AIM:The aim of the present study was to investigate the association between the activities of daily living and the oral health-related quality of life and dementia in older adults. METHODS:Over a period of 18 months, we visited 12 elderly care facilities and recruited 375 participants, 345 of whom were selected to undergo oral health examinations and oral health-related surveys. Each investigation was carried out face-to-face by a professional worker. RESULTS:Cognitive ability was found to be good when the results of the activities of daily living and the oral health-related quality of life examinations were good. If the results of the activities of daily living examination were bad, the odds ratio of dementia was 2.66, and adjusted odds ratio for age, sex, residence type, education level and denture was 2.99, representing a significant difference (P < 0.05). CONCLUSIONS:Most oral problems are not simply the outcome of aging, with oral hygiene management being the most important determining factor. Oral health problems can be prevented, and in order to improve the quality of life of older adults, attention must be paid to oral healthcare. Geriatr Gerontol Int 2018; 18: 943-949.

Stroke is the second cause of death worldwide, although the survival period is increasing after the occurrence of stroke, severe physical disability is caused with aftereffect. Oral inflammation is not limited to the oral cavity, it can cause malignant changes in other tissues and organs. In previous studies, we confirmed the relationship between tooth loss and stroke due to periodontal inflammation. The purpose of this study was to investigate the relationship between oral health and stroke such as oral hygiene behavior, tooth loss and periodontal disease among Korean adults over 40 years of age. This study was analyzed using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3,389 adults over 40 years of age were analyzed as final subjects. Socioeconomic statuses and oral health status was analyzed using a complex sample analysis technique. Logistic regression was used to analyze the relationship of oral health and stroke, and 95% confidence intervals were computed using SPSS. When the prevalence of stroke according to oral hygiene behavior was checked, the prevalence of strokes was lower in subjects who had a lot of brushings per day and subjects who used oral hygiene products (p<0.05). The risk of stroke was 2.17 times (95% confidence interval, 1.43∼3.28) higher in the group with less than 19 remaining teeth, but it was not statistically significant as a result of adjusting for age and sex, income level, education level, drinking and smoking (p＞0.05). Loss of teeth was found to be associated with the risk factor of stroke. Therefore, loss of teeth due to periodontal disease is an additional issue that should be considered as a risk factor for stroke.

Drynaria fortunei (D. fortunei), widely used in traditional Korean medicine, is reportedly effective in treating inflammation, hyperlipidemia, bone fractures, oxidative damage, arteriosclerosis, rheumatism, and gynecological diseases. The objective of this study was to evaluate the antibacterial effects of the chloroform fraction of D. fortunei (DFCF) and assess the synergistic effects of DFCF with antibiotics against bacterial pathogens. This was carried out by calculating the minimal inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) and performing checkerboard dilution test and time-kill assays. The MICs/MBCs for DFCF, ampicillin, and gentamicin against all oral strains were >39-2,500/5,000 μg/mL, 0.25-64/0.25-64 µg/mL, and 0.5-256/1-512 µg/mL, respectively. DFCF exhibited the highest activity against the periodontic pathogens Prevotella intermedia and Porphylomonas gingivalis. DFCF in combination with ampicillin showed a strong synergistic effect against oral bacteria (fractional inhibitory concentration (FIC) index ≤0.5), whereas on combining with gentamicin, it reduced the on half-eighth times than used alone (FICI ≤ 0.5). DFCF combined with ampicillin or gentamicin killed 100% of most tested bacteria within 3-4 h. The results of this study demonstrate the antimicrobial and synergistic activity of DFCF and antibiotics against oral pathogens.

Objectives Stress is a psychological reaction to stimuli such as anxiety or threat felt by a person either physically or mentally when placed in a difficult situation. Although a relationship between stress and dry mouth has been reported, it remains understudied. The purpose of this study was to investigate the association between stress and subjective dry mouth among the elderly living in a rural region. Methods A total of 214 people aged ≥60 years living in a rural area were recruited with an informed consent for a cross-sectional analysis. Information about stress and subjective dry mouth was obtained by an interview survey with a constructed questionnaire. Data on other potential confounding factors (including oral factors) such as socio-demographic data, health-related behaviors, the number of remaining teeth, and subjective chewing ability were also gathered at the same time. Logistic regression models were used to analyze the relationship of stress and dry mouth using SPSS. Results The Crude odds ratio (OR) of stress awareness affecting subjective dry mouth was 2.59 (95% confidence interval: 1.43–4.68). After adjusting for sex, education, income, smoking, and alcohol intake, the adjusted OR was 2.52 (95% confidence interval: 1.30–4.87) which was statistically significant. Conclusions Elderly people who were stressed had an approximately 2-fold increase in experiencing subjective dry mouth when compared to their stress-free counterparts.

