As an organization taking progressive approach in caries treatment we conducted the ICDAS awareness survey of 1,206 members in order to find out awareness and understanding of ICDAS and evaluation of the ICDAS-II photo panel designed to promote clinical application of ICDAS. The collection rate was rather low (26.5%), so this does not necessarily represent the average or trend of all members; of those who replied 215 members (65.3%) answered “read or heard about ICDAS”; and more than 90% answered “instrumental in examination and explanation to patients”. Together with the results of the survey on clinical application of ICDAS, a good footing for promotion of ICDAS in Japan was gained.

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Topical fluoride application should start at the time of eruption of lower deciduous incisors. In this paper are presented its justifications. In the final report presented by Japanese Association for Dental Science (Fluoride Working Group) in 1999 application of fluoride spray or use of fluoride tooth paste is recommended to start at one year-old. In Japan, however, only one in ten dentists practice application of fluoride toothpaste to 1.5 year-old, and five in ten to 3 year-old. FDI and WHO suggest that topical application of fluoride to children younger than 3 year old be adjusted depending on regional differences. Recommendations of application of fluoride toothpaste in European and North American countries in accordance with fluoridation environment are laid out. European Academy of Paediatric Dentistry (EAPD) recommends application of pea-size fluoride toothpaste (500ppm) to children between 6 month- and 3 year-old twice a day. The deciduous teeth eruption time is considered “susceptibility window” (Evans and Stamm, 1991) for dental fluorosis, so experts’ advice on its application may be valuable during this period.

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In Japanese “amelogenesis imperfecta” and “enamel hypomineralization” are often misunderstood as a single disorder and expressed in a term. However, they are actually different disorders. The former means hereditary disorders while the latter means nonhereditary congenital disorders considered as chronological disturbances. Here, I describe “amelogenesis imperfecta” and “enamel hypomineralization” from the standpoint of their difference, classification, pathogenesis, typical cases and treatment indications.

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The homeostatic mechanism of oral environment is a compound of clearance mechanism, site-specificity, and salivary buffering. In this paper the result of the experiment on these functions is introduced. My conclusions are as follows; 1. The oral environment contantly changes depending on the saliva secreation rate, pH fluctuation, plaque growth, dietary and brushing practice; 2. pH of saliva under resting conditions and buffer of stimulating saliva govern the oral environment in terms of balance between acidity and alkalinity; 3. Saliva tests, if conducted several times over a certain period of time, should be able to provide sufficient amount of information to evaluate daily cycle of patient's overall oral conditions, but oral conditions cannot be properly evaluated after tested only once or twice; and 4. Oral conditions vary from site to site, so the assessment of demineralization and remineralization must be site-specific.

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There are both congenital and posteriori factors for malocclusions; the former are mainly genetic while the latter include nasopharyngeal diseases, bad habits, etc, which are preventable. Of posteriori factors, 1. nasal congestion, oral respiration, and low tongue position 2. thumb-sucking and pacifiers 3. food and chewing habits 4. postures (resting one's cheeks/chin on his/her hands) and sleeping postures are outlined and discussed. Also presented are cases where early detections make treatments easier: malocclusions lead to skeletal abnormality as the patients grow and abnormal eruption, which, if left untreated, would cause considerable damage on occlusion, periodontia and temporomandibular joint.

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Traditional diagnostic criteria for caries is sufficient for restorative treatment purposes, but is insufficient in order to account for follow-up evaluation or remineralization of incipient caries. The ICDAS-II code makes it possible to follow up and keep an objective record of progress of caries, and in particular, of incipient caries. Its applicability independent of examiners is also a plus. At my clinic the ICDAS-II scores combined with the X-ray examination code make up a clinical record. Introduction of ICDAS-II did not only help our communication with patients or among staff members, but also helped us more closely and carefully examine patients' oral conditions. At a local public clinic mainly for patients with disabilities where different dentists and hygienists take turn, ICDAS-II helps us keep objective records and improve mouth-cleaning before examination (by having staff members learn where to pay attention). It takes some time to be acquainted with the codes and calibration, but once acquired the ICDAS-II code system is very instrumental.

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Member clinics which keep the record of new patients’ oral conditions, i.e., of children and minors, a DMFT score and of adults, a DMFT score, number of residual teeth, conditions of periodontia, and smoking background in digital data format, have participated in this fact finding survey. This year’s report is based on data of 10,216 new patients (male 4,207, female 6,009) collected at 29 clinics across the country and of 10,216 new patients (male 4,207, female 6,009) from January 1st - December 31st 2009. Steady improvement is seen in the DMFT score (since 2005–9.82 9.49 8.96 8.52 8.64) of female between 20-25 years old; whereas, a drawback is seen in female patients between 50-65 years old. As for male patients, increase of DMFT is seen in the broader age bracket, 40-65 years old. In the last five years drawback of the DMFT score is seen in male patients of the broad working age group.

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