Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

A cross-sectional study was conducted among 3- to 5-year-old preschool children in Yangon City in 2016-2017 to investigate the association between their caries experience and maternal factors. Children’s oral examination and questionnaire surveys to their mothers were conducted. Children’s caries prevalence was 82.9% with mean dmft of 6.4 ± 4.9. Mean oral health knowledge score of their mothers was 8.5 ± 2.8. Mother’s educational level and oral health knowledge were significant predictors of childhood caries. Third- or later-born children were twice more likely to have dental caries than first-born children ( P = .022). Mother’s regular dental check-up resulted in significantly lower odds ratios for caries development in her child. Children’s caries experience was high and mother’s oral health knowledge regarding the importance of primary teeth was unsatisfactory. It is, therefore, necessary to improve awareness and attentiveness for prevention of childhood caries among parents and guardians in Myanmar.

DOI： 10.1177/10105395231197900

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Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/10105395231197900

Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/cdoe.12896

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

(1) Background: The aim of this study is to review the benefits of the 8020 Campaign since its inception. (2) Methods: We followed the PRISMA guideline and collected information regarding the 8020 Campaign through online database searches. (3) Results: Twenty-five studies met the inclusion criteria and were eligible for analysis. The main outcomes of the 25 included studies were reviewed. The quality evaluation demonstrated a range of studies showing a credible relationship between masticatory function, number of teeth, salivary secretion, frequent dental check-ups, and general health concerns. Due to the risk of bias, publication bias, and indirectness, 22 studies were considered that only had “fair” quality. (4) Conclusions: The 8020 Foundation funded several of the studies, and other research papers noted the 8020 Campaign in their papers, however there were no clear explanations for any direct relationship between their findings and the 8020 Campaign. As a result, evidence for the direct effectiveness and benefits assessment of the 8020 Campaign positive outcomes were compromised by confounding social and economic variables over the 30-year period. To fully elucidate how improvement in Japan’s oral health was directly related to the 8020 Campaign, a more informed and systematic explanation of the campaign’s structure and activities is required.

DOI： 10.3390/ijerph20031883

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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：Medknow  

Abstract

Periodontal disease is quite common in many developing countries, but no nationally representative data on periodontal disease is available in Myanmar until 2016. A nationwide cross-sectional survey with a stratified two-stage sampling method was conducted among 4668 participants aged 12–74 years. Periodontal assessments and self-administered questionnaire surveys were conducted to assess the periodontal status and risk factors in the Myanmar population using data from the first national oral health survey in 2016–2017. Descriptive statistics and logistic regression analysis were performed to assess the prevalence of periodontitis and its association with potential risk factors. The prevalence of gingivitis was 38.2%, 41.5%, 44.4%, and 43.7% in 12, 15–18, 35–44, and 60–74 year-olds, respectively. The prevalence of periodontitis in the latter three age groups was 2.3%, 16.3%, and 35.2%, respectively. After adjusting for other risk factors, younger participants aged 15–18 years (odds ratio [OR]: 0.1, 95% confidence interval [95% CI]: 0.0–0.2) and aged 35–44 years (OR: 0.4, 95% CI: 0.3–0.5) were less likely to have periodontitis. Moreover, participants educated upto junior high school level (OR: 1.6, 95% CI: 1.1–2.7), primary school and below level (OR: 1.9, 95% CI: 1.2–3.2), everyday smokers (OR: 1.6, 95% CI: 1.3–2.0), and everyday tobacco chewers (OR: 1.5, 95% CI: 1.2–1.8) were associated with increased risk of periodontitis. Periodontal complications were prevalent in Myanmar older adults. Prevention efforts should focus on tobacco control and oral hygiene.

DOI： 10.4103/who-seajph.who-seajph_177_22

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Language：Japanese   Publisher：新潟歯学会  

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Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

The study aimed to investigate the prevalence and associated factors of dental caries on primary teeth and to evaluate the cariogenic bacteria in dental plaque and saliva among Myanmar schoolchildren. A cross-sectional study was undertaken among 264 schoolchildren from three primary schools in the urban area of Yangon city in 2019. Clinical oral examinations, caries risk tests, and questionnaire surveys were conducted. Overall caries prevalence was 84.1% with a mean decayed, missing, filled primary teeth (dmft) count of 5.84 ± 4.57. Children’s caries experience and debris scores were significantly associated with their bacteria score level. Father’s occupation was significantly associated with caries prevalence ( P = .024) and dmft ( P = .021). Father’s occupation, snack types, habit of eating sweet food combinations, drink types, and debris score were five significant predictors of dental caries in our study. Dental caries is currently a public health problem among Myanmar children. Caries experience and oral hygiene status were strongly influenced by cariogenic bacteria.

DOI： 10.1177/10105395221139347

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Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/10105395221139347

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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Authorship：Lead author  

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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  

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

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/ger.12627

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ger.12627

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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

FDI世界歯科連盟が開発したモバイルアプリ(Oral Health Observatory)を用いて、歯科医院通院患者および歯科医師を対象に、口腔衛生に関する認識、生活の質や歯科医院への通院習慣、口腔衛生行動に及ぼす影響、また患者の口腔状態等に関連した内容についてアンケート調査を実施した。その結果、いくつかの生活習慣や口腔衛生習慣と口腔状態との関連が示され、患者-歯科医師間での情報共有ツールとしてのモバイルアプリの有効性が示唆された。(著者抄録)

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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)  

OBJECTIVE: To investigate the potential association between periodontitis and arterial stiffness among the older Japanese population. BACKGROUND: The prevalence of periodontitis is increasing in Japanese older adults. Arterial stiffness increases the risks of cardiovascular events and death, morbidity, and dementia. METHODS: This secondary analysis of data from a cross-sectional study evaluated the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue that was estimated by a full-mouth periodontal examination. Severe periodontitis was defined per the parameters provided by the Centers for Disease Control/American Academy of Periodontology. The Cardio-Ankle Vascular Index (CAVI) was used for measuring the overall stiffness of the artery, and higher CAVI indicated increased arterial stiffness. An ordinal logistic regression model was used to evaluate the association between periodontitis and arterial stiffness. RESULTS: The analysis included 185 Japanese adults [35% men; age, mean (standard deviation) 80.2 (4.4) years]. The average PISA and the prevalence of severe periodontitis were 64.4 mm2 and 27.6%, respectively; 54 (29.2%), 56 (30.3%), and 75 (40.5%) participants were stratified to the CAVI < 9, 9 ≤ CAVI <10, and CAVI ≥ 10 groups, respectively. After adjusting for potential confounders, the odds ratio of the prevalence and severity of arterial stiffness evaluated using CAVI was 1.06 [95% confidence interval (CI) 1.01 to 1.10] for PISA per 10 mm2 and 2.12 (95% CI 1.09 to 4.11) for severe periodontitis. CONCLUSION: Periodontitis was associated with arterial stiffness among Japanese older adults. Further studies are needed to investigate whether arterial stiffness is an intermediate factor in the pathway between periodontitis and systemic diseases, including cardiovascular disease and dementia.

