Chapter 5

Oral care in the future– The future envisioned by Lion

In a social environment that has changed dramatically, with declining birthrates and a
rapidly aging population, what oral health activities should exist in the future? In
Chapter 5, the final chapter, we turn our gaze from the past to the future, and intro52

duce Lion's blueprint for oral health promotion over the next century.

Expanding into a nationwide
movement
Promoting oral health as a national project
Lion’s continuous work on oral health since 1913 has led to an era in which
oral health is a government-supported project. In 1989, the Ministry of Healthand Welfare proposed the 8020 Campaign, aimed at having 80-year-olds
retain at least 20 of their teeth. Also, Healthy Japan 21, a movement to promote the health of citizens in the 21st century, started in the year 2000. The
underlying Health Promotion Law framework specifies maintenance ofLabour and Welfare aimed to further promote the 8020 Campaign with thephrase "Chewing 30" to encourage people to chew their food at least 30
Dental Health Law, which the Japan Dental Association has hoped for years
would be enacted, finally was enacted in 2011. The purpose of this law is "tocomprehensively promote measures to maintain oral health by preventing
dental diseases, etc., because oral health plays an important role in physicaland mental health." This basic law is significant, as it clarifies the national
government’s responsibility for the dental health of Japan's people.

The future envisioned by Liontimes. To increase public awareness of the importance of healthier living, theChapter 5

healthy teeth among its major goals. What's more, the Ministry of Health,53

Improving quality of life with
"Healthy mouth - Beautiful mouth"
Good health begins with a healthy mouth
In 2010, as the national government and public administrations were intensifying their oral health activities, The Lion Foundation for Dental Health received
certification as a Public Interest Incorporated Foundation and has eagerly
assumed its new social responsibility to contribute even more to dental health. In
particular, the aging of Japanese society is an urgent issue, but even now only
about 40% of 80-year-olds still have 20 or more of their teeth. Improving this
Chapter 5

situation will require not only conventional cavity prevention, but also initiatives
to maintain a healthy mouth throughout one's lifetime. As the relationshipbetween periodontal disease and overall health has become clear, dental health

The future envisioned by Lion

has also become an essential issue in efforts to extend healthy life expectancy.
Therefore, Lion introduced the concepts "A healthy mouth beautifies the
body and mind" and "Healthy mouth - Beautiful mouth", and also developed
campaigns such as "Eat, Talk, Smile" to raise awareness of the essential role oforal care in everyday life. By giving sound guidance on proper maintenance oforal health, oral beauty and communication, we strive to promote better physical and mental health, in order to extend life expectancy and improve qualityof life. By calibrating steps to adapt to each stage of life, as described on page56, these activities address the challenges of achieving health and prosperity associety ages.

54

A healthy mouth beautiﬁes the body and mind

Extending healthy life
expectancy

Improving QOL (quality of life)
Promotinghealthy bodies

Promotinghealthy minds

Eat

Talk & Laugh
Chapter 5

Oral Health
Oral Beauty
Communication

The future envisioned by Lion

Healthy mouth ̶ Beautiful mouth

55

Activities for each stage of life — School age

Teaching at a diet education
event in Sumida-ku, Tokyo.
Instilling healthy habitsduring childhood leads tobetter lifelong health.

Developing important
health habits during childhood
Oral health activities for children
In our activities for children, in addition to the Children's Mass Toothbrushing Tournament, we put our energies into developing healthy habits ineveryday life. Various activities for schoolchildren have led to a reduction incaries, so that in the year 2014 the average 12-year-old schoolchild has had
an average of just one cavity. However, in spite of this, perhaps because
toothbrushing habits have not been properly established, there is a growing

Chapter 5

trend toward cavities and periodontal disease during and after adolescence.
Because the health habits formed in childhood significantly affect maintenance and improvement of subsequent health, we need to further increase

The future envisioned by Lion

awareness to establish good health habits. Specifically, we are aggressively
expanding activities such as instruction on toothbrushing at local community
events and extracurricular activities aimed at kindergartens, elementary
schoolchildren and mothers.
Since 2012, we have also conducted surveys in Ishigaki, Okinawa Prefecture, in cooperation with the municipal board of education, school nurses
and school dentists, to investigate toothbrushing habits of elementary andjunior high school students, and gauge parental awareness. The aim, besides
using the results to establish good health habits, is to "develop a healthy
community, beginning with children's oral health" across the entire region.

