後期高齢者歯科健康診査受診者の肺炎発症に関わる口腔保健関連因子の分析

後期高齢者歯科健康診査受診者の肺炎発症に関わる口腔保健関連因子の分析


Activation of Janus kinase 2 contributes to the autoimmune pathology in the salivary glands of patients with Sjögren's syndrome


Association between motivation scale score and oral condition on receiving basic periodontal therapy


口臭症患者に認められる揮発性硫黄化合物と 口腔環境との関連性

口臭症患者に認められる揮発性硫黄化合物と 口腔環境との関連性


歯磨き習慣と関連付けたYouTube動画の制作と視聴による教育的効果の検討

歯磨き習慣と関連付けたYouTube動画の制作と視聴による教育的効果の検討


Factors associated with diabetes control: 2-Year cohort study in outpatients with type 2 diabetes

Type 2 diabetes is a typical lifestyle disease. We aimed to identify the factors affecting glycemic control in 64 outpatients with type 2 diabetes over a 2-year period. We defined poor glycemic control using a change in glycosylated hemoglobin (?HbA1c) of ??0.5% over 2 years and/or HbA1c ??7.5% at the end of the study period. We used a questionnaire to collect information on oral health behavior and lifestyle, including eating and smoking habits, and analyzed the relationships between indices of diabetes control and responses to the questionnaire. The mean (SD) HbA1c of the participants was 6.87% (0.77%) at a baseline, and 6.93% (0.69%) after 2 years. Twenty-three participants (36.0%) had poor glycemic control. ?HbA1c and the change in body mass index (?BMI) correlated (Spearman's rank correlation, r?=?0.350, p?<?0.01). The HbA1c at baseline was associated with eating slowly?/?chewing well, and ?BMI was associated with perceived oral symptoms. Binominal logistic regression analysis revealed that poor glycemic control was associated with ?BMI and a smoking habit (odds ratio : 1.62, 95% confidence interval : 1.08?2.42?;?and 4.01, 1.12?14.36, respectively). These findings imply that weight gain and a smoking habit are associated with poor glycemic control in patients with type 2 diabetes. J. Med. Invest. 70 : 28-33, February, 2023.

The Journal of Medical Investigation : JMI


The relationship between subjective oral frailty and adverse health outcomes or medical and dental expenditures in the latterstage older adult: A 6year longitudinal study.

Clinical and Experimental Dental Research


Factors influencing dental caries in 3-year-old children: Effectiveness through prenatal oral health examination on the behavioral change


Analysis of Factors Related to Periodontal Condition in Pregnant Women

妊婦の歯周状態に関連する因子の分析


1,450 ppmフッ化物配合歯磨剤によるブラッシング後の安静時唾液中フッ化物イオンの残存状況に関する報告


ピロカルピン塩酸塩を用いた口腔リンス法の有用性と安全性の検討

ピロカルピン塩酸塩を用いた口腔リンス法の有用性と安全性の検討


Oral care tablet containing kiwifruit powder affects tongue coating microbiome


後期高齢者の口腔状態と要介護認定または死亡発生との関連性

後期高齢者の口腔状態と要介護認定または死亡発生との関連性


糖尿病患者における間食習慣および口腔保健行動と口腔環境との関連性

糖尿病患者における間食習慣および口腔保健行動と口腔環境との関連性


Association between Diabetes-related Clinical Indicators and Oral Health Behavior among Type-2 Diabetes Patients

Objective : The aim of this study was to evaluate the association between diabetes-related indicators and oral health behavior among patients with type 2 diabetes. Methods : Seventy-four outpatients were included. We administered a questionnaire and divided the patients into two groups according to oral health behavior and eating habits. We then compared diabetes-related clinical records between the groups and performed logistic regression analysis. Results : Participants who brushed their teeth before bedtime every night had lower BMIs than those who did not. Participants who reported eating slowly and chewing well every day had significantly lower HbA1c than their counterparts. Participants who reported gum bleeding had significantly higher LDL-cholesterol than their counterparts. Binominal logistic regression analysis revealed that BMI < 25 was associated with not brushing teeth before bedtime every night, HbA1c < 7.5 with not eating slowly or chewing well every day, and LDL-cholesterol < 120 with gum bleeding (odds ratio : 0.140, 95% confidence interval : 0.036-0.540 ; OR : 0.085, 95% CI : 0.010-0.736, OR : 0.275, 95% CI : 0.077-0.979, respectively). Conclusions : Our findings suggest that toothbrushing before bedtime every night is associated with reduced risk of obesity and that eating slowly and chewing well are advantageous for glycemic control in patients with type 2 diabetes.J. Med. Invest. 68 : 140-147, February, 2021.


There is an association between gingival inflammation and obesity in Japanese male adolescents


Involvement of oral bacteria and oral immunity as risk factors for chemotherapy- induced fever with neutropenia in patients with hematological cancer

The aim of this study is to investigate the association between chemotherapy-induced fever with neutropenia less than 1500/μL (FwN) and oral bacteria and/or oral immunity in patients with hematological cancer. Thirty-two patients with hematological cancer were enrolled in the study. Secretory immunoglobulin A (sIgA) in saliva and the anaerobic bacteria in tongue coating of each subject were assessed before the first chemotherapy. Eleven subjects had an onset of FwN and 21 subjects did not during the observation periods. It was revealed by the Cox-proportional hazard model analysis that the levels of sIgA were low (HR 0.98, p < 0.05) and the rate of Fusobacterium nucleatum [F. nucleatum count per total bacterial count (%)] was high (HR 1.65, p < 0.05) in patients with FwN onset. Using ROC curve analysis, the optimal cutoff point based on the AUC in the F. nucleatum/sIgA ratio was 0.023, and this model had a 78.4% probability (p < 0.01). The risk of FwN onset was also significantly higher among the group of ≥ 0.023 F. nucleatum/sIgA ratio (HR 66.06, p < 0.01). These results suggest that the rate of F. nucleatum and the levels of sIgA at baseline might be related to FwN onset as risk factors.


