Patients complaining of oral malodor (halitosis) at the Oral Malodor Clinic of Fukuoka Dental College, Medical and Dental Hospital, were asked to complete a questionnaire. In this study, we evaluated the relationship between the clinical classification and the results of the questionnaire. The study population consisted of 238 subjects (100 males and 138 females) aged 46.3±15.3 years (mean±SD). The participants understood the nature of the research project and provided informed consent. Patients with pseudo-halitosis tended to be more aware of their own perceived oral malodor than subjects with genuine halitosis (ρ<0.05), and many subjects with pseudo-halitosis had difficulties in their social life and interpersonal relationships because they tended to take their condition too seriously. In the questionnaire, with regard to subjective symptoms pertaining to the oral cavity, problems associated with dental surgery were notable in the subjects with oral pathologic halitosis, including gum bleeding and caries. In contrast, feelings such as tooth pain and bad taste were characteristic of the subjects with pseudo-halitosis. More than half of the pseudo-halitosis subjects worried about work, family, or friends (ρ<0.05). They also stated that nobody around them had oral malodor (ρ<0.01). The questionnaire showed distinct trends in the clinical classification of halitosis. Consequently, it may be useful for diagnosing halitosis and identifying psychological halitosis.

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Recently, the need for preventive care for frail elderly subjects has been recognized. This study aimed to obtain information about the relationship between the oral status and general health in subjects older than 65 years according to selected items related to the frail elderly. We selected 852 subjects older than 65 years who participated in general health examinations. We conducted personal interviews to obtain information regarding habitual function, physical function, nutritional status, social withdrawal, dementia, and depression in addition to the oral status such as chewing function, feelings of suffocation while eating, and dry mouth. We counted the pertinent number of items for habitual function, physical function, nutrition status, social withdrawl, dementia, and depression. We compared the average number of items with oral function, including chewing ability, feelings of suffocation while eating, and dry mouth. The mean number of items for the disorders was higher in the elderly with the oral disorders assessed. In particular, there was a significant difference in the mean number of pertinent items related to dementia and depression between subjects with compared to those without oral disorders. These findings indicate the presence of a significant relationship between the oral status and general health conditions in frail elderly subjects. Preventive activities to maintain a good general status in frail elderly subjects should focus on improving oral function.

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There have been few cohort-based studies on the failure of dental restorations and their length of service in private Japanese practices. The purpose of this study was to determine factors associated with the longevity of dental restorations in posterior teeth. The treatment records of ten dentists working in one metropolitan area of Japan between 1991 and 2005 were selected. The survival curves of various types of restorations placed in 649 posterior teeth of 95 adult patients (33.3±14.2 years old) were depicted using the Kaplan-Meier method. Factors associated with the longevity of dental restorations were evaluated using multivariate Cox proportional hazards regression analysis. Reasons for the failure of dental restorations were also recorded when dentists decided to replace them. The mean survival time for composite resins, metal inlays, metal onlays, metal crowns, and metal bridges were 3,532, 3,804, 3,332, 3,276, and 2,557 days, respectively. The survival probability of metal bridges was lower than of any other restorations (p<0.01). Secondary caries presence was the most frequent reason for the replacement of composite resins, metal inlays, and metal onlays. Metal crowns were replaced mostly for endodontic reasons. There was no evidence that the life span of dental restorations depended on age, sex, or tooth type. However, the longevity was significantly shorter in subjects diagnosed with Eichner Index B1 (p<0.05), B2 (p<0.001), and B3 (p<0.01) compared to those with Eichner Index A. These results suggest that the longevity of dental restorations placed in posterior teeth was associated with the occlusal status.

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Periodontally healthy subjects as well as patients with periodontitis complain of halitosis. We focused on physiologically confirmed halitosis patients to examine the relationship between volatile sulfur compounds (VSC) in mouth air and the tongue coating. We assessed 6 subjects who were in good general health. After improving their periodontal status, VSC in their morning breath were measured via gas chromatography. Subsequently, professional tooth cleaning of all teeth was performed, and VSC were measured. Immediately following the latter procedures, tongue cleaning was performed, and VSC were measured again. Subsequently, the bacteria in the tongue coating, which were removed by tongue cleaning, were anaerobically cultured on blood agar and identified using Gram's stain. There was a significant reduction in VSC after tongue cleaning (P<0.05). There was no positive correlation between the number of bacteria removed in the tongue coating and the decrease in VSC. However, there was a positive correlation between the distribution of Grampositive rods and the decrease in VSC (p<0.10). It was suggested that the main source of oral malodor in periodontally healthy subjects might be the tongue coating. It was also concluded that bacterial distribution in the tongue coating might affect the concentration of VSC in the mouth air of periodontally healthy subjects.

