Reliability and cross-cultural validity of a Japanese version of the Dental Fear Survey.

BACKGROUND: This study established the reliability and cross-cultural validity of a Japanese version of the Dental Fear Survey (DFS). METHODS: Two studies were carried out in separate populations. The first involved 166 Japanese dental and nursing students and assessed internal consistency and test-retest reliability. The second involved 2,095 Japanese parents or guardians of school children and tested the hypothesis that the conceptual structure of the Japanese translation was consistent with the U.S. version using Structural Equation Modeling (SEM). RESULTS: In the first study Cronbach alpha ranged from .94 to .96 and test-retest reliability (Spearman correlation) ranged from .89 to .92. The intra-class correlation coefficients (ICC) was 0.919 (95%CI: 0.892 - 0.940). In the second study SEM was used on the covariance matrix of the 20 questions in a random sample of 600 questionnaires to evaluate the goodness of fit of the theoretical model; and then, in an exploratory manner corrected for specification errors until a model that fit the data well was achieved. CONCLUSION: The Japanese version of the DFS appears reliable and demonstrates cross-cultural validity. The modeling confirms the three factors on which the English language version was based.

Using a caries activity test to predict caries risk in early childhood.

BACKGROUND: The authors conducted a two-year longitudinal study to show the predictive abilities of a caries activity test (Cariostat, Dentsply-Sankin, Tokyo), and to include the predicted screening indexes that were based on previous caries activity test results and lifestyle factors that influence caries activity. METHODS: The subjects were 1,206 children born in 2000. These children participated in health examinations at 18 months, 2 years and 3 1/2 years of age at Kurashiki-City Public Health Center in Kurashiki-City, Japan. Two of the authors performed caries activity tests at 18-month and 2-year examinations. Questionnaires regarding the patient's lifestyle were mailed to each participant's parents or guardians. The authors analyzed these questionnaires to evaluate lifestyle factors that made participants susceptible to caries. RESULTS: A caries activity test score at 18 months of age not only reflected caries incidence but also predicted caries incidence and screening results in 2- and 3 1/2-year-old children. A caries activity test score at 2 years of age both reflected and predicted children's caries incidence and screening results at 3 1/2 years of age. Breast-feeding and use of the bottle to intake liquids other than water produced significant caries susceptibility in 18-month-old children. Additionally, increased frequency and total time of sucrose intake put 2-year-old children at high risk of developing caries and failure of parental brushing produced a high risk in 3 1/2-year-old children. CONCLUSIONS: A caries activity test could predict 3 1/2-year-old children's caries risk based on 18-month and 2-year-old test results. Early weaning, less sucrose intake and toothbrushing by parents were effective in reducing a child's caries risk. CLINICAL IMPLICATIONS: The caries activity test is more useful than oral examination because it can indicate the need for caries-preventive treatment before a carious lesion actually is manifest.

Cariogenic bacteria and caries risk in elderly Japanese aged 80 and older with at least 20 teeth.

OBJECTIVES: To assess caries risk and check the presence of four commonly found oral cariogenic bacteria in "8020" achievers. DESIGN: Initial report based on Japan's newly implemented "8020" campaign, which aims to promote health and awareness in older people. Simply stated, the goal is, at 80 years, to maintain 20 teeth. SETTING: Healthy community-dwelling elderly individuals of Okayama Prefecture, Japan. PARTICIPANTS: One hundred sixty individuals aged 80 and older with 20 of their own natural teeth. MEASUREMENTS: General and oral health conditions, caries risk assessment using the Cariostat method, and polymerase chain reaction (PCR) detection of four oral cariogenic bacteria. RESULTS: The participants had an average of 24.7 teeth, of which 12.1 were sound, 12.2 were treated, and 0.4 were untreated. Based on Cariostat scores, 64.4% had low caries risk. Using PCR, Streptococcus mutans, S. sobrinus, Lactobacillus casei, and L. plantarum were detected in 51.3%, 23.1%, 40%, and 25% of the participants, respectively. S. mutans (P<.001), S. sobrinus (P=.002), L. casei (P<.001), and L. plantarum (P=.001) deoxyribonucleic acid band was detected more in participants with high caries risk scores. CONCLUSION: Participants with low caries risk scores had low prevalence of cariogenic bacteria, 20 or more sound teeth, and fewer missing teeth. Incorporating caries risk assessment, using the Cariostat and PCR analysis, in the "8020" campaign in health systems worldwide will contribute to a better life for the aging society, initiate research interest regarding the program, and improve current health policies.

