Factors Related to Regular Dental Check-Ups in Adults With Intellectual Disabilities in Japan.

BACKGROUND: We investigated the factors associated with regular dental check-ups among adults with intellectual disabilities in Japan, with the aim of increasing the attendance rate of regular dental check-ups, which are important for maintaining the oral health of persons with intellectual disabilities. METHODS: A questionnaire survey focused on oral health was conducted with 971 adults with intellectual disabilities in Japan. The survey included questions related to disability diagnosis, severity of intellectual disability, residence type, and several oral-health factors, including proxy-reported number of teeth, presence of a family dentist, frequency of regular dental check-ups, tooth-brushing habits, and availability of a dental hygienist at a facility. Logistic regression analysis was used to determine the association between regular dental check-ups (dependent variable) and independent variables. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: In a multivariate analysis, sex, diagnosis of disability, severity of intellectual disability, residence type, and the presence of a family dentist were significantly associated with regular dental check-ups. The ORs for nonregular dental check-ups were significantly higher for adults with Down syndrome, those with mild disability, and those living at home with family; the respective mean ORs (95% CIs) were 2.3 (1.2-4.4), 3.3 (1.3-8.4), and 1.8 (1.1-3.0). The absence of a family dentist had a particularly strong association with a lack of regular dental check-ups, with a mean OR (95% CI) of 15.0 (8.7-26.0). CONCLUSIONS: Regular dental check-ups among adults with intellectual disabilities in Japan were associated with sex, diagnosis of disability, severity of disability, type of residence, and the presence of a family dentist.

Factors Related to Early Childhood Caries in 17- to 23-Month-Old Children in Aichi Prefecture, Japan: A Cross-Sectional Study.

Dental caries is the most prevalent of chronic oral conditions. We investigated child and parental factors associated with early childhood caries (ECC) in 17- to 23-month-old children in Aichi Prefecture, Japan. Of the 61,714 children who underwent a health examination at 18 months of age, 54,206 (27,860 males, 26,346 females) were included in the analysis. The parents of the children completed a self-administered questionnaire comprising items related to the child's eating habits and lifestyle and the parent's lifestyle and childcare factors. Logistic regression analyses were performed using ECC as the dependent variable, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The prevalence of ECC was 0.8%. In the multivariate analysis, children who consumed sweetened beverages daily and snacked frequently had significantly higher ORs for ECC: 1.29 (95% CI: 1.05-1.59) and 1.49 (95% CI: 1.15-1.91), respectively. Bedtime breastfeeding and bottle-feeding were significantly associated with higher ORs for ECC: 4.88 (95% CI: 4.01-5.94) and 2.31 (95% CI: 1.72-3.10), respectively. Not eating breakfast daily and late bedtime were associated with high ORs for ECC: 1.41 (95% CI: 1.02-1.96) and 1.31 (95% CI: 1.05-1.64), respectively. The OR for ECC was significantly higher in children whose father was a smoker than in those whose father was not: 1.44 (95% CI: 1.18-1.76). The OR for ECC was significantly higher in children with no childcare adviser than in those with a childcare adviser: 1.67 (95% CI: 1.06-2.65). Children who had not been vaccinated had a significantly higher OR for ECC compared to children who had: 1.49 (95% CI: 1.14-1.94). These results imply the importance of enhancing parental guidance on the lifestyle habits of children and creating an environment in which parents can consult with others regarding parenting.

Utilization of Dental Care and the Incidence of Dementia: A Longitudinal Study of an Older Japanese Cohort.