Objectives: The purposes of this study is to examine the relationship between emotional labor and burnout among dental hygienists. Methods: A self-reported questionnaire was completed by 247 dental hygienists from September 4 to October 9, 2014. The questionnaire consisted of emotional labor, job burnout, and job stress. Emotional labor included frequency of emotional expression, compliance with emotional regulation, emotional diversity, and emotional dissonance by the instrument pf Morris and Feldman. Job burnout was adopted from Maslach burnout inventory(MBI). Job stress was adpoted from instrument of Chang. Except 13 incomplete answers, 234 data were analyzed by AMOS 18.0 and SPSS 18.0 program. Results: The emotional labor has a significant positive relation to the job burnout. There was a statistical significance between emotional labor and job stress. Job stress had a positive relation to job burnout. Job stress had a mediating effect between emotional labor and job burnout. Emotional labor had a direct effect on the job burnout. Job stress also had a mediating effect on job burnout. Conclusions: It is necessary to improve working environment that can enhance emotional balance and to develop job stress management program.

Objectives: The purpose of the study was to investigate the association between remaining functional teeth and oral health-related quality of life using Geriatric Oral Health Assessment Index(GOHAI) in the elderly. Methods: A self-reported questionnaire was completed by 237 female elderly in Daegu from May to September, 2015. The questionnaire consisted of general characteristics of the subjects and Geriatric Oral Health Assessment Index(GOHAI). A total of 216 female elderly data were analyzed for oral health status and their GOHAI score. Data were analyzed using SPSS 23.0 version. Logistic regression analysis showed the association of functional teeth and GOHAI score. Results: Number of functional teeth can affect oral health related quality of life in the elderly. When functional teeth is small, the odds ratio(OR) was 2.119(95% CI: 1.215-3.696). After adjusting age, residence type and education, OR was 1.900(95% CI: 1.060-3.399). Policies to preserve natural tooth should be recommended for increasing quality of life in general. Conclusions: This study showed significant association between number of functional teeth and the GOHAI score of the elderly women.

이 연구는 대구 지역 일부 청소년을 대상으로 구강건강상태와 구강건강 관련 삶의 질에 대해 조사하였으며, 청소년의 구강건강 관련 삶의 질에 미치는 요인에 대해 분석하였다. 연구 대상자 중 주관적 구강건강 상태에 대해서 나쁘다고 생각하는 청소년은 24명(20.2%), 보통은 67명(56.3%), 좋다고 생각하는 청소년은 28명(23.5%)이었고, 1년 내 구강 내 통증을 느낀 적이 있다고 응답한 청소년은 72명(60.5%), '없다'는 47명(39.5%)이었다. 구강건강 관련 삶의 질의 점수는 최하 14~70점까지로 연구 대상자의 평균 총 점수는 $64.76({\pm}6.71)$점으로, 점수가 높을수록 구강 문제로 인한 삶의 질의 영향이 낮은 것이다. 청소년의 구강건강 관련 삶의 질에 영향을 미치는 요인은 1년 내 구강 내 통증 경험이 있을수록 구강건강 관련 삶의 질이 낮은 것으로 나타났으며, 주관적 구강건강 상태, 학년 순으로 영향이 있는 것으로 나타났다. 일생 동안 신체적, 정신적 변화가 가장 많은 청소년 시기의 삶의 질은 매우 중요하다. 이러한 삶의 질에 구강건강이 미치는 영향에 대해 조사한 연구로 매우 의미 있는 연구이며, 청소년의 구강건강 불편 증상을 최소화하기 위한 노력이 필요할 것으로 생각된다. The purpose of this study was to evaluate the association between oral health status and oral health-related quality of life (OHRQoL) by using the Oral Health Impact Profile-14 (OHIP-14) among adolescents in a metropolis of Korea. A total of 119 students in 1st grade in middle school and 1st grade in high school participated in this cross-sectional study. Oral examination was conducted by two trained dentists to collect in for mation about Decayed, Missing, and Filled Teeth (DMFT) and Community Periodontal Index (CPI). OHRQoL was evaluated by short-form of OHIP-14. Wilcoxon correlation, Kruskal-Wallis test and multiple regression analyses were performed to assess the association between oral health status and OHRQoL. All data was analyzed by SPSS 22.0 and the significance level was set at 0.05. The average of OHIP-14 score in adolescents having no dental caries ($17.88{\pm}5.13$) was higher than those having more than one DMFT index ($19.75{\pm}7.16$). The average of OHIP-14 score in adolescents having bleeding observed ($20.21{\pm}8.01$) was higher than those having more than calculus detected ($18.66{\pm}5.65$). The level of OHRQoL was higher in the participants perceiving better oral health condition compared to those perceiving poorer condition (p<0.05). The result of this study could provide the information that OHRQoL from adolescents positively associated with self-assessed oral health status than oral health with DMFT and CPI. Further studies are needed to well-designed follow-up studies.

