This case study reflects on the treatment journey of a patient managed at our clinic for 46 years, culminating in a necessary tooth extraction. A retrospective analysis was conducted regarding the decision-making process, timing of extraction, and potential alternative interventions. Despite the clinical regret associated with tooth loss, the extraction ultimately preserved the patient’s trust and maintained their motivation for continued periodontal maintenance. This case highlights that in long-term care, clinical success is not defined solely by tooth retention, but also by sustained patient engagement and psychological support. Furthermore, it underscores the necessity of maintaining robust clinical records, continuously updating medical knowledge, and employing patient-centered "medical hospitality " to manage anxiety during transition periods.

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Background: As the elderly population increasingly maintains an active professional life, prosthetic treatment must evolve beyond simple functional restoration to consider a patient's social background and psychological well-being. Case Description: A female hairdresser in her 70s with a unilateral chewing habit required restoration of occlusal support. Treatment involved a mandibular implant on the right and a maxillary tooth auto-transplantation on the left. This fixed prosthetic treatment was selected to provide maximum comfort and accommodate the patient’s active professional lifestyle. Outcomes: The intervention restored bilateral occlusion and improved esthetics, resulting in high patient satisfaction and renewed motivation for work. Conclusion: For socially independent elderly patients, fixed prostheses offer significant psychological and functional advantages. Treatment success depends on a personalized design that accounts for the patient’s social background and specific clinical needs.

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This document summarises and provides commentary on three consensus statements established jointly by the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD). Established via a Delphi consensus process involving 25 international experts, these statements shift the focus of caries management from reactive repair to comprehensive approach to control or reduce caries activity. The core strategy prioritises non-, micro- and minimally invasive interventions tailored according to the individual's caries risk, caries activity and compliance. The statements emphasise managing the entire continuum of the caries process——from initial demineralization to cavitated lesions. Compared to the treatment of children and adults with coronal caries, the scientific evidence for the treatment of dental caries in older adults and on root surface is relatively scarce, calling for further research in this field.

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Background: In 2023, four Japanese dental academic societies updated the "Recommendations for the Use of Fluoride Toothpaste in Japan ", advising 900-1,000 ppm F for children under 6 years old and 1,400-1,500 ppm F for individuals aged 6 years and over. Despite these specific clinical targets, some fluoride toothpastes sold in Japan do not disclose their precise fluoride concentrations, complicating evidence-based product selection for consumers and clinicians. Purpose: This study aimed to quantify the fluoride ion concentration in sodium fluoride (NaF) toothpastes available in the Japanese market that lack specific concentration labeling. Methods: Eight brands of NaF-containing toothpaste were selected based on the absence of specific ppm F labeling on the packaging or manufacturer’s website. Each sample was dissolved in distilled water, and the fluoride ion concentration was measured by an ion-specific electrode and expressed as ppm. Results: The measured concentrations varied widely among the eight brands: (1) One brand contained < 500 ppm F; (2) Four brands contained approximately 500 ppm F; (3) Three brands contained 900-1,000 ppm F. Conclusion: These findings highlight a discrepancy between clinical recommendations and available consumer information. Without mandatory labeling of fluoride concentrations, even for products below 1,000 ppm, it remains difficult for consumers to adhere to the latest preventive dentistry recommendations. Manufacturers should be encouraged to disclose precise fluoride levels to facilitate appropriate product selection for dental caries prevention.

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【Objective】This study aimed to understand the characteristics of first-time patients at dental clinics offering regular management services. To achieve this, anonymized clinical records routinely documented at dental clinics operated by members of the Japan Healthcare Dentistry Association (hereinafter referred to as participating clinics) were collected. The characteristics of these first-time patients were then compared and analyzed by region. 【Methods and Materials】This study aggregated oral records of first-time patients (total of 16,124 patients with recorded birthdate and gender: 6,952 males, 9,172 females) from 72 clinics nationwide over one year (January 1 to December 31, 2023). The data were grouped into seven clusters based on clinic location for aggregation and analysis. Among member clinics, those capable of submitting digitized oral records for all new patients in principle were requested to cooperate. For children aged 6 years and older, data on the average number of decayed, missing, and filled teeth (DMFT index) per person was collected. For adults, data on the number of remaining teeth, periodontal disease progression, and smoking history (not necessarily complete for all items) was collected. Anonymized records were then aggregated. Using this method, records from over 10,000 new patients have been collected annually since 2005 across 17 surveys. Building on this, this study surveyed new patients in 2023. Participating clinics were divided into seven groups based on the average income of the local residents. Data for each group was compiled and compared regarding: (1) children's DMFT, (2) adult smoking rates by age group, (3) adult periodontal disease progression, and (4) adult current tooth count by age. 【Results】Higher regional economic status of clinic locations was associated with: (1) reduced pediatric DMFT, (2) lower adult smoking rates by age group, (3) decreased in patients with advanced periodontal disease, and (4) increased number of remaining teeth by age group. Compared to past studies, these disparities showed a decreasing trend. 【Conclusion】Oral health disparities are evident among residents not receiving regular dental care. Oral health disparities strongly correlate with regional economic disparities.

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