DOI： 10.1111/jre.12835

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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：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本老年医学会  

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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

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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：Japanese   Publisher：(一社)日本口腔衛生学会  

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

Resolution of dysbiosis following treatment for periodontal disease and tobacco dependence has been reported in longitudinal intervention studies. In the present report, we evaluated the biological findings regarding the effect of smoking on the periodontal microbiome. A standardized electronic search was conducted using MEDLINE; overall, 1099 papers were extracted. Studies that addressed the relationship between tobacco and periodontal pathogens were included. Finally, 42 papers were deemed appropriate for the present review. Functional changes in periodontal pathogens exposed to nicotine and cigarette smoke extract support the clinical findings regarding dysbiosis of the subgingival microbiome. Dysbiosis of the periodontal microbiome was presented in smokers regardless of their periodontal condition (healthy, gingivitis, or periodontitis) and remained significant only in smokers even after the resolution of experimentally-induced gingivitis and following reduction of clinical signs of periodontitis with non-surgical periodontal treatment and over 3 months post-therapy. Based on these findings, smoking cessation in periodontitis patients is beneficial for promoting a health-compatible subgingival microbial community. To maximize the benefits of these interventions in dental settings, further studies on periodontal microbiome are needed to elucidate the impact of tobacco intervention on preventing recurrence of periodontal destruction in the susceptible subjects.

DOI： 10.1016/j.jdsr.2019.03.002

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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  

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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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00440&link_issn=&doc_id=20190807110003&doc_link_id=%2Fdk1dehea%2F2019%2F006903%2F003%2F0131-0138%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2019%2F006903%2F003%2F0131-0138%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

BACKGROUND AND OBJECTIVES: Identification of modifiable factors for mild cognitive impairment (MCI) is important since individuals with MCI are at a high risk of dementia and disability. Previous studies have suggested a potential association between periodontitis and cognitive impairment, but the results remain inconclusive. We designed a 5-year longitudinal study to explore the association between MCI and periodontitis and periodontal inflammation in older adults. METHODS: This study included 179 community-dwelling dentate individuals (62 men and 117 women, average age: 80.1 years). A full-mouth periodontal examination at six sites per tooth was performed at baseline. Case definitions provided by the European Workshop in Periodontology Group C (EWP definition) and the Centers for Disease Control/American Academy of Periodontology (CDC/AAP definition) were used to define severe periodontitis. Additionally, the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated using clinical periodontal parameters. Follow-up cognitive examinations for MCI diagnosis were performed by neurologists 1, 2, 3, and 5 years after baseline. Odds ratios (ORs) for MCI according to the presence of periodontitis and periodontal inflammation at baseline were calculated using multilevel mixed-effects logistic regression. RESULTS: At baseline, 56.4% and 27.4% of the participants had severe periodontitis by the EWP and CDC/AAP definitions, respectively. After adjusting for follow-up period and other baseline health characteristics (age, sex, smoking status, educational level, physical activity level, obesity, depression, and diabetes), severe periodontitis by either definition was significantly associated with MCI (for the EWP definition: adjusted OR = 3.58, 95% confidence interval [CI] = 1.45-8.87; for the CDC/AAP definition: adjusted OR = 2.61, 95% CI = 1.08-6.28). Periodontal inflammation assessed by PISA was also significantly associated with a higher OR for MCI (adjusted OR = 1.05, 95% CI = 1.01-1.10, per 10-mm2 increase in PISA). CONCLUSION: Severe periodontitis and periodontal inflammation were associated with incident MCI among older community-dwelling men and women.

DOI： 10.1111/jre.12623

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

BACKGROUND AND OBJECTIVES: Identification of modifiable factors for mild cognitive impairment (MCI) is important since individuals with MCI are at a high risk of dementia and disability. Previous studies have suggested a potential association between periodontitis and cognitive impairment, but the results remain inconclusive. We designed a 5-year longitudinal study to explore the association between MCI and periodontitis and periodontal inflammation in older adults. METHODS: This study included 179 community-dwelling dentate individuals (62 men and 117 women, average age: 80.1 years). A full-mouth periodontal examination at six sites per tooth was performed at baseline. Case definitions provided by the European Workshop in Periodontology Group C (EWP definition) and the Centers for Disease Control/American Academy of Periodontology (CDC/AAP definition) were used to define severe periodontitis. Additionally, the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated using clinical periodontal parameters. Follow-up cognitive examinations for MCI diagnosis were performed by neurologists 1, 2, 3, and 5 years after baseline. Odds ratios (ORs) for MCI according to the presence of periodontitis and periodontal inflammation at baseline were calculated using multilevel mixed-effects logistic regression. RESULTS: At baseline, 56.4% and 27.4% of the participants had severe periodontitis by the EWP and CDC/AAP definitions, respectively. After adjusting for follow-up period and other baseline health characteristics (age, sex, smoking status, educational level, physical activity level, obesity, depression, and diabetes), severe periodontitis by either definition was significantly associated with MCI (for the EWP definition: adjusted OR = 3.58, 95% confidence interval [CI] = 1.45-8.87; for the CDC/AAP definition: adjusted OR = 2.61, 95% CI = 1.08-6.28). Periodontal inflammation assessed by PISA was also significantly associated with a higher OR for MCI (adjusted OR = 1.05, 95% CI = 1.01-1.10, per 10-mm2 increase in PISA). CONCLUSION: Severe periodontitis and periodontal inflammation were associated with incident MCI among older community-dwelling men and women.

