From the year 2000, an increasing number of reports have focused on the association between periodontal and cardiovascular diseases. Periodontal measurements are carried out in a number of ways, and, therefore, the grading of periodontitis in each study may differ according to the measurements used. Some previous studies included meta-analyses; however, the heterogeneity of periodontal measurements was not taken into account. Therefore, we divided periodontal measurements which are taken more frequently into two groups: Group A, which included measurements reflecting inflammation on examination, as indicated by Bleeding on Probing (BOP) and Probing Pocket Depth (PPD); and Group B, which included measurements not reflecting inflammation on examination, indicated by Clinical Attachment Loss (CAL), and analyzed the pooled odds ratios (OR) of each group.
 We conducted online and manual searches, which revealed 688 articles, of which 11 fulfilled the inclusion criteria. The measurements in Group A did not reveal a significant correlation between periodontal and cerebrovascular diseases (OR = 1.35; 95% confidence interval [CI], 0.90-2.02), while Group B measurements revealed a significant positive correlation between the 2 diseases (OR = 1.96; 95% CI, 1.32-2.90). To assess the existence of publication bias, we drew funnel plots, which revealed the possibility of publication bias. In order to analyze non-published articles, a trim and fill method was used to assess Group B. After putative non-published articles were included in the analysis, a significant correlation was observed between periodontitis and cerebrovascular diseases (OR = 1.48; 95% CI, 1.07-2.06).
 Differences were observed between periodontitis and cerebrovascular disease due to different periodontal measurements. BOP and PPD cannot indicate the duration of periodontal disease, while CAL is a cumulative measure that can indicate the duration of periodontitis. Therefore, a stronger association may exist between CAL and cerebrovascular disease than that of BOP or PPD. This study suggests that the association between periodontal disease and stroke may differ according to periodontal measurements. Therefore, careful analysis is required while investigating the association between periodontal and cerebrovascular diseases, and further studies are warranted.

View full abstract

Abstract in Japanese

View full abstract

 The purpose of this study was to identify oral conditions associated with the nutritional status in independent elderly outpatients who visited the Department of Dentistry in a university hospital. The participants were aged 65 to 84 years, and able to walk independently. The number of teeth, selfmasticatory ability, mouth dryness, taste disorder, and denture use were examined. The Mini-Nutritional Assessment Short Form (MNA-SF) and Body Mass Index (BMI) were used to assess the nutritional status. MNA-SF was associated with taste disorder (p=0.020). Underweight outpatients (BMI<18.5) had significantly fewer teeth than normal weight (p=0.016) and overweight (p=0.046) outpatients. From these results, there is a possibility that the existence of a taste disorder and number of teeth are diagnostic items to assess independent elderly people's nutritional status.

View full abstract

 The aim of this study was to investigate the knowledge of 45 caregivers who have not received any formal instruction using a questionnaire about an oral health care program for the elderly in a nursing health care facility in Shizuoka. The importance of plaque control and oral care was generally recognized. As many as 91% wanted to learn the correct method of oral health care, and 80% of the subjects wanted professional dentists and dental hygienists to step in, and a practical oral health care program was desired. There was also an association between the brushing habit of the caregivers and oral health care provided for the elderly.
 These results showed that an oral health care program is necessary for caregivers. Regarding daily life support for the elderly, a daily oral health care program implemented by caregivers in nursing care facilities would be important before any professional intervention. Further educational programs for caregivers may be needed to promote oral function improvement in the elderly.

View full abstract

 The support programs extended by The Nippon Dental University in collaboration withthe Niigata Dental Association for people with a pathological aversion to interpersonal contact andsocial involvement have led to an increase in their requests to see dentists and seek advice. This paperdescribes the results of dental treatment of three socially withdrawn patients.
 Case 1 was a 26-year-old man who had been socially withdrawn since his high-school days. He hadcomplained about a bad toothache due to dental caries, so his caregiver asked us to see him. The patientwas admitted to our hospital and underwent caries treatment under intravenous sedation. Radiographicexamination did not show any signs of root canal treatment, despite the fact that there were manycavities. Withdrawal had prevented him from visiting a dentist. After he was discharged, he visited ourhospital with relative ease for follow-up treatment as an outpatient. This was a good example showingthat dental treatment led to the amelioration of social withdrawal.
 Case 2 was a 21-year-old man. The man was in the process of recovery from social withdrawal fromwhich he had been suffering for three years. He underwent dental treatment at the suggestion of adentist from whom he had received dental health guidance at an open-door rehabilitation facility. Thepatient had many decayed teeth. Dental treatment increased the rate of recovery.
 Case 3 was a 24-year-old man. The man was in the process of recovery from withdrawal. He receiveddental treatment at our hospital, but canceled further appointments due to the aggravation of withdrawalsymptoms. Follow-up treatment had to be provided by house call. This patient relapsed into withdrawal,although we provided dental treatment over a few visits.
 With an increase in the number of socially withdrawn people, it is expected that patients with suchmental illness will visit dental clinics for examination and treatment more frequently. Considering thepresent situation, dental professionals need to update their knowledge and be prepared to provide betterdental health services for them.

View full abstract