Jin-Bom Kim

The Association of Smoking and Diabetes With Periodontitis in a Korean Population

BACKGROUND Smoking and diabetes are well-known risk factors for periodontitis. The aims of this study are to examine whether these factors are associated with periodontitis in representative samples of Koreans and to estimate the interaction impact of smoking and diabetes on periodontitis in this population. METHODS The Korean National Oral Health Survey (KNOHS) 2006 collected nationally representative samples of oral epidemiologic data. A community periodontal index (CPI) of 3 to 4 and a CPI value of 0 to 2 were classified as periodontitis and non-periodontitis, respectively. A total of 4,118 participants from KNOHS 2006 were interviewed on smoking and diabetes. Periodontitis was the outcome variable. Smoking and diabetes were the major explanatory variables. The confounders consisted of age, sex, education, occupation, monthly income, and residential area. Logistic regression analyses were used to evaluate the associations of smoking and diabetes with periodontitis after adjustment for confounders. RESULTS The overall prevalence of periodontitis, current smoking, and self-reported diabetes in Korean adults was 10.1%, 25.9%, and 4.5%, respectively. Associations of smoking and diabetes with periodontitis were : current smokers, odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.02 to 1.90; and diabetes, OR = 1.21, 95% CI = 0.82 to 1.77. The association between diabetes and periodontitis was not significant and there were no synergistic interactions of smoking and diabetes on periodontitis. CONCLUSIONS The results suggest that smoking has a significant impact on the periodontal health of Korean adults, but the combined effect of smoking and diabetes had no significant impact.

Salivary bisphenol-A levels due to dental sealant/resin: a case-control study in Korean children.

Dental sealants and composite filling materials containing bisphenol-A (BPA) derivatives are increasingly used in children. The aim of this study was to evaluate the association between salivary BPA and the number of tooth surfaces filled with dental sealant, and to determine a cutoff BPA level. Salivary BPA concentration and the number of tooth surfaces filled with dental sealant/resin were determined in 124 age and gender matched children: 62 controls had no dental sealant/resin on their tooth surfaces and 62 cases had more than 4 tooth surfaces with dental sealant/resin. Analysis of covariance (ANCOVA) and conditional logistic regression were performed after controlling for age, gender, salivary flow rate, salivary buffer capacity, frequency of snacking, and frequency of tooth brushing. Salivary BPA levels were 0.002 to 8.305 µg/L. The BPA level of control (0.40 µg/L) was significantly lower than that of case (0.92 µg/L) after controlling for confounders (P = 0.026). Although the 90th BPA percentile had an adjusted OR of 4.58 (95% CI 1.04-20.26, P = 0.045), the significance disappeared in the conditional logistic model. There may be a relationship between salivary BPA level and dental sealant/resin.

Risk factors for dental caries in childhood: a five‐year survival analysis

OBJECTIVES The purpose of this study was to examine the risk factors of dental caries at the level of an individual person with survival analysis of the prospective data for 5 years. METHODS A total of 249 first-grade students participated in a follow-up study for 5 years. All participants responded to a questionnaire inquiring about socio-demographic variables and oral health behaviors. They also received an oral examination and were tested for Dentocult SM and LB. Over 5 years, the participants received yearly oral follow-up examinations to determine the incidence of dental caries. The incidence of one or more dental caries (DC1) and four or more dental caries (DC4) were defined as one or more and four or more decayed, missing, and filled permanent teeth increments, respectively. Socio-demographic variables, oral health behaviors, and status and caries activity tests were assessed as risk factors for DC1 and DC4. The adjusted hazard ratios (HRs) of risk factors for DC1 and DC4 were calculated using Cox proportional hazard regression models. RESULTS During the 5-year follow-up period, DC1 and DC4 occurred in 87 and 25 participants, respectively. In multivariate hazard models, five or more decayed, missing, and filled primary molar teeth [HR 1.93, 95% confidence interval (CI) 1.19-3.13], and Dentocult LB of two or three (HR 2.21, 95% CI 1.37-3.56) were independent risk factors of DC1. For DC4, only Dentocult LB of two or three was an independent risk factor (HR 2.95, 95% CI 1.11-7.79). CONCLUSIONS Our results suggest that dental caries incidence at an individual level can be associated with the experience of dental caries in primary teeth and Dentocult LB based on the survival models for the 5-year prospective data.

