Impact of Various Effects of Smoking in the Mouth on Motivating Dental Patients to Quit Smoking

We explored the impact of addressing personally relevant effects of smoking in the mouth on promoting the motivation to quit in a dental setting at personal and public levels. Stages of behavior change and attempts to quit smoking by smokers were recorded during dental visits. Dentists selected and gave motivational information from 24 topics relevant to a patient's oral health status, risk, or dental treatment. During the dental visit, each topic was presented to patients. Topics of gingival melanin pigmentation and periodontal disease risk were most frequently presented. Progression through stages of behavior change and attempts to quit smoking were observed after presentation of each topic. At a personal level, progression through stages was most frequently observed after the patient was shown an image of pediatric dental caries and smoker's palate, and attempts to quit was most frequently observed after the patient shown an image of the effects of smoking cessation and pediatric dental caries. At the public level, enhancing the motivation to progress through stages and attempts to quit was most frequently observed after the presentation of effects of smoking cessation and discoloration of teeth, although the intensity of enhanced motivation significantly correlated with the frequency of presentation, which was not the highest for these topics. Although various smoking effects on the mouth have potential impact on promoting the motivation to quit, the impact on enhancing motivation is not necessarily consistent at personal and public levels

Insomnia and depression impair oral-health related quality of life in the old-old

福岡歯科大学2015年

Xylitol gummy bear snacks: a school-based randomized clinical trial

Background: Habitual consumption of xylitol reduces mutans streptococci (MS) levels but the effect on Lactobacillus spp. is less clear. Reduction is dependent on daily dose and frequency of consumption. For xylitol to be successfully used in prevention programs to reduce MS and prevent caries, effective xylitol delivery methods must be identified. This study examines the response of MS, specifically S. mutans/sobrinus and Lactobacillus spp., levels to xylitol delivered via gummy bears at optimal exposures. Methods: Children, first to fifth grade (n = 154), from two elementary schools in rural Washington State, USA, were randomized to xylitol 15.6 g/day (X16, n = 53) or 11.7 g/day (X12, n = 49), or maltitol 44.7 g/ day (M45, n = 52). Gummy bear snacks were pre-packaged in unit-doses, labeled with ID numbers, and distributed three times/day during school hours. No snacks were sent home. Plaque was sampled at baseline and six weeks and cultured on modified Mitis Salivarius agar for S. mutans/sobrinus and Rogosa SL agar for Lactobacillus spp. enumeration. Results: There were no differences in S. mutans/sobrinus and Lactobacillus spp. levels in plaque between the groups at baseline. At six weeks, log10 S. mutans/sobrinus levels showed significant reductions for all groups (p = 0.0001): X16 = 1.13 (SD = 1.65); X12 = 0.89 (SD = 1.11); M45 = 0.91 (SD = 1.46). Reductions were not statistically different between groups. Results for Lactobacillus spp. were mixed. Group X16 and M45 showed 0.31 (SD = 2.35), and 0.52 (SD = 2.41) log10 reductions, respectively, while X12 showed a 0.11 (SD = 2.26) log10 increase. These changes were not significant. Post-study discussions with school staff indicated that it is feasible to implement an in-classroom gummy bear snack program. Parents are accepting and children willing to consume gummy bear snacks daily. Conclusion: Reductions in S. mutans/sobrinus levels were observed after six weeks of gummy bear snack consumption containing xylitol at 11.7 or 15.6 g/day or maltitol at 44.7 g/day divided in three exposures. Lactobacillus spp. levels were essentially unchanged in all groups. These results suggest that a xylitol gummy bear snack may be an alternative to xylitol chewing gum for dental caries prevention. Positive results with high dose maltitol limit the validity of xylitol findings. A larger clinical trial is needed to confirm the xylitol results. Trial registration: [ISRCTN63160504].Supported by Grant No. U54DE14254 from the National Institute of Dental and Craniofacial Research, and Grant No. 90YD0188 from the Office of Head Start

EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids (CEF); Scientific Opinion on Flavouring Group Evaluation 20, Revision 3 (FGE.20Rev3): Benzyl alcohols, benzaldehydes, a related acetal, benzoic acids, and related esters from chemical groups 23 and 30

