The purpose of this study was to determine the usefulness of salivary biochemical markers for the screening of periodontal disease and examine the agreement between the results of saliva enzyme tests and those of probing depth. The present study included a total of 187 subjects who underwent annual medical check-ups at the Comprehensive Health Care Center, Honjo, Saitama Prefecture, Japan. Periodontal pocket probing was performed with a WHO probe, and various enzymes and biochemical parameters in saliva were measured. For lactate dehydrogenase (LDH), the proportions of the five isoenzymes were calculated. To decide the cut-off point for each enzymatic activity, receiver operating characteristic curves (ROC curves) were constructed and the points of minimum difference between sensitivity and specificity were decided. Among the biochemical markers tested, salivary LDH level had the highest sensitivity and specificity (sensitivity 0.66, specificity 0.67), while salivary levels of aspartate aminotransferase (AST) and blood urea nitrogen (BUN) also had sensitivity and specificity above 0.60. Among the LDH isoenzymes, LDH4 and LDH5 dominated in whole saliva samples. Salivary LDH may be a feasible and useful parameter for the screening of periodontal disease, while salivary AST and BUN also appear to be potentially useful for this purpose. (J. Oral Sci. 48, [177][178][179][180][181][182][183] 2006)
Many studies suggest that mutans streptococci (MS), Lactobacillus (LB), and salivary buffering capacity are important risk factors for dental caries. However, target populations for most studies were children. In adult patients, the same risk factors affect the number of fillings or prostheses or secondary caries. It is therefore important to investigate these risk factors as predictors of caries in adults. In the present study, we evaluated the oral conditions of adult subjects at private dental offices using bite-wing radiographs. Detection of salivary LB level using Dentocult LB had a statistically significant correlation with the number of flat surface caries and approximal caries (P < 0.001). Detection of salivary MS level using Dentocult MS and salivary buffering capacity did not predict dental caries. Thus, detection of salivary LB level using Dentocult LB may be a useful tool for detecting approximal and secondary caries.
Recently, the distribution of dental caries has been shown to be skewed, and precise prediction models cannot be obtained using all the data. We applied a balancing technique to obtain more appropriate and robust models, and compared their accuracy with that of the conventional model. The data were obtained from annual oral check-ups for schoolchildren conducted in Japan. Five hundred children were followed from ages 5 to 8, and the three-year follow-up data were used. The variables used were salivary levels of mutans streptococci and lactobacilli, 3-min stimulated saliva volume, salivary pH, fluoride usage, and frequency of consumption of sweet snacks and beverages. Initially, conventional models were constructed by logistic regression analysis, neural network (a kind of prediction method), and decision analysis. Next, the balancing technique was used. To construct new models, we randomly sampled the same number of subjects with and without new dental caries. By repeated sampling, 10 models were constructed for each method. Application of the balancing technique resulted in the most robust model, with 0.73 sensitivity and 0.77 specificity obtained by C 5.0 analysis. For data with a skewed distribution, the balancing method could be one of the important techniques for obtaining a suitable and robust prediction model for dental caries.
The purpose of this survey was to investigate the relationship between demographic characteristics and willingness of patients to pay for regular dental check-ups in Japan. Questionnaires were distributed at private dental offices and collected via postage-paid return envelopes addressed to the center of the study groups. Questions focused on demographics and willingness to pay for regular check-ups. Five thousand one hundred thirty-two questionnaires were collected (response rate 56.8%). The 3 groups most likely to have regular dental check-ups were found to be the under 20s, 50 to 59 year olds and civil servants. Of these groups, civil servants were found to be the most likely of all to have regular check-ups. More females than males were represented in the sample. More than 60% of the patients responded that they would be willing to pay for regular check-ups if the cost were less than 2,000 yen (about 20 dollars). However, no statistically significant differences were observed in relation to household income. The results suggested that participation in regular dental check-ups might be related to gender and age, but not to household income.
The aim of this study was to investigate the relationship between dental clinic credibility and patient satisfaction with regular dental check-ups, to compare the level of satisfaction of patients who had regular check-ups with those who did not, and to identify factors associated with regular dental checkups. Thirty-nine private dental clinics in 17 prefectures throughout Japan participated in this study. A total of 9024 questionnaires were distributed to the patients at these clinics, and patients returned the questionnaires using a pre-paid envelope (response rate 56.8%). The questionnaires consisted of items related to patient demographics and 11 items concerning the level of patient satisfaction with the dental clinic. Using multiple logistic regression analysis, the strongest correlation was found between dental clinic credibility in regular checkups and the technical competence of the dentist. The responses to those items concerning making an appointment, and the cleanliness and neatness of the waiting room were different between patients who had regular check-ups and those who did not. To investigate the factors that encourage regular dental check-ups, correlation of factors with regular check up experience were analyzed. Multivariate-adjusted odds ratios indicated a strong association between regular dental check ups and both the technical competence of the dental hygienist and the cost of treatment.
The questionnaires used in this study are useful for measuring patient satisfaction in the dental school hospital setting.
The involvement of reactive oxygen species (ROS) in the pathophysiology of Sjögren’s syndrome (SS), an autoimmune disorder, and irradiation-induced impairments in salivary secretion has been reported. Meanwhile, the strong antioxidant astaxanthin (Ast) has been suggested to have therapeutic effects on various diseases. In the present study, we examined the ROS scavenging capacity of Ast using a human salivary gland epithelial cell line (HSY) and investigated the effects of Ast on salivary secretion in a mouse model of irradiation-induced salivary gland dysfunction. Furthermore, we performed a clinical study of Ast in six SS patients and six normal individuals, quantifying the volume of saliva secretion and the level of oxidative stress markers in the saliva. Ast partially suppressed hydrogen peroxide-induced ROS in HSY cells. The mouse model demonstrated that the pre-administration of Ast resulted in the suppression of irradiation-induced hyposalivation. Furthermore, the administration of Ast appeared to increase salivary output in both the SS and normal groups. The level of oxidative stress marker, hexanoyl-lysine, in the saliva was reduced after Ast intake. These results suggest that Ast might act as an ROS scavenger, providing benefits to SS patients with impaired salivary secretion.
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