DOI： 10.1111/jre.12623

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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：Blackwell Munksgaard  

Early Childhood Caries (ECC) is prevalent around the world, but in particular the disease is growing rapidly in low- and middle-income countries in parallel with changing diet and lifestyles. In many countries, ECC is often left untreated, a condition which leads to pain and adversely affects general health, growth and development, and quality of life of children, their families and their communities. Importantly, ECC is also a global public health burden, medically, socially and economically. In many countries, a substantial number of children require general anaesthesia for the treatment of caries in their primary teeth (usually extractions), and this has considerable cost and social implications. A WHO Global Consultation with oral health experts on “Public Health Intervention against Early Childhood Caries” was held on 26-28 January 2016 in Bangkok (Thailand) to identify public health solutions and to highlight their applicability to low- and middle-income countries. After a 3-day consultation, participants agreed on specific recommendations for further action. National health authorities should develop strategies and implement interventions aimed at preventing and controlling ECC. These should align with existing international initiatives such as the Sixtieth World Health Assembly Resolution WHA 60.17 Oral health: action plan for promotion and integrated disease prevention, WHO Guideline on Sugars and WHO breastfeeding recommendation. ECC prevention and control interventions should be integrated into existing primary healthcare systems. WHO public health principles must be considered when tackling the effect of social determinants in ECC. Initiatives aimed at modifying behaviour should focus on families and communities. The involvement of communities in health promotion, and population-directed and individual fluoride administration for the prevention and control of ECC is essential. Surveillance and research, including cost-effectiveness studies, should be conducted to evaluate interventions aimed at preventing ECC in different population groups.

DOI： 10.1111/cdoe.12362

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

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Language：English   Publisher：Blackwell Munksgaard  

The burden of oral disease is high in populations across the world. This is because of high consumption of free sugars. The WHO Guideline on Sugars Intake for Adults and Children recommended limiting free sugars to no more than 5% energy intake to protect oral health throughout the life-course. The objectives of this paper are to consider the implications of the Guideline for dental health practice and to advocate use of the common risk factor approach when providing dietary advice. As part of a broad range of actions needed to reduce free sugars intake, improved education for dental health professionals and supporting patients to eat less free sugars are key actions for the dental profession. All dental health professionals should have the skills and confidence to provide their patients with healthier eating advice, including how to limit free sugars intake. It is therefore important that dental health professionals receive adequate education in diet and nutrition, and there is a need for dental educational regulating bodies to define the content of the dental curriculum with respect to nutrition. All patients, or their parents or carers, should receive dietary advice to reduce free sugars within the context of a healthy diet for the prevention of all NCDs. Dietary advice should: (i) focus on reducing the amount of free sugars consumed
(ii) be tailored according to the patient's body mass status (eg underweight, overweight, normal weight)
(iii) encourage the consumption of fresh fruits and vegetables, nuts, seeds, and wholegrain starch-rich foods
(iv) discourage the consumption of foods high in saturated fat and salt
and (v) discourage the consumption of all drinks containing free sugars. The dental health professional has an opportunity to support patients to reduce their intake of free sugars—such advice and support will have positive impacts beyond the mouth.

DOI： 10.1111/cdoe.12353

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Quintessence Publishing Co., Ltd  

Purpose: This report intends to review the global burden of oral disease among older people and to examine their oral health needs. The evidence on the inter-relationships between poor oral health conditions of older people, general health and quality of life is highlighted. Finally, WHO strategies to improve oral health of older people are reviewed. Methods: The information relevant to this review was extracted from the WHO Global Oral Health Data Bank, the PubMed database, and the Cochrane Library. Surveys were carried out according to the criteria recommended by the WHO epidemiological manual Oral Health Surveys - Basic Methods. In addition, global data were sought on coverage of oral health care among older people. Finally, WHO policy documents on health care for aged people were gathered through the WHO website. Results: Across the globe, many older people suffer from oral pain or discomfort. Poor oral health during old age is mostly manifest in high caries experience, high prevalence rates of advanced periodontal disease, severe tooth loss, dry mouth, and oral pre-cancer/cancer. In both developing and developed countries, the burden of disease is particularly high among underprivileged and disadvantaged older people. In numerous countries, high proportions of the aged population are not covered by primary oral health care
this is mainly the case in low and middle income countries due to a critical shortage of dentists. Conclusions: In 2015, the WHO published the World Report on Ageing and Health, which outlines a framework for action to foster healthy ageing. The policies are highly relevant to the improvement of oral health. Transformation of oral health systems away from a disease-based curative model and towards disease prevention, as well as the provision of older-person-centred integrated care are required. Moreover, wide-ranging public health action on ageing is urgently needed.

DOI： 10.3290/j.ohpd.a40309

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

フレイルと歯・口腔の健康との関連は疫学的に十分に解明されていない。今回われわれは、地域在住高齢者における現在歯数および義歯の使用状況・主観的評価とフレイルとの関連を明らかにすることを目的とする横断研究を実施した。79歳高齢者344人を解析対象とした。フレイルは、Study of Osteoporotic Fracture Criteria for Frailtyを一部改変したものを用いて定義し、目的変数とした。説明変数には現在歯数および義歯の使用状況・主観的評価を用いた。そして両者の関連を性別、体格、および精神健康状態を共変量とするロジスティック回帰分析を用いて評価した。解析対象者におけるフレイルの頻度は8.4%であった。現在歯数(1本増加ごとの調整済オッズ比[OR]=0.94、95%信頼区間[CI]=0.90-0.99)、現在歯数20本以上有すること(20本未満と比較した調整済OR=0.39、95%CI=0.15-0.97)、義歯不使用(義歯使用者と比較した調整済OR=17.89、95%CI=5.00-64.32)、主観的に義歯不具合の訴えがあること(訴えなしと比較した調整済OR=3.38、95%CI=1.01-11.27)はフレイルと有意に関連していた。本研究結果から、地域在住高齢者において現在歯数および義歯の使用状況・主観的評価はフレイルと有意に関連していることが示された。(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=20180515200001&doc_link_id=%2Fdk1dehea%2F2018%2F006802%2F001%2F0068-0075%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk1dehea%2F2018%2F006802%2F001%2F0068-0075%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：WILEY  

The ageing of populations worldwide is rapidly accelerating. However, the global burden of oral disease remains a critical and often underestimated problem. As ageing progresses globally, oral health maintenance becomes a matter not only of public health, but also of human rights. Therefore, in low- and middle-income countries, policymakers are seeking to realize universal health coverage even as they struggle with severe resource limitations. To achieve and maintain global oral health, we propose an ongoing global monitoring cycle consisting of the following four steps: needs assessment, implementation of appropriate health care systems and provisions, reducing the global burden of oral disease, and working to achieve a healthy ageing society. Rather than a unidirectional information flow from high income to low- and middle-income countries, the proposed system would establish a multidirectional information-sharing cycle that would benefit all countries. To make this possible, however, we must develop a standardized set of core oral health indicators that all countries use, as well as a global repository for gathering, compiling, and sharing the data. This system would allow each country to move forward at its own pace and in locally-appropriate ways, making it more effective and efficient in the long run than the current pattern of setting unrealistic goals that all countries are expected to achieve by a certain point in time.

