Correlation between attitude towards dental care for older adults and ageism in dental students and clinical trainees: Cross-sectional study.

INTRODUCTION: Since the needs for dental care among older adults in Japan are expected to increase in the future, this study aimed to examine the influence of ageism among dental students and clinical trainees on the attitude towards the older adults in dental care. MATERIALS AND METHODS: In 2022, we conducted a questionnaire survey of 9th-, 11th-semester dental students and first-year clinical trainees enrolled at Kyushu Dental University, using the Japanese version of Ageism Scale for Dental Students (ASDS-J), Japanese version of Fraboni Scale of Ageism (FSA-J). Questions on intention to provide dental care to the older adults, relationships with the older adults and living with the older adults were also surveyed. RESULTS: There were 162 participants (84 males and 78 females), and the response rate was 71.7%. The participants were divided into the positive group for dental care to older adults (68 respondents) and the negative group (94 respondents). The ASDS-J score of the negative group was significantly higher than that of the positive group [49 (36-66) vs. 52 (34-88), p < .001]. The binomial logistic regression analysis revealed that the odds ratio of being negative attitude was 1.1 per one point of ASDS-J (95% confidence interval: 1.0-1.2) in the model adjusted for student grade, interaction with the older adults, gender, experience living with the older adults and FSA-J. CONCLUSION: These findings suggest that ageism specific to dental students and clinical trainees (as assessed using the ASDS-J) was independently correlated with negative attitudes towards dental care for older adults.

Relationship between Self-Compassion and Uneasiness about the Professional Future among Dental Hygiene Students: A Cross-Sectional Study.

Purpose: To examine the self-compassion of dental hygiene students in Japan and the correlation between their self-compassion and uneasiness about their professional future. Methods: This study was conducted from May to September 2021. Students were invited from three colleges and one university in Fukuoka Prefecture to take the survey. Participants provided information regarding demographic variables (e.g., gender and year of study) and answered six questions regarding feeling uneasy about one's future, matters of learning, and what might happen after graduation. Self-compassion was assessed using the Japanese short version of the self-compassion scale (SCS), with the positive- and negative-SCS subdomains. Resilience was measured using the bidimensional resilience scale with the subdomains of innate and acquired resilience. For the statistical analysis, participants were divided into the "yes" group, where members felt uneasy and the "no" group, where members did not feel uneasy. Results: Data were obtained from 464 participants (response rate: 96.3%). The scores of total-, positive-, and negative-SCS were 36 (12-56), 18 (6-29), and 19 (6-30), respectively; 55.2% of students felt uneasy about their professional future. There was a statistically significant difference in scores for positive- and negative-SCS and innate resilience between the "yes" and "no" groups. Binomial logistic regression analysis revealed that when negative-SCS increased by one point, the risk of feeling uneasy about one's professional future was 1.12 times higher (95% confidence interval: 1.07-1.17) after adjusting for resilience and the answers to the remaining five questions. Conclusion: Our findings suggest that the negative factor of self-compassion is related to increasing the risk of feeling uneasy about one's professional future as a dental hygienist.

Correlation between Dietary Intake of Vitamins and Oral Health Behaviors: A Cross-Sectional Study.

This study aimed to investigate whether oral health behaviors were related to the dietary intake of vitamins. In this cross-sectional study, we included respondents of the 2016 national health and nutrition examination survey, and dental diseases from Hyogo Prefecture, Japan. Data on sociodemographic characteristics, findings of blood tests related to metabolic syndrome, dietary intake, oral health status, and behaviors were collected. Participants were divided into two groups based on their oral health behavior: the yes group (performed interdental cleaning or tongue brushing) and the no group (did not perform the behaviors). The study included 218 participants (male: 107, female: 111) aged 64.5 (range, 22-93) years. There were 133 (61.0%) and 85 (39.0%) participants in the yes and no groups, respectively. The daily intake of vitamins A, B2, B6, E, and K, folic acid, and niacin in the yes group was significantly higher than that in the no group. Oral health behavior correlated with the intake of vitamin B2 (p = 0.029), folic acid (p = 0.006), and vitamin K (p = 0.043) after adjusting for possible confounders. Oral health behavior (interdental cleaning or tongue brushing) correlated with the daily intake of vitamins B2, K, and folic acid.

Correlation of Salivary Occult Blood with the Plasma Concentration of Branched-Chain Amino Acids: A Cross-Sectional Study.