56

Causes of lost teeth

Other

25.8%

Periodontal
disease41.8%
Caries32.4%

Campaign to strengthen awarenessof periodontal disease

Activities for each stage of life — Adulthood

Few people notice periodontal
disease because it causes nopain, but it is a serious illness that
leads to loss of teeth. From the8020 Promotion Foundation's"Investigation Into the Removal of
Permanent Teeth."

Oral health initiatives for adults
The biggest topic related to adults is combatting periodontal disease.
Proper care at this stage is important, both in regard to the goals of the8020 Campaign, and in its connection to future health.
Periodontal disease occurs when periodontal bacteria, etc. multiply inspaces between the teeth and gums (periodontal pockets), or in accumulated
plaque. It is a terrible illness and the number one cause of tooth loss. In
lifestyle habits is a key to preventing periodontal disease. Smoking, accumulated fatigue, lack of sleep, and stress can reduce the body's resistancein particular increases the likelihood that periodontal disease will progress,
because it creates an environment inside the mouth that is conducive to thegrowth of periodontal bacteria, and nicotine suppresses the capillaries' ability to protect the body. In many cases, the disease becomes quite severe
before it is even noticed. Furthermore, reduced immunity due to stress canexacerbate periodontal disease and make healing difficult. In oral health ini-

The future envisioned by Lionand are major factors that increase the risk of periodontal disease. Smoking

Chapter 5

addition to daily care with a toothbrush and inter-dental brush, improving

tiatives for adults, it is essential that educational activities such as these be
carried out thoroughly.
57

Activities for each stage of life — Adulthood

The Lion Foundation for Dental
Health's Periodontal Disease Risk
Examination Program provided
examinations and instruction to980 participants on November
24-25, 2012.

Periodontal disease can lead tobodily disease
The mouth is the entranceway for infection
Recent research has revealed that periodontal disease has an adverse effect ona variety of systemic diseases, such as diabetes and arteriosclerosis. The mouth,
besides being the entranceway for food, is also the port of entry for things likebacteria and viruses. Especially in the case of periodontal disease patients, themucous membranes that normally prevent bacterial invasion have become soreinside the periodontal pockets, which allows bacteria to easily enter capillaries

Chapter 5

and spread throughout the body. Periodontal disease bacteria entering the body
have been found to worsen diabetes, as well as increase the risk of arteriosclerotic diseases such as cerebral infarction and myocardial infarction.

The future envisioned by LionAt Lion, we are cooperating with health care workers to further clarify theconnection between periodontal disease and systemic disease. We will continue to propose effective measures, while developing activities to raise the general public's awareness of periodontal disease. We put great energy into implementing our own independently developed programs such as The Periodontal Disease Risk Testing Program and The Periodontal Disease Prevention Program. Other activities include surveys of lifestyle habits, occult bloodmeasurements in gums, and measuring levels of mouth cleaning. From these
we determine a person's risk of periodontal disease in the future, and urge thesubject to beware of any risks.

58

A breakdown of the Health InsuranceSociety's insurance benefit costs
Meal expenses
while hospitalized

0.7%

Other medical
benefit expenses

20.0%

Hospitalization

24.0%

Dentistry

13.8%

Outpatient

41.5%

The medical costs of treating
periodontal disease

Activities for each stage of life — Adulthood

A breakdown of 2007
medical benefit expenses(cash benefits, excluding
extra benefits) which
totaled 1,405.4 billion yen.

