Health behaviors and tooth retention among older adults in China: findings from the 4th Chinese national oral health survey.

BACKGROUND: This study aimed to examine the association between oral health behaviors and tooth retention among Chinese older adults. METHODS: Data were used from the 4th Chinese National Oral Health Survey, a nationally representative sample. The sample included 9054 older adults aged 55 to 74. Control variables and oral health behaviors were measured through a questionnaire interview, and the number of remaining teeth and periodontal health were obtained from an oral health examination. A chi-square test was used for univariate analysis. Multivariate Logistic regression was used to explore the association between health behaviors and the number of remaining teeth. RESULTS: The average number of remaining teeth in the sample was 24.4 ± 7.7. There was a higher proportion of older adults living in urban areas with 20 or more teeth than those living in rural areas (83.2% vs. 79.4%, P < 0.001); and a higher proportion of individuals with high education levels with 20 or more teeth compared to those with low education levels (P < 0.001). Logistic regression models showed that older adults who used toothpicks `(OR = 3.37, 95% CI 2.94-3.85), dental floss (OR = 1.93, 95% CI 1.05-3.53), toothpaste (OR = 3.89, 95% CI 3.14-4.83); and never smoked (OR = 1.43 95% CI 1.20-1.70) were more likely to retain 20 or more natural teeth; whereas older adults who had a dental visit were less likely to retain 20 or more natural teeth (OR = 0.45, 95% CI 0.39-052). CONCLUSION: Good oral hygiene practices, never smoking, and regular dental visits focusing on prevention are significantly associated with teeth retention. It is critical to promote a healthy lifestyle and improve prevention-oriented oral health care systems.

Diet and lifestyle habits associated with caries in deciduous teeth among 3- to 5-year-old preschool children in Jiangxi province, China.

BACKGROUND: The purpose of this study was to investigate the status of caries in deciduous teeth and the effect of diet and lifestyle habits on dental caries among 3- to 5-year-old preschool children in Jiangxi Province, China. METHODS: In total, 2880 cases involving preschool children were selected by stratified cluster sampling. The dental examination methods and criteria followed the WHO guidelines. SPSS 19.0 was used for the statistical analysis. Chi square tests were used to compare the caries prevalence among children with different social characteristics. Non-parametric tests were used to compare the decayed, missing and filled teeth (dmft) index values. Univariate and multivariate regression analyses were used to study the effect of diet and lifestyle habits on dental caries. RESULTS: The caries prevalence among the 2880 cases of 3- to 5-year-old preschool children in Jiangxi Province, China was 49.13%. There was no gender difference in this rate (P > 0.05). The caries prevalence increased with age (P < 0.05). The prevalence of caries in the rural areas was higher than that in the urban areas (P < 0.05). The deciduous central incisors and deciduous molars had a higher caries prevalence than the other deciduous teeth. According to the multivariate logistic regression analysis, the caries risk increased with living in a rural area, exclusive breastfeeding, greater frequency of daily snacking, high frequency of snacking before sleep and beginning to brush teeth at a late age; the caries risk decreased when parents helped their children brush their teeth. CONCLUSION: The caries prevalence among 3- to 5-year-old preschool children in Jiangxi was lower than the level throughout the country and lower than the rate in other developing countries. The children's diet and lifestyle habits were closely related to dental caries. Parents and children should be more aware of oral health, and parents should help their children develop healthy lifestyle behaviours.

[Effect and mechanism of miR-124 on osteogenic differentiation of dental pulp mesenchymal stem cells].

