With advanced aging, there are growing demands for the management of sick persons and medical liaison systems. In such a situation, clinics are expected to play roles as primary medical institutions, such as dealing with diverse patients and promoting community-based multi-professional collaboration. To clarify the association between the statuses of different types of professionals working in dental clinics and their service contents, a questionnaire survey was conducted, involving all dental clinics in Niigata Prefecture (1,186 as of August 1, 2012), along with examination of their service provision in July of the same year. Among these clinics, 950 that responded to the questionnaire without missing values were analyzed. With the number of dentists or dental hygienists working in the study clinics as an explanatory variable and those of dental assistants and clerks as covariances, logistic regression analysis was performed to analyze the contents of home dental care services. Ordered logistic regression analysis was also used to examine the management of patients with disabilities and the provision of feeding/swallowing guidance.
The items only associated with the number of dental hygienists were home dental care services, visits to care facilities, dental hygiene guidance for care facilities, and the management of patients with disabilities (adjusted odds ratio [95% confidence interval]=1.12 [1.03-1.23], 1.11 [1.03-1.23], 1.31 [1.16-1.47], and 1.27 [1.16-1.40], respectively). The provision of feeding/swallowing guidance was only associated with the number of dentists (1.24 [1.04-1.48]).
In order to promote the management of diverse patients in dental clinics and their liaison with hospitals, it may be necessary to enhance dentists’ awareness as a premise and basis for ensuring sufficient numbers of dentists and dental hygienists working in such clinics.
Assessment of gingivitis is generally dependent on visual examination and probing. Currently, there is no procedure available that is non-invasive, easily performed, objective, and reproducible for the screening of gingivitis. In this study, we investigated whether substances in the gingival crevicular fluid (GCF) can be useful as biomarkers for gingivitis. The participants were 107 elementary school children (fifth and sixth graders) in Kitakyushu City. We collected samples of GCF from each child using a blotting brush and quantitated the levels of α-1 antitrypsin (A1AT), lactoferrin (Lf), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) in the fluid. We then compared the results with oral gingival findings, such as the PMA index (PMA), community periodontal index (CPI), and plaque attachment index (PlI). The PMA and PlI results were binarized into a low-value group and a high-value group and then compared with each GCF substance. Significant differences (p<0.05) were identified for all substances when compared with the PMA results and for all substances, except LDH, when compared with the PlI results. The cut-off points from the ROC curve analysis for these substances (A1AT, Lf, AST, ALT, ALP, and LDH) compared with the PMA results were 283.8, 152.1, 4.5, 1.5, 2.5, and 26.0, respectively, and those compared with the PlI results were 248.3, 114.4, 2.5, 1.5, and 2.5, respectively. The positive likelihood ratio was approximately 1.5 to 3.0.
These results suggest that A1AT, Lf, AST, ALT, and ALP levels in GCF may be useful as biomarkers for gingivitis screening in children.
For oral health in the workplace, dental examinations for the early detection of oral diseases have been mainly conducted. In order to shift from conventional dental examination programs to those for investigating environmental risks and promoting behavioral changes, the Japan Dental Association developed a new oral health examination, assessment, and health instruction program for adults.
The aim of this study was to evaluate how dental examination and health instruction based on this program improved health-promoting behavior compared with the traditional dental examination program.
Subjects were recruited from employees of three companies in Niigata City (n=129; 44.6±11.5 years old). They were randomly divided into an intervention group and a control group. For the intervention group, dental examination and health instruction, based on the program newly developed by the Japan Dental Association, were conducted, whereas only a dental examination was conducted for the control group. Questionnaire surveys were performed at the baseline and 3 months, 6 months, and 1 year later to evaluate behavioral changes.
As a result, “tooth brushing at the workplace and outside home”, “use of fluoride-containing dentifrice”, and “use of interdental brush or dental floss” were significantly improved in both groups. In the intervention group, changes were noted at all time points until 1 year later, but changes were limited and only seen at some time-points in the control group.
This study revealed that the conventional dental examination program only marginally improves health behavior, but the new dental examination and health instruction program more markedly improves such behavior and its effects persist for at least 1 year.
The purposes of this study were to analyze the trend in primary tooth eruption and identify factors related to tooth emergence using data on tooth eruption collected during 18-month-old health examinations over a 33-year period.
Subjects were 27,454 children who participated in 18-month-old health examinations in Ebetsu, Japan between 1980 and 2012. This study focused on data from physical and dental examinations. The long-term trend in the average number of teeth present was analyzed by sex using general linear model (GLM) analysis. For logistic regression analysis, the prevalence of children with ≥16 erupted teeth was used as a dependent variable. Birth year, sex, birth order, birth weight, height, and chest girth at 18 months of age, year of health examination, and mothers’ age were used as independent variables. The following results were obtained: 1) The birth weight, body weight, and height at 18 months of age, average number of teeth, and percentage of children with ≥16 erupted teeth all decreased over the 33-year period. The GLM analysis revealed that the annual change in the number of teeth was -0.0188 for boys and -0.0181 for girls. 2) Compared with girls, boys tended to have more teeth, and a higher percentage of boys had ≥16 erupted teeth. 3) The prevalence of tooth fusion increased over the 33-year period; however, these trends were more typical for boys than girls. 4) The birth weight and body weight and height at 18 months of age were significantly correlated with ≥16 erupted teeth.
The present results demonstrated that over the 33-year period examined, the eruption of primary teeth became delayed and the birth weight and body weight and height at 18 months of age were related to tooth eruption.