The worse a person's periodontal disease, the higher the medical costs
The rate of periodontal disease infection is extremely high, and has been cited as acause of rising health care costs. According to a survey by the Ministry of Health,
Labor and Welfare, periodontal disease is increasing rapidly in people over 40, andit was revealed that about half of Japanese people from 40-64 years old have periodontal disease pockets (periodontitis). This is a cause of ballooning dental expenses, as dental care costs comprise about 14% of the Health Insurance Society's mediaround one-fifth of overall benefit costs. In addition, because periodontal disease
can also lead to systemic disease, the more people who have periodontal disease,results, people with periodontal disease have 21% higher medical costs on averagethan those without periodontal disease.
To protect the health of people like these who are in the prime of life, Lion
proposes individualized programs tailored to each company to raise employee
awareness of periodontal disease prevention. This aspect of our ongoing industrial dental health activities for workplaces is aimed at optimizing the Health

The future envisioned by Lionthe higher total medical costs tend to rise. According to some published survey

Chapter 5

cal benefit costs. Excluding hospital treatment, dental care expenses now make up

Insurance Societies' medical expenses.
Significant results, such as savings of around 28,000 yen per person over six years indental care costs, have been achieved at companies participating in Lion's initiatives.
59

Activities for each stage of life — Old age

Keeping the mouthclean extends healthy
life expectancy for
elderly people.

Aiming to extend life
expectancy and health
Oral health initiatives for the elderly
With our oral health initiatives for the elderly, we continue to help
people lead longer, healthier lives. Japanese men’s and women’s life
expectancies are among the highest in the world, although the healthy
life expectancy of an independent (not bed-ridden) person remains at
71.19 years for men and 74.21 years for women (2014, Ministry of
Health, Labor and Welfare). At The Lion Foundation for Dental Health

Chapter 5

we aim to extend healthy life expectancy by maintaining oral health, andhelp people remain independent throughout more of their lives.
For example, at special nursing homes for the elderly in Kyotango,

The future envisioned by Lion

Kyoto Prefecture and Neyagawa, Osaka Prefecture, we are taking measures to prevent aspiration pneumonia through oral care. When elderly
people swallow food, some of it can inadvertently enter the airways, andif the mouth and dentures are not kept clean, bacteria can enter the lungs,
possibly leading to pneumonia. Therefore, by providing oral hygiene
instruction to the elderly and to the facilities' staff, our activities prevent
pneumonia. By deploying useful care methods nationwide, we are helping to extend healthy life expectancy.

60

Activities for each stage of life — Old age

Using various tools tomaintain and improveoral function

Preventing dementia by improving oral function
The Lion Foundation for Dental Health also conducts research studies
to develop concrete approaches to maintain and improve oral function,and to contribute to the health of the elderly.
We carried out an investigative survey from 2012 to 2013 in Miyakojima, Okinawa Prefecture on preventing deterioration of cognitive function by improving elderly people's oral function. This study was jointly
Metropolitan Institute of Gerontology. With the cooperation of local
dental hygienists and public health nurses, we carried out a five-montholder. Elderly people doing various exercises to improve oral function
increased their biting strength and swallowing strength, which also improved their functions of execution and alertness. This, in turn, slowed
the decline of cognitive function. These results were announced at an
information meeting at Miyakojima Hirara Health Center at which theimportance of oral care was demonstrated to dental hygienists and offi-

The future envisioned by Lionoral function improvement program involving 162 people aged 65 or

Chapter 5

conducted by The Lion Foundation for Dental Health and the Tokyo

cials of senior care facilities.

61

Activities for each stage of life — Old age

Maintaining oral health through“Healthy mouth — Beautiful mouth”
exercises
To enjoy delicious food forever
The Lion Foundation for Dental Health developed "Healthy mouth - Beautiful mouth” exercises that make it easy for elderly people to enhance their oral
function and overall health. Three exercises that vitalize the area around themouth, biting strength and swallowing strength are combined to train themuscles that support oral function, thereby preventing aspiration and choking
accidents.

