A multilevel analysis of the importance of oral health instructions for preventing tooth loss: The 8020 Promotion Foundation Study of Japanese Dental Patients.

BACKGROUND: Many studies have reported risk factors for tooth loss. Oral health instruction is considered effective at improving oral health behavior and oral health. However, few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. Here, we conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss. METHODS: Baseline surveys were conducted at 1216 dental clinics in 46 prefectures in Japan, and 12,399 dental patients aged 20 years and over underwent oral examinations and completed a questionnaire. The dental clinics also completed a questionnaire at baseline. A 3-year follow-up survey included 2488 patients in 585 dental clinics. Multilevel multivariate logistic regression analysis was used to examine the risk of tooth loss at the patient and clinic levels. RESULTS: Of the patient variables, older age, higher mean probing pocket depth, current or past smoking, and bleeding during tooth brushing were associated with higher risks of tooth loss. Individuals with many teeth who visited dental clinics for maintenance were at significantly lower risk of tooth loss. Of the clinic variables, patients attending dental clinics with four or more dental hygienists had a significantly lower risk of tooth loss (OR 0.68, 95% CI 0.50-0.99). Patients attending dental clinics that provide oral health instructions for 20 min or more had a significantly lower risk of tooth loss (OR 0.69, 95% CI 0.50-0.96). CONCLUSIONS: In addition to individual risk factors for tooth loss, dental clinic factors such as length of oral health instruction and number of dental hygienists are associated with tooth loss. In dental clinics, ensuring sufficient time for dental hygienists to provide oral health instructions can help prevent tooth loss in dental patients.

Association between number of pairs of opposing posterior teeth, metabolic syndrome, and obesity.

We investigated the relationship between the number of pairs of posterior teeth and metabolic syndrome (MetS), abdominal obesity (AO), and obesity, among Japanese adults. In 2005, 2,807 Japanese adults aged 25-74 years participated in the Survey of Dental Diseases and the National Health and Nutrition Survey. Based on the survey data, BMI, AO (JAS) determined by the Japan Atherosclerosis Society, AO (IDF) by the International Diabetes Federation, and MetS were assessed. Total functional tooth units (t-FTUs) were scored with pairs of opposing posterior teeth, including artificial teeth. Subjects were divided into three categories of chewing ability based on the score of t-FTUs: Poor (if score ≤ 9), Good (if score = 10-11), and Complete (if score = 12). The relationships between chewing ability and BMI ≥ 25, BMI ≥ 30, AO (JAS), AO (IDF), and MetS were tested using univariate and multivariate logistic regression analysis. The chewing ability was significantly associated with MetS, AO, and obesity in the univariate and multivariate logistic regression analysis. Adjusted OR of "Poor" compared to "Complete" were 1.51 (95% confidence interval (CI), 1.24-1.84) for BMI ≥ 25, 2.10 (95% CI 1.40-3.14) for BMI ≥ 30, 1.31 (95% CI 1.07-1.61) for AO (JAS), 1.40 (95% CI 1.15-1.70) for AO (IDF), and 1.34 (95% CI 1.04-1.72) for MetS. All were statistically significant. Preventing tooth loss and maintaining pairs of good chewing ability may be important factors in preventing MetS, AO, and obesity.

Feasibility of dose-dense epirubicin and cyclophosphamide with subcutaneous pegfilgrastim 3.6 mg support: a single-center prospective study in Japan.