BACKGROUND: Plasma branched-chain amino acids (BCAA) levels are predictors of glycometabolic disorders, leading to diabetes. Microbes, including periodontal pathogens, are thought to be associated with elevated plasma BCAA levels. This study aimed to evaluate the relationship between salivary occult blood (SOB) and plasma BCAA levels in middle-aged Japanese individuals. METHODS: Sixty-four Japanese individuals aged ≥ 40 years were recruited for this study, which was conducted in Fukuoka Prefecture, Japan, from August to December 2021. Individuals diagnosed with and/or treated for diabetes were excluded from the study. The body mass index (BMI); plasma concentrations of total, high-density, and low-density lipoprotein cholesterol; triglyceride, glucose, and BCAA; and glycosylated hemoglobin ratio were measured. A basic periodontal examination was performed after the SOB test. RESULTS: The median age of participants (men-20; women-44) was 55 (range, 41-78) years. The plasma BCAA concentration in the SOB-positive group (477 [400-658] µmol/L) was higher than that in the SOB-negative group (432 [307-665] µmol/L). Linear regression analysis revealed that SOB remained independently associated with the plasma BCAA level with statistical significance (ß = 0.17, p = 0.02) after adjusting for sex, age, and BMI. CONCLUSIONS: SOB was positively correlated with plasma BCAA levels in middle-aged Japanese individuals. Thus, SOB may be a predictor of elevated plasma BCAA levels.

The Association between Tannerella forsythia and the Onset of Fever in Older Nursing Home Residents: A Prospective Cohort Study.

Background: Periodontal pathogens are related to the incidence of systemic diseases. This study aimed to examine whether periodontal pathogen burden is associated with the risk of fever onset in older adults. Methods: Older adults in nursing homes, aged ≥65 years, were enrolled. The study was set in Kitakyushu, Japan. The body temperatures of participants were ≥37.2 °C and were recorded for eight months. As periodontal pathogens, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia were qualified by a real-time polymerase chain reaction at the baseline. For statistical analysis, the number of bacterial counts was logarithmically conversed to 10 as a base. Results: Data from 56 participants with a median age of 88 (62−98) years were available for analysis. The logarithmic-conversed bacterial counts of T. forsythia, but not P. gingivalis or T. denticola, were associated with the onset of fever in older residents. The Kaplan−Meier method revealed that the group with <104 of T. forsythia had significantly less cumulative fever incidence than the group with ≥104 of T. forsythia. The group with ≥104 of T. forsythia was associated with an increased risk of fever onset (hazard ratio, 3.7; 98% confidence interval, 1.3−10.2; p = 0.012), which was adjusted for possible confounders. Conclusions: Bacterial burden of T. forsythia in the oral cavity was associated with the risk of the onset of fever in older nursing homes residents.

Swallowing dysfunction and the onset of fever in older residents with special care needs: a thirteen-month longitudinal prospective study.

A decline in swallowing function is frequently observed among older residents in nursing homes. We investigated whether swallowing dysfunction was related to the onset of fever in such individuals. Older residents aged ≥ 65 years from three nursing homes were included in this prospective study conducted from July 2017 to May 2019. The follow-up period was 13 months. The outcome was fever incidence in relation to the swallowing dysfunction. Baseline data on the activities of daily living, cognitive function, swallowing function, respiratory function, tongue pressure, and comorbidity conditions were collected. Dates on which the axillary temperature measured ay of participants was > 37.5 °C during the follow-up period were also recorded. For the statistical analyses, swallowing function assessed by the modified water swallow test (MWST) score was used to divide the participants into three groups: scores ≤ 3, 4, and 5. A total of 52 participants [median age, 89.5 years (67-104)] were enrolled. Kaplan-Meier analysis showed that the average periods until onset of fever in participants with MWST scores of ≤ 3, 4, and 5 were 8.0 (6.0-11.0), 10.0 (7.0-12.0), and 12.0 (10.0-13.0) months, respectively. Cox's proportional hazards regression model revealed that participants with an MWST score ≤ 3 were at a higher risk of fever than those with an MWST score of 5 (hazard ratio 11.5, 95% confidence interval 1.5-63.4, adjusted for possible confounders. The swallowing dysfunction correlated with the risk of fever in older residents of nursing homes.