DOI： 10.1111/idj.12347

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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

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Language：Japanese   Publisher：新潟歯学会  

本研究は、フィリピン国マンダウエ市において学童の公立あるいは私立学校就学という社会的属性による齲蝕有病状況、成長発育、口腔保健状況および食習慣の差異を調べ、さらにそれら相互の関連を検討することを目的とした。公立学校就学(公立群)の6歳児41名、12歳児42名、私立学校就学(私立群)の6歳児47名、12歳児50名を対象とした。6歳児のdf者率、12歳児のDMF者率はいずれも公立群の方が有意に高かったが、私立群も先進国と比較すれば決して良好な齲蝕有病状況とはいえなかった。身長は私立群の方が有意に高く、歯の交換状況も加味すると公立群は成長発育遅延の可能性が示唆された。さらに、公立群は低体重児が多く、対照的に私立群は肥満傾向があった。また、公立群の児童およびその保護者は口腔保健に対する意識や知識量が私立群よりも低く、その差は保護者の方がより大きかった。各項目と齲蝕有病状況との関連は6歳児ではdft、df者率ともに保護者の歯科的な訴えの有無および歯科受療の有無との有意な関連が認められた。12歳児では保護者の学歴と齲蝕有病状況に有意な関連があった。以上より学童の公立あるいは私立学校就学という社会的属性の間に保護者の学歴、教育環境などに関する様々な社会的格差が存在し、これらが要因となって児童の齲蝕有病状況、受療行動および健康意識に影響を及ぼしている可能性が示唆された。(著者抄録)

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

The prevalence of tobacco smoking among adolescents aged 13-15 years old in Madagascar was previously reported to be higher than the average in other African regions. A preventive approach is urgently needed to avoid the initiation of early tobacco smoking. Therefore, the aims of this study were to evaluate the status of tobacco smoking among primary schoolchildren in Madagascar and explore the factors associated with initiation of tobacco smoking in the young. This study was conducted in the Mahajanga region of Madagascar. Three primary schools in this region and children of both genders between the ages of nine to 12 years old were randomly selected and approached to participate in this study. A self-administered questionnaire modified from the Global Youth Tobacco Survey Core Questionnaire 2007 was used to assess the status of tobacco smoking among primary schoolchildren. A total of 150 schoolchildren (14.0%) declared that they had smoked tobacco, with 30% starting to smoke tobacco at the age of seven or younger. The prevalence of tobacco smoking was lower among schoolchildren with non-smoking parents (p &lt; 0.001) or non-smoking close friends (p &lt; 0.001). Furthermore, schoolchildren's antismoking intention (p &lt; 0.001) and their knowledge about the harmfulness of tobacco (p = 0.009) had significant effects on the prevalence of tobacco smoking. The results of this study indicate that tobacco smoking among schoolchildren in Madagascar may be influenced by peers, or parents, as well as smoking intention and knowledge about the harmfulness of tobacco use.

DOI： 10.1093/heapro/daw077

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

Sarcopenia is an age-related loss of muscle mass and muscle strength or physical performance. There are limited data on the association between oral health and sarcopenia. To test the hypothesis that impaired dentition status was associated with sarcopenia, we conducted a cross-sectional study. A total of 272 community-dwelling Japanese adults aged 75years for whom data were available from comprehensive health examinations conducted in 2015 were included in this study. During dental examination, the number of natural teeth and occluding pairs of natural teeth was counted. In denture wearers, the fit of the removable dentures was also evaluated. The criteria proposed by the Asian Working Group for Sarcopenia were used to define sarcopenia. A multivariable logistic regression model was used to evaluate the association between dentition status and the presence of sarcopenia. The prevalence of sarcopenia was 257% (70/272). Compared to individuals with 10 occluding pairs of natural teeth, those with no occluding pairs of natural teeth had significantly higher risk of having sarcopenia (adjusted odds ratio, 337; 95% confidence interval, 107-1061), after adjusting for possible confounders. In addition, compared to individuals with well-fitting dentures, those with ill-fitting dentures had significantly higher risk of having sarcopenia (adjusted odds ratio, 507; 95% confidence interval, 159-1619). Our findings suggest that impaired dentition status is significantly associated with sarcopenia among community-dwelling Japanese adults aged 75years. Future longitudinal studies with larger, more diverse populations are necessary to validate our findings.

DOI： 10.1111/joor.12460

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

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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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publisher：F D I WORLD DENTAL PRESS LTD  

DOI： 10.1922/CDH_Petersen03

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

To determine the clinical effectiveness of a community milk fluoridation programme. Basic research design: Parallel arm 5-year cohort study, with final cross-sectional comparisons between groups. Participants: 3-year-olds in 8 Bulgarian cities/towns entered the cohort study with random samples (n=1,782) recruited at baseline in 2004. After 5 years in 2009 sub-samples (about 30%) of these now aged 8 were randomly selected in intervention sites for follow-up examination (n=454); 276 controls were examined at the age 8 years. For cross-sectional comparisons, in 2004, 284 3-year-olds from control cities were baseline examined for caries, then 276 children at the age 8 years in 2009. Interventions: In six intervention communities: 1,498 examined children received 0.5mg F in 100 or 200ml school milk or yogurt provided each school day; a further 180 received non-fluoridated milk. In two control communities, fluoride was not added to 284 children's school milk. Main outcome measures: Dental caries experience of primary, and permanent teeth. Results: For primary teeth, caries increments were 46% (p&lt;0.001) and 30% (p&lt;0.01) lower in the fluoridated milk groups compared with non-fluoridated milk groups in the intervention and control communities, respectively. For permanent teeth those reductions were 61% and 53% (p&lt;0.001). The cross-sectional comparisons of 8-year-olds showed significant changes in dental caries experience over time; in children consuming fluoridated milk the level of dmfs fell by 43% (2004 and 2009) against 11% in the control group. Among children consuming fluoridated milk the DMFS fell 68% against rising 3% in the controls. Conclusions: Fluoridated milk delivered daily in schools in Bulgaria resulted in substantially lower caries development compared with children in schools receiving milk without added fluoride. The nation-wide experiences from milk fluoridation indicate that such a public health scheme can be effective to the global fight against dental caries of children.

