Dental-macrowear and diet of Tigara foragers from Point Hope, northern Alaska.

SUMMARY: Ethnographic studies indicate that Eskimo foragers are characterized by well-defined sexual division of labor and extensive use of anterior teeth as a tool, resulting in higher degrees of wear. However, little is known about the intra-population variation in molar-macrowear rates and dietary implications. Here, percentages of dentin exposure (PDE) were recorded on first mandibular molars among Tigara foragers from Point Hope (Alaska) and attempt to correlate age and sex variation in wear patterns. We found that no overall sex-related differences in PDE exist and suggest that molars did not take a part in para-masticatory or cultural practices. Strong correlation with increasing age was found as expected but males wore their teeth at higher rates than females related to masticatory demands during growth. Our findings suggest that individual variation in molar-macrowear must be attributed to biomechanics of chewing and cultural behavior rather than sexual variation in food acquisition.

Sociocultural Factors that Affect Chewing Behaviors among Betel Nut Chewers and Ex-Chewers on Guam.

Areca nut (betel nut) is chewed by an estimated 10% of the world's population which is equivalent to about 600 million people. It is classified as a Group 1 carcinogen by the World Health Organization (WHO) and has been linked to various types of oral cancer. Chewing areca predominates in South and South East Asia, East Africa, and the Western Pacific and has important social and cultural implications. The purpose of the pilot study was twofold: (1) to examine sociocultural factors that affect why people on Guam chew betel nut, their chewing behaviors, perceptions of risks, probability of changing behaviors, and methods that could be used to reduce use or quit; and (2) to pilot two surveys (one for chewers and one for ex-chewers) to be used in a larger study in the future. A mixed methods design was employed that included surveys pertaining to their status (chewer or ex-chewer) and in-depth interviews. A total of 30 adults participated in this pilot study: adult betel nut chewers (n = 15) and ex-chewers (n = 15). Chewing betel nut is a learned behavior, embedded within the culture, and is viewed as an important cultural identifier. Socially, chewing is viewed as positive. Chewers stated that they were not as aware of health issues; however, ex-chewers stated health reasons for quitting.

Induction of nuclear anomalies in exfoliated buccal cells of coca chewers: results of a field study.

The leaves of coca (Erythroxylum coca var. coca), a South American shrub which contains cocaine, other alkaloids and phenolics are widely used by indigenous populations of the Andes. It is currently not known if coca consumption causes genotoxic effects in humans. This information is important to predict potential long-term toxic effects such as cancer induction. Therefore, the buccal cytome assay was used to analyze oral cells from 45 uni- and bilateral chewers and 23 controls living in the Altiplano of the Peruvian Andes. In total, 123,471 cells were evaluated from chewers and 57,916 from controls. Information concerning the consumption levels and habits and also use of lime were collected with questionnaires. Chewing of the leaves did not induce nuclear anomalies reflecting genetic damage such as micronuclei (MNi) and nuclear buds; in the highest exposure group (but not in the overall group) even a significant decrease in the frequencies of cells with MNi (by 64 %) was observed. However, we found significantly elevated levels of other nuclear anomalies (karyorrhexis and karyolysis) which reflect cytotoxic effects in the coca users. The frequencies of these anomalies increased with the daily consumption and when lime was used to improve the release of the alkaloids. In contrast to other chewing habits (betel, tobacco and khat), consumption of coca leaves does not induce genetic instability in cells from the oral cavity and our findings indicate that no adverse health effects take place in chewers which are associated with DNA damage. However, the significant increase in certain anomalies shows that acute toxic effects are caused by coca consumption.

An investigation of the frequency of bacteraemia following dental extraction, tooth brushing and chewing.

We conducted a study to determine the frequency of bacteraemias following dental extraction and common oral procedures, namely tooth brushing and chewing, and the relationship between bacteraemia and oral health in black patients. Positive blood cultures were detected in 29.6% of patients after dental extraction, in 10.8% of patients after tooth brushing and in no patients after chewing. No relationship between the state of oral health, which was assessed using the plaque and gingival indices, and the incidence of bacteraemia was found. The duration of bacteraemia was less than 15 minutes. One patient had a positive blood culture prior to dental extraction; his oral health status was poor. Our study confirmed that bacteraemia occurs after tooth brushing.

