Assessing the progression of chronic periodontitis using subgingival pathogen levels: a 24-month prospective multicenter cohort study.

BACKGROUND: The diagnosis of the progression of periodontitis presently depends on the use of clinical symptoms (such as attachment loss) and radiographic imaging. The aim of the multicenter study described here was to evaluate the diagnostic use of the bacterial content of subgingival plaque recovered from the deepest pockets in assessing disease progression in chronic periodontitis patients. METHODS: This study consisted of a 24-month investigation of a total of 163 patients with chronic periodontitis who received trimonthly follow-up care. Subgingival plaque from the deepest pockets was recovered and assessed for bacterial content of Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans using the modified Invader PLUS assay. The corresponding serum IgG titers were measured using ELISA. Changes in clinical parameters were evaluated over the course of 24 months. The sensitivity, specificity, and prediction values were calculated and used to determine cutoff points for prediction of the progression of chronic periodontitis. RESULTS: Of the 124 individuals who completed the 24-month monitoring phase, 62 exhibited progression of periodontitis, whereas 62 demonstrated stable disease. The P. gingivalis counts of subgingival plaque from the deepest pockets was significantly associated with the progression of periodontitis (p < 0.001, positive predictive value = 0.708). CONCLUSIONS: The P. gingivalis counts of subgingival plaque from the deepest pockets may be associated with the progression of periodontitis.

Salivary pathogen and serum antibody to assess the progression of chronic periodontitis: a 24-mo prospective multicenter cohort study.

BACKGROUND AND OBJECTIVE: A diagnosis of periodontitis progression is presently limited to clinical parameters such as attachment loss and radiographic imaging. The aim of this multicenter study was to monitor disease progression in patients with chronic periodontitis during a 24-mo follow-up program and to evaluate the amount of bacteria in saliva and corresponding IgG titers in serum for determining the diagnostic usefulness of each in indicating disease progression and stability. MATERIAL AND METHODS: A total of 163 patients with chronic periodontitis who received trimonthly follow-up care were observed for 24 mo. The clinical parameters and salivary content of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans were assessed using the modified Invader PLUS assay, and the corresponding serum IgG titers were measured using ELISA. The changes through 24 mo were analyzed using cut-off values calculated for each factor. One-way ANOVA or Fisher's exact test was used to perform between-group comparison for the data collected. Diagnostic values were calculated using Fisher's exact test. RESULTS: Of the 124 individuals who completed the 24-mo monitoring phase, 62 exhibited periodontitis progression, whereas 62 demonstrated stable disease. Seven patients withdrew because of acute periodontal abscess. The ratio of P. gingivalis to total bacteria and the combination of P. gingivalis counts and IgG titers against P. gingivalis were significantly related to the progression of periodontitis. The combination of P. gingivalis ratio and P. gingivalis IgG titers was significantly associated with the progression of periodontitis (p = 0.001, sensitivity = 0.339, specificity = 0.790). CONCLUSIONS: It is suggested that the combination of P. gingivalis ratio in saliva and serum IgG titers against P. gingivalis may be associated with the progression of periodontitis.

Periostin of human periodontal ligament fibroblasts promotes migration of human mesenchymal stem cell through the αvß3 integrin/FAK/PI3K/Akt pathway.