Posterior teeth occlusion is related independently to onset of fever in residents of aged person welfare facility: Perspective cohort study.

BACKGROUND: Onset of fever is a common presentation of symptoms in older adults. Loss of posterior teeth occlusion provokes dysphagia, which is commonly related to infectious diseases of the respiratory tract. However, a correlation between posterior teeth occlusion and the onset of fever has not been studied. The aim of the present study was to investigate whether posterior teeth occlusion is correlated with the onset of fever in residents of aged person welfare facilities. METHODS: This perspective cohort study was carried out from February 2019 to December 2019 in Kitakyushu, Japan. The follow-up period was 8 months. Overall, 141 residents aged ≥ 65 years from 10 aged person welfare facility were included. Dates when the body temperatures of participants were more than 37.2°C were recorded. Posterior teeth occlusion was evaluated by assessing functional tooth units (FTUs). RESULTS: Data from 100 participants [median age, 89 (67-102)] were used for analysis. Total of 53 participants got a fever. The Kaplan-Meier analysis showed that the average period until onset of fever in participants with scores 0, 1-11 and 12 for FTU was 7.7 ± 0.6, 7.4 ± 1.0 and 3.9 ± 1.0, respectively. Cox's proportional hazards regression model revealed that participants with FTU = 0 were at higher risk of fever compared with those with FTU = 12 (hazards ratio: 3.2, 95% confidence interval: 1.4-7.7), adjusted for possible confounders. CONCLUSIONS: Posterior teeth occlusion correlated with the risk of fever in older residents of nursing homes.

Analgesic Mechanisms of Steroid Ointment against Oral Ulcerative Mucositis in a Rat Model.

Despite the long history of use of steroid ointments for oral mucositis, the analgesic mechanism has not been fully elucidated. In this study, we examined the effects of triamcinolone acetonide (Tmc) on oral ulcerative mucositis-induced pain in conscious rats by our proprietary assay system. Based on evaluations of the physical properties and retention periods in the oral mucosa of human volunteers and rats, we selected TRAFUL® ointment as a long-lasting base. In oral ulcerative mucositis model rats, TRAFUL® with Tmc suppressed cyclooxygenase-dependent inflammatory responses with upregulations of glucocorticoid receptor-induced anti-inflammatory genes and inhibited spontaneous nociceptive behavior. When an ointment with a shorter residual period was used, the effects of Tmc were not elicited or were induced to a lesser extent. Importantly, TRAFUL® with Tmc also improved oral ulcerative mucositis-induced mechanical allodynia, which has been reported to be independent of cyclooxygenase. Ca2+ imaging in dissociated trigeminal ganglion neurons showed that long-term preincubation with Tmc inhibited the hypertonic stimulation-induced Ca2+ response. These results suggest that the representative steroid Tmc suppresses oral ulcerative mucositis-induced pain by general anti-inflammatory actions and inhibits mechanical sensitivity in peripheral nerves. For drug delivery, long-lasting ointments such as TRAFUL® are needed to sufficiently induce the therapeutic effects.

Tongue cleaning in the elderly and its role in the respiratory and swallowing functions: Benefits and medical perspectives.

Oral dysfunction, including oral uncleanness and decline in tongue motor function, tongue pressure and swallowing function, precedes frailty. The tongue's dorsum is a reservoir of oral microbiota, desquamated epithelial mucosa and leukocytes due to the multi-papillate anatomy, and leads to tongue coating. The tongue coating is frequently found in older adults because of hyposalivation, immunity's hypoactivity, diminished motor function and compromised tongue's pressure with age. Anaerobe-driven volatile sulphur compounds in tongue coating are a major cause of intra-oral malodor. Dysbiosis of the tongue-coating microbiome rather than the amount of microorganisms is associated with a risk of aspiration pneumonia. Daily tongue cleaning with a brush or scraper is an easy way to control tongue coating deposits and quality. Using mouth wash or rinse-containing germicides is also a way to control the microbiota of tongue coating. The tongue function is closely related to swallowing. Tongue and suprahyoid muscles are linked with respiratory muscles through the endothoracic fascia. The mechanical stimulation during the cleaning of the tongue may stimulate the respiratory muscles. An intervention trial revealed that tongue cleaning by mucosal brush improves tongue pressure, swallowing and respiratory function in old residents of nursing homes, suggesting a rehabilitative effect of tongue cleaning on the swallowing and respiratory functions, preventing aspiration pneumonia. This narrative review assesses the tongue-cleaning benefits for respiratory and swallowing functions and the possibility of preventing aspiration pneumonia.