INTRODUCTION: A relationship between periodontal disease and dementia has been reported. It is important to visit a dentist to maintain healthy periodontal tissue. Few studies have been reported on the association between dental visits and the risk of dementia. This study examined the relationship between the use of dental care among older people and the incidence of dementia based on health insurance claims data. MATERIALS AND METHODS: We targeted 31,775 people aged 75 or 80 years. Dental utilization was obtained from the health insurance claims data from April 2014 to March 2015. The month when dementia medical costs were first incurred during the 4-year follow-up period was defined as the dementia onset month. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the incidence of dementia for the use of dental care. RESULTS: Regarding the type of dental visit, the adjusted HR of overall dementia was significantly lower (0.89: 95% CI, 0.81-0.98) in those who received periodontal treatment compared with those who did not receive any dental treatment. Regarding the days of periodontal treatment, participants with ≥5 days had significantly lower adjusted HRs for overall dementia, Alzheimer's disease, and vascular dementia than those with 0 days, and the adjusted HRs were 0.84 (95% CI, 0.75-0.94), 0.88 (95% CI, 0.77-1.00), and 0.82 (95% CI, 0.69-0.99), respectively. CONCLUSION: Individuals who received periodontal treatment on many days had a low risk of dementia. Regular dental visits to treat or prevent periodontal disease may be important to prevent dementia.

Association Between Oral Health and the Medical Costs of Dementia: A Longitudinal Study of Older Japanese.

OBJECTIVE: Oral health status may be associated with dementia, which in turn results in higher medical costs among older people. METHODS: This STUDY enrolled 4,275 older individuals. Generalized linear models were constructed with the medical costs of dementia as the dependent variable, and number of teeth, Community Periodontal Index (CPI), and other factors as independent variables. RESULTS: Individuals with fewer teeth or with poor periodontal condition had significantly higher medical costs ratios for dementia independent of other confounding variables. The adjusted medical costs ratios of dementia were 4.13 (95% CI [confidence interval]; 1.79-9.56) for those with ≤9 teeth compared with those with ≥20 teeth and 3.48 (95% CI; 1.71-7.08) for those with personal CPI code 4 compared with those with personal CPI code 0-2. CONCLUSIONS: Oral health status was associated with the medical costs of dementia. Preventing tooth loss and maintaining periodontal health may contribute to controlling dementia costs.

Association of oral health factors related to oral function with mortality in older Japanese.

OBJECTIVE: To examine the effects of oral health factors related to oral function and their combination on mortality in older people. BACKGROUND: Recent studies have reported that oral factors, including oral function, are associated with mortality. MATERIALS AND METHODS: The participants were 4765 community-dwelling individuals aged 75 and 80 years. The follow-up period for survival or death was 3.5 years, and the date of death was defined based on data managed by the insurer. A Cox proportional hazard model was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality as dependent variables for oral health factors, including the number of teeth, swallowing disability, oral dryness and oral hygiene and the combinations of oral health factors as independent variables. RESULTS: In univariate analyses, all four oral health factors were significantly associated with mortality. After adjusting for age, sex, smoking, body mass index and medical history, and analysing the oral health factors separately, swallowing difficulty had the highest HR for mortality (adjusted HR, 2.12; 95% CI, 1.35-3.33). In the analysis using combinations of oral health factors as the independent variable, the participants with swallowing disability, oral dryness and poor oral hygiene had the highest HR for mortality (adjusted HR, 8.35; 95% CI, 3.45-21.08). CONCLUSION: Oral health factors related to oral function appear to be associated with mortality risk and an accumulation of oral health factors increases mortality risk among older people.

Oral Factors Associated with Swallowing Function in Independent Elders.

PURPOSE: This study clarified the oral factors related to swallowing function using the results of dental check-ups among community-dwelling independent elders. MATERIALS AND METHODS: Data on oral and medical health check-ups from 4,676 participants aged 75 and 80 years were analysed. Swallowing function was evaluated using the repetitive saliva swallowing test (RSST), which assesses the ability to swallow saliva. Swallowing three or more times during a 30 s period was recorded as normal, while swallowing twice or less in 30 s was considered to indicate swallowing difficulty. Multivariate logistic regression analyses were performed to examine the relationship between oral factors and swallowing function. RESULTS: In all participants, the odds ratio (OR) for swallowing difficulty was 3.42 (95% confidence interval (CI): 1.78-6.55) and 6.68 (95% CI: 1.97-22.64) among those who had 10-19 teeth without dentures and those who had 0-9 teeth without dentures, respectively, compared to individuals with ≥ 20 teeth without dentures. Those with moderate or severe dry mouth had a statistically significantly higher OR (8.01, 95% CI: 4.84-13.27) for swallowing difficulty than those without dry mouth. Among dentate participants, in addition to statistically significant variables in the analysis among all participants, those with abundant dental plaque showed a significantly higher OR (2.58, 95% CI: 1.54-4.32) for swallowing difficulty compared to those with no or slight dental plaque. CONCLUSION: These results suggest that oral factors such as having few teeth without dentures, dry mouth, and poor oral hygiene are related to swallowing function in elders.