<p>The Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids of the European Food Safety Authority was requested to evaluate five flavouring substances in the Flavouring Group Evaluation 304, using the Procedure in Commission Regulation (EC) No 1565/2000. None of the substances were considered to have genotoxic potential. The substances were evaluated through a stepwise approach (the Procedure) that integrates information on structure-activity relationships, intake from current uses, toxicological threshold of concern, and available data on metabolism and toxicity. The Panel concluded that the three substances [FL-no: 16.117, 16.123 and 16.125] do not give rise to safety concerns at their levels of dietary intake, estimated on the basis of the MSDI approach. For the remaining two candidate substances [FL-no: 16.118 and 16.124], no appropriate NOAEL was available and additional data are required. Besides the safety assessment of these flavouring substances, the specifications for the materials of commerce have also been considered. Specifications including complete purity criteria and identity for the materials of commerce have been provided for all five candidate substances.</p&gt

The role of tobacco use on dental care and oral disease severity within community dental clinics in Japan

Background To examine facilitators of dental smoking intervention practices in Japan, where smokeless tobacco is rarely used, we evaluated the characteristics of dental care for smokers. Methods Community dentists volunteered to record the treated disease or encounter with patients that was principally responsible for their dental care on the survey day. Patients were classified into groups receiving gingival/periodontal treatment (GPT), caries/endodontic treatment (CET), prosthetic treatment (PRT), periodical check-up/orthodontic treatment (POT), or other encounters/treatments. Potential effect of dentist clustering was adjusted by incorporating the complex survey design into the analysis. Results Data of 2835 current smokers (CS) and 6850 non-smokers (NS) from 753 clinics were analysed. Distribution of treatments significantly differed between CS and NS (P = 0.001). In ad hoc multiple comparisons for each treatment, CS were significantly higher than NS for CET (47.1% vs. 43.6%, P = 0.002), and lower for POT (1.6% vs. 2.7%, P = 0.001), whereas GPT and PRT proportions were equivalent by smoking. When stage of disease progression was compared in the GPT subpopulation, CS were more likely received treatment for advanced stage disease than NS in the age groups of 40–59 years (24.9% vs. 15.3%, P = 0.001) and more than 60 years (40.8% vs. 22.1%, P < 0.001). However, the difference was less apparent in the entire population (9.7% vs. 6.0%), and CS were not predominant among patients receiving GPT for advanced stage disease (37.6%). Conclusions The association of smoking with type of dental care of CET and GPT severity would warrant the need for dental professionals to engage their patients smoking within clinical practice. The detrimental effects of smoking in dental care for smokers, as evidenced by the distribution of treatment and encounter and stage of treated disease, may not be clearly realized by dental professionals, unless the smoking status of all patients is identified

A natural experiment for inferring causal association between smoking and tooth loss: a study of a workplace contemporary cohort

Background: Natural experiments in former smokers are an important criterion for inferring causality between smoking and tooth loss. We examined how former smoking influenced risk estimate of tooth loss incidence. Methods:Records of dental check-ups of the work cohort were examined. The sample consisted of data from 1,724 workers recorded at the ages of 40 years and 50 years, and this was analyzed for tooth loss incidence during a 10-year period. Former smokers were categorized into two groups based on whether they quit smoking before or during the observational period. Variables used for adjustment were age, sex, oral and overall health behavior, dental visit, and number of existing teeth immediately prior to observation. Results: The prevalence of tooth loss incidence and number of teeth lost during the observational period were both higher in current smokers than in never smokers (33.7% vs. 23.9% and 0.83 vs. 0.42, respectively). Incident odds ratio of tooth loss in long-term quitters relative to never smokers was not significant and less than one (incident odds ratio 0.85, 95% confidence interval 0.56-1.29). Incident odds ratios of short-term quitters and current smokers were both significant, though short-term quitters exhibited higher values (1.72, 1.15-2.55) than current smokers (1.48, 1.10-2.00). Conclusions: The causal interpretation is strengthened by attenuation of the risk in long-term quitters. However, additional factors may influence the risk estimates of former smokers, suggesting potential limitations of a natural experiment for inferring causal association between smoking and tooth loss