PURPOSE: To evaluate the effect of microRNA (miR)-124 on osteogenic differentiation of dental pulp mesenchymal stem cells (DPSCs) and to explore the possible mechanism. METHODS: Logarithmic DPSCs were collected and divided into blank group, no-load group, miR-124 inhibitor group, miR-124 inhibitor combined with N-[N-(3,5-difluorophenacetyl)-1-alanyl]-S-ph (DAPT, Notch signaling pathway inhibitor) group. The blank group was not treated, the empty group was transfected with negative control vector inhibitor-NC, the miR-124 inhibitor group was transfected with miR-124 inhibitor, the miR-124 inhibitor combined with DAPT group was transfected with miR-124 inhibitor, and DAPT was added to make the final concentration of 5 µmol/L. The proliferation ability was tested by CCK-8 method 48 h after transfection. Alkaline phosphatase (ALP) activity was tested by p-nitrophenyl phosphate (P-NPP) method after 2 weeks of induction. The area of calcified nodules was tested by alizarin red staining method. The protein expression of hair-like division-related enhancer 1 (HEY1), hair-like division-related enhancer 2 (HEY2), and cyclin D1 gene (CCND1) were tested by Western blot. The data was analyzed by SPSS 19.0 software package. RESULTS: Compared with the blank group and no-load group, the A450 value at 24, 48, 72 h detected by CCK-8 experiment, A450 value of ALP activity, the area composition ratio of calcified nodules, and expression of HEY1, HEY2, and CCND1 in the miR-124 inhibitor group were increased (P<0.05). Compared with miR-124 inhibitor group, the A450 value at 24, 48, 72 h detected by CCK-8 experiment, A450 value of ALP activity, the area composition ratio of calcified nodules, and the expression of HEY1, HEY2, and CCND1 in the miR-124 inhibitor combined with DAPT group were significantly decreased(P<0.05). CONCLUSIONS: Down-regulation of miR-124 can promote osteogenic differentiation of DPSCs. It is speculated that the mechanism of action is related to the activation of Notch signaling pathway.

Effects of grape seed proanthocyanidins on the expression of inflammatory mediators in gingival epithelial cells.

OBJECTIVES: This study aims to determine the effect of grape seed proanthocyanidin (GSP) pretreatment on lipopolysaccharide (LPS)-induced inflammation of human gingival epithelial cells (HGECs). METHODS: HGECs were cultivated with different concentrations of GSPs (0, 1, 5, 10, 20, 40, 60, 80, 100 µg·mL-1) for 6, 12, 24, and 48 h. CCK-8 was used to detect the proliferation activity of HGECs. HGECs were treated with different concentrations of GSPs (0, 10, 20, and 40 µg·mL-1) for 24 h and then cultured with 1.0 µg·mL-1 LPS. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of pro-inflammatory cytokine tumor necrosis factor-α (TNF-α), interleukin (IL)-1ß, and IL-6 and anti-inflammatory cytokines IL-4, IL-10, and transforming growth factor-ß (TGF-ß). Quantitative real-time polymerase chain reaction (QRT-PCR) was used to detect the mRNA expression levels of TNF-α, IL-1ß, IL-6, IL-4, IL-10, and TGF-ß. RESULTS: When the GSP concentration was 0-40 µg·mL-1, the cell proliferation had no significant difference. When the action time reached 24 h, the cell proliferation was the highest. The results of ELISA and QRT-PCR showed that 10, 20, and 40 µg·mL-1 GSPS decreased the expression levels of TNF-α, IL-1ß, and IL-6 (P<0.05) and increased the expression levels of IL-4, IL-10, and TGF-ß compared with 0 µg·mL-1 GSPS (P<0.05). CONCLUSIONS: GSPS (0-40 µg·mL-1) has no significant effect on the proliferation activity of HGECs. Pretreatment with GSPS can inhibit the expression of pro-inflammatory factors and enhance the expression of anti-inflammatory factors. Hence, GSPS has a certain preventive effect on the resistance of HGECs to the stimulation of endotoxin.

Analysis of gum bleeding among children aged 12-15 years in Jiangxi Province and related influencing factors.

OBJECTIVE: To study the prevalence of gum bleeding in children aged 12-15 years in Jiangxi Province and related influencing factors for the development of effective prevention and treatment strategies. METHODS: A multistage cluster stratified sampling method was used to select 8,160 children aged 12-15 years for this study. Enrolled children completed a set of survey questionnaires covering children's gender, age, parents' educational level, oral health knowledge scores, attitude scores, and brushing habits in addition of dental examination. All the data were analyzed using the chi-square test and logistic regression. RESULTS: Among 8,160 children, the gum bleeding rate was 66.5 percent (95% CI: 65.8%-68.1%). The gum bleeding rate in urban children (68.0 percent) was higher than that in rural areas (65.0 percent) (P < 0.01); the gum bleeding rate in boys (67.6 percent) was higher than that in girls (65.4 percent) (P < 0.05). The results of binary logistic regression analysis showed that age, urban and rural areas, mother education, knowledge score, attitude score, and brushing frequency were all important factors affecting gum bleeding. CONCLUSION: This study showed that incidence of gum bleeding in Jiangxi children is high which is affected by their age, mother's education, and several other factors. These new findings form the baseline information essential for the development of more effective approaches to prevent and control children gum bleeding in Jiangxi and other regions in the future.

