Factors Associated with Number of Present Teeth in Adults in Japanese Urban City.

The purpose of this study was to identify which factors were associated with number of present teeth (PT) in older adults as their clarification might contribute to maintaining the number of PT in this population. These factors were investigated by means of a questionnaire on oral health condition, general health behavior, and anamnesis of diabetes mellitus together with a dental examination. Data were obtained from a total of 7,741 Japanese subjects (2,623 males and 5,118 females), all of whom were aged 40, 50, or 60 years. Significant differences were observed in the mean number of PT between a positive or negative response to questions on anamnesis of diabetes mellitus, current smoking, and having loose teeth in all age groups in males; significant differences were also observed for current smoking, lower intake of dairy milk products, having loose teeth, no experience of tooth brushing instruction, and poor oral hygiene status in all age groups in females. Stepwise logistic regression analysis revealed having loose teeth (odds ratio [OR], 1.82), gingival swelling (OR, 1.40), an anamnesis of diabetes mellitus (OR, 1.72), current smoking (OR, 1.86), lower intake of dairy milk products (OR, 1.22), preference for salty seasonings (OR, 1.23), frequent sweet intake (OR, 1.29), no experience of tooth brushing instruction (OR, 1.38), and poor oral hygiene (OR, 2.04) as significant risk factors for the number of PT being <24 after adjusting for age and sex. These results indicate that an anamnesis of diabetes mellitus, a history of smoking, the presence of loose teeth, and poor oral hygiene status in a self-reported evaluation of oral health might correlate with <24 PT in older adults.

Relationship between General Health, Lifestyle, Oral Health, and Periodontal Disease in Adults: A Large Cross-sectional Study in Japan.

The aim of this study was to investigate how general health, oral conditions, and lifestyle were associated with periodontal disease in adults, as clarifying this relationship may be useful in preventing periodontal disease. Medical checkups were conducted on individuals aged 40, 50, or 60 years. Data were obtained for analysis on a total of 36,110 patients (men, 12,784; women, 22,896). A stepwise logistic regression model was used to calculate the odds ratio (OR) for patients who were ≥code 3 according to the Community Periodontal Index (CPI). Approximately 40, 60, and 70% of men aged 40, 50, and 60 years, respectively, had a CPI score of ≥3. There were 10% fewer women than men at each age. Stepwise logistic regression revealed a BMI score of ≥30 kg/m2(OR, 1.44; 95% confidence interval [95%CI], 1.20-1.73); systolic blood pressure of ≥140 mmHg (OR, 1.09; 95%CI, 1.02-1.18); a fasting blood sugar level of ≥110 mg/dl (OR, 1.17; 95%CI, 1.04-1.30); high-density lipoprotein cholesterol level of <40 mg/dl (OR, 1.21; 95%CI, 1.06-1.37); smoker (OR, 1.59; 95%CI, 1.48-1.71); drinking ≥3 cups of Japanese sake per day (OR, 1.09; 95%CI, 1.05-1.14); use of salts for seasoning (OR, 1.17; 95%CI, 1.07-1.28); and fair and poor oral hygiene (OR, 2.27; 95%CI, 2.08-2.47) as significant risk factors for a CPI score of ≥3. These results suggest that smoking, oral hygiene status, and factors associated with metabolic syndrome are associated with periodontitis. This indicates that health guidance on tooth brushing, the importance of quitting smoking, and control of obesity may be effective in preventing the development of periodontal disease in adults.

Risk factors affecting third molar autotransplantation during 5 and 10 years.

The aim of this study was to investigate risk factors affecting 5- and 10-year survival in autotransplantation of third molars with complete root formation at dental clinics. Participating dentists were requested to provide information on transplantations performed between 1 January 1990 and 31 December 2009. After data screening and elimination, 183 teeth in 171 men aged 20-72 years (mean, 44.8 years) and 205 teeth in 189 women aged 20-74 years (mean, 42.0 years) were included in the study. A single-factor analysis using the log-rank test revealed that the following factors had a significant influence (p<0.05) on 5-year survival in transplanted teeth in men: recipient site in the maxilla and fewer than 25 present teeth; those for 10-year survival, on the other hand, were recipient site tooth extraction due to periodontal disease, recipient site in the maxilla, fewer than 25 present teeth, and Eichner index Group B1 to C. Cox regression analysis revealed that the odds ratio for 5-year survival for recipient site in the maxilla was 2.873 (95% CI, 1.073-7.695), while that for 10-year survival was 3.713 (95% CI, 1.601-8.609) for recipient site extraction due to periodontal disease, 2.190 (95% CI, 1.021-4.700) for recipient site in the maxilla, and 3.110 (95% CI, 1.470-6.581) for fewer than 25 present teeth. In women, the log-rank test indicated experience of less than 10-year in performing treatment as a significant factor (p <0.05) in 5-year survival. These results suggest that medium-term survival in transplanted teeth is influenced by operational risk factors in women, while long-term survival in transplanted teeth is influenced by individual oral status in men.

