It is known that oral health of 6 to 20 year-old children and addolescents has a considerable impact on lifetime overall health; however, a clinical report on long-term caries-preventive treatment in the Japanese setting is not available. Sugiyama Dental Clinic updated its clinical policies on dental caries and periodontal disease to prevention oriented and has since maintained the database of clinical records. The present study was conducted to analyze the relevance of caries-preventive treatment frequency to an increase of DMF teeth during the period between 6 and 20 years old, using the said database. Patients were divided into 3 groups: Group A—those who received caries-preventive care 1-12 times between 6 to 20 years old; Group B—13 - 24 times; Group C—25 times or more. DMF teeth increased in Group A by 4.9（±4.50）, in Group B by 2.3 （±2.98）, and in Group C by 2.0 （±2.28）. As such, the increase of DMF teeth was smaller in Group B （P-value=0.048） and C （P-value=0.026） in comparison to Group A. For the same subjects, increase of DMF teeth was assessed, based on whether there was an interruption in caries-preventive treatment （i.e. interval of 1 year or longer）. As a result, a greater increase in DMF teeth was found in Group I—with interruption （3.3± 3.49） compared to Group WI—without interruption （1.9±3.15）. These results suggested that caries-preventive treatment may be relevant to controlling or lowering the increase of DMF teeth on average and also caries-preventive care with appropriate interval may be effective in lowering the increase of DMF teeth to 2 on average during 6 to 20 year-old period.

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This retrospective study was conducted to analyze the follow-up of pulpectomized teeth and infected teeth treated at Tamashima dental clinic and also factors relevant to the healing results. Of the 426 teeth in 256 patients, 300 had not been previously treated （213 vital teeth and 87 non-vital teeth with apical lesions） and 126 previously treated teeth had apical lesions. According to the strict standard, i.e. the treatment is considered “successful” if and only if an x-ray image shows sound periodontal space, otherwise considered “failure” regardless of the sign of improvement seen in the region—the overall success rate was limited to 60.8%. Among teeth that were endodontically treated for the first time, the success rate was 70% for the vital teeth and 56.3% for the non-vital teeth while that for the re-treated teeth was 48.4%. When teeth with signs of improvement were included in the category of “success”, the overall success rate was 73.2%. According to the assessment criteria of the guidelines of AAE （American Association of Endodontists）, success rate （healed and healing included） was 94.1%. Factors relevant to successful treatment include sex, post-treatment period （in case of retreatment）, size of enlargement, number of root canals involved, apical terminus location of the root canal filling, and dentist’s experience, while other factors such as number of treatments （or visits）, number of days spent before the filling procedure, patient’s age at the time of treatment, were indicated as not relevant. It is difficult to draw any conclusion in comparison with outcomes at other clinics and institutions considering the differences in conditions and backgrounds, but nonetheless the gaps in the success rate between Tamashima dental clinic and universities and specialists’ clinics were worthy of attention. Factors contributing to the success rate might include quality of basic treatment and degree of adherence to the guidelines as well as the nature of medical insurance system in Japan.

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A 52-year-old female patient first came to our clinic, with 13 remaining teeth, and it seemed like a matter of time before she would become edentulous. After one year of treatment, however, the patient, who once seemed resigned about her oral health, became interested in maintaining her teeth. She has since paid a visit to our clinic for maintenance for 20 years. As a result of consistent maintenance visits and patient’s self-care effort, ten teeth are still present, maintaining a good oral condition. The contributing factors, I believe, include the success of TBI in the initial treatment, which motivated the patient and helped building the trust between the patient and our clinic and also technical improvement in the dental hygienists’ professional cleaning skills over the course of the maintenance period.

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A patient initially with a low caries risk, who had been coming to our clinic for maintenance from an infancy, presented with an early carious lesion after becoming a junior high school student and going through environmental and lifestyle change, due to club activities and cram school attendance. The patient had no subjective symptom and was not aware of the lesion, but his consistent maintenance visit helped reducing the risk of further developing the caries lesion at the early stage and prevented cavity formation. This case reminded us of importance of continuous maintenance treatment, reliable detection of the initial carious lesions, and appropriate response to the change in patient’s caries risk.

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Dental treatment is said to be a team approach. In particular, an advanced team approach is required for long-term prevention oriented dental practice. However, various close calls, minor incidents, and communication errors occur in daily practice. As such, we were searching for solutions for the various problems within the clinic and stumbled upon Agile methods. One of the core values is to treat the problems that occur every day as “organizational or institutional problems” rather than “individual problems”. The Agile approach was applicable to our dental clinic and proved effective; this article is to outline the gist of the Agile based team approach and its implementation at our clinic.

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The present article is to report on utility of a caries lesion detection device (DIAGNOcam, KaVo Dental Systems Japan) employing near-infrared (780 nm wavelength) radiation. The device was installed at the Sugiyama dental clinic in 2013 and has been used in conjunction with radiograph examination, and I feel it is safe to say that the device is useful for diagnosing dental caries. In order to further scrutinize and facilitate its utility, we formulated diagnostic criteria by DIAGNOcam. By using it together with ICDAS and radio graphic scores—used to classify depth of approximal carious lesions, we believe that it can be used not only among clinic staff but also for sharing information with patients.

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This survey was conducted to investigate oral health status of new patients at dental clinics practicing routine maintenance. Subjects were collected in anonymised digital format from Japan Health Care Dental Association (JHCDA) member clinics. The subjects of this 11th survey included 13,598 new patients (5,632 male and 7,966 female patients) during the period between January 1st and December 31st, 2015, collected from 47 clinics (in 21 prefectures). For children and minors, the DMFT scores were recorded, and for adults the DMFT scores, the number of remaining teeth, the condition of periodontal tissues and smoking status were recorded, but subjects with incomplete information were also included. The DMFT index by age group continued to decrease while decrease of male smoking population across all age groups was observed. As for the number of remaining teeth, sharp decline was observed around 75 years old in male population and around 70 years old in female population. Also, the subjects were divided into 4 groups based on the amount of municipal or ward tax according to the location of the participating clinics and findings include; ① in the population 10 years old and over, a higher DMFT score was observed in low income groups; ② in the adult population, the DMFT index naturally increases along with the age, and this trend was more prominent in low income groups; and ③ in the population 60 years old and over, the trend by tax-amount-per-capita group—the higher the local tax the more remaining teeth—was observed.

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