BACKGROUND: Dose-dense chemotherapy consisting of a combination of epirubicin and cyclophosphamide (EC) improves the survival of patients with breast cancer. Although pegfilgrastim was used at a subcutaneous dose of 6.0 mg in a pivotal study of dose-dense EC treatment, pegfilgrastim at a dose of 3.6 mg has been approved in Japan. We have assessed the feasibility of dose-dense EC treatment supported with a 3.6 mg dose of pegfilgrastim by evaluating the relative dose intensity (RDI) and safety of the treatment, together with measuring the pegfilgrastim concentrations remaining on the day of starting the next cycle of chemotherapy. METHODS: Patients with primary breast cancer received a total of 4 cycles of dose-dense EC treatment every 2 weeks, together with a subcutaneous injection of 3.6 mg pegfilgrastim on the day after chemotherapy. The serum granulocyte colony-stimulating factor (G-CSF) concentrations were measured on the 15th day of every chemotherapy cycle. RESULTS: From March 2015 through to July 2016, a total of 51 patients (median age 51 years; range 33-73 years) were studied. The mean RDI was 95.2% (range 60.0-100%). Although most adverse events were consistent with those reported in previous studies, pneumocystis pneumonia developed in two patients during the following course of docetaxel treatment. The median serum G-CSF concentration was 92.5 (range 30.4-440) pg/ml. CONCLUSIONS: With support provided by pegfilgrastim injection at a dose of 3.6 mg, dose-dense EC is feasible and associated with maintenance of a high RDI. There was no clinically significant accumulation of serum G-CSF concentrations associated with the use of a 3.6 mg dose of pegfilgrastim at 2-week intervals.

School-Based Fluoride Mouth-Rinse Program Dissemination Associated With Decreasing Dental Caries Inequalities Between Japanese Prefectures: An Ecological Study.

BACKGROUND: Dental caries inequalities still severely burden individuals' and society's health, even in countries where fluoride toothpastes are widely used and the incidence of dental caries has been decreasing. School-based fluoride mouth-rinse (S-FMR) programs, a population strategy for dental caries prevention, might decrease dental caries inequalities. This study investigated the association between S-FMR and decreasing dental caries prevalence and caries-related inequalities in 12-year-olds by Japanese prefecture. METHODS: We conducted an ecological study using multi-year prefecture-level aggregated data of children born between 1994 and 2000 in all 47 Japanese prefectures. Using two-level linear regression analyses (birth year nested within prefecture), the association between S-FMR utilization in each prefecture and 12-year-olds' decayed, missing, or filled permanent teeth (DMFT), which indicates dental caries experience in their permanent teeth, were examined. Variables that could explain DMFT inequalities between prefectures, such as dental caries experience at age 3 years, dentist density, and prefectural socioeconomic circumstances, were also considered. RESULTS: High S-FMR utilization was significantly associated with low DMFT at age 12 (coefficient -0.011; 95% confidence interval, -0.018 to -0.005). S-FMR utilization explained 25.2% of the DMFT variance between prefectures after considering other variables. Interaction between S-FMR and dental caries experience at age 3 years showed that S-FMR was significantly more effective in prefectures where the 3-year-olds had high levels of dental caries experience. CONCLUSIONS: S-FMR, administered to children of all socioeconomic statuses, was associated with lower DMFT. Utilization of S-FMR reduced dental caries inequalities via proportionate universalism.

A Phase II clinical trial of pegylated liposomal doxorubicin and carboplatin in Japanese patients with platinum-sensitive recurrent ovarian, fallopian tube or primary peritoneal cancer.

OBJECTIVE: This single-arm Phase II trial was designed to assess the safety and efficacy of pegylated liposomal doxorubicin and carboplatin combination chemotherapy in patients with platinum-sensitive recurrent ovarian cancer. METHODS: Patients with a histological diagnosis of epithelial ovarian, fallopian tube or primary peritoneal carcinoma, who were relapse-free at least 6 months after completion of first-line platinum-based chemotherapy, and who had measurable disease and gave consent to participate in this study received infusions of pegylated liposomal doxorubicin (30 mg/m(2)) at 1 mg/min, followed by carboplatin (AUC 5 mg min/ml) over 30 min every 28 days. RESULTS: Thirty-three of 35 enrolled patients were eligible for efficacy analysis. One patient (3.0%) achieved a complete response, while 16 (48.5%) achieved a partial response, with an overall objective response rate of 51.5% (95% confidence interval, 34.5-68.6%). Among the 22 patients who had evaluable CA125 levels at entry, responses were observed in 18 patients, with a response rate of 81.8% (95% confidence interval, 65.3-98.3%). The median progression-free survival and overall survival rates for all 35 patients were 10.7 months (95% confidence interval, 8.1-13.2 months) and 38.8 months (95% confidence interval, 31.0-46.7 months), respectively. The most frequent Grade 3-4 toxicities, regardless of cause, were neutropenia (82.9%), thrombocytopenia (51.4%), leukopenia (45.7%) and anemia (17.1%). CONCLUSIONS: The safety and efficacy of pegylated liposomal doxorubicin and carboplatin combination chemotherapy in patients with platinum-sensitive recurrent ovarian cancer were confirmed. Although there were concerns of severe hematological toxicity with this therapy, this potential complication was safely managed through adequate monitoring of bone marrow function.