Fundic gland polyps accurately predict a low risk of future gastric carcinogenesis.

OBJECTIVES: Few reports have analyzed the clinical importance of sporadic fundic gland polyps (FGPs). The aim of this study was to investigate the relationship between sporadic FGPs and condition of the gastric mucosa stratified by serum pepsinogen levels and Helicobacter pylori antibody level. METHODS: Three hundred and seventy-five subjects undergoing gastrointestinal endoscopy were enrolled. Subjects on proton pump inhibitors were excluded. Pathologically proven FGPs, and other endoscopic findings (reflux esophagitis, gastric and duodenal ulcer) were examined and serum pepsinogen levels, H. pylori antibody concentration and gastric juice pH were measured simultaneously. Subjects with normal serum pepsinogen and negative H. pylori antibodies were defined as having "low risk" stomachs, suggesting low risk of gastric carcinogenesis. RESULTS: Of the 375 subjects, 44 showed FGPs. The prevalence of "low risk" stomach in subjects with and without FGPs was 98% and 48%, respectively. Multivariable logistic regression analysis indicated three variables as independent factors positively associated with "low risk" stomachs: FGPs (odds ratio [OR] 38.6), reflux esophagitis (OR 4.8), and age<60 years (OR 1.89). Gastric juice pH, which is associated with mucosal atrophy grade and low pH indicates less mucosal atrophy, was significantly lower in subjects with (1.64 ± 0.64) than without FGPs in "low risk" (1.94 ± 1.12) and "high risk" stomachs (3.99 ± 2.31). CONCLUSIONS: Sporadic FGPs tend to be related to the least atrophic mucosa among non-gastric atrophy subjects without H. pylori infection, and can be used as predictors of a low risk of gastric carcinogenesis.

Effect of clinical factors on bacterial contamination of bone chips collected during implant surgery.

PURPOSE: The objective of this study was to investigate the relationship between various clinical factors and bacterial contamination of bone chips (BC) collected during dental implant surgery and to elucidate how bacterial contamination might be minimized. MATERIALS AND METHODS: Implants were installed in 55 partially edentulous patients (36 men and 19 women), among whom the relationship between various clinical factors and bacterial contamination of BC collected by bone trap was investigated in 37. The effect of rinsing with a saline on BC was determined in 18 patients. Number of contaminating microorganisms was expressed as colony-forming units (CFUs). RESULTS: CFUs in the maxilla were lower than those in the mandible (P < 0.01). CFUs at the incisors or canines were lower than those at the premolars or molars (P < 0.01). Logistic regression analysis revealed a relationship between average bacterial count and duration of surgery (odds ratio, 1.046; 95% CI, 1.012-1.081). Rinsing of BC reduced bacterial contamination. CONCLUSION: Duration of surgery is a major clinical factor affecting contamination risk in BC, and rinsing of BC with a sterile saline solution reduces bacterial number.

Transmission of periodontopathic bacteria from natural teeth to implants.

PURPOSE: Prevention of peri-implantitis is essential for the success of implant rehabilitation. Infection by periodontopathic bacteria is a major cause of peri-implantitis. The aim of the present study was to identify the source of peri-implant colonization by periodontopathic bacteria. MATERIALS AND METHODS: Twenty-one patients with implants were enrolled in the study. Subgingival plaque samples from the adjacent, occluding, and contralateral natural teeth were collected prior to second-stage surgery. Samples from implant sulci were then obtained 2 weeks later. Detection of periodontopathic bacteria was performed by the polymerase chain reaction. RESULTS: The detection rates for Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Fusobacterium nucleatum in all subgingival samples from natural teeth were similar to that in the peri-implant sulci. Multiple logistic regression analysis revealed an association between the detection of A. actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, and F. nucleatum in the gingival crevices of adjacent teeth and that of the peri-implant sulcus, but no association for Tannerella forsythia. CONCLUSIONS: The present findings suggest that colonization by A. actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, and F. nucleatum at the implant sulcus was affected by these microorganisms in the gingival crevice of adjacent teeth rather than those on occluding and contralateral teeth.