Trypsin-Like Activity in Oral Cavity Is Associated with Risk of Fever Onset in Older Residents of Nursing Homes: An 8-Month Longitudinal Prospective Cohort Pilot Study.

This study aimed to evaluate the association between trypsin-like activity in the oral cavity and the onset of fever in independent older residents of nursing homes. Independent older residents aged ≥ 65 years in 10 nursing homes were included in this study, which was conducted in Kitakyushu, Japan. For 8 months, follow-up dates on which the body temperatures of participants were more than 37.2 °C were noted. Trypsin-like activity in the oral cavity was detected by ADCHECK® with five-grade evaluation at baseline. Data from 53 independent participants with median age 89.0 (67­102) years were available for analysis. ADCHECK® scores were associated with fever days (r = 0.312, p = 0.029). The average periods until the onset of fever in participants with ADCHECK® Scores 1 and 2, Score 3, and Scores 4 and 5 were 6.6 ± 0.5, 5.0 ± 0.7, and 4.1 ± 1.0 months, respectively. ADCHECK® Scores 4 and 5 signified a higher risk of fever compared to ADCHECK® Scores 1 and 2 (hazards ratio 5.9, 95% confidence interval 1.4­23.9, p = 0.013), adjusted for possible confounders. We concluded that trypsin-like activity in the oral cavity was associated with the risk of fever in independent older residents of nursing homes.

Tongue cleaning maintains respiratory function in older individuals: A 1-year randomised controlled trial.

OBJECTIVE: The aim of this 1-year longitudinal randomised controlled trial was to evaluate the effectiveness of tongue cleaning on the maintenance of respiratory function in older adults requiring care. METHODS: The participants included 24 residents of two nursing homes in Kitakyushu, Japan. The participants were randomised to receive tongue cleaning with routine oral care (intervention group, n = 12), or routine oral care alone (control group, n = 12). Among the participants, three in the intervention group and four in the control group had cerebrovascular disease history, four in the intervention group and four in the control group had a history of cardiac disease, and five in the intervention group and four in the control group were without medical history. Respiratory function was assessed on the basis of the peak expiratory flow rate (PEFR). Tongue pressure, swallowing function, oral health status, activities of daily living and nutritional status were also measured at baseline and at the end of the 1-year follow-up period. RESULTS: The number of analysed participants in each group was 12. In the control group, the PEFR (1.6 [0.4-4.2] L s-1 vs 1.4 [0.4-3.2] L s-1 , P = .034) and tongue pressure (16.4 [1.7-35.2] kPa vs 8.0 [1.4-38.6] kPa, P = .032) significantly declined after 1-year. However, the PEFR (1.5 [0.8-2.9] L s-1 vs 1.6 [0.7-4.2] L s-1 , P = .366) and tongue pressure (18.1 [4.2-37.1] kPa vs 16.1 [5.2-41] kPa, P = .307) were maintained in the intervention group. The change in the PEFR was significantly greater in the intervention group compared with the control group (0.130 [-0.45-1.70] L s-1 vs -1.70 [-10.00-10.00] L s-1 , P = .028). CONCLUSION: Our findings suggest that tongue cleaning may help maintain tongue and respiratory function in older adults requiring care.

Comparison of dental plaque reduction after use of electric toothbrushes with and without QLF-D-applied plaque visualization: a 1-week randomized controlled trial.

BACKGROUND: To evaluate the efficacy of a newly developed electric toothbrush in reducing dental plaque via a quantitative light-induced fluorescence-digital (QLF-D)-applied visualisation system in the brush head. METHODS: Participants included 20 adults aged 19 to 28 years. Participants were randomly assigned either (i) an electric toothbrush with a monitor to visualise red-fluorescent dental plaque via a camera built into the brush head (monitor usage group, n = 10) or (ii) an electric toothbrush without a monitor (monitor-non-use group, n = 10). The amount of dental plaque was assessed by personal hygiene performance (PHP) at baseline and 1 week later. RESULTS: In the monitor-usage group, PHP score was significantly lower at the 1-week follow-up than at baseline (6 vs 16; range, 0-12 vs 13-21; P = 0.029). This change was not observed in the monitor-non-use group (14 vs 13; range, 6-21 vs 2-26; P = 0.778). After 1 week, the change in PHP scores in the monitor usage group was significantly greater than that in the monitor non-use group (- 10 vs 0; range, - 21 to 9 vs - 8 to 16; P = 0.021). CONCLUSIONS: Our results clearly demonstrate that brushing teeth while looking at a monitor that depicts red-autofluorescent dental plaque via application of QLF-D improved the efficacy of dental-plaque removal relative to brushing teeth without a monitor. TRIAL REGISTRATION: Trial registration number: UMIN000033699. Name of registry: Study on effect of new devise for oral care on dental plaque clearance. Date of registration: 8th September 2018. Status of registration: Completed.

