Examination of the Relationship between Oral Health and Arterial Sclerosis without Genetic Confounding through the Study of Older Japanese Twins

OBJECTIVE

Although researchers have recently demonstrated a relationship between oral health and arterial sclerosis, the genetic contribution to this relationship has been ignored even though genetic factors are expected to have some effect on various diseases. The aim of this study was to evaluate oral health as a significant risk factor related to arterial sclerosis after eliminating genetic confounding through study of older Japanese twins.

SUBJECTS AND METHODS

Medical and dental surveys were conducted individually for 106 Japanese twin pairs over the age of 50 years. Maximal carotid intima-media thickness (IMT-Cmax) was measured as a surrogate marker of arterial sclerosis. IMT-Cmax > 1.0 mm was diagnosed as arterial sclerosis. All of the twins were examined for the number of remaining teeth, masticatory performance, and periodontal status. We evaluated each measurement related with IMT-Cmax and arterial sclerosis using generalized estimating equations analysis adjusted for potential risk factors. For non-smoking monozygotic twins, a regression analysis using a "between within" model was conducted to evaluate the relationship between IMT-Cmax and the number of teeth as the environmental factor controlling genetic and familial confounding.

RESULTS

We examined 91 monozygotic and 15 dizygotic twin pairs (males: 42, females: 64) with a mean (± standard deviation) age of 67.4 ± 10.0 years. Out of all of the oral health-related measurements collected, only the number of teeth was significantly related to arterial sclerosis (odds ratio: 0.72, 95% confidence interval: 0.52-0.99 per five teeth). Regression analysis showed a significant association between the IMT-Cmax and the number of teeth as an environmental factor (p = 0.037).

CONCLUSIONS

Analysis of monozygotic twins older than 50 years of age showed that having fewer teeth could be a significant environmental factor related to arterial sclerosis, even after controlling for genetic and familial confounding.

Health-oriented electronic oral health record for health surveillance

Public health surveillance of oral health might benefit from increased access to and analysis of electronically available data including systematic collection, analysis, interpretation, and dissemination of outcome-specific data for use in public health action to improve oral health. This study aimed to develop and evaluate a new Health-oriented Electronic Oral Health Record (Health-EOHR) that integrated new oral health status graphical user interface, the health-oriented status and intervention model to facilitate oral health surveillance. We designed an experiment using focus groups and a Delphi process to develop health-oriented status and intervention model and graphical user interface. The Health-EOHR was implemented and integrated into the existing Electronic Health Record widely used in community hospitals. The study on usefulness for oral health surveillance was conducted. Overall, the dentists were significantly satisfied with the Health-EOHR compared to the existing EOHR (p < 0.001). The dentists found it easy to use and were generally satisfied with the function and the impact on their work, oral health services and surveillance.

Comments on: Cardoso, C.F.; Drummond, A.F.; Lages, E.M.B.; Pretti, H.; Ferreira, E.F.; Abreu, M.H.N.G. The Dental Aesthetic Index and Dental Health Component of the Index of Orthodontic Treatment Need as Tools in Epidemiological Studies. Int. J. Environ. Res. Public Health 2011, 8, 3277-3286

In regard to the article entitled "The Dental Aesthetic Index and Dental Health Component of the Index of Orthodontic Treatment Need as Tools in Epidemiological Studies" by Cardoso et al. [1] which checks the validity and agreement of two scales for orthodontic treatment need, we would like to draw your attention to a number of discrepancies in the design and methodology which have affected the results. [...].

Oral health of 65-year olds in Sweden and Norway: a global question and ICF, the latest conceptual model from WHO

OBJECTIVE

The aims of this study were to identify explanatory factors of satisfaction with oral health among Norwegian and Swedish 65 year olds in terms of items from four different domains of ICF and to compare the strengths of the various ICF domains in explaining satisfaction with oral health. Further it was to assess whether the explanatory factors of ICF domains vary between Norway and Sweden.

MATERIALS AND METHODS

In 2007, standardized questionnaires were mailed to all the residents in certain counties of Sweden and Norway who were born in 1942. Response rates were 73.1% (n = 6078) in Sweden and 56.0% (n = 4062) in Norway.

RESULTS

In total, 33 questions based on four different ICF domains were chosen to explain satisfaction with oral health. Logistic regression showed that four different ICF domains in terms of body function, body structure, activity/participation and environmental factors explained, respectively, 53%, 31%, 12% and 34% of the explanatory variance in the satisfaction with oral health. In the final analysis, only nine items were statistically significant (p < 0.05).

CONCLUSION

This study indicates that ICF as a conceptual model could cover a broad spectrum of factors embedded in OHRQoL measured by a global question in Sweden and Norway. Nine items, representing four ICF domains, were important in the final model for explaining satisfaction with oral health.

Association of clinical oral health status with self-rated oral health and GOHAI in Japanese adults

OBJECTIVE

The objective of this study was to investigate clinical oral health status relationships that affect quality of life (using the 12-item General Oral Health Assessment Index (GOHAI)) and self-rated oral health in a community of Japanese residents.

METHODS

459 residents of Yokote City, Japan aged 40-55 years had oral health examinations and completed self-administered questionnaires collecting data on age, gender, GOHAI items and self-rated oral health. Linear regression analysis was performed with GOHAI or self-rated oral health as a dependent variable and gender, age and indicators of oral health status as independent variables.

RESULTS

The GOHAI indicated 42.7% of subjects were concerned about the appearance of their teeth, 30.1% were worried about teeth problems and 27.5% concerned about sensitive teeth. Analyses showed that gender, decayed teeth, oral dryness and missing teeth were significantly associated with variation in GOHAI scores, and that gender, decayed teeth, oral dryness and oral hygiene were significantly associated with variation in self-rated oral health.

CONCLUSION

This study revealed that in this sample of Japanese adults aged 40-55 years, decayed teeth and oral dryness affected both GOHAI and self-rated oral health, whereas missing teeth affected GOHAI and oral hygiene affected self-rated oral health. Subjects did not recognise periodontal disease as a quality of life impacting condition or as a health problem.