Fasting gastric pH of Japanese subjects stratified by IgG concentration against Helicobacter pylori and pepsinogen status.

BACKGROUND: The clinical significance of Helicobacter pylori antibody titer has been controversial, and the association between the extent of gastric atrophy or acid secretion and H. pylori antibody concentration has not been elucidated. MATERIALS AND METHODS: Serum pepsinogen, H. pylori antibody concentration, and fasting gastric pH (as an indicator of acid secretion) were measured in 231 patients undergoing upper gastrointestinal endoscopy. "Atrophic" pepsinogen was defined as pepsinogen-I < 70 ng/mL and pepsinogen-I/II ratio < 3. Other levels of pepsinogen were defined as "normal". Fasting gastric pH was analyzed in subjects stratified by pepsinogen level and by H. pylori antibody concentration. RESULTS: Helicobacter pylori antibody concentration showed no significant relationship with fasting gastric pH when all subjects were analyzed together. In H. pylori-seronegative subjects, fasting gastric pH was within the normal range, irrespective of the extent of mucosal atrophy. In H. pylori-seropositive subjects, H. pylori antibody concentration was positively correlated with fasting gastric pH in subjects with "normal" pepsinogen, but inversely correlated in those with "atrophic" pepsinogen. Particularly in subjects with low H. pylori antibody concentration and atrophic mucosa, a group reportedly at high risk of noncardia cancer, the most impaired acid secretion was shown among subjects with atrophic mucosa. CONCLUSIONS: The relationship between acid secretion and H. pylori antibody concentration differs depending on the presence of mucosal atrophy. Our findings provide a possible rationalization for measuring both serum pepsinogen levels and H. pylori antibody concentration in gastric cancer screening.

Serum nitrate/nitrite concentration correlates with gastric juice nitrate/nitrite: a possible marker for mutagenesis of the proximal stomach.

BACKGROUND/AIMS: In the normal acid-secreting stomach, luminally generated nitric oxide, which contributes to carcinogenesis in the proximal stomach, is associated with the concentration of nitrate plus nitrite (nitrate/nitrite) in gastric juice. We investigated whether the serum nitrate/nitrite concentration is associated with that of gastric juice and whether it can be used as a serum marker. METHODS: Serum and gastric juice nitrate/nitrite concentration, Helicobacter pylori antibody, and gastric pH were measured in 176 patients undergoing upper endoscopy. RESULTS: Multiple regression analysis revealed that serum nitrate/nitrite concentration was the best independent predictor of gastric juice nitrate/nitrite concentration. On single regression analysis, serum and gastric juice nitrate/nitrite concentration were significantly correlated, according to the following equation: gastric juice nitrate/nitrite concentration (µmol/l) = 3.93 - 0.54 × serum nitrate/nitrite concentration (µmol/l; correlation coefficient = 0.429, p < 0.001). In analyses confined to subjects with gastric pH less than 2.0, and in those with serum markers suggesting normal acid secretion (pepsinogen-I >30 ng/ml and negative H. pylori antibody), the serum nitrate/nitrite concentration was an independent predictor of the gastric juice nitrate/nitrite concentration (p < 0.001). CONCLUSION: Measuring the serum nitrate/nitrite concentration has potential in estimating the gastric juice nitrate/nitrite concentration. The serum nitrate/nitrite concentration could be useful as a marker for mutagenesis in the proximal stomach.

Factors associated with root surface caries in elderly.