Comparison of attitudes towards persons with dementia, knowledge of dementia and ageism amongst students in Taiwan and Japan: A cross-sectional study.

INTRODUCTION: This study aimed to compare the attitudes towards people with dementia, knowledge of dementia and ageism amongst Taiwanese and Japanese dental hygiene students. MATERIAL AND METHODS: A total of 328 students participated in this cross-sectional study. Attitudes, knowledge and ageism were assessed using self-reports. Participants' association with older adults or persons with dementia was also assessed. Primary outcomes included attitude, knowledge and ageism amongst students. Secondary outcomes were the factors related to their desire to work with persons with dementia. RESULTS: Data of 175 Taiwanese and 91 Japanese students were analysed. There were significantly more Japanese (69.2%) than Taiwanese (33.2%) students without experience of cohabitation with older adults. More Taiwanese (45.1%) than Japanese students (30.8%) gave a neutral answer regarding their desire to work with persons with dementia. Japanese students scored significantly higher on the attitude and ageism scales than did Taiwanese students; however, the scores of knowledge assessment were approximately the same. Attitude or ageism did not correlate with knowledge amongst students from either country. Logistic regression analysis revealed that the desire to work with persons having dementia was related to ageism and the relationship with these people, irrespective of country. CONCLUSION: Although the students had comparable levels of knowledge, there existed significant difference in the attitudes and the degree of ageism between students from Taiwan vs Japan. This finding may prompt improvement of education on dementia, where differences in nationality and lifestyle, including the rate of ageing and family structure, are taken into consideration.

Relationship between the state of tongue hygiene and the number of residual teeth in convalescent-ward inpatients, cross- sectional study.

BACKGROUND: The changed disease landscape in Japan because of an increasing aging population has contributed to an increase in convalescent inpatients, warranting important considerations of their oral care needs. However, information on the oral state of these inpatients is scarce. We evaluated the correlation between the number of residual teeth and tongue hygiene state in these inpatients. METHODS: This cross-sectional study included convalescent-ward inpatients, aged 34-100 years. The study was conducted between April 2017 and March 2018 in Kitakyushu, Japan. Data regarding age, sex, number of residual teeth, odontotherapy requirement, medications with oral side effects, and the reason for hospitalization, were collected. Oral hygiene level was assessed using the Oral Health Assessment Tool (OHAT). The correlation between each element of OHAT and the number of residual teeth was analyzed using Pearson's correlation analysis. The risk of a remarkable tongue state was analyzed using binominal logistic regression analysis. RESULTS: Correlations were observed between the number of residual teeth and OHAT subscales, including tongue, saliva, and dentures. A significantly higher percentage of inpatients with ≤19 teeth had a tongue state score of 1 or higher, compared with those with ≥20 teeth. (78.6% vs 57.7%, p = 0.047). In inpatients with ≥20 teeth, the remarkable saliva state significantly increased the risk of the remarkable tongue state by 10.49-fold (95% confidence interval = 2.86-38.51), after adjusting for potential confounders. CONCLUSION: Poor tongue hygiene is associated with the number of teeth and salivary state in convalescent-ward inpatients. Inpatients with ≤19 teeth had a higher risk of poor tongue hygiene, regardless of the salivary condition, as assessed using OHAT.

Dental Hygiene Students' Attitudes and Knowledge Regarding People with Dementia: A Four-Year Prospective Study.