BACKGROUND AND OBJECTIVE: The periodontal ligament (PDL) is characterized by rapid turnover, high remodeling capacity and high inherent regenerative potential compared with other connective tissues. Periostin, which is highly expressed in the fibroblasts in the PDL, has been widely discussed in relation to collagen fibrillogenesis in the PDL. Recently, several reports have indicated periostin in cell migration. The aim of this study was to examine whether human PDL fibroblasts (hPDLFs) with high levels of periostin expression promote the migration of human bone marrow mesenchymal stem cells (hMSCs). MATERIAL AND METHODS: The migration of hMSCs was examined by transwell chamber migration assay under different conditions: medium alone, hPDLFs, human dermal fibroblasts, recombinant periostin, integrin αvß3 blocking antibody (anti-CD51/61 antibody) and inhibitors of FAK (PF431396) and PI3K (LY294002). Phosphorylation of FAK and Akt in hMSCs under stimulation of periostin was examined by western blotting. RESULTS: The migration assay revealed that the number of migrated hMSCs by hPDLFs was significantly larger than those by dermal fibroblasts, periostin small interfering RNA hPDLFs and medium alone. Furthermore, recombinant periostin also strongly induced hMSC migration. The addition of anti-CD51/61 antibody, PF431396 and LY294002 caused a significant reduction in the number of migrated hMSCs respectively. The anti-CD51/61 antibody inhibited both FAK and Akt phosphorylations under periostin stimulation. PF431396 inhibited both FAK and Akt phosphorylations. LY294002 inhibited only Akt phosphorylation, and FAK phosphorylation was not influenced under periostin stimulation. CONCLUSION: Periostin expression in hPDLFs promotes the migration of hMSCs through the αvß3 integrin/FAK/PI3K/Akt pathway in vitro.

Relationship between the mandibular inferior cortex and bone stiffness in elderly Japanese people.

UNLABELLED: SUMARRY: This study assessed the relationship between the mandibular inferior cortex (MIC) and bone stiffness in elderly Japanese subjects. Results suggest that MIC classification may be useful for screening patients for the possibility of osteoporosis by measuring bone stiffness with ultrasound bone densitometry. INTRODUCTION: The prevention of fractures is a priority for patients with osteoporosis. Dental panoramic radiographs are frequently taken for the examination of teeth and jaws in general dental practice worldwide. This study assessed the relationship between the mandibular inferior cortex (MIC) and bone stiffness in elderly Japanese subjects. METHODS: This study included 519 healthy subjects (263 men and 256 women) aged 70 years old. We evaluated the relationship between MIC classification and bone stiffness using Scheffe's multiple comparison test. Multiple linear regression analysis was used to assess the relationship between MIC classification and bone stiffness after controlling for confounding factors. RESULTS: A significant correlation was found between MIC classification and bone stiffness in men (C1 vs C2: p < 0.05) and women (C1 vs C2: p = NS, C1 vs C3: p < 0.01, C2 vs C3: p < 0.05). MIC classification was significantly associated with bone stiffness on multiple linear regression analysis after controlling for sex, body mass index, regular exercise, and smoking (beta = -0.11, p < 0.01, R(2) = 0.387, p < 0.001). CONCLUSIONS: Our study suggests that MIC classification may be useful for screening patients for the possibility of osteoporosis by measuring bone stiffness with ultrasound bone densitometry.

Physical function is weakly associated with angiotensin-converting enzyme gene I/D polymorphism in elderly Japanese subjects.

BACKGROUND: The turning point in the deterioration of physical function seems to occur between the ages of 70 and 80 years. In particular, muscle strength may decline even more in subjects older than 75. A recent study found that the angiotensin-converting enzyme (ACE) genotype also affects physiological left ventricular hypertrophy. A very limited number of papers have examined genetic differences in resistance and endurance forms of a single sporting discipline. OBJECTIVE: The purpose of this study was to evaluate the relationship between ACE genotype and physical function by controlling the known confounding factors including dental status. METHODS: We selected 431 subjects who were aged 76 years and did not require special care for their daily activities. We conducted a medical examination, followed by 5 physical function tests, as follows: (1) maximum hand grip strength, (2) maximal isometric knee extensor strength, (3) maximal stepping rate for 10 s, (4) one-leg standing time with eyes open and (5) 10-meter maximum walking speed. Subjects were genotyped for the ACE intron 16 Alu insertion. In addition, serum concentrations of total cholesterol, total protein, IgA and IgG were measured at a commercial laboratory. The Eichner index was used as an indicator of occlusal condition. Multiple linear regression analysis was performed to evaluate the relationship between the ACE gene insertion/deletion (I/D) polymorphism and physical function considering confounding factors. RESULTS: The ACE gene I/D polymorphism was positively associated with hand grip strength and 10-meter maximum walking speed. Betas of hand grip strength were 0.09 for I/D (p = 0.022) and 0.12 for insertion/insertion (I/I; p = 0.004). Betas of 10-meter walking speed were -0.11 for I/D (p = 0.093) and -0.14 for I/I (p = 0.039). Dental status such as Eichner index class C was significantly associated with one-leg standing time with eyes open (beta -0.11; p = 0.028). CONCLUSION: This study suggests that there is a significant relationship between ACE genotype and physical function. In particular, subjects with the ACE deletion/deletion genotype were associated with upper extremities.

