In recent years, it has been shown that oral care in independent and dependent elderly people is effective for overall health management, such as for the prevention of deglutition pneumonia. However, there have been no studies that have examined in detail the oral microbial flora, which is a risk factor. Therefore, in the present study, we attempted to identify microbes in dental plaque at two time points, at the time of initiating the study and again one year later, with the aim of studying the differences in oral microbial flora in independent and dependent elderly subjects. We also examined the correlations between oral microbial flora and the oral conditions and oral habits of the subjects. The mean number of types of oral microbes found in the independent subjects (n = 41) was 3.0 ± 1.3 at the beginning of the study, and was 4.3 ±1.7 one year later. The corresponding values in the dependent subjects (n = 20) were 3.3 ±1.5 and 3.5 ± 1.6, respectively. In general, the oral cleanliness of the subjects was good. In both groups, the aerobic microbe Candida sp. And the anaerobic microbe Prevotella melaninogenica were detected at the highest rates. Furthermore, in both groups, anaerobic microbes were detected at higher rates than aerobic microbes. High rates of Candida sp. were also observed in dependent subjects with dentures. Finally, there was a negative correlation between the daily number of denture cleanings and the detection rate of Candida sp. and P. melaninogenica in the independent subjects.

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To develop a health promotion program for preventing periodontal disease in a community, a needs assessment was performed at Akitsu-cho, one of the rural towns in Hiroshima Prefecture. The questionnaire composed was based on the PRECEDEHPROCEED model and was used for the assessment. All of the women of age 25 to 54 who resided in the town were involved in the study. The questionnaires were distributed to houses and collected by volunteers from the town. The number of distributed questionnaires was 2,534, and 1,982 (78.2%) were recovered. According to the social assessment, the quality of life in the older age group was low compared to that in the younger age group. An epidemiological assessment showed that the rate of individuals with symptoms of periodontal diseased increased with age. It was shown that those who received regular dental checkups had better health behavior and life styles. Since individuals who satisfied the predisposing, reinforcing, and enabling factors tended to receive regular dental checkups, these factors should be considered in planning the health education program.

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This study investigated the factors influencing the attendance of regular dental check-ups by a questionnaire survey which consisted of items dealing mainly with dental health behavior and personal characteristics. The questionnaire was sent to 1,200 inhabitants selected randomly from the electoral register of Hiroshima City. Sixhundred thirty-five of them returned the questionnaire, and 5 factors were obtained. The factors were as follows, in order of the contribution toward the attendance : 1. Interest in dental health '・ "Interest in the health of the teeth and gums", etc. 2. Emotion regarding dental treatment ': "Fear of dental treatment", etc. 3. Familiarity with the community : "The period one has lived at one's present address", etc. 4. Trust in dentists '. "Sufficient explanation of the treatment", etc. 5. Economic condition : "Having money to spare", etc. Using these results, dental professionals could attempt to increase the attendance rate of regular dental check-ups.

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Several reports on the effect of dextranase in toothpaste or gel on the inhibition of plaque formation have been published. The purpose of this study was to clarify this desirable effect by using dextranase in a mouth rinse solution. The subjects of this study were 82 adults, and double-blinded clinical studies were conducted according to good clinical practice (GCP). The mouth rinse solution contained 17.5 units/g dextranase, and the control solution had the same composition, but with no dextranase. The effects were evaluated using the plaque score and microbial colony count. The plaque adhesions of the subjects, evaluated as 4 for the maximum level of the plaque score in the first day of the study, decreased clearly after 1 week with statistical significance (p<0.0l). The average plaque scores by tooth surface did not show any difference af ter 3 days, but showed a difference after 5 days in all the tooth surfaces in the tested group, which was more clear after 1 week (p<0.05). These results suggest that the dextranase-containing mouth rinse was more effective for inhibition of plaque adhesion in the subjects with an insufficient level of plaque control, and that the inhibition increased with longer use.

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The purpose of this study was to investigate the association of temporomandibular disorders (TMD) with parafunctional habits and related factors. A total of 783 girls attending a senior high school (16-18 years old) participated in the present study. The prevalence rates of temporomandibular joint (TMJ) noise, tiredness in the jaws, pain on jaw movement and difficulty in mouth opening were 35.0, 19.2, 19.3 and 14.0%, respectively. Significant correlations by multiple logistic regression analysis were found between tooth grinding (1-2 times a week or more), cheek or lip biting (1-2 times a week or more), five or more filled teeth, and TMJ noise. Tooth clenching (1-2 times a month, 1-2 times a week or more) and cheek or lip biting (1-2 times a month) were contributing factors for tiredness in the jaws. Leaning of the head on the palm (1-2 times a week or more), tooth clenching (1-2 times a month, 1-2 times a week or more), gum chewing (1-2 times a month, 1-2 times a week or more), and stress (1-2 times a week or more) were associated with pain on jaw movement. Leaning of the head on the palm (1-2 times a week or more), tooth grinding (1-2 times a month), gum chewing (1-2 times a month), and number of present teeth< 28 were related to difficulty in mouth opening. These results suggested that TMD has a multifactorial nature, and symptoms of TMD are affected according to the frequency of parafunctional habits and stress.