In an increasingly aging society, dental hygienists who are prepared to provide care for patients with dementia are much needed. The aim of this study was to identify factors related to dental hygiene students' willingness to treat patients with dementia, including their attitudes towards these patients and their knowledge of the disease. All 134 students in three dental hygiene programs in Japan were invited to participate in the study; data were analyzed for 122 students (91% response rate). Students' attitudes towards patients with dementia and their knowledge of dementia were assessed in the first, second, and third years and at the end of the third year. Questionnaires were administered to assess the students' willingness to treat patients with dementia, relationship and cohabitation with individuals with dementia, and cohabitation with elderly people. For each characteristic, a higher score implied better/more favorable behavior/performance. Students' scores for attitudes towards patients with dementia peaked at the end of the third year, following a decrease earlier in the third year. Meanwhile, their scores for knowledge increased with each year. Their dementia-related attitudes and knowledge were inversely correlated in the first year, but the correlation became positive after the third year. The proportion of students who expressed willingness to treat was highest at the end of the third year, following a decline earlier in the third year. The willingness to treat was positively correlated with yearly promotion (odds ratio: 1.20 [1.01-1.43]; p=0.035) and attitudes (odds ratio: 1.08 [10.4-1.11]; p<0.001), but not with knowledge (p=0.973). These results support the idea that, to promote dental hygiene students' willingness to treat patients with dementia, it is important to cultivate in them a positive attitude towards these patients.

Activities of daily living decline is a predictor of lowered coughing ability and correlates with rehabilitative effect of tongue cleaning on coughing ability.

Basic activities of daily living (ADL) is a critical indicator of independency in older adults. The purpose of this study is to evaluate impact of ADL decline on coughing ability, as determined by peak expiratory flow rate (PEFR), and to evaluate impact of ADL decline on the ability of tongue cleaning intervention to improve PEFR. Methods: Participants comprised 95 residents of 11 group homes and nursing homes in Kumamoto, Japan. Participants were randomly assigned to cohorts with or without tongue cleaning intervention. Coughing ability was evaluated by measuring PEFR before and after 2 weeks, 4 weeks, and 3 months of intervention. Basic ADL was assessed by Barthel index (BI). Mean BI score among the participants was 59.3 ± 24.2. PEFR in a cohort with ≤ 60 BI score (LB) (1.2, 0.2-4.7 L s-1) was significantly lower than that in a cohort with ≥ 61 BI score (HB) (1.8, 0.5-6.5 L s- 1; p < 0.001). Multiple regression analysis revealed that BI score significantly correlated with PEFR after adjustment for various confounders (p < 0.004). Although tongue cleaning intervention increased PEFR in both cohorts, BI score only correlated with the amount of change of PEFR in the intervention group (p = 0.048). Basic ADL decline closely correlated with lowered coughing ability, as assessed by PEFR. Additionally, the rehabilitative effect of tongue cleaning on coughing ability was affected by basic ADL in older adults.

Denture Wearing Moderates the Association between Aspiration Risk and Incident Pneumonia in Older Nursing Home Residents: A Prospective Cohort Study.

Aspiration is increasingly recognized as a major risk for pneumonia, but a potential link between wearing dentures and incident pneumonia with aspiration risk is unclear. The aim of this study was to investigate whether denture wearing moderates the association between aspiration risk and incident pneumonia in older adults. We used prospective cohort data of 156 residents aged >70 years from eight nursing homes in Aso, Japan. Aspiration risk was evaluated using the modified water swallowing test. During a 1-year follow-up (2014 to 2015), information on incident pneumonia was obtained from nursing home medical records. During follow-up, pneumonia developed in 7.1% of participants. In the multivariate-adjusted Cox proportional hazards model, after adjusting for potential confounders, aspiration risk was independently associated with a 4.4-fold higher hazard ratio (HR) of incident pneumonia (95% confidence interval, CI, 1.16⁻16.43). The difference in the risk of incident pneumonia between subjects with aspiration risk who were wearing dentures and those not at risk of aspiration was not significant, whereas those with aspiration risk without dentures had a 7.3-fold higher HR of incident pneumonia than those not at risk of aspiration (95% CI, 1.02⁻52.63). Denture wearing might partially moderate the increased risk of incident pneumonia associated with aspiration risk.

Attitudes towards people with dementia: a cross-sectional study comparing dental hygiene students with registered dental hygienists.

