Trends in Primary Tooth Emergence Pattern and Associated Factors in Japanese Infants.

OBJECTIVE: The purposes of this study were to analyse trends in primary tooth emergence patterns and to identify physical factors potentially associated with them. METHODS: The participants were 27,454 infants who underwent routine 18-month-old health examinations in Ebetsu City, Japan, between 1980 and 2012. This study was conducted using data from infants' 18-month-old health examinations over a 33-year period. The mean number of emerged primary teeth was analysed by sex using a general linear model. For logistic regression analysis, the proportion of infants with 16 emerged teeth or more at 18 months old was used as a dependent variable. Examination year; birth order; birth weight; weight, height, and chest girth at 18 months old; number of fused teeth; and mother's age were used as independent variables. RESULTS: The mean number of emerged primary teeth decreased over the 33-year period. Birth weight and weight and height at 18 months old decreased, and the proportion of low-birth-weight (<2500 g) infants increased over the 33-year period. On general linear model analysis, the yearly change in the mean number of emerged primary teeth was -0.0188 for boys and -0.0181 for girls. Birth weight and weight and height at 18 months old were significantly associated with the presence of 16 emerged primary teeth or more, according to the logistic regression analysis. CONCLUSIONS: The results demonstrated that, over the 33-year period examined, the mean number of emerged primary teeth decreased and birth weight and weight and height at 18 months old were associated with the pattern of tooth emergence.

Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation.

GOAL OF WORK: Little is known about the effects of professional oral health care (POHC) on the outcome of hematopoietic stem cell transplantation (HSCT). We evaluated the effects of POHC given by dentists and dental hygienists on the development of oral mucositis and febrile neutropenia (FN) after allogeneic bone marrow transplantation (BMT). PATIENTS AND METHODS: We retrospectively studied 140 adult patients who had received allogeneic BMT, with or without POHC, in our hospital consecutively between February 2002 and December 2009. Oral mucositis was evaluated according to the World Health Organization scale. MAIN RESULTS: The incidence of oral mucositis was 66.7% (52/78) in the patients who had received POHC, compared to 93.5% (58/62) in the non-POHC group (P < 0.001). The incidence of FN and the maximal level of CRP were also significantly lower in the POHC group. Multivariate analysis revealed that the POHC was significantly associated with the incidence of oral mucositis (odds ratio, 7.58; 95%CI, 2.45-23.34; P < 0.001). CONCLUSIONS: We concluded that POHC reduced the incidences of oral mucositis and FN by upgrading the overall oral hygiene during HSCT.

A comparison of oral mucositis in allogeneic hematopoietic stem cell transplantation between conventional and reduced-intensity regimens.

Severe oral mucositis developed in allogeneic hematopoietic stem cell transplantation (HSCT) accompanies intolerable pain and risk for systemic bacteremia infection. Conventional stem cell transplantation (CST) and reduced-intensity regimens for allogeneic HSCT (RIST) may differently affect the occurrence and severity of oral mucositis. Here, we comparatively examined oral mucositis in patients undergoing CST and that in RIST patients to search for measures to alleviate oral mucositis. We retrospectively analyzed the data of 130 consecutive patients undergoing HSCT (conventional, 60; RIST, 70). Oral mucositis was evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. We also investigated the risk factors for severe oral mucositis in each regimen. The incidence of oral mucositis was not significantly different between RIST and CST patients. The use of opioid analgesics to control pain due to oral mucositis was significantly less in patients undergoing RIST compared with those receiving CST. The risk factors for severe oral mucositis, determined by univariate and multivariate analyses, were "younger age (<40)" in CST and "longer duration of neutropenia (≥ 14 days)" in RIST. Although the incidences of oral mucositis were almost the same, the need for opioid analgesics and the risk factors for severe oral mucositis differed between CST and RIST patients.

Daily life habits associated with eveningness lead to a higher prevalence of dental caries in children.