DOI： 10.1922/CDH_3629Petersen05

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

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：F D I WORLD DENTAL PRESS 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 &lt;= 9 teeth and with 10-19 teeth had significantly lower FDSK-11 scores than women with &gt;= 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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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：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

The present study aims to investigate the correlation between SNP genotype patterns and periodontitis severity in Japanese type II diabetic patients. A cross-sectional study in 43 Japanese diabetic patients with periodontitis was performed. Blood samples were drawn for single nucleotide polymorphism (SNP) analyses and periodontal index (probing pocket depth and clinical attachment level) was subsequently recorded. Twelve functional genes with SNPs that had been shown to be associated with diabetes and/or inflammation were genotyped using a nuclease-mediated SNP-specific ligation method. Subjects with two or more sites with clinical attachment level a parts per thousand yen6 mm and who additionally had one or more sites with pocket depth a parts per thousand yen5 mm were classified as having severe periodontitis. Proportions of risk genotypes/non-risk genotypes between severe and non-severe periodontitis were subsequently compared. A high frequency (21/43 participants, 49 %) of adiponectin gene polymorphism (ADIPOQ 45T &gt; G) homozygous risk genotype (TT genotype) was observed in the participants. The frequency of TGF-beta 1 SNP (29C &gt; T) risk genotype (TT genotype) in severe periodontitis (34 %, n = 11) was significantly higher than in non-severe periodontitis (0 %, n = 0) (p = 0.04). Our study suggests that TGF-beta 1 SNPs (29C &gt; T) may be used as one of the risk indicators for severe periodontitis in Japanese diabetic patients.

DOI： 10.1007/s10266-014-0171-4

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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：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：English   Publisher：Elsevier Ltd  

Inadequate training for dental professionals hampers the implementation of tobacco use interventions for the improvement of dental practice and oral and overall health. To improve dental education regarding tobacco use prevention and cessation (DENTUPAC), we examined literature addressing previous efforts and experiences with this goal. The majority of studies, published in the US and Europe, reported that a transition from didactic to clinical education achieved moderate-level interventions. The need for a comprehensive multidisciplinary approach and the low confidence of faculty members in their own ability to effectively teach DENTUPAC are commonly reported barriers to DENTUPAC in clinical settings. Objective structured clinical examinations of standardized patients and motivational interviewing have proven consistently successful in DENTUPAC and are included in faculty development workshops and internet-based training. However, levels of intervention from dentists on quitting smoking reported by their patients were relatively low compared to those from physicians, although most dentists reported that they counsel patients. In addition to previous efforts and experiences in developing and disseminating DENTUPAC, the optimization of DENTUPAC by evaluating education on health behavior interventions may help increase the involvement of dentists in cessation counseling upon graduation.

DOI： 10.1016/j.jdsr.2015.03.003

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DOI： 10.5897/JDOH2014.0142.

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

The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.

DOI： 10.4239/wjd.v5.i6.924

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

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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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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Tobacco use is a modifiable risk factor for oral disease. Dental professionals are able to reduce the burden of oral and overall health by influencing tobacco use.Results of electronic searches for literature indicated progress in tobacco interventions in dentistry. Patients believed that dentists should routinely offer smoking cessation services, and those interested in quitting felt comfortable receiving advice about quitting. Dental professionals were aware of the importance of tobacco interventions. However, tobacco intervention practices were limited or restricted, and dental professionals have not fully embraced opportunities for tobacco intervention. A consistently reported barrier was the lack of training. Although various factors were identified as barriers and facilitators, few study assessed structure for the implementation of tobacco interventions. Tobacco-related education of undergraduate students has been recognized as an important issue. Globally, the majority of dental students recognized themselves as role models in society and believed they should receive training. However, few reported receiving such formal training.Dental researchers and educators around the world should explore new knowledge and exchange experiences to make full use of the unique opportunity of providing dental interventions against tobacco use. © 2012 Japanese Association for Dental Science.

DOI： 10.1016/j.jdsr.2012.11.005

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

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DOI： 10.1111/j.1600-0757.2011.00425.x

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DOI： 10.1111/j.1600-0757.2012.00451.x

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Language：Japanese   Publisher：新潟歯学会  

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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：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：F D I WORLD DENTAL PRESS LTD  

Background: The aim of this report is 1) to provide a global overview of oral health conditions in older people, use of oral health services, and self care practices; 2) to explore what types of oral health services are available to older people, and 3) to identify some major barriers to and opportunities for the establishment of oral health services and health promotion programmes. Methods: A postal questionnaire designed by the World Health Organization (WHO) was distributed worldwide to the Chief Dental Officers or country oral health focal points at ministries of health. WHO received 46 questionnaires from countries (39% response rate). In addition, systematic data were collected from the WHO Global Oral Health Data Bank and the World Health Survey in order to include oral health information on the remaining countries. In total, the data base covers 136 out 193 countries, i.e. 71% of all WHO Member States. Results: Dental caries and periodontal disease comprise a considerable public health problem in the majority of countries. Significant disparities within and between regions are observed in epidemiologic indicators of oral disease. The prevalence rates of tooth loss and experience of oral problems vary substantially by WHO Region and national income. Experience of oral problems among older people is high in low income countries; meanwhile, access to health care is poor, in particular in rural areas. Although tooth brushing is the most popular oral hygiene practice across the world, regular tooth brushing appears less common among older people than the population at large. In particular, this practice is less frequent in low income countries; in contrast, traditional oral self-care is prevalent in several countries of Africa and Asia. While fluoridated toothpaste is widely used in developed countries, it is extremely infrequent in most developing countries. Oral health services are available in developed countries; however, the use of such services is low among the older people. Lack of financial support from government and/or lack of third party payment systems render oral health services unaffordable to them. According to the country reports, health promotion programmes targeting older people are rare and this reflects the lack of oral health policies. Although some countries have introduced oral health promotion initiatives, worldwide there are few population-oriented preventive or curative activities currently implemented that focus specifically on the elderly. Barriers to the organization of such programmes relate to weak national health policy, lack of economic resources, the impact of poor oral health, and lack of tradition in oral health. Opportunities for oral health programmes for old-age people are related to updated information on the burden of oral disease and need for care, fair financing of age-friendly primary health care, integration of oral health into national health programmes, availability of oral health services, and ancillary personnel. Conclusion: It is highly recommended that countries establish oral health programmes to meet the needs of the elderly. Relevant and measurable goals must be defined to direct the selection of suitable interventions to improve their oral health. The common risk factors approach must be applied in public health interventions for disease prevention. The integration of oral health into national general health programmes may be effective to improve the oral health status and quality of life of this population group.

