correlations between dysphagia and a low OHIP score (<i>p</i><0.001), the number of foods that can be masticated (<i>p</i><0.001), subjective health evaluation (<i>p</i><0.001), and MNA-SF (<i>p</i>=0.007).</p><p> Furthermore, logistic regression analysis revealed that the nutritional status was associated with dysphagia (<i>p</i>=0.043)．These findings suggest the association of dysphagia with malnutrition in elderly people living at home.</p>

DOI： 10.5834/jdh.68.2_76

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Other Link： http://search.jamas.or.jp/link/ui/2018250456

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Ltd  

Objective Detailed evidence of a relationship between maltreated children and dental caries is limited. The purpose of this study was to investigate the prevalence of dmft and DMFT, and the characteristics of dental treatment level of children at two child guidance centers (CGC). Subject and methods A total of 166 children (mean age: 11.6 y ± 2.8) staying at two CGCs were examine, and their results were compared with those of the Survey of Dental Disease (SDD) carried out by the Japanese Society for Oral Health. Results Mean numbers of dental caries were 5.70 at the CGCs and 2.25 in the SDD. “Completely treated” children were 21.7% of total participants in the SDD, but only 3.6% at the CGCs. In addition, 7.0% of participants were “untreated” in the SDD, but 41.0% at the CGCs. The percentage of children without dental caries was 18.7% at the CGCs and 45.7% in the SDD. These differences between the CGCs and in the SDD were statistically significant. Conclusions Our results indicate that, due to a lack of daily oral care, dental caries are significantly more prevalent in children at CGCs. CGCs may be good places to improve neglected children's dental caries and oral health care.

DOI： 10.1016/j.pdj.2017.08.003

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.
Methods We pooled 2416 population-based studies with measurements of height and weight on 128.9 million participants aged 5 years and older, including 31.5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).
Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0.01 kg/m (2) per decade; 95% credible interval -0.42 to 0.39, posterior probability [PP] of the observed decrease being a true decrease= 0.5098) in eastern Europe to an increase of 1.00 kg/m(2) per decade (0.69-1.35, PP&gt; 0.9999) in central Latin America and an increase of 0.95 kg/m (2) per decade (0.64-1.25, PP&gt; 0.9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0.09 kg/m(2) per decade (-0.33 to 0.49, PP= 0.6926) in eastern Europe to an increase of 0.77 kg/m (2) per decade (0.50-1.06, PP&gt; 0.9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0.7% (0.4-1.2) in 1975 to 5.6% (4.8-6.5) in 2016 in girls, and from 0.9% (0.5-1.3) in 1975 to 7.8% (6.7-9.1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9.2% (6.0-12.9) in 1975 to 8.4% (6.8-10.1) in 2016 in girls and from 14.8% (10.4-19.5) in 1975 to 12.4% (10.3-14.5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22.7% (16.7-29.6) among girls and 30.7% (23.5-38.0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.
Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.

DOI： 10.1016/S0140-6736(17)32129-3

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

ObjectivesThe aim of this study was to examine the association between periodontal disease and renal function in elderly women with different genotypes.
Material and MethodsA total of 332 postmenopausal never-smoking women were analysed. Poor renal function was defined as serum cystatin C&gt;0.91mg/l. Periodontal disease markers such as periodontal inflamed surface area (PISA) were evaluated. Selected variables, including PISA quartile, body mass index (BMI), HbA1C and age in Arg allele carriers and non-carriers based on the beta-3 adrenergic receptor, or between Ala allele carriers and non-carriers based on peroxisome proliferator-activated receptor gamma, were analysed using multiple logistic regression analysis.
ResultsThe odds ratios of serum cystatin C level and PISA (fourth quartile) were significantly positive for both Arg (2.52; p=0.035) and Ala allele non-carriers (2.36; p=0.021). A significant association was also found between serum cystatin C level and BMI for both Arg (1.18; p=0.001) and Ala allele non-carriers (1.12; p=0.003).
ConclusionThe results of this study suggest that periodontal inflammation might be associated with renal function. Furthermore, in both the Arg and Ala allele non-carriers, the associations between BMI and PISA for renal function became stronger.

DOI： 10.1111/jcpe.12708

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s40496-017-0127-1

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：日本歯科衛生学会  

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AimGrowing evidence suggests that tooth loss is associated with increased risk of stroke. In the current study, we investigated cumulative medical costs related to stroke using data from the Advanced Elderly Medical Service System. We hypothesized that tooth loss was associated with an increase in medical costs related to stroke among older Japanese adults.
MethodsA total of 273 Japanese adults aged 80 years were enrolled in the current study. Baseline medical and dental examinations were carried out in June 2008. Medical care use and costs were monitored by linkage with National Health Insurance claim files from baseline to the end of February 2011. Medical costs related to stroke per month were calculated and examined for any association with the baseline number of remaining teeth using a linear regression model with robust standard errors.
ResultsA total of 19 individuals were admitted to hospital for stroke during the follow-up period. A significant negative association was found between the number of teeth and medical costs related to stroke per month. The regression coefficients of the number of teeth in relation to medical costs related to stroke was -248 (95% CI -438 to -58, P=0.011) in the crude model and -226 (95% CI -413 to -38, P=0.018) after adjusting for other confounders.
ConclusionWithin the limitations of the present study, the reported findings suggest an independent relationship of tooth loss with increase in medical cost related to stroke among older Japanese adults. Further studies are necessary to substantiate these findings. Geriatr Gerontol Int 2017; 17: 202-210.

DOI： 10.1111/ggi.12687

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Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher.
Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure.
Findings We pooled 1479 studies that had measured the blood pressures of 19.1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127.0 mm Hg (95% credible interval 125.7-128.3) in men and 122.3 mm Hg (121.0-123.6) in women; age-standardised mean diastolic blood pressure was 78.7 mm Hg (77.9-79.5) for men and 76.7 mm Hg (75.9-77.6) for women. Global age-standardised prevalence of raised blood pressure was 24.1% (21.4-27.1) in men and 20.1% (17.8-22.5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence.
Interpretation During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe.
Funding Wellcome Trust. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license.

DOI： 10.1016/S0140-6736(16)31919-5

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Language：Japanese   Publisher：Japanese Society for Oral Health  

<p>The oral health of elderly people is not only important in the maintenance of solid nutrition and articulation but also for their quality of life (QOL). The presence of ≥20 teeth is one of the criteria in the maintenance of the oral function and general health. In 2015, the Ministry of Health, Labour and Welfare of Japan announced the guideline called "Healthy Diet", which supports the longevity of Japanese people. We examined the association between the presence of ≥20 teeth and healthy diet among 75-year-old people. This study included 338 people aged 75 years who participated in the Niigata Elderly Study (2003), in which oral examination, medical checkup, and a brief-type self-administered diet history questionnaire (BDHQ) survey had been carried out. A healthy dietary pattern was defined according to Japan's healthy diet guideline. The healthy diet assumes that one meal consists of three main dishes: grain dish, fish or meat dish, and vegetable dish. For each dish, there are lower and upper limits on the amount of food consumed per meal. For this reason, we set the per-day lower limit as equal to three times the lower limit for a meal. In this study, the sufficiency group satisfied all three dish divisions (i.e., those who achieved a healthy dietary pattern), and the insufficiency group did not meet at least one dish division. The association between the presence of ≥20 teeth and a healthy dietary pattern was evaluated using multivariable logistic regression. As a result, individuals with ≥20 teeth had significantly higher odds of having a healthy dietary pattern (adjusted odds ratio, 1.7; 95% confidence interval: 1.1–2.6). In conclusion, our results suggest that there is a relationship between the presence of ≥20 teeth and meal patterns in elderly people.</p>

DOI： 10.5834/jdh.67.3_172

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Other Link： http://search.jamas.or.jp/link/ui/2017356870

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectiveThe aim of this study was to investigate the relationship between oral dysfunction and depressive symptoms in Japanese community-dwelling seniors.
Materials and methodsParticipants included 351 community-dwelling seniors (189 men, 162 women) aged 77years. During dental examination, teeth and periodontal condition, including number of teeth, number of dental caries, pocket depth and clinical attachment level, were assessed, and unstimulated and stimulated salivary flow rates were measured. The General Health Questionnaire 30 (GHQ-30) was used to assess depression. The Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence was used to assess activities of daily living.
ResultsMultiple logistic regression analysis revealed that gender (odds ratio [OR] = 2.3), low unstimulated salivary flow rate (OR = 2.1), Complaint of mouth pain' (OR = 2.4), Complaint of physical disorders' (OR = 2.1), and the total TMIG Index of Competence score (OR = 2.0) were positively associated with the high GHQ-30 score.
ConclusionSubjective and objective oral dryness and oral pain are associated with depressive symptoms.

DOI： 10.1111/ger.12177

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Limited information is available on the temporal association between dentition status and dietary intake. The aim of this 5-year prospective cohort study was to investigate whether impaired dentition was associated with subsequent decline in dietary intake in older Japanese adults. Two hundred and eighty-six community-dwelling Japanese individuals, all aged 75 years at baseline, were included in the study. Functional tooth units (FTUs), defined as a pair of opposing natural or prosthetic teeth excluding third molars (range: 0-14), were counted on the basis of baseline dental examinations. Individuals with 5 FTUs were defined as having impaired dentition. Dietary intake was assessed at baseline and 5 years later, using a validated dietary questionnaire. Robust regression analyses were used to evaluate the differences in change in dietary intake between participants with and without impaired functional dentition, after adjustment for potential confounders. Sixty-one study participants (213 %) were defined as having impaired dentition. Overall, mean values for all estimated dietary variables (energy, nutrients and food groups) declined over time. Notably, individuals with impaired dentition demonstrated a significantly (P &lt; 005) greater degree of decline in the intake of multiple nutrients (protein, sodium, potassium, calcium, vitamin A, vitamin E and dietary fibre) and food groups (vegetable and meat) than those without impaired dentition, after adjusting for potential confounders. The results of this study describe the temporal association of impaired dentition with the decline in selected nutrient and food group intake among older Japanese adults.

DOI： 10.1111/joor.12427

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Background and Objective: Epidemiologic data examining the longitudinal relationship between periodontitis and cognitive status are very limited, especially in Asian populations. The present study examined the longitudinal relationship of periodontitis with cognitive decline in 85 Japanese community-dwelling individuals (average age: 79.3 years) for whom data were available from comprehensive health examinations conducted in 2010 and 2013.
Material and Methods: Based on a baseline full-mouth periodontal examination, severe periodontitis was defined using a Centers for Disease Control and Prevention/American Academy of Periodontology definition. Cognitive decline during the 3-year study period was defined using the results of the Mini-Mental State Examination (MMSE). Information on age, gender, education, depression, body mass index, smoking status, alcohol use, exercise, hypertension, diabetes, history of cardiovascular disease and stroke, and baseline MMSE scores were obtained and tested as potential confounders in the statistical models.
Results: Among 85 study participants, 21 (24.7%) were defined as having severe periodontitis. Multivariable Poisson regression analyses revealed that severe periodontitis was significantly associated with an increased risk of cognitive decline [adjusted relative risk = 2.2; 95% confidence interval (95% CI): 1.1-4.5]. Furthermore, multivariable linear regression analyses revealed that participants with severe periodontitis had a 1.8-point greater decrease (95% CI: -3.3 to -0.2) in MMSE score than those without severe periodontitis.
Conclusion: Within the limitations related to its small sample size, the findings of the present study suggest that severe periodontitis is significantly associated with future decline in cognitive function among community-dwelling older Japanese subjects.

DOI： 10.1111/jre.12348

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Background and ObjectiveAccumulating evidence suggests that decreased kidney function characterised by low estimated glomerular filtration rate (eGFR) may be associated with periodontitis. Recent studies have suggested that the use of cystatin C strengthens the association between the eGFR and the risks of adverse outcomes in decreased kidney function. The aim of this cross-sectional study was to investigate the association of cystatin C-based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcreat), the commonly used method to assess kidney function, with periodontitis in 502 Japanese women (average age, 68.6years).
Materials and MethodsGFR was estimated from serum cystatin C and serum creatinine, respectively, using the Japanese equation for GFR. Participants were classified into five groups according to their eGFRcys and eGFRcreat values. Poisson regression models with robust error variance assessed the associations of eGFRcys and eGFRcreat with periodontitis. Tests for trends were performed by fitting the five-category eGFR variables in their continuous form to the regression models.
ResultsParticipants with eGFRcys&lt;50ml/min/1.73 m(2) were at significantly higher risk of periodontitis compared with the reference group (90ml/min/1.73m(2)) (adjusted relative risk = 2.12, 95% confidence interval = 1.12 to 4.02). Additionally, there was a trend towards a higher risk of periodontitis among participants with lower eGFRcys values (p for trend in the multivariable model = 0.008). In contrast, eGFRcreat did not show a significant association with periodontitis.
ConclusionThe findings of this study of Japanese older women showed that eGFRcys had a stronger and more linear association with periodontitis than eGFRcreat.

DOI： 10.1111/ger.12159

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ObjectivesThe purpose of this study was to evaluate the reciprocal effects of chronic kidney disease (CKD) and periodontal disease.
Material and MethodsA total of 332 postmenopausal never smoking women were enrolled, and their serum high-sensitivity C-reactive protein, serum osteocalcin and serum cystatin C levels were measured. Poor renal function was defined as serum cystatin C&gt;0.91mg/l. Periodontal disease markers, including clinical attachment level and the periodontal inflamed surface area (PISA), were also evaluated. Logistic regression analysis was conducted to evaluate the relationships between renal function and periodontal disease markers, serum osteocalcin level and hsCRP level. The prevalence-rate ratios (PRRs) on multiple Poisson regression analyses were determined to evaluate the relationships between periodontal disease markers and serum osteocalcin, serum cystatin C and serum hsCRP levels.
ResultsOn logistic regression analysis, PISA was significantly associated with serum cystatin C level. The odds ratio for serum cystatin C level was 2.44 (p=0.011). The PRR between serum cystatin C level and periodontal disease markers such as number of sites with clinical attachment level 6mm was significantly positive (3.12, p&lt;0.001). Similar tendencies were shown for serum osteocalcin level.
ConclusionThis study suggests that CKD and periodontal disease can have reciprocal effects.

DOI： 10.1111/jcpe.12576

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Publishing Ltd  

There is limited information on the impact of oral function on mortality among older adults. The aim of this prospective cohort study was to examine whether an objective measure of oral function, maximum bite force (MBF), is associated with mortality in older adults during a 13-year follow-up period. Five hundred and fifty-nine community-dwelling Japanese (282 men and 277 women) aged 70 years at baseline were included in the study. Medical and dental examinations and a questionnaire survey were conducted at baseline. Maximum bite force was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up investigation to ascertain vital status was conducted 13 years after baseline examinations. Survival rates among MBF tertiles were compared using Cox proportional hazards regression models stratified by sex. There were a total of 111 deaths (82 events for men and 29 for women). Univariable analysis revealed that male participants in the lower MBF tertile had increased risk of all-cause mortality [hazard ratio (HR) = 1·94, 95% confidence interval (CI) = 1·13–3·34] compared with those in the upper MBF tertile. This association remained significant after adjustment for confounders (adjusted HR = 1·84, 95% CI = 1·07–3·19). Conversely, no association between MBF and all-cause mortality was observed in female participants. Maximum bite force was independently associated with all-cause mortality in older Japanese male adults. These data provide additional evidence for the association between oral function and geriatric health.

DOI： 10.1111/joor.12401

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Language：Japanese   Publisher：日本歯科衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELIFE SCIENCES PUBLICATIONS LTD  

Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.

DOI： 10.7554/eLife.13410

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Purpose:' The aim of this study was to reveal whether the differences in further loss of teeth and occlusal supports, and change in masticatory ability depend on the status of dentition at the age of 70 in community-dwelling elderly people.
Methods: A 10-year longitudinal survey was carried out on 349 (176 females and 173 males) elderly subjects. The subjects to be analyzed were classified into four groups in accordance with the classifications of Miyachi's Triangular Classification. Zone A: subjects with ten or more occlusal supports. Zone B: those with nine to five occlusal supports. Zone D: those with four or fewer occlusal supports and 11 or more remaining teeth. Zone C: those with ten or fewer remaining teeth. The numbers of remaining teeth and occlusal supports were recorded in both examinations. Questionnaires regarding their food intake status were given to subjects.
Results: Subjects in Zone B had greater numbers of teeth loss than those in Zones A and C. Subjects in Zone B and D lost greater numbers of occlusal supports than subjects in Zones A and C. The number of food items that could be chewed had significantly decreased in subjects who remained in Zone A and those who changed from Zone B to Zones D and C.
Conclusions: It was shown that various states of dentition classified by Miyachi's Triangular Classification at the age of 70 resulted in different numbers of remaining teeth and occlusal supports and changes in masticatory ability 10 years later in community-dwelling elderly people. (C) 2016 Japan Prosthodontic Society. Published by Elsevier Ltd.

DOI： 10.1016/j.jpor.2015.12.008

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Aim: Along with rapid aging, medical expenditure for older adults has been increasing in Japan. Research has shown that periodontitis is a useful predictor for excess medical expenditure; however, limited information is available on the elderly population after adequately considering confounding factors. The aim of the present study was to evaluate the association between periodontitis and long-term medical expenditure in elderly Japanese.
Methods: Baseline health and periodontal examinations were carried out in June 2008. Japanese adults (n = 245) aged 80 years were classified into quartiles based on periodontal inflamed surface area (PISA), which quantifies the degree of periodontal inflammation. Medical care use and costs were monitored by assessment of the National Health Insurance claim files from the baseline survey through the end of February 2011. Multivariable analysis of the differences in medical expenditure among PISA quartiles was carried out using linear regression with robust standard errors.
Results: The participants in the fourth (with the largest PISA) and third quartiles had significantly higher inpatient medical expenditure compared with those of the first quartile (P &lt; 0.01 and = 0.04, respectively). Participants in the fourth quartile had significantly higher total medical expenditure (P &lt; 0.01) compared with the first quartile. A trend was observed of higher inpatient and total medical expenditure with increasing PISA.
Conclusions: A significant association was found between periodontitis and future increase in medical expenditure, suggesting that periodontitis might be a modifiable factor for the reduction of excess medical expenditure among elderly Japanese.

DOI： 10.1111/ggi.12569

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TOHOKU UNIV MEDICAL PRESS  

Diet and food intake play an important role in the development of osteoporosis. However, apart from calcium and vitamin D, how nutrients affect bone status is not fully understood. The purpose of this study was to determine cross-sectional and longitudinal associations between dietary intake and bone mineral density (BMD) in Japanese postmenopausal women. This 5-year cohort study included 600 community dwelling women aged 55-74 years at baseline in 2005. Information on demographics, nutrition, and lifestyle was obtained through interviews, and nutritional and dietary intake was assessed using a validated food frequency questionnaire. BMD measurements were performed by dual energy X-ray absorptiometry. In 2010, 498 women underwent follow-up BMD examinations. Multiple linear regression analysis was performed to determine associations of predictor variables with BMD, adjusting for confounders. In cross-sectional analyses, coffee or black tea consumption was positively associated with lumbar spine (P = 0.004) and total hip (P = 0.003) BMD, and alcohol intake was positively associated with femoral neck (P = 0.005) and total hip (P = 0.001) BMD. In longitudinal analyses, vitamin K (P = 0.028) and natto (fermented soybeans) (P = 0.023) were positively associated with lumbar spine BMD, and meat or meat product consumption was inversely associated with total hip (P = 0.047) BMD. In conclusion, dietary factors other than calcium and vitamin D intake are predictors of bone mass and bone loss in Japanese postmenopausal women. In particular, natto intake is recommended for preventing postmenopausal bone loss on the basis of current evidence.

DOI： 10.1620/tjem.239.95

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Background and ObjectivePotentially significant associations between metabolic syndrome (MetS) and periodontal disease have been reported in recent studies; however, there is a dearth of literature regarding the relationship of MetS with serum antibody levels to periodontal pathogens. The aim of this cross-sectional study was to investigate the association between MetS and serum antibody to the periodontal pathogen Porphyromonas gingivalis (P.gingivalis) in 216 Japanese individuals aged 79years.
Materials and MethodsSerum antibody levels to P.gingivalis were measured by enzyme-linked immunosorbent assay. An elevated serum antibody response was defined as the upper quartile and was considered as the outcome variable. A multivariable logistic regression model was used to evaluate the association of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria with an elevated antibody status. Adjustments for gender, income, education, smoking status, dental-care utilisation patterns and brushing frequency were considered.
ResultsThe prevalence of MetS was 22.2% (n=48). Study participants with MetS were 2.9 times more likely to have an elevated serum antibody to P.gingivalis (adjusted odds ratio=2.91, 95% confidence interval=1.24-6.85) after simultaneous adjustment for other covariates.
ConclusionOur findings suggest an independent relationship between MetS and serum antibody levels to P.gingivalis in the Japanese elderly. Additional longitudinal epidemiologic studies with larger, more diversified samples and more complete information are needed to substantiate our findings.

