Numerous epidemiological studies have demonstrated that dental disease is related to systemic disease. In the present study, medical expenses and total number of days of treatment were evaluated in order to investigate the relationship between systemic and dental diseases in the workplace. A total of 282 employees aged between 20 and 39 years working for a publishing company in Okayama City participated in this study. Their dental and medical care insurance records for a 12-month period were obtained. Eighty-three percent of the subjects consulted medical doctors and 43% consulted dentists during the examined period. Eighty-nine percent of the dental patients were diagnosed as having periodontal disease. Individuals who underwent at least one dental examination spent more money and days (p<0.01) visiting medical institutions than those who received no dental care. In conclusion, these results show that individuals who consulted dentists tended to receive more frequent medical treatment.

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The purpose of this study was to examine the hypothesis that people who are excessively interested in their oral status are sensitive to their own bad breath. A total of 106 high school students were surveyed in May 2000. In the survey, we carried oral examination, measurement of the volatile sulphur compounds (VSC) levels in mouth air by a portable sulphide monitor (Halimeter ® , and a questionnaire about bad breath, oral symptoms, daily habits and human relationships. At the oral examination, students were requested to select one illustration representing their gingival conditions from among four levels of gingival inflammation by their self-judgment. Data was analyzed statistically. We divided subjects in two groups by VSC levels : the bad breath group (VSC level≧150 ppb), and the group without bad breath (VSC level<150 ppb). Students with bad breath tended to seldom suffer toothaches from sweeteners or cold stimulation (p<0.05), they were not satisfied with school life (p<0.05), and the level of sensitivity to their own bad breath was low. We then divided students without bad breath in two groups, one group was sensitive to bad breath, and the other was not. Students who were sensitive to bad breath tended to be aware of dryness in their mouths (p<0.05), to be stressful in daily life (p<0.05), and to judge their level of gingival inflammation severely (p<0.05). In conclusion, it was shown that sensitivity to bad breath was not related to VSC levels and students who were excessively interested in their oral status had a tendency to judge their oral condition severely and be sensitive to their own bad breath. Further, students who were sensitive to their own bad breath in spite of normal VSC level have a tendency to be sensitive to oral status and be stressful in their daily life. It was indicated that a condition of excessive sensitivity to their bad breath might be established, and those with a tendency to evaluate their oral status severely might experience superfluous stress in human relationships. This study was supported by a Grant-in-Aid for Scientific Research by the Ministry of Education, Culture, Sports, Science and Technology, Japan, Project No. 11672055.

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Smoking habit has been reported as a risk factor for periodontal disease and low vitamin C intake has been associated with periodontal status. In this randomized controlled trial, we investigated the efficacy of dietary supplementation with antioxidative vitamins, vitamins C and E, on suppression of the progression of periodontal disease in smokers. A total of 65 patients who were current smokers were randomly assigned to one of the following groups : 1) VC (1,000 mg/day) ; 2) VE (135 mg/day) ; 3) combination of VC and VE ; 4) placebo. Plaque index (PI), clinical attachment level (CAL), pocket depth (PD) and cross-linked carboxyterminal telopeptide of type I collagen (I CTP) from gingival crevicular fluid (GCF) as a biomarker of periodontal disease, were measured at baseline, 12 and 24 weeks following the start of supplementation. CAL and PD in VC, VE and the combination groups showed significant improvements during this trial comparing with the placebo group (p<0.05). Furthermore, in the combination group, the rate of GCF samples in which I CTP was decreased or maintained was significantly greater than that in the placebo group at 24 weeks (p<0.05). On the other hand, VC levels in blood samples from VC and the combination groups (p<0.01) and VE levels from VE and the combination groups significantly rose from each level at baseline (p<0.05). These results suggest that supplements of VC and VE may maintain the periodontal health status in smokers by controlling oxidative status and other mechanisms.

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In this study, the use of fluoride toothpaste was surveyed by questionnaire in 2,188 subjects aged between 1 and 56 years in Sendai City, Miyagi Prefecture, for the purpose of the promotion of its use. The subjects were categorized as 1-3 year-old children, 4-5 year-old children, primary school children, their parents and vocational school students. The survey was carried out from April to June 2000 using a questionnaire prepared by the Committee for the Promotion of Fluoride Use of the Japanese Society for Dental Health, and the results were as follows : 1. Tooth brushing was performed once a day or more in 88.8% of the subjects. The percentages of the daily use of fluoride during brushing in 1-3 year-old children, 4-5 year-old children, primary school children, vocational school students and the parents were 13.4, 34.0, 52.3, 55.3 and 66.5 (%), respectively. 2. The parents and vocational school students used a larger amount of toothpaste and rinsed more frequently than younger subjects. There was a significant difference in the frequency of mouth rinsing after brushing among the groups, dependent on the amount of toothpaste used. 3. The first reason for toothpaste selection was the preventive effect on dental caries and the second was inclusion of fluoride. For infants, most of the parents did not use toothpaste because of the anxiety of swallowing toothpaste. The vocational school students selected toothpaste primarily because it was available at home. Our findings suggested that dental professionals should prepare guidelines for appropriate use of toothpaste and should recommend the use of fluoride-containing toothpaste to increase exposure to small amounts of fluoride.