Dental caries and associated factors among adolescents aged 12 to 15 in Jiangxi Province, China.

BACKGROUND: The purpose of this survey was to examine the association of general characteristics, oral health knowledge, attitudes, behavior, and dental caries status among adolescents in Jiangxi Province and to provide a basis for future prevention of dental caries among middle school students. METHODS: A total of 8,160 adolescents aged 12 to 15 years were invited to participate in this survey by a stratified random cluster sampling method from 30 schools in five counties in Jiangxi Province. A self-administered questionnaire was used to understand their basic characteristics, including oral health behaviors, knowledge, and attitudes. Chi-square tests were used to compare dental caries status and general characteristics. Univariate and multivariate logistic regression analyses were used to study the effects of oral health knowledge, attitudes, and behavior on dental caries. RESULTS: The prevalence of dental caries in permanent teeth was 25.8 percent, and the mean DMFT score of 12- to 15-year-old adolescents was 0.48 ± 1.04. The prevalence in rural areas was higher than that in urban areas (P < 0.001). The prevalence was higher in girls than in boys (P < 0.001). No significant age differences were observed (P > 0.05) in the prevalence of dental caries. The multivariate logistic regression analysis indicated that the variables associated with dental caries were tooth brushing frequency, use of toothpaste, frequency of sugary milk intake, smoking, and oral health attitudes. CONCLUSIONS: This study revealed that adolescent oral health behaviors and attitudes were associated with dental caries. It is important to implement targeted oral disease prevention and control measures among adolescents.

[Prevalence of malocclusion among 5 387 12- to 14-year-old adolescents in Jiangxi province, China: an epidemiological study].

OBJECTIVE: We provided baseline data for oral public health through epidemiological surveys to investigate the prevalence of malocclusion and orthodontic treatment proportion in 12- to 14-year-old adolescents in Jiangxi province, China. METHODS: Multi-stage random cluster sampling was used. A total of 5 387 12- to 14-year-old adolescents were examined by three professional dentists according to Angle's classification of malocclusion. The subjects were recruited from 30 secondary schools in five counties in Jiangxi Province. Results were statistically analyzed by SPSS19.0. RESULTS: The prevalence of malocclusion was 79.67% among adolescents aged 12-14 years in Jiangxi province. The composition ratios of ClassⅠ, Class Ⅱ Division 1, Class Ⅱ Division 2, and Class Ⅲ malocclusion were 30.96%, 16.36%, 12.78%, and 19.13% respectively. ClassⅠmalocclusion had the highest composition ratio, and the most common clinical manifestation of malocclusion was dentition crowding with a prevalence of 91.30%. The prevalence rate of malocclusion was higher in boys than in girls at 81.16% and 78.21%, respectively (P<0.05). This condition had different prevalence rates in Nanchang, Yichun, Jiujiang, Shangrao, and Ganzhou (P<0.05) with the highest in Nanchang and lowest in Ganzhou. Malocclusion was related to caries, and its prevalence rate was higher in patients with caries than in those without caries (P<0.05). The orthodontic rate of malocclusion was 2.63%, and the value was higher for girls than that for boys (P<0.05). The rate of orthodontic in urban areas was higher than that in rural areas (P<0.05). CONCLUSIONS: Compared with local and international findings on malocclusion of adolescents, high prevalence and low orthodontic rate were found in Jiangxi province. Strengthening the combination of prevention and treatment is important for the physical and mental health of adolescents. We should actively conduct oral health education, popularize the knowledge of malocclusion, and actively treat caries.

[Status and strategies of oral health service demand and medical treatment utilization among 3- to 5-year-old preschool children in Jiangxi province].