DOI： 10.1111/ger.12135

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Background One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes.
Methods We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.
Findings We used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (&gt;30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.
Interpretation Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries.
Funding Wellcome Trust. Copyright (C) NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY.

DOI： 10.1016/S0140-6736(16)00618-8

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

DOI： 10.5834/jdh.66.3_338

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00440&link_issn=&doc_id=20160524380005&doc_link_id=%2Fdk1dehea%2F2016%2F006603%2F005%2F0338-0343%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2016%2F006603%2F005%2F0338-0343%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries.
Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (&lt;18.5 kg/m(2) [underweight], 18.5 kg/m(2) to &lt;20 kg/m(2), 20 kg/m(2) to &lt;25 kg/m(2), 25 kg/m(2) to &lt;30 kg/m(2), 30 kg/m(2) to &lt;35 kg/m(2), 35 kg/m(2) to &lt;40 kg/m(2), = 40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.
Findings We used 1698 population-based data sources, with more than 19.2 million adult participants (9.9 million men and 9.3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21.7 kg/m(2) (95% credible interval 21.3-22.1) in 1975 to 24.2 kg/m(2) (24.0-24.4) in 2014 in men, and from 22.1 kg/m(2) (21.7-22.5) in 1975 to 24.4 kg/m(2) (24.2-24.6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21.4 kg/m(2) in central Africa and south Asia to 29.2 kg/m(2) (28.6-29.8) in Polynesia and Micronesia; for women the range was from 21.8 kg/m(2) (21.4-22.3) in south Asia to 32.2 kg/m(2) (31.5-32.8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13.8% (10.5-17.4) to 8.8% (7.4-10.3) in men and from 14.6% (11.6-17.9) to 9.7% (8.3-11.1) in women. South Asia had the highest prevalence of underweight in 2014, 23.4% (17.8-29.2) in men and 24.0% (18.9-29.3) in women. Age-standardised prevalence of obesity increased from 3.2% (2.4-4.1) in 1975 to 10.8% (9.7-12.0) in 2014 in men, and from 6.4% (5.1-7.8) to 14.9% (13.6-16.1) in women. 2.3% (2.0-2.7) of the world's men and 5.0% (4.4-5.6) of women were severely obese (ie, have BMI = 35 kg/m(2)). Globally, prevalence of morbid obesity was 0.64% (0.46-0.86) in men and 1.6% (1.3-1.9) in women.
Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. Copyright (C) NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY.

DOI： 10.1016/S0140-6736(16)30054-X

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AimSaliva is important for maintaining oral function and regulating oral health. Reduced saliva flow rate, which is common among older adults, has been reported to be associated with perceived chewing and swallowing difficulties; however, its relationship to actual nutrient intake is unclear. The aim of the present cross-sectional study was to evaluate the relationship between hyposalivation and nutrient intake among older Japanese adults.
MethodsThe participants were 352 community-based Japanese aged 80 years. A stimulated salivary flow rate &lt;0.5mL/min was defined as hyposalivation. Multivariable analysis of differences in nutrient and food intake outcome variables, which were collected through a validated food frequency questionnaire, between groups with/without hyposalivation was carried out using general linear models. Models included adjustment for number of teeth, denture use, sex, income, education, body mass index, smoking status, alcohol use, diabetes, medication, activities of daily living, depression and total calorie intake.
ResultsThe hyposalivation group had significantly lower intake of n-3 polyunsaturated fatty acid, potassium, vitamin D, vitamin E, vitamin B6 and folate than the group without hyposalivation (P&lt;0.05) after adjusting for confounders. Vegetable, fish and shellfish consumption was significantly lower in the hyposalivation group (P&lt;0.05).
ConclusionsDietary intake was poorer in those with hyposalivation than among those without. A decrease in stimulated salivary flow rate could have negative effects on geriatric nutrition. Geriatr Gerontol Int 2016; 16: 500-507.

DOI： 10.1111/ggi.12500

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER INTERNATIONAL PUBLISHING AG  

Physical fitness is an indicator of systemic well-being in humans. Little is known about the role of physical fitness for maintaining systemic health in the elderly. Here, we study elderly subjects to determine the relationships between physical fitness and CD56 and CD16 surface NK cell markers on peripheral blood lymphocytes, as well as to analyze the relationship between the surface markers and incidence of death. We selected 253 independent elderly subjects (122 female; 131 male) who were 79-80 years old. Subjects having a higher proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, or ration of CD56(dim)CD16(high) and CD56(dim)CD16(-) cells had a significant positive correlation with maximum bilateral knee extensor strength/weight (kg) (r = 0.425; P &lt; 0.0001 or r = 0.323; P &lt; 0.0001). In contrast, an increased proportion of CD56(bright)CD16(-) cells within lymphocyte significantly negatively correlated with the maximum bilateral knee extensor strength/weight (kg) (r = -0.290; P = 0.0004); and these subjects had a significantly lower mortality during the 5 years following measurement of death. Therefore, we found that a synergistic effect of the right and left leg muscle strength was associated with proportion of matured NK and NKT cells and induced a low proportion of CD56(bright)CD16(-) cells within lymphocyte. Moreover, the low proportion of CD56(bright)CD16(-) cells was associated with incidence of death. In conclusion, measurements of physical fitness, the proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, the ratio of CD56(dim)CD56(high) and CD56(dim)CD16(-) cells, and the proportion of CD56(bright)C16(-) cells in lymphocytes are important indicators to check elderly health.

DOI： 10.1186/s40064-016-1884-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

BackgroundSeveral studies have reported inconsistent results regarding the association between the PPARPro12Ala polymorphism and obesity. Obese individuals had higher C-reactive protein (CRP) levels compared with those of normal weight, and PPAR activation could significantly reduce serum high-sensitive CRP level. We have previously suggested that the Pro12Ala polymorphism represents a susceptibility factor for periodontitis, which is a known risk factor for increased CRP level.
ObjectivesThe aim was to investigate associations between PPAR gene polymorphism, serum CRP level, BMI and/or periodontitis among post-menopausal Japanese women.
Materials and methodsThe final sample in this study comprised 359 post-menopausal Japanese women. Periodontal parameters, including PD, CAL and BOP, were measured per tooth. PPARPro12Ala genotype was determined by PCR-RFLP. Hs-CRP value was measured by a latex nephelometry assay.
ResultsNo significant differences in age, BMI or periodontal parameters were found between the genotypes. The percentages of sites with PD4mm were significantly higher among the hsCRP1mg/l group than the hsCRP&lt;1mg/l group (p=0.003). Positive correlations were found between serum hsCRP levels and the percentages of sites with PD4mm (p=0.043) in PPAR Ala allele carriers, and BMI (p=0.033) in non-carriers. After adjustment for model covariates, BMI was significantly associated with serum hsCRP level.
ConclusionThe PPARPro12Ala polymorphism was not independently associated with periodontitis, serum CRP level or BMI in post-menopausal Japanese women. However, serum hsCRP level correlated with periodontitis in Ala allele carriers, and with BMI in non-carriers.

DOI： 10.1111/ger.12110

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

BackgroundSeveral studies have reported inconsistent results regarding the association between the PPARPro12Ala polymorphism and obesity. Obese individuals had higher C-reactive protein (CRP) levels compared with those of normal weight, and PPAR activation could significantly reduce serum high-sensitive CRP level. We have previously suggested that the Pro12Ala polymorphism represents a susceptibility factor for periodontitis, which is a known risk factor for increased CRP level.
ObjectivesThe aim was to investigate associations between PPAR gene polymorphism, serum CRP level, BMI and/or periodontitis among post-menopausal Japanese women.
Materials and methodsThe final sample in this study comprised 359 post-menopausal Japanese women. Periodontal parameters, including PD, CAL and BOP, were measured per tooth. PPARPro12Ala genotype was determined by PCR-RFLP. Hs-CRP value was measured by a latex nephelometry assay.
ResultsNo significant differences in age, BMI or periodontal parameters were found between the genotypes. The percentages of sites with PD4mm were significantly higher among the hsCRP1mg/l group than the hsCRP&lt;1mg/l group (p=0.003). Positive correlations were found between serum hsCRP levels and the percentages of sites with PD4mm (p=0.043) in PPAR Ala allele carriers, and BMI (p=0.033) in non-carriers. After adjustment for model covariates, BMI was significantly associated with serum hsCRP level.
ConclusionThe PPARPro12Ala polymorphism was not independently associated with periodontitis, serum CRP level or BMI in post-menopausal Japanese women. However, serum hsCRP level correlated with periodontitis in Ala allele carriers, and with BMI in non-carriers.

DOI： 10.1111/ger.12110

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本有病者歯科医療学会  

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Epidemiologic data examining the relationship between oral health status and cognitive status are sparse, especially in Asian populations. This study aimed to assess whether periodontal disease and tooth loss were related to cognitive impairment among older Japanese. Study participants were 291 Japanese (101 men and 190 women, average age: 80.9 years), classified into three groups based on a clinical examination of oral health status: no periodontal disease, periodontal disease, and edentulous. Periodontal disease was defined using criteria recommended in the consensus report of the European Workshop in Periodontology with a modification. Cognitive impairment was defined using the results of the Mini-mental State Examination (MMSE) and Hasegawa Dementia Scale-Revised (HDS-R) scores. Multivariable logistic regression analyses assessed the relationship of the three-category oral health status variable (reference category = no periodontal disease) with low MMSE score (≤23) and low HDS-R score (≤20). Age, gender, years of education, body mass index, smoking status, drinking behavior, and history of cardiovascular disease were tested as potential confounders in the multivariable models. Periodontal disease and edentulous were significantly associated with greater odds of low cognitive performance after controlling for potential confounders. The multivariable adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for low MMSE score associated with periodontal disease and edentulous were 2.21 (1.01-4.84) and 2.28 (1.06-4.90), respectively. The multivariable adjusted ORs (95% CIs) for low HDS-R score associated with periodontal disease and edentulous were 4.85 (1.29-18.15) and 3.86 (1.05-14.20), respectively. Poor oral health status was significantly associated with cognitive impairment among community-dwelling older Japanese. Additional well-controlled longitudinal studies are needed to elucidate whether there may be a possible cause-and-effect relationship between oral health status and cognitive function.

DOI： 10.1002/cre2.2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions.
Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA(1c) (HbA(1c) &gt;= 6 . 5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG &gt;= 7 . 0 mmol/L or 2hOGTT &gt;= 11 . 1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori.
Findings Population prevalence of diabetes based on FPG- or-2hOGTT was correlated with prevalence based on FPG alone (r= 0 . 98), but was higher by 2-6 percentage points at different prevalence levels. Prevalence based on HbA(1c) was lower than prevalence based on FPG in 42 . 8% of age-sex-survey groups and higher in another 41 . 6%; in the other 15 . 6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA(1c)-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA(1c) 6 . 5% or more had a pooled sensitivity of 52 . 8% (95% CI 51 . 3-54 . 3%) and a pooled specificity of 99 . 74% (99 . 71-99 . 78%) compared with FPG 7 . 0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30 . 5% (28 . 7-32 . 3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA(1c) versus FPG.
Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA(1c)-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.

DOI： 10.1016/S2213-8587(15)00129-1

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD PERIODONTOLOGY  

Background: It has been hypothesized that beta-3 adrenergic receptor and peroxisome proliferator-activated receptor gamma (PPARg) might have gene-environmental and gene-gene interactions in periodontal disease. The purpose of this study is to elucidate the interaction between beta-3 adrenergic receptor and PPARg gene polymorphism with periodontal disease.
Methods: Three hundred thirty-two postmenopausal females were enrolled, and their serum high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c) were examined. beta-3 adrenergic receptor and PPARg genotypes were then determined. An oral examination was performed. The number of remaining teeth was counted, and the probing depth (PD) and clinical attachment level (CAL) were measured. Prevalence-rate ratios (PRRs) were calculated by multiple Poisson regression analyses to evaluate the relationship among periodontal disease markers, such as the number of sites with CAL 4 to 5 or &gt;= 6 mm or PD 4 to 5 or &gt;= 6 mm, and beta-3 adrenergic receptor polymorphisms, PPARg polymorphisms, and the interaction term adjusted by age, hsCRP, and HbA1c, after converting the number of remaining teeth (n) to an offset variable.
Results: In the participants with body mass index (BMI) &gt;= 25, PRRs of beta-3 adrenergic receptor genotype (Trp/Arg and Arg/Arg) for periodontal disease markers were 0.13 to 0.70 (P &lt;0.0001 to 0.74), those of PPARg genotype (Pro/Pro) were 0.66 to 3.14 (P = 0.01 to 0.68), and those of the interaction term for the two genotypes were 1.69 to 12.61 (P &lt;0.0001 to 0.33). However, in the participants with BMI &lt;25, a constant tendency was not observed.
Conclusion: The results confirmed a positive relationship between the interaction term for beta-3 adrenergic receptor genotype and PPARg genotype and various periodontal markers in obese elderly females.

DOI： 10.1902/jop.2015.140472

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Language：Japanese   Publisher：日本歯科衛生学会  

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Other Link： http://search.jamas.or.jp/link/ui/2015396580

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectivesSeveral epidemiological studies have shown the association between tooth loss and mortality. However, the impact of number of teeth on mortality has not yet been fully addressed in an elderly population with many teeth. Thus, the purpose of this cohort study was to assess the possible role of number of teeth as a predictor of mortality in the elderly.
MethodsThe subjects included in this study were generated from a cohort study started in 1998. Oral examinations and the completion of a questionnaire were carried out. A total of 600 subjects aged 70years were enrolled at baseline. All the subjects were in good general health and did not require any special care for their daily activities. The 5-year mortality data were collected after the baseline survey. After excluding those with incomplete data, 569 subjects were analyzed. The Kaplan-Meier method was used to analyze survival curves and a Cox regression model to clarify the impact of the number of remaining teeth on the 5-year mortality.
ResultsDuring the follow-up period, 25 (4.4%) subjects died. Subjects with 20 teeth or more had a significantly lower mortality rate (2.5%) than those with 19 teeth or fewer (6.1%, log-rank test, P=0.036). Even after adjusting for confounders including gender, BMI, serum albumin level, current smoking status, education, number of family members living together and a history of chronic diseases, the risk of all-cause mortality was significantly associated with the number of remaining teeth (P=0.047) with a hazard ratio of 0.96, indicating that there was a 4% point increase in the 5-year survival rate per additional tooth retained at the age of 70.
ConclusionThe findings of this study suggest that retaining more teeth might be a useful indicator for longevity of older people.

DOI： 10.1111/cdoe.12146

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PERGAMON-ELSEVIER SCIENCE LTD  

Objective: IL-6 plays critical roles in bone resorption and the pathogenesis of periodontitis in both inflammation and alveolar bone loss. A negative correlation was observed between periodontitis and truncal bone mineral density (BMD) in postmenopausal women. The C allele carriers of a genetic polymorphism IL-6-572G/C have higher levels of serum IL-6 compared to G allele carriers. We investigated the possible effect of IL-6-572G/C polymorphism on the relationship between low BMD and periodontitis in postmenopausal women.
Subjects and methods: A total of 300 postmenopausal Japanese women who lived in Yokogoshi area of Niigata City, Japan, participated in this study. Genomic DNA was extracted from peripheral blood. The IL-6-572G/C genotypes were determined by the restriction fragment length polymorphism method. Bone mineral density (BMD) of right femoral neck and serum bone metabolism markers were measured. Low BMD was defined to have the BMD &lt; 80% of the mean for young adults. Periodontal parameters at two sites per tooth were measured.
Results: Serum osteocalcin levels were significantly lower in the IL-6-572G/G genotype (p = 0.025). In the -572G allele non-carriers, percentages of PPD &gt;= 4 mm sites were significantly higher in low BMD group compared with the healthy control group (p = 0.021). Logistic regression analysis revealed low BMD to be associated with periodontitis (Odds ratio = 1.736, p = 0.027) after adjusted with IL-6-572G carriage, age, serum albumin level.
Conclusions: IL-6-572G/C polymorphism was not an independent risk factor of low BMD or periodontitis, but may affect the relationship between the two diseases in postmenopausal Japanese women. (C) 2015 Published by Elsevier Ltd.

DOI： 10.1016/j.archoralbio.2014.12.005

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD PERIODONTOLOGY  

Background: There has been little evaluation in longitudinal epidemiologic studies of the effect of metabolic syndrome (MetS) on periodontal status. The specific aim of this longitudinal study is to investigate whether MetS in the Japanese population could be a risk factor for periodontal disease.
Methods: A total of 125 older adults from Japan for whom data were available for the years 2003 to 2006 were selected for the current study. Full-mouth periodontal status, measured as clinical attachment level (CAL), was recorded at baseline and in follow-up examinations. Development of periodontal disease was considered to be &gt;= 2 teeth demonstrating a longitudinal loss of proximal attachment of &gt;= 3 mm at the follow-up dental examination. A multivariable Poisson regression model with robust error variance was used to evaluate the association of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria with development of periodontal disease. Adjustments for sex, income, education, smoking status, number of teeth at baseline, mean CAL at baseline, pattern of visits to a dentist, and brushing frequency were considered.
Results: The prevalence of MetS was 21.6% (27/125). Study participants with MetS were approximately 2.6 times more likely to develop periodontal disease (adjusted relative risk 2.58, 95% confidence interval 1.17 to 5.67) after simultaneous adjustment for other covariates.
Conclusions: These findings support the hypothesis that MetS may be a risk factor for periodontal disease in older Japanese individuals. Additional studies with larger, more diverse populations and more complete information are needed to substantiate the findings.

DOI： 10.1902/jop.2015.140398

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Background and ObjectivePotentially significant associations between metabolic syndrome (MetS) and periodontitis have been reported in recent studies; however, there are limited data on their association in the very old. The aim of this cross-sectional study was to investigate the association between MetS and periodontitis among 80-year-old Japanese subjects.
Material and MethodsThe subjects were 234 Japanese aged 80years old who participated in a health and periodontal examination in June 2008 in Niigata city, Japan, and were classified into three groups: (i) severe periodontitis: having six or more interproximal sites with clinical attachment level 6mm and three or more interproximal sites with probing pocket depth (PPD) 5mm (not on the same tooth) (n=19); (ii) moderate periodontitis: having six or more interproximal sites with clinical attachment level 4mm or six or more interproximal sites with PPD 5mm (not on the same tooth) (n=162); and (iii) no or mild periodontitis: neither moderate nor severe periodontitis (n=53). MetS was defined using the modified criteria of the guidelines for the diagnosis of MetS in Japan. An ordinal logistic regression model was used to evaluate the association between MetS and periodontitis. Adjustments for gender, income, education, smoking status, dental visiting patterns, brushing frequency, exercise habits and dietary energy and food intake were considered.
ResultsOverall, 57 individuals (24.4%) were diagnosed as having MetS. MetS was associated with the presence and severity of periodontitis (crude odds ratio=2.24, 95% confidence interval=1.14-4.41). This association remained statistically significant after multivariate adjustments (adjusted odds ratio=2.10, 95% confidence interval=1.03-4.28).
ConclusionOur findings provide evidence of an association between MetS and periodontitis in elderly Japanese.

DOI： 10.1111/jre.12190

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Dennis Barber Ltd  

Objective: To investigate the relationship of dental status to food diversity among older Japanese. Design and Setting: A community-based cross-sectional study conducted in the town of Tosa, Kochi Prefecture, Japan. Methods: The study participants were 252 Japanese (84 men and 168 women, average age 81.2 years) and dentate participants were classified into three groups: 1-9 teeth, 10-19 teeth and 20 or more teeth. Food diversity was assessed as a validated measure of dietary quality using the 11-item Food Diversity Score Kyoto (FDSK-11), which evaluates frequency of consumption of 11 main food groups. Multivariable analysis of the differences in FDSK-11 score ranging from 0 to 11, with a higher score indicating greater food diversity, among the three dental status groups was conducted using general linear models. All the performed analyses were stratified by gender. Results: There was no association between dental status and food diversity score in models for men. In contrast, women with ≤9 teeth and with 10-19 teeth had significantly lower FDSK-11 scores than women with ≥20 teeth after adjusting for confounders (p&lt
0.001 and p=0.009, respectively). Additionally, there was a trend toward lower scores for FDSK-11 with fewer teeth (p=0.001). Conclusion: A less varied diet, as indicated by low FDSK-11 score, was observed in female participants with fewer teeth. Tooth loss was associated with poor diet quality among older Japanese women.