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In this prospective study, the effectiveness of an oral health promotion program at a dental clinic was evaluated. Fifty-three patients in their thirties who complied with the recommended maintenance schedule of every 3 months were observed for 8 years. They received oral health instruction consisting of instruction in plaque control, scaling, PMTC and professional fluoride application after the examination, which included assessment of dental caries and periodontal disease using CPI and bleeding on probing, every 3 months. At the first visit, subjects were divided into 3 groups according to their periodontal condition ; group A : healthy periodontal tissue or slight periodontal disease (CPI=0, 1), B : some calculus with no periodontal pockets (CPI=2), C : some periodontal pockets (CPI=3, 4). Of a total of 53 patients, 6 were classified into group A, 46 were classified into group B and only one was classified into group C. The patient in group C underwent complex periodontal treatments, then came back to this program. The other patients participated in this program after the examination. During the 8 year maintenance period, 80 new dental caries were found, and 4 teeth were lost due to reasons other than caries or periodontal diseases, such as occlusal trauma and root fracture. The mean DMFT increased from 13.0 to 14.5 for 8 years. The bleeding on probing was 48.5% at the initial examination, however, it decreased 3 years later and was stable at 20 to 25% after that. The CPI code of the patients aged 35 to 39 of 5 years later was compared with that of the patients aged 35 to 39 at the initial examination. The patients with CPI code 3 or 4 decreased from 61.5% to 19.2%. In contrast, the patients with CPI code 0 to 2 increased 38.5% to 80.7% (p<0.01). Eight years later, most periodontal tissues had been kept good condition. The drop-out rate in the maintenance program was less than 10%. The results demonstrated that the oral health promotion program of treatment every 3 months was effective in improving periodontal condition and preventing tooth loss, and this system was well accepted by patients. The findings in this study will provide useful information for the new family dentist system introduced in the Japanese health insurance system and will contribute to achieve 8020 (keeping 20 teeth until age 80).

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The purpose of the present study was to clarify the phenotypic characteristics of the dental arch and palate in Korean subjects. We measured 209 pairs of maxillomandibular plaster models obtained from 105 male and 104 female Korean students (18-32 years old), and compared the findings in the present study with those in 12 other groups that we previously reported. A significant difference was observed between sexes in nearly all measurements among the Korean models. Further, both male and female Koreans demonstrated a significant difference in many measurement items from Jicaques models from Central America. We also studied the oral cavities of the Korean subjects using cluster analysis, a neighbor-joining method, and multidimensional scaling (MDS) for the purpose of elucidating anthropological orientation. We found that the male and female Korean subjects were more similar to Japanese and Taiwanese than to Balinese, Taiwan aboriginal people, or Jicaques.

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Extracts from eucalyptus leaves have been reported to show antibacterial activity against various oral bacteria and to inhibit glucosyltransferase activity of Streptococcus mutans and Streptococcus sobrinus. Although the antibacterial mechanism of the extracts against cariogenic bacteria has been examined in detail, little is known about the antibacterial effect of the extracts on periodontopathic bacteria. The purpose of this study was to investigate the antibacterial activity of eucalyptus leaf extracts on various periodontopathic bacteria and to evaluate the possibility of developing the extracts to periodontal diseasepreventive substances. In order to examine the antibacterial activity, various periodontopathic bacteria were cultured in media with or without various amounts of extracts from eucalyptus leaves at 35℃ anaerobically, and OD_<660nm> was measured for 48 h. Extracts from green tea were used as control. The growth of tested periodontopathic bacteria was inhibited by 250μg/ml eucalyptus leaf extracts, especially, the growth of Porphyromonas gingivalis was strongly inhibited by addition of 10 μg/ml eucalyptus leaf extracts. This strong inhibition was observed in three strains of P. gingivalis, namely, ATCC 33277, OMZ 314 and W 50, indicating that eucalyptus leaf extracts had strong growth-inhibitory effects against a wide range of P. gingivalis. Although green tea extracts have been reported to possess antibacterial activity for P. gingivalis, growthinhibitory effect was weaker than that of eucalyptus leaf extracts at the concentration of 10 μg/ml in this study. In order to determine the nature of the inhibition, some periodontopathic bacteria were cultured in media containing determined amounts of eucalyptus leaf extracts at 35℃ anaerobically. At determined periods, aliquots were removed and applied on blood-agar plates. After incubation for 3 days, colony-forming units (CFU)/ml were counted. For P. gingivalis strains, no considerable decrease of CFU/ml were observed by incubation with 100 μg/ml eucalyptus leaf extracts for 36 h, suggesting that the antibacterial activity of eucalyptus leaf extracts against P. gingivalis was bacteriostatic but not bactericidal. Similar results were obtained for P. intermedia ATCC 49046 and Fusobacterium nucleatum ATCC 23726. From these results, it is suggested that extracts from eucalyptus leaves may have bacteriostatic antibacterial activity against various periodontopathic bacteria, especially P. gingivalis. Considering the significant antibacterial activity against P. gingivalis, extracts from eucalyptus leaves may be useful for clinical application as preventive substances for periodontal disease.

