Dentists In Japan Research Articles

Effects of Ultrasound and Sonic Toothbrushes on Oral Hygiene Status

Objective: To evaluate the effects of ultrasound and sonic toothbrushes on the oral hygiene status of healthy people. Methods: This study was administered with a randomized, controlled, and double-blind trial. Twenty-nine firstyear dental hygiene students answered a questionnaire on oral hygiene behavior, and they were divided into one of four groups after pre-examination. Each group used an electronic toothbrush with different modes (2 times/day, 3 min) after tooth brushing instruction (TBI) for four weeks; A (control): used with power off; B: used with the sonic mode (sonic wave: 16,000 strokes/min); C: used with the ultrasound mode (ultrasound frequency: 1.6 MHz); D: used with the ultrasound + sonic mode. The plaque index (PlI) and gingival index (GI) were assessed. The unstimulated saliva flow rate was measured (spitting method, 1 min). The Ethical Committee of the Japan Dental Hygienists’ Association approved this study’s protocol (vote number: 2). A Wilcoxon signed-rank test was used. Results: The PlI decreased in group C (baseline: 1.42 ± 0.83; 4 weeks: 0.92 ± 0.34; p<0.05) and D (baseline: 1.41 ± 0.3; 4 weeks: 0.92 ± 0.3; p<0.01). The unstimulated saliva flow rate of group C and D, which used electronic toothbrushes with ultrasound, increased significantly (baseline: 0.57 ± 0.33 mg; 4 weeks: 0.78 ± 0.5 mg; p<0.05). The GI did not change in all groups. Participants who had received TBI before this study had an increased unstimulated saliva flow rate (baseline: 0.65 ± 0.35 mg; 4 weeks: 0.87 ± 0.5 mg; p<0.05). Conclusion: The use of electronic toothbrushes with ultrasound for four weeks effectively decreased the PlI and increased the unstimulated saliva flow rate. Professional prophylaxis was required to improve gingival status. TBI enabled participants to use electronic toothbrushes more effectively to stimulate the salivary gland and to increase the unstimulated saliva flow rate.

Influence of SOC on the Mental Health Status of Postgraduate Trainee Dentists in Japan

Purpose: The aim of this research is to examine whether dental trainees’ stress-coping ability and health-maintenance capability affect their mental health during training. Methods: Trainee dentists who began their postgraduate clinical training for one year in 2010 (n = 60) and 2011 (n = 64) at Kyushu University Hospital were eligible to participate in the study. The questionnaire survey was conducted five times throughout the training year using the 13-item Sense of Coherence (SOC-13), the 28-item General Health Questionnaire (GHQ-28), and the 22-item Job Content Questionnaire (JCQ-22). Results: A 107 trainee dentists were completed (female n = 48, male n = 59). We identified the influence of SOC on the mental health status of postgraduate trainee dentists; that is, trainee dentists with high SOC showed favorable mental health, whereas those with low SOC showed poor mental health during the training. Concerning work conditions, trainee dentists with high SOC had adequate support from their supervisors and coworkers. Conclusion: This study showed the possibility of applying SOC for predicting the mental health status of trainee dentists. The results also suggest the need to introduce a solid support system from the early stages of training, in order to achieve the effects of mental health support for trainee dentists with low SOC.

Dental sleep medicine promotion in Japan

An important research theme in sleep medicine that needs to be tackled by dentists is obstructive sleep apnea syndrome. As an increased demand for the involvement of dentists in sleep medicine has been anticipated from the society, the Japanese Academy of Dental Sleep Medicine is not only working to enhance sleep research in the field of dentistry but has also established sleep training for dentists and a certification programme for sleep dentists. This paper presents the range covered by sleep dentistry in relation to dentists in Japan and the current educational situation.

