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Notes: Objective: To detect the periodontal status of male smokers and betel chewers in a rural community in Sri Lanka and compare it with that of male non-tobacco users of the same community. Methods: A cross-sectional community based study was carried out in a sample of 2277 rural adult males aged 20–60 years, adopting multistage cluster sampling technique. The present analysis was confined to 2178 subjects who were mutually exclusive smokers, betel chewers or non-tobacco users. The periodontal status was assessed by clinical measurement of levels of bacterial plaque (PLI), gingival inflammation (GI) and loss of epithelial attachment (LA). All measurements were carried out on four sites of all teeth present except third molars and the mean values for periodontal parameters were calculated. Results: Bivariate analysis revealed that the overall periodontitis levels were significantly higher in betel chewers and smokers than in non-tobacco users. Multiple linear regression analysis showed that there were no significant effects of smoking and betel chewing per se on LA, independent of age, socioeconomic status (SES) and whether or not controlled for PLI. The effect of the quantified tobacco use on LA was statistically significant regardless of age, PLI or SES. However, the effect of the quantified tobacco use was considered limited when compared to that of oral hygiene. Conclusions: The findings highlighted the importance of oral hygiene in the aetiology of periodontitis while confirming the statistical significance of the quantified tobacco use on LA. Oral hygiene and the quantified tobacco use may be considered as risk indicators for periodontitis.

Notes: Abstract –Objectives: A strategy for the control of periodontal disease progression is required to prevent tooth loss in older people. However, detailed epidemiological data on periodontal conditions in elderly people is limited. The purpose of the present study is to describe the natural history of periodontal disease and to evaluate the intraoral factors relating to the disease progression in systemically healthy elderly people.Methods: In the cross-sectional study, 599 and 162 subjects aged 70 and 80 years, respectively, were examined. Of those subjects aged 70 years, 436 (73%) participated in the 2-year longitudinal study. Pocket depth (PD) and attachment level (AL) were measured for all functioning teeth at six sites per tooth. In the cross-sectional study, AL of 4 mm or greater and 7 mm or greater were defined as moderate and severe disease, respectively. In the longitudinal study, a change in AL of 3 mm or greater at each site was defined as periodontal disease progression.Results: In the cross-sectional study, 97.1% of the subjects had at least one site of AL of 4 mm or greater (4+ mm). The prevalence of AL of 7 mm or greater (7+ mm) was 47.9%, with 2.8 affected teeth per person in those with AL 7+ mm. These findings reveal that periodontal disease is extremely widespread in the elderly population. However, very few had many teeth with severe periodontal conditions. In the longitudinal study, 75.1% experienced attachment loss of 3 mm or greater (3+ mm) during the 2-year study period. Of those subjects who experienced attachment loss, a mean of 4.7 teeth exhibited attachment loss. Multivariate logistic regression showed that both the highest AL in each tooth at baseline and abutment teeth for removable partial dentures were significantly related to periodontal disease progression as well as tooth loss incidence.Conclusions: These results suggest that teeth with poor periodontal conditions as well as abutment teeth for removable partial dentures were significant intraoral factors relating to periodontal disease progression as well as tooth loss.

Notes: Objective:  This study used a precise weighing method to assess whether tooth loss was related to nutrient intake in elderly Japanese subjects.Material and methods:  Fifty-seven subjects aged 74 years were randomly selected from a longitudinal interdisciplinary study of ageing. Complete 3-day food intake data were obtained by a precise weighing method. The dietary intakes of energy and nutrients were calculated based on the Standard Tables of Food Composition in Japan (5th ed.). A clinical evaluation of the number of teeth present was carried out. Multiple regression standardised coefficients for each nutrient was estimated based on a continuous scale adjusted for gender, smoking habits, and educational level. After dividing the subjects into two groups according to the number of teeth present (0–19, 20+), the difference in the intake of nutrients and the amount of food consumed per day was evaluated.Results:  The number of teeth present had a significant relationship with the intake of several nutrients. In particular, total protein, animal protein, sodium, vitamin D, vitamin B1, vitamin B6, niacin, and pantothenic acid were significantly associated with the number of teeth present and with the two groups (0–19, 20+). The intake of vegetables and fish, shellfish, and their products was significantly lower among subjects with fewer teeth.Conclusion:  This study suggests that there was a significant relationship between nutrient intake, such as minerals and vitamins from food, and tooth loss.

