Association of periodontal status with occlusal force and food acceptability in 70‐year‐old adults: from SONIC Study

This cross‐sectional study aimed to investigate the association of periodontal status with occlusal force and food acceptability. We hypothesised that mastication deteriorated with reduced periodontal support, even when posterior occlusal contacts with natural teeth were maintained and the patients remained clinically asymptomatic. Participants were 482 independently living 69‐71‐year‐olds, classified as Eichner's group A, having no mobile teeth and no periodontal symptoms. The periodontal probing depth (PPD) and restoration status of each tooth were examined. Occlusal force in the intercuspal position was measured with pressure‐sensitive films. Food acceptability was evaluated from the difficulty experienced in chewing apples, grilled beef, and hard rice crackers. Multivariate regression analysis was performed to investigate the association of periodontal status with occlusal force and food acceptability. A P‐value of <0·05 was considered statistically significant. Multiple linear regression analysis showed that occlusal force had significant negative associations with maximal PPD (standardised partial regression coefficient (β) = ?0·121) after controlling for gender, handgrip strength, number of teeth, and percentage of restored teeth. Approximately 15% of participants were included in the compromised food acceptability group. Logistic regression analyses showed that compromised food acceptability was significantly associated with PPD, after controlling for gender, number of teeth, and percentage of restored teeth. Periodontal probing depth (PPD) was significantly correlated with occlusal force and self‐rated food acceptability after controlling for the possible confounding factors in septuagenarians, even those with complete posterior occlusal contacts and no tooth mobility.     

Factors related to taste sensitivity in elderly: cross‐sectional findings from SONIC study

The sense of taste is important, as it allows for assessment of nutritional value, as well as safety and quality of foods, with several factors suggested to be associated with taste sensitivity. However, comprehensive variables regarding taste and related factors have not been utilised in previous studies for assessments of sensitivity. In the present study, we performed cross‐sectional analyses of taste sensitivity and related factors in geriatric individuals who participated in the SONIC Study. We analysed 2 groups divided by age, 69–71 years (young–old, n = 687) and 79–81 years (old–old, n = 621), and performed a general health assessment, an oral examination and determination of taste sensitivity. Contributing variables were selected by univariate analysis and then subjected to multivariate logistic regression analysis. In both groups, females showed significantly better sensitivity for bitter and sour tastes. Additionally, higher cognitive scores for subjects with a fine taste for salty were commonly seen in both groups, while smoking, drinking, hypertension, number of teeth, stimulated salivary flow salt intake and years of education were also shown to be associated with taste sensitivity. We found gender and cognitive status to be major factors affecting taste sensitivity in geriatric individuals.     

Significance of occlusal force for dietary fibre and vitamin intakes in independently living 70-year-old Japanese: from SONIC Study

Objectives

The number of teeth has frequently been used as an indicator of oral health in investigations of food intake; however, this measure does not represent the efficacy of the masticatory performance. Masticatory performance may be more important for food selection and avoidance than number of remaining teeth. The aim of this study was to investigate the association of occlusal force with habitual dietary intakes in independently living older Japanese.

Methods

The study population was 757 community-dwelling people aged 69–71 years old. Bilateral maximal occlusal force in the intercuspal position was measured with pressure-sensitive sheets. Removable denture wearers kept their dentures in place during the measurements. Dietary habits during the preceding month were assessed using a brief-type self-administered diet history questionnaire that measures consumption frequencies of selected food commonly consumed and calculates energy-adjusted dietary intakes. Linear trends of food and nutrient intakes with decreasing occlusal force were tested after adjusting for gender and socioeconomic factors.

Results

After adjusting for socioeconomic status and the number of remaining teeth, decline of occlusal force was significantly associated with lower intakes of vegetables, vitamins A, C, B₆, folate, and dietary fibre (P for trend < 0.05). In contrast, number of teeth was significantly associated only with calcium and zinc, controlling for occlusal force.

Conclusions

It is concluded that occlusal force was significantly associated with intakes of vitamins and dietary fibre rather than number of remaining teeth in independently living older Japanese.     

Effects of chewing exercises on the occlusal force and masseter muscle thickness in community-dwelling Koreans aged 65 years and older: A randomised assessor-blind trial

Chewing exercises have been applied in clinical settings to improve the occlusal force and function of the masseter muscle in elderly individuals. However, the clinical relevance and effects of chewing exercises are unclear. This study aimed to investigate the effects of bilateral chewing exercises on the occlusal force and masseter muscle thickness in community-dwelling Koreans aged 65 years. Forty community-dwelling healthy elderly individuals were enrolled in this study. They were assigned to the experimental or the control group. The experimental group performed chewing exercises using medical equipment developed to facilitate such exercises. The chewing exercises were divided into isometric and isotonic types and were performed for 20 min/d, 5 days/wk, for 6 weeks. The control group did not perform any chewing exercises. The outcome measures were occlusal force and masseter muscle thickness, which were evaluated using an occlusometer and ultrasound device, respectively. A paired t test and an independent t test were used to evaluate the training effects. Within-group comparisons showed that occlusal force and masseter muscle thickness improved significantly in the experimental group (P < .001 for both), while the control group showed no significant improvements (P = .098 and .130). Between-group comparisons showed that the experimental group had a greater increase in occlusal force and masseter muscle thickness (P < .05 for both) compared to the control group. These results suggest that chewing exercises are effective in improving occlusal force and masseter muscle thickness in healthy elderly individuals.     