DOI： 10.1922/CDH_3502Iwasaki07

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DOI： 10.5897/JDOH2014.0142.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER HEIDELBERG  

The aim of this study was to demonstrate the effectiveness of an analysis of tooth brushing cycles using a system that measures tooth brushing motion and brushing force with an accelerometer and strain tension gage attached to a toothbrush.
Mechanical plaque removal with a manual toothbrush remains the primary method of maintaining good oral hygiene for the majority of the population. Because toothbrush motion has not been fully understood, it should be clarified by analysis of tooth brushing cycles.
Twenty healthy female dental hygienists participated in this study. Their tooth brushing motions were measured and analyzed using an American Dental Association-approved manual toothbrush to which a three-dimensional (3-D) accelerometer and strain tension gage were attached. 3-D motion and brushing force on the labial surface of the mandibular right central incisor and the lingual surface of the mandibular left first molar were measured, analyzed, and compared. Multilevel linear model analysis was applied to estimate variables and compare motion and forces related to the two tooth surfaces.
The analysis of tooth brushing cycles was feasible, and significant differences were detected for durations and 3-D ranges of toothbrush motion as well as brushing force between the two tooth surfaces.
The analysis used in this study demonstrated an ability to detect characteristics of tooth brushing motion, showing tooth brushing motion to change depending on the brushed location. These results also suggest that more detailed instructions might be required according to patient's oral condition.

DOI： 10.1007/s00784-013-1172-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER HEIDELBERG  

The aim of this study was to demonstrate the effectiveness of an analysis of tooth brushing cycles using a system that measures tooth brushing motion and brushing force with an accelerometer and strain tension gage attached to a toothbrush.
Mechanical plaque removal with a manual toothbrush remains the primary method of maintaining good oral hygiene for the majority of the population. Because toothbrush motion has not been fully understood, it should be clarified by analysis of tooth brushing cycles.
Twenty healthy female dental hygienists participated in this study. Their tooth brushing motions were measured and analyzed using an American Dental Association-approved manual toothbrush to which a three-dimensional (3-D) accelerometer and strain tension gage were attached. 3-D motion and brushing force on the labial surface of the mandibular right central incisor and the lingual surface of the mandibular left first molar were measured, analyzed, and compared. Multilevel linear model analysis was applied to estimate variables and compare motion and forces related to the two tooth surfaces.
The analysis of tooth brushing cycles was feasible, and significant differences were detected for durations and 3-D ranges of toothbrush motion as well as brushing force between the two tooth surfaces.
The analysis used in this study demonstrated an ability to detect characteristics of tooth brushing motion, showing tooth brushing motion to change depending on the brushed location. These results also suggest that more detailed instructions might be required according to patient's oral condition.

DOI： 10.1007/s00784-013-1172-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectivesThe aim of this cross-sectional study was to investigate the relationship of oral health status defined on the basis of presence of posterior occluding pairs (POPs) and adequacy of removable denture fit as determined by self-report to nutrient and food intake among older Japanese.
MethodsThe subjects were 353 Japanese aged 80years in 2008 and were classified into four groups according to the number of POPs, defined as pairs of occluding natural, restored, or fixed prosthetic postcanine teeth (range: 0-8) and removable denture status. The groups were: (i) good dentition (n=56; 8 POPs and no removable prosthesis), (ii) well-fitting dentures (n=158; &lt;8 POPs with self-reported good-fitting dentures), (iii) ill-fitting dentures (n=70; &lt;8 POPs with self-reported ill-fitting dentures), and (iv) compromised dentition (n=69; &lt;8 POPs and no removable prosthesis). Multivariable analysis of the differences in nutrient and food intake outcome variables which were collected via validated food frequency questionnaire among the four oral health status groups was conducted using general linear models.
ResultsIntake of multiple nutrients was significantly (P&lt;0.05) lower in the group with ill-fitting dentures or compromised dentition than in the good dentition group. Vegetable, fish, and shellfish consumption was significantly lower in the ill-fitting dentures or compromised dentition groups. No significant differences were seen in dietary intake between the well-fitting dentures and good dentition groups.
ConclusionsDietary intake was poorer in those with self-perceived ill-fitting dentures or fewer POPs than among those having all POPs. Regular dental care to maintain intact dentition, as well as dental treatment to replace missing teeth and ensure adequate denture fit and function, may be important to the diet intake and subsequent nutritional status of older Japanese.

DOI： 10.1111/cdoe.12100

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectivesThe aim of this cross-sectional study was to investigate the relationship of oral health status defined on the basis of presence of posterior occluding pairs (POPs) and adequacy of removable denture fit as determined by self-report to nutrient and food intake among older Japanese.
MethodsThe subjects were 353 Japanese aged 80years in 2008 and were classified into four groups according to the number of POPs, defined as pairs of occluding natural, restored, or fixed prosthetic postcanine teeth (range: 0-8) and removable denture status. The groups were: (i) good dentition (n=56; 8 POPs and no removable prosthesis), (ii) well-fitting dentures (n=158; &lt;8 POPs with self-reported good-fitting dentures), (iii) ill-fitting dentures (n=70; &lt;8 POPs with self-reported ill-fitting dentures), and (iv) compromised dentition (n=69; &lt;8 POPs and no removable prosthesis). Multivariable analysis of the differences in nutrient and food intake outcome variables which were collected via validated food frequency questionnaire among the four oral health status groups was conducted using general linear models.
ResultsIntake of multiple nutrients was significantly (P&lt;0.05) lower in the group with ill-fitting dentures or compromised dentition than in the good dentition group. Vegetable, fish, and shellfish consumption was significantly lower in the ill-fitting dentures or compromised dentition groups. No significant differences were seen in dietary intake between the well-fitting dentures and good dentition groups.
ConclusionsDietary intake was poorer in those with self-perceived ill-fitting dentures or fewer POPs than among those having all POPs. Regular dental care to maintain intact dentition, as well as dental treatment to replace missing teeth and ensure adequate denture fit and function, may be important to the diet intake and subsequent nutritional status of older Japanese.

DOI： 10.1111/cdoe.12100

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: There is a growing interest in comparing periodontal conditions between countries. This study compared periodontal disease conditions in three elderly populations- one from Japan and two from Germany.
Materials and Methods: We compared periodontal data of 70-year-old subjects from the Niigata Study with 65-74-year-old subjects from the Study of Health in Pomerania (SHIP) and from West Germany (DMS III). A total of 489, 399 and 549 dentate subjects were analysed, respectively. Recording protocols were standardized. Linear or logistic models were used to compare Niigata Study with SHIP.
Results: Elderly German subjects in SHIP and DMS III had significantly more severe periodontal conditions and fewer remaining teeth compared to those in Niigata Study, though differences were less pronounced for DMS III. German subjects showed a significantly different pattern of various periodontal risk factors compared to Japanese subjects. Even after adjustment for putative periodontal risk factors, SHIP subjects still presented significantly higher adjusted values for most periodontal parameters compared to Niigata Study subjects (p &lt; 0.05).
Conclusions: Periodontitis was more prevalent in SHIP compared with Niigata Study, even after comprehensive risk factor adjustment. Only to a very small extent, differences between studies could be explained by the risk factors explored.

DOI： 10.1111/jcpe.12267

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: There is a growing interest in comparing periodontal conditions between countries. This study compared periodontal disease conditions in three elderly populations- one from Japan and two from Germany.
Materials and Methods: We compared periodontal data of 70-year-old subjects from the Niigata Study with 65-74-year-old subjects from the Study of Health in Pomerania (SHIP) and from West Germany (DMS III). A total of 489, 399 and 549 dentate subjects were analysed, respectively. Recording protocols were standardized. Linear or logistic models were used to compare Niigata Study with SHIP.
Results: Elderly German subjects in SHIP and DMS III had significantly more severe periodontal conditions and fewer remaining teeth compared to those in Niigata Study, though differences were less pronounced for DMS III. German subjects showed a significantly different pattern of various periodontal risk factors compared to Japanese subjects. Even after adjustment for putative periodontal risk factors, SHIP subjects still presented significantly higher adjusted values for most periodontal parameters compared to Niigata Study subjects (p &lt; 0.05).
Conclusions: Periodontitis was more prevalent in SHIP compared with Niigata Study, even after comprehensive risk factor adjustment. Only to a very small extent, differences between studies could be explained by the risk factors explored.

DOI： 10.1111/jcpe.12267

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectivesThis longitudinal study evaluated the relationship between low renal function and tooth loss in elderly subjects.
Material and methodsSubjects comprised 406 female subjects (55-74years old) who agreed to participate in a baseline examination and a follow-up examination after 5years. Serum cystatin C levels were used to assess renal function. Multiple logistic regression analysis was used to evaluate the relationship between tooth loss and change in serum cystatin C levels over 5years. Tooth loss over 5years (0: no, 1: yes) was used as the dependent variable. Seven variables were used as independent variables, including change in serum cystatin C levels over 5years.
ResultsResults of multiple logistic regression analysis showed that cystatin C change over 5years, age, number of remaining teeth at baseline, number of sites with 4mm clinical attachment level at baseline and serum 25-hydroxyvitamin D levels at baseline were significantly associated with tooth loss. The odds ratio for tooth loss with cystatin C change over 5years was 7.70 (p=0.029).
ConclusionThis study indicates a relationship between serum cystatin C levels and number of missing teeth, and thus suggests that low renal function is associated with tooth loss.

DOI： 10.1111/ger.12015

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectivesThis longitudinal study evaluated the relationship between low renal function and tooth loss in elderly subjects.
Material and methodsSubjects comprised 406 female subjects (55-74years old) who agreed to participate in a baseline examination and a follow-up examination after 5years. Serum cystatin C levels were used to assess renal function. Multiple logistic regression analysis was used to evaluate the relationship between tooth loss and change in serum cystatin C levels over 5years. Tooth loss over 5years (0: no, 1: yes) was used as the dependent variable. Seven variables were used as independent variables, including change in serum cystatin C levels over 5years.
ResultsResults of multiple logistic regression analysis showed that cystatin C change over 5years, age, number of remaining teeth at baseline, number of sites with 4mm clinical attachment level at baseline and serum 25-hydroxyvitamin D levels at baseline were significantly associated with tooth loss. The odds ratio for tooth loss with cystatin C change over 5years was 7.70 (p=0.029).
ConclusionThis study indicates a relationship between serum cystatin C levels and number of missing teeth, and thus suggests that low renal function is associated with tooth loss.

DOI： 10.1111/ger.12015

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objectives
The purpose of this study was to elucidate whether the association between beta-3 adrenergic receptor polymorphism and periodontal disease is modified by body weight.
Material and Methods
We enrolled 332 postmenopausal women and determined their HbA1C levels (%) and beta-3 adrenergic receptor (rs4994) genotypes. Periodontal parameters including clinical attachment level (CAL) were measured. After selecting subjects for each body mass index (BMI) level, the prevalence rate ratio (PRR) by multiple Poisson regression analysis was calculated to evaluate the relationship between periodontal disease and beta-3 adrenergic receptor polymorphism. The number of sites with CAL &gt;= 6mm was used as a dependent variable, and beta-3 adrenergic receptor genotype [categorized as Arg non-carriers (reference) or Arg carriers], age (y) and HbA1C (%) were adopted as independent variables. We converted the number of probing sites (n) to an offset variable.
Results
The PRR of the beta-3 adrenergic receptor genotype for the number of sites of CAL &gt;= 6mm showed a positive association in subjects with BMI &gt;= 25.0 and increased markedly with BMI. The PRR in subjects with BMI &gt;= 30 was 3.10 (p&lt;0.0001).
Conclusion
This study indicates a positive association between periodontal disease and the beta-3 adrenergic receptor genotype in obese individuals.

DOI： 10.1111/jcpe.12235

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Objectives
The purpose of this study was to elucidate whether the association between beta-3 adrenergic receptor polymorphism and periodontal disease is modified by body weight.
Material and Methods
We enrolled 332 postmenopausal women and determined their HbA1C levels (%) and beta-3 adrenergic receptor (rs4994) genotypes. Periodontal parameters including clinical attachment level (CAL) were measured. After selecting subjects for each body mass index (BMI) level, the prevalence rate ratio (PRR) by multiple Poisson regression analysis was calculated to evaluate the relationship between periodontal disease and beta-3 adrenergic receptor polymorphism. The number of sites with CAL &gt;= 6mm was used as a dependent variable, and beta-3 adrenergic receptor genotype [categorized as Arg non-carriers (reference) or Arg carriers], age (y) and HbA1C (%) were adopted as independent variables. We converted the number of probing sites (n) to an offset variable.
Results
The PRR of the beta-3 adrenergic receptor genotype for the number of sites of CAL &gt;= 6mm showed a positive association in subjects with BMI &gt;= 25.0 and increased markedly with BMI. The PRR in subjects with BMI &gt;= 30 was 3.10 (p&lt;0.0001).
Conclusion
This study indicates a positive association between periodontal disease and the beta-3 adrenergic receptor genotype in obese individuals.

DOI： 10.1111/jcpe.12235

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH INST RADIOLOGY  

Objectives: The mandibular inferior cortex (MIC) classification that was determined by observing the mandible distally from the mental foramen in panoramic radiography can be considered to reflect bone loss in the jaws. The purpose of this 9-year study was to investigate whether there is a relationship between MIC condition and total serum calcium (TSC) in elderly Japanese people.
Methods: A total of 280 subjects aged 70 years at baseline (137 males and 143 females) took part in this longitudinal study design. TSC and dental panoramic radiographs were carried out at the baseline in 1998 and the final year in 2007.
Results: The results of the MIC measurement were divided into two groups according to changes in MIC after the 9-year study period, namely no change group and change group. A significant relationship was found in females but not in males between the MIC condition and the TSC. The regression showed that female subjects are 3.26 times more likely to have increased erosion of the inferior border of the mandible than male subjects after the 9-year study period.
Conclusions: These results suggest that an increase in erosion of the inferior border of the mandible was significantly associated with an elevated TSC after 9 years and only in females.

DOI： 10.1259/dmfr.20130341

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We conducted a cohort study exploring an association between serum 25-hydroxyvitamin D (serum 25(OH)D) and parathyroid hormone (PTH) levels and 5-year changes in bone mineral density (BMD) in 482 postmenopausal women. High serum 25(OH)D levels do not retard postmenopausal bone loss within the lumbar spine or femoral neck, and high PTH levels potentially increase hip bone loss.
Purpose The aim of this study was to explore an association between serum 25(OH)D levels and 5-year changes in BMD in postmenopausal women.
Methods This 5-year cohort study included 482 women between 55 and 74 years of age who lived in a community in Japan. Medical examinations were conducted in 2005 and 2010. Data were obtained on baseline serum 25(OH)D and intact parathyroid hormone (iPTH) levels. Outcomes of this study were 5-year changes in BMDs of the lumbar spine and femoral neck. Covariates included years since menopause, body mass index (BMI), lifestyle factors, and weight change. Changes in BMDs among quartiles of serum 25(OH)D were compared with analysis of covariance.
Results The mean age of subjects was 63.1 years, and mean serum25(OH)D levelswere 56.0 nmol/L. Age and decrease in weight were significantly associated with decreases in BMDs of both the lumbar spine (P for trend&lt;0.001 and =0.002, respectively) and femoral neck (P for trend=0.026 and &lt;0.001, respectively); low BMI was associated with a decrease in lumbar spine BMD (P for trend&lt;0.001). No significant associations were found between serum 25(OH)D levels and changes in BMDs. High serum iPTH levels were associated with a greater decrease in femoral neck BMD (P for trend=0.026).
Conclusions High serum 25(OH)D levels do not retard postmenopausal bone loss within the lumbar spine or femoral neck, and high PTH levels potentially increase hip bone loss.

DOI： 10.1007/s11657-013-0153-0

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Background: Previous studies have shown conflicting results as to whether low bone mineral density (BMD) is associated with severe clinical attachment loss (AL). The effect of dental restoration on AL was not considered in most studies. In addition, studies of this association in Japanese individuals are limited. The aim of this crosssectional study is to evaluate the possible association between BMD and AL with dental restoration information in Japanese community-dwelling postmenopausal females. Methods: The participants were 397 females (average age: 68.2 years). BMDs of the lumbar spine and right proximal femur were measured by the dual-energy x-ray absorptiometry method. Based on lower BMD/young adult mean (YAM) among the two sites measured, participants were classified into three groups: 1) normal: BMD = 80% YAM or higher (n = 161)
2) osteopenia: BMD = 70% to 80% YAM (n = 136)
and 3) osteoporosis: BMD = &lt
70% YAM (n = 100). Multivariable analyses of the differences in AL values among three BMD groups was conducted using general linear models. Adjustments for the percentage of teeth restored and other covariates were considered. Results: Individuals with osteopenia had significantly higher average AL than individuals with normal BMD (P = 0.022). Additionally, the osteoporosis group displayed significantly higher average AL (P = 0.003) and higher percentages of sites with AL ≥4 mm (P = 0.007). Conclusion: The results of the present study indicate that low systemic BMD was associated with severe AL in Japanese community-dwelling postmenopausal females.

DOI： 10.1902/jop.2013.120613

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We conducted a cohort study exploring an association between serum 25-hydroxyvitamin D (serum 25(OH)D) and parathyroid hormone (PTH) levels and 5-year changes in bone mineral density (BMD) in 482 postmenopausal women. High serum 25(OH)D levels do not retard postmenopausal bone loss within the lumbar spine or femoral neck, and high PTH levels potentially increase hip bone loss.
Purpose The aim of this study was to explore an association between serum 25(OH)D levels and 5-year changes in BMD in postmenopausal women.
Methods This 5-year cohort study included 482 women between 55 and 74 years of age who lived in a community in Japan. Medical examinations were conducted in 2005 and 2010. Data were obtained on baseline serum 25(OH)D and intact parathyroid hormone (iPTH) levels. Outcomes of this study were 5-year changes in BMDs of the lumbar spine and femoral neck. Covariates included years since menopause, body mass index (BMI), lifestyle factors, and weight change. Changes in BMDs among quartiles of serum 25(OH)D were compared with analysis of covariance.
Results The mean age of subjects was 63.1 years, and mean serum25(OH)D levelswere 56.0 nmol/L. Age and decrease in weight were significantly associated with decreases in BMDs of both the lumbar spine (P for trend&lt;0.001 and =0.002, respectively) and femoral neck (P for trend=0.026 and &lt;0.001, respectively); low BMI was associated with a decrease in lumbar spine BMD (P for trend&lt;0.001). No significant associations were found between serum 25(OH)D levels and changes in BMDs. High serum iPTH levels were associated with a greater decrease in femoral neck BMD (P for trend=0.026).
Conclusions High serum 25(OH)D levels do not retard postmenopausal bone loss within the lumbar spine or femoral neck, and high PTH levels potentially increase hip bone loss.

DOI： 10.1007/s11657-013-0153-0

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Serum albumin levels are a practical marker of general health status in the elderly and have been used to determine the severity of underlying diseases and the risk for death. This longitudinal study evaluated the relationship between serum albumin concentrations and tooth loss over 10years in elderly subjects, after controlling for confounding factors. A sample of 554 dentate subjects among enrolled subjects (n=600) was involved in this planned longitudinal study with follow-up examinations after 5 and 10years. At the 5-year follow-up, 373 (673%), subjects were available for re-examination. In addition, 331 (597%) were available at the 10-year follow-up. Multiple Poisson regression analysis was conducted to evaluate the relationship between the number of missing teeth over 5 or 10years and serum albumin levels at baseline after adjusting for 10 variables: gender, serum markers levels at baseline, dental status, smoking habits and educational years and oral health behaviour. The number of missing teeth over 5 or 10years was significantly negatively associated with serum albumin levels at baseline [incidence rate ratios (IRR)=0373, P&lt;00001 for 5years; IRR=0570, P&lt;00001 for 10years]. We conclude that elderly subjects with hypoalbuminemia are at high risk for 5- and 10-year tooth loss.

DOI： 10.1111/joor.12083

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Aim: The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly.
Methods: The study population consisted of 269 community-dwelling elderly aged &gt;= 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11).
Results: Number of teeth was significantly related to chewing ability (P &lt; 0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance (P = 0.029) and intellectual activity (P = 0.021). There was a significant association between low chewing ability and depression (P &lt; 0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE (P = 0.022), HDSR (P = 0.017) and FAB (P = 0.002). The participants with low chewing ability had lower food variety (P &lt; 0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability.
Conclusion: Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings. Geriatr Gerontol Int 2013; 13: 718-725.

DOI： 10.1111/ggi.12006

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OBJECTIVES: PPARg regulates bone metabolism and inflammation. Our previous study suggested PPARg Pro12Ala polymorphism to represent a susceptibility factor for periodontitis in pregnant Japanese women. Several recent papers have drawn attention to a possible link between low bone mineral density (BMD) and periodontitis in postmenopausal women. Since the pathogenesis for both involve bone remodeling, they might share common risk factors such as gene polymorphisms and vitamin D level. The present study investigated possible associations between the PPARgPro12Ala polymorphism, periodontitis, BMD and serum 25(OH)D in postmenopausal Japanese women.
MATERIALS AND METHODS: PPARgPro12Ala genotypes of 359 women were determined by PCR-RFLP. BMD and periodontal parameters of each woman were measured. Serum 25(OH)D levels were determined by radioimmunoassay.
RESULTS: PPARgPro12Ala polymorphism was not associated with periodontitis or BMD as an independent factor. Serum 25(OH)D was significantly higher in Ala allele carriers compared to non-carriers. Only in the Ala allele carriers, positive correlations were found between mean clinical attachment level and BMD, between BMD and 25(OH)D, and between percentage of sites with probing depth &gt;= 4 mm and 25(OH)D.
CONCLUSIONS: PPARgPro12Ala polymorphism was not independently associated with periodontitis or BMD. However, the polymorphism might be a modulator of the relationship between the two conditions in postmenopausal Japanese women.