BACKGROUND/PURPOSE: Circadian rhythm is an endogenous daily variation observed in most physiological functions including salivary secretion. Irregular lifestyle causes many diseases such as obesity and sleep disorders. The aim of this study is to examine the effects of the timings of sleep and meal on the prevalence of dental caries. MATERIALS AND METHODS: Study was conducted at university hospital in Japan. We asked 230 children (1-16 years old) to record the following life habits for 8 days: waking time, bedtime, mealtimes, snacking frequency, and tooth brushing frequency. We analyzed sleep habits from all data and compared dental caries and life habits using data from subjects with primary (2-7 years old) or permanent (11-16 years old) dentition period. RESULTS: The number of dental caries assessed using the decay or filled teeth (dft) index correlated with bedtime, supper time, regularity of supper time, and snacking frequency in subjects with primary dentition. Multiple regression analysis revealed that bedtime and snacking frequency were mutually independent risk factors for dental caries. No correlations were found between the prevalence of dental caries and other measurement items. The number of caries correlated with the regularity of supper time and age in subjects with permanent dentition. CONCLUSION: Children with daily life habits associated with eveningness have a higher prevalence of dental caries.

Prevalence of oral malodor and the relationship with habitual mouth breathing in children.

The prevalence of oral malodor and association of habitual mouth breathing with oral malodor were investigated in children residing in rural areas. One hundred and nineteen children participated in this study. A sulfide monitor and organoleptic method were used to evaluate oral malodor. About 8% of children had a sulfide level in mouth air above the socially acceptable limit (75 ppb). Habitual mouth breathing was a factor contributing to oral malodor. Oral malodor was not significantly correlated with plaque index, history of caries or frequency of toothbrushing.

A simple test for salivary gland function measuring resting and stimulated submandibular and sublingual secretions.

OBJECTIVE: This study examined the application of a simple screening test for salivary gland function by measuring resting and stimulated submandibular and sublingual secretions. STUDY DESIGN: An assay system was designed to use filter paper incorporating the chromophore of melanoidin or stimuli such as capsaicin and citric acid. We investigated the relationship between resting and stimulated secretions and melanoidin migration at 2 minutes for healthy and dry mouth groups. RESULTS: The healthy group showed a significant increase in the migration of melanoidin in the paper after citric acid or capsaicin stimulation. In contrast, patients with Sjögren syndrome showed no significant migration in spite of the stimulation. However, some participants with Sjögren syndrome or dry mouth showed a significant increase in the migration of melanoidin after stimulation. CONCLUSIONS: These results show that the newly developed method should be useful for evaluation of residual salivary gland function and screening for hyposalivation with dry mouth.

A screening test for capsaicin-stimulated salivary flow using filter paper: a study for diagnosis of hyposalivation with a complaint of dry mouth.

OBJECTIVE: The purpose of this study was to develop a simple screening technique for diagnosis of hyposalivation with dry mouth by estimation of capsaicin-stimulated salivary flow using filter paper. STUDY DESIGN: An assay system comprising 5 spots containing starch and potassium iodide on filter paper incorporating or without capsaicin and a coloring reagent was designed. We investigated whether the number of colored spots using the filter paper incorporating capsaicin could distinguish between healthy subjects and subjects with hyposalivation and dry mouth. RESULTS: In the healthy group (>200 µL/min; n = 33), the capsaicin-stimulated salivary flow significantly increased as compared with the resting salivary flow, from 1.2 ± 1.4 to 2.9 ± 1.3 colored spots (P < .05). In contrast, the hyposalivation group with dry mouth (<100 µL/min; n = 32) hardly changed (4.4 ± 1.0 vs 4.9 ± 0.2), except for 3 subjects who had considerable elevated secretion on capsaicin stimulation. CONCLUSION: By measuring resting and stimulated salivary flows, this method should be useful for evaluating retained functional ability of salivary glands and screening of hyposalivation with dry mouth.

A pilot study of a simple screening technique for estimation of salivary flow.

OBJECTIVES: The purpose of this study was to develop a simple screening technique for estimation of salivary flow and to test the usefulness of the method for determining decreased salivary flow. STUDY DESIGN: A novel assay system comprising 3 spots containing 30 microg starch and 49.6 microg potassium iodide per spot on filter paper and a coloring reagent, based on the color reaction of iodine-starch and theory of paper chromatography, was designed. We investigated the relationship between resting whole salivary rates and the number of colored spots on the filter produced by 41 hospitalized subjects. RESULTS: A significant negative correlation was observed between the number of colored spots and the resting salivary flow rate (n = 41; r = -0.803; P < .01). For all complaints of decreased salivary flow (n = 9) having cutoff values <100 microL/min for the salivary flow rate, 3 colored spots appeared on the paper, whereas for healthy subjects there was < or =1 colored spot. CONCLUSION: This novel assay system might be effective for estimation of salivary flow not only in healthy but also in bedridden and disabled elderly people.