Oral health‐related quality of life of 12‐ and 15‐year‐old Thai children: findings from a national survey

Abstract – Objective: To assess the prevalence and characteristics of oral impacts on daily life, and the relationship between certain dental conditions and impacts attributed to them, in a nationally representative population of Thai school children aged 12 and 15 years. Methods: A cross‐sectional study on a representative sample of children in Sixth Thailand National Oral Health Survey. Sample included half the children aged 12‐ and 15‐year‐old selected in Bangkok and all participants in 8 of 16 provinces included in national survey. Children were individually interviewed using the Child‐OIDP (12‐year‐old) and OIDP indices (15‐year‐old), and two questions for overall subjective assessments. Results: A total of 1066 12‐year‐olds and 815 15‐year‐olds were interviewed. Some 85.2% of 12‐year‐olds reported experiencing oral impacts during the past 3 months. Child‐OIDP scores ranged from 0 to 68.0 (mean = 7.83, SD = 7.8). Eating was the most commonly affected performance (64.4%), followed by cleaning teeth (51.7%) and maintaining emotional state (49.1%). Among 15‐year‐old children, 83.3% had oral impacts during the past 6 months. OIDP scores ranged from 0 to 39.5 (mean = 5.47, SD = 6.0). The three most commonly affected performances were eating (64.0%), cleaning teeth (55.3%) and maintaining emotional state (53.1%). Toothache and oral ulcers were the two most important perceived causes in 12‐year‐olds. Impacts from toothache were the most prevalent (39.2%) and had a condition‐specific (CS) Child‐OIDP score of 7.0, while oral ulcers affected 24.7% of children; mean CS‐score of 8.0. Among 15‐year‐olds, oral ulcers ranked first in terms of both prevalence (36.2%) and CS‐score (6.0), followed by toothache (prevalence 33.9% and CS‐score 5.0). For both age groups, problems with gums were of less concern. Conclusions: Oral impacts were common but not severe in Thai children and adolescents. For both age groups, impacts were mostly on eating performance; toothache and oral ulcers were the two important perceived causes reflecting needs for oral health promotion and treatment of dental caries and oral ulcers.     

High fear of intra‐oral injections: prevalence and relationship to dental fear and dental avoidance among 10‐ to 16‐yr‐old children

The present study aimed to: (i) estimate the prevalence of self‐reported high fear of intra‐oral injections, high blood‐injury fear, and injection fear; (ii) explore the overlap between high fear of intra‐oral injections and high fear of dental treatment; and (iii) evaluate the possible consequence of high fear of intra‐oral injections in terms of avoidance of dental care. The sample included 1,441 subjects, 10‐ to 16‐yr of age, attending elementary schools in a county of Norway. Data were collected using questionnaires that were completed in classrooms. The survey instruments used were the Intra‐Oral Injection Fear‐scale, the Children's Fear Survey Schedule‐Dental Subscale, the Injection Phobia scale for children, and the Mutilation Questionnaire for children. In total, 13.9% of the children reported high intra‐oral injection fear. A strong association was found between fear of intra‐oral injections and dental fear. When an intra‐oral injection was needed, 10.6% would avoid dental treatment. In multiple regression analysis, high intra‐oral injection fear was found to be associated with avoidance of dental treatment (OR = 6.52; 95% CI: 3.99–10.67). It was concluded that high fear of intra‐oral injections was prevalent and might lead to avoidance of necessary dental treatment. Hence, intra‐oral injection fear should be addressed before treatment of dental fear.     

What statistical method should be used to evaluate risk factors associated with dmfs index? Evidence from the National Pathfinder Survey of 4‐year‐old Italian children

Background: Traditional approaches to the analysis of dmfs/DMFS count data pose analytical challenges, considering the increasing proportion of zeroes in the distribution. The aim of this paper was to predict the probability of ‘caries‐free’ subjects and the dependence of dmfs index on the influence of childhood sociodemographic factors, through the application of regression models. Methods: Data were gathered as part of the National Pathfinder Survey of 4‐year‐old Italian children. Clinical data on caries disease (dmfs) and childhood sociodemographic factors were collected. The predicted probability for Poisson, negative binomial and zero‐inflated models (Poisson and negative binomial) were estimated using STATA commands for count outcomes. The outcome variable in the regression models was the severity of the disease (dmfs index), while statistically significant variables on bivariate analysis were considered as covariates. Results: Out of 5538 children, 4344 (78.44%) had a dmfs = 0. The mean dmfs index was 1.36 (range: 0–104). The statistical significance of the dispersion parameter (O = 141.6, P < 0.0001) showed the inappropriateness of the Poisson model when compared with the negative binomial model. Vuong’s test indicated that the zero‐inflated models (ZIP and ZINB) fitted the data significantly better than the others (P < 0.001). A significative likelihood ratio statistic indicates that the ZINB regression model fitted better than ZIP model (P < 0.0001). The father’s educational level was significant in both parts of the ZINB regression model (P < 0.05), implying that the degree of caries experience increases in children whose fathers have a low level of education, while the excess of caries‐free children decreases. Moreover, the increase of coefficients in the zero‐inflated part of ZINB regression model implies that the excess of caries‐free subjects increases with the later age of tooth eruption. The observed underestimation of the frequencies of zero dmfs counts by the Poisson model is a common result when a dual‐group process is not taken into account. Conclusions: These regression models provide a useful approach to handling count outcomes as dmfs/DMFS index in caries epidemiology.