SY17-2 - Approach of medical-dental cooperation in National Cancer Center Hospital

Oral complications are common in patients receiving chemotherapy or undergoing radiation therapy of the head and neck. Oral complications during cancer treatment are directly linked to ingestion problems, and may even serve as a source of various infections such as aspiration pneumonia, thereby exacerbating systemic conditions, and sometimes preventing the completion of cancer treatment with negative effects on treatment prognoses. Oral health status of patients with cancer is associated with the incidence rate and the degree of severity of oral complications. Effective oral hygiene management before initiating cancer treatment will contribute to the reduction of oral complications such as mouth sores, oral mucositis, or dental infections, and provide important support to facilitate smooth cancer treatment. To prevent or reducing oral complications, we check complication during cancer treatment oral conditions of the patients, identify the patients at risk, start preventive measures before cancer therapy begins. Our routine activities for cancer patient is below: 1. Management of oral complications of high-dose chemotherapy and/or stem cell transplant before treatment begins 2. Prevention and treatment of oral complications during chemotherapy and/or radiation therapy 3. Perioperative dental management for the prevention of postoperative pneumonia with oral, pharynx and esophageal surgery 4. Making prostheses for restoration of postoperative facial defects 5. Prevention and treatment of medication-associated osteonecrosis of the jaw (MRONJ) 6. Cooperation business of a medical department and dentistry for the solution to dental problem of the cancer patient So that all cancer patients may receive dental support during cancer treatment, We started that coordinated approach with the Japan Dental Association. We report that medical-dental coordinated system between national cancer center hospital and Japan Dental Association.

A Comparison of Management Conditions in Japan's Dental Clinics and Medical Clinics

In recent years, national medical expenditures have continued to increase in Japan, and have now reached 39 trillion yen. In contrast, dental clinic expenditures have been slow to grow over the past few years, totaling 2.7132 trillion yen. At the same time, the number of dentists continues to increase, with a total of 102,551 dentists in 2012, surpassing the 100,544 physicians at medical clinics. Objective: Given this, we compared management conditions at dental clinics and medical clinics over time to determine whether management conditions of dental clinics are really as harsh as often claimed. Methods: we used the relevant data provided in the Central Social Insurance Medical Council's Survey on Economic Conditions in Health Care for statistics, which depicts management conditions at clinics, and analyzed the causes. Results: Annual fluctuations in the revenue/expense gap (revenue less expense) show that the gap for dentists far undercut that for physicians at medical clinics. The main reason for this decline in revenue is that the number of dental patients declined more that the unit price rose compared to the medical clinic. Conclusion: We determined that management conditions are harsh for dental clinics. DOI: 10.14693/jdi.v22i2.507

Impact of Osteonecrosis of the Jaw on Osteoporosis Treatment in Japan: Results of a Questionnaire-Based Survey by the Adequate Treatment of Osteoporosis (A-TOP) Research Group.

Dentists request a discontinuation of antiresorptive agents, such as bisphosphonate, before and after tooth extractions to prevent osteonecrosis of the jaw (ONJ). However, little is known about how this affects ONJ and osteoporosis treatment and how medical professionals and dentists cooperate to treat ONJ in patients with osteoporosis. This study aimed to clarify the impact of ONJ on osteoporosis treatment in Japan. A structured questionnaire including 14 key clinical queries was sent to 488 medical professionals as part of the Japanese Osteoporosis Intervention Trial (JOINT)-04, and 206 responses were received. A total of 173 respondents had received discontinuation requests from dentists. Of these, 28 respondents experienced 30 adverse events including ten fractures and one incidence of ONJ. The respondents who refused discontinuation requests observed no cases of ONJ. Approximately 16 % of respondents had patients who discontinued osteoporosis treatment, following a requested drug discontinuation, after tooth extraction. Dentists requested discontinuations for many medications that were not associated with the incidence of ONJ. Approximately 76 % of respondents had never requested oral health care from dentists before osteoporosis treatment and 72 % reported no cooperation between dentists and medical professionals in their region. Our results suggest that drug discontinuation may increase adverse events and disturb osteoporosis treatment without completely preventing ONJ. Currently, both medical professionals and dentists in Japan still continue to recommend their own treatment position. A forum to share information about ONJ among medical professionals, dentists, and patients is required.

Treatment Capabilities of Postgraduate Dental Trainees at Tokyo Dental College Suidobashi Hospital Based on Dental Services Income.