Oral hypofunction and its association with frailty in community-dwelling older people.

AIM: This large epidemiological survey of older people examined oral hypofunction and the relationship between oral hypofunction and frailty. METHODS: Participants were community-dwelling adults aged 65-85 years in Japan. The oral function evaluation included seven items (oral hygiene, oral dryness, occlusal force, tongue-lip motor function, tongue pressure, masticatory function and swallowing function), and oral hypofunction was defined as having abnormalities in at least three of these items. The frailty status was classified into three categories (robust, pre-frail and frail) according to the total Kihon Checklist score. We analyzed 978 subjects with complete data. The relationship between oral function and frailty status was analyzed using multivariate multinomial logistic regression analyses. RESULTS: Approximately 60% of the older adults had oral hypofunction. The multivariate odds ratios (ORs) for a pre-frail or frail status were significantly higher for older people with reduced occlusal force, reduced tongue-lip motor function and deteriorated swallowing function than in those without deterioration of those items. Of the oral function items, swallowing function was most strongly associated with the frailty status, and the ORs (95% confidence interval [CI]) for deteriorated swallowing function in pre-frail and frail patients were 6.4 (3.9-10.8) and 10.2 (5.4-19.1), respectively. Those with oral hypofunction had significantly higher adjusted ORs for pre-frail (OR 1.4, 95% CI 1.1-2.0) and frail (OR 2.1, 95% CI 1.2-3.5) statuses. CONCLUSION: Many community-dwelling older people have reduced oral function or oral hypofunction, which is significantly associated with frailty in older people. Geriatr Gerontol Int 2020; 20: 917-926.

Posterior occluding pairs of teeth or dentures and 1-year mortality in nursing home residents in Japan.

BACKGROUND: Associations between tooth loss and mortality have been reported in older individuals. However, limited information is available regarding the association between occlusion and mortality in nursing home residents. OBJECTIVE: We investigated the association between posterior occluding pairs (POPs) of teeth or dentures and 1-year mortality in nursing home residents. METHODS: The subjects of this study were residents from four nursing homes in Aichi prefecture, Japan, who were capable of eating and were enrolled in baseline examinations. We examined the number of present teeth and POPs (0-8 pairs), defined as pairs of occluding natural, restored or fixed prosthetic post-canine teeth. Then, we defined prosthetic POPs (0-8 pairs) as pairs of occluding natural, restored or fixed prosthetic post-canine teeth and removable dentures. Nutritional status, activities of daily living, cognitive function and comorbid conditions were assessed. One year later, we followed up the subjects. Ultimately, we analysed 173 elderly people (mean age ± SD: 87.1 ± 8.6 years; the survival group: N = 145, the deceased group: N = 28). RESULTS: In univariate analyses, mortality was significantly associated with age, peripheral vascular disease, nutritional status, diet texture and POPs. In multivariate logistic regression analysis, subjects who had 0 prosthetic POPs had significantly higher odds of a high mortality, compared with 8 prosthetic POPs. CONCLUSION: Lack of properly occluding posterior teeth, whether remaining teeth or dentures, is associated with 1-year mortality. (228 words/250).

Association between dental consultation and oral health status among male Japanese employees.

