Many epidemiological studies have shown that the prevention of dental caries by fluoride is a basic and indispensable method to maintain and improve dental health. However, the countermeasures for maintenance of dental health and implementation of preventive programs for caries are still not satisfactory in Japan. In developed countries, it is thought that the prevalence of water fluoridation and use of fluoride-containing dentifrices are the primary factors responsible for the remarkable decrease in the prevalence of dental caries in children. Topical application of fluorides, especially fluoride mouth rinsing, has an extremely important role in Japan as compared with various other countries, because systemic application of fluorides, such as water fluoridation and use of fluoride tablets are not yet available in Japan. However, fluoride mouth rinsing has not become prevalent on a nationwide scale. Therefore, it is hoped that fluoride mouth rinsing will be enforced in more kindergartens, elementary schools, and junior high schools to contribute to the improvement of dental health in the future.

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To study the involvement of lipopeptide, a component of Gram-positive bacteria, in the pathogenesis of inflammatory osteolysis including periodontitis and osteomyelitis, we investigated whether lipopeptide influenced the differentiation and activation of osteoclasts. Pam₃CSK₄, a synthetic triacylated lipopeptide which has been proved to activate macrophages through TLR2, stimulated osteoclastogenesis at all the concentrations examined (between 10 and 1000 ng/ml), without adding RANKL exogenously, in bone marrow-derived preosteoclasts. Moreover, local injection of Pam₃CSK₄ to wild-type mouse induced osteolysis in calvaria, which was not observed in TLR2-null mouse, indicating that bone resorption in vivo also occurred through a TLR2-dependent mechanism. These findings demonstrate an important role of triacylated lipopeptide in differentiation and activation of osteoclasts which results in pathological bone destruction through TLR2 ligation.

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The purpose of this study is to examine the relationship between salivary flow and candida carriage. This study measured the unstimulated (resting) whole saliva flow rate (UWS) and stimulated whole saliva flow rate (SWS), and investigates their influence on the candida colonization. The relationship between candida carriage and onset of signs on the oral mucosa was also investigated. A total of 2,678 subjects (male: female = 446 : 2,232, mean age of 66.8) who visited the Dry Mouth Clinic at Tsurumi University Dental Hospital with a complaint of dry mouth were recruited for this study.
One thousand five hundred forty-eight patients (57.8%) carried candida. The highest CFU was observed in patients with Sjögren's syndrome (Group I), and followed by non-Sjögren's syndrome patients with decreased UWS and SWS (Group II), patients with only decreased UWS (Group III), patients with only decreased SWS (Group IV), and a group with UWS and SWS within the normal limit. (Group V). The results suggested that hyposalivation is risk factor in an increase of candida CFU, especially in Sjögren's syndrome patients. Unstimulated saliva flow may therefore contribute more to an increase of candida CFU than SWS, because there were more candida colonies in Group III than Group IV.
The occurrence of signs of erythematous candidiasis such as atrophy of lingual papilla, redness of oral mucosa is significantly higher in patients who detected candida in their mouth than those that did not. The study suggested that an increase of candida CFU due to hyposalivation led to the onset of oral candidiasis.

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We report a case of angioedema in the tongue and oral floor potentially induced by angiotensin II receptor blockers (ARB).
A 77-year-old woman with a history of hypertension was treated with an ARB, and edematous lesions in the tongue and oral floor suddenly occurred about one week after the start of the treatment. She visited an emergency hospital, and was prescribed serrapeptase, a complex of betamethasone and chlorpheniramine maleate, and epinastine hydrochloride. But since the edema was poorly controlled, she was referred to our department. The ARB was strongly suspected to have caused the angioedema, so we stopped the ARB that she was taking. Edema disappeared one day after the onset of symptoms, and there has been no recurrence of symptoms after the termination of ARB treatment.

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To prevent drug-induced medical malpractice in dental practice, it is important to confirm the safety of the planned dental treatment sufficiently, and further to select an appropriate drug for the targeted treatment adequately. We thus considered that a reference material, if available, may be useful for achieving more efficient and adequate selection of an appropriate drug when the confirmation of safety must be performed during a rather busy dental practice or when an alternative drug must be selected if the intended drug could not be used due to some reason. Therefore, several important points we should bear in mind when a local anesthetic, antimicrobial agent or analgesic is selected were extracted from the literature concerned. In addition, these drugs were then classified for arrangement to make a summarized list for reference.

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The objectives of report were: 1) to identify the guidelines for the management of patients on antithrombotic therapy requiring dental extraction; 2) to summarize the evidence and recommendations; and 3) to provide guidance for the dentists on identifying which patients can be managed in primary care.
We searched systematically for literatures in several electronic databases, focusing on dental surgery in patients receiving continuous antithrombotic therapy.
The following evidence-based recommendations were organized; (1) for patients within the stably therapeutic range of International Normalized Ratio (INR: 2.0-3.5), anticoagulant therapy continued for dental extraction with appropriate local haemostatic measures. (2) A check INR is recommended 72 hours prior to dental extraction. (3) It is not necessary to interrupt low-dose aspirin therapy (100mg/day or less) for dental extraction.

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