DOI： 10.1111/odi.12032

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly.
Methods: The study population consisted of 269 community-dwelling elderly aged &gt;= 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11).
Results: Number of teeth was significantly related to chewing ability (P &lt; 0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance (P = 0.029) and intellectual activity (P = 0.021). There was a significant association between low chewing ability and depression (P &lt; 0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE (P = 0.022), HDSR (P = 0.017) and FAB (P = 0.002). The participants with low chewing ability had lower food variety (P &lt; 0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability.
Conclusion: Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings. Geriatr Gerontol Int 2013; 13: 718-725.

DOI： 10.1111/ggi.12006

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：有限責任中間法人日本口腔衛生学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：有限責任中間法人日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

Objective: To investigate the longitudinal relationship between the intake of dietary antioxidants and periodontal disease in community-dwelling older Japanese.
Design: A retrospective cohort study, with a follow-up of 2 years (2003-2005). Intakes of dietary antioxidants (vitamin C, vitamin E, alpha-carotene and beta-carotene) were assessed with a validated FFQ. Participants were classified by tertile of antioxidant intake. Full-mouth periodontal status, measured as the clinical attachment level, was recorded at baseline and follow-up examinations. Periodontal disease progression was considered as loss of attachment of 3mm or greater over the study period at the interproximal site for each tooth. Finally, the number of teeth with periodontal disease progression per person was calculated and was used as the outcome. Poisson regression analysis was conducted, with dietary antioxidants as the main exposure, to estimate their influence on the number of teeth with periodontal disease progression.
Setting: Niigata City (Japan).
Subjects: Dentate individuals aged 75 years in 2003, for whom data were available, were included in the analyses (n 264).
Results: A higher intake of dietary antioxidants was inversely associated with the number of teeth with periodontal disease progression, controlling for other variables. The multivariate-adjusted incidence rate ratios in the first, second and third tertiles were 1.00, 0.76 (95% CI 0.60, 0.97) and 0.72 (95% CI 0.56, 0.93) for vitamin C; 1.00, 0.79 (95% CI 0.62, 0.99) and 0.55 (95% CI 0.42, 0.72), for vitamin E; and 1.00, 1.02 (95% CI 0.81, 1.29) and 0.73 (95% CI 0.56, 0.95) for beta-carotene.
Conclusions: The study results suggest that higher intake of antioxidants may mitigate periodontal disease in community-dwelling older Japanese.

DOI： 10.1017/S1368980012002637

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

Objective: To investigate the longitudinal relationship between the intake of dietary antioxidants and periodontal disease in community-dwelling older Japanese.
Design: A retrospective cohort study, with a follow-up of 2 years (2003-2005). Intakes of dietary antioxidants (vitamin C, vitamin E, alpha-carotene and beta-carotene) were assessed with a validated FFQ. Participants were classified by tertile of antioxidant intake. Full-mouth periodontal status, measured as the clinical attachment level, was recorded at baseline and follow-up examinations. Periodontal disease progression was considered as loss of attachment of 3mm or greater over the study period at the interproximal site for each tooth. Finally, the number of teeth with periodontal disease progression per person was calculated and was used as the outcome. Poisson regression analysis was conducted, with dietary antioxidants as the main exposure, to estimate their influence on the number of teeth with periodontal disease progression.
Setting: Niigata City (Japan).
Subjects: Dentate individuals aged 75 years in 2003, for whom data were available, were included in the analyses (n 264).
Results: A higher intake of dietary antioxidants was inversely associated with the number of teeth with periodontal disease progression, controlling for other variables. The multivariate-adjusted incidence rate ratios in the first, second and third tertiles were 1.00, 0.76 (95% CI 0.60, 0.97) and 0.72 (95% CI 0.56, 0.93) for vitamin C; 1.00, 0.79 (95% CI 0.62, 0.99) and 0.55 (95% CI 0.42, 0.72), for vitamin E; and 1.00, 1.02 (95% CI 0.81, 1.29) and 0.73 (95% CI 0.56, 0.95) for beta-carotene.
Conclusions: The study results suggest that higher intake of antioxidants may mitigate periodontal disease in community-dwelling older Japanese.

DOI： 10.1017/S1368980012002637

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publisher：Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo  

Objective: Xerostomia, temporomandibular disorder, and periodontal disease are frequently seen in menopausal women. However, few studies have reported the prevalence of oralsymptoms during menopause or the cooperation between doctors at outpatient clinics for women and dentists. The purpose of this study was to investigate the frequency of oral symptoms and the cooperation between doctors at outpatient clinics for women and dentists. Methods: A questionnaire was sent to 380 outpatient clinics for women in Japan. The questionnaire included characteristics for the person completing it, staff structure,cooperation with medicalspecialists, the existence of oralsymptoms, details of these symptoms, cooperation with dentists, and space for free responses. Results: The survey response rate was 57.9% (220 of 380 institutions). Most respondents (81.6%) thought that female sex hormones influenced the mouth, and 79.4% had encountered oralsymptoms. The most frequently encountered symptoms were oral dryness, taste disorder, and burning sensation of the mouth. The necessity of cooperation between doctors and dentists was recognized by 63.1%. Staff that recognised the influence of female hormones on the mouth were significantly more likely than others to acknowledge the importance of cooperation (p<0.01). However, as only half of the staff had referred patients to a dental clinic, it seems possible that patients whose symptoms could have been alleviated by dentists were not appropriately managed. Conclusion: Although oral symptoms can relate to menopause, the cooperation between doctors and dentists is poor. Improved cooperation may relieve not only oral complaints but also systemic menopausal symptoms.

DOI： 10.5466/ijoms.12.21

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Other Link： http://search.jamas.or.jp/link/ui/2014375639

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE PUBLICATIONS INC  

Potentially significant associations between periodontal disease and chronic kidney disease (CKD) have been reported in recent studies. The aim of this cross-sectional study was to investigate the association between serum antibody to the periodontal pathogen Porphyromonas gingivalis (P. gingivalis) and CKD in 215 Japanese individuals, aged 79 yrs. Serum antibody levels to P. gingivalis were measured by enzyme-linked immunosorbent assay. An elevated serum antibody response was defined as the upper quartile and was compared with the bottom three quartiles. Participants were classified as having CKD when their glomerular filtration rate was between 15 and 59 mL/min/1.73 m(2). A multivariable logistic regression model was used to evaluate the association between elevated antibody status and the presence of CKD. Study participants with an elevated serum antibody to P. gingivalis were 2.6 times more likely to have CKD. The adjusted odds ratio of CKD for participants in the highest quartile of serum antibody to P. gingivalis was 2.59 (95% confidence interval, 1.05-6.34) when compared with others in lower quartiles after simultaneous adjustment for other covariates. In conclusion, the present study suggests that elevated serum antibody to P. gingivalis was significantly associated with decreased kidney function in a community-based cohort of elderly Japanese.

DOI： 10.1177/0022034512455063

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The aim of this longitudinal study was to investigate the association between the change in bone mineral density (BMD) and tooth loss in Japanese community-dwelling postmenopausal women. The subjects were 404 women. At baseline (2005) and follow-up (2010), BMDs of the lumbar spine and right femoral neck were measured using dual-energy X-ray absorptiometry (QDR4500a) and participants were classified by tertiles of the annual percentage change in BMD. The number of teeth was counted at the baseline and follow-up to calculate the number of lost teeth over 5 years. Poisson regression analysis was conducted with tertiles of the changes in BMDs of the lumbar spine and femoral neck as the main exposures to estimate their influence on the number of lost teeth. Participants in the tertile with a greater decrease in BMD at each skeletal site (lumbar spine and femoral neck, respectively) had a larger number of lost teeth, controlling for possible confounders. The adjusted relative risks (95% confidence interval) for the mean number of lost teeth in the first, second, and third tertiles were 1.00, 1.15 (0.91-1.45), and 1.38 (1.11-1.72) for the lumbar spine and 1.00, 1.17 (0.93-1.47), and 1.27 (1.01-1.59) for the femoral neck, respectively. In conclusion, a significant relationship exists between a change in BMD and the number of lost teeth during 5-year study period in Japanese community-dwelling postmenopausal women.

DOI： 10.1007/s00774-011-0337-x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER TOKYO  

The aim of this longitudinal study was to investigate the association between the change in bone mineral density (BMD) and tooth loss in Japanese community-dwelling postmenopausal women. The subjects were 404 women. At baseline (2005) and follow-up (2010), BMDs of the lumbar spine and right femoral neck were measured using dual-energy X-ray absorptiometry (QDR4500a) and participants were classified by tertiles of the annual percentage change in BMD. The number of teeth was counted at the baseline and follow-up to calculate the number of lost teeth over 5 years. Poisson regression analysis was conducted with tertiles of the changes in BMDs of the lumbar spine and femoral neck as the main exposures to estimate their influence on the number of lost teeth. Participants in the tertile with a greater decrease in BMD at each skeletal site (lumbar spine and femoral neck, respectively) had a larger number of lost teeth, controlling for possible confounders. The adjusted relative risks (95% confidence interval) for the mean number of lost teeth in the first, second, and third tertiles were 1.00, 1.15 (0.91-1.45), and 1.38 (1.11-1.72) for the lumbar spine and 1.00, 1.17 (0.93-1.47), and 1.27 (1.01-1.59) for the femoral neck, respectively. In conclusion, a significant relationship exists between a change in BMD and the number of lost teeth during 5-year study period in Japanese community-dwelling postmenopausal women.

DOI： 10.1007/s00774-011-0337-x

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Background and aims: Poor physical performance is known to be inversely related to mortality. The purpose of the present study was to determine whether an association between physical performance and 10-year mortality could be extended to a Japanese 70-year-old community-dwelling population, and to compare findings with those found in an octogenarian population. Methods: Seventy-year-old subjects residing in Niigata city, Japan, participated. Baseline examinations, including a physical performance test of four tests of muscle strength, one test of balance, and one test of agility, were carried out in June 1998 for 600 participants, and these individuals were then followed for 10 years. Results: During the 10-year follow up, 80 subjects died. Cox regression analysis with adjustment for confounding factors showed that high scores in muscle strength tests for lower extremities, such as single-leg and double-leg extensor strength and isokinetic leg extensor power, were found to be related to decreases in total cause mortality. Conclusions: In an elderly 70-year-old Japanese community-dwelling population, poor muscle strength was found to be an independent predictor of total mortality. Together with our previous findings in an 80-year-old population, the association between poor strength and high mortality may have effects at 70 but not 80 years of age. (C)2012, Editrice Kurtis

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Objectives: This study examined whether low renal function is associated with the number of remaining teeth among community-dwelling elderly Japanese.
Background data: Many elderly individuals display both low renal function and tooth loss.
Materials and Methods: Subjects comprised 405 randomly selected women (55-74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross-linked N-telopeptide of type I collagen level; body mass index and smoking habits.
Results: Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was -0.11 (p = 0.018).
Conclusion: This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.

DOI： 10.1111/j.1741-2358.2011.00481.x

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Objectives: This study examined whether low renal function is associated with the number of remaining teeth among community-dwelling elderly Japanese.
Background data: Many elderly individuals display both low renal function and tooth loss.
Materials and Methods: Subjects comprised 405 randomly selected women (55-74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross-linked N-telopeptide of type I collagen level; body mass index and smoking habits.
Results: Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was -0.11 (p = 0.018).
Conclusion: This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.

DOI： 10.1111/j.1741-2358.2011.00481.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Background and aims: Poor physical performance is known to be inversely related to mortality. The purpose of the present study was to determine whether an association between physical performance and 10-year mortality could be extended to a Japanese 70-year-old community-dwelling population, and to compare findings with those found in an octogenarian population. Methods: Seventy-year-old subjects residing in Niigata city, Japan, participated. Baseline examinations, including a physical performance test of four tests of muscle strength, one test of balance, and one test of agility, were carried out in June 1998 for 600 participants, and these individuals were then followed for 10 years. Results: During the 10-year follow up, 80 subjects died. Cox regression analysis with adjustment for confounding factors showed that high scores in muscle strength tests for lower extremities, such as single-leg and double-leg extensor strength and isokinetic leg extensor power, were found to be related to decreases in total cause mortality. Conclusions: In an elderly 70-year-old Japanese community-dwelling population, poor muscle strength was found to be an independent predictor of total mortality. Together with our previous findings in an 80-year-old population, the association between poor strength and high mortality may have effects at 70 but not 80 years of age. (C)2012, Editrice Kurtis

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD PERIODONTOLOGY  

Background: Periodontal pathogenic microorganisms produce volatile sulfur compounds (VSCs), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. VSCs are toxic to periodontal tissue. Therefore, there is a relationship between periodontitis and the VSC level of mouth air. However, the association between VSC and periodontal disease progression has not been investigated in a longitudinal study. The purpose of this study is to evaluate the association between VSCs in mouth air and periodontal disease progression among elderly dentulous non-smokers.
Methods: Two hundred forty-one dentulous non-smokers (103 males and 138 females; all 70 years old) had their VSC levels examined with a portable sulfide monitor, and their periodontal status was assessed. Periodontal examinations were performed at baseline and once a year for 3 years to investigate the clinical attachment levels of all teeth. Participants were classified by membership in tertile groups (lowest, middle, and highest) according to the value of baseline VSC measurements.
Results: In negative binomial regression analysis, the number of teeth with periodontal disease progression for participants in the highest tertile of VSC measurement was greater (incidence rate ratio of 1.33, P = 0.011) than for the reference group (lowest tertile of VSC measurement) after simultaneously adjusting for sex, number of remaining teeth, and maximum clinical attachment level.
Conclusions: VSC measurements were significantly associated with periodontal disease progression in a non-smoking dentulous elderly population. This suggests that VSC measurements are useful for the diagnosis of periodontal disease progression. J Periodontol 2012;83:635-643.

DOI： 10.1902/jop.2011.110275

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD PERIODONTOLOGY  

Background: Periodontal pathogenic microorganisms produce volatile sulfur compounds (VSCs), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. VSCs are toxic to periodontal tissue. Therefore, there is a relationship between periodontitis and the VSC level of mouth air. However, the association between VSC and periodontal disease progression has not been investigated in a longitudinal study. The purpose of this study is to evaluate the association between VSCs in mouth air and periodontal disease progression among elderly dentulous non-smokers.
Methods: Two hundred forty-one dentulous non-smokers (103 males and 138 females; all 70 years old) had their VSC levels examined with a portable sulfide monitor, and their periodontal status was assessed. Periodontal examinations were performed at baseline and once a year for 3 years to investigate the clinical attachment levels of all teeth. Participants were classified by membership in tertile groups (lowest, middle, and highest) according to the value of baseline VSC measurements.
Results: In negative binomial regression analysis, the number of teeth with periodontal disease progression for participants in the highest tertile of VSC measurement was greater (incidence rate ratio of 1.33, P = 0.011) than for the reference group (lowest tertile of VSC measurement) after simultaneously adjusting for sex, number of remaining teeth, and maximum clinical attachment level.
Conclusions: VSC measurements were significantly associated with periodontal disease progression in a non-smoking dentulous elderly population. This suggests that VSC measurements are useful for the diagnosis of periodontal disease progression. J Periodontol 2012;83:635-643.

DOI： 10.1902/jop.2011.110275

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objectives: To appropriately explore risk factors for tooth loss operating at the tooth-level, subject-related factors and a hierarchical data structure have to be considered. The purpose of this study was to evaluate tooth-related and subject-related risk factors affecting tooth loss. Methods: A 10-year longitudinal survey was carried out on 286 elderly subjects. At baseline, the prosthodontic status and abutment function of the 5574 teeth were recorded. Tooth loss was defined as the main outcome variable, and a multilevel logistic regression model considering subject and tooth levels was applied. Results: Tooth loss was found in 75% of subjects and most frequently in molars. A multivariable, multilevel logistic regression revealed that the following tooth-related variables were significantly related to tooth loss over 10 years: maxillary teeth, multirooted teeth, single crowns, abutment teeth for a fixed/removable partial denture (FPD/RPD), and periodontally involved teeth. Among them, single crowns, abutment teeth for an FPD, and teeth with severe periodontal disease at baseline had the highest odds of 5.1, 6.0, and 7.1, respectively. Conclusion: The findings of this study suggest that tooth loss is the result of complex interactions of tooth-related factors. Several tooth-related variables including multirooted teeth, abutments, and single crowns were found to be possible risk factors for tooth loss. Thus, these findings confirm and underline the potential benefit of minimizing prosthetic treatment of molars.

DOI： 10.1111/j.1600-0528.2011.00648.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objectives: To appropriately explore risk factors for tooth loss operating at the tooth-level, subject-related factors and a hierarchical data structure have to be considered. The purpose of this study was to evaluate tooth-related and subject-related risk factors affecting tooth loss. Methods: A 10-year longitudinal survey was carried out on 286 elderly subjects. At baseline, the prosthodontic status and abutment function of the 5574 teeth were recorded. Tooth loss was defined as the main outcome variable, and a multilevel logistic regression model considering subject and tooth levels was applied. Results: Tooth loss was found in 75% of subjects and most frequently in molars. A multivariable, multilevel logistic regression revealed that the following tooth-related variables were significantly related to tooth loss over 10 years: maxillary teeth, multirooted teeth, single crowns, abutment teeth for a fixed/removable partial denture (FPD/RPD), and periodontally involved teeth. Among them, single crowns, abutment teeth for an FPD, and teeth with severe periodontal disease at baseline had the highest odds of 5.1, 6.0, and 7.1, respectively. Conclusion: The findings of this study suggest that tooth loss is the result of complex interactions of tooth-related factors. Several tooth-related variables including multirooted teeth, abutments, and single crowns were found to be possible risk factors for tooth loss. Thus, these findings confirm and underline the potential benefit of minimizing prosthetic treatment of molars.

DOI： 10.1111/j.1600-0528.2011.00648.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

Objective: The purpose of this cross-sectional study was to evaluate the association between loss of attachment (LA) which is clinical index of periodontitis and bone mineral density (BMD) of the lumbar vertebrae and femur measured with dual energy X-ray absorptiometry (DXA) in Japanese community-dwelling postmenopausal women.
Subjects and methods: Subjects were 347 women aged 55-74. The oral cavity was divided into 6 areas according to the WHO's method for the determination of the clinical attachment level score (CALscore); the LA was measured at 6 sites using a WHO probe in 17, 16, 11, 26, 27, 37, 36, 31, 46, and 47, and the values were recorded in mm. Then, we assessed BMD of the lumbar vertebrae (L2-L4) and femur (femoral neck, proximal part) by DXA. Based on these data, analysis of covariance was used to estimate relation between periodontitis and systemic BMD status excluding effect of age. Multiple linear regression analysis was used to estimate relation between periodontitis and BMD adjusted for 17 variables.
Results: Significant differences were observed in the mean value between the mean CALscore = 0 and CALscore &gt;= 1 groups in the Z value in lumbar vertebrate (106.9 +/- 18.7 vs. 102.3 +/- 1.0, p &lt; 0.05, t-test). Multiple regression analysis was conducted using the mean LA as dependent variable. Lumbar vertebral BMD (regression coefficient: B = -1.039 +/- 0.379, p = 0.007), femoral neck BMD (B = -1.332 +/- 0.627, p = 0.034), and proximal femoral BMD (B = -1.329 +/- 0.536, p = 0.014) all exhibited a significant negative correlation with the mean LA.
Conclusion: A significant negative correlation was observed between periodontal disease and truncal bone BMD in this study. (C) 2012 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jdent.2012.01.005

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

Objective: The purpose of this cross-sectional study was to evaluate the association between loss of attachment (LA) which is clinical index of periodontitis and bone mineral density (BMD) of the lumbar vertebrae and femur measured with dual energy X-ray absorptiometry (DXA) in Japanese community-dwelling postmenopausal women.
Subjects and methods: Subjects were 347 women aged 55-74. The oral cavity was divided into 6 areas according to the WHO's method for the determination of the clinical attachment level score (CALscore); the LA was measured at 6 sites using a WHO probe in 17, 16, 11, 26, 27, 37, 36, 31, 46, and 47, and the values were recorded in mm. Then, we assessed BMD of the lumbar vertebrae (L2-L4) and femur (femoral neck, proximal part) by DXA. Based on these data, analysis of covariance was used to estimate relation between periodontitis and systemic BMD status excluding effect of age. Multiple linear regression analysis was used to estimate relation between periodontitis and BMD adjusted for 17 variables.
Results: Significant differences were observed in the mean value between the mean CALscore = 0 and CALscore &gt;= 1 groups in the Z value in lumbar vertebrate (106.9 +/- 18.7 vs. 102.3 +/- 1.0, p &lt; 0.05, t-test). Multiple regression analysis was conducted using the mean LA as dependent variable. Lumbar vertebral BMD (regression coefficient: B = -1.039 +/- 0.379, p = 0.007), femoral neck BMD (B = -1.332 +/- 0.627, p = 0.034), and proximal femoral BMD (B = -1.329 +/- 0.536, p = 0.014) all exhibited a significant negative correlation with the mean LA.
Conclusion: A significant negative correlation was observed between periodontal disease and truncal bone BMD in this study. (C) 2012 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jdent.2012.01.005

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：W B SAUNDERS CO-ELSEVIER INC  

Background: Early detection of decreased kidney function can help prevent the progression of kidney disease to kidney failure and cardiovascular events. Potentially significant associations between kidney function and periodontal disease have been reported in cross-sectional studies. However, no longitudinal study has been performed and no study has been performed in Japan. The aim of this longitudinal study was to investigate the effect of periodontal disease on kidney function in community-dwelling Japanese elderly.
Study Design: Retrospective cohort.
Setting & Participants: Members of this cohort were drawn from a longitudinal interdisciplinary study of aging. Included for this analysis were 317 participants (166 men, 151 women) aged 75 years in 2003.
Predictor: The periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated for each participant. Participants were classified in quartile groups according to PISA, then divided into 2 groups (highest quartile vs the other 3 groups combined).
Outcomes: The primary outcome for the analysis was decreased kidney function, defined as a decrease in estimated glomerular filtration rate at follow-up.
Measurements: Multivariable logistic regression analyses were performed to predict decreased kidney function on the basis of periodontal status, risk factors for kidney disease, and other potentially relevant covariates.
Results: During the 2-year follow-up (2003-2005), 45 participants (14.2%) developed decreased kidney function. The highest PISA quartile was associated significantly with a greater cumulative incidence of decreased kidney function (OR, 2.24; 95% CI, 1.05-4.79) than the referent group (the other 3 quartiles) after adjusting for covariates.
Limitations: Extension of interpreting the findings to other age groups is limited.
Conclusion: These results suggest that periodontal disease may be a risk factor for decreased kidney function in Japanese elderly. Am J Kidney Dis. 59(2):202-209. (C) 2012 by the National Kidney Foundation, Inc.

