コウクウ サイキン ノ ネツ ショック タンパクシツ ト ソノ シシュウビョウ エノ カンヨ

The oral cavity is subjected to a wide range of environmental changes such as heat stress that may affect the biology of oral bacteria. Bacterial heat shock proteins (HSPs), especially, GroEL protein is one of immunodoninant antigen in infection. The high degree of conservation of GroEL implies that molecular mimicry may occur, antibodies against microbial GroEL can cross-react with host HSP60 antigens. Several groups showed that GroEL proteins from periodontopathogenic bacteria were immunodoninant serum antigens in patients with periodontitis. It also revealed in our study the immunologic cross-reactivity between human fibronectin and Actinobacillus actinomycetmcomitans GroEL. These phenomena may lead to an autoimmune response and contribute to tissue destruction during periodontitis. On the other hand, Campylobacter rectus GroEL and A. actinomycetmcomitans GroEL possessed the ability to stimulate production of interleukin (IL)-6 by a confluent monolayer of human gingival epithelial cells and gingival fibroblasts. This result clearly indicates that GroEL proteins play a role in initiation and progression of periodontal disease. Interestingly, salivary IgA antibody directed to C. rectus GroEL from patients with priodontitis caused a partial inhibition of IL-6 production. Salivary IgA may have a protective role by reducing the inflammatory response induced by oral microbial GroEL. I review here the several reports regarding HSPs from oral bacteria and demonstrate their potential contributions to periodontal disease

コウシュウ ノ シンダン ト コウシュウ チリョウ

Most of patients with genuine halitosis were diagnosed as the halitosis from oral origin, and it is possible to improve the symptom by the treatment in dental clinic. We should provide the information for patients that the appropriate professional oral care can improve the halitosis by controlling the volume and the quality of volatile sulfur compounds in addition to self-care such as tongue cleaning. It is also needed for current smoker to recognize that own breath air might be related to the oral pathologic halitosis

フィンランド ノ イリョウ フクシ ブンヤ ニオケル ICT ノ カツヨウ

We visited to Institute of Dentistry at The University of Oulu to see a Finnish medical information system and to see on-the-spot welfare in August 2012. We report the use of the information communication technology (ICT) in the field of a medical and welfare in Finland. The need for interoperable health information system is most important theme in health informatics field. In Finland, the ministry of Social Affairs and Health initiated an implementation project to build a national, centralized health information archive. This Finnish system consists of a national health records archive, a national electric prescriptions system and a wab portal for citizens' access to personal health information. A national health records archive is the database of the citizen's medical information record. Any doctor can see the patient's medical information such as the treatment records and results of physical examination and blood test, outcome of treatment, and so on. An electric prescription is the system that helps to issue and sign the prescriptions electronically. This system is included in the pharmaceutical database. eAccess is called“ My own health”. All people can see the history of his/her prescriptions and treatment and his/her health records by eAccess. This Finnish system is still under construction. The goal of this project will be finished in September 2015. After integration of the Nations in EU, peoples move to the other country freely without VISA. A lot of people can move to the countries in EU easily. Therefore, the traveler with the disease may be increased. This Finnish system will be provided with their important medical record data for the doctor or dentist to help to treat their disease anytime and anywhere. In near future, we should introduce the health information system like the Finnish system for keeping our health condition. It is one of useful tool that the medical bill and medical malpractice will be reduced

A Review of Evidence for a Therapeutic Application of Traditional Japanese Kampo Medicine for Oral Diseases/Disorders

Kampo medicines prescribed by specialized medical practitioners and Japanese physicians have gradually reemerged in Japan as alternatives to Western medications. Kampo formulations are composed of several plant extracts and, as such, the broad variety of phytochemicals they contain likely act synergistically to provide their beneficial effects. Kampo medicines have traditionally been prescribed for a number of health conditions, including chronic hepatitis, bronchial asthma, anemia, etc. The aim of this article is to review the beneficial effects of Kampos with respect to oral health. Pertinent papers published between 1970 and 2017 were retrieved by searching in PubMed, ScienceDirect, Web of Science, and Scopus using key words followed by evaluation of the relevant articles. In vitro studies have identified a number of properties that give credence to the potential of Kampos for treating or preventing oral diseases/disorders. Given their anti-microbial and anti-inflammatory properties, they may be promising agents for controlling periodontal diseases, oral mucositis, xerostomia, and drug-induced gingival overgrowth. Since some oral diseases have a complex etiology that involves microbial pathogens and the host immune response, agents with dual functionality such as Kampo phytochemicals may offer a therapeutic advantage