Relation of bone turnover markers to periodontal disease and jaw bone morphology in elderly Japanese subjects.

OBJECTIVE: The purpose of this study was to evaluate the relation of bone turnover markers such as bone formation and resorption to periodontal disease and jaw bone morphology in elderly Japanese subjects. SUBJECTS AND METHODS: We selected 148 subjects for participation in this study. All subjects were aged 77 years. The periodontal examination included the assessment of clinical attachment level (CAL). Biochemical parameters of bone turnover measured included urinary deoxypyridinoline, serum osteocalcin (S-OC), and serum bone-specific alkaline phosphatase. In addition, to evaluate the jawbone, we used the mandibular inferior cortex classification (MIC). RESULTS: Serum osteocalcin had significantly higher (males: P = 0.038, females: P = 0.041) tendency for MIC Class (ANOVA). Multiple linear regression results showed that the number of remaining teeth and S-OC were negatively associated with the percentage of sites with > or =6 mm CAL (R(2) = 0.322, P < 0.001). Coefficients and betas were -0.71, -0.46 (P < 0.001) and -1.11, -0.28 (P = 0.002), respectively. CONCLUSION: In conclusion, this study suggests that there is a significant relation of bone turnover markers to periodontal disease and jaw bone morphology in elderly Japanese subjects.

Relationship between mandibular inferior cortex and general bone metabolism in older adults.

UNLABELLED: The purpose of this study was to investigate whether a link exists between the jawbone and general bone metabolism. The results of our study indicate that a mandibular inferior cortical erosion finding on dental panoramic radiographs is significantly associated with increased biochemical markers of bone turnover. INTRODUCTION: The purpose of this study was to investigate whether a link exists between the jawbone and general bone metabolism. METHODS: We measured values of serum bone-specific alkaline phosphatase (S-BAP) and urinary N-telopeptide cross-links of type I collagen (U-NTX). To evaluate the jawbone, we used mandibular inferior cortex (MIC) classification on dental panoramic radiographs. After 134 subjects were divided into three groups (C1: normal cortex, C2: mildly to moderately eroded cortex, C3: severely eroded cortex), we evaluated the relationship between S-BAP or U-NTX and MIC classification by Scheffe's multiple comparison test. RESULTS: A significant correlation was found between MIC classification and S-BAP (C1 vs. C2: p < 0.01, C1 vs. C3: p < 0.01, C2 vs. C3: NS). A significant correlation was found between MIC classification and U-NTX (C1 vs. C2: p < 0.01, C1 vs. C3: p < 0.001, C2 vs. C3: p < 0.01). CONCLUSIONS: The results of our study indicate that the mandibular inferior cortical erosion finding on dental panoramic radiographs is significantly associated with increased S-BAP and U-NTX levels. We suggest that there is an association between the jawbone and general bone metabolism.

Laser capture microdissection of rat periodontal ligament for gene analysis.

