Oral Health-Related Factors Associated with Dysphagia Risk among Older, Healthy, Community-Dwelling Korean Adults: A Pilot Study.

Most previous studies addressing dysphagia examined individuals who already had diseases causing dysphagia and did not pay much attention to oral health conditions as a risk factor. This pilot study investigated 62 healthy adults aged 65 years or older who were living independently in the community, performed basic activities of daily living independently, and had no history of a causative disease of dysphagia to identify the factors associated with dysphagia risk, especially oral health. The Dysphagia Risk Assessment Scale was used to screen the patients for dysphagia. Hyposalivation was diagnosed by evaluating the unstimulated salivary flow rate, and orofacial muscle strength (anterior tongue elevation, buccinator muscle, and lip strength) was quantitatively measured using the Iowa Oral Performance Instrument. To analyze the factors associated with dysphagia risk, the Mann-Whitney test, Kruskal-Wallis test, and multiple logistic regression analyses were conducted. In the final regression model adjusted for sociodemographic characteristics, the oral health-related factors independently associated with dysphagia risk were buccinator muscle strength, hyposalivation, and subjective masticatory discomfort (p < 0.05). Therefore, our findings suggest that weak buccinator muscle strength, hyposalivation, and subjective masticatory discomfort are valuable indicators for the early detection of dysphagia in older, healthy, independent, community-dwelling adults.

Association between Handgrip Strength and Periodontitis in Korean Adults Aged ≥30 Years: Data from the Korea National Health and Nutrition Examination Survey (2014-2015).

This study used data from the Korea National Health and Nutrition Examination Survey 2014-2015 database to analyze the association between periodontitis and handgrip strength, a representative measure of hand impairment and function, in adults aged ≥30 years. The data of 5926 adults (male: 2766, females: 3160) who underwent handgrip strength and periodontal tissue examination and had neither rheumatoid arthritis nor osteoarthritis were analyzed. Handgrip strength was assessed using a digital grip strength dynamometer. The average values of the right handgrip strength, calculated separately by sex and age group (five 10-year age groups), were used as the cut-off for reduced handgrip strength. Periodontal status was evaluated using the Community Periodontal Index, defining scores ≥ 3 as periodontitis. Chi-square test and multivariate logistic regression analyses were performed to compare the differences in the prevalence of periodontitis according to handgrip strength. In the final regression model adjusted for risk factors for periodontitis, the likelihood of periodontitis decreased as the level of handgrip strength increased (p < 0.05). Therefore, this study suggests that handgrip strength may be a valuable indicator of periodontal health.

Relationship between Vitamin D Deficiency and Periodontitis in Korean Adults Aged ≥60 Years: Analysis of Data from the Korea National Health and Nutrition Examination Survey (2013-2014).

There have been contradictory reports on the effects of vitamin D in the prevention of periodontitis. We analyzed the association between vitamin D status (levels of plasma 25(OH)D) and periodontitis using the Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2014 database. Among the participants in the KNHANES (2013-2014), only those aged ≥60 years who completed a health interview survey, periodontal examination, and blood test were included in the study. Thus, data from 701 participants were used in the final analysis. Periodontal status was evaluated using the Community Periodontal Index (CPI), and periodontitis was defined as having a CPI score of 3 or 4. Plasma 25(OH)D levels were classified according to two criteria: 20 ng/mL and quartile value. The chi-square test and multivariate logistic regression analyses were performed to analyze the prevalence of periodontitis according to plasma 25(OH)D levels. Univariate analyses showed that periodontitis was not significantly associated with plasma 25(OH)D levels. In the multivariate logistic regression model adjusted for sociodemographic characteristics, the difference in the prevalence of periodontitis between those with a normal range of 25(OH)D and those with low plasma of 25(OH)D levels was not statistically significant. Vitamin D intake has been reported to have benefits in maintaining periodontal health; however, total plasma 25(OH)D levels showed no significant association with periodontitis based on CPI scores in this study. Additionally, these findings reaffirmed the importance of toothbrushing and smoking cessation to prevent periodontitis in people aged ≥60 years.

Antibacterial and antibiofilm activities of cinnamon essential oil nanoemulsion against multi-species oral biofilms.