OBJECTIVE: To investigate the association between dental consultation and oral health status among male Japanese employees. METHODS: The participants were 3351 male employees who received a workplace oral health examination conducted at the ages of 35, 40, 45, 50, 55, and 59 years before retirement in conjunction with an annual health checkup. Data on dental expenditures were collected from health insurance claims. The number of dental visits and dental care expenses, alone or in combination, were used as indices of the dental consultation status for the analyses. The effects of dental consultation status on oral health status (number of total teeth, number of decayed teeth, and periodontal status) were analyzed using multivariate multinomial logistic regression analyses adjusted for confounders. RESULTS: Multivariate analyses revealed that the odds ratio (OR) for 20-27 teeth (losing 1-8 teeth) was significantly higher (OR 1.4, 95% confidence interval (CI) 1.1-1.7) in those who had a high number of dental visits and high dental care expenses than in those who did not have a dental visit. By contrast, the ORs for ≤19 teeth (losing ≥9 teeth), having ≥3 decayed teeth, or having a periodontal pocket ≥6 mm were significantly lower (OR 0.2, 95% CI 0.1-0.6; OR 0.5, 95% CI 0.3-0.6; OR 0.7, 95% CI 0.5-1.0, respectively) in those who had fewer dental visits and lower dental care expenses. CONCLUSIONS: These results imply that the dental consultation status is associated with oral health status among male employees.

Associations of number of teeth with medical costs and hospitalization duration in an older Japanese population.

AIM: Many studies have reported close relationships between oral and systemic health. We explored the association of the number of remaining teeth with medical costs and hospitalization duration in people aged 75 and 80 years. METHODS: Oral health examinations were carried out at dental clinics in 2014. Medical cost and hospitalization duration data for fiscal year 2015 were obtained from the Mie Prefecture health insurer. We analyzed the data of 4700 individuals who met our inclusion criteria: 2745 75-year-olds and 1955 80-year-olds. The effects of remaining tooth numbers on medical costs and hospitalization days were analyzed using a generalized linear model with log link adjustment for confounders. RESULTS: Total medical costs for all diseases were significantly higher in those with 20-27, 10-19 and 1-9 teeth, and in edentulous older individuals, compared with those with 28 teeth. Outpatient medical costs for diabetes were significantly higher in those with 20-27 and 1-9 teeth. Inpatient medical costs for digestive cancers were significantly higher in those with 10-19 and 1-9 teeth, and in edentulous older individuals. Hospitalization for digestive cancer was significantly longer in those with 20-27, 10-19 and 1-9 teeth, and in edentulous older individuals, than in those with 28 teeth. The number of teeth as a continuous variable was significantly inversely associated with medical costs for cerebrovascular disease and digestive cancer, and hospitalization days for digestive cancer. CONCLUSION: Small numbers of teeth were associated with higher medical costs and longer hospital stays for older Japanese. Geriatr Gerontol Int 2019; 19: 335-341.

Number of Teeth, Oral Self-care, Eating Speed, and Metabolic Syndrome in an Aged Japanese Population.

BACKGROUND: Many studies have reported that oral health status is associated with various systemic health issues. This study examined the correlations among oral health, lifestyle factors, and metabolic syndrome (MetS) in aged participants. METHODS: We analyzed cross-sectional oral and medical health checkup data from 2,379 participants aged 75 and 80 years. MetS was diagnosed according to the Harmonization criteria, with the exception of the criterion for central obesity, and body mass index was used instead of waist circumference. Logistic regression analyses were performed to evaluate the correlation between oral health status and lifestyle factors and MetS in both sexes and by sex. RESULTS: In both sexes, the odds ratio (OR) for MetS was 1.54 (95% confidence interval [CI], 1.10-2.17) among those who had 0-9 teeth compared with those with 20-28 teeth. MetS was significantly more likely for those eating quickly than those eating slowly (OR 2.06; 95% CI, 1.35-3.16). Participants using secondary oral hygiene products every day had a significantly lower OR (0.71; 95% CI, 0.55-0.92) for MetS than did those who did not. Participants with 0-9 teeth who ate quickly had a significantly higher OR (2.48; 95% CI, 1.06-5.78) for MetS compared with those with 20-28 teeth who ate slowly. CONCLUSION: These results suggest that maintaining teeth, eating slowly, and using secondary oral hygiene products every day are associated with a lower likelihood of MetS in the aged population.

