Microplastic chip occurrence at toothbrush bristle tips: an optical microscopy investigation

Seung-Hwa Jeong , You-Jin Cho , Eun-Joo Jun

Abstract : Objectives: This study aimed to investigate the presence of microplastic chips at the tips of toothbrush bristles using optical microscopy. Methods: Toothbrushes available in South Korea were tested. We randomly selected 12 toothbrushes, including four domestically produced and eight imported toothbrushes. Toothbrushes with tapered bristle ends were excluded. Toothbrushes with conventional bristle shapes based on visual inspection were included. Three identical toothbrushes were prepared. The outer bristles of each toothbrush were sampled using Scotch^TM tape and prepared using a scalpel for optical microscopy. The inspector visually assessed both the bristle diameter and the presence of microplastic chips that remained attached to the ends of the toothbrush bristles under light microscopy (40× magnification). Results: All toothbrush bristles met the criteria for soft bristles (diameters ranging from 0.2 to 0.25 mm). The incidence of microplastic chips varied among toothbrush bristles, ranging from a minimum of 3.6% to a maximum of 86.2%. Notably, toothbrushes with smaller diameter bristles exhibited higher levels of microplastic chips. Conclusions: This study confirmed that the trimming conditions of toothbrush bristles and the occurrence of microplastic chips vary among different toothbrushes. Our findings suggest that toothbrush manufacturers need to improve their manufacturing processes to prevent the generation of microplastic chips during bristle trimming.

Usefulness of the odontogenic ameloblast-associated protein and quantitative analysis of periodontal disease-associated bacteria as biomarkers for evaluation of improvement in periodontal status following scaling intervention

Su-Jin Park , Hyunsook Bae

Abstract : Objectives: In this study, we investigated the validity and effectiveness of biomarkers and oral microbiome analysis for evaluation of periodontal status following scaling intervention. Methods: The study included 15 participants who were selected based on inclusion/exclusion criteria. Periodontal indices, including the plaque index, probing depth, modified sulcus bleeding index, and calculus index were measured to evaluate clinical periodontal status and disease progression. Pre- and post-scaling gingival crevicular fluid (GCF) was obtained from 12-20 sites per patient to measure changes in the odontogenic ameloblast-associated protein (ODAM) concentration using an enzyme-linked immunosorbent assay. Additionally, pre- and post-treatment salivary samples were obtained for quantitative analysis of oral microbiome distribution. Results: All clinical parameters showed significant differences in pre- and post-scaling values and significant changes in the ODAM concentration in the GCF in patients with initial and moderate periodontitis. Quantitative analysis performed after scaling intervention revealed changes in eight oral disease-causing bacteria associated with periodontal disease, including Aggregatibacter, Porphyromonas, Tannerella, Treponema, Prevotella, and Fusobacterium. Specifically, Tannerella forsythia and Fusobacterium nucleatum (well-known major periodontal pathogens) numbers were significantly decreased following non-surgical periodontal therapy. However, no significant association was observed between changes in the salivary oral microbiota and ODAM concentration in the GCF, following treatment. Conclusions: Based on the findings of this study, we propose the use of ODAM protein and quantitative analysis of periodontal disease-associated bacteria as objective and quantitative biomarkers for evaluation of improvement in periodontal disease following scaling intervention.

Association between chronic kidney disease and tooth loss in elderly Koreans: The Korea National Health and Nutrition Examination Survey 2016-2018

Na-Yeong Kim , Ji-Eun Kim , Choong-Ho Choi , Ki-Ho Chung

Abstract : Objectives: This study was aimed to investigate the association between chronic kidney disease and tooth loss in elderly Koreans. Methods: Data of 2,419 elderly people aged 65 years or older who participated in the 7th Korea National Health and Nutrition Examination Survey (2016-2018) were obtained. Those with no missing values were analyzed. Complex samples multiple logistic regression analysis was performed to determine the effect of chronic kidney disease on tooth loss. Results: After adjusting for all covariates, chronic kidney disease was significantly associated with fewer than 20 present teeth (OR 1.53, 95% CI 1.01-2.30). Conclusions: In elderly Korean people, chronic kidney disease was significantly associated with having less than 20 teeth, suggesting that chronic kidney disease is a risk factor for tooth loss in the elderly.