Cinnamon essential oil (CEO) has antibacterial properties, but its ability to suppress the formation of multi-species oral biofilms has not been fully elucidated. This study evaluated the antibacterial and antibiofilm activities of cinnamon essential oil nanoemulsion (CEON) against oral biofilms formed using a microcosm biofilm model. The biofilms were formed on bovine enamel specimens over a 7-day period, during which all specimens were treated with one of three solutions: 5% CEON (n = 35), 0.5% cocamidopropyl betaine (n = 35), or 0.12% chlorhexidine gluconate (CHX; n = 35). Antibacterial and antibiofilm activities were determined by the red/green ratios (R/G values) of 7-day-old mature biofilms photographed with quantitative light-induced fluorescence-digital, the number of aciduric bacterial colony-forming units (CFUs) within each biofilm, and the absorbance of bacterial suspensions. One-way and repeated-measures analysis of variance were performed to compare differences among the three solutions. R/G values were lowest in the 0.12% CHX group, but not significantly differ from the 5% CEON group. The number of CFUs and absorbance were lowest in the 5% CEON group. This study showed that nanoemulsified CEO inhibited the maturation of multi-species oral biofilms and the growth of oral microorganisms in biofilms, including aciduric bacteria that cause dental caries.

The effect of indirect vision skills on head and shoulder posture amongst Korean dental hygienists.

OBJECTIVES: This study aimed to investigate the effects of indirect vision skills on head and shoulder posture in dental hygienists. MATERIALS AND METHODS: This cross-sectional study included a total of 100 female clinical dental hygienists. It evaluated musculoskeletal symptoms of the neck, shoulders and back, head and shoulder posture (craniovertebral angle [CVA] and sagittal shoulder posture angle [SSPA]). Indirect vision skills were assessed using the O'Connor tweezer test under indirect vision with a mirror. To analyse factors associated with the CVA and SSPA, an independent t test, one-way ANOVA, and multiple linear regression analysis were conducted, respectively. RESULTS: The body region in which the greatest number of symptoms of work-related musculoskeletal disorders was recognised was the neck (89.0%). In the multiple linear regression model, which adjusted for other factors associated with musculoskeletal disorders, dental hygienists with poor indirect vision skills showed relatively small SSPA value (P < .05). However, indirect vision skills were not associated with the CVA value. CONCLUSIONS: Good indirect vision skills contribute to the prevention of rounded shoulders in dental hygienists. Therefore, where possible, dental hygienists should perform clinical procedures using indirect vision with a dental mirror to maintain a balanced posture and reduce flexion of the back or the neck. A dental hygiene curriculum should include training to improve clinical skills, as well as education regarding dental ergonomics and a monitoring system to determine whether ergonomic principles are well observed.

Hand motor functions on the presence of red fluorescent dental biofilm in older community-dwelling Koreans.

BACKGROUND: The Quantitative Light-induced Fluorescence-Digital (QLF-D) system visualizes old and mature dental biofilm as red fluorescence. Risk factors for poor oral hygiene have been identified, however, few studies have evaluated the relationship between mature dental biofilm and hand motor functions. This study aimed to investigate the effects of two important manual motor functions for object manipulation -handgrip strength and manual dexterity- on the presence of red fluorescent dental biofilm in older community-dwelling Koreans using QLF-D, an optical device that reveals dental biofilm. METHODS: This cross-sectional study included 70 Korean participants aged ≥65 years, all of whom completed questionnaires and were tested for handgrip strength and manual dexterity. In total, 840 dental surfaces were photographed using QLF-D, and ΔR20 values, which reflect mature dental biofilm accumulation, were calculated. The t-test was performed to analyze the differences in the ∆R20 values according to sociodemographic characteristics, health-related characteristics and hand motor functions, while multiple linear regression analysis was used to investigate the effects of hand motor functions on the ∆R20 values. RESULTS: Multivariate regression analysis revealed that handgrip strength (ß = -0.294) was the factor most strongly affecting mature dental biofilm accumulation (ΔR20), followed by tooth-brushing time (ß = -0.262) and manual dexterity (ß = -0.241). CONCLUSIONS: Reductions in handgrip strength and manual dexterity were independent risk factors for pathogenic dental biofilm accumulation. The results of this investigation suggest that programs designed to prevent the decline, as well as improve, handgrip strength and manual dexterity might improve the oral hygiene of older adults.