DOI： 10.1922/CDH_2711Petersen11

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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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Matsumoto S, Ogawa H, Soda S, Hirayama S, Amarasena N, Aizawa Y, Miyazaki H. Effect of antimicrobial periodontal treatment and maintenance on serum adiponectin in Type 2 Diabetes Mellitus. J Clin Periodontol 2009; 36: -. doi: 10.1111/j.1600-051X.2008.01359.x.
The aims of this study were to evaluate the effect of mechanical periodontal treatment with local application of minocycline (APT) on serum adiponectin as a marker of insulin resistance improvement in type 2 diabetes mellitus (T2DM) patients and to investigate if effect of APT on serum adiponectin level was sustained by periodontal maintenance (PM).
Twenty-seven T2DM patients were randomly assigned into test or control groups. Test received scaling with ultrasonic devices at baseline and APT biweekly for 2 months while control received scaling at baseline and mechanical tooth cleaning (MPT) at the same interval. At 6 months, all patients received mechanical tooth cleaning as PM. Periodontal examination and blood measurements were performed at baseline, 4 and 9 months.
Adiponectin concentrations in test had significantly increased by 31.4% after APT (p=0.024) and by 30.4% after PM (p=0.002) compared with baseline. The percentage of &gt;= 4 mm probing depths (PD) had shown 8.3% and 9.3% reduction after APT and PM (p=0.046, 0.02) in test while 5.0% reduction after MPT in control group (p=0.031).
Our results suggested that APT and PM not only improve periodontal disease but also increase serum adiponectin in T2DM patients.

DOI： 10.1111/j.1600-051X.2008.01359.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：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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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：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：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

Serum albumin levels are a practical marker of general health status in the elderly and have been used to determine the severity of an underlying disease and the risk for death. This longitudinal study evaluated the relationship between serum albumin levels and root caries. A total of 266 persons with at least 1 tooth at baseline underwent a baseline examination and then annual investigations for 6 years. Multiple linear regression analysis was used to assess the relationship between changes in serum albumin levels and the number of root caries lesions over 6 years, after adjustment for confounding factors. Change in the number of root caries lesions was significantly associated with change in serum albumin concentrations. The standardized coefficient was -0.148 (p = 0.024). We can confirm that serum albumin concentration correlates with root caries events. From these data, we conclude that persons with hypoalbuminemia are at high risk for root caries.

DOI： 10.1177/154405910708601118

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Language：Japanese   Publisher：The Japanese Society for Dental Health  

The present study was carried out to assess the efficiency of the Community Periodontal Index (CPI) and Loss of Attachment (LA) as well as to evaluate periodontal disease progression for 5 years in community-dwelling elderly aged 70 years. A total of 313 selected subjects received a full mouth examination at six sites around the teeth for assessing gingival bleeding, dental calculus, periodontal pocketing, and the level of epithelial attachment. All data were modified in CPI and LA classification according to the WHO Oral Health Basic Method, 4th edition. Comparisons were made between full mouth recording and partial 10 index teeth recording to indicate the % of subjects and sextants according to each category of CPI and LA. As a result, 93.7% of subjects were diagnosed as CPI-1 or higher score by partial recording, while 97.4% were diagnosed as such by full mouth recording. The percentage of LA-1 and higher sextants by partial recording was 66.9%, as compared to 78.8% by full mouth recording. Sensitivities of CPI and LA between the two different recordings were also relatively reasonable, with 76.1% for CPI-3 and higher, and 84.9% for LA-1 and higher. The percentage of subjects with PD 6+mm increased up to 51.7%, while that for LA 9+mm was 43.2% for the five years. Our results may suggest that CPI and LA in an original 10 index teeth examination would be useful to promote a better oral health status for elderly people in monitoring periodontal disease progression.

DOI： 10.5834/jdh.57.1_28

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Other Link： http://search.jamas.or.jp/link/ui/2007146356

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

objectives: The purpose of this study was to explore the relationship between flow rate and spirmbarkeit of stimulated whole saliva and periodontal conditions in healthy elderly people.
Methods: Three hundred and fifty-five dentate subjects aged 76 years were included. The pocket probing depth (PD), attachment level (AL), and bleeding on probing (BOP) were measured. Stimulated whole saliva was collected and the salivary flow rate (SFR) was calculated. Then, salivary spirmbarkeit (SS) was immediately measured.
Results: The mean SFR and SS were 1.44 ml/min and 1.91 mm, respectively. SFR was not significantly related to each periodontal parameter. On the other hand, subjects with SS &lt;= 2.00 mm had a significantly lower mean AL (p &lt; 0.05). When subjects were divided into four groups according to a combination of SFR and SS, subjects with SFR &lt; 0.7 ml/min and SS &gt; 2.00 mm exhibited a significantly higher mean PD (p &lt; 0.05), % of sites with PD &gt;= 4 mm (p &lt; 0.05), mean AL (p &lt; 0.01), % of site with AL &gt;= 4 mm (p &lt; 0.05) and % of sites with AL &gt;= 6 mm (p &lt; 0.01) than subjects in the other three groups (one-way ANOVA). In the logistic regression analysis, the factors significantly associated with the highest quintile of PD &gt;= 4 mm were: the low salivary flow and the high salivary spirmbarkeit (OR 3.84), current smokers (OR 5.08), cleaning interdental spaces rarely/never (OR 2.12), and frequent BOP (OR 5.20).
Conclusion: These findings suggest that high salivary spirmbarkeit in addition to a low salivary flow rate might be a high risk for periodontal disease in elderly people. (C) 2006 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jdent.2006.01.001

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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 general health status in community-dwelling elderly using serum albumin concentration as a criterion index of the severity of an underlying disease and nutrition status.
Methods: Serum albumin level was detected by the bromcresol green albumin (BCG) method and the data for serum albumin were available in 368 subjects aged 75 years. Pressure-sensitive probes were used to measure loss of attachment (LA) on six sites of all teeth present. Information relevant to gender and smoking habit was obtained by means of a personal interview, while body mass index (BMI) and biochemical serum markers were investigated.
Results: Serum albumin concentration ranged from 3.2 to 4.8 g/dl with a mean of 4.1 +/- 0.2. More than 70% of subjects had at least one site with LA 6+ mm, while 91 exhibited 10% or more sites with LA 6+ mm. Using a multiple regression analysis, we found that sites of LA 6+ mm had a significant effect on serum albumin level (correlation coefficient=-0.14; p &lt; 0.05), which was independent of the other covariates.
Conclusions: The findings of the present study indicated that there might be an inverse relationship between periodontal disease and serum albumin concentration in these elderly subjects.

