The Effects of Providing Advance Notice and Stress-Coping Traits on Physiological Stress of Patients during Dental Treatment.

Patients tend to feel stress in association with dental treatment due to uneasiness and fear. We investigated the effects of providing advance notice and stress-coping traits on the physiological stress of patients during dental treatment. Sixty non-dental professionals (male, n = 26; female, n = 34; mean age, 49.9 years) were recruited for this study and informed consent was obtained. Subjects were given simulated dental treatment including three stimuli, air, percussion and running of an air turbine, with or without advance notice of the stimulation during dental treatment. Real-time sympathetic nerve activity (SN) and parasympathetic nerve activity (PN) during the treatment were measured using a biological information monitor. The stress-coping traits of each subject were examined using the Lazarus-Type Stress Coping Inventory (SCI). Correlations between the nerve-activity and scores of eight stress-coping strategies of SCI and the presence/absence of advance notice were analyzed. Age, types of stimuli and order of stimuli significantly affected SN, while age, types of stimuli, and the pattern of stimulation significantly affected PN. The interaction of the stress-coping trait and presence/absence of advance notice significantly affected PN. Providing advance notice may have different effects on physiological stress depending on how the patient copes with stress.

A survey of oral health status, subjective oral symptoms and oral health behaviors among first-year dental students at a Japanese university.

PURPOSE: The rapid deterioration of oral health in young adults is an alarming problem in Japan. The aim of the present study is to investigate the oral health status, subjective oral symptoms and oral health behaviors of dental students. METHODS: Participants were 108 first-year students attending dental school in 2018-2019. Oral examinations were performed to assess dental caries indices, oral hygiene status, gingival bleeding on probing (BOP) and pocket depth. A self-administered questionnaire was used to assess subjective oral symptoms and oral health behaviors. RESULTS: The prevalence of decayed teeth (DT) and gingivitis (BOP ≥ 10%) were 43.5% and 50.0%, respectively. Having DT and gingivitis were significantly associated with poorer oral hygiene. No association was observed between DT and subjective symptoms. Having gingivitis was significantly associated with xerostomia, mouth-breathing and less use of interdental cleaning tools. Multiple logistic regression analysis for gingivitis yielded an odds ratio of 1.41 (95% confidence interval: 1.19-1.67) for plaque score, and 2.75 (1.27-5.98) for xerostomia. CONCLUSION: Since a relatively high ratio of students had DT and gingivitis without clear subjective symptoms, they require regular dental visits for early treatment and oral hygiene maintenance from the start of their time at university.

Does second-hand smoke associate with tooth loss among older Japanese? JAGES cross-sectional study.

OBJECTIVE: Second-hand smoke (SHS) is considered a risk factor for a number of oral diseases. However, its influence on tooth loss, which is the final consequence of periodontal disease and caries, remains unknown. We aimed to evaluate the association between SHS experience and the number of remaining teeth among non-smoking older Japanese individuals. METHODS: Cross-sectional data from the Japan Gerontological Evaluation Study (JAGES) 2013 were used. From the 27,561 people ≥65 years of age who responded to a self-reported questionnaire (response rate = 71.1%), data of 18,865 respondents who had never smoked were analysed. Multinomial logistic regression with multiple imputations was applied to estimate the odds ratio of the frequency of SHS exposures on the number of remaining teeth. RESULTS: The prevalence of participants with ≥20 teeth, 10-19 teeth, 5-9 teeth, 1-4 teeth, and no teeth were 53.2%, 20.4%, 9.9%, 6.6%, and 9.9%, respectively. The proportion of participants with SHS was 37.5%. After adjusting for sex, the SHS experience tended to be associated with a lower risk of having the fewer number of remaining teeth (P < 0.05). However, after being adjusted for age and sex, participants with SHS exposure at "a few times a week" and "almost every day" were significantly associated with the fewer number of teeth. After adding all other covariates, compared to the participants without any exposure to SHS, the odds ratio for having no teeth rather than having ≥20 teeth among the participants with daily exposure to SHS was 1.35 (P < 0.01). CONCLUSION: Daily second-hand smoke was significantly associated with fewer remaining teeth based on the self-reported survey among older Japanese people.

Differences between Computer-Based and Paper-Based Assessments of the Clinical Reasoning Competency of Dental Students.

Clinical reasoning competency is essential for an appropriate clinical dental treatment. Among the tools for the assessment of clinical reasoning competency, computer-based testing (CBT) is considered more useful than paper-based testing (PBT), because teachers can control the timing of information given to the examinees. Such timings could possibly affect the thinking process of examinees. However, few studies reported differences of reasoning between the two testing modes. In the present study, we developed an assessment of clinical reasoning and applied it using CBT and PBT to compare the examinees' performance. The participants comprised 60 students in the fifth-year class in 2012 of the School of Dentistry, Faculty of Dentistry, Tokyo Medical and Dental University. The tests comprised 25 problems, each with four questions, totaling 100 questions. The contents of the questions were the same in CBT and PBT. The students were assigned to CBT (Group C, n = 30) and PBT (Group P, n = 30) groups, with an almost equal gender ratio in the groups. The difference between scores was analyzed with a univariate analysis of variance. No significant intergroup differences were found regarding the test duration, total score, and average score of each question. The number of problems with perfect marks was higher in Group P than in Group C (P < 0.05), probably because Group P students could access the information of the previous question (s) within a problem. Thus, the differences of the examinees' performance between the two testing modes were small.

Factor analysis of the perception of clinical attire in the Dental Hospital, Tokyo Medical and Dental University.

This study analysed the perceptions of dental clinical attire among patients, dentists and dental students at the Dental Hospital, Tokyo Medical and Dental University using factor analysis to investigate what kinds of factors would underlie the perceptions and would guide evaluation of wearing items of dentist. The subjects comprised 146 patients, 97 dentists, and 81 students of the Dental Hospital. Using a five-point Likert scale, the subjects were asked to score their preferences for 35 items that might be worn by a dentist in the clinic. These scores were analysed using factor analysis and seven factors were extracted. The factors were classified into three categories; the first was a traditional factor representing the public self of dentists, next was casual factors representing the private self of individual dentists, and the other was practical factors. Using MANOVA and univariate ANOVA, differences in perceptions among the subjects were found for factors of casual items while that for traditional items not (P<0.05). Thus, clinical attire would be evaluated from the viewpoint of interplay between public self and private self of the clinician as well as practical aspects. The variation in perceptions would be influenced by wearers' gender and observers' age.

The possibility of digital imaging in the diagnosis of occlusal caries.

The aim of this study was to assess the possibility of digital image analysis of pit-and-fissure discoloration in order to diagnose caries. Digital images showing pit-and-fissure discoloration in 100 teeth of 19 patients were analyzed to obtain the fractal dimension (FD) and the proportion of the area of pit-and-fissure discoloration to the area of occlusal surface (PA). DIAGNOdent values were measured (DD), and dentists' diagnoses were also obtained. The sensitivity and specificity of FD, PA, DD, and the combination of FD and PA compared to the dentists' diagnoses were calculated. The sensitivities of FD, PA, DD, and the combination of FD and PA were 0.89, 0.47, 0.69, and 0.86, respectively, and the specificities were 0.84, 0.95, 0.91, and 0.86, respectively. Although further research is needed for the practical use, it is possible to use the analysis of digital images of pit-and-fissure molar discoloration as a diagnostic tool.