Docetaxel, cisplatin, and fluorouracil with pegfilgrastim on day 3 as neoadjuvant chemotherapy for esophageal cancer.

PURPOSE: A high risk of febrile neutropenia (FN) from neoadjuvant chemotherapy with docetaxel, cisplatin, and fluorouracil (DCF) for esophageal cancer has been reported. The optimal timing of prophylactic use of pegfilgrastim remains to be elucidated. To evaluate the effect of pegfilgrastim administered on day 3, we conducted a feasibility study. METHODS: Chemotherapy consisted of intravenous administration of docetaxel (70 mg/m2 per day) and cisplatin (70 mg/m2 per day) on day 1 and continuous infusion of 5-fluorouracil (750 mg/m2 per day) on days 1-5. Pegfilgrastim was given as a single subcutaneous injection at a dose of 3.6 mg on day 3 during each treatment course. This regimen was repeated every 3 weeks for up to a maximum of three courses. Prophylactic antibiotics were not needed but were allowed to be given at the discretion of the physician. The primary endpoint was the incidence of FN. RESULTS: Twenty-six patients were administered DCF in combination with pegfilgrastim on day 3. After the first course of DCF, 10 out of 26 patients (38.5%) experienced grade 4 neutropenia, and two patients (7.7%) experienced FN. Of the 14 patients who did not receive prophylactic antibiotics, four had grade 4 neutropenia, including two who developed FN. On the contrary, of the 12 patients who received prophylactic levofloxacin, six had grade 4 neutropenia, but no cases of FN were observed. CONCLUSION: Administration of pegfilgrastim on day 3 was not sufficient to prevent FN due to DCF treatment, and prophylactic administration of both pegfilgrastim and antibiotics could be a solution.

Dental health behavior of parents of children using non-fluoride toothpaste: a cross-sectional study.

BACKGROUND: One of the dental health goals of Health Japan 21, in which the Japanese government clarified its health policy, was to ensure the use of fluoride toothpaste in 90% or more of schoolchildren. This goal was not achieved. The aim of this cross-sectional questionnaire study was to evaluate the characteristics of parents whose children use non-fluoride toothpaste. METHODS: In December 2010, questionnaire forms were sent to 18 elementary schools or school dentists. Students (6-12 years old) were asked to take the forms home for their parents to fill in, and to bring the completed questionnaire to school. The collected questionnaires were mailed from schools to the author's institution by the end of March 2011. The relationship between fluoride in toothpaste and reasons for choice of toothpaste, the child's toothbrushing habits, and attitude toward child caries prevention was examined in the 6,069 respondents who answered all the questions for the analyses and indicated that their children use toothpaste. RESULTS: Non-fluoride toothpaste users accounted for 5.1% of all toothpaste users. Among the children using non-fluoride toothpaste, significantly greater numbers gave 'anti-gingivitis', 'halitosis prevention' or 'tartar control' as reasons for choice of toothpaste; did not give 'has fluoride', 'is cheaper' or 'tastes good' as reasons for choice of toothpaste; or used toothpaste sometimes, or were in 4th - 6th grades. There was no significant relationship between use of non-fluoride toothpaste and measures taken for caries prevention in children. Multilevel (first level: individual, second level: school) logistic regression analysis indicated that use of non-fluoride toothpaste was significantly related to: giving 'anti-gingivitis' (odds ratio: 1.44) as a reason for choice of toothpaste; not giving 'has fluoride' (0.40), 'tastes good' (0.49) or 'is cheaper' (0.50) as the reason for choice of toothpaste; to toothbrushing less often (twice a day: 1.34, once a day or less: 1.46) and to using toothpaste less often (sometimes: 1.39). CONCLUSIONS: It is necessary to teach parents that dental caries is the dental health issue with the highest priority for children, and therefore fluoride toothpaste should be used.