Type of dental visit and number of remaining teeth in Japanese elders.

The aim of this study was to examine the association between type of dental visit and number of remaining teeth in Japanese elders. Data were collected from 3,163 adults aged 75 or 80 years who underwent an oral health examination. Type of dental visit was classified into four categories by treatment(s) received (none, periodontal, caries, or other treatment). Number of remaining teeth was classified as ≥20, 10-19, or 0-9 teeth. Multivariate multinomial logistic regression analysis was used to examine associations between type of dental visit and number of remaining teeth among all participants and the 3,032 dentate elderly. As compared with elders who did not visit a dentist, those who received periodontal or caries treatments had a significantly lower odds ratio for having 0-9 teeth, and those who received periodontal treatment had a significantly lower odds ratio of having 10-19 teeth. In the multivariate linear regression model, number of days of periodontal treatment was positively associated with number of remaining teeth. Our results suggest that type of dental visit is associated with number of remaining teeth in Japanese elders.

Association between dental visits for periodontal treatment and type 2 diabetes mellitus in an elderly Japanese cohort.

AIM: There is an association between type 2 diabetes mellitus (T2DM) and periodontitis. We examined the association between the dental visit status and diabetes status in the Japanese elderly population. MATERIALS AND METHODS: In total, 14,551 participants, aged 75 or 80 years, who underwent systemic health examinations were analysed. Three independent variables of dental visit status were investigated according to dental claims data, including whether dental treatment was received, type of dental treatment (no visit, periodontal treatment, or other dental treatment), and number of days of periodontal treatment (0, 1-4, or ≥5 days). We performed multivariate logistic and linear regression analyses to examine the relationship between dental visit status and diabetes status. RESULTS: The multivariate odds ratio (OR) for T2DM was significantly lower (0.74, 95% confidence interval: 0.66-0.82) for subjects who received periodontal treatment compared with those who did not receive dental treatment. Subjects who received periodontal treatment had a significantly lower OR for T2DM, regardless of the number of days of treatment. In the multivariate linear regression model, receiving periodontal treatment was significantly associated with decrease in A1c (p < .05). CONCLUSION: Dental visits to receive periodontal treatment were associated with a better diabetes status in the Japanese elderly population.

Descriptive study of dental injury incurred by junior high school and high school students during participation in school sports clubs.

AIM: Students often injure their teeth during participation in school-based sports clubs. This study examined the frequencies and types of dental injuries sustained at school sports clubs and compared the risk of dental injury among different sports. METHODS: Based on injury statistics from the Japan Sport Council of the junior high schools and high schools in seven prefectures during fiscal year 2006, the risk of dental injury was estimated using a rate ratio (RR) by calculating the ratio of occurrence of dental injury under various circumstances. RESULTS: The RRs of exercise-related dental injury for boys and girls in junior high school were 0.7 (P < 0.001) and 1.3 (P < 0.05), respectively, and for those in high school were 2.6 (P < 0.001) and 2.7 (P < 0.001), respectively. In junior high school, softball (RR = 7.7) for boys and handball (RR = 3.9) for girls commonly led to dental injuries. In high school, Japanese-style wrestling (RR = 18.5) and rugby (RR = 7.3) for boys and handball (RR = 6.5) for girls had high risks for dental injury. Crown fracture was the predominant dental injury among boys and girls attending both junior high school and high school. The proportion of alveolar fracture was higher in school sports clubs than outside school sports clubs among high school boys. Contact or limited-contact sports had significantly higher risks for dental injuries than did noncontact sports. CONCLUSION: The results of this study suggest that teachers and administrators at schools should pay attention to the risk of dental injury among students participating in high-risk sports.