The loss of teeth is known to influence the mastication of foods and nutritional status. Therefore, we hypothesize that poor dentition status can impair the systemic health of the aged. To clarify the influence of dentition status on deterioration in physical ability, mental impairment, and mortality, we conducted a six-year prospective cohort study of the institutionalized elderly living in 29 of the 30 institutions for the elderly in Kitakyushu, Japan. Bivariate analysis revealed that worse dentition status at baseline led to significantly worse physical and mental impairment, and higher mortality. In a multiple logistic regression analysis, the physical ability of edentulous subjects without dentures significantly deteriorated compared with that of dentate subjects with 20 or more teeth. The six-year mortality rate of the edentulous subjects without dentures was significantly higher than that of the subjects with 20 or more teeth. Poorer dentition status, especially edentulousness without dentures, may therefore be related to deterioration in the systemic health of the aged.
Upper body obesity, related to visceral fat accumulation, is known to increase the risk of various adult diseases, especially type 2 diabetes and cardiovascular disease. This study was conducted to clarify the relationship between upper body obesity and periodontitis. We studied 643 apparently healthy, dentulous Japanese adults who attended programs at Fukuoka Health Promotion Center. Waist-hip ratio, body-mass index (BMI), and body fat were significant risk indicators for periodontitis after adjustment for known risk factors (p < 0.002). Subjects were divided into four BMI (or body fat) categories. In only the subjects with high waist-hip ratio, higher categories of BMI (or body fat) significantly increased the adjusted risk of periodontitis, compared with subjects with low waist-hip ratios and the lowest category of BMI (or body fat). The reported relationship between cardiovascular disease and periodontitis should be reconsidered, since abdominal adiposity or visceral fat can be related to both diseases.
This population-based study determined the salivary microbiota composition of 2,343 adult residents of Hisayama town, Japan, using 16S rRNA gene next-generation high-throughput sequencing. Of 550 identified species-level operational taxonomic units (OTUs), 72 were common, in ≥75% of all individuals, as well as in ≥75% of the individuals in the lowest quintile of phylogenetic diversity (PD). These "core" OTUs constituted 90.9 ± 6.1% of each microbiome. The relative abundance profiles of 22 of the core OTUs with mean relative abundances ≥1% were stratified into community type I and community type II by partitioning around medoids clustering. Multiple regression analysis revealed that a lower PD was associated with better conditions for oral health, including a lower plaque index, absence of decayed teeth, less gingival bleeding, shallower periodontal pockets and not smoking, and was also associated with tooth loss. By contrast, multiple Poisson regression analysis demonstrated that community type II, as characterized by a higher ratio of the nine dominant core OTUs, including Neisseria flavescens, was implicated in younger age, lower body mass index, fewer teeth with caries experience, and not smoking. Our large-scale data analyses reveal variation in the salivary microbiome among Japanese adults and oral health-related conditions associated with the salivary microbiome.The human oral cavity is colonized by numerous and diverse microorganisms as commensals. These bacteria constitute complex microbial communities on intraoral surfaces, and dental plaque microbiota that form on the teeth are the cause of two major oral diseases, dental caries and periodontitis. Mutans streptococci are the major etiologic agent of dental caries 1 and Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola are prime suspects in periodontitis 2 . Furthermore, recent studies that have used open-ended molecular approaches and the 16S rRNA gene have implicated other commensal members with the etiology of each disease, such as lactobacilli for dental caries 3 and as many as 17 species, including Filifactor alosis for periodontitis 4 .Saliva is a biological fluid secreted from the salivary glands into the oral cavity and contains bacteria shed from adhering microbial communities on various intraoral surfaces, including tooth surfaces, gingival crevices, tongue dorsum, and buccal mucosa. Oral bacteria in a planktonic state (as in saliva) are not generally regarded as direct causal agents of the oral diseases. However, intraoral transmission of pathogenic bacteria is likely to be mediated by bacteria dispersed via saliva 5,6 .The salivary microbiome, which is comprised of indigenous bacteria that are specific to each person, exhibits long-term stability (on the scale of years) [7][8][9][10] . On the other hand, oral disorders alter the structure of the teeth and their surroundings. Along with the loss of teeth, tooth decay and its treatment alter the structure of the tooth surfaces on which bacteria are attached. Gingival crevi...
Obesity was associated with deep pockets in Japanese women, even after adjusting for oral glucose tolerance test.
Recent studies have suggested that several systemic conditions--such as obesity, hypertension, hyperlipidemia, and diabetes--are related to periodontitis. The objective of this study was to examine the relationship between periodontitis and 5 components of metabolic syndrome--abdominal obesity, triglyceride level, high-density lipoprotein cholesterol level, blood pressure, and fasting blood sugar level--in 584 Japanese women. In multivariate analyses, persons exhibiting more components of metabolic syndrome had significantly higher odds ratios for a greater pocket depth and clinical attachment loss than did those with no components; the odds ratios for a greater pocket depth and clinical attachment loss of the persons exhibiting 4 or 5 components were 6.6 (95% confidence interval = 2.6-16.4) and 4.2 (95% confidence interval = 1.2-14.8), respectively. These results indicate that metabolic syndrome increases risk of periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination.
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