DOI： 10.1111/j.1600-051X.2005.00901.x

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Language：English   Publisher：AMER ACAD PERIODONTOLOGY  

Background: The aim of this paper is to provide an overview of the burden of periodontal disease in adult populations worldwide, to emphasize the essential risk factors common to periodontal disease and chronic diseases, to outline important new strategies for effective prevention of periodontal disease, and to inform about the role of the World Health Organization (WHO) in developing a national capacity for the prevention of disease.
Methods: Information about periodontal health status as measured by the Community Periodontal Index system is stored in the WHO Global Oral Health Data Bank. Updated information concerning WHO standard age groups was used to describe the prevalence rates of signs of periodontal disease, i.e., gingival bleeding, periodontal pocketing, and loss of attachment.
Results: Gingival bleeding is highly prevalent among adult populations in all regions of the world; advanced disease with deep periodontal pockets (&gt;= 6 mm) affects similar to 10% to 15% of adults worldwide. The available evidence shows that important risk factors for periodontal disease relate to poor oral hygiene, tobacco use, excessive alcohol consumption, stress, and diabetes mellitus. Integrated preventive strategies based on the common risk factors approach are recommended for public health practice.
Conclusions: The vast majority of countries need to establish a surveillance system for measuring progress in the control of periodontal disease and promotion of oral health. WHO has designed approaches for the integration of oral disease prevention within the prevention of non-communicable chronic diseases, and global strategies are currently being implemented in all regions of the world.

DOI： 10.1902/jop.2005.76.12.2187

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

Objective: The main objective of this study was to determine the relationship between bleeding on probing (BOP) and periodontal disease progression in community-dwelling older adults.
Methods: A 3-year longitudinal study was carried out in 229 non-smoking healthy older adults aged 70 years. Using pressure-controlled periodontal probes, BOP, pocket depth and attachment level at 13,289 sites were measured annually. Periodontal disease progression was defined as an increase in attachment loss of &gt;= 3mm from the baseline to the final examination. The backward stepwise logistic regression analysis was performed to assess the relationship between the total number of sites with BOP in the four examinations and periodontal progression.
Results: Logistic regression analysis showed that the odds ratios of BOP frequency for periodontal disease progression ranged from 1.4 to 6.2 after controlling for pocket depth &gt;= 4mm at baseline, number of missing teeth, jaw type and tooth site.
Conclusion: Increasing frequencies of bleeding might increase the probability of periodontal disease progression in community-dwelling older adults.

DOI： 10.1111/j.1600-051X.2005.00834

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WORLD HEALTH ORGANIZATION  

This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has been designed by WHO and used by countries worldwide for the surveillance of oral disease and health. Global, regional and national oral health databanks have highlighted the changing patterns of oral disease which primarily reflect changing risk profiles and the implementation of oral health programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas-targeted to oral health professionals, policy-makers, health planners, researchers and the general public. WHO has developed global and regional oral health databanks for surveillance, and international projects have designed oral health indicators for use in oral health information systems for assessing the quality of oral health care and surveillance systems. Modern oral health information systems are being developed within the framework of the WHO STEPwise approach to surveillance of noncommunicable, chronic disease, and data stored in the WHO Global InfoBase may allow advanced health systems research. Sound knowledge about progress made in prevention of oral and chronic disease and in health promotion may assist countries to implement effective public health programmes to the benefit of the poor and disadvantaged population groups worldwide.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WORLD HEALTH ORGANIZATION  

This paper outlines the burden of oral diseases worldwide and describes the influence of major sociobehavioural risk factors in oral health. Despite great improvements in the oral health of populations in several countries, global problems still persist. The burden of oral disease is particularly high for the disadvantaged and poor population groups in both developing and developed countries. Oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions and oropharyngeal cancers, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related oral disease and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life. The diversity in oral disease patterns and development trends across countries and regions reflects distinct risk profiles and the establishment of preventive oral health care programmes. The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys.-In addition to poor living conditions, the major risk factors relate to unhealthy lifestyles (i.e. poor diet, nutrition and oral hygiene and use of tobacco and alcohol), and limited availability and accessibility of oral health services. Several oral diseases are linked to noncommunicable chronic diseases primarily because of common risk factors. Moreover, general diseases often have oral manifestations (e.g. diabetes or HIV/AIDS). Worldwide strengthening of public health programmes through the implementation of effective measures for the prevention of oral disease and promotion of oral health is urgently needed. The challenges of improving oral health are particularly great in developing countries.

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Background: Fc gamma RIIIb genotypes and smoking are risk factors for periodontal disease. However, the interaction of Fc gamma RIIIb-NA1-NA2 polymorphism with smoking remains unclear. The purpose of this study was to determine if Fc gamma RIIIb-NA1-NA2 polymorphism and smoking are associated with periodontal disease progression among elderly people.
Methods: Among 70-year-old subjects, 164 with neither diabetes mellitus nor blood sugar &gt;= 140 mg/dl, who had more than 20 teeth and who could participate in both the baseline and the follow-up examinations were included in the study. The NA1 group comprised subjects with Fc gamma RIllb-NA1NA1 genotype (N = 53), while the NA2 group included subjects with Fc gamma RIIIb-NA1NA2 or NA2NA2 genotype (N = 111). We examined the progression of periodontitis by measuring attachment loss during 3 years.
Results: The frequency of subjects who showed &gt;= 4 mm additional attachment loss at one or more sites was 55.6% for smokers and 37.2% for non-smokers. The odds ratio (OR) was 2.13 (confidence interval [CI]: 0.92 to 4.76). We found a better association between periodontal progression and smoking in the NA2 group. The OR for smokers was 3.03 (CI: 1.12 to 8.33, P = 0.028). Additionally, the mean number of sites with &gt;= 4 mm additional attachment loss per person between smokers and non-smokers in the NA2 group or between smokers and non-smokers in the NA1 group was 2.90 +/- 3.42 and 0.74 +/- 1.53 or 0.57 +/- 0.79 and 0.68 +/- 1.03, respectively (P &lt; 0.001; analysis of variance [ANOVA]).
Conclusion: Our results may suggest an association between smoking and periodontal disease progression in elderly people with Fc gamma RIIIb-NA2 polymorphism.

DOI： 10.1902/jop.2005.76.2.250

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

Objective: To determine the relationship between serum vitamin C and periodontitis as estimated by clinical attachment loss (CAL) in community-dwelling elderly Japanese.
Material and Methods: This analysis was confined to 413 Niigata citizens aged 70 years in whom the data for serum vitamin C and CAL were available. High-pressure liquid chromatography method was used to ascertain the serum vitamin C levels while CAL was assessed on six sites of all teeth present including third molars by means of pressure-sensitive probes. Other variables included gender, smoking, toothbrushing frequency, number of teeth present and random blood sugar levels.
Results: Serum vitamin C concentration was inversely related to CAL (r=-0.23, p&lt;0.00005) at bivariate level. Multiple linear regression analysis showed that CAL was 4% greater in subjects with lower serum vitamin C levels than in subjects with higher serum vitamin C levels notwithstanding smoking, diabetes, oral hygiene, gender or number of teeth present.
Conclusion: The findings suggested that serum vitamin C might have relatively weak but a statistically significant relationship with periodontitis in this elderly population.

