Health-Risk Behavior-, Mental Health-, and Physical Exercise-Related Risk Factors for Tooth Fractures in Korean Adolescents.

We aimed to determine factors related to tooth fracture experience in Korean adolescents. This study used data from the 14th Korea Youth Risk Behavior Survey in 2018, a cross-sectional web-based survey of health-risk behaviors among a representative sample of Korean middle- and high-school students aged 12-17 years. A total of 60,040 participants were selected using a complex sampling design of the survey from 400 middle schools and 400 high schools. They answered a self-administered questionnaire survey in classrooms. Explanatory variables included those pertaining to health-risk behaviors, mental health, and physical exercise. Complex-sample multivariable logistic regression models were applied to identify factors related to tooth fracture experience in the past 12 months. The overall prevalence of dental fracture experience was 11.4%. Risk factors related to tooth fractures in Korean adolescents were unhealthy behaviors such as alcohol and tobacco consumption; mental health problems including stress, depression, and suicidal ideation; and intensive physical exercise. The major risk factor related to tooth fractures was depression. To prevent tooth fractures among adolescents, schools should strengthen mental health education, encourage mouthguard use during intensive physical exercise, and develop school environments to prevent orofacial injuries. Further studies on various risk factors related to tooth fractures are warranted.

Factors Related to Oral Healthcare Service Utilization among Korean Adults Aged 25-79 Years.

The factors related to oral healthcare service utilization (OHSU) among Korean adults aged 25-79 years were assessed using the Andersen model with the sixth Korean National Health and Nutrition Examination Survey data. The study included 12,937 participants aged 25-79 years who answered questions on the predisposing, enabling, and need factors related to OHSU at dental clinics within the past 1 year. Age, sex, and education level were selected as predisposing factors; household income, residence region, and national and private health insurance status as enabling factors; and self-perceived oral health, dental pain, chewing status, and discomfort while speaking as need factors. These factors were assessed using multivariable complex logistic regression models. OHSU at dental clinics within the past 1 year was lower among less-educated participants, those with low, middle-low, and middle-high household income levels, rural participants, those benefiting from the Medicaid system, and non-insured participants. OHSU was higher among older participants, those who rated their self-perceived oral health status as bad, those with experience of dental pain, and those who experienced discomfort while chewing and speaking. The need factors were the most influential. Thus, interventions to reduce inequalities in OHSU are required to promote oral health for all.

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.

Association of stress, depression, and suicidal ideation with subjective oral health status and oral functions in Korean adults aged 35 years or more.

BACKGROUND: Oral health greatly affects well-being throughout the different stages of life from childhood to late adulthood. Loss of teeth due to poor oral health hinders mastication, leading to poor nutrition absorption, and affects pronunciation and aesthetics, leading to interpersonal difficulties. As social activities become limited, a sense of isolation and loneliness, stress, and depression grows while happiness decreases. This study aimed to examine the association of stress, depression, and suicidal ideation with oral health status and oral functions in a large nationwide sample of Korean adults aged 35 years or more. METHODS: The sample comprised 15,716 adults, selected using a rolling survey sampling method and data were extracted from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES) (2010-2012). Participants were interviewed about their self-evaluation of health including oral health status and mental health, such as stress, depression, and suicidal ideation. Data from 11,347 adults were finally selected after excluding participants with missing answers. The dependent variables were stress, depression, and suicidal ideation. The independent variables were gender, age, household income, education, smoking, drinking, oral health perception, chewing, and speaking. Complex samples logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Participants met the criteria for stress (25.4%), depression (13.0%), and suicidal ideation (13.9%). Subjective oral health status was not significantly associated with stress, depression, and suicidal ideation. However, the presence of very uncomfortable chewing problems was significantly associated with stress (OR = 2.294, 95% CI = 1.41, 3.72), depression (OR = 3.232, 95% CI = 1.97, 5.31), and suicidal ideation (OR = 2.727, 95% CI = 1.58, 4.72). The presence of very uncomfortable speaking problems was significantly associated with stress (OR = 1.592, 95% CI = 1.13, 2.24) but not significantly associated with depression and suicidal ideation. CONCLUSIONS: Oral functional problems including chewing and speaking difficulties can be associated with mental health. It is necessary to develop oral health promotion programs for adults and help them maintain a good quality of life and mental health.

The decline in dental caries among Korean children aged 8 and 12 years from 2000 to 2012 focusing SiC Index and DMFT.