Evaluation of the Total Design Method in a survey of Japanese dentists.

BACKGROUND: This study assessed the application of the Total Design Method (TDM) in a mail survey of Japanese dentists. The TDM was chosen because survey response rates in Japan are unacceptably low and the TDM had previously been used in a general population survey. METHODS: Four hundred and seventy eight dentist members of the Okayama Medical and Dental Practitioner's Association were surveyed. The nine-page, 27-item questionnaire covered dentist job satisfaction, physical practice, and dentist and patient characteristics. Respondents to the first mailing or the one-week follow-up postcard were defined as early responders; others who responded were late responders. Responder bias was assessed by examining age, gender and training. RESULTS: The overall response rate was 46.7% (223/478). The response rates by follow-up mailing were, 18% after the first mailing, 35.4% after the follow-up postcard, 42.3% after the second mailing, and 46.7% after the third mailing. Respondents did not differ from non-respondents in age or gender, nor were there differences between early and late responders. CONCLUSION: The application of TDM in this survey of Japanese dentists produced lower rates of response than expected from previous Japanese and US studies.

The Children's Fear Survey Schedule-Dental Subscale in Japan.

OBJECTIVES: The aims of this research are to examine the reliability and validity of the Japanese version of the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS), and to examine the responses of children in the dental setting and in the community. METHODS: The CFSS-DS was translated into Japanese and administered to three samples. The first sample comprised 134 child patients aged 8-15 years, of whom 100 were assigned for test-retest analysis, and the behavior of the remaining 34 additional children were rated during their dental appointments, and compared with their questionnaire results. A second sample of 532 child patients aged 8-15 years, completed the CFSS-DS and also one additional item measuring fear of returning to the dentist. A third sample of 1250 school children aged 8-15 years was surveyed using the CFSS-DS and the additional item measuring fear of returning to the dentist. RESULTS: The Japanese version of the CFSS-DS showed good internal consistency (alpha=0.91) and test-retest reliability (r=0.90), as well as good criterion validity assessed by the relationship with actual child behavior (r(s)=0.51). It also showed good construct validity assessed by correlation with willingness to return to the dentist. Fear levels were higher in the school sample than in the clinic sample (27.7 versus 24.6). Girls reported more fear than boys (26.2 versus 23.2 in the clinic sample, and 30.7 versus 24.8 in the school sample). Injections, choking, having a stranger touch them, and drilling were the most common fears. Factor analyses demonstrated a factor pattern similar to the results found in other cultures. CONCLUSION: The results suggest that the CFSS-DS is reliable and valid and operates in Japan as it does in other cultures.

Oral manifestations of cyclic neutropenia in a Japanese child: case report with a 5-year follow-up.

Cyclic neutropenia is an uncommon hematologic disorder characterized by a marked decrease in the number of neutrophils in the peripheral blood occurring at regular intervals. The neutropenic phase is characteristically associated with clinical symptoms such as recurrent fever, malaise, headaches, anorexia, pharyngitis, ulcers of the oral mucous membrane, and gingival inflammation. This case report describes a Japanese girl who has this disease and suffers from periodontitis and oral ulceration. Her case has been followed up for the past 5 years from age 7 to 12. The importance of regular oral hygiene, careful removal of subgingival plaque and calculus, and periodic and thorough professional mechanical tooth cleaning was emphasized to arrest the progress of periodontal breakdown. Local antibiotic application with minocycline ointment in periodontal pockets was beneficial as an ancillary treatment, especially during neutropenic periods.