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The purposes of this study were: 1) to examine the association of the smoking status with oral-health-related daily life difficulties of workers, 2) assess employees' opinions and knowledge on tobacco, and 3) explore the necessity of smoking-cessation support activities as part of an oral health program in the workplace. The subjects of this study were 855 male office or technical workers, who work for an electronics company. The mean age was 42.1. A questionnaire survey and oral examinations were conducted from September 2004 to August 2005. The questionnaire items included: 1) oral health behavior, 2) oral-health-related daily life difficulties (five items), and 3) tobacco-related questions. The results showed that the prevalence of smokers was 38.7%, ex-smokers 12.9%, and non-smokers 48.4%. The common oral-health-related daily life difficulty questions showed that 20.6% of subjects felt uncomfortable esthetically, followed by having chewing and tasting (13.7%), speaking and pronunciation (10.1%), work-related (6.1%), and sleeping (3.5%) difficulties. The logistic regression analysis showed an association between the smoking status and oral-health-related daily life difficulties: esthetic problems (OR for smokers=1.60), chewing and tasting difficulties (OR for smokers=2.03, and OR for ex-smokers=1.98), and difficulty in sleeping (OR for smokers=4.01). About a quarter of the employees answered that smoking-cessation support was inadequate, and 29.3% reported the necessity of smoking-cessation support by dental professionals in the company. Knowledge about tobacco-related diseases (oral cancer; 67.1%, and periodontal disease; 54.6%) was insufficient. These results showed the close association of the smoking status with oral-health-related daily life difficulties of male workers, and the necessity of smoking-cessation support for and provision of information on tobacco to male employees. Therefore, dental professionals should provide smoking-cessation support as a part of oral health promotion in the workplace.

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The subjects of the present study were 183 adults aged 40 years or older who attended the general health examination organized by the Health and Welfare Division of the local government in Atown, Kagoshima Prefecture, Japan. We examined the association between the periodontal status and serum IgG antibody titers for periodontopathic microorganisms. The severity of periodontal disease was evaluated using the Community Periodontal Index (CPI). Serum IgG antibody titers for whole cells of Aggregatibacter (Actinobacillus) actinomycetemcomitans (serotypes a-e) and Porphyromonas gingivalis, and for P. gingivalis fimbriae were analyzed by the enzyme-linked immunosorbent assay. The serum antibody titers among the 5 serotypes of A. actinomycetemcomitans were significantly correlated using Spearman's correlation coefficient. Furthermore, the serum antibody titers for A. actinomycetemcomitans serotypes c and e were significantly correlated with the titer for whole cells of P. gingivalis. While the serum antibody titers for P. gingivalis fimbriae were significantly correlated with the titer for whole cells of P. gingivalis, they were weakly correlated with A. actinomycetemcomitans serotype a. The antibody titers for whole cells of A. actinomycetemcomitans serotypes a and e, and of whole cells and fimbriae of P. gingivalis were significantly associated with the status of periodontal disease using the Kruskal-Wallis test and Spearman's correlation coefficient. The measurement of serum antibody titers for these antigens was suggested to be helpful in screening a large number of subjects for periodontal disease.

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The purpose of this study was to evaluate the effect of fluoridated dentifrice with mucin on remineralization using the QLF (quantitative light-induced fluorescence) method. A total of 160 bovine enamel specimens (5mm in diameter) were mounted on an acrylic rod and polished. Incipient lesions were formed in specimens by immersion for 48 and 96 hours in demineralizing solution (lactic acid: 100mM, hydroxyapatite: 3g/l, carboxymethyl cellulose sodium salt: 0.2g/l, pH: 5.0). Specimens were exposed to mucin-free and mucin-containing (0.29mg/ml, 0.87mg/ml, and 2.70mg/ml) artificial saliva (KCl: 130mM, KH_2PO_4: 0.9mM, CaCl_2: 1.5mM, HEPES: 20mM, NaN_3: 0.05%, pH: 7.0) for 28 days. Half of each specimen was immersed in 25 vol% of fluoride dentifrice solution for 5 min, 3 times per day. Surface images of specimens were recorded on days 3, 6, 9, 12, 15, 21, and 28 during the remineralization process with QLF. The results indicate that the rate of recovery of specimens stored in only the remineralizing solution containing mucin was particularly low in the 2.70mg/ml group, and that of the mucin-free group was highest in both 48- and 96-hour demineralized enamel specimens. For the specimens stored in the remineralizing solution containing mucin and fluoridated dentifrice solution, the recovery rate of the 2.70mg/ml group reached a plateau in 9 days, and significant differences appeared between that group and the others (mucin-free, 0.29mg/ml, and 0.87mg/ml) on the 15th day. In combination with fluoridated dentifrice, a high rate of remineralization was observed in mucin-free, 0.29mg/ml, and 0.87mg/ml groups on the 28th day. It was concluded that without fluoridated dentifrice, mucin in the remineralizing solution delayed the remineralization of the demineralized enamel lesions, especially in the 2.70mg/ml group. A strong remineralization-promoting effect is caused by a concentration of up to 0.87mg/ml of fluoridated dentifrice in incipient enamel caries lesions. Consequently, mucin could be considered as an important factor in the remineralization of demineralized enamel lesions.

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