The periodontal ligament (PDL) is a connective tissue interposed between two hard tissues, viz., the root of a tooth and the alveolar bone, which makes it difficult to obtain directly. In the study reported here, PDL, subgingival connective tissue and pulp of rat molars were extracted directly by laser capture microdissection and the gene expression of TGF-beta1 on the microdissected PDL was examined. The maxillae of rats were dissected and rapidly immersed in isopentane cooled with liquid nitrogen. Serial frontal sections of the rat first molar area were used for immunohistochemistry and for laser capture microdissection to localize the TGF-beta1 gene. Gene expression and immunohistochemical localization of TGF-beta1 also were examined in the pulp and subgingival connective tissues. TGF-beta1 was located immunohistochemically in the fibroblasts in the PDL. A considerable amount of RNA was obtained by laser capture microdissection of these three tissues for analysis of gene expression. The reverse transcription- polymerase chain reaction demonstrated that glyceraldehyde 3-phosphate dehydrogenase was amplified in all three tissues, and that TGF-beta1 was detected in the PDL. Laser capture microdissection makes it possible to analyze the gene expression of PDL and expression of TGF-beta1 in the PDL suggests that this gene could function in maintaining PDL.

Longitudinal relationship between root caries and serum albumin.

Serum albumin levels are a practical marker of general health status in the elderly and have been used to determine the severity of an underlying disease and the risk for death. This longitudinal study evaluated the relationship between serum albumin levels and root caries. A total of 266 persons with at least 1 tooth at baseline underwent a baseline examination and then annual investigations for 6 years. Multiple linear regression analysis was used to assess the relationship between changes in serum albumin levels and the number of root caries lesions over 6 years, after adjustment for confounding factors. Change in the number of root caries lesions was significantly associated with change in serum albumin concentrations. The standardized coefficient was -0.148 (p = 0.024). We can confirm that serum albumin concentration correlates with root caries events. From these data, we conclude that persons with hypoalbuminemia are at high risk for root caries.

Serum markers of chronic dehydration are associated with saliva spinability.

Findings of a relationship between saliva and dehydration have been observed, but the precise nature of these relationships is unclear and no evidence of a direct link has been found. In particular, no study reports a relationship between chronic dehydration and saliva conditions in community-dwelling older adults. This study aimed to identify whether salivary conditions are sensitive to body hydration markers in an elderly population. A total of 403 subjects aged 76 years participated in the study. Stimulated saliva flow rate and spinability of saliva were measured. In addition, determinations of serum levels of uric acid, blood urea nitrogen (BUN), creatinine, sodium and potassium were made. Dehydration was defined as uric acid >/= 7 mg dL(-1) according to the standard value. The salivary spinability were significantly associated with the concentration of uric acid (OR=2.06, P=0.044) according to multiple logistic regression analysis. In addition, after adjusting for gender, the uric acid concentration and the salivary spinability was significantly associated with BUN, potassium and creatinine levels. The subjects with high uric acid levels (>/= 7 mg dL(-1)) had the most elastic saliva. Both BUN and serum creatinine are the most commonly used indicators of renal function. Therefore, our findings might demonstrate that older adults who are dehydrated showed highly elastic saliva, which was associated with renal function. In conclusion, this study suggests that there is a significant relationship between chronic dehydration status and salivary spinability level.

Association between commensal bacteria and opportunistic pathogens in the dental plaque of elderly individuals.