Notes: Oral health conditions, including dental conditions, temporomandibular joint (TMJ) conditions, denture status, and oral hygiene status, were assessed on 1908 institutionalized elderly people 65 yr of age and older at 29 of the 30 existing institutions in the city of Kitakyushu, Japan. The percentage of edentulous people was 27% in the65–74-yr-old group, and increased with age to 56%, in the 85 yr and older group. In dentate persons, the mean number of remaining teeth and DF teeth were 13.4 and 8.6, 9.5 and 6.8, and 8.4 and 6.5 in the groups aged65–74 yr old.75–84 yr old and 85 yr and older, respectively 81% of all the persons examined had no unusual symptoms in their TMJ. A clicking sound was the most frequent symptom (17%). Hygiene of both their teeth and dentures was very poor. Of all the subjects 36% needed new full and/or partial denture(s) and 41%, needed only repair. When the institutionalized elderly people were compared according to their general health condition, no clear differences were observed in percentage edentu-lousness, mean number of remaining teeth and DF teeth, and TMJ conditions. However, a higher level of both untreated teeth and denture treatment needs, and poorer oral hygiene, was found in elderly people having poor general health than was observed in those with better health. These findings indicate that dental care systems for institutionalized elderly people, especially disabled elderly people, should be planned, and that the importance of oral health programs among younger generations should be stressed, because (a) dental care for the elderly becomes more difficult with increasing age and (b) dental health care is provided too late for most people.

Notes: Abstract – The Dental Aesthetic Index (DAI) was used to evaluate malocclusion in Japanese high school students (n= 409, ages 15–18 yr). The purpose of this study was to obtain basic data concerning malocclusion in Japanese high school students. This study used a sample of students from randomly selected urban and rural high schools in Japan's Kyushu district. The DAI scores for urban and rural high school students, as well as the total DAI scores from these two areas were significantly higher than that of American high school students. These results showed that the number of students with an acceptable dental appearance among Japanese high school students is significantly lower than among American high school students. This indicates a higher need for orthodontic treatment among Japanese high school students.

Notes: Abstract: The aim of this study was to elucidate any association between oral lichen planus (OLP) and serum antioxidant micronutrients by a population-based case-control study. A total of 9536 subjects were examined, and 62 (58 reticular, 4 atrophic and erosive) diagnosed with OLP at referral facilities were compared with four controls per case (n=248) selected among disease-free subjects matched for age and sex. Serum levels of micronutrients (retinol, α-tocopherol, zeaxanthin/lutein and cryptoxanthin, lycopene, α-carotene and β-carotene) were estimated by the high performence liquid chromatography (HPLC) method. Among cases, mean serum retinol level (2.820±0.849 μmol/l) was significantly higher compared with that of controls (2.562±0.735 μmol/l) (P〈0.05). No significant differences were noted in carotenoid levels examined in this study, except for a lower level of lycopene found in atrophic/erosive OLP cases. The results of this study suggest that low serum retinol or carotenoid levels are not risk factors for occurrence of lichen planus, and any specific benefits of antioxidant micronutrients cannot be claimed for this inflammatory disorder.

Notes: Objective: To ascertain the association between tobacco use and gingival bleeding in a rural community in Sri Lanka.Material and methods: A cross-sectional field-based study was carried out in 2178 rural males aged 20–60 years, employing a multistage cluster sampling technique. The levels of plaque and gingivitis were recorded on four sites of all teeth present excluding third molars, using the plaque index (PLI) and gingival index (GI). Information pertaining to sociodemographic variables, oral hygiene practices and tobacco consumption habits was obtained from all subjects.Results: One-way anova combined with the Bonferroni test disclosed that betel chewers had a significantly higher mean number of sites with gingival bleeding (22.6±21.8) than smokers (10.8±11.2) and nontobacco users (8.7±6.8) (p〈0.0001). A higher proportion of betel chewers (55.1%) showed ≥12 bleeding sites compared to smokers (27.6%). Logistic regression analysis revealed that the association between betel chewing and gingival bleeding was positive (OR=2.41; p〈0.0001) whereas that of smoking and gingival bleeding was negative (OR=0.75; p〈0.05). Oral hygiene had the strongest relationship with gingival bleeding (OR=18.11).Conclusion: While confirming the masking effect of smoking on gingival bleeding, these findings indicate that betel chewing might significantly enhance gingival bleeding in the population studied.