Manual dexterity and dental biofilm accumulation in independent older adults without hand disabilities: A cross-sectional study.

BACKGROUND: This study investigated the relationship between manual dexterity and dental biofilm accumulation in independent older Koreans using Quantitative Light-Induced Fluorescence-Digital (QLF-D). METHODS: This cross-sectional study included 44 participants recruited from senior welfare facilities in South Korea and aged ≥65 years. Participants were surveyed using face-to-face structured interviews; manual dexterity was assessed using the Box and Blocks Test. To evaluate dental biofilm accumulation, the 528 surfaces of six index teeth were imaged using QLF-D and then quantified into Simple Plaque Scores (SPS) and ΔR20 values. The t-test and one-way analysis of variance were used to analyze differences in SPS and ΔR20 according to general characteristics and manual dexterity. RESULTS: Those who brushed their teeth ≤2 times per day had higher SPS and ΔR20 values on the lingual surface of tooth #24 than those who brushed ≥3 times per day (p < 0.05). The low manual dexterity group had higher SPS on lingual surfaces of teeth #12, #24, and #32, as well as higher ΔR20 values on the lingual surfaces of teeth #12, #24, #32, and #44 (p < 0.05) than the normal group. CONCLUSIONS: The low manual dexterity group had more dental biofilm-particularly on the lingual surfaces of teeth-and more mature biofilm than the normal group. These findings indicate that reduced manual dexterity could be a predictor of poor oral hygiene in independent older adults without hand disabilities. Therefore, we suggest manual dexterity be assessed in advance of dental biofilm assessment and tooth brushing instruction.

Simplified Prediction Model for Accurate Assessment of Dental Caries Risk among Participants Aged 10-18 Years.

Dental caries assessment needs to be targeted at specific age groups, as many risk factors are related to patient age. Pre-teen and teenage patients, who are still at risk of occurrence of new carious lesions, need more individualized caries management strategies. Therefore, this study aimed to identify caries-related risk factors and develop a simplified risk prediction model for dental caries. Risk factors for caries were assessed in 171 participants aged 10-18 years, based on a questionnaire survey, previous history of caries, oral hygiene, microorganism colonization, saliva secretion, saliva buffer capacity examinations, and the acidogenicity of dental biofilms. These risk factors were entered into a computer-based risk assessment program (the Cariogram), and correlations between these factors and Cariogram scores were investigated. Significant risk predictors were used to develop a simplified risk prediction model. The performance of this model in predicting dental caries incidence was evaluated using receiver operating characteristic analysis, to determine its applicability to the management of caries. Our simplified prediction model included three predictors that were significantly associated with caries incidence: use of fluoride-containing toothpaste, the acidogenicity of dental biofilms, and saliva secretion (p < 0.001). The resulting model had a sensitivity and specificity of 60.5 and 85.0%, respectively, with a cut-off value of 69.41 as the threshold. The area under the curve of this model was 0.782 (95% confidence interval = 0.681-0.884, p < 0.001). Our new caries risk prediction model is expected to allow clinicians to accurately and easily predict patients' risk of occurrence of new caries.

Unilateral Chewing as a Risk Factor for Hearing Loss: Association between Chewing Habits and Hearing Acuity.

Hearing loss is a common disease in older adults. In order to lower the prevalence of hearing loss, it is important to identify its risk factors. Although some studies have found a relationship between dental status and hearing acuity, few studies have investigated the relationship between unilateral chewing and hearing acuity. This study aimed to assess the effects of unilateral chewing on hearing acuity, with a focus on the risk of hearing loss. Eighty-one participants (aged 51-87 years) were included in the present study. Their chewing habits were determined by visual inspection. The participants were divided into two groups: the Unilateral Chewing Group (UCG; n = 43) and the Bilateral Chewing Group (BCG; n = 38). The preferred chewing side was identified for the UCG. Hearing acuity was determined using pure tone audiometry in a noise-free chamber, conducted at frequencies of 500, 1,000, 2,000, and 4,000 Hz. Hearing loss was defined as a lower hearing threshold greater than 50 dB in either ear at any frequency. Mean hearing thresholds at frequencies of 2,000 and 4,000 Hz were significantly higher, by 5.12 and 15.75 dB, respectively, for the UCG compared to the BCG (P < 0.05). The UCG had a 3.78-fold higher likelihood of suffering from hearing loss (95% confidence interval [CI]: 1.81-7.88). The results suggest that bilateral chewing could be beneficial for preventing hearing loss. This study may provide evidence to support clinical interventions aimed at reducing the risk of hearing loss in patients with unilateral chewing habits.

