The aim of this cross-sectional study was to evaluate the associations of tooth loss, denture use, and self-perceived denture fit with frailty in community-dwelling older Japanese adults. The subjects were 344 Japanese adults (177 men and 167 women) aged 79 years in Niigata City (Japan), who participated in an oral and general health examination and a questionnaire survey in 2007. Frailty was defined as the presence of ≥ 2 of the following 3 factors derived and modified from the Study of Osteoporotic Fracture Criteria for Frailty: 1) weight loss ≥ 5% over 2 years, 2) inability to do chair stands, and 3) answer of “no” to the question “Do you feel full of energy?”. Associations between frailty and tooth loss, denture use, and self-perceived denture fit were evaluated using logistic regression analysis. The multivariable models were adjusted for sex, body mass index, and mental health. The frequency of frailty in this study was 8.4%. Multivariable logistic regression indicated that tooth loss (per each additional tooth present, adjusted odds ratio [OR]=0.94; 95% confidence interval [CI]=0.90–0.99), the presence of 20 teeth or more (compared with the presence of less than 20 teeth, adjusted OR=0.39, 95% CI=0.15–0.97), denture non-use (compared with denture use, adjusted OR=17.89, 95% CI=5.00–64.32), and self-perceived ill-fitting denture (compared with well-fitting denture, adjusted OR=3.38, 95% CI=1.01–11.27) were significantly correlated with frailty. Our results suggest that tooth loss, denture non-use, and self-perceived ill-fitting denture were associated with frailty in community-dwelling older Japanese adults.

 This study investigated the relationship between dysphagia and the nutritional status of elderly individuals living at home when screened with Eating Assessment Tool-10 (EAT-10). A total of 129 participants (62 males, 67 females, aged 85 years) were surveyed. Participants were sent a questionnaire by mail and asked to complete and return it to the authors. Assessments included in the questionnaire were EAT-10, the self-reported number of teeth, Short-form Mini Nutritional Assessment (MNA-SF), a subjective health evaluation, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-Index of Competence), Oral Health Impact Profile-49 (OHIP), and number of foods that can be masticated. To evaluate variation in the study’s variables, the analysis was based on established scores of EAT-10: those suspected of having dysphagia score above three; those with no suspicion of dysphagia score below two.

 When screened with EAT-10, 52.7% of the participants were classified as being suspected of having dysphagia. There were significant correlations between dysphagia and a low OHIP score (p<0.001), the number of foods that can be masticated (p<0.001), subjective health evaluation (p<0.001), and MNA-SF (p=0.007).

 Furthermore, logistic regression analysis revealed that the nutritional status was associated with dysphagia (p=0.043)．These findings suggest the association of dysphagia with malnutrition in elderly people living at home.

 Health inequalities among children with caries resulting from the socioeconomic status, such as education, income, or geographic location, have been reported. However, the temporal trends in health inequalities has not been reported. This study aimed to clarify the temporal trend of the absolute and relative inequalities in 3-year-old children with caries within Ibaraki Prefecture’s municipalities. We conducted an ecological study of all 44 municipalities in Ibaraki. We used the data on caries prevalence in 3-year-old children and the mean municipality income per capita as indexes of the socioeconomic status for each municipality from 2005 to 2013. We used the Slope Index of Inequality (SII), which represents the absolute disparity, and the Relative Index of Inequality (RII), which represents the relative disparity, as indicators of health inequalities. The results showed that caries prevalence itself had declined in almost all municipalities in Ibaraki, but health inequalities within the prefecture still existed. The SII declined, while the RII had remained almost unchanged over the observation period. Local governments need to periodically monitor health inequalities as well as implement public health approaches to reduce such inequalities.

 The Japanese Ministry of Health, Labour, and Welfare has been conducting periodontal disease screening as a part of senior health services since 1995, and as an independent medical examination for individuals aged between 40 and 50 years since 2000. This service has been extended for individuals aged between 60 and 70 years since 2004. The consultation rate for periodontal disease screening in Japan has not been reported recently, and so its current status is unknown. In this study, we estimated and assessed periodic and regional differences in the consultation rate for periodontal disease screening over a period of 15 years.

 We calculated the consultation rate for periodontal disease screening by dividing the number of individuals screened for periodontal disease (as recorded in the regional health care and health promotion service report), by the total population (as per the Basic Resident Register and multiplying by 100), from the year 2000 to 2015. At the national level, the consultation rate was 1.27% in 2000, 2.74% in 2005, 3.34% in 2010, and 4.30% in 2015. The highest rate in a prefecture was 13.33% and the lowest rate was 0.34% reveling that consultation rates differed markedly among prefectures. Multiple linear regression analysis that factored in socio-demographic variables revealed that prefectures with larger total numbers of oral examinations and health guidance sessions (partial correlation coefficient= 0.356; p=0.016), a larger proportion of health care costs (partial correlation coefficient=0.295; p=0.049), and a higher level of available funds (partial correlation coefficient=0.337; p=0.024), had higher consultation rates.

 It was concluded that the total consultation rate showed an increasing trend, while the regional differences widened. The total consultation rate may increase in the future by focusing efforts on improving regional consultation rates.

Abstract in Japaneses