Chapter 5

Exercises to vitalize the area around the mouth strengthen muscles of thelips and cheeks, helping to prevent food spillage while enabling proper pronunciation as well as a wide range of facial expressions that enhance elderly

The future envisioned by Lion

activity and sociability. Exercises to vitalize biting strength make eating safer
by enhancing chewing power and increasing saliva flow, which clean theinside of the mouth, prevent caries and periodontal disease, and facilitate
swallowing. Biting firmly also activates the brain and helps prevent dementia.
Exercises to enhance swallowing strength train the muscles used for swallowing food, which prevents the aspiration of food and saliva into the trachea.
The Lion Foundation for Dental Health holds oral care workshops in cooperation with various municipalities to promote “Healthy mouth - Beautiful
mouth” exercises. We develop these activities to help the elderly continue toenjoy delicious food, happy conversation and lives filled with laughter.

62

Activities for each stage of life — Old age

A DVD was produced
that gives an easy-tounderstand introduction
to methods and resultsof "Healthy mouth —Beautiful mouth” exercises. Our activities
promote improved
vitality of the mouth.

“Healthy mouth — Beautiful mouth” exercises

Lesson 1

Exercises to vitalize
the area around the mouth
1Make "ooh" and "eeh" sounds, exaggerating
the changes in mouth shape.

eeh

Pucker your mouth strongly.

The future envisioned by Lion

2

Pull your lips wide.

Puff your cheeks out big.

Puff out yourleft cheek.

Puff out yourright cheek.

Chapter 5ooh

Puff out
both cheeks.

63-renowned
alth
The world
Dental He
r
fo
n
o
ti
a
d
Lion Foun

T h e p re s e n t a t i o n o f t h e
Clinical Research Award
from the American Academyof Periodontology.

Clarifying the connection
between periodontal disease andmetabolic syndrome● Winning double prizes, in Europe and America
With periodontal disease identified as the cause of various diseases, in 2011
The Lion Foundation for Dental Health carried out epidemiological studies toshow that periodontal disease worsens metabolic syndrome. Metabolic syndrome can cause various lifestyle diseases, and a global response is required todeal with this affliction because it increases the risk of stroke and myocardial
Chapter 5

infarction. However, the discovery that measures to prevent periodontal diseasealso prevent metabolic syndrome was a major breakthrough.
In November 2011, this research earned a Clinical Research Award from theAmerican Academy of Periodontology. It was the first time that the award was

The future envisioned by Lion

won by Japanese.
At Europerio7, held the following year in June 2012, a paper by The Lion Foundation for Dental Health was awarded first prize among papers on periodontal
disease that had been published over the previous three years.
As a scientific research institute approved for funding by the Ministry of Education, Culture, Sports, Science and Technology, The Lion Foundation for Dental
Health has received high evaluations for its research, and the two awards fromthe United States and Europe, respectively, attracted worldwide attention.

64

"Polish Your Health,
Increase Your Smiles"
is a 200-page pocket
edition simply organized with plenty ofillustrations.

Proposals for healthy habits
at each stage of life
The "Polish Your Health, Increase Your Smiles" series is published
At Lion, we believe that the secret to happy everyday living is to "examine your health and develop good habits." Therefore, our wide range ofactivities delivers information for better health in general, not only for theteeth and mouth. In 2015, we published the “Polish Your Health, IncreaseYour Smiles” series of books about adopting good health habits at eachstage of life.
Papa To Do" is oriented toward early childhood, and explains child-rearing tips for everything from nutrition to discipline. For schoolchildren
school". For adults there is "The body's danger signals that go surprisingly
unnoticed by working-age people — Notice them to instantly turn yourlife around." For the elderly, "A healthy head and body — Training for a
lifetime of health" is packed with information on how to stay healthy andmaintain an active life. Each of the books is aimed at helping a particular
generation enjoy happy living now and in the future, on the basis of

The future envisioned by Lion

there is "74 Habits for developing effective kids that they don't teach in

Chapter 5

Of these four books, the one entitled "58 Things Baby Wants Mama and"health, comfort, and environment."