DOI： 10.1053/j.ajkd.2011.08.027

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE PUBLICATIONS INC  

Low concentrations of serum anti-oxidants, including ascorbic acid and alpha-tocopherol, are associated with higher risks of many inflammatory diseases that interrelate with oral health. The present study examined the longitudinal relationship of serum ascorbic acid and alpha-tocopherol to periodontal disease in 224 Japanese individuals, aged 71 yrs, for whom data were available for the years 1999-2007. Participants were classified by tertiles of serum ascorbic acid and of alpha-tocopherol. Full-mouth periodontal status, measured as clinical attachment level (CAL), was recorded at baseline and annual follow-up examinations. The number of teeth with a loss of CAL &gt;= 3 mm at any site over the study period was calculated as 'periodontal disease events'. Poisson regression analysis was conducted to assess predictors of periodontal disease events, with serum ascorbic acid and alpha-tocopherol as the primary predictors of interest. The multivariate adjusted relative risks (95% confidence intervals) in the highest, middle, and lowest tertiles were 1.00 (reference), 1.12 (1.01-1.26), and 1.30 (1.16-1.47) for ascorbic acid and 1.00 (reference), 1.09 (0.98-1.21), and 1.15 (1.04-1.28) for alpha-tocopherol, respectively. Our findings support the hypothesis that low serum levels of ascorbic acid and alpha-tocopherol may be a risk factor for periodontal disease in Japanese elderly.

DOI： 10.1177/0022034511431702

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：W B SAUNDERS CO-ELSEVIER INC  

Background: Early detection of decreased kidney function can help prevent the progression of kidney disease to kidney failure and cardiovascular events. Potentially significant associations between kidney function and periodontal disease have been reported in cross-sectional studies. However, no longitudinal study has been performed and no study has been performed in Japan. The aim of this longitudinal study was to investigate the effect of periodontal disease on kidney function in community-dwelling Japanese elderly.
Study Design: Retrospective cohort.
Setting & Participants: Members of this cohort were drawn from a longitudinal interdisciplinary study of aging. Included for this analysis were 317 participants (166 men, 151 women) aged 75 years in 2003.
Predictor: The periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated for each participant. Participants were classified in quartile groups according to PISA, then divided into 2 groups (highest quartile vs the other 3 groups combined).
Outcomes: The primary outcome for the analysis was decreased kidney function, defined as a decrease in estimated glomerular filtration rate at follow-up.
Measurements: Multivariable logistic regression analyses were performed to predict decreased kidney function on the basis of periodontal status, risk factors for kidney disease, and other potentially relevant covariates.
Results: During the 2-year follow-up (2003-2005), 45 participants (14.2%) developed decreased kidney function. The highest PISA quartile was associated significantly with a greater cumulative incidence of decreased kidney function (OR, 2.24; 95% CI, 1.05-4.79) than the referent group (the other 3 quartiles) after adjusting for covariates.
Limitations: Extension of interpreting the findings to other age groups is limited.
Conclusion: These results suggest that periodontal disease may be a risk factor for decreased kidney function in Japanese elderly. Am J Kidney Dis. 59(2):202-209. (C) 2012 by the National Kidney Foundation, Inc.

DOI： 10.1053/j.ajkd.2011.08.027

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Although an association between SA concentrations and mortality in the patients is well known, this association is not conclusive in elderly community-dwelling populations. We therefore attempted to determine whether this association could be extended to a Japanese 70-year-old community-dwelling population. Seventy-year-old subjects residing in Niigata City, Japan participated. Baseline examinations including a determination of SA concentrations were performed in June 1998 in 600 participants, and they were followed for 10 years. During the 10-year follow up, 80 subjects died. Albumin levels were divided into four groups (highest &gt; 45 g/l, higher 43-44 g/l, lower 41-42 g/l, lowest &lt; 40 g/l). The survival rate using Kaplan-Meier methods was longer in the highest and higher albumin groups than in the lowest and lower groups. No differences were found between the four groups in the mortalities from cancer, cardiovascular disease (CVD) or pneumonia. Individuals with the lowest albumin levels had 2.7 or 2.9 times higher total mortality, whether adjusted with confounding factors or not, using Cox regression analysis. The mortality hazard ratio (HR) found in the lowest group was compared to the highest group. In an elderly 70-year-old Japanese community-dwelling population, lower SA concentrations were an independent predictor of total mortality, but not mortality due to cancer, CVD, or pneumonia. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.archger.2011.02.018

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Although an association between SA concentrations and mortality in the patients is well known, this association is not conclusive in elderly community-dwelling populations. We therefore attempted to determine whether this association could be extended to a Japanese 70-year-old community-dwelling population. Seventy-year-old subjects residing in Niigata City, Japan participated. Baseline examinations including a determination of SA concentrations were performed in June 1998 in 600 participants, and they were followed for 10 years. During the 10-year follow up, 80 subjects died. Albumin levels were divided into four groups (highest &gt; 45 g/l, higher 43-44 g/l, lower 41-42 g/l, lowest &lt; 40 g/l). The survival rate using Kaplan-Meier methods was longer in the highest and higher albumin groups than in the lowest and lower groups. No differences were found between the four groups in the mortalities from cancer, cardiovascular disease (CVD) or pneumonia. Individuals with the lowest albumin levels had 2.7 or 2.9 times higher total mortality, whether adjusted with confounding factors or not, using Cox regression analysis. The mortality hazard ratio (HR) found in the lowest group was compared to the highest group. In an elderly 70-year-old Japanese community-dwelling population, lower SA concentrations were an independent predictor of total mortality, but not mortality due to cancer, CVD, or pneumonia. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.archger.2011.02.018

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：QUINTESSENCE PUBLISHING CO INC  

Purpose: To determine whether variation in glucan synthesis by Streptococcus mutans isolates is associated with caries development in children receiving a fluoride mouth rinse (FMR).Materials and Methods: Of 122 children (aged 9 to 10 years), 64 had received FMR (FMR(+) group) and the remaining 58 children had not (FMR() group). The number of decayed and filled teeth (DFT) and increases in the number of DFT in 1 year (dDFT) were recorded. Saliva samples were collected to isolate the clinical S. mutans strains. The isolates were incubated in heart infusion broth supplemented with 1% sucrose, then the amount of water-insoluble glucan (WIG) formed on a glass tube surface was evaluated.Results: In the FMR() group, children carrying S. mutans had a higher DFT (P = 0.039) and tended to have a higher dDFT (P = 0.080) than the others. In the FMR(+) group, although the differences between children with and without S. mutans were not significant, children carrying S. mutans that produced a high amount of WIG had higher dDFT than the other S. mutans-positive children (P = 0.034).Conclusions: This study revealed that the variation in glucan synthesis by S. mutans is associated with caries development in children receiving a FMR.

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Other Link： http://search.jamas.or.jp/link/ui/2013092615

Language：English   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Dental Health  

The one-leg standing test has been widely practiced as an equilibrium function test in the elderly because of its simple evaluation method. Previous studies confirmed that those who cannot maintain a one-leg standing position with eyes open for 30 seconds had a significantly increased risk of falls. Falls in the elderly can cause fracture, gait disturbance, hospital admission, and death. Mean-while, the study results regarding oral function and physical strength in the elderly showed that the one-leg standing time and number of teeth present/occlusal support area are closely associated. A color-changeable chewing gum test for masticatory performance is a simple method that can evaluate a subject's masticatory performance in a short period of time. The results of this test show a significant correlation with the number of teeth present or occlusal support area. This study examined the association between masticatory performance using a color-changeable chewing gum and the one-leg standing time with eyes open in community-dwelling elderly women. The subjects were 138 women aged between 65 and 74 years who participated in the surveys conducted in 2009 and 2010, and consented to undergo a medical interview, body measurement, one-leg standing test with eyes open, and oral examination. Color-changeable chewing gum was used to measure the masticatory performance. The color of the gum after chewing for 2 minutes was assessed using a color chart, and the masticatory ability was evaluated using a 5-point rating scale (score of 1-5). Based on the scores, the subjects were divided into three groups (high performance group: 5 points; moderate performance group: 4 points; low performance group: 1-3 points). Denture wearers underwent tests with their dentures in. Logistic regression analyses were performed, with masticatory performance using a color-changeable chewing gum as the main variable, to estimate its influence on the ability to stand on one leg with eyes open for 30 seconds. Tested potential confounders included the number of teeth present, age, and motor function. A lower masticatory performance was significantly associated with the inability to stand on one leg with eyes open for 30 seconds (adjusted odds ratio [95% CI] = 2.34 [0.91-6.01] in moderate performance and 3.61 [1.14-11.4] in low performance groups). A decrease in the motor function was also significantly associated with the inability to stand on one leg with eyes open for 30 seconds (adjusted odds ratio [95%CI] = 5.00 [1.30-19.1]). The results indicated that there was a significant association between the masticatory performance using a color-changeable chewing gum and one-leg standing time with eyes open in community-dwelling elderly women.

DOI： 10.5834/jdh.62.3_289

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：QUINTESSENCE PUBLISHING CO INC  

Purpose: To determine whether variation in glucan synthesis by Streptococcus mutans isolates is associated with caries development in children receiving a fluoride mouth rinse (FMR).Materials and Methods: Of 122 children (aged 9 to 10 years), 64 had received FMR (FMR(+) group) and the remaining 58 children had not (FMR() group). The number of decayed and filled teeth (DFT) and increases in the number of DFT in 1 year (dDFT) were recorded. Saliva samples were collected to isolate the clinical S. mutans strains. The isolates were incubated in heart infusion broth supplemented with 1% sucrose, then the amount of water-insoluble glucan (WIG) formed on a glass tube surface was evaluated.Results: In the FMR() group, children carrying S. mutans had a higher DFT (P = 0.039) and tended to have a higher dDFT (P = 0.080) than the others. In the FMR(+) group, although the differences between children with and without S. mutans were not significant, children carrying S. mutans that produced a high amount of WIG had higher dDFT than the other S. mutans-positive children (P = 0.034).Conclusions: This study revealed that the variation in glucan synthesis by S. mutans is associated with caries development in children receiving a FMR.

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Oral Health  

The one-leg standing test has been widely practiced as an equilibrium function test in the elderly because of its simple evaluation method. Previous studies confirmed that those who cannot maintain a one-leg standing position with eyes open for 30 seconds had a significantly increased risk of falls. Falls in the elderly can cause fracture, gait disturbance, hospital admission, and death. Mean-while, the study results regarding oral function and physical strength in the elderly showed that the one-leg standing time and number of teeth present/occlusal support area are closely associated. A color-changeable chewing gum test for masticatory performance is a simple method that can evaluate a subject&#039;s masticatory performance in a short period of time. &lt;br&gt;The results of this test show a significant correlation with the number of teeth present or occlusal support area. This study examined the association between masticatory performance using a color-changeable chewing gum and the one-leg standing time with eyes open in community-dwelling elderly women. &lt;br&gt;The subjects were 138 women aged between 65 and 74 years who participated in the surveys conducted in 2009 and 2010, and consented t

DOI： 10.5834/jdh.62.3_289

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DOI： 10.5834/jdh.62.5_445

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Other Link： http://search.jamas.or.jp/link/ui/2013097159

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

doi: 10.1111/j.1741-2358.2010.00367.x ? Relationship between root caries and cardiac dysrythmia

DOI： 10.1111/j.1741-2358.2010.00367.x

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doi: 10.1111/j.1741-2358.2010.00367.x ? Relationship between root caries and cardiac dysrythmia

DOI： 10.1111/j.1741-2358.2010.00367.x

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Objective: Evidence from physiological and clinical studies regarding the mechanism by which calcium and magnesium are associated with periodontal disease, adjusted for smoking habits, is lacking. This longitudinal study evaluated the association of serum calcium levels and the calcium/magnesium (Ca/Mg) ratio with periodontal disease progression among smokers and non-smokers.
Material and Methods: A total of 309 subjects aged 73 years were included. Followup surveys were carried out every year for 6 years. After dividing subjects into smokers and non-smokers, multiple logistic regression analysis for men was performed to evaluate the relationship between the serum Ca/Mg ratio and periodontal disease progression. We used the 25th percentile of periodontal disease events for 6 years as the dependent variable and seven other variables, including quartiles for serum Ca/Mg ratios, as independent variables.
Results: There was a clear dose-response relationship of Ca/Mg ratio quartiles for periodontal disease events among smokers. Significant differences in odds ratios in the first and second quartiles were seen compared with the fourth quartile (reference): 6.28 (p = 0.014) and 5.96 (p = 0.022), respectively. However, there was no significant dose-response relationship among non-smokers.
Conclusion: A low serum Ca/Mg ratio was significantly associated with periodontal disease progression in Japanese elderly smokers.

DOI： 10.1111/j.1600-051X.2011.01769.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objective: Evidence from physiological and clinical studies regarding the mechanism by which calcium and magnesium are associated with periodontal disease, adjusted for smoking habits, is lacking. This longitudinal study evaluated the association of serum calcium levels and the calcium/magnesium (Ca/Mg) ratio with periodontal disease progression among smokers and non-smokers.
Material and Methods: A total of 309 subjects aged 73 years were included. Followup surveys were carried out every year for 6 years. After dividing subjects into smokers and non-smokers, multiple logistic regression analysis for men was performed to evaluate the relationship between the serum Ca/Mg ratio and periodontal disease progression. We used the 25th percentile of periodontal disease events for 6 years as the dependent variable and seven other variables, including quartiles for serum Ca/Mg ratios, as independent variables.
Results: There was a clear dose-response relationship of Ca/Mg ratio quartiles for periodontal disease events among smokers. Significant differences in odds ratios in the first and second quartiles were seen compared with the fourth quartile (reference): 6.28 (p = 0.014) and 5.96 (p = 0.022), respectively. However, there was no significant dose-response relationship among non-smokers.
Conclusion: A low serum Ca/Mg ratio was significantly associated with periodontal disease progression in Japanese elderly smokers.

DOI： 10.1111/j.1600-051X.2011.01769.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Objective: The effect of physical activity on musculoskeletal health in older adults is not completely understood. The aim of this study was to determine the relationship between physical activity and 5-year changes in physical performance tests and bone mineral density (BMD) in postmenopausal women.
Study design: The design was a 5-year cohort study.
Main outcome measures: Subjects were 507 women (55-74 years old) living in a rural community in Japan. Physical activity assessed included housework, farm work, and moderate leisure-time physical activity within the previous week. Measurements at baseline included handgrip strength, walking time (timed "Up & Go" test) and BMD of the femoral neck and vertebrae. Five-year changes in these measures (outcome variables) were compared among groups with different levels of physical activity by analysis of covariance.
Results: Women who did not do housework performed worse in changes in handgrip strength (difference = 2.22 kg, P = 0.0201) and worse in changes in the walking time (difference = 0.54 s, P = 0.0072) than those who did housework alone. Women who spent at least 9 h per week (median = 24) doing farm work performed better in changes in handgrip strength (difference = 0.28 kg, P= 0.0334), but worse in changes in the walking time (difference = 0.66 s, P&lt;0.0001) than those who did not do farm work. However, leisure-time activity was not associated with changes in any outcome variable, and none of the physical activities predicted BMD changes.
Conclusions: Engaging in housework and farm work are determinants of physical function in postmenopausal women, which may help them maintain independence in daily living. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.maturitas.2011.06.014

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Objective: The effect of physical activity on musculoskeletal health in older adults is not completely understood. The aim of this study was to determine the relationship between physical activity and 5-year changes in physical performance tests and bone mineral density (BMD) in postmenopausal women.
Study design: The design was a 5-year cohort study.
Main outcome measures: Subjects were 507 women (55-74 years old) living in a rural community in Japan. Physical activity assessed included housework, farm work, and moderate leisure-time physical activity within the previous week. Measurements at baseline included handgrip strength, walking time (timed "Up & Go" test) and BMD of the femoral neck and vertebrae. Five-year changes in these measures (outcome variables) were compared among groups with different levels of physical activity by analysis of covariance.
Results: Women who did not do housework performed worse in changes in handgrip strength (difference = 2.22 kg, P = 0.0201) and worse in changes in the walking time (difference = 0.54 s, P = 0.0072) than those who did housework alone. Women who spent at least 9 h per week (median = 24) doing farm work performed better in changes in handgrip strength (difference = 0.28 kg, P= 0.0334), but worse in changes in the walking time (difference = 0.66 s, P&lt;0.0001) than those who did not do farm work. However, leisure-time activity was not associated with changes in any outcome variable, and none of the physical activities predicted BMD changes.
Conclusions: Engaging in housework and farm work are determinants of physical function in postmenopausal women, which may help them maintain independence in daily living. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.maturitas.2011.06.014

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Background and Objective: We hypothesized that renal function is associated with the relationship between periodontal disease and bone metabolism. The present study evaluated the relationship of bone formation and resorption markers to periodontal disease, taking renal function into consideration, in elderly Japanese subjects.
Material and Methods: We selected 148 subjects aged 77 years. The periodontal examination included the assessment of clinical attachment level (CAL). We measured two bone formation markers (serum bone-specific alkaline phosphatase and serum osteocalcin) and two bone resorption markers (urinary deoxypyridinoline and urinary cross-linked N-telopeptide of type I collagen). Creatinine clearance per 24 h, as a measure of renal function, was also determined. The correlations between mean CAL or percentage of sites with &gt;= 6 mm CAL (6+ mm CAL) and bone turnover markers, and between bone turnover markers and creatinine clearance levels, were performed by multiple linear regression analysis.
Results: There were significant negative relationships between mean CAL or 6+ mm CAL and serum osteocalcin levels adjusted for gender, smoking habits and oral care habits (beta - -0.25, p - 0.014 and beta - -0.35, p - 0.001, respectively). In addition, there was a negative relationship between serum osteocalcin and creatinine clearance levels adjusted for gender and smoking habits (beta = -0.45, p &lt; 0.0001).
Conclusion: Results from the present study suggest that serum osteocalcin was significantly associated with renal function and periodontal disease. The low systemic bone metabolism, which might be caused by low renal function, is associated with periodontal disease.