Relationship between smoking habits of mothers and dental health behavior or the oral health condition of their children

母親の喫煙習慣と歯科保健行動および子どもの口腔状態との関連性

Objective: It is known that secondhand smoke exposure is associated with dental caries in children, and it is also speculated that mothers with smoking habits may have little awareness of their dental health and their children. The purpose of this study was to analyze the relationship between smoking habits of mothers and dental health behavior or the oral health condition of their children, and to clarify the factors involved in dental caries of deciduous teeth.Methods: The subjects enrolled in this study were mothers and their children who received health checkup for both 18-month-old children and 3-year-old children in N City, Tokushima Prefecture, Japan. One hundred sixty-five subjects (mothers) were divided into two groups, non-smoker group (n=152) and smoker group (n=13). The results of dental examinations for 3-year-old children and the questionnaire surveys from mothers were collated and analyzed.Results: Dental caries prevalence of deciduous teeth was 46.2% in children of the smoker group, which was significantly higher than that of 21.1% in children of the non-smoker group (p<0.05). Among the questionnaire survey items regarding the regular dental checkup of mothers, the percentage of "no visit" in the smoker group was 76.9% and 46.1% in the non-smoker group, and it showed a significant difference (p<0.05). In the item of the dental examination for pregnant woman, the percentage of "did not receive" in the smoker group was 76.9% and 43.7% in the non-smoker group, and it showed a significant difference (p<0.05). There were significant differences between the presence and absence of smoking habits of mothers regarding the age of mother (p<0.01) and smoking habits of the other families (p<0.05). In addition, the binomial logistic regression analysis showed that oral hygiene condition (OR=2.92, p<0.05), regular between meal eating (OR=3.99, p<0.01) and smoking habits of mothers (OR=4.13, p<0.05) were significantly corelated with the presence of dental caries in 3-year-old children.Conclusions: These results suggest that the mothers in the smoking group was younger and higher rate that included smoker families, in addition to poor regular dental check-up during pregnancy and currently. It was also suggested that smoking habits of mothers were associated with dental caries in 3-year-old children.

小児の受動喫煙とう蝕罹患との関連性が報告されている．また，喫煙習慣を持つ母親は自身や子どもに対する歯科健康意識が低いと推察される．そこで本研究では，母親の喫煙習慣と歯科保健行動および子どもの口腔状態との関連性を分析し，乳歯う蝕罹患に関わる因子を明らかにすることを目的とした．徳島県N市にて実施した1歳6か月児健康診査および3歳児健康診査を両方受診した母子を対象とした．調査対象児165名の母親を，非喫煙者(152名)と喫煙者(13名)の2群に分け，3歳児の歯科健診結果および母親からのアンケート調査結果を突合して分析した．乳歯う蝕罹患率は喫煙者群では46.2%で，非喫煙者群の21.1%と比較して有意にう蝕罹患の割合が高かった(p<0.05)．アンケート調査項目の母親の現在の定期歯科健診において，「受診なし」の者の割合が喫煙者群では76.9%，非喫煙者群では46.1%で，2群間に有意な差が認められた(p<0.05)．妊婦中の歯科健診の項目において，喫煙者群の「受診なし」の者の割合は76.9%，非喫煙者群では43.7%で有意な差が認められた(p<0.05)．また，喫煙者群では非喫煙者群に比べて，母親の年齢において若年層の割合が有意に高く，母親以外の家族の喫煙習慣ありの割合も高かった(各々p<0.01，p<0.05)．さらに，3歳児のう蝕経験の有無を目的変数として二項ロジスティック回帰分析を行った結果，「清掃状態」(オッズ比:2.92，p<0.05)，「間食時間の決定」(オッズ比:3.99，p<0.01)，「母親の喫煙習慣」(オッズ比:4.13，p<0.05)において有意な関連が認められた．以上の結果より，喫煙習慣を有する母親は，年齢が低い者の割合が高く，他の家族の喫煙率も高く，そして，妊娠期および現在も歯科健診受診の割合が低いことが示された．また，母親の喫煙習慣が3歳児の乳歯う蝕罹患に関連することが示唆された．

Japanese Journal of Smoking Control Science


Association between Oral Health Status and Diabetic Nephropathy-Related Indices in Japanese Middle-Aged Men


Effectiveness of an oral care tablet containing kiwifruit powder in reducing oral bacteria in tongue coating: A crossover trial

The aim of this study was to investigate the effect of an oral care tablet containing kiwifruit powder on oral bacteria in tongue coating compared with tongue brushing. Thirty-two healthy, young adults were enrolled, and a crossover clinical trial was conducted. The volatile sulfur compound (VSC) concentration, Winkel tongue-coating index (WTCI), and the number of total bacteria in addition to Fusobacterium nucleatum in tongue coating were measured. We instructed subjects to remove tongue coating by tongue brush for Intervention I, to keep the oral care tablet containing kiwifruit powder on the tongue dorsum and to let it dissolve naturally for Intervention II, and three oral care tablets 1 day before the measurement for Intervention III. There were significant differences in terms of the level of H S, VSC, and WTCI at Intervention I and all evaluation values at Intervention II. There were significant differences in terms of the level of H S, VSC, WTCI, the number of total bacteria, and F. nucleatum at Intervention III. The value of WTCI, the number of bacteria, and F. nucleatum decreased significantly after taking the oral care tablets than after tongue brushing. When compared with Interventions I and III, Intervention III showed the effective results; there were significant differences in the number of total bacteria and F. nucleatum between tongue brushing and taking tablets. These results suggested that the oral care tablet containing kiwifruit powder could be effective in reducing total bacteria and F. nucleatum in tongue coating when compared with tongue brushing.