OBJECTIVE: This study aimed to investigate the oral health service needs and dental treatment among 3-year-old to 5-year-old preschool children in Jiangxi province and provide data to support the development of relevant oral health policies, enhance the oral health service utilization and visit rate, and optimize oral manpower and service resources. METHODS: A total of 2 880 preschool children were selected via stratified cluster sampling. Dental examination methods and criteria according to the fourth national oral health epidemiological survey were adopted. Excel 2007 and SPSS 19.0 softwares were used for statistics analysis. Chi-square test and logistic regression analysis were performed. RESULTS: The caries prevalence was 49.13% (1 415/2 880) among the 2 880 cases of 3-
year-old to 5-year-old preschool children in Jiangxi province, approximately 53.37% (1 537/2 880) of which possessed oral health service needs. The parents of younger children assessed the oral situation better in older age than in their younger years (P<0.05), which was better in urban children than in rural children (P<0.05). The visiting rate of all the respondents was 12.33% (355/2 880), while the visiting rate of children with oral diseases was 17.31% (266/1 537). The top three reasons why patients did not visit the dentist were as follows: children's teeth have no problem, the teeth damage in teeth was considerably minimal, and primary teeth would be replaced without the need for treatment. The influencing factors included lower visiting rate in females than in males (OR=0.499, 95%CI: 0.411-0.606) and lower visiting rates in rural areas than in urban areas (OR=0.428, 95%CI: 0.353-0.519). Subjects with poor oral health and high oral knowledge scores possessed high dental service visit rates. CONCLUSIONS: The prevalence of caries in 3-year-old to 5-year-old preschool children in Jiangxi province is at a lower level than that in the national level. The proportion of the population actively seeking medical services is low, and their main purpose of treatment is to treat rather than prevention. Oral health education should be strengthened, and it should be incorporated to the contents of the kindergarten teacher training program to improve residents' awareness regarding children's oral health.

[Grape seed proanthocyanidin extracts inhibit lipopolysaccharide of Porphyromonas gingivalis].

PURPOSE: To study the inhibitory effect of grape seed proanthocyanidin extracts on 1ipopolysacharides of Porphyromonas gingivalis. METHODS: Grape seed proanthocyanidin extracts were double-diluted to different concentrations by two-fold dilution. The effect on Porphyromonas gingivalis was measured by minimal inhibitory concentration (MIC). The inhibition effect of grape seed proanthocyanidin extracts on lipopolysaccharide was measured by limulus assay with 6 concentrations below the minimal inhibitory concentration. SPSS 17.0 software package was used for statistical analysis. RESULTS: The value of MIC of grape seed proanthocyanidin extracts was 0.8 mg/mL to the strains of the experimental bacteria. The inhibitory effect on lipopolysaccharide enhanced with the increasing of the concentration of grape seed proanthocyanidin extracts within the scope of 0.05 to 0.4 mg/mL (P<0.05,0.01). CONCLUSIONS: Grape seed proanthocyanidin extracts have inhibitory effect on lipopolysaccharide of Porphyromonas gingivalis.

[The application of desocclusol and manual mechanical method in endodontic retreatment].

PURPOSE: To investigate the clinical method to remove a gutta-percha and root canal sealers. METHODS: 168 root canals which had been filled with gutta-percha were selected,all root canals needed endodontic retreatment.The root canal fillings were removed and the root canal was re-prepared with the method of desocclusol and manual mechanical method. Then the root canal was filled again with lateral condensation technique. RESULTS: With manual mechanical method and desocclusol,all original root canal fillings were removed completely. The combined method could effectively prevent the formation of step,root canal-side wear,broken equipment or other complications during the course of retreatment.The success rate of retreatment was 89.3%. CONCLUSIONS: Combined manual mechanical method with desocclusol could improve the success rate of recanalization of the root canal and saved time and effort. It is a method which could reduce the intensity and improve the efficiency of dentists, and worthy of wide clinical application.

[Dental caries and periodontal diseases in adult Jiangxi cohort: a sample investigation].

PURPOSE: To investigate the current status of dental caries and periodontal diseases in the population aged 35-44 and 65-74 years in Jiangxi province, and to provide information for prevention of these diseases. METHODS: 1584 people (aged 35-44 and 65-74 years) were selected by equal-sized stratified multi- stage and random sampling. Their dental caries and periodontal diseases were examined in routine epidemiologic surgery manner. Student's t test and Chi-square test were applied for statistical analysis using SPSS12.0 software package. RESULTS: In the age group of 35-44 and 65-74 years, the prevalence rate of dental caries was 59.4% and 85.5%, the mean DMFT was 2.19 and 4.91, the prevalence rate of root caries was 32.7% and 79.5%, the mean DFRoot was 0.28 and 1.25,the rate of healthy periodontal tissues was 0.1% and 5.3%. CONCLUSIONS: Dental caries and periodontal diseases are quite common diseases in Jiangxi Province. We should reinforce the oral health care and the propaganda for oral care knowledge in order to treat caries and periodontal diseases better and earlier, and improve the life quality of middle-aged and elderly citizens.