Yoh Tamaki

Factors affecting the oral condition of patients with severe motor and intellectual disabilities

BACKGROUND Handicapped persons living in nursing homes have special risks for oral diseases. OBJECTIVE To investigate the specific factors related to the occurrence of dental caries and tooth extraction in patients with severe motor and intellectual disabilities (PSMI) residing in an institution. METHODS One hundred eighty-nine PSMI residing in a single institution in Japan were followed for 3 years. Oral examinations were conducted at baseline and 3 years later. The following items were investigated: age of subject at admission, period of institutionalization, age at baseline oral examination, status of rumination, drooling, type of ward, dietary mode, and etiology of the impairment. Logistic regression analyses were conducted to examine factors associated with new dental caries and tooth extraction occurring during the study period. RESULTS By multivariate analysis, rumination and tube feeding were identified as significant factors associated with new dental caries. On the other hand, infancy or childhood impairment and drooling were identified as significant factors related to tooth extraction. CONCLUSION Some specific factors in this patient population affect the dental caries and tooth extraction and oral programs targeting these factors may reduce dental degeneration in these patients.

Evaluation of risk factors for dental caries from 6 to 8 years old children

The aim of this study is to evaluate the risk factors for dental caries in young children in Japan. We studied 645 children attending 13 of 30 elementary schools in two areas in Japan. Total salivary level of mutans streptococci and lactobacilli were evaluated at pre-school medical check-ups. Other factors we evaluated included use of fluoride containing dentifrices, administration of fluoride varnish in a private dental office, having regular check-ups, use of mouthwash with fluoride, and daily intake of sweet juice or snacks. Oral examinations were carried out at annual medical check-ups with 2.5 years follow-up and finally 585 children were analyzed. By multivariate logistic regression analysis, only three factors; gender, salivary levels of mutans streptococci and the presence or absence of dental caries in deciduous teeth had a statistically significant correlation with the incidence of dental caries after 2.5 years of follow-up. At age 8, odds ratios were 1.821 for female gender, 1.259 for mutans streptococci (log10 cfu/ml) and 2.262 for dental caries in deciduous teeth. Although the prevalence of dental caries has declined in Japan, mutans streptococci remain a risk factor.

A randomized controlled trial by the 3DS for dental caries

Abstract The aim of this study is to evaluate the povidone-iodine for the suppression of oral cariogenic bacteria and compare its effects to that of fluoride in children. We carried out a randomized controlled trial to compare the effects of povidone-iodine to those for sodium fluoride. Pre-school children (n=210) with more than 10 5 cfu/m l mutans streptococci in their stimulated saliva were randomly sampled and randomly allocated into three groups. We planned the preventive program by 3DS (Dental Drag Delivery System). The groups that provided preventive programs were the povidone-iodine group (n=70) and the sodium fluoride group (n=70). A control group (n=70) received no intervention. Povidone-iodine or sodium fluoride was applied to the tooth surface using custom made trays. Subsequent home care was obligatory for one month. After one month, the salivary levels of mutans streptococci were low level when compared to the based data. However the difference in salivary levels of mutans streptococci among groups was not statistically significant when comparing the povidone-iodine group with the sodium fluoride group ( P =0.625). After 2.5 years follow up, differences in incidence of new dental caries among the three groups were not statistically significant ( P =0.583). Clinical application of anti-microbial drugs may be effective, but only a single intervention is not sufficient to reduce the incidence of new dental caries.

Fluoride-containing mouthrinses in three European countries

The caries-preventive effect of fluoride is well known. The widespread use of fluoride-containing toothpastes and mouthrinses has been recommended to reduce dental caries. Many kinds of fluoride containing toothpastes are available in Japan. However, only two kinds of mouthrinses which contain fluoride are comically available. The aim of this study was to investigate the current status of fluoride-containing mouthrinses on the market in three European countries. Fluoride-containing mouthrinses were purchased from retail outlets in Athens, Amsterdam and Geneva. The labels of ingredients were studied to determine the type and concentration of fluoride. Most of the mouthrinses contained sodium fluoride (90%); some contained stannous fluoride (5%) or potassium fluoride (7%). The concentrations of fluoride ranged from 100 ppm to 500 ppm.

Salivary Levels of Hemoglobin for Screening Periodontal Disease: A Systematic Review

Periodontal disease is a common inflammatory disease. It affects about 20–50% of global population in both developed and developing countries. Early detection of slight changes of periodontal tissue plays an important role in prevention of onset and progression of periodontal disease. Hence, there is a need of a screening test to assess periodontal tissue for health check-ups. Salivary levels hemoglobin (Hb) has been proposed to assess the conditions of the inflammation of gingiva. The aim of this systematic review was to evaluate and summarize critically the current evidences for Hb as periodontal screening test. We performed a literature search of report published using PubMed databases. A total of 55 articles were retrieved and 16 were selected. Our review focuses on corelation coefficient with periodontal clinical parameters or sensitivity and specificity. As a result, fourteen studies calculated sensitivity and specificity of Hb. Six studies measured salivary levels hemoglobin at laboratory: three studies used polyclonal antibody reactions and other studies used colorimetric tests. Eight studies used paper strip method: 4 studies used monoclonal antibody reaction and 4 studies used colorimetric tests. Youdens indexes by antibody reaction were better than those of colorimetric methods. Evidences are described above and further studies are necessary to set the cut off values stratified by gender, age and number of remaining teeth.

Correlation of Dental Health Behavior With Health Awareness and Subjective Symptoms in a Rural Population in Japan

The aim of this study was to determine the association of dental health behavior with health awareness, oral condition, and subjective symptoms in Japan. The present study included 1699 individuals who underwent dental checkups at the public health center of Miura City. All those who underwent dental checkups were asked to fill out a questionnaire. The correlation between having a regular dentist and each of the other items was analyzed. Undergoing regular checkups was significantly related to having a regular dentist. To analyze the correlation of dental health behavior with Subjective symptoms and Health awareness, structured equation modeling was performed following factor analysis. As a result, only the regression weight between dental health behavior and health awareness was found to be statistically significant. The present survey indicates that dental health behavior was significantly related to Health awareness but not to Subjective symptoms.

Fluoride-containing toothpastes available in two European countries

The caries-preventive effect of fluoride is well known. The widespread use of fluoride-containing toothpastes and mouthrinses has been recommended to reduce dental caries. Many kinds of fluoride-containing toothpastes are available in Japan. The aim of this study was to investigate the current status of fluoride-containing toothpastes on the market in two European countries. Fluoride-containing toothpastes were purchased from retail outlets in Cardiff, United Kingdom, and Frankfurt, Germany. The ingredients labels were studied to determine the type and concentration of fluoride. Most of the toothpastes contained sodium fluoride (56.4%); some contained monofluoroacetic sodium (31.7%), stearyl trihydroxyethyl propylenediamine dihydrofluoride (1.0%), aluminium fluoride (1.0%), stannous fluoride (2.0%), or amine fluoride (5.0%). The concentration of fluoride in these products ranged from 800 to 1,500 ppm.