Notes: The aim of this study was to identify the risk factors for periodontal disease progression by individual characteristics at baseline among elderly people over a 2-year period. Subjects were selected from 4542 people aged 70 years residing in Niigata who were in good general health and who did not require special care for their daily activities. Gender, smoking and alcohol drinking habits were obtained using a questionnaire, while serum levels of disease markers were investigated and attachment levels were clinically recorded. For the assessment of periodontal disease progression, additional attachment loss was used if one or more sites had a 3-mm or more increase in probing attachment level over a 2-year period. In all, 394 subjects (208 males and 186 females) were surveyed. Approximately 75% of subjects exhibited additional attachment loss over a 2-year period. Significant associations were found between additional attachment loss and smoking, and attachment level of 6 mm or more at baseline, with odds ratios of 3.75 and 2.29, respectively. Smoking habit and baseline attachment level of 6 mm or more may be considered risk factors for further attachment loss among healthy elderly people.

Notes: Abstract. The aim of the present overview is to evaluate the periodontal conditions in European populations. Study was made of a number of extensive surveys of periodontal diseases carried out in a number of European countries, primarily North West Europe. These surveys often provide considerable detail. However, international comparisons are difficult to perform because of the different methods applied. Therefore, the latest overviews of results of periodontal surveys, based on the CPITN method and stored in the WHO Global Oral Data Bank, are given for the age groups 15–19 years and 35–44 years. Based on this approach, the conclusions are as follows. Trends and prevalences in periodontal health and disease in Europe are clear, at least up to the age of 60 year. Severe periodontal destruction seems to be a limited problem, seldom leading to tooth loss before age 50 and certainly not a major cause of edentulousness before age 60. For a large majority, in most of the populations observed, the progress of periodontal destruction seems to be compatible with the retention of a natural, functioning dentition into older age. However, the periodontal problem might still be of considerable magnitude and importance as bleeding on probing is widely encountered in the younger age groups. Furthermore, 5–15% of populations affected by a serious, irreversible condition at age 40 years is high, compared with most other diseases.

Notes: Objective: Bone loss is a common feature of periodontitis and osteoporosis. Both diseases may share common etiologic agents which may either affect or modulate the process of both diseases. The purpose of this study was to evaluate the relationship between systemic bone mineral density (BMD) and periodontal disease among older people.Materials and Methods: Among all 4542 inhabitants aged 70 years according to a registry of residents in Niigata city in Japan, 600 people were selected randomly. One hundred and eighty-four subjects who did not have diabetes mellitus, whose blood sugar was 〈140 mg/dl, who had more than 20 teeth, who were non-smokers, and who did not take medication for osteoporosis, were included in the study. Four dentists performed clinical evaluations on probing attachment level (PAL). We also utilized the data on BMD of the heel, which we measured using an ultrasound bone densitometer. Follow-up clinical surveys were done by measuring PAL after 3 years. Finally, 179 subjects who could participate in both the baseline and the follow-up examinations were included in the analysis. After dividing the subjects into an osteopenia group (OG) and non-osteopenia group (NOG), we evaluated the relationship between BMD and the number of progressive sites which had 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE548:ges" location="ges.gif"/〉3 mm additional attachment loss during 3 years after controlling the known confounding factors.Results: The mean number of progressive sites for the OG and the NOG, respectively, were 4.65±5.51 and 3.26±3.01 in females and 6.88±9.41 and 3.41±2.79 in males. Two-way analysis of variance was performed to discriminate among effects of gender, BMD, and gender–BMD interaction. A significant effect of BMD (OG or NOG, p=0.043) with a significant interaction (p=0.038) was observed. Furthermore, BMD was associated with the number of progressive sites which had 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE548:ges" location="ges.gif"/〉3 mm additional attachment loss during the 3 years (p=0.001) by multiple linear regression analysis.Conclusions: This study suggested that there was a significant relationship between periodontal disease and general BMD.