Toru Takiguchi

Mortality rates of community-residing adults with and without dentures

Aim:  To prospectively study how dental status with and without dentures could become a predictor of overall mortality risk.

Functional tooth number and 15‐year mortality in a cohort of community‐residing older people

Background:  To study how dental status can become a predictor of overall mortality risk.

Cost-effectiveness of alendronate for the treatment of osteopenic postmenopausal women in Japan.

Many postmenopausal women have osteopenia, a condition characterized by loss of bone mineral density (BMD) that is not as severe as in osteoporosis. The objective of this study was to estimate the cost‐effectiveness of alendronate to prevent fractures in osteopenic postmenopausal women without a history of fracture in Japan. An individual simulation model was developed to predict lifetime costs and quality‐adjusted life years (QALYs) of 5 years of preventive alendronate therapy versus no preventive therapy. The risk of hip and vertebral fracture associated with age and BMD was derived from epidemiologic studies in Japan. We ran the model with different combinations of age (65, 70, and 75 years), BMD (70%, 75%, and 80% of young adult mean [YAM]), and additional clinical risk factors. For 70‐year‐old women with a BMD of 70% of the YAM having one of the following risk factors: a family history of hip fracture, high alcohol intake, or current smoking, the incremental cost‐effectiveness ratio (ICER) of alendronate was

Associations between functional tooth number and physical complaints of community-residing adults in a 15-year cohort study.

92,937,

Critical tooth number without subjective dysphagia

126,251, and

Dental health and longevity

129,067 per QALY, respectively. These results were sensitive to age, BMD, and number of clinical risk factors. Probabilistic sensitivity analysis for the base case showed that in the presence of one, two, and three risk factors, alendronate was cost‐effective in 0.2% to 2.6%, 13.1% to 56.1%, and 99.1% of the simulations, respectively, if society is willing to pay

Estimated tooth loss based on number of present teeth in Japanese adults using national surveys of dental disease.

50,000 per QALY. Additional analysis indicated that alendronate can be a good value in osteopenic women if the 10‐year probability for a osteoporotic hip or vertebral fracture is more than 26.2%. Our results indicate that whether to treat osteopenia with alendronate should be determined on the basis of age, BMD, and number of clinical risk factors in terms of cost‐effectiveness.

Association between underweight and taste sensitivity in middle‐ to old‐aged nursing home residents in Sri Lanka: a cross‐sectional study

Background:  Oral function influences various general health and organ diseases. We wondered if physical complaints of unknown origin were related to oral function.

Survival Rate in Autotransplanted Premolars with Complete Root Formation: A Retrospective Clinical Survey

Aim:  To assess the critical tooth number (CTN) required for prevention of subjective dysphagia caused by oral impairments and to evaluate the relationship between this CTN and mortality.

A model-based cost-effectiveness analysis of osteoporosis screening and treatment strategy for postmenopausal Japanese women

Geriatrics & Gerontology International has published many studies concerning how dental medicine contributes to geriatrics. In Japan, dental and general medicines are systematically separated and are administered by different courses of education, medication and payment. However, recent evidence of close relationships between dental and medical health suggests that the dental area is one of the organs of the whole body. Yoneyama et al. found that oral care reduced pneumonia by approximately 40% in self-care dependent older people. Oral hygiene might determine nutritional status, activity of daily living, osteoporosis and even cognitive activity in older people, which suggests that the dental organ intimately influences not only disease, but also general health. Geriatric syndrome is a multiorgan disease specifically occurring in older people. Instead of having organ-specific specialists treat each organ-specific disease separately, geriatric syndrome might be better thought of as being caused by a single pathogenesis, which would suggest that each organ disease is intimately related to the other organ diseases. Because of these close relationships among geriatric diseases, we might treat geriatric patients by weighing the severity of symptoms and treating key points of a systemic syndrome with a single pathogenesis. If the dental organ is also intimately related to the whole body, it seems likely that dental health also contributes to determining life expectancy, as do the other organs. Fukai et al. suggested that functional tooth number might determine 15-year mortality in a cohort of community-residing older people. Furthermore, they found that dental care factors, such as dentures are associated with mortality rates, especially in female subjects with less than 10 functional teeth. Considering these effects of dental health on general health as well as mortality, it is our position that dental medicine cannot be separated from general medicine, and that both dental and general medicine should be managed by a single administrative system.