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

福岡歯科大学2015年

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

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

Oral cancer screening practices of oral health professionals in Australia

Abstract Background To evaluate oral cancer-related screening practices of Oral Health Professionals (OHPs - dentists, dental hygienists, dental therapists, and oral health therapists) practising in Victoria, Australia. Methods A 36-item survey was distributed to 3343 OHPs. Items included socio-demographic and work-related characteristics; self-assessed knowledge of oral cancer; perceived level of confidence in discussing oral health behaviors with patients; oral cancer screening practices; and self-evaluated need for additional training on screening procedures for oral cancer. Results A total of 380 OHPs responded this survey, achieving an overall response rate of 9.4%. Forty-five were excluded from further analysis. Of these 335 OHP, 72% were dentists; (n = 241); either GDP or Dental Specialists; 13.7% (n = 46) were dental hygienists; 12.2% (n = 41) were oral health therapists, and the remaining 2.1% (n = 7) were dental therapists. While the majority (95.2%) agreed that oral cancer screening should be routinely performed, in actual practice around half (51.4%) screened all their patients. Another 12.8% “Very rarely” conducted screening examinations. The probability of routinely conducting an oral cancer screening was explored utilising Logistic Regression Analysis. Four variables remained statistically significant (p < 0.0001). Results indicate that the likelihood of conducting an oral cancer screening rose with increasing levels of OHPs’ confidence in oral cancer-related knowledge (OR = 1.35; 95% CI: 1.09–1.67) and with higher levels of confidence in discussing oral hygiene practices with patients (OR = 1.25; 95% CI: 1.03–1.52). Results also showed that dental specialists were less likely to perform oral cancer screening examinations compared with other OHPs (OR = 0.18; 95% CI: 0.07–0.52) and the likelihood of performing an oral cancer screening decreased when the “patient complained of a problem” (OR = 0.21; 95% CI: 0.10–0.44). Conclusion Only half the study sample performed oral cancer screening examinations for all of their patients. This study provides evidence of the need for further oral cancer-related education and screening training for OHPs, which is vital to enhance oral cancer prevention and early detection

病院看護師が実施する高齢患者の口腔機能に関するアセスメントおよびケアの実態調査

高齢者の健康寿命の延伸に口腔機能の維持・向上が重要であるが、病院に勤務する看護師による介入は明らかになされていない。そこで本研究では、病院勤務の看護師を対象に、口腔機能に関するアセスメントおよびケアの実態について明らかにすることを目的とする。 福岡県内の8施設の病院看護師503名を対象に、オーラルフレイルおよび口腔機能低下症の認知度、口腔機能に関するアセスメントの認知度および実施度、機能的口腔ケアの実施度について質問紙調査を実施した。その結果、オーラルフレイルおよび口腔機能低下症の認知度は約50％であった。口腔アセスメント項目の認知度は舌苔の付着程度、口腔粘膜湿潤状態、残存歯数・義歯の状態では約75％で、その実施度は60％台であった。その他の項目の認知度は60％以下で、実施度は40％以下であった。口腔ケアの実施度では、器質的口腔ケアで90％以上であるのに対し、機能的口腔ケアは30％未満であった。 これらのことから、病院看護師のオーラルフレイルおよび口腔機能低下症の認知度は低く、器質的口腔ケアは実施できているものの、機能的口腔ケアはほぼ実施されていないことが明らかとなった。オーラルフレイルや口腔機能低下症を認知している看護師は、認知していない看護師よりも口腔アセスメント項目の認知度・実施度および口腔機能訓練の実施度が高かったことから、オーラルフレイルおよび口腔機能低下症の予防と早期発見のためには、機能的口腔ケアに関する知識・技術の普及が課題であることが示唆された。While it is important to maintain and improve oral function to extend the healthy life expectancy of the elderly, the extent of its implementation by hospital nurses for patients is not clearly indicated. Therefore, this study aimed to clarify the actual status of assessment and care for oral function among hospital nurses. A questionnaire survey was administered to 503 hospital nurses across eight facilities in Fukuoka Prefecture to investigate their perceptions of oral frailty and hypofunction, their assessment of oral function, and their provision of organic and functional oral care. Approximately 50% were aware of assessment items such as tongue coating, moistness of oral mucosa, number of remaining teeth, and denture status, with 60–69% actually implementing these assessments. Awareness of other assessment items were approximately 75%, but less than 40% implemented them. While the implementation rate of organic oral care was more than 90%, functional oral care was less than 30%. These findings indicate that the level of perceptions of oral frailty and hypofunction, as well as their implementation of functional oral care, was low, even though they performed well in organic oral care. Nurses with a higher awareness of oral frailty and hypofunction were more likely to recognize assessment items and to implement functional oral care compared to those with lower awareness. The results suggest that enhancing nurses’ knowledge and skills related to functional oral care is crucial for early prevention and detection of oral frailty and hypofunction