DOI： 10.1111/j.1600-051X.2004.00643.x

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Language：Japanese   Publisher：The Japanese Society for Dental Health  

The purpose of this study was to investigate the prevalence and intraoral distribution of root caries in the elderly, and to identify the association between root caries and coronal caries. Six hundred noninstitutionalized adults aged 70 years in Niigata, Japan were examined for their oral status and general health status. A total of 544 subjects identified as dentate was available for assessment. The prevalence of root caries was evaluated as the percentage of the subjects with one or more root caries and the mean number of teeth with root caries. The intraoral distribution was evaluated a...

DOI： 10.5834/jdh.53.5_592

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Asia-Pacific Academic Consortium for Public Health  

This study was to determine the dental caries prevalence among the Myanmar population, and to investigate the correlations between oral clinical indices and knowledge, attitudes and practices (KAP) on oral health. Subjects were randomly selected from 140,000 people residing in the Kyauktan township in a cross-sectional community-based study. The present analysis was confined to 739 subjects (353 males and 386 females) aged 12, 35-44 and 65-74 years, who were divided into two specified groups based on urban or rural location. KAP on oral health data and social demographc information were collected, while dental caries status was assessed by DMFT. The mean number of decayed teeth (DT) in rural areas was higher than that in urban areas, while the mean number of filled teeth (FT) in rural areas was lower than that in urban areas. Mean knowledge and attitude scores for correct answers were also significantly higher for the urban than the rural subjects. There were statistically significant correlations between the correct/incorrect responses to knowledge and attitude questionnaires on oral health and the mean number of DMFT. KAP pertaining to oral health of Myanmar population, especially those of rural subjects, might not be satisfactory and related to threaten their dental caries status.

DOI： 10.1177/101053950301500207

Scopus

PubMed

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

The aim of this study was to identify the risk factors for periodontal disease progression by individual characteristics at baseline among elderly people over a 2-year period. Subjects were selected from 4542 people aged 70 years residing in Niigata who were in good general health and who did not require special care for their daily activities. Gender, smoking and alcohol drinking habits were obtained using a questionnaire, while serum levels of disease markers were investigated and attachment levels were clinically recorded. For the assessment of periodontal disease progression, additional attachment loss was used if one or more sites had a 3-mm or more increase in probing attachment level over a 2-year period. In all, 394 subjects (208 males and 186 females) were surveyed. Approximately 75% of subjects exhibited additional attachment loss over a 2-year period. Significant associations were found between additional attachment loss and smoking, and attachment level of 6 mm or more at baseline, with odds ratios of 3.75 and 2.29, respectively. Smoking habit and baseline attachment level of 6 mm or more may be considered risk factors for further attachment loss among healthy elderly people.

DOI： 10.1034/j.1600-051X.2002.290702.x

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Total pages：9, 240p   Language：Japanese

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Total pages：xii, 259p   Language：Japanese

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Total pages：78p   Language：Japanese

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Total pages：ix, 260p   Language：Japanese

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Total pages：viii, 163p   Language：Japanese

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Total pages：vii, 137p   Language：Japanese

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Total pages：xi, 265p   Language：Japanese

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Total pages：xiv, 303p   Language：Japanese

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Total pages：xiv, 135p   Language：Japanese

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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  

わが国の歯科医師・歯科衛生士の国家試験出題基準および教育モデルには、タバコ使用に関する医療面接および使用介入の内容が掲載されている。喫煙率の低下目標の達成に資するために、世界のタバコ使用介入の歯科教育の文献レビューを行った。また、タバコ使用介入の歯科卒前教育への提言を行った。日本のタバコ使用中止介入の教育実態および教育者の意識の把握により、行動目標の基盤となる介入レベルの判断や教育モデルの策定が行われる必要があると思われた。

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)  

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)   Publisher：クインテッセンス出版(株)  

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Language：Japanese   Publisher：(公財)8020推進財団  

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Other Link： http://search.jamas.or.jp/link/ui/2016223480

Language：Japanese   Publisher：(公財)8020推進財団  

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Other Link： http://search.jamas.or.jp/link/ui/2016223479

Language：Japanese   Publisher：医歯薬出版(株)  

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

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Other Link： http://search.jamas.or.jp/link/ui/2015274933

Language：Japanese   Publisher：(公財)8020推進財団  

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Other Link： http://search.jamas.or.jp/link/ui/2015205351

Language：Japanese   Publisher：日本歯科医師会  

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Other Link： http://search.jamas.or.jp/link/ui/2015109095

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

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Language：Japanese   Publisher：日本歯科医学教育学会  

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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：Japanese   Publisher：日本歯科医学教育学会  

J-GLOBAL

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Language：Japanese   Publisher：有限責任中間法人日本口腔衛生学会  

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

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

J-GLOBAL

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Language：Japanese   Publisher：日本歯科医学教育学会  

J-GLOBAL

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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  

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Language：Japanese   Publisher：新潟歯学会  

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Other Link： http://search.jamas.or.jp/link/ui/2004067348

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R  

Web of Science

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Language：Japanese  

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Language：Japanese   Publisher：The Japanese Society for Dental Health  

The purpose of this study was to evaluate sampling bias caused by present teeth or general health condition in an oral health survey of elderly subjects. A mailed questionnaire survey was carried out for residents of Niigata City who were 70 or 80 years old, investigating the number of present teeth, general health condition and intention to participate in an oral examination. Follow-up mailings were sent once to non-respondents. The response rate was increased from 60.4% to 79.5% by the follow-up mailing. A telephone survey was carried out for subjects who didn&#039;t answer the questionnaire. ...

DOI： 10.5834/jdh.50.3_322

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Language：Japanese   Publisher：新潟歯学会  

本学歯学部附属病院の通院・受診しやすい環境づくりを考える上で疾病治療ならびに健康状態の主観的改善,そして医師の技能や説明には高い信頼と評価が得られたものの,事務部門の対人関係を含めた病院を取り巻く諸設備には患者サービスの視点から改善すべき点がある

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Language：Japanese   Publisher：Niigata University  

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

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Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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