BACKGROUND: The aim of this study was to analyse the prevalence and severity of dental caries among Korean children aged 8 and 12 years over a period of 12 years by determining the number of decayed, missing, and filled teeth (DMFT) and the Significant Caries index (SiC index). METHODS: Stratified cluster-sampled data from the National Oral Health Survey conducted from 2000 to 2012 were analysed. In 2000, 2006, and 2012, a total of 2397, 2650, and 9601 children aged 8 and 12 years were examined, respectively. The children's oral health status, including the number of DMFT and fissures sealed teeth, was examined and recorded. The SiC index was calculated according to the child's residential district. RESULTS: Over the 12-year period, the percentages of caries-free children aged 8 and 12 years increased from 26.0 to 42.7 % and from 53.4 to 69.6 %, respectively. The percentages of children aged 8 and 12 years with sealed teeth in 2012 were 62.1 and 62.5 %, respectively, more than triple the rates in 2000. The mean DMFT values of children aged 8 and 12 years decreased from1.04 to 0.67 and from 2.86 to 1.84, respectively. The SiC index of children aged 8 and 12 years also decreased from 2.73 to 1.97 and from 6.13 to 4.51, respectively. The rate of reduction in DMFT among 8- and 12-year-old children in the second 6 years of the observation period was lower than that in the first 6 years. CONCLUSIONS: A remarkable decline in dental caries of 8- and 12-year-old Korean children was observed over the 12-year study period. The mean DMFT values and SiC index of children aged 8 and 12 years decreased. The reduction rate between 2000 and 2006 was higher than that between 2006 and 2012.

Association between estimated fluoride intake and dental caries prevalence among 5-year-old children in Korea.

BACKGROUND: The purposes of this study were to estimate the fluoride intake from food and drink in 5-year-old Korean children, and to measure the association between estimated fluoride intake and dental caries prevalence. METHODS: The study involved a secondary analysis of raw data from the 4(th) Korea National Health and Nutrition Examination Survey (KNHANES; 2007-2009). The study subjects were 167 boys and 147 girls aged 5 years who had undergone both physical and nutritional examination as part of the survey. The KNHANES comprised a health questionnaire, a physical examination, and a nutritional examination. The nutritional examination of KNHANES consisted of 3 parts: a dietary life survey, a food-frequency questionnaire, and a food intake investigation. The food intake investigation used the 24-h recall method, with information being provided by the children's parents. On the basis of this information, we evaluated the fluoride content in a total of 310 food items using the hexamethyldisiloxane (HMDS)-facilitated diffusion method, modified using Taves' microdiffusion method. As part of the KNHANES survey, oral examinations were conducted at a mobile examination centre by trained dentists using dental mirrors under a fluorescent light. These examinations were performed using methods proposed by the World Health Organization. RESULTS: The dietary fluoride intake of 5-year-old Korean children was estimated to be 0.35 mg/day, or 0.016 mg/kg/day. The "decayed or filled surfaces" (dfs) indices of primary teeth were higher in children who had a lower dietary intake of fluoride. There was a significant inverse association between dietary fluoride intake and the prevalence of dental caries. CONCLUSION: The inverse association between dietary fluoride intake levels and prevalence of dental caries implies that the introduction of community caries prevention programmes may be beneficial. Such programmes would include water fluoridation and a fluoride supplementation programme.

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.

Nitric oxide modulates levels of salivary Lactobacilli.

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.

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.

Synthetic chenodeoxycholic acid derivative HS-1200-induced apoptosis of p815 mastocytoma cells is augmented by co-treatment with lactacystin.

The antitumor activity of a synthetic chenodeoxycholic acid derivative, HS-1200, on the p815 mastocytoma cell line was investigated. We present several lines of evidence indicating that HS-1200 at 35 microM induced apoptosis of p815 cells. Reduction of mitochondrial membrane potential, the release of cytochrome to cytosol, activation of caspase-3, nuclear condensation, production of poly(ADP-ribose) polymerase cleavage, generation of DNA fragmentation and nuclear condensation were demonstrated. Importantly, HS-1200 inhibited proteasome activity. Next, the combination treatment of HS-1200 or a proteasome inhibitor lactacystin was undertaken. Although the single treatment of 20 microM HS-1200 or 1 microM lactacystin induced apoptosis slightly, the combination treatment of them augmented prominently the extent of apoptosis. The combination therapy of HS-1200 and lactacystin could be potentially a therapeutic strategy reducing the extent and severity of treatment-related toxicity.