Opportunistic infections in the oral cavity of the elderly may increase the incidence of systemic disease. The objective of this study was to investigate the differences in the oral bacterial flora between dependent elderly (inpatients) and independent elderly (community-dwelling residents). After multiple variables were taken into account, inpatients had significantly lower detection rates than community-dwelling residents for alpha-streptococci (p < 0.001) and Neisseria (p 0.004), and higher detection rates for Pseudomonas aeruginosa (p 0.024), methicillin-resistant Staphylococcus aureus (MRSA) (p 0.011) and Actinomyces spp. (p 0.005). Among inpatients, the requirement for a high degree of care was related negatively to detection of alpha-streptococci, but was related significantly to detection of P. aeruginosa (p 0.018) or MRSA (p 0.004). Tube-fed inpatients had a significantly lower detection rate for alpha-streptococci (p 0.041) and a higher detection rate for P. aeruginosa (p 0.004) than those who did not require tube feeding. Inpatients with a history of antibiotic use had a significantly lower detection rate for alpha-streptococci (p 0.049) and a higher detection rate for MRSA (p 0.007) than those without a history of antibiotic use. The detection rates for P. aeruginosa or MRSA in inpatients without alpha-streptococci were higher than in inpatients with alpha-streptococci after controlling for age and gender (P. aeruginosa, p 0.006; MRSA, p 0.001). Overall, detection of alpha-streptococci had an inverse correlation with the detection of P. aeruginosa and MRSA in the oral cavity and is likely to be an indicator of pathogenic bacterial infection.

Predominant presence of Streptococcus anginosus in the saliva of alcoholics.

Chronic alcohol consumption is known to be a major risk factor for cancers of the upper aerodigestive tract. The incidence of esophageal cancer (4.4%) in alcoholics is reported to be much higher than that in the Japanese population as a whole (0.0001%). This suggests the presence of specific factors in chronic alcohol consumption-related carcinogenesis. Recently, data showing a significant correlation between Streptococcus anginosus and carcinogenesis in the upper aerodigestive tract have been reported. In this study, the ratio of S. anginosus to oral bacteria in the saliva of 38 alcoholic patients was investigated to determine if there is an association between alcoholic patients and S. anginosus infection. The level of S. anginosus in the saliva from 22 healthy people, 41 esophageal cancer patients, 32 gastritis patients, and 24 periodontitis patients was also investigated and compared to the level in alcoholic patients. In the saliva from esophageal cancer patients, the level of S. anginosus was not significantly different from that of healthy people. The levels of S. anginosus in periodontitis and gastritis patients were also similar. In alcoholics, however, there was an extremely high level of S. anginosus, suggesting that they, rather than healthy people and general esophageal cancer patients, have a high risk for S. anginosus infection.

The relationship between bone mineral density and the number of remaining teeth in community-dwelling older adults.

Tooth loss and osteoporosis may share common aetiologic agents which influence the process of both diseases. The purpose of this study was to evaluate the relationship between bone mineral density (BMD) of the os calcis and the number of remaining teeth, controlling the known confounding factors. Among all 70-year-old inhabitants in Niigata City, Japan, 600 people were selected randomly in order to have approximately the same number of each gender. We analysed 460 subjects. We evaluated the BMD of the os calcis using an ultrasound bone densitometer, then we counted the number of remaining teeth excluding the third molars. Stiffness is a clinical index which is calculated by the spread speed of supersonic waves. To monitor the general health condition of the subjects, serum levels of disease markers and smoking habits were also investigated. The mean number of remaining teeth for the osteopenia group (OG) and the no-osteopenia group (NOG) was 15.97+/- 9.98 and 18.31+/- 8.06, respectively in females, and 16.32+/- 9.93 and 18.12+/- 9.33, respectively in males (OG versus NOG, P=0.047 by two-way anova). In addition, stiffness was significantly associated with the number of remaining teeth (CV=-0.157, P=0.005) using linear multiple regression analysis adjusted by four other variables. In this study, there was a significant relationship between the number of remaining teeth and BMD of the os calcis.

Serum vitamin C-periodontal relationship in community-dwelling elderly Japanese.