As of fiscal year 2006, it became compulsory for all newly licensed dentists in Japan to undergo a year of practical training at one of the designated training facilities found throughout the country as part of their postgraduate programs. The goal of this training is for the trainees to acquire diagnostic and therapeutic skills. While officially trainees, they are nonetheless regarded as members of staff. Clinical training emphasizes improving both technical skills and theoretical knowledge. However, taking on such trainees is sometimes considered unprofitable, as work productivity is claimed to be low. The purpose of this study was to compare work outcomes and income generated between trainees and part-time dentists working at the Tokyo Dental College Suidobashi Hospital. The part-time dentists comprised clinical instructors and dentists responsible for outpatients. Postgraduate dental trainees also generally conduct dental treatment for outpatients. Therefore, part-time dentists were considered the most suitable for a control group. No significant difference was observed in the total number of patients seen by either group by the final term of clinical training. Furthermore, no significant difference was observed in insurance-based dental treatment unit income (insured care unit income) per patient between the two groups from the mid-term period of training onwards. These results suggest that, although the trainees were less efficient in terms of time taken to provide a diagnosis and treatment, their performance was almost equal when viewed from the viewpoint of insured care provided. Taken together, this suggests that time-related care efficiency must be increased and specific training policies and strategies developed to improve the work productivity of dental trainees.

Factors affecting changes in compliance with infection control practices by dentists in Japan

We surveyed compliance with infection control practices (ICPs) and factors associated with ICPs reported by dentists in Japan in 2008 and 2011. ICPs improved during this period as did the proportion of dentists specializing in oral surgery, the proportion of dentists reporting a willingness to treat HIV and AIDS patients, and the proportion of dentists reporting knowledge about universal and standard precautions. Stronger associations between ICPs and these 3 factors were found in 2011 than in2008.

Nutritional status and dysphagia risk among community-dwelling frail older adults.

Although the presence of dysphagia is a key determinant of nutritional status among older adults, few studies have focused on the association between malnutrition and dysphagia risk in community-dwelling frail older adults. This study estimated the prevalence of malnutrition and quantified the association between malnutrition and dysphagia risk among community-dwelling older Japanese adults requiring long-term care. Cross-sectional study. This study was conducted with the cooperation of the Japan Dental Association and local dental associations in all 47 prefectures from January to February 2012. Individuals aged ≥65 years capable of oral nutrient intake who were living at home and receiving home dental care and treatment. Individual demographic characteristics and factors associated with health loss-related functional decline were obtained through interviews by home-visit dentists and self-administered questionnaires. Nutritional status and dysphagia risk were evaluated using the Mini Nutritional Assessment Short Form and the Dysphagia Risk Assessment for the Community-dwelling Elderly. Among 874 respondents (345 men and 529 women), 24.6% were malnourished, 67.4% were at risk of malnutrition, and 8.0% were well nourished. Dysphagia risk was related to an increased likelihood of malnutrition at an old age, even after adjusting for covariates (PR = 1.30, 95% CI = 1.01-1.67). Malnutrition is highly prevalent among community-dwelling frail older adults, and dysphagia risk is independently associated with malnutrition. Dysphagia may be an important predictor of malnutrition progression in aged populations.

External versus internal abutment connection implants: a survey of opinions and decision making among experienced implant dentists in Japan

Internal connection implants have been attracting attention in recent years leading to their being adopted for many implant systems and an increase in market share over other connections. However, internal connection implants have only been used clinically for a short period of time resulting in few clinical studies investigating outcomes and a lack of comparative clinical evidence to support their use over external hex systems at this time. Given the fact that clinical evidence is lacking regarding implant connection performance comparisons, it is important to understand what information clinicians use to choose between systems. The purpose of this study regarding implant decision-making was to ask clinicians to provide subjective evaluations of internal connection implants, in comparison with external connection implants. The survey was constructed to cover four aspects of interest; general responder information, surgical procedures and experience, prosthodontic treatments and outcomes, and implant complications. The dentists' responses indicated that internal connection implants are as user-friendly as external hex implants with respect to implant surgery, but they are favored for prosthodontic handling because impression coping and abutment placement are felt to be easier. In addition, it was revealed that dentists strongly feel that there is a lack of biological and prosthodontic evidence to support the use of internal connection implants. The findings reveal the responding clinicians recognize that they often make decisions without compelling evidence to favor one system over another. Decisions are often based on perceived ease of use or third party (colleague or manufacturer) input. For future investigations, we will seek to better understand the relative influence and validity of all forms of information used (especially third party input), as well as what barriers exist to clinicians' use of more evidence based data.