Synthesis of Sterically Protected Isoindoles from ortho-Phthalaldehyde

o-Phthalaldehyde (OPA) reacts with O-protected tris(hydroxyalkyl)aminomethanes in the presence of 1-propanethiol to afford a novel class of stable isoindoles. Steric protection provided by the bulkiness of C 3-symmetric primary amines derived from tris(hydroxymethyl)aminomethane could be significant for the stabilization of 1-alkylthio-2-alkyl-substituted isoindoles derived from OPA. A plausible reaction mechanism is proposed to explain the formation of the isoindole and an isoindolin-1-one by-product.


歯肉溝液中の炎症関連バイオマーカーと糖尿病・腎機能マーカーとの関連性

歯肉溝液中の炎症関連バイオマーカーと糖尿病・腎機能マーカーとの関連性


Hydrogen-Rich Water Intake Accelerates Oral Palatal Wound Healing via Activation of the Nrf2/Antioxidant Defense Pathways in a Rat Model.

The wound healing process attempts to restore the integrity and function of the injured tissue. Additionally, proinflammatory cytokines, growth factors, and oxidative stress play important roles in wound healing. The aim of this study was to determine whether hydrogen-rich water intake induces the activation of the Nrf2/antioxidant defense pathway in rat palatal tissue, thereby reducing systemic oxidative stress and proinflammatory cytokine levels and promoting healing-associated genes. A circular excisional wound was created in the oral palatal region, and the wound healing process was observed. The rats were divided into two experimental groups in which either hydrogen-rich water or distilled water was consumed. In the drinking hydrogen-rich water, the palatal wound healing process was accelerated compared to that in the control group. As molecular hydrogen upregulated the Nrf2 pathway, systemic oxidative stresses were decreased by the activation of antioxidant activity. Furthermore, hydrogen-rich water intake reduced proinflammatory cytokine levels and promoted the expression of healing-associated factors in rat palatal tissue. In conclusion, hydrogen-rich water intake exhibited multiple beneficial effects through activation of the Nrf2/antioxidant defense pathway. The results of this study support the hypothesis that oral administration of hydrogen-rich water benefits the wound healing process by decreasing oxidative stress and inflammatory responses.

Oxidative Medicine and Cellular Longevity


Correlation between arteriosclerosis and periodontal condition assessed by lactoferrin and [alpha]1-antitrypsin levels in gingival crevicular fluid.

Patients with periodontal disease exhibit exacerbated atherosclerosis, aortic stiffness, or vascular endothelial dysfunction. However, in a recent scientific statement, the American Heart Association noted that neither has periodontal disease been proven to cause atherosclerotic vascular disease nor has the treatment of periodontal disease been proven to prevent atherosclerotic vascular disease. Therefore, the aim of the present study was to examine the correlation between periodontal condition and arteriosclerosis in patients with coronary artery disease (CAD), which is usually accompanied by systemic arteriosclerosis.We measured levels of gingival crevicular fluid lactoferrin (GCF-Lf) and 1-antitrypsin (GCF-AT) in 72 patients (67 ± 8 years, 56 men) with CAD. Furthermore, we evaluated the maximum intima-media thickness (max IMT) and plaque score of the carotid arteries as well as brachial-ankle pulse wave velocity (baPWV) and flow-mediated dilation (FMD) of the brachial artery, each of which is a parameter for determining arteriosclerosis status. The average level of GCF-Lf was 0.29 ± 0.36 µg/mL and that of GCF-AT was 0.31 ± 0.66 µg/mL, with significant correlation between the two (r = 0.701, P < 0.001). No significant difference in GCF-Lf and GCF-AT levels was observed between patients with single-, double-, and triple-vessel CAD. There were no significant correlations between the arteriosclerosis parameters (ie, max IMT, plaque score, baPWV, and FMD) and GCF-Lf or GCF-AT.No correlation between the GCF biomarkers and the severity of arteriosclerosis was detected. This result may suggest that worsening of the periodontal condition assessed by GCF biomarkers is not a major potential risk factor for arteriosclerosis.


Relationship among salivary antioxidant activity, cytokines and periodontitis: the Nagasaki Island study.

These findings suggest that the evaluation of salivary antioxidant activities, as assessed by electron spin resonance, are associated with periodontitis and various clinical variables in community-dwelling participants (ClinicalTrials. gov number NCT01742728). This article is protected by copyright. All rights reserved.


Biological impacts of resveratrol, quercetin, and N-acetylcysteine on oxidative stress in human gingival fibroblasts.

In periodontitis, production of reactive oxygen species (ROS) by neutrophils induces oxidative stress and deteriorates surrounding tissues. Antioxidants reduce damage caused by ROS and are used to treat diseases involving oxidative stress. This study summarizes the different effects of resveratrol, quercetin, and N-acetylcysteine (NAC) on human gingival fibroblasts (HGFs) under oxidative stress induced by hydrogen peroxide. Real-time cytotoxicity analyses reveals that resveratrol and quercetin enhanced cell proliferation even under oxidative stress. Of the antioxidants tested, resveratrol is the most effective at inhibiting ROS production. HGFs incubated with resveratrol and quercetin up-regulate the transcription of type I collagen gene after 3 h, but only resveratrol sustained this up-regulation for 24 h. A measurement of the oxygen consumption rate (OCR, mitochondrial respiration) shows that resveratrol generates the highest maximal respiratory capacity, followed by quercetin and NAC. Simultaneous measurement of OCR and the extracellular acidification rate (non-mitochondrial respiration) reveals that resveratrol and quercetin induce an increase in mitochondrial respiration when compared with untreated cells. NAC treatment consumes less oxygen and enhances more non-mitochondrial respiration. In conclusion, resveratrol is the most effective antioxidant in terms of real-time cytotoxicity analysis, reduction of ROS production, and enhancement of type I collagen synthesis and mitochondrial respiration in HGFs.