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Periodontal disease has been correlated with skeletal bone mineral density (BMD). Estrogen deficiency due to menopause or other reasons and low dietary calcium (Ca) intake have been reported as common risk factors for systemic bone loss and periodontal disease. The purpose of this randomized controlled trial was to investigate the effects of dietary supplementation with Ca and soy isoflavone, a natural analog of estrogen, on skeletal bone and periodontal health in postmenopausal women during periodontal maintenance. Forty-eight patients were randomly assigned to one of the following groups : l) the test group : Ca (500nig/day) and isoflavone (10mg/day) ; 2) the double-dose group : Ca (1,000 mg/day) and isoflavone (20mg/day) ; or 3) the placebo group : 4 placebo tablets per day. Measurements of plaque index (Pi), clinical attachment level (CAL), alveolar bone density (ABD), alveolar crestal height (ACH) and cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in the gingival crevicular fluid (GCF) were performed at baseline, and 6 and/or 12 months following dietary supplementation. In addition, skeletal BMD was measured at baseline and 12 months. Though the CAL in all 3 groups showed significant improvement during this trial (p< 0.01), there were no significant differences among the groups. The mean ABD gain from baseline to 12 months in the test group was significantly higher than that in the placebo group (p<0.05). That in the double-dose group showed the tendency to be higher than that in the placebo group. In addition, the ACH gain in the test group showed the tendency to be higher than that in the placebo group. Patients in the placebo group showed a significant decrease of skeletal BMD, compared to that at baseline, at 12 months (p< 0.01). In addition, the mean ICTP level of the GCF of the placebo group was significantly increased from baseline to 6 months (p< 0.01). The results from this study suggest that dietary supplementation with Ca and Soy isoflavone may suppress the loss of skeletal BMD, ABD and ACH, and maintain levels of periodontal health in postmenopausal women in periodontal maintenance.

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Purpose : This study was designed to determine whether the long term use of fluoride mouthrinse affected the salivary levels of Mutans streptococci in 9- and 11-year-old children. Material and Methods : The subjects consisted of 281 nine and eleven-year-old children. Among these subjects, 161 children had received fluoride mouthrinse. The remaining 120 children had not received fluoride mouthrinse. Clinical, saliva, and questionnaire examinations were conducted. The levels of Mutans streptococci were measured using Dentocult SM Strip®. Results : Nine-year-old children using fluoride mouthrinse had lower levels of Mutans streptococci. There was a significant association between the experience of fluoride mouthrinse and the Dentocult SM Strip® score by multiple logistic regression analysis (Odds ratio : 0.35, p = 0.02). However, there was no significant difference in 11-year-olds. Conclusion : The data presented here may suggest that long-term use of fluoride mouthrinse has an effect of reducing the salivary level of Mutans streptococci, especially during the mixed dentition period.

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There are many elderly people who enjoy meals in their daily life. The purpose of this study was to evaluate the relationship between appetite and quality of life, controlling the known confounding factors. In this study, 600 subjects aged 70 years were included. In order to integrate quality of life, we used a face scale which has five face figures considered appropriate for a five-stage evaluation. A questionnaire survey was conducted to evaluate appetite. In addition, we obtained data on physical factors, healthy actions, social factors and oral symptoms. The comparison of the appetite, score of oral symptoms and other general factors between two groups divided according to the face scale score was investigated by multiple logistic regression analysis. We selected two kinds of dependent variables according to each face scale score (models 1 and 2). Appetite, total score of oral symptoms, Tokyo Metropolitan Institute of Gerontology index (TMIG index), amount of sleep and gender as independent variables were selected in both models. In model 1, appetite (Odds ratio : 2.77, p<0.05), total score of oral symptoms (Odds ratio : 1.25, p<0.05) , TMIG index (Odds ratio : 1.25, p<0.0l) were significant. On the other hand, in model 2, appetite (Odds ratio : 3.23, p<0.00l), TMIG index (Odds ratio : 1.24, p< 0.001) and amount of sleep (Odds ratio : 1.72,p<0.0l) were significant. Appetite was associated significantly with the face scale in both models 1 and 2, and the total score of oral symptoms was associated with the face scale in model 1. This study suggests that there was a significant relationship between appetite and quality of life in community-dwelling older adults, and a recovery of oral symptoms was necessary for improvement in the quality of life.

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