Objectives: The purpose of the study is to investigate the cognition of dental caries prevention by the level of socioeconomic status based on Gallup survey in Korea. Methods: This study was done by Korean Gallup survey in October, 2010. A trained researcher carried out the computer aided telephone interview(CATI) using a structured questionnaire. This study was based on the latest population statistics of resident registration and whole country's phone data base. This survey included 869 selected Korean adults over 19 years old, and they were asked to answer a CATI. The questionnaire consisted of general characteristics of the subjects and socioeconomic factors including age, gender, education level, monthly income, and residential area. Cognition of dental caries prevention was measured by Likert 4 scale including ‘much’, ‘a little’, ‘rarely’, and ‘never’. The attitude toward dental caries prevention consisted of daily tooth brushing frequency, experience of oral health education, regular dental checkup, chewing gums(xylitol), regular scaling, and use of oral care devices. Data were analyzed using SPSS 20.0 for frequency analysis, t-test, chi-square test, and one way ANOVA. Cronbach’s alpha was 0.462 in oral health concern and attitude. Results: Mean of the frequencies of daily tooth brushing in men was 2.54 times and 2.78 in women. By the comparison to age group, 35-44 years old group had 2.82 times, 19-37 years old group had 2.72 times, and 45-64 years old group had 2.51 times. The level of education and monthly income was proportional to the tooth brushing frequency. Highly educated and higher monthly income group received regular dental checkup within a year and used the auxiliary oral health care devices. Conclusions: This study suggested the relationship between dental caries prevention and socioeconomic status. It is important to provide the low socioeconomic group with the better oral health promotion services in the future.

Objectives Recently, studies aiming to improve the quality of life of the elderly have become more common. In the aging population, oral health is an important consideration for overall good systemic health. Oral health is closely related to general health and should not be ignored. The purpose of this study was to determine whether there are associations between the mastication level and number of remaining teeth and the cognitive function. These associations were investigated using the Mini-Mental State Examination (MMSE) score and the results of oral examinations in elderly individuals. Methods Participants who were aged over 60 years and living in Daegu city underwent oral examination for assessing their oral condition; their cognitive function was evaluated using the MMSE. The collected data were analyzed using the chi-square test, t-test, and logistic regression in SPSS. Logistic regression was used to analyze the relationship between the MMSE score and the number of remaining teeth, and the 95% confidence intervals were computed. Results Although a significant relationship was found between the number of remaining teeth and the MMSE score, the differences were not large. The odds ratio (OR) when the number of remaining teeth was 0-10 was 3.02 (95% confidence interval: 1.200-7.581). Conclusions This study showed a slight but significant relationship between the MMSE score and the number of remaining teeth in elderly individuals.

Objectives Rheumatoid arthritis (RA) has been associated with systemic diseases, such as periodontal diseases. Periodontal diseases and RA appear to share many pathologic features. The etiology of the two diseases may differ, but they share similar pathological characteristics. Therefore, the aim of this study was to evaluate the correlation between RA and periodontal diseases. Methods Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHNES) were used to analyze periodontal status according to the presence of RA. Demographics and oral behaviors were analyzed using the complex chi-square test to compare participants with RA with those without RA. Complex logistic regression was used to analyze relationships of periodontal diseases with RA and other covariates. Results The odds ratio for periodontal diseases was 1.91 (95% confidence interval: 1.05-3.48) in participants with RA compared with participants without RA. Conclusions The results of this study provide evidence of a significant association between periodontal diseases and RA.