DOI： 10.1111/j.1600-0765.2011.01365.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

The longitudinal relationship between dietary n-6 to n-3 PUFAs ratio and periodontal disease in 235 Japanese subjects for whom data were available for the years 2003-2006 was investigated. PUFAs intake was assessed at baseline with a brief-type self-administered diet history questionnaire. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and once a year for 3 years. The number of teeth with a change in the loss of CAL &gt;= 3 mm at any site over a year was calculated as 'periodontal disease events'. Poisson regression analysis was conducted, with dietary n-6 to n-3 PUFAs ratio as the main predictor, to estimate its influence on periodontal disease events. A high dietary n-6 to n-3 PUFAs ratio was significantly associated with greater number of periodontal disease events. The findings suggest the dietary n-6 to n-3 PUFAs ratio is associated with periodontal disease among older Japanese. (C) 2011 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.plefa.2011.04.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

The longitudinal relationship between dietary n-6 to n-3 PUFAs ratio and periodontal disease in 235 Japanese subjects for whom data were available for the years 2003-2006 was investigated. PUFAs intake was assessed at baseline with a brief-type self-administered diet history questionnaire. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and once a year for 3 years. The number of teeth with a change in the loss of CAL &gt;= 3 mm at any site over a year was calculated as 'periodontal disease events'. Poisson regression analysis was conducted, with dietary n-6 to n-3 PUFAs ratio as the main predictor, to estimate its influence on periodontal disease events. A high dietary n-6 to n-3 PUFAs ratio was significantly associated with greater number of periodontal disease events. The findings suggest the dietary n-6 to n-3 PUFAs ratio is associated with periodontal disease among older Japanese. (C) 2011 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.plefa.2011.04.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE PUBLICATIONS INC  

Saturated fatty acids (SFAs) produce an inflammatory response. Hyperinflammation is now recognized as one of the key underlying etiologic factors in periodontal disease. The longitudinal relationship between dietary SFAs and periodontal disease in 264 Japanese individuals, aged 75 years, for whom data were available for the years 2003-2004, was investigated. SFA intake was assessed with a brief self-administered diet history questionnaire. Participants were classified by quartiles of SFA intake. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and follow-up examinations. The number of teeth with a loss of CAL &gt;= 3 mm at any site over a year was calculated as &apos;periodontal disease events&apos;. Poisson regression analysis was conducted, with dietary SFAs as the primary predictor of interest, to estimate their influence on periodontal disease events. High dietary SFA intake was significantly associated with a greater number of periodontal disease events among nonsmokers. The multivariate adjusted relative risk (95% confidence intervals) in the 1st, 2nd, 3rd, and 4th quartiles of dietary SFAs was 1.00, 1.19 (0.72-1.97), 1.55 (0.95-2.52), and 1.92 (1.19-3.11), respectively. These findings suggest an independent association of dietary SFA intake to the progression of periodontal disease in older Japanese non-smokers.

DOI： 10.1177/0022034511405384

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：F D I WORLD DENTAL PRESS LTD  

Objective: The purpose of this study was to evaluate the relationship between bone fragility of the mandibular inferior cortex and tooth loss in older adults by accounting for periodontal disease and bone metabolism markers. Research Design: A total of 177 subjects aged 77 years participated in this study. We counted the number of remaining teeth. The mandibular cortex condition was examined using the mandibular inferior cortex classification (MICC) on dental panoramic radiographs. The mandibular inferior cortex was detected on both sides of the mandible, distally from the mental foramen (C1, normal; C2, mild/moderate erosion; C3, severe erosion). Multiple linear regression analysis was performed to assess the relationship between the mandibular cortex condition with the MICC and the number of remaining teeth after controlling for confounding factors such as gender, the percentage of sites with &gt;= 4 mm clinical attachment levels, and serum osteocalcin levels. Results: The mean +/- SD number of remaining teeth of MICC C1, C2 and C3 were 20.7+/-7.5, 14.6+/-8.1 and 4.0+/-0.0 for males, and MICC C1, C2, and C3 were 21.7+/-7.6, 17.2+/-8.0, and 16.2+/-10.4 for females. The MICC was significantly associated with the number of remaining teeth using multiple linear regression analysis (beta= -0.21, p=0.031). Conclusion: This study suggests that there is a relationship between bone fragility of the mandibular inferior cortex and tooth loss related to periodontal disease.

DOI： 10.1922/CDH_2532Yoshihara05

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objective:
To investigate medications that are related to volume of saliva in the elderly.
Background data:
In the elderly, many cases of mouth dryness may represent side effects of medication.
Materials and methods:
The volume of unstimulated saliva was measured for 30 s (cotton roll test), and with stimulation for 3 min (gum test) in 368 subjects 79-80 years old (177 men, 191 women). Medications were investigated using subject&apos;s medication notebooks.
Results:
Mean volumes of unstimulated and stimulated saliva were 0.14 +/- 0.13 and 4.30 +/- 2.54 ml respectively. Significant differences were seen between gender and mean volume of saliva. The volume of unstimulated saliva was 0.16 +/- 0.15 ml for men and 0.11 +/- 0.10 ml for women. The volume of stimulated saliva was 4.99 +/- 2.67 ml for men and 3.67 +/- 2.25 ml for women. The percentage of subjects taking medication was 64.7% (238/368). Mean number of medications was 2.08 +/- 2.26, with no significant difference with gender (2.01 +/- 2.37 for men, 2.16 +/- 2.16 for women). In a stepwise multiple regression analysis with volume of saliva as the objective variable and number of drugs by category as explanatory variables, significant explanatory variables in addition to gender and number of medications were blood-coagulating agents, Ca antagonists and peptic ulcer drugs for volume of unstimulated saliva, and diabetes medications and peptic ulcer drugs for volume of stimulated saliva.
Conclusion:
These findings suggest that differences exist between gender in volume of saliva for elderly individuals, and that the volume of saliva is affected by the number and type of medications.

DOI： 10.1111/j.1741-2358.2009.00358.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Objective:
To investigate medications that are related to volume of saliva in the elderly.
Background data:
In the elderly, many cases of mouth dryness may represent side effects of medication.
Materials and methods:
The volume of unstimulated saliva was measured for 30 s (cotton roll test), and with stimulation for 3 min (gum test) in 368 subjects 79-80 years old (177 men, 191 women). Medications were investigated using subject&apos;s medication notebooks.
Results:
Mean volumes of unstimulated and stimulated saliva were 0.14 +/- 0.13 and 4.30 +/- 2.54 ml respectively. Significant differences were seen between gender and mean volume of saliva. The volume of unstimulated saliva was 0.16 +/- 0.15 ml for men and 0.11 +/- 0.10 ml for women. The volume of stimulated saliva was 4.99 +/- 2.67 ml for men and 3.67 +/- 2.25 ml for women. The percentage of subjects taking medication was 64.7% (238/368). Mean number of medications was 2.08 +/- 2.26, with no significant difference with gender (2.01 +/- 2.37 for men, 2.16 +/- 2.16 for women). In a stepwise multiple regression analysis with volume of saliva as the objective variable and number of drugs by category as explanatory variables, significant explanatory variables in addition to gender and number of medications were blood-coagulating agents, Ca antagonists and peptic ulcer drugs for volume of unstimulated saliva, and diabetes medications and peptic ulcer drugs for volume of stimulated saliva.
Conclusion:
These findings suggest that differences exist between gender in volume of saliva for elderly individuals, and that the volume of saliva is affected by the number and type of medications.

DOI： 10.1111/j.1741-2358.2009.00358.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：EDITRICE KURTIS S R L  

Background and aims: The equation for Japanese estimated glomeruiar filtration rate (eGFR) was revised by measuring GFR by inulin clearance. The association of the new eGFR with all-cause mortality and mortality from cardiovascular disease (CVD) was assessed in an elderly Japanese population. Methods: Seventy-year-old subjects, residents of Niigata, Japan, participated. Baseline examinations were carried out in June 1998. The new eGFR measure, 194 x (serum creatinine)(-1.094) x Age(-0.287) x (0.739 if female), was calculated. According to eGFR results, subjects were classified into normal or slightly impaired (&gt;= 60 mL/min/1.73 me), moderately impaired (40-59 mL/min/1.73 m(2)) and severely impaired (&lt;40 mL/min/1.73 m(2)). Participants were under survey for 10 years. Results: The overall survival rate with the Kaplan-Meier method was shorter in subjects with severely impaired eGFR than in those with normal, slightly or moderately impaired eGFR. Similarly, mortality from CVD was higher for individuals with severely impaired eGFR than those with normal or slightly impaired eGFR. There were no associations of mortality from cancer or pneumonia with eGFR. The hazard ratio by the Cox proportional regression model for total mortality was 3.9 times higher in the severely impaired group than in normal or slightly impaired groups, with adjustment for confounding factors. Mortality from CVD was 13.6 times higher in the former than in the latter, with adjustment. Conclusions: There is an association of the new Japanese eGFR with total mortality and CVD mortality, suggesting that the new equation may be independently predictive of all-cause mortality and mortality from CVD in the general 70-year-old Japanese population. (Aging Clin Exp Res 2011; 23: 223-230) (c) 2011, Editrice Kurtis

DOI： 10.3275/7207

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：EDITRICE KURTIS S R L  

Background and aims: The equation for Japanese estimated glomeruiar filtration rate (eGFR) was revised by measuring GFR by inulin clearance. The association of the new eGFR with all-cause mortality and mortality from cardiovascular disease (CVD) was assessed in an elderly Japanese population. Methods: Seventy-year-old subjects, residents of Niigata, Japan, participated. Baseline examinations were carried out in June 1998. The new eGFR measure, 194 x (serum creatinine)(-1.094) x Age(-0.287) x (0.739 if female), was calculated. According to eGFR results, subjects were classified into normal or slightly impaired (&gt;= 60 mL/min/1.73 me), moderately impaired (40-59 mL/min/1.73 m(2)) and severely impaired (&lt;40 mL/min/1.73 m(2)). Participants were under survey for 10 years. Results: The overall survival rate with the Kaplan-Meier method was shorter in subjects with severely impaired eGFR than in those with normal, slightly or moderately impaired eGFR. Similarly, mortality from CVD was higher for individuals with severely impaired eGFR than those with normal or slightly impaired eGFR. There were no associations of mortality from cancer or pneumonia with eGFR. The hazard ratio by the Cox proportional regression model for total mortality was 3.9 times higher in the severely impaired group than in normal or slightly impaired groups, with adjustment for confounding factors. Mortality from CVD was 13.6 times higher in the former than in the latter, with adjustment. Conclusions: There is an association of the new Japanese eGFR with total mortality and CVD mortality, suggesting that the new equation may be independently predictive of all-cause mortality and mortality from CVD in the general 70-year-old Japanese population. (Aging Clin Exp Res 2011; 23: 223-230) (c) 2011, Editrice Kurtis

DOI： 10.3275/7207

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

The aim of this study was to clarify the relationship between dental occlusion and physical fitness by a longitudinal survey. A sample of 348 subjects (171 men and 177 women) aged 71 was investigated by Eichner index (EI) as an occlusal condition (Class A: no loss; Class B: partial loss; Class C: complete loss) and five types of physical fitness tests and were re-examined 8 years later. The upper 50% were sampled to analyze the correlation between each physical fitness decline and the EI at the baseline by logistic regression models. Logistic regression analyses revealed that leg extensor power (Class B vs. Class A; odds ratio = OR = 4.61, p = 0.010) and one-leg standing time with eyes open (Class C vs. Class A; OR = 4.27, p = 0.031) showed significant correlations with the EI at the baseline. In this study, partial or complete loss of occlusion was associated with a decline in leg extensor power or a decrease in one-leg standing time with eyes open. These findings suggest that maintenance of dental occlusion may prevent a decrease in activities of daily living in the elderly. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.archger.2010.03.011

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.5834/jdh.61.5_573

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The purpose of this study was to evaluate the long-term caries preventive effects of school-based fluoride mouth rinse (FMR) program in adults aged 20 years and older. 637 mothers aged from 20 to 39 years were surveyed. Clinical examinations were carried out for subjects to obtain data on dental caries prevalence when they visited local health centers to take their children for medical and dental check-ups at 1.5- or 3-years old. We also obtained information regarding the FMR program: the duration that the subjects participated between nursery school and junior high school. When analyzing data, subjects were divided into 4 groups: FMR from nursery to junior high school group (N-JH group, n=22), FMR limited to the elementary school group (El group, n=62), FMR no-experience group (n=545), and other subjects whose FMR experience is not clear (n=8). For evaluation of the FMR program effect, multiple regression analysis was used. As independent variable, the FMR program patterns were converted into dummy data, and mean DMFT was used as dependent variable. The results of multiple regression analysis between mean DMFT and FMR program patterns showed that the N-JH group and El group were negatively associated with the mean DMFT (ß=-0.20, p&lt
0.001 for N-JH group and ß=-0.11, p=0.003 for El group). The positive caries preventive effects of school-based FMR program from nursery school to junior high school can continue in adults aged 20 years and older. © Neko-Uwagawa et al.

DOI： 10.2174/1874210601105010024

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Language：English   Publishing type：Research paper (scientific journal)  

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DOI： 10.5834/jdh.61.5_563

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Objective: Fish oil has anti-inflammatory actions that may benefit periodontal health. We investigated the longitudinal relation between dietary omega-3 fatty acids (FAs), docosahexaenoic acid, (DHA), and eicosapentaenoic acid (EPA) to periodontal disease in community-dwelling elderly.
Methods: Fifty-five participants aged 74 y were randomly selected from a longitudinal interdisciplinary study of aging. Dietary intake data were obtained by a 3-d weighed food intake. The dietary intakes of energy, DHA, and EPA were calculated based on the Standard Food Composition Tables in Japan. Dental examinations were carried out at baseline and once a year for 5 y. The number of teeth with periodontal progression over 5 y per person was calculated as "periodontal disease events." Negative binomial regression analysis was conducted, which included DHA, EPA, and other covariates as independent variables to estimate the influence on periodontal disease events. Longitudinal data were analyzed for participants for whom data were available for 5 y (n = 36).
Results: Low DHA intake was significantly associated with more periodontal disease events. The mean number of periodontal disease events for participants who consumed the lowest tertile of DHA was approximately 1.5 times larger (lowest tertile, incidence rate ratio 1.49, 95% confidence interval 1.01-2.21) than the reference group (highest tertile of DHA consumption), after simultaneously adjusting for possible confounders.
Conclusion: The findings suggest there may be an inverse, independent relation of dietary DHA intake to the progression of periodontal disease in older people. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.nut.2009.09.010

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TEKNOSCIENZE PUBL  

Objective: we investigated the longitudinal relation of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to periodontal disease. Methods: dietary intake data were obtained by a 3-day weighed food intake. Dental examinations were carried out at baseline and once a year for 5 years in 36 participants. The number of teeth with periodontal progression per person was calculated as "periodontal disease events". Results: negative binomial regression analysis revealed that the mean number of periodontal disease events for participants who consumed the lowest tertile of DHA was approximately 1.5 times larger than the reference group (highest tertile), after simultaneously adjusting for possible confounders. Conclusion: within the limitations of the reported study, an inverse, independent relationship between dietary DHA intake and the progression of periodontal disease was found. Further studies are necessary to confirm these findings.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Objective: Fish oil has anti-inflammatory actions that may benefit periodontal health. We investigated the longitudinal relation between dietary omega-3 fatty acids (FAs), docosahexaenoic acid, (DHA), and eicosapentaenoic acid (EPA) to periodontal disease in community-dwelling elderly.
Methods: Fifty-five participants aged 74 y were randomly selected from a longitudinal interdisciplinary study of aging. Dietary intake data were obtained by a 3-d weighed food intake. The dietary intakes of energy, DHA, and EPA were calculated based on the Standard Food Composition Tables in Japan. Dental examinations were carried out at baseline and once a year for 5 y. The number of teeth with periodontal progression over 5 y per person was calculated as "periodontal disease events." Negative binomial regression analysis was conducted, which included DHA, EPA, and other covariates as independent variables to estimate the influence on periodontal disease events. Longitudinal data were analyzed for participants for whom data were available for 5 y (n = 36).
Results: Low DHA intake was significantly associated with more periodontal disease events. The mean number of periodontal disease events for participants who consumed the lowest tertile of DHA was approximately 1.5 times larger (lowest tertile, incidence rate ratio 1.49, 95% confidence interval 1.01-2.21) than the reference group (highest tertile of DHA consumption), after simultaneously adjusting for possible confounders.
Conclusion: The findings suggest there may be an inverse, independent relation of dietary DHA intake to the progression of periodontal disease in older people. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.nut.2009.09.010

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本口腔衛生学会  

2003年1月に厚生労働省はフッ化物洗口ガイドラインを都道府県知事宛に通知した。これに先行して「健康日本21」の歯の健康項目の策定と「8020運動推進特別事業」が展開されてきた。これらの施策がその後の都道府県全体における集団フッ化物洗口の普及にどのような影響を及ぼしたかを検討したところ、国の施策実施前後の2000年頃を境に全国の約4分の1にあたる府県で集団フッ化物洗口の増加を認めた。また、1994年から2008年のデータをもとにフッ化物洗口実施率を目的変数としたマルチレベル分析を行ったところ、調査年度間と都道府県間に統計学的に有意な差を認めた。調査年ごとに平均0.48%の実施率の上昇、およびガイドライン実施後はそれに加えて1.31%の実施率の上昇が認められた。よって、フッ化物洗口ガイドラインは集団フッ化物洗口の拡大に有意に影響を及ぼし始めていることが推定された。以上のように、歯の健康づくりに国の各種施策が果たした役割は大きいことが示唆された。(著者抄録)

DOI： 10.5834/jdh.60.5_556

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J00440&link_issn=&doc_id=20101109220001&doc_link_id=%2Fdk1dehea%2F2010%2F006005%2F002%2F0556-0562%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2010%2F006005%2F002%2F0556-0562%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本口腔衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

P&gt;Objective
While most previous epidemiological studies have focused on subject-level risk factors for periodontal destruction, tooth-related factors have not been fully explored. The purpose of this study was to evaluate both tooth-related and subject-related factors affecting periodontal disease progression using a two-level multilevel model.
Material and Methods
A longitudinal survey over a period of 10 years was carried out on 286 community-dwelling elderly subjects aged 70 years at baseline. Clinical attachment level (CAL) was measured at six sites per tooth on all teeth present and periodontal disease progression was defined as CAL &gt;= 3 mm.
Results
Periodontal disease progression was found in 79% of the subjects and most frequently in maxillary molars. Multilevel logistic regressions revealed that subjects wearing removable dentures were significantly at risk for periodontal disease progression. Abutment teeth for removable/fixed dentures were also significantly more likely to suffer periodontal breakdown. Furthermore, the following tooth-related variables were found to be possible risk factors for periodontal disease progression: maxillary and multirooted teeth.
Conclusion
Multirooted teeth and abutments for a fixed denture were possible risk factors for periodontal disease progression.

DOI： 10.1111/j.1600-051X.2010.01565.x

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER LONDON LTD  

This study assessed the relationship between the mandibular inferior cortex (MIC) and bone stiffness in elderly Japanese subjects. Results suggest that MIC classification may be useful for screening patients for the possibility of osteoporosis by measuring bone stiffness with ultrasound bone densitometry.
The prevention of fractures is a priority for patients with osteoporosis. Dental panoramic radiographs are frequently taken for the examination of teeth and jaws in general dental practice worldwide. This study assessed the relationship between the mandibular inferior cortex (MIC) and bone stiffness in elderly Japanese subjects.
This study included 519 healthy subjects (263 men and 256 women) aged 70 years old. We evaluated the relationship between MIC classification and bone stiffness using Scheffe&apos;s multiple comparison test. Multiple linear regression analysis was used to assess the relationship between MIC classification and bone stiffness after controlling for confounding factors.
A significant correlation was found between MIC classification and bone stiffness in men (C1 vs C2: p &lt; 0.05) and women (C1 vs C2: p = NS, C1 vs C3: p &lt; 0.01, C2 vs C3: p &lt; 0.05). MIC classification was significantly associated with bone stiffness on multiple linear regression analysis after controlling for sex, body mass index, regular exercise, and smoking (beta = -0.11, p &lt; 0.01, R (2) = 0.387, p &lt; 0.001).
Our study suggests that MIC classification may be useful for screening patients for the possibility of osteoporosis by measuring bone stiffness with ultrasound bone densitometry.