Journal of Clinical Biochemistry and Nutrition


Resveratrol improves oxidative stress and prevents the progression of periodontitis via the activation of the Sirt1/AMPK and the Nrf2/antioxidant defense pathways in a rat periodontitis model.

Oxidative stress is a key factor regulating the systemic pathophysiological effects associated with periodontitis. Resveratrol is a phytochemical with antioxidant and anti-inflammatory properties that can reduce oxidative stress and inflammation. We hypothesized that resveratrol may prevent the progression of periodontitis and reduce systemic oxidative stress through the activation of the Sirtuin1 (Sirt1)/AMP-activated protein kinase (AMPK) and the nuclear factor-E2 related factor 2 (Nrf2)/antioxidant defense pathways. Three groups of male Wistar rats (periodontitis treated with melinjo resveratrol, periodontitis without resveratrol, and control rats with no periodontitis or resveratrol treatment) were examined. A ligature was placed around the maxillary molars for 3 weeks to induce periodontitis, and the rats were then given drinking water with or without melinjo resveratrol. In rats with periodontitis, ligature placement induced alveolar bone resorption, quantified using three-dimensional images taken by micro-CT, and increased proinflammatory cytokine levels in gingival tissue. Melinjo resveratrol intake relieved alveolar bone resorption and activated the Sirt1/AMPK and the Nrf2/antioxidant defense pathways in inflamed gingival tissues. Further, melinjo resveratrol improved the systemic levels of 8-hydroxydeoxyguanosine, dityrosine, nitric oxide metabolism, nitrotyrosine, and proinflammatory cytokines. We concluded that oral administration of melinjo resveratrol may prevent the progression of ligature-induced periodontitis and improve systemic oxidative and nitrosative stress.


Oxidative stress and antibody levels to periodontal bacteria in adults: the Nagasaki Islands study.

OBJECTIVE: Periodontitis is a chronic inflammatory disease of the tissues supporting the teeth and is caused by subgingival plaque. Systemic increases in reactive oxygen species are involved in pathogenesis of periodontitis. This study addressed the relationship between levels of serum oxidative stress and antibodies against putative periodontopathic bacteria and their association with periodontal conditions, in a community-based study. SUBJECTS AND METHODS: Serum samples were measured for reactive oxygen metabolite (ROM) levels and anti-oxidant capacity. The serum levels of immunoglobulin G (IgG) antibodies to Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Aggregatibacter actinomycetemcomitans (Aa), and Eikenella corrodens (Ec) were determined by ELISA. RESULTS: The participants with greater clinical attachment loss had higher serum ROM levels and IgG antibody titers to Pg. Serum ROM levels were positively correlated with antibody titers to Pg, Pi, and Ec. When the participants with greater probing pocket depth and clinical attachment loss were used as the dependent variables, high ROM levels showed a statistically significant associations in multivariate logistic analyses; the adjusted odds ratios were 2.9 (95% confidence interval = 1.0-8.5) and 6.0 (95% confidence interval = 2.0-17.6), respectively. CONCLUSIONS: It was concluded that an increased oxidative stress may be detrimental to periodontitis in Japanese community-dwelling adults.


Study on the Subgel-Phase Formation Using an Asymmetric Phospholipid Bilayer Membrane by High-Pressure Fluorometry

The myristoylpalmitoylphosphatidylcholine (MPPC) bilayer membrane shows a complicated temperature-pressure phase diagram. The large portion of the lamellar gel (L(β)'), ripple gel (P(β)'), and pressure-induced gel (L(β)I) phases exist as metastable phases due to the extremely stable subgel (L(c)) phase. The stable L(c) phase enables us to examine the properties of the L(c) phase. The phases of the MPPC bilayers under atmospheric and high pressures were studied by small-angle neutron scattering (SANS) and fluorescence spectroscopy using a polarity-sensitive fluorescent probe Prodan. The SANS measurements clearly demonstrated the existence of the metastable L(β)I phase with the smallest lamellar repeat distance. From a second-derivative analysis of the fluorescence data, the line shape for the L(c) phase under high pressure was characterized by a broad peak with a minimum of ca. 460 nm. The line shapes and the minimum intensity wavelength (λ''(min)) values changed with pressure, indicating that the L(c) phase has highly pressure-sensible structure. The λ''(min) values of the L(c) phase spectra were split into ca. 430 and 500 nm in the L(β)I phase region, which corresponds to the formation of a interdigitated subgel L(c) (L(c)I) phase. Moreover, the phase transitions related to the L(c) phase were reversible transitions under high pressure. Taking into account the fluorescence behavior of Prodan for the L(c) phase, we concluded that the structure of the L(c) phase is highly probably a staggered structure, which can transform into the L(c)I phase easily.


Mucosal immune features to phosphorylcholine by nasal Flt3 ligand cDNA-based vaccination

Phosphorylcholine (PC) is an immunodominant epitope in some pathogens including Streptococcus pneumoniae and it is well-known that PC-specific antibodies (Abs) play a key role in the induction of protective immunity against pneumococcal infection. In this study, we examined whether nasal administration of DNA plasmid encoding Flt3 ligand gene (pFL) as a mucosal adjuvant plus PC-conjugated keyhole limpet hemocyanin (PC-KLH), would elicit PC-specific immune responses, and characterized mucosal immune responses to PC induced by this nasal vaccination. Nasal immunization with pFL plus PC-KLH enhanced induction of PC-specific IgA and IgM Abs in airway secretions when compared with mice given PC-KLH with or without empty plasmid gene (pORF) as controls; in addition to the mucosal immune responses, PC-specific immune responses in serum were also induced. Furthermore, the mucosal and serum IgA and IgM Abs in mice given pFL plus PC-KLH nasally, exhibited high-specificity for the PC molecule. Of interest, the PC-specific Abs bound dose-dependently to anti-T15 idiotype (AB1-2). Thus, the inhibition of S. pneumoniae colonization on the nasal cavity and lungs after nasal challenge with the live organism was significantly elicited in mice immunized with pFL plus PC-KLH compared to that of mice immunized with antigen with pORF. Taken together, these findings show that nasal administration of pFL with PC-KLH elicited T15-like anti-PC IgA and IgM Abs in the respiratory tracts, and further attenuated S. pneumoniae colonization on the respiratory tracts. Nasal administration of Flt3 ligand cDNA with PC may contribute to the development of nasal vaccination for prevention of S. pneumoniae infection.