Case study of a long-term care resident with oral health problem

Sol Han , Ji-A Park , Yoo-Young Lee , Bo-Hyoung Jin

Abstract : This study aimed to analyze the extent of oral health problems among elderly residents of long-term care facilities who have difficulties accessing care at dental clinics due to physical limitations and other challenges. Seventy-four elderly individuals residing in long-term care facilities in A-gu, Seoul, were screened. From these, we randomly selected three older adults (MMSE-K≥24) who were able to communicate freely in the study. Relevant information was obtained through document review, observational surveys, and one-on-one interviews to identify oral health problems and physical limitations experienced by these older adults. The elderly in long-term care facilities experienced pain and discomfort due to oral problems, and improperly fitting dentures and other prosthetics. These oral problems led to limitations in compromised oral functions and alterations in dietary patterns. Despite the need for customized oral care and treatment, the specific oral health needs of the elderly residents were not met due to barriers that hindered their access to healthcare facilities, such as restricted mobility. To alleviate oral functional limitations in elderly residents of long-term care facilities, interventions, such as necessary treatments and personalized oral care, should be implemented. Establishing a systematic approach, including timely visits to long-term care facilities by dentists and a referral system between facilities and dental services, is crucial to optimizing dental care for elderly individuals living in residential aged care.

Awareness of the concept and role of public oral health care in Korea among oral health professionals

Yong-Jin Lee , Na-Rae Lee , Yun-Sook Jung , Min Lee , Hoi-In Jung , Youn-Hee Choi

Abstract : Objectives: The importance of public healthcare has been further emphasized by the arrival of the era of super-aged societies. This study investigates the landscape among oral health professionals, focusing on the concept development of the public oral health care (POHC) and essential oral health care (EOHC). Methods: A questionnaire survey of oral health professionals was conducted at six associations or societies who have an interest in POHC from December 21 to December 29, 2022. Chi-squared and logistic regression analyses were adopted to identify significant differences between the responses according to general characteristics. Significant differences were considered at a P-value of 0.05. Results: A total of 100 oral health professionals (48 dentists and 52 dental hygienists) participated in this study. The results revealed that there is a need for improvement of the POHC and the establishment of concepts related to the POHC and EOHC. The agreement rate was 90%, 85%, and 86% for the responsible organization, the target object and field, and the concept in the definition of the POHC, respectively. In the case of the construction of the EOHC, the agreement rate was 91% for “Quality of life,” and 85% for “Life and safety.” Among the community oral health programs as the POHC programs, “Oral health education program” showed the highest agreement rate. In healthcare institutions that are capable of providing the POHC services, “Oral health center in the public health center” had the highest agreement rate. Conclusions: The POHC would be reasonable to define to ensure universal access to oral healthcare services for all citizens. In the case of EOHC, further research is needed to establish terminology and specific concepts in the future. This study could contribute valuable insights to the field of the POHC in an era of super-aged societies. As further research, more oral health professionals need to participate in the POHC-related policy and health care system.