OBJECTIVE: In order to adequately care for patients with dementia, it is necessary for dental hygienists to develop unprejudiced attitudes towards and obtain sufficient knowledge of dementia. The aim of this study was to assess attitudes towards and knowledge of dementia among Japanese dental hygiene students and identify related factors to the attitude and the knowledge. We compared the attitude and the knowledge between dental hygiene students and practising dental hygienists. BACKGROUND: Dental hygienists are required to care for patients with dementia by developing appropriate attitudes towards dementia and gaining knowledge of dementia. MATERIAL AND METHODS: Between May 2016 and July 2016, 191 third-grade dental hygiene students and 64 registered dental hygienists were surveyed. We modified questionnaires to assess attitudes towards and knowledge of dementia. Ageism was assessed using the Fraboni Ageism scale. To determine potential dementia awareness factors, information regarding participants' experiences with dementia was collected. RESULTS: Factor analysis revealed four factors in the attitude scale (Cronbach's α, 0.652-0.820). All item-total correlation coefficients for the knowledge scale were above 0.3, and Cronbach's α was 0.827. All awareness factors for dementia were significantly different between students and registered dental hygienists. Total scores of attitude and knowledge were higher among registered dental hygienists, indicating better attitude and knowledge, but total scores of ageism were lower among registered dental hygienists, indicating worse ageism. Multiple regression analysis revealed that the attitudes towards dementia correlated with years of experience, ageism, interest in dementia and desire to work with patients with dementia. CONCLUSION: Registered dental hygienists had more positive and more knowledge compared to dental hygiene students. Attitudes towards dementia, but not knowledge of dementia, were significantly positively correlated with ageism.

Relationship between anxiety/depression and oral health-related quality of life in inpatients of convalescent hospitals.

The aim of this study is to examin the association between anxiety/depressive tendency and oral health-related quality of life in inpatients of convalescent wards. This cross-sectional study included inpatients of convalescent wards (age range 34-100 years). Data on age, sex, functional independence measure, number of teeth, odontotherapy status, and primary disease for which hospitalization was required were collected. The Hospital Anxiety and Depression Scale (HADS) was used to assess emotional distress. The oral health-related quality of life was evaluated by the Geriatric Oral Health Assessment Index (GOHAI). Oral hygiene level was assessed by the Oral Health Assessment Tool (OHAT). We performed a multiple regression analysis to assess relationships among HADS, GOHAI, and OHAT. Following the analysis, causal connections of these factors were evaluated with structural equations modeling. The scores of GOHAI and OHAT in the caseness cohort (HADS score > 11) were significantly worse than those in the non-caseness cohort (HADS score < 7). Multiple regression analysis revealed that GOHAI was a statistically significant predictor of HADS score (p = 0.012), and that HADS and OHAT scores were predictors of GOHAI (p = 0.012 and < 0.001, respectively), adjusted by sex and age. We found that a model connected from OHAT to HADS through GOHAI was a good fit for the data of inpatients. Oral health-related quality of life, affected by oral hygiene status, was strongly associated with emotional distress in inpatients of convalescent wards. Daily oral care and assessment by healthcare professionals can reduce the emotional distress of inpatients in convalescent wards.

Relationship Between Resilience and Self-Rated Health in Dental Hygiene Students and Registered Dental Hygienists.

The aim of this study was to investigate whether two aspects of resilience-acquired and innate resilience-were related to self-rated health status in registered dental hygienists and students. In May through July 2017, 405 students at three dental hygiene programs and 85 registered dental hygienists, all in Fukuoka prefecture in Japan, were invited to participate in a survey including three scales: the Bidimensional Resilience Scale (BRS) to assess innate and acquired resilience, the Stress Response Scale-18 (SRS-18) to assess daily stress responses, and the Sense of Coherence 13-item scale (SOC-13) to assess the sense of coherence. Information about self-rated health status and number of years of clinical experience was also collected. Respondents were 398 students (98.2% response rate) and all 85 dental hygienists (100% response rate). The cohort with a self-rated "healthy" status scored higher on total scale and each domain of the BRS, SRS-18, and SOC-13 scales than the cohort with other self-rated health statuses. These three scales and self-rated health status were significantly correlated with each other. When innate resilience increased by one point, average self-rated health was 1.14-fold higher. In contrast, when the depression/anxiety domain score of SRS-18 increased by one point, self-rated health was 0.84-fold lower. The number of years of clinical experience was also negatively correlated with self-rated health. For these participants, innate resilience was a significant predictor of better self-rated health. To maintain the health of dental hygienists and students, it is important to understand their innate resilience as well as stress responses related to depression/anxiety factors and length of clinical experience.