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The purpose of this study was to investigate the prevalence and intraoral distribution of root caries in the elderly, and to identify the association between root caries and coronal caries. Six hundred noninstitutionalized adults aged 70 years in Niigata, Japan were examined for their oral status and general health status. A total of 544 subjects identified as dentate was available for assessment. The prevalence of root caries was evaluated as the percentage of the subjects with one or more root caries and the mean number of teeth with root caries. The intraoral distribution was evaluated as the mean percentage of exposed root surfaces affected by root caries in terms of tooth surface (buccal, lingual, distal, mesial) and tooth group (incisor, canine, premolar, molar). In the analysis of the associations, subjects were divided into 4 groups according to the number of coronal caries first, and then the prevalence of root caries was evaluated in each group. Next, logistic regression analysis where the dependent variable was one or more root caries and the independent variables including the number of teeth with coronal caries was performed. The percentage of male subjects with one or more root caries (DF) was 56.9% and that of female subjects was 53.3%. The mean number of root DFT was 1.81 (SD=2.41) per person for males and that for females was 1.41 (SD=1.93) per person, respectively. As for untreated root caries (D), the percentage of male subjects with one or more root D was 21.7% and that of female subjects was 19.8%. The mean number of root DT for males was 0.46 (SD=1.10) per person and that for females was 0.32 (SD=0.81) per person. The tooth type most commonly affected by root caries in the maxilla was canine and in the mandible it was premolar. The percentage of exposed root surfaces affected by root caries was 17.5% and 11.5%, respectively. As for tooth surface distribution, the buccal surfaces were the most commonly affected with a percentage of 15.8%. The mean number of teeth with root caries and the percentage of subjects with root caries increased with the number of coronal caries. Logistic regression analysis indicated that the prevalence of coronal caries was significantly associated with that of root caries (odds ratio=1.08, p<0.001) after adjusting for other oral variables. In conclusion, the results suggest that the prevalence of root caries in the elderly was high, and the prevalence of coronal caries was associated with root caries prevalence.

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The objective of this study was to measure the concentrations of volatile sulfur compounds (VSC) in mouth air from people aged 85 years, and to evaluate the relationship between VSC concentrations and oral health status. Tongue coating status (tongue coating score) and VSC concentrations in mouth air were assessed in 168 subjects The concentrations in each subject were measured with a VSC monitor (Oral Chroma^TM). In addition, dental condition (decayed teeth) and periodontal condition (CPI Codes 3 and 4 recording teeth) were assessed for dentulous subjects. The results were as follows. 1. The percentage of subjects with an objectionable level of hydrogen sulfide (H₂S≧112 ppb) was 11%, that of methyl mercaptan (CH₃SH≧26 ppb) was 28%, and that of H₂S or CH₃SH (H₂S≧112 ppb or CH₃ SH≧26 ppb) was 33%. 2. The percentage of edentulous subjects with an objectionable level of H₂S was 11% in subjects with tongue coating score 2 or 3, while it was 0% in the subjects with tongue coating score 0 or 1. The percentage of dentulous subjects with an objectionable level of CH₃SH was 55% in the subjects with deep pockets, while it was 27% in the subjects without. 3. There was a significant correlation between H₂S concentration and tongue coating status in edentulous subjects (Spearman's ρ=0.48, p<0.001), and between CH₃SH concentration and periodontal condition in dentulous subjects (Spearman's ρ=0.30, p<0.05). 4. In the multiple logistic regression analysis, the tongue coating status was significantly related to an objectionable level of H₂S in edentulous subjects. On the other hand, the periodontal condition was significantly related to an objectionable level of CH₃SH in dentulous subjects. The results of this study suggested that there was an association between H₂S and tongue coating in edentulous elderly people, and between CH₃SH and periodontal disease in dentulous elderly people.

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