In this study, sophoraflavanone G obtained from Sophora flavescens was evaluated against 10 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA), either alone or in combination with ampicillin or oxacillin, via checkerboard assay. At the end point of an optically clear well, the minimum inhibitory concentrations (MICs) ranged from 0.5 to 8 microg/ml for sophoraflavanone G, from 64 to 1024 microg/ml for ampicillin, and from 256 to 1024 microg/ml for oxacillin. The combination of sophoraflavanone G and ampicillin or oxacillin yielded a fractional inhibitory concentration index ranging from 0.188 to 0.375, thereby indicating a principally synergistic effect. The synergistic interaction was verified by time-kill studies using sophoraflavanone G and/or antibiotics. Thirty minutes of treatment with sophoraflavanone G with ampicillin or oxacillin resulted in an increase in the rate of killing in units of CFU/ml to a greater degree than was observed with Sophoraflavanone G alone. These findings indicated that the application of the tested sophoraflavanone G alone or in combination with antibiotics might prove useful in the control and treatment of MRSA infections.

The chemical components of the essential oil obtained from Chrysanthemum indicum L. were analyzed by GC-MS. Seventy-three compounds accounting for 96.65% of the extracted essential oil were identified. The main compounds in the oil were α-pinene (4.4%), 1,8-cineole (10.4%), α-thujone (6.05%), camphor (10.12%), terpinen-4-ol (3.4%), bornyl acetate (6.1%), borneol (3.6%), cis-chrysanthenol (3.4%), β-caryophyllene (5.1%), germacrene D (10.6%), and α-cadinol (3.0%). The essential oil of C. indicum exhibited stronger antibacterial activity against all oral bacteria tested (MICs, 0.1 to 1.6 mg/ml; MBCs, 0.2 to 3.2 mg/ml) than their major compounds. Furthermore, the MICs/MBCs were reduced to one half ~ one sixteenth as a result of the combinations included the essential oil with ampicillin or gentamicin for all oral bacteria. A strong bactericidal effect was exerted in drug combinations. The in vitro data suggest that the essential oil of C. indicum with other antibiotics may be microbiologically beneficial and synergistic.

One of the traditional Korean medicine, Drynaria fortunei (D. fortunei) is one of candidates known to be effective for the treatment of inflammation, hyperlipemia, arteriosclerosis, rheumatism, and gynecological diseases such as osteoporosis and bone resorption. The present study investigated the antimicrobial activity of methanol (MeOH) extract and n-butanol (n-BuOH), chloroform (CHCl₃), and ethyl acetate (EtOAc) fractions of D. fortunei against oral bacteria. The n-BuOH and CHCl₃ fractions (MICs, 0.0078 to 0.3125 ㎎/㎖; MBCs, 0.019 to 0.625 ㎎/㎖) were demonstrated as strong antibacterial activity than the MeOH extract and EtOAc fraction. The combination effects of n-BuOH fraction with ampicillin or gentamicin were synergistic against some oral bacteria. We suggest that D. fortunei could be employed as a natural antibacterial agent in oral care products.

The chemical components of the essential oil from Artemisia feddei LEV. et VNT. were analyzed using GC-MS. Ninety-nine compounds, accounting for 96.23% of the extracted essential oil, were identified. The main oil compounds were 1,8-cineole (16.86%), chamazulene (9.04%), alpha-terpineol (8.18%), alpha-phellandrene (5.78%), alpha-thujone (5.51%), alpha-terpinyl acetate (5.07%), borneol (5.08%), beta- caryophyllene (4.71%), camphor (4.04%), and terpinen-4-ol (3.04%). The antimicrobial activity of the essential oil and some of its compounds was tested against 15 different genera of oral bacteria. The essential oil from A. feddei had a considerable inhibitory effect on all the obligate anaerobic bacteria tested (MICs, 0.025 to 0.05 mg/ml; MBCs, 0.025 to 0.1mg/ml), whereas the major compounds demonstrated different degrees of growth inhibition.