Relationship between remaining teeth and self-rated chewing ability among population aged 45 years or older in Kaohsiung City, Taiwan.

The purposes of this study were to (1) examine the relationship between the number of various types of healthy remaining natural teeth at different sites and self-rated chewing ability and (2) evaluate the relationship between the number of functional tooth units (FTUs), comprising functional natural teeth (FNT) or fixed prostheses, and self-rated chewing ability. A sample of 296 adults (122 men and 174 women), aged 45 years or older (average age, 56.6±9.7), were recruited from seven dental clinics in Kaohsiung City. Dental information on the number and status of remaining teeth was obtained through examination by trained and calibrated dentists. Self-assessment of chewing ability (masticatory score) was evaluated with a self-administered questionnaire. Results showed that increased age is associated with a greater likelihood of difficulty in chewing. To avoid chewing difficulty, at least 24.7 FNT, 13.3 posterior-FNT, 8.1 units of natural tooth-FTUs, or 9.6 units of fixed tooth-FTUs must remain. Age and the number of healthy remaining teeth, including natural teeth and fixed prostheses, are key factors in chewing ability. Given that aging is unavoidable, the preservation of healthy remaining teeth plays a relatively important role in the maintenance of chewing ability among middle-aged and elderly people.

Perforated peptic ulcer in southeastern Taiwan.

BACKGROUND: No studies focus on the population with perforated peptic ulcer in southeastern Taiwan. The present study aimed to assess the differences between the different races and the risk factors related to mortality and morbidity in postoperative patients in southeastern Taiwan. METHODS: The medical records of 237 patients were reviewed retrospectively. The following factors were analyzed: patient profiles, coexisting illnesses, diagnostic method, fever, preoperative shock, clinical data at emergency room, delay operation, site of perforation, operative method, positive ascites culture, species of microbes in ascites culture, postoperative complications, death and the length of hospital stay. RESULTS: Aborigines were significantly different from non-aborigines in the ratio of female cases and in the habits of alcohol drinking and betel nut chewing. There were also four significantly different variables between them: fever, hemoglobin value, site of perforation and operative method. Total postoperative complication rate was 41.3% and 39 patients (16.6%) died. In multivariate analysis, age > or = 65 years, lipase > upper normal limit and preoperative shock were independent predictors of mortality. Significant risk factors associated with morbidity were NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock. CONCLUSION: Aborigines were different from non-aborigines in several categories. In southeastern Taiwan, NSAIDs use, creatinine > 1.5 mg/dL and preoperative shock were independent risk factors of morbidity, and age > or = 65 years, lipase > upper normal limit and preoperative shock were independent risk factors of mortality in postoperative perforated peptic ulcer. Lipase > upper normal limit is needed for further research on the influence on mortality.

[Tooth wear in Hindu betel nut chewers]. / Starcie zebów w wybranej populacji hinduskiej zujacej betel.

Literature data describe the impact of certain factors on oral health. Very well known is habitual chewing of different plant products, including tobacco, which depending on the geographical area and the substances used, have various names. It has been estimated that approximately 200 million residents of the West Pacific Rim and South-East Asia indulge in betel chewing. Betel is composed of a leaf of the betel pepper, lime, tobacco and the nut of the areca palm. This study aimed to assess the degree of abrasive changes in residents of the Korunalaya Leprosy Care Center. The examinations were carried out on 85 patients (45 females and 40 males), aged 35-95 years, at the local dental surgery. Patients had their teeth assessed and they were further interviewed as to the duration of their habit with regard to their sex and age (35-44; 45-64 and > or = 65 years). The abrasive changes were evaluated using Gerasimov's 7-degree scale. Interview data indicate that 71.76% of the patients were habitual betel chewers. Among female patients, third-degree abrasion was the most frequent change while among males--fifth degree (53.3% and 45.0%, respectively). The abrasive changes, increasing with age, can be attributed to the duration of betel chewing. It is worth noticing that a vegetarian diet can be a contributing factor to abrasion as most of the food consumed by Hindus are plants.