Masticatory efficiency contributing to the improved dynamic postural balance: A cross-sectional study.

OBJECTIVE: To evaluate whether masticatory efficiency is associated with dynamic postural balance. BACKGROUND: Masticatory dysfunction can cause deterioration of general health due to nutritional imbalances, thereby negatively affecting postural balance. However, few studies have investigated the association between masticatory efficiency and postural balance. MATERIALS AND METHODS: The masticatory efficiency of 74 participants was evaluated by calculating mixing ability index (MAI) using a wax cube. The timed up and go test (TUGT) was used to measure dynamic balance. Participants with an MAI above or below the median value of 1.05 were defined as having high or low masticatory efficiency, respectively. An independent samples t-test was used to identify significant differences in TUGT, according to masticatory efficiency. Analysis of covariance was performed to adjust for confounding factors. Logistic regression analysis was used to assess the correlation between masticatory efficiency and postural balance. RESULTS: The high masticatory efficiency group could complete the TUGT exercise approximately 1.67 seconds faster while maintaining the postural balance, compared to the low masticatory efficiency group (P = .005). Furthermore, the postural imbalance odds of the group with high mastication efficiency decreased by 0.14-fold, relative to the group with low mastication efficiency (95% confidence interval: 0.04-0.46). CONCLUSION: With some reservations about statistical power, the association found between masticatory efficiency and postural balance justifies further investigations to confirm the strength of the associations, and possibly to identify causal relationships between mastication and posture in old age.

Relationship between salivary haemoglobin and number of remaining teeth in older Koreans.

OBJECTIVE: We investigated the relationship between saliva and dental biofilm characteristics, oral hygiene behaviours and the number of remaining teeth in a sample of older Koreans. MATERIALS AND METHODS: This cross-sectional study included 133 participants, aged 65 years and older, recruited from senior welfare facilities in Incheon, South Korea. The outcome variable was the number of remaining teeth, and its associations with the independent variables of participants' general characteristics, salivary haemoglobin level, dental biofilm acidogenicity, salivary flow rate and oral hygiene behaviours were assessed. For statistical analyses, chi-squared test and step-wise multiple linear regression were used. RESULTS: The multiple linear regression model, which included all related factors identified in the bivariate analyses, showed that older adults who had high salivary haemoglobin levels (P < .05), brushed their teeth using the horizontal scrub method (P< .001), and did not use an interproximal cleaning device (P < .01) were more likely to have fewer remaining teeth. However, dental biofilm acidogenicity was not associated with the number of remaining teeth. CONCLUSION: The number of remaining teeth was associated with salivary haemoglobin level, appropriate toothbrushing technique and interdental cleaning. These findings suggest that the monitoring of salivary haemoglobin may contribute to the prevention of tooth loss caused by periodontal disease.

Dehydration of Glycerin to Acrolein Over Heteropolyacid Nano-Catalysts Supported on Silica-Alumina.

A series of H3PW12O40 nano-catalysts supported on silica-alumina (XH3PW12O40/SA (X = 10, 15, 20, 25, and 30)) with different H3PW12O40 content (X, wt%) were prepared, and they were applied to the dehydration of glycerin to acrolein. The effect of H3PW12O40 content on the physicochemical properties and catalytic activities of XH3PW12O40/SA nano-catalysts was investigated. Surface area and pore volume of XH3PW12O40/SA catalysts decreased with increasing H3PW12O40 content. Formation of H3PW12O40 aggregates was observed in the catalysts with high H3PW12O40 loading. Brønsted acidity of the catalysts showed a volcano-shaped trend with respect to H3PW12O40 content. It was revealed that yield for acrolein increased with increasing Brønsted acidity of XH3PW12O40/SA catalysts. Brønsted acidity of XH3PW12O40/SA catalysts served as a crucial factor determining the catalytic performance in the dehydration of glycerin. Among the catalysts tested, 25H3PW12O40/SA catalyst with the largest Brønsted acidity showed the best catalytic performance.