Income and expenditure in private dental clinics in Japan

Summary Although national dental care expenditure has not changed, the number of dental clinics has increased. Mass media has been reporting on the financial difficulties of dental clinics. To address this issue, we reviewed articles that showed the distribution and changes in net income, that is, total expenses subtracted from total income, of private dental clinics in Japan using data from a survey conducted by the Japan Dental Association. We also reviewed articles analyzing the factors relating to the net income. The results of the articles showed that distribution of net income has become positively skewed, with the mean dragged to the right by a few high scores. This means that the median is more appropriate than the mean as a measure of central tendency of net income. Factors relating to net income of private dental clinics have changed: private dental clinics that were opened after 1989 (new) and had dental hygienists, who may conduct dental maintenance, had high net income, suggesting that they are well-managed or having a different type of patient mix in recent years. These analyses provide important and useful information for not only better management of private dental clinics but also policy-making in dental health care.

Gender Differences in Dentists Working at Schools of Dentistry, Dental Colleges, and Graduate Schools, and Availability and Use of Support Systems for Female Dentists in Japan

Gender Differences in Dentists Working at Schools of Dentistry, Dental Colleges, and Graduate Schools, and Availability and Use of Support Systems for Female Dentists in Japan

Does Mandatory Postgraduate Clinical Training Worsen Geographic Distribution of Dentists in Japan?

Postgraduate clinical training for dentists has been mandatory in Japan since 2006. Hirata et al. reported that the geographic distribution of postgraduate dental trainees by prefecture in 2006 was worse than that of practicing dentists. This suggests that the postgraduate clinical training system could intensify the problem of distribution of dentists. In this study, therefore, we reviewed the geographic distribution of postgraduate dental trainees and practicing dentists between 2006 and 2010 in detail by city, ward, town and village by using the Lorenz curve and Gini coefficient. The results showed that while there was no significant worsening of geographic distribution of postgraduate dental trainees, the distribution of practicing dentists continued to deteriorate. A number of reasons may explain these findings: the clinical training system is based on a one-year employment contract, and dentists subsequently relocate as driven by the market; and geographic distribution among cities, towns and villages has worsened as a result of the merger of municipalities. The geographic distribution of practicing dentists is expected to deteriorate further if the number of dentists takes a downward turn in the future. Therefore, it is necessary to continuously review the distribution of postgraduate dental trainees.

Trends in Percentage of Postgraduate Dental Trainees at Dental Clinics

A facilities-group system designed to provide clinical training at dental clinics was developed after postgraduate clinical training became mandatory for dentists in Japan in 2006. As a result, there has been a steady increase in the number of dental clinics collaborating with dental school hospitals under this program. A larger number of dental clinics have also been designated as single-system facilities, program management facilities or collaborating facilities. However, it remains to be determined whether this increase in the number of dental clinics designated as clinical training facilities has led to an increase in the amount of training offered. Therefore, the purpose of this study was to investigate trends in the percentage of postgraduate dental trainees at dental clinics between fiscal years 2006 and 2010. The results showed no significant correlation among (1) the percentage of dental clinics designated as single-system collaborating facilities, (2) the percentage of training programs at dental clinics, and (3) the proportion of training program recruitment offers by dental clinics compared to the total number of recruits. These findings showed that increasing the number of collaborating dental clinics did not lead to an increase in the amount of clinical training at dental clinics. The findings also suggest that increasing the number of single-system or program management dental clinics is important in promoting clinical training at dental clinics.

新しい成人口腔保健プログラム ―日本歯科医師会「標準的な成人歯科健診プログラム・保健指導マニュアル」―

新しい成人口腔保健プログラム ―日本歯科医師会「標準的な成人歯科健診プログラム・保健指導マニュアル」―

Developing role of dental hygienists in Japan

Summary In Japan, the profession of the dental hygienist was created at the behest of GHQ in 1948, and as such forms part of the occupation's contribution to public health against a backdrop of postwar politics. The law was revised seven years later, allowing dental hygienists to assist in dental practice, particularly at dental clinics/hospitals. The number of dental hygienists currently exceeds 100,000, which is greater than the number of both dentists and dental technicians. This may reflect the inclusion of insurance-covered dental health guidance as part of their duties. Indeed, it has been confirmed that dental clinics with more dental hygienists make higher profits. Revision of legislation relating to dental hygienists enhanced demand for dental hygienists and led to an increase in the number of training institutions for dental hygienists, longer duration of training, and more four-year colleges. Therefore, the Japan Dental Association and Japanese Association of Dental Science undertook a review of the scope of the duties of the dental hygienist.