A novel assay system for myeloperoxidase activity in whole saliva.

OBJECTIVES: The application of a novel assay system for the direct measurement of MPO (myeloperoxidase) activity in whole saliva. DESIGN AND METHODS: The assay system employs a novel sensitive substrate from 3,3'-diaminobenzidine (DAB) and guaiacol in the presence of dapsone (4,4'-diaminodiphenylsulfone) to determine MPO activity in whole saliva using an original "sandwich" test-disk (DEAE-cellulose paper and cellulose chromatography paper). The saliva (0.1 mL) was directly applied to the sandwich test-disk, and then 0.1 mL of the substrate solution containing 1 mM dapsone in 0.3 M Tris-HCl buffer (pH 7.5) was added. After incubation for 30 min at room temperature, absorbance on the test-disk was measured at 460 nm with an optical analyzer. RESULTS: The assay system was shown to distinguish MPO from salivary peroxidase in whole mixed saliva and was sensitive, easy and cheap. The assays revealed that MPO activity in whole saliva from subjects with periodontal disease was significantly higher than in saliva from healthy subjects. There was also a significant positive correlation between MPO activity and the probing depth of subgingival pockets (r=0.736, p<0.001). CONCLUSIONS: These results indicate that this novel assay system for measurement of MPO is a useful technique for predicting the progression of periodontal disease.

Comparison of antioxidant enzymes in saliva of elderly smokers and non-smokers.

OBJECTIVES: This study was designed to compare the levels of copper/zinc superoxide dismutase (Cu/Zn SOD), peroxidase (POx) and glutathione peroxidase (GSH-Px) in saliva of smokers and those in saliva of non-smokers. METHODS: Unstimulated saliva samples were collected from 88 elderly males (65 years old or over) who visited a private dental clinic. Forty-four subjects were current smokers (more than 20 cigarettes daily for at least 30 years) and 44 were non-smokers. The levels of salivary thiocyanate, Cu/Zn SOD, GSH-Px, and POx activity were measured using standard procedures. RESULTS: The mean levels of salivary thiocyanate (SCN(-)) and SOD were significantly higher (p < 0.01) in the smoking group than in the non-smoking group, whereas the specific activity levels of POx and GSH-Px were significantly higher (p < 0.05) in the non-smoking group than in the smoking group. Significant correlation coefficients were found between the levels of SCN(-) and SOD (r = 0.37, p < 0.001). In the non-smoking group, a significant positive association was found between specific activity of POx and age (r = 0.33, p < 0.05). CONCLUSION: Measurement of SCN(-) and Cu/Zn SOD in human saliva might be useful for estimating the level of oxidative stress caused by cigarette smoke. Despite increased H2O2 level as a defense system induced by SOD, detoxification of H2O2 might be deteriorated in the oral cavity of elderly smokers.

Relationship between salivary histatin 5 levels and Candida CFU counts in healthy elderly.

OBJECTIVES: Few epidemiological studies have confirmed the antifungal activity of histatin 5 in saliva against Candida species. The purpose of this study was to examine the relationship between concentrations of histatin 5 and the number of cultivable Candida in saliva samples from elderly. METHODS: Whole saliva samples were obtained from 124 elderly people, 65 years or older, living in a rural community. The concentrations of histatin 5 in saliva samples were determined by the enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody. Total colony-forming units (CFUs) were counted on a selective medium for Candida. Multiple linear regression analysis was performed to determine the independent contribution of explanatory variables to Candida CFUs using age, sex, histatin 5 concentration and type of denture prosthesis as independent variables. RESULTS: Saliva samples from 104 subjects (84%) were candidal colony-positive. The youngest group (65-69 years old) showed significantly smaller Candida CFU counts than those in the older group. The mean Candida CFU count of denture wearers was significantly higher than that of non-denture wearers. Significantly negative associations were found between Candida CFU counts and histatin 5 level in the oldest group (p < 0.05) and in the full-denture wearers (p < 0.01). Multiple linear regression analysis revealed that Candida CFU counts were mostly associated with type of dentures, followed by histatin 5 concentration. CONCLUSION: Possible activity of histatin 5 against Candida in whole saliva of elderly people was epidemiologically confirmed. The area covered by the prostheses was a strong factor associated with the Candida CFU count.