OBJECTIVE: To determine the relationship between serum vitamin C and periodontitis as estimated by clinical attachment loss (CAL) in community-dwelling elderly Japanese. MATERIAL AND METHODS: This analysis was confined to 413 Niigata citizens aged 70 years in whom the data for serum vitamin C and CAL were available. High-pressure liquid chromatography method was used to ascertain the serum vitamin C levels while CAL was assessed on six sites of all teeth present including third molars by means of pressure-sensitive probes. Other variables included gender, smoking, toothbrushing frequency, number of teeth present and random blood sugar levels. RESULTS: Serum vitamin C concentration was inversely related to CAL (r=-0.23, p<0.00005) at bivariate level. Multiple linear regression analysis showed that CAL was 4% greater in subjects with lower serum vitamin C levels than in subjects with higher serum vitamin C levels notwithstanding smoking, diabetes, oral hygiene, gender or number of teeth present. CONCLUSION: The findings suggested that serum vitamin C might have relatively weak but a statistically significant relationship with periodontitis in this elderly population.

Molecular analysis of age-related changes of Streptococcus anginosus group and Streptococcus mitis in saliva.

The purpose of this study was to survey the prevalence of streptococcal species, especially Streptococcus anginosus (which has been reported to be associated with cancer in the upper digestive tract), Streptococcus constellatus, and Streptococcus intermedius in the saliva of different age groups. A sequence analysis of 16S rDNA was performed and DNA quantified using real-time polymerase chain reaction. The S. anginosus level increased with age, whereas the levels of S. constellatus and S. intermedius did not change. Streptococcus mitis was the predominant species in the saliva of all the age groups but, unlike the S. anginosus, the proportion of S. mitis in the salivary bacteria decreased with age. The increase in S. anginosus with age should be carefully monitored because of its association with diseases, including cancer.

Role of peptide antigen for induction of inhibitory antibodies to Streptococcus mutans in human oral cavity.

The alanine-rich repeating region (A-region) in the surface protein antigen (PAc) of Streptococcus mutans has received much attention as an antigenic component for vaccines against dental caries. The PAc (residue 361-386) peptide in the A-region possesses a multiple binding motif (L- -V-K- -A) to various HLA-DR molecules and a B-cell core epitope (- Y- - -L- -Y- - - -) that recognizes the inhibiting antibody to S. mutans. In the present study, we investigated the immunogenicity of the PAc (361-386) peptide in humans and regulators of induction of the anti-PAc (361-386) peptide IgA antibody (aPPA) in saliva. The PAc (361-386) peptide was confirmed as an ideal peptide antigen for induction of the inhibiting antibody to S. mutans in 151 healthy human subjects (36.6 +/- 12.6 years old) by quantitative analyses of oral bacteria and ELISA, as the aPPA titre in human saliva decreased significantly in an age-dependent manner. Homozygous DRB1*0405 and 1502, and heterozygous DRB1*0405/1502 showed a negative association with production of aPPA and tended to reduce the number of total streptococci in saliva. In contrast, the DRB1*1501 allele was significantly correlated with a high level of induction of the antibodies, and also tended to reduce lactobacilli and mutans streptococci. Further, peptide immunogenicity was confirmed in NOD-SCID mice grafted with human peripheral blood mononuclear cells. Our results indicate that the interplay between regulators such as age, DRB1 genotype, cytokines, and peptide immunogenicity may provide a potential means for developing a vaccine useful for the prevention of dental caries as well as their diagnosis.

Systemic diseases in association with microbial species in oral biofilm from elderly requiring care.