Fluoride profiles of perikymata in enamel surfaces of human premolars.

Twenty-five premolars (from Nagoya, Japan < 0.1 parts/10(-6)F in drinking water) were sampled to determine the fluoride content in imbrication lines of Retzius between the grooves and ridges of perikymata on the enamel surface. Eight small windows were formed on each surface in groove and ridge regions using an etched microsampling technique. By using a regression curve, y = ax(-b), fluoride concentrations were compared at depths of 1, 3, 5, 10, 20, 30 and 50 microm in the perikymata regions. Fluoride concentrations increased gradually from the age of 10 to 12 years on the premolar surfaces, but were significantly higher in 12-year-olds or older (erupted teeth) than in 10-year-olds or younger (unerupted teeth). No obvious difference in fluoride concentrations was found between males and females. In the outermost enamel ( < 5 microm depth), fluoride concentrations were significantly higher in the grooves than the ridges of the perikymata. Comparison of the exponential regression coefficients (-b) of the fluoride profiles showed a significant difference between the grooves and ridges. It was concluded that fluoride concentrations and profiles were higher in grooves than in ridges of perikymata, probably because they are naturally porous and are stagnation areas attracting dental plaque.

Association between viral hepatitis B infection and halitosis

Abstract Objective. Oral malodor can be increased in breath of liver patients. However, no study has been performed for the association between volatile sulfur compounds (VSCs) and viral hepatitis. The aim of the present study was to determine the relationship between viral hepatitis and VSCs. Methods. This study analyzed 182 subjects and measured hydrogen sulfide (H2S), methyl mercaptan (CH3SH) and dimethyl sulfide [(CH3)2S] using the OralChroma®. Hepatitis type B was evaluated. Periodontal health was assessed using the Community Periodontal Index (CPI) and bleeding on probing (BOP). Tongue coating score (TCS) was evaluated. Multiple logistic regression analyses were conducted to evaluate the relationship. Results. Viral hepatitis had an elevated odds of dimethyl sulfide defined halitosis (OR = 9.22, 95% CI = 2.08–40.95) after controlling for age, gender, alcohol consumption, current smoking, periodontitis, BOP, TCS and tongue brushing habit. The magnitude of the association between viral hepatitis and VSCs defined halitosis attenuated with adjustment of mediators (alcohol consumption, periodontitis, BOP, TCS and tongue brushing habit for hydrogen sulfide defined halitosis; periodontitis, TCS and tongue brushing habit for methyl mercaptan defined halitosis; tongue brushing habit for dimethyl sulfide defined halitosis). Conclusions. Findings of this study suggest that viral hepatitis may be associated with methyl mercaptan defined halitosis.

The role of glutathione metabolism in cariogenic bacterial growth and caries in Korean children.

AIM The involvement of antioxidants in oral diseases suggests that salivary glutathione level may be associated with cariogenic bacteria and dental caries. The aim of this study was to determine the association of salivary glutathione with dental caries and cariogenic bacteria. MATERIALS AND METHODS This is a cross-sectional oral health survey of 257 children aged 6-14 years. Total glutathione, reduced glutathione (GSH) and oxidised glutathione (GSSG) levels were measured. Salivary mutans streptococci (MS) and Lactobacilli (LB) were measured using Dentocult MS and Dentocult LB kits. The dental caries status was examined. Analysis of covariance (ANCOVA) and a linear regression model were used to evaluate the association among glutathione metabolites, cariogenic bacteria and dental caries status. RESULTS The salivary GSH level of the children was found to be significantly increased according to the salivary LB level and DMFT (decayed, missing, filled teeth) (p=0.034 for salivary LB level; p=0.018 for DMFT). The glutathione metabolite levels were significantly higher in the decayed tooth (DT) group (p<0.001 for total glutathione and GSH; p=0.012 for GSSG). The GSH level showed a significant linear relationship with the salivary LB level (p=0.016), DMFT score (p=0.005) and DT score (p=0.010). Total glutathione and GSSG levels exhibited a significant linear relationship with DT (p=0.021). CONCLUSIONS This result indicates that the GSH level in saliva increased significantly in children according to the salivary LB level and the presence of dental caries. GSH may be a biomarker for cariogenic bacteria and dental caries.