Long- and Short-Term Trends in Outpatient Attendance by Speciality in Japan: A Joinpoint Regression Analysis in the Context of the COVID-19 Pandemic.

The COVID-19 pandemic resulted in a decline in outpatient attendance. Therefore, this study aimed to clarify long- and short-term clinic attendance trends by speciality in Japan between 2009 and 2021. A retrospective observational study of Japan's claims between 2009 and 2021 was conducted using the Estimated Medical Expenses Database. The number of monthly outpatient claims in clinics was used as a proxy indicator for monthly outpatient attendance, and specialities were categorised into internal medicine, paediatrics, surgery, orthopaedics, dermatology, obstetrics and gynaecology, ophthalmology, otolaryngology, and dentistry. The annually summarised age-standardised proportions and the percentage of change were calculated. Joinpoint regression analysis was used to evaluate long-term secular trends. The data set included 4,975,464,894 outpatient claims. A long-term statistically significant decrease was observed in outpatient attendance in internal medicine, paediatrics, surgery, ophthalmology, and otolaryngology during the pandemic. From March 2020 to December 2021, which includes the COVID-19 pandemic period, outpatient attendance in paediatrics, surgery, and otolaryngology decreased in all months compared with that of the corresponding months in 2019. For some specialities, the impact of the pandemic was substantial, even in the context of long-term trends. Speciality-specific preparedness is required to ensure essential outpatient services in future public health emergencies.

Changes in masticatory performance and the new onset of diabetes mellitus in older adults: a 5-year longitudinal study.

Objective: Although masticatory performance is affected by age-related reduction in number of teeth (or treatment), the relationship between longitudinal changes in masticatory performance and diabetes mellitus is unknown. This longitudinal study investigated the association between changes in masticatory performance and new-onset diabetes mellitus among community-dwelling Japanese older adults. Methods: The data of 214 older adults living in Ohnan Town, Shimane, Japan, who participated in two surveys conducted between 2012 and 2017 were analyzed. Diabetes mellitus was defined as a hemoglobin A1c level ≥ 6.5% or self-reported diabetes mellitus. The masticatory performance (measured by number of gummy jelly pieces collected after chewing) was evaluated by dental hygienists. Masticatory performance was categorized into two groups (high or low) based on the median in each survey; further, four groups (Group A: remained consistently high, Group B: changed from low to high, Group C: remained consistently low, Group D: changed from high to low) were used to determine longitudinal changes in masticatory performance. Logistic regression was used to analyze the association between changes in masticatory performance and new-onset diabetes mellitus. Results: Overall, 10.3% of participants had diabetes mellitus at the follow-up survey. Multivariate analysis showed that Group D (odds ratio 8.69, 95% confidence interval 1.98-38.22) was positively associated with the development of diabetes mellitus compared with Group A after adjusting for sex, age, body mass index, alcohol consumption, physical activity, and eating speed. Conclusions: Deteriorating masticatory performance for 5 years may cause diabetes mellitus among older adults.

Extravasation of pegylated-liposomal doxorubicin: favorable outcome after immediate subcutaneous administration of corticosteroids.

A massive extravasation of pegylated-liposomal doxorubicin (Doxil) accidentally occurred, affecting the right forearm of a 54-year-old woman with metastatic ovarian cancer who was receiving an intravenous infusion of the drug. In accordance with the institutional guidelines for vesicant drugs, a corticosteroid preparation was immediately injected subcutaneously into the surrounding tissues. Clobetasol propionate and an ice pack were then topically applied to the affected region. There were no serious complications at the extravasation site, such as tissue necrosis or severe pain, and only a transient erythema of the skin and desquamation remained after 2 months.

Evaluation of occlusal status of Japanese adults based on functional tooth units.

OBJECTIVES: Although extensive national oral health data on dental caries and periodontal diseases in Japan are available, few studies have assessed the occlusal status of the Japanese population, and none are based on national survey data. The presence and prosthodontic conditions of the molar region are important for masticatory function, and the functional tooth unit (FTU) approach can be used to evaluate the occlusal status. Thus, using the national oral health survey data, this study investigated the occlusal status of the Japanese population using FTU. METHODS: Overall, 3,605 adults (aged ≥20 years) who participated in the 2011 Japanese national oral health survey were included. FTUs were used as indices for evaluating the occlusal status. FTUs were calculated according to sex, age group, and the number of teeth present, and their associations were further analysed. RESULTS: The number of teeth present, posterior teeth, and FTUs decreased with age in both men and women. In the age group of those ≥60 years, all only natural teeth-FTU (n-FTU) and natural teeth and artificial teeth from fixed prostheses or implant-supported FTU (nif-FTU) scores were <8. The total-FTU scores of all age groups, except the 60-69 and 70-79 years age groups, were >10. CONCLUSION: This is the first study to use FTUs and national oral health survey data to investigate the occlusal status in the Japanese population. People aged ≥60 years who have low n-FTU or natural teeth and artificial teeth from fixed prostheses or implant-supported FTU scores or those aged 60-70 years who have the lowest total-FTU scores require careful evaluation of masticatory performance.

Trends in dental visits during the state of emergency for COVID-19 in Japan: a retrospective observational study.

OBJECTIVES: To determine national medium-term trends in dental visits during three COVID-19 emergency declaration periods in Japan and to analyse how these trends varied according to prefectural emergency measures and COVID-19 incidence. DESIGN AND SETTING: A retrospective observational study of Japan's dental claims from January 2017 to December 2021. DATA SOURCES: Data from a monthly report by the Health Insurance Claims Review and Reimbursement Services (HICRRS) in Japan. HICRRS handles the claims of employer-based health insurance. DATA ANALYSIS: We determined the number of monthly dental claims nationwide from January 2017 to December 2021 and the percentage change in the number of monthly dental claims based on the difference in the COVID-19 alert level between the three emergency declaration periods in 2020-2021 and the corresponding periods in 2019. Results were analysed using descriptive statistics, multiple regression model, graphical figures, and narrative synthesis. OUTCOME MEASURES: The main outcome was the change in the number of dental visits between the emergency declaration periods in 2020-2021 and the corresponding periods in 2019. We also assessed the difference in the number of dental visits based on the COVID-19 alert level. RESULTS: The data set included a total of 736 946 088 dental claims. Until the end of 2021, the greatest decrease in monthly dental claims was in April 2020, which was 22.3% lower than that in April 2019. As indicated by the coefficient in the regression model, the percentage change in monthly dental claims decreased by 5.01% (95% CI -8.27 to -1.74) depending on the difference between the prefectures designated as being under special precautions and other prefectures. CONCLUSIONS: The decrease in dental visits was greater during the first state of emergency, ie, April-May 2020, and in prefectures designated as being under special precautions. Further efforts to promote appropriate dental visits at different alert levels are necessary.

Reduced masticatory performance and not using dentures are associated with hypertension in older adults with tooth loss: the Shimane CoHRE study.

The relationship between masticatory performance and hypertension has seldom been studied. The association between hypertension and tooth loss with/without denture use is unclear. This cross-sectional study examined the relationship between hypertension and masticatory performance and whether the relationship between hypertension and the number of teeth varied with denture use among older Japanese adults. Hypertension was defined as a systolic or diastolic blood pressure ≥140 or ≥90 mm Hg, respectively, or the use of antihypertensive medications. Masticatory performance was assessed using a chewable gummy jelly. The number of teeth and denture use were visually assessed by a trained dental hygienist. Poisson regression analyses were carried out to estimate the prevalence ratio and 95% confidence interval (CI) of hypertension with the number of teeth (≥28, 20-27, or 0-19 teeth), quartiles of masticatory performance (Q1: highest [reference] to Q4: lowest), and tooth loss with/without denture use. Hypertension was significantly associated with masticatory performance in participants in Q3 (prevalence ratio = 1.35; 95% CI = 1.07, 1.72) and Q4 (prevalence ratio = 1.31; 95% CI = 1.01, 1.69). There was no association between tooth loss and hypertension. Compared to participants with >28 teeth, the prevalence ratios and 95% CIs of those without dentures and those with 20-27 teeth were 1.33 (95% CI = 1.06, 1.68) and 1.69 (95% CI = 1.21, 2.37), respectively, in those with 0-19 teeth. Masticatory performance was inversely associated with hypertension, and tooth loss without the use of dentures was related to hypertension. Therefore, masticatory function may be important for preventing hypertension among older adults.