Oral care tablet containing kiwifruit powder affects tongue coating microbiome

Objectives: Tongue coating, a kind of biofilm formed on the tongue dorsum, is the cause of various clinical conditions, such as oral halitosis and periodontal diseases, because Fusobacterium nucleatum acts as a bridge between other oral bacteria and periodontopathogenic bacteria in biofilm formation. Our previous clinical study revealed that taking oral care tablets containing kiwifruit powder significantly reduced not only tongue‐coating index and volatile sulfur compounds but also total bacteria and F. nucleatum in tongue coating. In this study, we analyzed the microbiome of tongue coating samples obtained before and after oral care tablets intake to clarify whether this tablet is a useful tool for daily tongue care. Methods: Thirty‐two healthy young adults were enrolled, and a crossover clinical trial was conducted. 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. Microbial DNA was isolated from the collected tongue coating samples in each subject, then 16S rRNA next‐generation sequencing, operational taxonomic unit clustering, and statistical analysis were performed. Results: The microbiome analysis revealed that the oral care tablet in intervention II prompted a significant change in the tongue microbiota composition, a significant reduction in the relative abundance of Prevotella and Porphyromonas, and an increase in Firmicutes/Bacteroidetes ratio when compared to that in intervention I. Conclusion: These results suggested that the oral care tablet might contribute to the improvement of the oral condition due to its good influence on the tongue coating microbiome

Current status of collaborative relationships between dialysis facilities and dental facilities in Japan : results of a nationwide survey

Background: Recent studies have reported an association between periodontal disease and mortality among dialysis patients. Therefore, preventive dental care should be considered very important for this population. In Japan, no systematic education has been undertaken regarding the importance of preventive dental care for hemodialysis patients—even though these individuals tend to have oral and dental problems. The aim of this study was to investigate the current state of collaborative relationships between hemodialysis facilities and dental services in Japan and also to identify strategies to encourage preventive dental visits among hemodialysis outpatients. Methods: A nationwide questionnaire on the collaborative relationship between dialysis facilities and dental facilities was sent by mail to all medical facilities in Japan offering outpatient hemodialysis treatment. Results: Responses were obtained from 1414 of 4014 facilities (35.2%). Among the 1414 facilities, 272 (19.2%) had a dental service department. Approximately 100,000 dialysis outpatients were receiving treatment at these participating facilities, which amounts to one-third of all dialysis patients in Japan. Of those patients, 82.9% received hemodialysis at medical facilities without dental departments. Only 87 of 454 small clinics without in-house dental departments (19.2%) had collaborative registered dental clinics. Medical facilities with registered dental clinics demonstrated a significantly more proactive attitude to routine collaboration on dental matters than facilities lacking such clinics. Conclusions: Our nationwide survey revealed that most dialysis facilities in Japan have neither an in-house dental department nor a collaborative relationship with a registered dental clinic. Registration of dental clinics appears to promote collaboration with dental facilities on a routine basis, which would be beneficial for oral health management in hemodialysis patients

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

Objectives: 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. Material and methods: 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. Results: There were significant differences in terms of the level of H2S, VSC, and WTCI at Intervention I and all evaluation values at Intervention II. There were significant differences in terms of the level of H2S, 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. Conclusions: 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

Association between Oral Health Conditions and Nutritional Status in Hemodialysis Patients