Levels of salivary stress markers in patients with anxiety about halitosis

To investigate the relationship between salivary stress markers and mental stress states in patients complaining of oral malodour. The utility of the salivary stress markers in assessment of mental conditions of those patients was also investigated. The study population included 74 patients, aged 20-59 years, who complained of oral malodour and were referred to the Breath Odor Clinic at Tokushima University Hospital. Patients were classified into two groups, genuine halitosis (GH) and psychosomatic halitosis (PH), according to the results of organoleptic rating measurement. All patients were subjected to examination by the Cornell Medical Index (CMI) Health Questionnaire. Resting saliva was collected and levels of salivary IgA, cortisol and chromogranin A were determined by ELISA. Twenty-three volunteers not complaining of halitosis were included as the control group. Kruskal-Wallis test and Mann-Whitney's U-test were used for statistical analysis. A significant increase was observed in the concentrations of salivary cortisol in the PH group as compared with GH and control groups (p<0.05). Concentrations of IgA and chromogranin A in saliva were not significantly different among the three groups. In addition, higher salivary cortisol concentrations were found in CMI scale III and IV (tendency towards neurosis) than in scale I and II (normal) (p<0.05). Since salivary cortisol reflects a status of chronic stress condition, psychosomatic halitosis might be closely related to this state of chronic stress. Determination of cortisol levels in saliva may provide useful information for evaluating the mental status of patients complaining of halitosis.


Attenuation of inducible respiratory immune responses by oseltamivir treatment in mice infected with influenza A virus.

The antiviral neuraminidase inhibitor oseltamivir (OSV) is widely used to suppress viral replication in the treatment of influenza. Here, we report that OSV administration significantly suppressed respiratory mucosal secretory IgA responses with respect to antigen (Ag)-specific antibody (Ab) production and also the induction of Ag-specific IgA Ab-forming cells, but not systemic IgG responses, in weanling mice as a model of pediatric influenza. Neutralizing activities of the airway fluids in oral OSV-treated mice were significantly less than those of sham-treated mice. Our findings suggest the risk of re-infection in patients showing a low mucosal response following OSV treatment.


The study of oral health promotion for pregnant women at Tokushima University Hospital

徳島大学病院における妊婦の口腔保健向上に関する研究

The Journal of Japan Society for Dental Hygiene


リアルタイム定量PCR(qPCR)法による唾液中の総細菌数の測定 口腔清潔度の指標としての試み

The state of oral hygiene has been evaluated by employing various indices, such as the Oral Hygiene Index, Plaque Index, Patient Hygiene Performance, and Plaque Control Record (O'Leary's PCR). Measuring the scores of these indices is time- and labor-consuming, requiring manual reading and recording by professionals, standardization of examination methods. In contrast, measuring the total number of bacteria in saliva using quantitative real-time PCR (qPCR) allows the straightforward collection and storage of samples, making it possible to measure many samples at the same time. This technique facilitates the quantification of the number of bacteria within a shorter time than the culture method. In the present study, the total number of bacteria measured by qPCR was found to be significantly decreased (p<0.05) in stimulated whole saliva collected from 5 volunteers by chewing paraffin after tooth cleaning. These findings were in agreement with the decreases shown by Greene's Debris Index and O'Leary's PCR values. There was a significant correlation (r=0.55, p<0.01) between the salivary bacterial counts measured by qPCR from 81 subjects before and after a 4-month interval. These findings suggest that it is possible to measure the total number of bacteria in saliva using qPCR. This technique is convenient and is suggested to be applicable for assessing the oral hygiene status in the future.

口腔清潔度の指標としては,歯面への歯垢の付着度を測定する方法が一般的であるが,診査や記録等の人材的,時間的負担を要することから,集団歯科健診で用いられることは少ない.集団歯科健診においてう蝕や歯周疾患,口臭症のリスクを評価するために,簡便かつ有効な口腔清潔度の評価法の開発が望まれている.リアルタイム定量PCR(qPCR)法による唾液中の総細菌数の測定は,検体の採取や保管が容易で多検体の一括処理が可能であることから,本目的に合致する有望な測定法であると考えられる.本研究では,qPCR法を用いた唾液中の総細菌数の測定が口腔清潔度の評価法として使用できるかどうか検討を行った.5名のボランティアから,ブラッシング中断時と再開後の2回,刺激唾液を採取し,唾液中の総細菌数をqPCR法により測定したところ,Debris Index,O'LearyのPCR値との間に相関は示されなかったものの,ブラッシング再開後では,中断時に比べ,有意に減少した.81名の被験者から4ヵ月の間隔を空けて2回刺激唾液を採取し,唾液中の総細菌数をqPCR法により測定したところ,前後の間に有意な正の相関を認めた.以上の結果より,qPCR法によって唾液中の総細菌数を測定することが可能であることが示された.本法は非常に簡便であることから,今後,口腔清潔度を検討する分野において応用できる可能性が考えられる.


急性期病院の脳神経疾患患者に対する口腔ケアニーズの分析

急性期病院の脳神経疾患患者に対する口腔ケアニーズの分析

The purpose of the present study was to identify factors related to oral health care among inpatients with neurological disorders. For each of the 143 inpatients included in our study, the oral as well as general health (level of consciousness, feeding style, etc.) conditions were investigated using an assessment sheet at their first visit. The study revealed that 80% of the hospitalized patients showed "dysfunction of oral periphery muscle and/or tongue movement", 60% of them presented "dry mouth" and/or a "reduced level of consciousness", and 25% exhibited "constant open mouth with no intention". By logistic regression analysis of the data, it was strongly suggested that "severe debris accumulation" could be attributed to "dry mouth". Furthermore, "dry mouth" was found to be significantly correlated with several features, including "constant open mouth", "impaired mouth rinse", "dysfunction of oral periphery muscle and/or tongue movement", and "reduced level of consciousness", which are conditions often observed in patients with neurological disorders. These results suggest that inpatients with both a "reduced level of consciousness" and "constant open mouth" should receive professional oral care in order to prevent "dry mouth", and undergo a careful follow-up to promote the maintenance of good oral hygiene and functions.

われわれは,平成16年より徳島大学病院栄養サポートチームの一員として病棟における専門的口腔ケアを展開してきた,当初より,脳神経疾患をもつ患者の占める割合が多く,平成20年2月までの間,計143名の当該患者の口腔ケアを行った.本研究では,これらの患者の初診時における口腔内状態および全身状態について調査し,口腔ケアのニーズにかかわる要因について統計学的に検討した.その結果,約80%の人が「口腔周囲筋や舌の動き」が十分でなく,約60%の人に「口腔乾燥」の発現や「意識レベル」の低下を認め,約25%の人に「不随意の常時開口」がみられた.ロジスティック回帰分析の結果,「口腔乾燥」の強さが多量の「不潔物付着」に強く寄与することが示唆された.また,「口腔乾燥」の強さは「常時開口」がみられる,「うがい」が不可能あるいは不十分,「口腔周囲筋や舌の動き」が低下,「意識レベル」が低下,といった脳神経疾患患者で高頻度にみられる所見と有意な関連を示すことが確かめられた.これらのことから,意識レベルの低下および常時開口がみられる患者に対しては,急性期から口腔乾燥を予防するとともに良好な口腔衛生状態の保持に努め,口腔機能にも配慮した専門的口腔ケアを行っていく必要性が示唆された.


Specific-wavelength Visible Light Irradiation Inhibits the Growth of Porphyromonas gingivalis.

The effects of laser irradiation on Porphyromonas gingivalis have been reported, but the results are still controversial regarding the efficiency because of the differences of the light sources and irradiation conditions. The aim of this study was to determine the wavelength and irradiation conditions under which the most effective inhibitory effect on P. gingivalis growth was seen without any photosensitizers. Using an Okazaki large spectrograph, monochromatic light spectra ranging from 400 to 700 nm were evaluated to determine which spectra effectively inhibited bacterial growth. Moreover, using a monochromatic 405-nm irradiating device, the effects of various irradiating conditions on P. gingivalis growth were examined. Growth of bacteria irradiated at 400 nm and 410 nm was significantly suppressed compared with a nonirradiated control, whereas wavelengths of 430 nm and longer produced no significant inhibition. A constant energy density of 15 J/cm2 was found to be enough to show an inhibitory effect. Significant inhibition of bacterial growth was found after only 1 min at 50 mW/cm2 irradiation. These results indicate that P. gingivalis growth is specifically suppressed by 405-nm light irradiation, suggesting that visible blue light irradiation is a promising means for eradicating periodontopathogenic bacteria from periodontal lesions.


Relationship between Campylobacter rectus and periodontal status during pregnancy.

In a previous study, we showed that the growth of Campylobacter rectus is stimulated by the presence of female sex hormones in the culture medium. In the present study, we examined the relationship between C. rectus levels in the saliva and the periodontal status of pregnant women. Unstimulated whole saliva was collected from 22 pregnant and 15 non-pregnant women. Periodontal pocket depth (PD) and bleeding on probing (BOP) were recorded. A quantitative real-time polymerase chain reaction was performed to determine the concentrations of suspected periodontopathogenic bacteria in the saliva samples. In addition, the concentration of estradiol in the saliva samples was measured by enzyme immunoassay. The average age, number of teeth, and total number of bacteria in the saliva of subjects in both groups were similar. The percentage of sites with a PD = 4 mm and the salivary estradiol concentrations were significantly higher in pregnant women than in non-pregnant women. In addition, the percentage of BOP sites and the C. rectus levels in the saliva of the pregnant women tended to be higher than in non-pregnant women, although these differences were not statistically significant. There were positive correlations between C. rectus levels and estradiol concentrations, and between C. rectus levels and the percentage of sites with PD = 4 mm in the pregnant women. These results indicate that C. rectus levels are higher in the oral flora of pregnant women and that this may be associated with increased salivary estradiol concentrations. This may contribute to periodontal disease progression during pregnancy.


Salivary immunoglobulin A directed to oral microbial GroEL in patients with periodontitis and their potential protective role.

The aim of this study was to identify salivary immunoglobulin A (IgA) directed to oral microbial GroEL in patients with periodontitis and to demonstrate their potential protective role through a reduction of inflammatory cytokine production induced by microbial GroEL. Using five different proteins belonging to the heat-shock protein 60 family, Western immunoblot analysis of salivary IgA from 63 subjects revealed immunoreactivities with Campylobacter rectus GroEL and Porphyromonas gingivalis GroEL in subjects with periodontitis (P < 0.05) compared to control subjects. Using the BIACORE 1000 to measure the salivary IgA titers directed towards C. rectus GroEL, high resonance unit (RU) values were observed in the saliva samples from patients with periodontitis (P < 0.01). Furthermore, the number of teeth with deep pocket depth (>or=5 mm) showed a high correlation coefficient with the RU value (r = 0.50, P < 0.01). C. rectus GroEL possessed the ability to stimulate the production of interleukin-6 by gingival fibroblasts. Interestingly, salivary IgA antibody directed to C. rectus GroEL caused a partial inhibition of interleukin-6 production. This study showed a relationship between high levels of salivary IgA directed to GroEL and periodontal disease severity. Although additional investigations are required, salivary IgA to GroEL may have a protective role by reducing the inflammatory response induced by GroEL derived from periodontopathogenic bacteria.