The purpose of this study was to determine the risk factors for root surface caries in the elderly and to evaluate the factors associated with gingival recession, one of the main risk factors for root surface caries. A total of 153 elderly people (35 men, 118 women) aged between 60 and 94 years (73.5+/-7.5 years) were surveyed. All participants were relatively healthy elderly who did not need special care in their daily lives. The survey was conducted in Chiba prefecture, Japan, and oral examinations and a questionnaire with face-to-face interviews were also carried out. Correlation analysis revealed that number of present teeth (p<0.001), gingival recession (p<0.001), bleeding on probing (p<0.001) and presence or absence of dentures (p<0.05) were significantly correlated with number of root surface caries. Stepwise multiple linear regression analysis for root surface caries revealed that the risk factors for increasing numbers of teeth with root surface caries were number of teeth with gingival recession (p<0.0001), bleeding on probing (p=0.0017) and self-reported dry mouth (p=0.0454). Sex (p<0.05), number of present teeth (p<0.001), bleeding on probing (p<0.01), the presence or absence of systemic disease (p<0.01), dentures (p<0.01), drinking alcohol (p<0.01) and smoking (p<0.01) were significantly correlated with amount of gingival recession by correlation analysis. Moreover, the risk factors for increasing number of teeth with gingival recession were living in an institution (p=0.0244), number of present teeth (p<0.0001) and smoking (p=0.0037), as determined by stepwise multiple linear regression analysis for gingival recession.

Prediction of fasting gastric pH using serum biological markers.

BACKGROUND/AIMS: Previous studies have suggested that hypochlorhydria has the potential to produce adverse effects such as the development of infections of the intestinal or respiratory tract and impaired drug absorption. This indicates the importance of obtaining a noninvasive method by which this condition may be diagnosed. The purpose of this study was to determine whether fasting gastric pH could be predicted noninvasively using serum biological markers. METHODOLOGY: One hundred thirty-two patients undergoing diagnostic upper gastrointestinal endoscopy were recruited. Serum levels of pepsinogen-I, pepsinogen-II and Helicobacter pylori antibody were analyzed and the pH of fasting gastric juice determined. Multiple linear regression analysis was used to determine the best predictors of fasting gastric pH. RESULTS: Pepsinogen-I and the presence of Helicobacter pylori were independent predictors of fasting gastric pH, and a high coefficient of determination was obtained (R2 = 0.503, root mean square error = 1.45). The equation for this model was as follows: fasting gastric pH = 2.97-0.026 (pepsinogen-I)+2.76 (presence of Helicobacter pylori: 0=absent, 1=present). CONCLUSIONS: The model equation offers a noninvasive method by which to identify patients at high-risk of developing complications induced by hypochlorhydria.

Percentile curves for present teeth in smokers and non-smokers in an adult male population.

The purpose of this study was to obtain percentile curves for present teeth in smokers and non-smokers for use in oral health education. Dental examinations were carried out by two dentists. The number of present teeth in each subject was counted, excluding the third molars. Subjects consisted of 2,283 men aged between 25 and 54 years enrolled in the health insurance union of a bank in Yokohama, Japan. Each subject completed a questionnaire on smoking habits and number of cigarettes smoked. They were classified into two groups: smokers and non-smokers. The mean number of present teeth in both groups was compared with the Mann-Whitney's U test. Smokers had fewer teeth than non-smokers in all age groups (p<0.05). At the age of 50, the 50th percentile for present teeth was 26 for smokers and 27 for non-smokers. However, the 3rd percentile for smokers' present teeth was 20.5 at 40 years of age and 14 at 50 years of age, while for non-smokers it was 22.5 at 40 years of age and 19 at 50 years of age. The 3rd percentile curve for smokers' present teeth decreased in those aged 45 years and over. The percentile curves in this analysis showed a clear difference between the two groups. These data should be made available for use in adult oral health education.

Relationship between oral health behaviors and general health behaviors in a Japanese adult population.

OBJECTIVE: The aim of this study was to analyze the relationship between oral health behaviors and general health behaviors in adults. METHODS: A total of 2,467 adults (1,208 men and 1,259 women aged 20-59 years) who consulted dentists in Chiba City were administered a questionnaire. RESULTS: Women, older participants, and those living with family had better health behaviors than the other subjects studied. Additive indices for oral and general health behaviors were significantly correlated. Toothbrushing frequency was significantly correlated with five items of general health behavior (smoking, drinking, exercise, eating breakfast, and having medical check-ups). Having dental check-ups was significantly correlated with having medical check-ups. There was a negative correlation between dental flossing and drinking. CONCLUSIONS: Of all oral health behaviors examined, toothbrushing frequency was the most predictive indicator of general health behavior.