近年透析患者の高齢化が進んでおり，透析患者における低栄養と生命予後の関連が報告されている．低栄養の主な原因は食事摂取量の低下と考えられているが，これまでの研究で歯科的要因の関与については十分に検討されていない．本研究では，透析患者の栄養状態と現在歯数および咬合支持状態との関連を明らかにすることを目的として，透析医療機関に併設する歯科口腔外科を受診した透析歴1 年以上の血液透析患者155 名を対象に歯科初診時の口腔状態と直近の栄養指標を横断的に調査し，その関連性について統計学的に検討した．その結果，現在歯数および健全歯根膜表面積より算出される咬合支持能力指数（Normal Periodontal Ligament Index: NPLI）と標準化蛋白異化率（normalized protein catabolic rate: nPCR）の間に有意な正の相関を認めた（Spearman 順位相関係数検定，p<0.05）．また，Eichner分類で群分けした場合（A 群 vs B/C 群），nPCR は2 群間で有意な差を認めた（0.97±0.20 vs 0.90±0.17, スチューデントt 検定，p=0.023）．さらに，二項ロジスティック回帰分析の結果，nPCR が0.8 未満であることに現在歯数やEichner 分類B/C 群が関連することが示された（それぞれオッズ比（95% 信頼区間），p 値：0.945（0.907–0.985）， p=0.007，2.464（1.079–5.626），p=0.032）．nPCR はタンパク質摂取量を反映する指標であることから，血液透析患者において歯の喪失や不十分な咬合支持状態がタンパク質摂取不足に繋がる可能性が示唆された．本研究の結果から，血液透析患者の低栄養のリスクとして，歯数や咬合支持など口腔環境を考慮する必要があることが示唆された．Recently, concerns over malnutrition in hemodialysis patients have been highlighted, along with the aging of patients. The most important cause of malnutrition in hemodialysis patients is considered to be an inadequate dietary intake. However, the involvement of oral health conditions in the malnutrition of hemodialysis patients has not been fully elucidated. The aim of this study was to clarify the relationships between oral health conditions [number of remaining natural teeth and occlusion status] and nutritional status in hemodialysis patients. We evaluated and analyzed oral health conditions [number of remaining natural teeth and occlusion status] and the nutritional status of patients at their first visit to the Department of Oral Surgery in a hemodialysis hospital. 　We found significant correlations between the number of remaining teeth or occlusion status and normalized protein catabolic rate (nPCR). Significant differences between groups divided according to the Eichner index (Group A vs. Group B/C) were also found (0.97±0.20 vs. 0.90±0.17, respectively, Student’s t-test, p=0.023). Moreover, logistic regression analysis suggested that nPCR could be attributed to the number of remaining natural teeth and Eichner index (OR=0.945, 95% CI: 0.907-0.985; p=0.007 and OR=2.464, 95% CI: 1.079-5.626; p=0.032, respectively). Since nPCR is an indicator used for monitoring protein intake, tooth loss and an inadequate occlusion status might lead to decreased protein intake in hemodialysis patients. These results suggest that it is necessary to consider the number of remaining natural teeth and occlusion status as risks of malnutrition in hemodialysis patients

Assessing the oral health

Aims : To compare assessment of the oral health conditions and behaviors of in-patients with diabetes using a clinical version of the Diabetes Oral Health Assessment Tool (C-DiOHAT©) with dental examinations. Methods : A cross-sectional design was used. A nurse assessed 60 in-patients using the C-DiOHAT© (a formatted questionnaire to assess four factors of patients’ oral health conditions and behaviors : oral health conditions, oral hygiene behaviors, sharing health information among patients and dental/medical professionals, and perception and knowledge of oral health) while a dentist examined their oral health conditions. Results : “Use of supplementary tools (e.g., interdental brush, dental floss)” in the item of C-DiOHAT© was significantly associated with dental examination of “the number of present teeth” and “no recommendation of further dental visit”. “Symptoms of gingival swelling” in the item of C-DiOHAT© was also significantly associated with “recommendation of dental visit”. “Knowledge of a relationship between periodontal disease and systemic disease including diabetes” was significantly associated with Community Periodontal Index. Conclusions : These results suggest that nurses should prioritize these assessment items to most quickly acquire useful information about patients’ oral health. It is important to encourage nurses to be interested in patients’ oral health by such small pile of clue

Regular dental visits among hemodialysis patients

AIM To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify the barriers to visiting the dentist. METHODS Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the χ 2 test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental check-ups. RESULTS There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients (4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups (χ 2 test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist (P < 0.05). CONCLUSION Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients