Factors Related to Early Childhood Caries in 17- to 23-Month-Old Children in Aichi Prefecture, Japan: A Cross-Sectional Study.

Dental caries is the most prevalent of chronic oral conditions. We investigated child and parental factors associated with early childhood caries (ECC) in 17- to 23-month-old children in Aichi Prefecture, Japan. Of the 61,714 children who underwent a health examination at 18 months of age, 54,206 (27,860 males, 26,346 females) were included in the analysis. The parents of the children completed a self-administered questionnaire comprising items related to the child's eating habits and lifestyle and the parent's lifestyle and childcare factors. Logistic regression analyses were performed using ECC as the dependent variable, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The prevalence of ECC was 0.8%. In the multivariate analysis, children who consumed sweetened beverages daily and snacked frequently had significantly higher ORs for ECC: 1.29 (95% CI: 1.05-1.59) and 1.49 (95% CI: 1.15-1.91), respectively. Bedtime breastfeeding and bottle-feeding were significantly associated with higher ORs for ECC: 4.88 (95% CI: 4.01-5.94) and 2.31 (95% CI: 1.72-3.10), respectively. Not eating breakfast daily and late bedtime were associated with high ORs for ECC: 1.41 (95% CI: 1.02-1.96) and 1.31 (95% CI: 1.05-1.64), respectively. The OR for ECC was significantly higher in children whose father was a smoker than in those whose father was not: 1.44 (95% CI: 1.18-1.76). The OR for ECC was significantly higher in children with no childcare adviser than in those with a childcare adviser: 1.67 (95% CI: 1.06-2.65). Children who had not been vaccinated had a significantly higher OR for ECC compared to children who had: 1.49 (95% CI: 1.14-1.94). These results imply the importance of enhancing parental guidance on the lifestyle habits of children and creating an environment in which parents can consult with others regarding parenting.

Posterior occluding pairs of teeth or dentures and 1-year mortality in nursing home residents in Japan.

BACKGROUND: Associations between tooth loss and mortality have been reported in older individuals. However, limited information is available regarding the association between occlusion and mortality in nursing home residents. OBJECTIVE: We investigated the association between posterior occluding pairs (POPs) of teeth or dentures and 1-year mortality in nursing home residents. METHODS: The subjects of this study were residents from four nursing homes in Aichi prefecture, Japan, who were capable of eating and were enrolled in baseline examinations. We examined the number of present teeth and POPs (0-8 pairs), defined as pairs of occluding natural, restored or fixed prosthetic post-canine teeth. Then, we defined prosthetic POPs (0-8 pairs) as pairs of occluding natural, restored or fixed prosthetic post-canine teeth and removable dentures. Nutritional status, activities of daily living, cognitive function and comorbid conditions were assessed. One year later, we followed up the subjects. Ultimately, we analysed 173 elderly people (mean age ± SD: 87.1 ± 8.6 years; the survival group: N = 145, the deceased group: N = 28). RESULTS: In univariate analyses, mortality was significantly associated with age, peripheral vascular disease, nutritional status, diet texture and POPs. In multivariate logistic regression analysis, subjects who had 0 prosthetic POPs had significantly higher odds of a high mortality, compared with 8 prosthetic POPs. CONCLUSION: Lack of properly occluding posterior teeth, whether remaining teeth or dentures, is associated with 1-year mortality. (228 words/250).

Functional Impairment and Periodontitis in Rheumatoid Arthritis.

BACKGROUND: This study explored the association of functional impairment due to rheumatoid arthritis (RA) and RA disease activity with periodontal disease in patients with RA. METHODS: Ninety-three patients with RA were included. Their RA functional status was assessed using the Steinbrocker classification. The serum level of matrix metalloproteinase-3 (MMP-3) was used as an indicator of RA disease activity. Probing depth (PD) and clinical attachment level (CAL) were used as indicators of periodontal status. We examined the association of RA severity and MMP-3 levels with periodontal status using a generalised linear model (GLM). RESULTS: In a multivariate GLM, the coefficient for the mean PD was significantly positive in those with RA severity classes III or IV (reference: class I; ß = 0.14; 95% confidence interval [CI], 0.03-0.25; P = .02) independent of other confounding variables. In multivariate GLM using the mean CAL as the dependent variable, the coefficient was significant in patients with high MMP-3 levels (10 ng/mL; ß = 0.005; 95% CI, 0.001-0.008; P = .02). CONCLUSIONS: Functional impairment due to RA may affect PD, and high serum levels of MMP-3 may affect CAL.

Polymeric micelles effectively reprogram the tumor microenvironment to potentiate nano-immunotherapy in mouse breast cancer models.