Association of Self-Perceived Oral Health and Function with Clinically Determined Oral Health Status among Adults Aged 35–54 Years: A Cross-Sectional Study

This study aimed to analyse the association of self-perceived oral health status (OHS) and functions with clinical OHS in Korean adults aged 35–54 years. The study was designed as a cross-sectional study using data from the Fourth Korea National Health and Nutrition Examination Survey (2007–2009). A total of 6605 subjects aged 35–54 years who completed the oral examination and questionnaires were included. An association of self-perceived OHS and functions with clinically determined OHS was confirmed by a complex-samples general linear model. Data on socioeconomic variables, i.e., household income and education level, self-perceived OHS and functions, such as chewing and speaking, were collected by trained interviewers. The clinical OHS was determined by trained dentists and included the number of untreated decayed teeth (DT); decayed, missing, and filled teeth (DMFT); prosthetic and periodontal status. The combined score was estimated as the sum of self-perceived OHS and functions. Based on the estimation coefficient, the clinical variables that were most strongly associated with self-perceived OHS and functions were, in order, periodontal status, prosthetic status, DT, and DMFT. In addition, the combined score for self-perceived OHS and functions was associated with household income, education, and clinically determined OHS.

Associations of Community Water Fluoridation with Caries Prevalence and Oral Health Inequality in Children

This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children’s overall oral health.

Fluorescence change of Fusobacterium nucleatum due to Porphyromonas gingivalis

The aim of this study was to measure changes in the fluorescence of Fusobacterium nucleatum interacting with Porphyromonas gingivalis for excitation with blue light at 405-nm. P. gingivalis was mono- and co-cultivated in close proximity with F. nucleatum. The fluorescence of the bacterial colonies was photographed using a QLF-D (Quantitative Light-induced Fluorescence-Digital) Biluminator camera system with a 405 nm light source and a specific filter. The red, green and blue intensities of fluorescence images were analyzed using the image analysis software. A fluorescence spectrometer was used to detect porphyrin synthesized by each bacterium. F. nucleatum, which emitted green fluorescence in single cultures, showed intense red fluorescence when it was grown in close proximity with P. gingivalis. F. nucleatum co-cultivated with P. gingivalis showed the same pattern of fluorescence peaks as for protoporphyrin IX in the red part of the spectrum. We conclude that the green fluorescence of F. nucleatum can change to red fluorescence in the presence of adjacent co-cultured with P. gingivalis, indicating that the fluorescence character of each bacterium might depend on the presence of other bacteria.

Nitric oxide modulates levels of salivary Lactobacilli.

Abstract Objective. Nitric Oxide (NO) is one of the most powerful antibacterial compounds. The aim of this study was to determine the association between salivary NO, dental caries and cariogenic bacteria. Materials and methods. The salivary NO concentration of 257 Korean children was analyzed by the Griess colorimetric reaction method. Salivary mutans streptococci (MS) and Lactobacilli (LB) were counted using the Dentocult MS and Dentocult LB kit, respectively. Dental caries status was examined using the WHO criteria. Confounders were age, gender, salivary flow rate and salivary buffer capacity. Analysis of covariance (ANCOVA) was used to evaluate the association among NO, salivary MS level, salivary LB level and dental caries status after adjusting for the effects of confounders. Results. A significant decrease was found in salivary NO levels as the salivary LB count increased after controlling for confounders (p = 0.049). However, the MS level, caries experience and active caries status showed no significant association. Conclusion. This result indicates that NO production might be a host defense mechanism against the growth of cariogenic bacteria.