Periodontal health predicts self-rated general health: A time-lagged cohort study.

OBJECTIVES: There is limited evidence of a temporal relationship between periodontal diseases and self-perceived general health. To plug this knowledge gap, we aimed to assess how periodontal health affects future self-rated health (SRH). METHODS: We collected data from five waves of an annual nationwide Japanese survey of dental patients from 2015 to 2019. The analysis of repeated measurements included 9306 observations from 4242 patients aged 20 years or older. The clinical periodontitis measurements were bleeding on probing, deepest periodontal pocket depth and most severe clinical attachment loss (CAL). We used a self-administered questionnaire to collect data on sociodemographic characteristics, diabetes history, health behaviour, SRH and self-reported periodontitis. We applied 2-level ordered logistic regression models for repeated measurements to examine the relationships between SRH (time t) and 1-year-lagged periodontal health (time t-1) after adjusting for covariates. RESULTS: The percentage of SRH responses recorded at time t as 'good', 'moderate' and 'poor' were 36.9%, 52.4% and 10.7%, respectively. Multivariate analyses showed that the risk of poorer SRH at time t increased in patients with CAL ≥7 mm (odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.02-1.30), those who reported bleeding gums (OR = 1.33, 95% CI = 1.21-1.46) and those who perceived swollen gums (OR = 1.40, 95% CI = 1.26-1.56) at time t-1. Sensitivity analyses using the 4-year follow-up model and 3-year-lagged cohort model also showed consistent results. CONCLUSION: Periodontitis shows a gradual contribution to future SRH in dental patients, even after adjusting for sociodemographic characteristics, general health and health-related behaviours.

Multilevel Analysis of the Association of Dental-Hygienist-Related Factors on Regular Dental Check-Up Behavior.

Few studies have examined the factors related to dental clinics during dental check-ups. We examined the association between dental-hygienist-related factors and patients' regular dental check-ups. This nationwide cross-sectional study was based on a survey conducted in Japan in 2014. The analyzed population included 12,139 patients from 1181 dental clinics. We used three-level Poisson regression analysis, considering patient‒clinic‒prefecture, to examine the association of dental-hygienist-related factors with dental check-up behavior. Patients attending treatment and regular check-ups constituted 63.0% and 37.0%, respectively. The adjusted prevalence ratios (PRs) for patients undergoing regular dental check-ups at dental clinics with dedicated dental hygienists' units, spending ≥20 min in patient education (compared to 0 min), and with three or more dental hygienists (compared to 0 hygienists) available were 1.17 (95% confidence interval [CI]: 1.06-1.30), 1.25 (95%CI: 1.07-1.46), and 2.05 (95%CI: 1.64-2.56), respectively. The median PR indicates that when a patient randomly moves to another dental clinic with more regular dental check-ups, this prevalence increased 1.69 times. These results suggest that dental check-up behavior is determined not only by individual factors but also dental-clinic-level factors. Improving the dental-hygienist-related factors is necessary to encourage people to visit dentists for regular check-ups.

Number of teeth and masticatory function are associated with sarcopenia and diabetes mellitus status among community-dwelling older adults: A Shimane CoHRE study.