Nano-immunotherapy improves breast cancer outcomes but not all patients respond and none are cured. To improve efficacy, research focuses on drugs that reprogram cancer-associated fibroblasts (CAFs) to improve therapeutic delivery and immunostimulation. These drugs, however, have a narrow therapeutic window and cause adverse effects. Developing strategies that increase CAF-reprogramming while limiting adverse effects is urgent. Here, taking advantage of the CAF-reprogramming capabilities of tranilast, we developed tranilast-loaded micelles. Strikingly, a 100-fold reduced dose of tranilast-micelles induces superior reprogramming compared to free drug owing to enhanced intratumoral accumulation and cancer-associated fibroblast uptake. Combination of tranilast-micelles and epirubicin-micelles or Doxil with immunotherapy increases T-cell infiltration, resulting in cures and immunological memory in mice bearing immunotherapy-resistant breast cancer. Furthermore, shear wave elastography (SWE) is able to monitor reduced tumor stiffness caused by tranilast-micelles and predict response to nano-immunotherapy. Micellar encapsulation is a promising strategy for TME-reprogramming and SWE is a potential biomarker of response.

Association Between the Extent of Periodontal Inflammation and the Severity of Rheumatoid Arthritis in Japanese Patients With Rheumatoid Arthritis.

OBJECTIVE: Periodontal inflammation can affect the progression of rheumatoid arthritis (RA), and RA drugs may influence the periodontal condition of patients with RA. We examined whether the association between periodontal inflammation and the severity of RA is influenced by RA medication. METHODS: This cross-sectional study recruited 98 Japanese patients with RA from an orthopaedic clinic. We assessed the severity of RA using the Steinbrocker class and stage. The periodontal inflamed surface area (PISA) was used as an indicator of periodontal status. We obtained data on RA medications from medical records. We examined the associations among periodontal tissue inflammation, RA medications, and RA severity using multinomial logistic regression analyses. RESULTS: In univariate multinomial logistic regression analyses, no significant association between PISA score and RA severity was observed. There was no significant association between PISA score and RA severity in multivariate analyses not including variables about RA drugs as independent variables. However, in multivariate analyses adjusted for RA drugs and other confounding variables, patients with a PISA >550 mm2 had significantly higher odds ratios (ORs) for Steinbrocker class III-IV and stage III-IV (OR, 20.24; 95% confidence interval [CI], 1.78-229.85 and OR, 12.42; 95% CI, 1.79-86.49, respectively) compared to patients with PISA score ≤550 mm2. CONCLUSION: The extent of periodontal inflammation is associated with the severity of RA independent of RA medications.

Relationship between Tooth Loss and the Medications Used for the Treatment of Rheumatoid Arthritis in Japanese Patients with Rheumatoid Arthritis: A Cross-Sectional Study.

BACKGROUND: There is limited information regarding the association between tooth loss and the medications used for the treatment of rheumatoid arthritis (RA). Here, we examined the association between tooth loss, disease severity, and drug treatment regimens in RA patients. METHOD: This study recruited 94 Japanese patients with RA. The severity of RA was assessed using the Steinbrocker classification of class and stage. Data on RA medications were obtained from medical records. We examined the associations between tooth loss, RA severity, and drug treatment regi mens using multinomial logistic regression analyses. RESULTS: Patients with 1-19 teeth had significantly higher odds ratios (ORs) of taking methotrexate (MTX) (OR, 8.74; 95% confidence interval (CI), 1.11-68.8) and biologic disease-modifying antirheumatic drugs (bDMARDs) (OR, 21.0; 95% CI, 1.3-339.1) compared to those with 27-28 teeth when adjusted for RA severity (class). Furthermore, patients with 1-19 teeth had significantly higher ORs of taking MTX (OR, 9.71; 95% CI, 1.22-77.1) and bDMARDs (OR, 50.2; 95% CI, 2.55-990.6) compared to those with 27-28 teeth when adjusted for RA severity (stage). CONCLUSION: RA patients with fewer teeth were more likely to take stronger RA therapies, independent of RA severity and other factors.

Influence of plaque control on the relationship between rheumatoid arthritis and periodontal health status among Japanese rheumatoid arthritis patients.

BACKGROUND: Functional disability of the finger joints in rheumatoid arthritis (RA) patients could affect their oral hygiene and periodontal status because of poor plaque control. We examined the influence of plaque control on the relationship between the severity of RA and periodontal status in RA patients. METHODS: This study recruited 89 Japanese RA patients who reported no difficulty in performing oral hygiene. We assessed RA severity using four indices: the Steinbrocker stage and class, the Health Assessment Questionnaire (HAQ) and the Disease Activity Score (DAS). Probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were taken as parameters of periodontal status. Oral hygiene status was assessed using the plaque index (PlI). We examined the association between the severity of RA and periodontal parameters using multivariable linear regression analyses. RESULTS: In multivariable linear regression analyses not including PlI, Steinbrocker stage III-IV patients had significantly higher PlI scores and greater PD compared with those of stage I. The class III-IV patients had significantly higher PlI scores and greater PD. Patients with an HAQ score ≥0.5 had a significantly higher PlI score than those with an HAQ score of 0. However, when PlI was added to each multivariable model as an independent variable, no significant relationship between RA severity and periodontal status was observed. CONCLUSIONS: This study suggests that it is important to consider the influence of plaque control when assessing the relationship between RA severity and periodontal health status in RA patients.