The effect of Greek yogurt on the surface of bovine tooth enamel

Ji-Eun Kim , Na-Yeong Kim , Choong-Ho Choi , Ki-Ho Chung

Abstract : Objectives: This study aim to evaluate the effect of Greek yogurt on the tooth surface by comparing it with liquid fermented milk. Methods: After purchasing Greek yogurt available on the domestic market and measuring pH and titratable acidity, Greek yogurt was selected as the Greek yogurt group, Jeju Samdasoo as the mineral water group, and liquid fermented milk as the liquid fermented milk group. The specimens were treated with the experimental drinks for 30 minutes. Afterwards, the change in surface microhardness of the tooth surface was measured and the surface change was observed. Results: The pH of the experimental beverage was slightly higher in the Greek yogurt group than the liquid fermented milk group. In the effect of Greek yogurt on tooth surface hardness, there was a statistically significant difference in surface microhardness before and after immersion in the liquid fermented milk group, but there was no significant difference between the mineral water group and the Greek yogurt group. When comparing the surface microhardness change values among groups, the difference in surface microhardness (△VHN) between before and after 30 minutes of immersion showed a statistically significant difference between the liquid fermented milk group and the mineral water group and the Greek yogurt group, but there was no significant difference between the mineral water group and the Greek yogurt group. As a result of scanning electron microscopy, the surfaces of the mineral water and Greek yogurt groups were smooth without damage, but the surfaces of the liquid fermented milk group were rough and uneven. Conclusions: Considering the results of this experiment, it is considered that Greek yogurt has a lower risk of causing dental erosion compared to liquid fermented milk, and these characteristics of Greek yogurt can be considered when providing dietary counseling regarding fermented milk products.

A qualitative study on the oral health of mobile platform workers: focus on tooth brushing experience

Jae-In Ryu , Na-Yeon Tak

Abstract : Objectives: The landscape of work environments has undergone rapid transformation in the wake of the COVID-19 pandemic. This study aims to identify oral health issues among mobile platform workers, analyze the risk factors within their working environment, and promote their oral health. Methods: A purposive sampling approach was employed to select fifteen participants, including replacement drivers, delivery drivers, and delivery couriers/messengers operating within Seoul’s mobile platform workforce. In-depth interviews were conducted between August and November 2023, with all sessions recorded and transcribed. Utilizing grounded theory methodology, data analysis progressed through stages of open coding, axial coding, and selective coding, ultimately leading to the construction of a paradigm model. Results: The majority of participants were male (93.3%), with an average age of 58.7 years. The paradigm model revealed low tooth brushing rates among mobile platform workers. This phenomenon was attributed to a poor brushing environment and a lack of willingness to brush, with the related context being the poor working environment. Intervention conditions included support for tooth brushing, oral health education, and oral examinations. Implementing an action-interaction strategy, which involves problem-solving pathways and a strong motivation to improve, resulted in improved tooth brushing rates. Conclusions: To promote the oral health of mobile platform workers, it is essential to improve the environment for tooth brushing, particularly by increasing the availability of restrooms and related facilities as brushing spaces. Additionally, It is necessary to develop oral health policies and implement interventions based on an understanding of the working environment of mobile platform workers.

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Association between oral health behaviors and dental scaling frequency: linked datasets from the National Health Insurance Service and the Korea National Health and Nutrition Examination Survey

Sang-Hyun Jung , Hyeonjeong Go , Keun-Bae Song , Youn-Hee Choi

Abstract : Objectives: This study aimed to investigate the association between oral health behaviors and dental scaling to suggest effective preventive oral health behaviors. Methods: This cross-sectional survey examined linked datasets derived from the Korean National Health Insurance Service and Korean National Health and Nutrition Examination Survey, 2014-2017. The data of 4,258 adults aged ≥19 years were included. A multivariate regression analysis was performed to evaluate the effect of oral health behaviors on willingness to undergo dental scaling. Results: The multivariate regression analysis revealed that the participants whose oral hygiene habits included a thrice-daily tooth brushing frequency were 1.5% more likely to undergo dental scaling (95% confidence interval [CI], 1.167-1.881) than the others. Furthermore, those whose oral hygiene habits included a thrice-daily tooth brushing frequency and the daily use of dental floss or an interdental brush were 1.6% more likely to undergo dental scaling (95% CI, 1.194-2.032) than their counterparts. Conclusions: The group with the most favorable oral health behaviors underwent dental scaling more frequently. Better personal oral health habits may lead to willingness to undergo dental scaling, and incremental dental hygiene improvements can be achieved through further oral health education. Educational programs are needed to raise awareness of and promote improvements in individual oral health behaviors.