DOI： 10.1007/s00198-009-0996-9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CLIN LAB PUBL  

Background: In the elderly, the necessity to promote oral health is increasing to improve their quality of life. The prediction of dental caries risk makes it possible to prolong the life span of teeth. To develop a quick diagnosis system for caries risk, two methods, the modified Saliva Check SM (TM) and Saliva Check sIgA, were investigated in elderly patients.
Methods: We developed a caries risk quick assessment system using Saliva Check sIgA that specifically recognizes secretory IgA (sIgA) in saliva against the binding site of the mutans streptococci (MS) to the salivary-coated tooth surface; and combined it with a modified Saliva Check SM (TM) to determine the number of MS. One hundred eighty three patients (80 females, 103 males) who participated in 2005 (average age 77 years) and in 2006 (average age 78 years) were assessed for caries risk using the systems in this cohort study.
Results: Subjects with a positive Saliva Check sIgA showed a significantly lower increment of decayed and filled teeth number (DFT) on the coronal surface; whereas those testing negative had root decay and increased filled teeth numbers (RDFT) at the root surface during the following year. The combination of Saliva Check sIgA and modified Saliva Check SM (TM) showed the subjects with Saliva Check sIgA positive and modified Saliva Check SM (TM) negative had less than half of the increment of DFT than other groups. In the other groups, Saliva Check sIgA negative and modified Saliva Check SM (TM) positive detected &gt;90% of the subjects with an MS level of &gt;5 x 10(5)/mL of saliva in patients that were assessed in 2006. This suggests these subjects may need extensive care.
Conclusions: This new combination system significantly evaluates the caries risk to predict future incidence for dental caries on the coronal surface and may be useful for risk diagnosis of caries during a visit to the dental office. (Clin. Lab. 2010;56:505-512)

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DOI： 10.5834/jdh.60.2_112

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Dental Health  

A brief-type self-administered diet history questionnaire (BDHQ) is a validated method of dietary assessment. This study investigated the relationship between the speed of eating, which is considered an eating behavior, and the estimated nutrient intake using the BDHQ in community-dwelling Japanese aged 80 years old. Three hundred and fifty-four participants (174 males and 180 females) aged 80 years old who participated in both dental examinations and BDHQ assessment conducted in 2008 were included in the analysis. The speed of eating was self-reported by giving a response chosen from five qualitative categories: 'very fast', 'relatively fast', 'medium', 'relatively slowly', and 'very slowly'. The five categories were classified into two categories for statistical analysis, that is, participants who answered 'very fast' and 'relatively fast' were defined as 'eating fast', while those who answered 'medium', 'relatively slowly', and 'very slowly' were defined as 'eating slowly'. The nutrient intake was calculated from the BDHQ using the ad-hoc program developed for nutrient calculation based on BDHQ responses. The estimated nutrient intake was compared between the two groups defined as eating 'fast' or 'slowly'. Furthermore, multivariable linear regression analysis was conducted using the speed of eating, gender, BMI, number of teeth, and masticatory function as independent variables to assess the influence on the estimated nutrient intake. The participants defined as eating 'fast' consumed significantly more zinc, copper, cryptoxanthin, and vitamin C than participants defined as eating 'slowly' (p=0.012, p=0.022, p=0.007, and p=0.049, respectively; Student's t-test). Moreover, the zinc, copper, cryptoxanthin, and vitamin C intakes of participants defined as eating 'fast' remained significantly higher than those of participants defined as eating 'slowly' after simultaneously adjusting for possible confounders (p=0.027, p=0.039, p=0.004, and p=0.043, respectively). The findings of this study suggest that Japanese people aged 80 years old who define themselves as eating fast consume higher levels of nutrients that are included in meat, fish, shellfish, vegetables, and fruits.

DOI： 10.5834/jdh.60.1_30

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Dental Health  

Dental examinations are often conducted in cities, towns, and villages as part of an oral health program for adults. However, in many places, a low percentage of subjects participate in these programs. This study evaluated the effects of a prevention program on periodontal disease focusing on personal education for adults, assessing whether or not the percentage of subjects who use interdental brushes or dental floss daily increase. Seventy-three mothers were surveyed in S city in Niigata Prefecture. Clinical examinations were performed for mothers who visited their local health centers while taking their children for their 1- or 2.5- year medical and dental check-ups. Subjects were divided into 2 groups: test group (n=29, mean age=32.7±5.1) and control group (n=44, mean age=30.2±5.2). For the test group, a chewing function test using chewing gum and a saliva bleeding test employing stimulated saliva as a screening examination, as well as personal education regarding dental care, were conducted by dental hygienists. The instruction was provided to improve the following two items: (1) the use of dental floss or interdental brushes, and (2) regular professional dental check-ups. We used a jaw model, booklets, and dental floss to support the personal instruction. For the control group, a dental examination using a probe and mirror was conducted, and tooth-brushing instructions were provided. Changes in oral health conditions and oral health behavior were evaluated over a 3-month period. The results showed that the rate of subjects who used dental floss or interdental brushes increased from 41.4% (baseline) to 62.1% (3 months) in the test group (20.7% change, P<0.001) compared with 34.1% (baseline) to 47.7% (3 months) in the control group (13.6% change, P<0.001). These results demonstrate that personal instruction with, a screening examination for mothers who bring their children for medical and dental check-ups may improve oral hygiene.

DOI： 10.5834/jdh.60.1_11

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DOI： 10.2174/1874210601004010230

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CLIN LAB PUBL  

Background: In the elderly, the necessity to promote oral health is increasing to improve their quality of life. The prediction of dental caries risk makes it possible to prolong the life span of teeth. To develop a quick diagnosis system for caries risk, two methods, the modified Saliva Check SM (TM) and Saliva Check sIgA, were investigated in elderly patients.
Methods: We developed a caries risk quick assessment system using Saliva Check sIgA that specifically recognizes secretory IgA (sIgA) in saliva against the binding site of the mutans streptococci (MS) to the salivary-coated tooth surface; and combined it with a modified Saliva Check SM (TM) to determine the number of MS. One hundred eighty three patients (80 females, 103 males) who participated in 2005 (average age 77 years) and in 2006 (average age 78 years) were assessed for caries risk using the systems in this cohort study.
Results: Subjects with a positive Saliva Check sIgA showed a significantly lower increment of decayed and filled teeth number (DFT) on the coronal surface; whereas those testing negative had root decay and increased filled teeth numbers (RDFT) at the root surface during the following year. The combination of Saliva Check sIgA and modified Saliva Check SM (TM) showed the subjects with Saliva Check sIgA positive and modified Saliva Check SM (TM) negative had less than half of the increment of DFT than other groups. In the other groups, Saliva Check sIgA negative and modified Saliva Check SM (TM) positive detected &gt;90% of the subjects with an MS level of &gt;5 x 10(5)/mL of saliva in patients that were assessed in 2006. This suggests these subjects may need extensive care.
Conclusions: This new combination system significantly evaluates the caries risk to predict future incidence for dental caries on the coronal surface and may be useful for risk diagnosis of caries during a visit to the dental office. (Clin. Lab. 2010;56:505-512)

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本口腔衛生学会  

高齢者の口腔乾燥感は主に薬剤の副作用によって生じると言われている。高齢者はストレスへの耐性が低いが、神経症症状と口腔乾燥感との関連を検討した報告は少ない。また、服薬および神経症症状と口腔乾燥感に関して、同じ対象者において同時に検討した報告も少ない。よって本研究では、高齢者における口腔乾燥感の自覚頻度を明らかにするとともに、服薬および神経症症状と口腔乾燥感の関連について検討することを目的とした。高齢者398名を対象として、質問紙や面接聞き取り等により口腔乾燥感、服薬状況および神経症症状を調査した。神経症症状の評価には、日本版GHQ30を用いた。口腔乾燥感を有する者は60.4%、神経症症状を有する者は27.6%であった。服薬中の者は72.3%、服薬数の最頻値は2剤であった。口渇高頻度薬剤の服用者は18.7%、服薬数の最頻値は1剤であった。口腔乾燥感を従属変数、性、神経症症状および口渇高頻度薬剤の服用を説明変数としたロジスティック回帰分析を行った結果、神経症症状のある者(オッズ比:2.059、p<0.05)および口渇高頻度薬剤の服用者(オッズ比:2.552、p<0.05)は、そうでない者と比べ統計学的に有意に口腔乾燥感のある者の割合が高かった。以上により、高齢者において神経症症状が、服薬と同様に口腔乾燥感に関連していることが示唆された。(著者抄録)

DOI： 10.5834/jdh.60.5_575

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Oral Health  

Objective: One of the main causes of subjective oral dryness in the elderly is the side effects of medication. In addition, the elderly&#039;s tolerance to stress is low, and stress may induce many symptoms including mouth dryness. Thus, it is necessary to examine their psychological well-being. However, few reports have considered the relationship between subjective oral dryness and psychological well-being. Furthermore, few reports have examined subjective oral dryness, medication use, and psychological well-being simultaneously. The purpose of this study was to investigate the rate of subjective oral dryness and effects of psychological well-being and medication in the elderly. Methods: A questionnaire survey and interview concerning subjective oral dryness, medication use, and psychological symptoms were conducted involving 398 elderly aged 77-78 years old in Japan. The rates of the side effect of subjective oral dryness caused by medication and drug efficacy were investigated using the book &#039;Drugs in Japan&#039;. The Japanese version of a general health questionnaire (GHQ 30), a self-entry type questionnaire, was used to evaluate psychological well-being. The elderly with scores greater

DOI： 10.5834/jdh.60.5_575

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.5834/jdh.60.2_128

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Many studies have examined the preventive effects of oral care provided by dental professionals against aspiration pneumonia in elderly nursing home residents who require care. However, few reports have evaluated routine oral care provided by nurses to inpatients. Therefore, we investigated the correlation between oral care provided to general ward patients and the incidence of fever and the detection of the etiologic agents of hospital-acquired pneumonia in the oral cavity in 69 in-patients, aged 40 years or older, who were admitted to four hospitals in Niigata and required assistance in oral care. The number and details of oral care procedures were recorded. The presence of Staphylococcus aureus, MRSA, and Pseudomonas aeruginosa in the oral cavity were quantified, and fevers of 37.5°C or higher over the previous week were recorded. The subjects were divided into two groups based on oral intake (oral intake and non-oral intake groups), and Fisher's direct probability test was used to compare their results. For the oral intake group, the incidence of fever and the detection rate of S. Aureus were significantly lower for subjects who received oral care three times a day. On the other hand, for the non-oral intake group, the ratio of patients with fevers was significantly lower for those who received oral care using toothbrushes. These findings suggest that, for inpatients who ingest food orally, frequent oral care can prevent fever and opportunistic pathogen colonization in the oral cavity, and that for inpatients who do not ingest food orally, fever can be prevented by mechanical oral care using a toothbrush. © 2010, Japanese Society for Infection Prevention and Control. All rights reserved.

DOI： 10.4058/jsei.25.85

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

Objective: Low Ca intake is common among Japanese women, but its effect Oil bone metabolism has not been fully elucidated. The aim Of the present study was to determine the relationship between Ca intake and serum markers of bone turnover ill postmenopausal Japanese women.
Design: A cross-sectional study.
Setting: A community setting.
Subjects: Subjects were 595 home-dwelling postmenopausal Japanese women. Ca intake was assessed by a validated FFQ, Serum type I collagen cross-linked N-telopeptides (NTX) and osteocalcin Were measured as markers of bone turnover. The relationships between demographic characteristics, lifestyles, serum Ca, vitamin D and intact serum parathyroid hormone and bone turnover were also assessed.
Results: The average age of the subjects was 64.5 (SD 5.8) years and the mean Ca intake was 527 (SD 160) mg/d. Ca intake was significantly associated with serum NTX (P=0.0104); but not with serum osteocalcin. Mean serum NTX concentration in the lowest quartile of Ca intake (&lt;417 mg/d) was significantly higher than in the fourth, referent quartile. Among these Japanese postmenopausal women, very low Ca intake (less than similar to 400 mg/d) was associated with increased bone resorption but not one formation.
Conclusions: Increased bone resorption may be one mechanism by which this Ca-depleted population normalizes bone metabolism and prevents osteoporosis.

DOI： 10.1017/S1368980009005084

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

Objective: Low Ca intake is common among Japanese women, but its effect Oil bone metabolism has not been fully elucidated. The aim Of the present study was to determine the relationship between Ca intake and serum markers of bone turnover ill postmenopausal Japanese women.
Design: A cross-sectional study.
Setting: A community setting.
Subjects: Subjects were 595 home-dwelling postmenopausal Japanese women. Ca intake was assessed by a validated FFQ, Serum type I collagen cross-linked N-telopeptides (NTX) and osteocalcin Were measured as markers of bone turnover. The relationships between demographic characteristics, lifestyles, serum Ca, vitamin D and intact serum parathyroid hormone and bone turnover were also assessed.
Results: The average age of the subjects was 64.5 (SD 5.8) years and the mean Ca intake was 527 (SD 160) mg/d. Ca intake was significantly associated with serum NTX (P=0.0104); but not with serum osteocalcin. Mean serum NTX concentration in the lowest quartile of Ca intake (&lt;417 mg/d) was significantly higher than in the fourth, referent quartile. Among these Japanese postmenopausal women, very low Ca intake (less than similar to 400 mg/d) was associated with increased bone resorption but not one formation.
Conclusions: Increased bone resorption may be one mechanism by which this Ca-depleted population normalizes bone metabolism and prevents osteoporosis.

DOI： 10.1017/S1368980009005084

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本口腔衛生学会  

NPO法人日本むし歯予防フッ素推進会議は、2008年3月現在の全国での集団応用フッ化物(F)洗口実施状況を、(財)8020推進財団、WHO口腔保健協力センターと共同調査した。F洗口実施率は、全国の施設総数の9.0%、児童生徒総数(4歳〜15歳未満)の5.1%と低かった。各施設(保育所、幼稚園、小学校、中学校、特別支援学校等)でF洗口実施人数の約50%を1割程度の自治体が占め、普及に都道府県間の格差を認めた。洗口回数は、保育所、幼稚園で週5回が、小学校、中学校、特別支援学校等で週1回が多かった。使用洗口液F濃度は、年齢が上がるにつれて900ppmFの割合が多いものの、特別支援学校等では450ppmFが多かった。洗口剤は保育所、幼稚園、特別支援学校で市販F洗口製剤が、小学校、中学校でフッ化ナトリウム試薬の使用割合が高かった。経費負担者・団体は、いずれの施設でも行政や教育委員会が最も多かった。「健康日本21の地方計画」にF応用が組み込まれず、F洗口の目標値のない自治体の存在や、実施状況に都道府県間の格差がみられたことから、格差是正に向け、公衆衛生施策としてF洗口を検討すべきである。本調査がF洗口の目標(数値目標)を検討するための基礎データとして利用され、2010〜2012年度に行われる「健康日本21」最終評価で、F洗口の目標や数値目標の設定を採択し、2013年度以降の運動推進に反映されるように提言する。(著者抄録)

DOI： 10.5834/jdh.59.5_586

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：F D I WORLD DENTAL PRESS LTD  

Aims: The evaluation of long-term effects five years after the completion of a school-based caries prevention programme combined with fluoride mouth rinse (FMR) and targeted sealant application (TS). Participants: 46 subjects in the FMR+TS group and 55 subjects in the FMR group, who were 20 -21 years old, were analysed. They had participated in each 11-year programme, underwent a dental examination at the age of 20 years and answered a self-administered questionnaire. Methods: The caries prevalence and mean DMFT were calculated, and differences between the two groups were analysed by the X(2) test and Mann-Whitney test, respectively. Logistic and multiple regression analyses were performed using sex, group, and five questionnaire items as independent variables. Results: The caries prevalence and mean DMFT (SD) was 28.3%, 1.56 (3.00) in the FMR+TS group and 60.0%, 2.20 (2.44) in the FMR group, and the difference was significant respectively. In the logistic regression analysis the odds ratio of the FMR+TS group to the FMR group was 0.28 (p &lt; 0.05). Conclusions: The caries-preventive effects of a school-based combined programme with FMR and TS continued for more than five years after the programme until the age of 20 years.

DOI： 10.1922/IDJ_2233Sakuma07

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Aims: The evaluation of long-term effects five years after the completion of a school-based caries prevention programme combined with fluoride mouth rinse (FMR) and targeted sealant application (TS). Participants: 46 subjects in the FMR+TS group and 55 subjects in the FMR group, who were 20 -21 years old, were analysed. They had participated in each 11-year programme, underwent a dental examination at the age of 20 years and answered a self-administered questionnaire. Methods: The caries prevalence and mean DMFT were calculated, and differences between the two groups were analysed by the X2 test and Mann-Whitney test, respectively. Logistic and multiple regression analyses were performed using sex, group, and five questionnaire items as independent variables. Results: The caries prevalence and mean DMFT (SD) was 28.3%, 1.56 (3.00) in the FMR+TS group and 60.0%, 2.20 (2.44) in the FMR group, and the difference was significant respectively. In the logistic regression analysis the odds ratio of the FMR+TS group to the FMR group was 0.28 (p &lt
0.05). Conclusions: The caries-preventive effects of a school-based combined programme with FMR and TS continued for more than five years after the programme until the age of 20 years. © 2009 FDI/World Dental Press.

DOI： 10.1922/IDJ-2233Sakuma07

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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DOI： 10.1111/j.1741-2358.2008.00244.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

We hypothesise that a difference in nutrition influences dental caries and periodontal disease. There are few previous studies especially longitudinal ones which have evaluated this hypothesis. This study investigated the relationship between nutritional intake, including milk and milk products (MMP), and dental disease, controlling for several confounding factors.A group of 600 subjects aged 70, randomly selected for this study, included approximately the same number of male and female subjects. The number of teeth on which root caries had occurred or where there was a periodontal event over a 6-year period was measured. To determine quantitative food intake at baseline, a semi-quantitative food frequency questionnaire was used during face-to-face interviews by dieticians. The stepwise method of multiple linear regression analysis was used to identify independent predictors of the number of root caries or periodontal disease events during the 6 years. Intake of the six food groups includes (i) fish, shellfish, meat, beans and eggs; (ii) MMP; (iii) dark green and yellow vegetables (DYV); (iv) other vegetables and fruits; (v) cereals, nuts and seeds, sugar and sweeteners, confectioneries (CNSC) and (vi) fats and oils. The alcohol, gender and anthropometric evaluation including measurements of weight and height for the calculation of body mass index, educational level, the number of family members and the number of remaining teeth were used as independent variables.According to stepwise multiple regression analysis, two variables (quantity of MMP, and gender) were negatively associated with the number of root caries events during the 6 years. The standardised coefficients were -0.14 (p = 0.035) and -0.17 (p = 0.007) respectively. In addition, DYV were negatively, and three other variables (CNSC; alcohol; and the number of remaining teeth at baseline) were positively associated with the number of periodontal disease events during the 6 years. The standardised coefficients were -0.16 (p = 0.001), 0.11 (p = 0.042), 0.10 (p = 0.041) and 0.58 (p < 0.001) respectively.Our results suggest that the intake of MMP in this elderly population correlated with root caries events. In addition, intake of vegetables negatively correlated, and intake of 'CNSC' positively correlated with periodontal disease events.

DOI： 10.1111/j.1741-2358.2008.00244.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD PERIODONTOLOGY  

Background: There are common risk factors for periodontal disease and cardiovascular disease in elderly patients. Some studies reported that a low total cholesterol (TC) serum level is associated with a higher level of death in the elderly. The purpose of this study was to investigate the relationship between serum lipids and periodontal disease in non-smoking elderly patients.
Methods: Two hundred thirty-four non-smokers (63 males and 171 females) participated in this study. Multiple regression analysis was performed to evaluate the relationship between serum lipids and periodontitis and between serum lipids and inflammatory factors. The percentage of sites with probing depth (PD) A mm, clinical attachment level (CAL) A mm, and bleeding on probing (BOP) were used as dependent variables. TC, high-density lipoprotein cholesterol (HDL-C), gender, and the number of teeth present were included in the model as independent variables in the first analysis. TC, HDL-C, and low-density lipoprotein cholesterol (LDL-C) were used as dependent variables. Albumin, inorganic phosphorus, calcium, and C-reactive protein were used as independent variables in the second analysis.
Results: According to the results of the multiple linear regression analysis, TC was associated with the percentage of sites with PD A mm (P &lt;0.01; beta = -0. 19), CAL &gt;= 4 mm (P &lt;0.01; beta = -0.20), and BOP (P = 0.03; beta = -0.16). HDL-C and LDL-C have a significant association with inflammatory markers and inorganic phosphorus and calcium, respectively.
Conclusion: Higher TC is associated with a lower prevalence of periodontitis in non-smoking elderly patients. J Periodontol 2009;80:740-748.

DOI： 10.1902/jop.2009.080584

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD PERIODONTOLOGY  

Background: There are common risk factors for periodontal disease and cardiovascular disease in elderly patients. Some studies reported that a low total cholesterol (TC) serum level is associated with a higher level of death in the elderly. The purpose of this study was to investigate the relationship between serum lipids and periodontal disease in non-smoking elderly patients.
Methods: Two hundred thirty-four non-smokers (63 males and 171 females) participated in this study. Multiple regression analysis was performed to evaluate the relationship between serum lipids and periodontitis and between serum lipids and inflammatory factors. The percentage of sites with probing depth (PD) A mm, clinical attachment level (CAL) A mm, and bleeding on probing (BOP) were used as dependent variables. TC, high-density lipoprotein cholesterol (HDL-C), gender, and the number of teeth present were included in the model as independent variables in the first analysis. TC, HDL-C, and low-density lipoprotein cholesterol (LDL-C) were used as dependent variables. Albumin, inorganic phosphorus, calcium, and C-reactive protein were used as independent variables in the second analysis.
Results: According to the results of the multiple linear regression analysis, TC was associated with the percentage of sites with PD A mm (P &lt;0.01; beta = -0. 19), CAL &gt;= 4 mm (P &lt;0.01; beta = -0.20), and BOP (P = 0.03; beta = -0.16). HDL-C and LDL-C have a significant association with inflammatory markers and inorganic phosphorus and calcium, respectively.
Conclusion: Higher TC is associated with a lower prevalence of periodontitis in non-smoking elderly patients. J Periodontol 2009;80:740-748.