The Effects of Supervised Fluoride Mouth Rinsing on Dental Caries Development : Analyses of Caries Development by Tooth Type and of the Relationship between Deciduous Tooth Caries and Permanent Tooth Caries --- 歯群別分析および乳歯う蝕と永久歯う蝕の関連性についての分析

フッ化物洗口実施校におけるう蝕予防効果 --- 歯群別分析および乳歯う蝕と永久歯う蝕の関連性についての分析

In 1993, a daily fluoride mouth rinsing program and biannual oral examination were started at the nursery school, elementary school and junior high school of the K District, Tokushima Prefecture. In this study, the longitudinal change of caries development in elementary school students was evaluated. Caries development by tooth type in schoolchildren of the 6th grade was evaluated, and furthermore, the relationship between deciduous tooth caries in 1st grade students and caries development in permanent teeth in 6th grade students was also elucidated. After starting the daily fluoride mouth rinsing program, caries development in the permanent teeth of the low grade children of the elementary school began to decrease first, followed by that of the high grade children, and then, the junior high school students. It was revealed that the strong suppression of caries development in the 1st molar was reflected in a decrease in total caries development in the 6th grade schoolchildren. In addition, a significant relationship between DMFT in the 6th grade schoolchildren and the number of deciduous tooth caries or the number of deciduous teeth in the 1st grade schoolchildren was detected. These results suggest that a fluoride mouth rinsing program before school age is effective for caries prevention in the 1st molar, but, in order to effectively prevent permanent tooth caries, a high risk strategy is needed for children with deciduous tooth caries.

徳島県の山間部に位置するK村では, 平成5年度より村内の保育園, 幼稚園, 小中学校において週5回のフッ化物洗口と年度2回の歯科健康診断を実施している.本研究では, フッ化物洗口を開始してからの児童生徒のう蝕有病状況の経年的変化をまとめ, 特に, 小学校6年生での歯群別のう蝕有病状況について詳しく調べた.さらには, 小学校1年生での乳歯う蝕の状況, 歯の萌出状況と6年生での永久歯う蝕経験との間の関連性について調べた.以上の結果, フッ化物洗口開始後のう蝕有病状況の経年的変化において, 永久歯う蝕は小学校低学年で早期に減少傾向が現れ, 次いで高学年, 中学生へと移行していることがわかった.小学校6年生での歯群別のう蝕有病状況から, 第一大臼歯のう蝕有病率が大幅に抑制されたことが, 全体のう歯数低下につながっていることが示唆された.一方, フッ化物洗口開始後も小学校1年生での乳歯未処置う歯の本数や乳歯の現在歯数が小学校6年生でのDMFTと有意に関連することがわかった.このことは, 就学前からのフッ化物洗口は第一大臼歯のう蝕罹患を抑制するのに効果的なう蝕予防施策であるが, さらに永久歯う蝕の抑制効果を期待するためには, 乳歯う蝕を指標としたう蝕リスクの高い幼児への介入が必要であることが示唆された.


官能試験の結果および質問票による口臭患者の分析

官能試験の結果および質問票による口臭患者の分析

The aim of this study is to analyze the characteristics of patients suffering from malodor using organoleptic rating and questionnaires. Patients who were examined for halitosis at the Clinic of Preventive Dentistry, Tokushima University Medical and Dental Hospital, were classified into 4 groups based on the results of organoleptic measurement using plastic air bag. Aa group; obvious malodor beyond a socially acceptable level is neither perceived by dentists nor the patient. Ab group; obvious malodor is not perceived by dentists, although the patient complains of its existence. Ba group; obvious malodor is perceived by dentists only. Bb group; obvious malodor is perceived by both dentists and the patient. The profile of the Cornell Medical Index (CMI) Health Questionnaire and the questionnaire about a general attitudes toward halitosis were analyzed in each category. Patients in Ab group, who are supposed to have psychosomatic halitosis, showed a stronger tendency toward neurosis. More patients in the Ab group responded in the questionnaire that "I'm always anxious about malodor", and that "I feel malodor stronger than before", than in the other groups. Furthermore, patients in Aa and Ab group seemed to be interested in oral hygiene since many patients in these groups habitually used inter-dental brushing instruments daily. These results suggest that the sell-evaluation of breath by patients might provide useful information about the psychological conditions of patients.

本研究の目的は, 官能試験や質問票の結果を用いて口臭患者の特性を分析することである.徳島大学医学部・歯学部附属病院歯科・予防歯科において口臭検査を受けた患者を, におい袋を用いた官能試験の結果をもとに分類し, 各群における患者のCMI健康調査表のプロファイルと口臭に関する質問票の答え方について分析した.すなわち, 複数の歯科医師(パネル)による官能試験の結果, 社会的容認限度をこえる不快な口臭が認められなかった群と認められた群をそれぞれA群, B群とし, 患者自身による評価で不快な口臭を認めなかった群と認めた群をそれぞれa群, b群として, クロス集計し, Aa群, Ab群, Ba群, Bb群の4群に分類した.CMI健康調査表の結果を各群別にみてみると, 自臭症傾向が強いと考えられるAb群では, ほかの群に比べて神経症傾向が強い人が多く含まれていた.また, Ab群では, 質問票のなかで「常に口臭を気にしている」, 「口臭の感じ方が強くなった」と答えた人の割合が多かった.また, Aa群, Ab群では, 歯間清掃用具を日常的に使用している率が高く, 口腔衛生に対して強い関心をもっていることが明らかとなった.これらの結果は口臭検査時に患者自身に口気を評価させることが, 患者の心理的状況の特性を把握するために有用な情報をもたらす可能性を示唆するものである.