The Shortage of Dental Hygienists at Dental Clinics in Japan : Report of a Questionnaire Survey of Japan Dental Association&apos;s Members

The Shortage of Dental Hygienists at Dental Clinics in Japan : Report of a Questionnaire Survey of Japan Dental Association&apos;s Members

Geographic distribution of dentists in Japan: 1980-2000

In the late 1950s and 1960s, Japan recognized that it had a shortage of dentists and that they were unevenly distributed. To solve these problems, four national and eight private dental schools were established, leading to a significant increase in the number of dental students in the 1970s and 1980s. The purpose of this study was to investigate the effects of this increased supply on the geographic distribution of dentists in Japan. We determined the number of dentists and the population in each of Japan's 3252 municipalities. The ratio of the number of dentists to the population of an area was assessed using Gini coefficients calculated from Lorenz curves. From 1980 to 2000, the average number of dentists per 100,000 persons in Japan increased from 44 to 70. The Lorenz curve plotted for 1980-1990 appeared as a nearly diagonal line, with the Gini coefficient decreasing from 0.310 to 0.263. The Gini coefficient in the year 2000 was 0.255, indicating only a slight improvement in 10 years from 1990 to 2000. The results suggest that the geographical distribution of dentists in Japan is influenced by municipalities' population size. While the number of dentists in municipalities with populations of less than 5000 increased during the years from 1980 to 2000, 25.9 percent of these municipalities still had no dentists at the end of this period. This is an important issue that warrants prompt corrective action.

Common knowledge regarding prevention of infective endocarditis among general dentists in Japan

Infective endocarditis (IE) is known as a life-threatening disease, with bacteremia-inducing dental procedures considered to be one of the major factors. Thus, prevention of IE onset with antibiotics is widely recommended. Guidelines composed in the USA for prevention and treatment are well known, while the Japanese Circulation Society recently presented their own guidelines. On the other hand, there are few studies of the general knowledge of dentists regarding IE prevention. Questionnaires were distributed by postal mail to dentists who graduated from the Osaka University Faculty of Dentistry. Those with special backgrounds, such as oral surgeons, anesthesiologists, and orthodontists, were excluded. We analyzed a total of 159 questionnaires that were returned by the owners and staff of private dental clinics throughout Japan, whose careers as dentists ranged from 5 to 53 years. Approximately 90% reported encountering fewer than several patients at risk for IE per year and only 40% of the respondents were aware of the guidelines for its prevention. Furthermore, only 23 dentists reported the use of amoxicillin for prevention of IE, with diverse dosages and timing noted. These findings suggest that promotion of guidelines for prevention of IE to general dentists is important, although the frequency of cases encountered by general dentists is extremely low.

Current challenges for dental education in Japan and the United States

Summary The education systems for dentists in Japan and in the United States face several current and future challenges. While there is an increasing demand for new dentists in the United States to this relatively financially rewarding health profession, there is a critical shortage of recent graduating dentists entering full-time academic and research positions at US dental schools. In Japan, while there are more extensive training programs to insure new future researchers and academicians, there is a perceived oversupply of dentists and an attempt to reduce the numbers of new dentists, which in turn discourages entry into dental education programs. Meeting these different challenges in both countries requires developing and reforming dental school curriculums that should be both scientifically and clinically up to date, that will stimulate critical scientific thinking and active life-long learning, and that will encourage students to pursue academic and research careers. In this review, both the common and different strategies developed by dental schools in Japan and the United States to encourage students to apply to dental schools and to pursue academic and research careers are presented, with emphasis on the reform efforts at the University of California, San Francisco (UCSF) and Tokyo Medical and Dental University (TMDU).