BACKGROUND: The oral cavity is a reservoir for colonization and infection of systemic organs by pathogenic bacteria. It is understood that aging, tooth eruption, hormonal changes, active disease, oral hygiene, and other factors have an influence on biofilm formation and bacterial accumulation in the oral cavity. OBJECTIVE: To understand the influence of systemic health care on microfloral changes, we conducted epidemiological studies of nursing home residents in an attempt to elucidate the relationship between underlying systemic diseases and the isolation frequency of oral opportunistic pathogens. METHODS: The prevalence of bacteria and fungi causing pneumonia in association with oral biofilm bacteria were determined using detection culture plates. The influences of gender, age, denture-wearing status, number of teeth, and bedridden status in the patients residing in nursing homes were then analyzed. RESULTS: The isolation frequency rates of Candida albicans, Pseudomonadaceae, Staphylococcus spp., and some strains of Enterobacteriaceae in plaque samples, as well as C. albicans and Xanthomonas maltophilia in samples from the pharynx, were significantly higher in those requiring systemic care (mean age 83.9 years) than in those who did not require such care (mean 71.0 years). In particular, the frequencies of Pseudomonas spp., C. albicans, and Serratia marcescens in plaque were significantly higher in those who were bedridden. Furthermore, the isolation of Pseudomonas spp. and Klebsiella pneumoniae, and/or C. albicans in plaque was significantly associated with heart disease. CONCLUSION: The coexistence of Pseudomonas spp. and C. albicans in elderly with 10-19 teeth is a potential indicator of high risk for pneumonia and heart disease. Therefore, attention to oral hygiene and professional care for removing the indicators may diminish the occurrence of systemic disease in the elderly requiring systemic care.

Real-time interaction of oral streptococci with human salivary components.

Oral streptococci are present in large numbers in dental plaque and several types interact with the enamel salivary pellicle to form a biofilm on tooth surfaces. The respective affinity of individual streptococci for salivary components has an influence on the etiologic properties of oral biofilm in the development of dental caries. We studied real-time biospecific interactions between oral streptococci and salivary components utilizing biosensor technology to analyze surface plasmon resonance. Streptococcus sanguis and Streptococcus mutans showed significant responses for binding to salivary components, in comparison with other bacteria. Further, the association rates (4.1 x 10-11/bacterium) and dissociation rate (5.7 +/- 0.9 x 10-3 Second(s)-1) were higher for S. sanguis than for S. mutans (2.4 x 10-11 and 2.9 +/- 0.8 x 10-3) and Streptococcus mitis (1.3 x 10-11 and 3.5 +/- 1.3 x 10-3). However, the association equilibrium constants (8.2 S/bacterium) for S. mutans was 2 times higher in than S. mitis (3.8) and slightly higher than S. sanguis (7.2). These findings may provide useful information regarding the mechanism of early biofilm formation by streptococci on the tooth surface.

Association between serum albumin and root caries in community-dwelling older adults.

Recently, associations between dental diseases and the general health condition have been reported. The purpose of this study was to evaluate, by serum albumin concentrations, the relationship between the general health condition and root caries. We randomly selected 763 individuals (600 70-year-olds and 163 80-year-olds) living in Niigata City, Japan. The variables body composition, blood measurements, daily nutrient intakes, and root caries were measured. The relationship between root caries and serum albumin concentration was evaluated. The differences in serum albumin concentrations between subjects with untreated root caries (DT = 0 and DT > 3) were 75.56 mg/dL in 70-year-olds and 202.97 mg/dL in 80-year-olds (p < 0.05, ANOVA). The findings of the present study indicated that a relationship between root caries and serum albumin concentration in these elderly subjects is highly possible.

Sexual differences in smoking behaviour and dental caries experience in young adults.

Smokers have been reported to exhibit a low awareness of their health. However, oral health awareness in smokers has not been fully studied. Having adequate oral care and high awareness of oral health from youth is necessary to prevent the deterioration of oral health in middle and old age. The aim of this study was to investigate the oral health status and oral health behaviour in young smokers. A survey composed of a questionnaire and an oral examination was administrated to adults aged 20-29 y who consulted dentists. The relationship between smoking behaviour and oral health status and oral health behaviour in subjects was analysed. In women, though no significant relationship between smoking behaviour and the number of decayed, missing, and filled teeth was seen, current smokers had significantly more decayed teeth, missing teeth and fewer filled teeth than ex-smokers and non-smokers. Current smokers tended to practice less oral health behaviour than non-smokers. In men, there was no significant relationship between smoking behaviour and each oral health status item. These findings suggested that the smoking group had lower oral health awareness than the non-smoking group in women.