Antigenic cross-reactivity and sequence homology between Actinobacillus actinomycetemcomitans GroEL protein and human fibronectin

The immunologic cross-reactivity between human fibronectin and Actinobacillus actinomycetemcomitans GroEL was examined. Analyses by SDS-PAGE/Western immunoblotting and ELISA showed that a polyclonal antibody directed against the purified GroEL protein of A. actinomycetemcomitans, but not against the Escherichia coli GroEL, cross-reacts with human fibronectin. No antigenic cross-reactivity was observed between anti-A. actinomycetemcomitans GroEL antibody and type IV collagen, another important constituent of the basement membrane. A comparative analysis of the amino acid sequences of A. actinomycetemcomitans GroEL and human fibronectin revealed eight instances of four-amino acid sequence homology between the two proteins. Six of these tetrapeptide sequences were also shared with E. coli GroEL, suggesting that the remaining two tetrapeptides, GQLI (Glycine-Glutamine-Leucine-Isoleucine) and TGLE (Threonine-Glycine-Leucine-Glutamic acid), may be associated with the epitope that the anti-A. actinomycetemcomitans GroEL antibody specifically recognizes. Reactivity between TGLE, but not GQLI, with anti-A. actinomycetemcomitans GroEL antibody was confirmed by a biospecific interaction analysis using a biosensor technology. Although additional investigations are required, the observed phenomenon may lead to an autoimmune response and thus contribute to tissue destruction during periodontitis.


Relationship between tongue coating and secretory-immunoglobulin A level in saliva obtained from patients complaining of oral malodor

The aim of this study was to confirm the relationships between oral malodor and periodontal condition, oral malodor and tongue coating, and to investigate the secretory-immunoglobulin A (S-IgA) level in saliva in relation to the accumulation of tongue coating. Fifty-four patients complaining of oral malodor were included in the study. Their periodontal conditions, tongue coating status and salivary characteristics (flow rate, protein and S-IgA concentrations) were assessed in addition to the level of volatile sulfur compounds (VSC) in oral cavity. The patients were divided into three groups according to their tongue coating level. There are significant relationships between oral malodor and specific periodontal parameters used. The degree of tongue coating was also significantly correlated with the amount of H2S, CH3SH and the total amount of VSC determined. The concentration of S-IgA in the group identified as slight tongue coating was significantly higher than in the moderate or the severe group. By Western immunoblotting analysis, a high level of S-IgA specific to Streptococcus species was recognized in all groups, whereas the reactivity of Porphyromonas gingivalis and Fusobacterium nucleatum with S-IgA was very weak in both the slight and the moderate groups. Data herein indicate that tongue coating is closely related to oral malodor. Furthermore, S-IgA in saliva may influence the accumulation of tongue coating, and S-IgA antibodies directed to Streptococcus species may play a role in protective immunity against the initial colonization of tongue plaque.


Effect of vitamin C and vitamin E supplement on periodontal disease in smokers

喫煙者の歯周病に対するビタミンCおよびビタミンE摂取の有効性の検討

Smoking habit has been reported as a risk factor for periodontal disease and low vitamin C intake has been associated with periodontal status. In this randomized controlled trial, we investigated the efficacy of dietary supplementation with antioxidative vitamins, vitamins C and E, on suppression of the progression of periodontal disease in smokers. A total of 65 patients who were current smokers were randomly assigned to one of the following groups : 1) VC (1,000 mg/day) ; 2) VE (135 mg/day) ; 3) combination of VC and VE ; 4) placebo. Plaque index (PI), clinical attachment level (CAL), pocket depth (PD) and cross-linked carboxyterminal telopeptide of type I collagen (I CTP) from gingival crevicular fluid (GCF) as a biomarker of periodontal disease, were measured at baseline, 12 and 24 weeks following the start of supplementation. CAL and PD in VC, VE and the combination groups showed significant improvements during this trial comparing with the placebo group (p<0.05). Furthermore, in the combination group, the rate of GCF samples in which I CTP was decreased or maintained was significantly greater than that in the placebo group at 24 weeks (p<0.05). On the other hand, VC levels in blood samples from VC and the combination groups (p<0.01) and VE levels from VE and the combination groups significantly rose from each level at baseline (p<0.05). These results suggest that supplements of VC and VE may maintain the periodontal health status in smokers by controlling oxidative status and other mechanisms.

喫煙習慣は,歯周病の危険因子の1つとして認識されてきている.本研究では,喫煙習慣を有する歯周病罹患者において,ビタミンC(VC)とビタミンE(VE)の摂取が歯周病に及ぼす作用を検討することを目的とし,無作為化比較対照試験を実施した.65名(平均年齢49.5±10.5歳,女性3名を含む)の被験者はVC群,VE群,その併用群およびプラセボ群の4群に分かれ,24週間タブレット状の試験製剤の摂取を行った.その結果,VC群,VE群およびその併用群は,プラセボ群と比較して,歯周病の臨床パラメータである臨床的アッタチメントレベル(CAL)と歯周ポケット深さ(PD)において,有意な進行の抑制作用を示した(p<0.05).また,歯周組織破壊の生化学的マーカーである歯肉溝滲出液中のI型コラーゲンC末端テロペプチド(I CTP)についても測定を行った.ベースライン時と比較して24週時点でI CTPの改善・維持が認められた部位の割合を群間で比較検討したところ,併用群はプラセボ群と比べ有意に高かった(p<0.05).一方,血中のVCレベルはVC群と併用群(p<0.01)で,VEレベルはVE群と併用群で,それぞれ有意に上昇していた(p<0.05).これらの結果は,VC,VEおよびその併用摂取が,喫煙者の歯周病のリスクを低減し,歯周組織の維持に効果を及ぼす可能性を示唆している.


Helicobacter pylori and Campylobacter rectus share a common antigen


Relationship between Halitosis and Biologically Active Substances in Saliva

口臭症と唾液生理活性物質の関連性