OBJECTIVES: We aimed to examine the number of teeth and masticatory function as oral health indices and clarify their roles in the pathogenesis of sarcopenia and diabetes mellitus in community-dwelling older adults. SUBJECTS AND METHODS: This cross-sectional study was conducted with 635 older adults in Ohnan, Shimane Prefecture, in rural Japan. The number of teeth and masticatory function (measured by the number of gummy jelly pieces collected after chewing) were evaluated by dental hygienists. Sarcopenia status was assessed using handgrip strength, skeletal muscle index, calf circumference, and a possible sarcopenia diagnosis based on the Asian Working Group for Sarcopenia 2019. Diabetes mellitus status was defined as a hemoglobin A1c level ≥6.5% or self-reported diabetes. A multivariable logistic regression model was used to analyze the association between oral health, sarcopenia, and diabetes mellitus after adjusting for confounders. RESULTS: After adjusting for all confounders, logistic regression analysis showed that the number of remaining teeth was negatively associated with a low level of handgrip strength (odds ratio [OR], 0.961; 95% confidence interval [CI], 0.932-0.992) and possible sarcopenia (OR, 0.949; 95% CI, 0.907-0.992). Higher levels of masticatory function were also negatively associated with a low level of handgrip strength (OR, 0.965; 95% CI, 0.941-0.990) and possible sarcopenia (OR, 0.941; 95% CI, 0.904-0.979). Logistic regression analysis showed that the number of remaining teeth and a higher level of masticatory function were negatively associated with diabetes mellitus (OR, 0.978; 95% CI, 0.957-0.999; OR, 0.976; 95% CI, 0.960-0.992, respectively). CONCLUSION: Our findings suggest that improvement in oral health, including the maintenance of masticatory function and remaining teeth, may contribute to the prevention of sarcopenia and diabetes mellitus in older adults.

Risk factors for tooth loss in adult Japanese dental patients: 8020 Promotion Foundation Study.

AIM: The assessment of the risk of tooth loss in patients visiting a dental clinic is important for managing their oral health. In the present study, we examined the risk factors for tooth loss among dental patients. METHODS: Data from the 8020 Promotion Foundation Study on the Health Promotion Effects of Dental Care were used in the present study. The study involved 2743 patients who visited a dental clinic in Japan and completed a questionnaire and oral health examination at baseline and at the 2-year follow up. Tooth- and person-level risk factors for tooth loss during 2 years were subjected to a multilevel multivariate logistic regression analysis. RESULTS: In both the person- and tooth-level analyses, age, smoking habit, reason for dental visit, economic status, number of remaining teeth, and periodontal status were significantly associated with tooth loss. In the tooth-level analysis, tooth type, tooth status, and periodontal status were significantly related to tooth loss. Persons who visited a dental clinic for periodic maintenance had a significantly lower risk of tooth loss than those who visited only to receive dental treatment. CONCLUSIONS: Various tooth-level factors and modifiable factors, such as smoking cessation and periodic maintenance, are important for the suppression of tooth loss in dental patients.

Periodontal status and self-reported systemic health of periodontal patients regularly visiting dental clinics in the 8020 Promotion Foundation Study of Japanese Dental Patients.

This nationwide cross-sectional survey investigated the association between periodontal disease and self-reported systemic health in periodontal patients who regularly visited private dental clinics in Japan. Data from 999 patients of 444 dental clinics were analyzed; the patients were aged 40 years or older, regularly visited dentists, and had diagnosed periodontal disease (defined as two or more teeth with a clinical attachment level ≥6 mm). Medical history was collected with a self-reported questionnaire. Number of teeth with a probing pocket depth (PPD) ≥5 mm was used to define periodontal status, and the highest quartile was used as the dependent variable. A Poisson regression model showed that histories of diabetes and hypertension were associated with a larger number of teeth with a PPD ≥5 mm (diabetes: prevalence rate ratio [PRR] 1.36, 95% confidence interval [CI] 1.00-1.85; hypertension: PRR 1.27, 95% CI 1.02-1.58) after adjusting for potential periodontal risk factors. These findings suggest that diabetes and hypertension are associated with worse periodontal disease. Dentists should confirm the diabetes and hypertension status of patients who receive maintenance care, because these conditions could affect periodontal management of patients.