DOI： 10.1902/jop.2009.080584

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

The purpose of this study was to evaluate the relation of bone turnover markers such as bone formation and resorption to periodontal disease and jaw bone morphology in elderly Japanese subjects.
We selected 148 subjects for participation in this study. All subjects were aged 77 years. The periodontal examination included the assessment of clinical attachment level (CAL). Biochemical parameters of bone turnover measured included urinary deoxypyridinoline, serum osteocalcin (S-OC), and serum bone-specific alkaline phosphatase. In addition, to evaluate the jawbone, we used the mandibular inferior cortex classification (MIC).
Serum osteocalcin had significantly higher (males: P = 0.038, females: P = 0.041) tendency for MIC Class (ANOVA). Multiple linear regression results showed that the number of remaining teeth and S-OC were negatively associated with the percentage of sites with &gt;= 6 mm CAL (R(2) = 0.322, P &lt; 0.001). Coefficients and betas were -0.71, -0.46 (P &lt; 0.001) and -1.11, -0.28 (P = 0.002), respectively.
In conclusion, this study suggests that there is a significant relation of bone turnover markers to periodontal disease and jaw bone morphology in elderly Japanese subjects.

DOI： 10.1111/j.1601-0825.2008.01511.x

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© 2009 Nova Science Publishers, Inc. Objectives The oral cavity, especially area around teeth, is a hotbed for bacteria, which compose a biofilm that becomes a significant source of continuous subclinical infection. Tumor necrosis factor-α (TNF-α), which is secreted from adipose tissue and developing type 2 diabetes, is also known to be secreted in periodontal inflammation. Moreover, there is a two-way relationship between diabetes and periodontal disease. We hypothesized that the circulating level of TNF-α is associated with the oral health condition, including periodontal disease. The purpose of this study was to assess the relationship between serum levels of TNF-α and the oral health condition in elderly Japanese people. Methods Among 418 Japanese subjects, 76 years old, who attended complete oral and general health examinations held in Niigata, Japan, in 2004, the serum TNF-α levels of 198 subjects were measured by ELISA. Among them, 76 subjects with healthy gingiva (maximum probing depth ≤ 5 mm, at least 10 teeth), 85 subjects with periodontitis (maximum probing depth ≥ 6 mm, at least 10 teeth), and 37 edentulous subjects were selected. Serum levels of TNF-α were compared among the groups using the Kruskal- Wallis test. The proportions of subjects with detectable levels of TNF-α (≥ 0.5 pg/mL) were compared by chi-square test. Results The median serum TNF-α levels in subjects with healthy gingiva, those with periodontitis, and edentulous subjects were 0.64 pg/mL (range 0-16.36), 0.72 pg/mL (range 0-4.53), and 0.00 pg/mL (range 0-1.83), respectively. The frequencies of detectable TNF-α levels were 48/76 (63.2%), 53/85 (62.4%), and 6/37 (16.2%), respectively. There were no significant differences between subjects with and without periodontitis. However, TNF-α levels and the frequency of subjects with detectable levels of TNF-α were significantly lower in edentulous subjects than in other groups (P &lt; 0.001). Conclusion In this study of elderly Japanese, the circulating TNF-α levels were not affected by current periodontal status. However, they were significantly lower in edentulous subjects than in the other two dentate groups, suggesting that the oral cavity in elderly people with teeth could be a source of systemic subclinical inflammation, which may have negative effects on general health.

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Language：Japanese   Publisher：(一社)日本口腔衛生学会  

平成18年度より、地域支援事業の一環として口腔機能向上事業が実施されている。本調査の目的は、口腔機能向上事業が高齢者の口腔の健康維持・増進に与える効果を検討し、今後の事業展開のための指針を得ることである。対象者は65歳以上の高齢者で、基本健康診査を受診し、厚生労働省が示す特定高齢者の選定に用いる基本チェックリストの「半年前に比べて固い物が食べにくくなりましたか」「お茶や汁物等でむせることがありますか」「口の渇きが気になりますか」の3項目すべてに該当する55名である。対象者に対して、口腔衛生指導や集団訓練としての機能的口腔ケアからなる口腔機能向上事業を、4回または6回コースとして3ヵ月間実施した。口腔衛生状態、口腔機能およびQOLについて事業前後の評価を行った。その結果、反復唾液嚥下テスト(RSST)積算時間は、1回目:事前7.5±5.6秒、事後5.6±3.1秒、2回目:事前16.2±9.7秒、事後12.4±6.9秒、3回目:事前25.7±14.7秒、事後19.4±10.9秒と改善がみられ、2回目、3回目について、その差は統計学的に有意であった(p&lt;0.01)。口腔機能についてはその他のすべての項目について、統計学的に有意な改善がみられた。本調査より、新潟市における口腔機能向上事業は、高齢者の摂食・嚥下機能をはじめとした口腔機能の維持・増進に有効であることが認められた。(著者抄録)

DOI： 10.5834/jdh.59.1_26

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11259/jsg.24.48

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.5834/jdh.59.3_198

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：KARGER  

Background: The turning point in the deterioration of physical function seems to occur between the ages of 70 and 80 years. In particular, muscle strength may decline even more in subjects older than 75. A recent study found that the angio-tens in converting enzyme (ACE) genotype also affects physiological left ventricular hypertrophy. A very limited number of papers have examined genetic differences in resistance and endurance forms of a single sporting discipline. Objective: The purpose of this study was to evaluate the relationship between ACE genotype and physical function by controlling the known confounding factors including dental status. Methods: We selected 431 subjects who were aged 76 years and did not require special care for their daily activities. We conducted a medical examination, followed by 5 physical function tests, as follows: (1) maximum hand grip strength, (2) maximal isometric knee extensor strength, (3) maximal stepping rate for 10 s, (4) one-leg standing time with eyes open and (5) 10-meter maximum walking speed. Subjects were genotyped for the ACE intron 16 Alu insertion. In addition, serum concentrations of total cholesterol, total protein, IgA and IgG were measured at a commercial laboratory. The Eichner index was used as an indicator of occlusal condition. Multiple linear regression analysis was performed to evaluate the relationship between the ACE gene insertion/deletion (I/D) polymorphism and physical function considering confounding factors. Results: The ACE gene I/D polymorphism was positively associated with hand grip strength and 10-meter maximum walking speed. Betas of hand grip strength were 0.09 for I/D (p = 0.022) and 0.12 for insertion/insertion (I/I; p = 0.004). Betas of 10-meter walking speed were -0.11 for I/D (p = 0.093) and -0.14 for I/I (p = 0.039). Dental status such as Eichner index class C was significantly associated with one-leg standing time with eyes open (beta -0.11; p = 0.028). Conclusion: This study suggests that there is a significant relationship between ACE genotype and physical function. In particular, subjects with the ACE deletion/deletion genotype were associated with upper extremities. Copyright (C) 2009 S. Karger AG, Basel

DOI： 10.1159/000222429

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11259/jsg.24.48

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Prosthodontic Society  

<B>Purpose:</B> This study aimed to define the relationship between satisfaction of wearing denture and three factors ("easy to chew", "retention in chewing", "absence of pain"), as well as the missing teeth pattern with Miyachi classification, the chewing ability.<br><B>Methods:</B> A total of 256 subjects (born in 1927) living in Niigata city, Japan who had answered a questionnaire survey in 2007 on the relationship between oral health and health status were selected for this study. Satisfaction with dentures and three factors ("easy to chew", "retention in chewing", and "absence of pain") were evaluated with the VAS score. This study also investigated grouping the pattern of missing teeth based on the Miyachi classification. In addition, a questionnaire was conducted to investigate whether the elderly people could chew around 15 different food items or not.<br><B>Result:</B> It was clearly shown that satisfaction with dentures was correlated with the three points of chewing easily, stability, and pain-free among elderly people. However, none of the three points showed a far stronger correlation than the others. The results also showed that there was no relation between the missing teeth pattern classified with the Miyachi classification and satisfaction with dentures. The results of the questionnaire revealed that the number of food items taken by the elderly people was significantly lower in the group not satisfied with dentures than the other groups (Excellent, good, poorly satisfaction group). <br><B>Conclusion:</B> It was confirmed that chewing easily, stability and pain-free enhance satisfaction with dentures. However, satisfaction with dentures was not ascribed to the pattern of missing teeth; accordingly, we consider that we can keep elderly people satisfied by fabricating good dentures and performing appropriate adjustments regardless of difficult patterns of missing teeth.

DOI： 10.2186/ajps.1.361

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Other Link： http://search.jamas.or.jp/link/ui/2010031506

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

To assess the effect of baseline serum calcium on the progression of periodontal disease in non-institutionalized elderly.
Although a few studies have found some evidence of the role played by dietary calcium in periodontal disease process, there is a paucity of information pertinent to longitudinal assessment of serum calcium-periodontal relationships.
Clinical attachment levels of 266 Japanese subjects aged 70 years were recorded at baseline and annually for six consecutive years. Progression of periodontal disease (PPD) was defined as the number of teeth that showed additional attachment loss of &gt;= 3 mm during the 6 years. The number of PPD was calculated for each subject and categorised into four levels, namely, PPD(0), PPD(1), PPD(2) and PPD(3) where the number of teeth with additional attachment loss ranged from 0, 1-10, 11-20 and &gt; 20 respectively. The levels of serum calcium, albumin, random blood sugar, immunoglobulin (IgG, IgA and IgM), gender, smoking habits, education, gingival bleeding and the number of teeth present were obtained at baseline.
Serum calcium, IgA, smoking, gingival bleeding and teeth present were associated with PPD at p &lt;= 0.10 and were included in a multinomial logistic regression analysis. Serum calcium was the only variable that was significantly associated with PPD with relative risks of 100 at PPD(1) and PPD(2), respectively, and 1000 at PPD(3).
Serum calcium may be considered a risk factor for periodontal disease progression in non-institutionalized elderly.

DOI： 10.1111/j.1741-2358.2007.00211.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

To assess the effect of baseline serum calcium on the progression of periodontal disease in non-institutionalized elderly.
Although a few studies have found some evidence of the role played by dietary calcium in periodontal disease process, there is a paucity of information pertinent to longitudinal assessment of serum calcium-periodontal relationships.
Clinical attachment levels of 266 Japanese subjects aged 70 years were recorded at baseline and annually for six consecutive years. Progression of periodontal disease (PPD) was defined as the number of teeth that showed additional attachment loss of &gt;= 3 mm during the 6 years. The number of PPD was calculated for each subject and categorised into four levels, namely, PPD(0), PPD(1), PPD(2) and PPD(3) where the number of teeth with additional attachment loss ranged from 0, 1-10, 11-20 and &gt; 20 respectively. The levels of serum calcium, albumin, random blood sugar, immunoglobulin (IgG, IgA and IgM), gender, smoking habits, education, gingival bleeding and the number of teeth present were obtained at baseline.
Serum calcium, IgA, smoking, gingival bleeding and teeth present were associated with PPD at p &lt;= 0.10 and were included in a multinomial logistic regression analysis. Serum calcium was the only variable that was significantly associated with PPD with relative risks of 100 at PPD(1) and PPD(2), respectively, and 1000 at PPD(3).
Serum calcium may be considered a risk factor for periodontal disease progression in non-institutionalized elderly.

DOI： 10.1111/j.1741-2358.2007.00211.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PERGAMON-ELSEVIER SCIENCE LTD  

Objective: To explore the relationship between the spinability of stimulated whole saliva and periodontal disease progression over 12 months in an elderly population.
Methods: Three hundred and thirty-two subjects aged 76 years at baseline were studied. Attachment loss was calculated on a site-by-site basis, and periodontal disease progression was defined as an attachment loss of &gt;= 3 mm. Stimulated whole saliva was collected and salivary spinability (SS) was measured. A multiple linear regression analysis was performed to assess the relationship between periodontal disease progression and SS after controlling for other covariates. The independent variables were selected from those which had significant relationships with disease progression in the bivariate analyses.
Results: Mean SS was 1.94 +/- 0.42 min in males and 1.88 +/- 0.32 mm in females; this difference was not significant. Simple linear regression analysis showed a significant positive relationship between periodontal disease progression and SS (P = 0.026), whereas there was no significant relationship between periodontal disease progression and salivary flow rate. Multiple regression analysis revealed a significant positive relationship between periodontal disease progression and SS (P = 0.024) after controlling for the number of remaining teeth and baseline periodontal conditions. The model explained 15.5% of the variance in the percentage of sites where the disease had progressed.
Conclusions: These findings suggest that elderly subjects with viscous saliva are prone to periodontal disease progression. (C) 2008 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.archoralbio.2008.05.009

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATL INST INFECTIOUS DISEASES  

Many of the protective immune responses of old people are impaired and this leads to an increased risk of oral bacterial infections. Little is known about the interaction between the systemic immune response on one hand and oral infections and oral diseases on the other. Here, we conducted an epidemiological study of the independent elderly to determine the relationships between activated natural killer (NK) cells and oral bacterial infections: oral diseases such as dental caries and periodontal disease. One hundred independent elderly people aged 77 years old (53 males, 47 females) were examined. Blood samples were drawn, and activated NK cells were evaluated using CD16, CD56, and CD69 monoclonal antibodies with flow cytometry. Bacterial counts for oral streptococci, lactobacillus, and opportunistic pathogens were performed using culture techniques. Oral disease examinations were performed by dentists. A larger percentage of CD69(+)NK cells (CD16(+)CD56(+)) showed significant correlations to the isolation numbers of total streptococci (r = 0.409, P &lt; 0.01), the species numbers of opportunistic pathogens (r = -0.318, P &lt; 0.01), die numbers of decayed teeth (r = -0.223, P &lt; 0.05), and the amount of bridge work (r = 0.219, P &lt; 0.05). A higher proportion of CD69(+)NK cells is associated with the incidence of dental caries and the number of opportunistic pathogens and total streptococci in the oral cavity of the elderly. This suggests that the proportionate number of CD69(+)NK cells may be a useful indicator for oral infection in elderly subjects.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Background and Objective: Diabetes and periodontitis are associated with each other. Adipokines, specifically adiponectin and resistin, are secreted from adipocytes and are thought to cause insulin resistance in rodents. Additionally, adiponectin and resistin may play a role in inflammation and immune responses. The aim of this study was to clarify the relationship between serum levels of adipokines and periodontal conditions in elderly Japanese people with and without periodontitis.
Material and Methods: A total of 158 Japanese men and women (76 years old) with or without periodontitis were selected for the study. Serum adiponectin, resistin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) concentrations were compared between subjects with and without periodontitis.
Results: Serum resistin levels and total leukocyte counts in subjects with periodontitis were higher than in control subjects. No significant differences were observed in adiponectin, IL-6 and TNF-alpha levels between subjects with and without periodontitis. Logistic regression analysis showed that periodontitis with at least one tooth that displayed a probing pocket depth of &gt;= 6 mm was significantly associated with higher serum resistin levels (odds ratio, 2.0; 95% confidence interval, 1.0-4.0). When excluding periodontitis subjects with &lt;= 10% of bleeding on probing and excluding control subjects with &gt; 10% bleeding on probing, differences between groups and odds ratio increased. Serum adiponectin tended to decrease in patients with periodontitis, albeit not significantly.
Conclusion: Increased serum resistin levels were significantly associated with periodontal condition, especially when considering bleeding on probing, in elderly Japanese people. There was also a trend, though non-significant, toward decreased levels of adiponectin in subjects with periodontitis.

DOI： 10.1111/j.1600-0765.2008.01085.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER LONDON LTD  

The purpose of this study was to investigate whether a link exists between the jawbone and general bone metabolism. The results of our study indicate that a mandibular inferior cortical erosion finding on dental panoramic radiographs is significantly associated with increased biochemical markers of bone turnover. Introduction The purpose of this study was to investigate whether a link exists between the jawbone and general bone metabolism.
Methods We measured values of serum bone-specific alkaline phosphatase (S-BAP) and urinary N-telopeptide cross-links of type I collagen (U-NTX). To evaluate the jawbone, we used mandibular inferior cortex (MIC) classification on dental panoramic radiographs. After 134 subjects were divided into three groups (C1: normal cortex, C2: mildly to moderately eroded cortex, C3: severely eroded cortex), we evaluated the relationship between S-BAP or U-NTX and MIC classification by Scheffe's multiple comparison test.
Results A significant correlation was found between MIC classification and S-BAP (C1 vs. C2: p &lt; 0.01, C1 vs. C3: p &lt; 0.01, C2 vs. C3: NS). A significant correlation was found between MIC classification and U-NTX (C1 vs. C2: p &lt; 0.01, C1 vs. C3: p &lt; 0.001, C2 vs. C3: p &lt; 0.01).
Conclusions The results of our study indicate that the mandibular inferior cortical erosion finding on dental panoramic radiographs is significantly associated with increased S-BAP and U-NTX levels. We suggest that there is an association between the jawbone and general bone metabolism.

DOI： 10.1007/s00198-007-0526-6

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL PUBLISHING  

Aim: The purpose of this study was to evaluate the relationship between periodontal disease and the general health status in community-dwelling elderly using the serum albumin concentration as a criterion index of the severity of underlying disease and nutrition.
Material and Methods: Six hundred subjects aged 70 years underwent a baseline examination. Dental examinations were carried out at baseline and once a year for 4 years. Periodontal conditions were estimated for subjects with at least one remaining tooth. Clinical attachment levels at six sites of all teeth present were measured. A change in loss of attachment of 3 mm or greater in 1 year at each site was defined as periodontal disease progression. Data were analysed in subjects for whom data were available for 4 years.
Results: Serum albumin concentration at baseline ranged from 3.4 to 5.0 g/dl with a mean of 4.3 +/- 0.2. When the analysis was stratified by smoking status, we found that serum albumin concentration had a significant effect on periodontal disease progression among non-smokers (standardized regression coefficient=-0.16; p=0.017), using multiple regression analysis.
Conclusions: The findings of the present study suggest that serum albumin concentration is a significant risk predictor of periodontal disease progression among elderly non-smokers.

DOI： 10.1111/j.1600-051X.2008.01215.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL PUBLISHING  

Aim: The purpose of this study was to evaluate the relationship between periodontal disease and the general health status in community-dwelling elderly using the serum albumin concentration as a criterion index of the severity of underlying disease and nutrition.
Material and Methods: Six hundred subjects aged 70 years underwent a baseline examination. Dental examinations were carried out at baseline and once a year for 4 years. Periodontal conditions were estimated for subjects with at least one remaining tooth. Clinical attachment levels at six sites of all teeth present were measured. A change in loss of attachment of 3 mm or greater in 1 year at each site was defined as periodontal disease progression. Data were analysed in subjects for whom data were available for 4 years.
Results: Serum albumin concentration at baseline ranged from 3.4 to 5.0 g/dl with a mean of 4.3 +/- 0.2. When the analysis was stratified by smoking status, we found that serum albumin concentration had a significant effect on periodontal disease progression among non-smokers (standardized regression coefficient=-0.16; p=0.017), using multiple regression analysis.
Conclusions: The findings of the present study suggest that serum albumin concentration is a significant risk predictor of periodontal disease progression among elderly non-smokers.

DOI： 10.1111/j.1600-051X.2008.01215.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Little has been understood about vitamin D status in relation to bone health in Asian women. The purpose of this study was to identify how the serum 25-hydroxyvitamin D (25[OH]D) concentration is associated with bone mass and bone metabolism. This cross-sectional, community-based epidemiologic study was conducted among 600 ambulatory postmenopausal women. The serum 25(OH)D concentration was measured with radioimmunoassay. Other blood biochemical measurements were intact parathyroid hormone and markers of bone turnover, including osteocalcin and type I collagen cross-linked N-telopeptides. Bone mineral density (BMD) of the lumbar spine and right femoral neck were measured with the dual-energy X-ray absorptiometry method using a QDR4500a. The mean serum 25(OH)D concentration was 55.6 nmol/L (SD 14.6). Serum 25(OH)D concentration was linearly associated with BMD of the femoral neck (R-2=0.020, P=0.003), but not with BMD of the lumbar spine. Odds ratios (ORs) for low BMD (defined as t score &lt;= -2.5 SD) were calculated for strata defined by 25(OH)D concentration. The prevalence of low BMD of the lumbar spine was significantly higher in the 40- to 50-nmol/L 25(OH)D group (adjusted OR=3.0, 95% CI: 1.3-7.0) compared to the reference group (&gt;= 70 nmol/L). Prevalence of low BMD for the femoral neck was significantly higher in the 30- to 40-nmol/L (adjusted OR=3.6, 95% CI: 1.1-12.1) and the 40- to 50-nmol/L (adjusted OR=7.6, 95% CI: 2.5-23.2) groups compared to the reference group (&gt;= 70 nmol/L). The mean serum concentration of intact PTH was significantly higher in subjects with serum 25(OH)D &lt; 50 nmol/L compared to those with serum 25(OH)D &gt;= 50 nmol/L. The present study suggests that higher serum 25(OH)D concentrations are associated with increased BMD of the femoral neck, and that a serum 25(OH)D concentration of at least 70 nmol/L is needed to obtain high BMD of the femoral neck, and that of at least 50 nmol/L is needed to achieve normal PTH levels and prevent low BMD in home-dwelling postmenopausal Japanese women. (c) 2007 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bone.2007.09.056