65

Promotional efforts include Lion
Dental Products Co., Ltd.’s Dent.File magazine introducing dental
clinics and dental hygienists
working in the field of preventive
dentistry.

Another topic:
Preventive dentistry
Aiming to make preventive dentistry a habit
In addition to the aforementioned life stage-specific care, Lion is also
working to "make preventive dentistry a habit" in the future. Preventive
dentistry provides appropriate care to maintain functions that prevent
mouth diseases. Lion advocates concrete measures to establish regularprofessional care by dentists, etc., and develop daily self-care routines.
Lion also includes other groups vigorously promoting preventive dentistChapter 5
The future envisioned by Lion66

ry. Lion Co., Ltd. brand campaigns and advertising promote relevant consumer education. Lion Dental Products, which sells dental supplies anddental treatment equipment, provides dentists and dental hygienists with
up-to-date information. We also support preventive dentistry by encouraging more clinics to provide it. Besides urging consumers to get regularcheckups and maintenance visits, The Lion Foundation for Dental Healthis also intensifying efforts to provide information to dental clinics. Multifaceted activities by each company are spreading awareness about thisfield.

The roots of the Tokyo Dental
Clinic, a leading preventive
dentistry clinic, go back to theestablishment in 1921 of theLion Dental Clinic for Children,
Japan's first specialized dental
clinic for children.

Strengthening preventive dental care at the Tokyo Dental Clinic
The Lion Foundation for Dental Health is actively introducing preventive dentistry into its dental practice. The Tokyo Dental Clinic is making amajor shift away from the conventional treatment of symptoms involving
grinding, pulling, and putting in false teeth, to a prevention and control(maintenance) system aimed at prevention of recurring problems.
Because dental caries do not heal naturally, and restoring gums to theirbe said that dental diseases are irreversible. In the U.S.A. and countries innorthern Europe, where dentistry is more developed, prevention and conpeople visiting dental clinics for maintenance procedures. Therefore, theTokyo Dental Clinic has set up a reception system for maintenance, where
patients can receive guidance about risk control dentistry consisting of
preventative treatments tailored according to each patient's risk of dental
and oral diseases. Up to seven different types of tests, including saliva
PH, bacteria counts in saliva, etc. are used to accurately determine the

The future envisioned by Liontrol of dental disease (maintenance) are common, with over 80% of

Chapter 5

previous state after periodontal disease occurs is almost impossible, it canpatient's risk level, and regular care helps to maintain mouth health.

67

Putting dental hygienists
in charge of preventive dentistry
Implementing detailed maintenance with a patient-centered system
At the Tokyo Dental Clinic, dental hygienists play a major role in effectively implementing risk control dentistry. While the dentist has final
responsibility for the patient, management of care for patients whose caries
treatment is finished, or whose periodontal disease condition has stabilized,
shifts to the dental hygienist. Dental hygienists, who have learned high-level techniques of professional care, perform specialized risk examinations
Chapter 5
The future envisioned by Lion68

and accordingly carry out maintenance work such as scaling, etc. The
Tokyo Dental Clinic has also introduced a system that assigns each patient a
dental hygienist in charge of that patient's ongoing care, providing a consistent program of prevention and health guidance. The dental hygienist is
actively involved in maintaining the health of the patient's teeth and mouth.
The Lion Dental Clinic For Children, predecessor of the Tokyo Dental
Clinic, was the training clinic for the first dental hygienists (called dental
hygiene nurses at the time) in Japan. A culture that prioritizes constant dedication to the health of the patient and tackling new challenges has been
passed down and has been consistently maintained for over 90 years.

Thai elementary schoolchildren
participate in the 70th Schoolchildren's Mass Toothbrushing Training via the Internet.

The Schoolchildren's
Toothbrushing Tournament
expands worldwide
Targeting participation by 5,000 schools and 500,000 people overseas
The Schoolchildren's Mass Toothbrushing Drills that helped prevent so many
children's cavities continue to evolve more than 80 years after their start in 1932.
The activity has changed from group toothbrushing exercises to more individualized tutorials that address lifestyle habits, including toothbrushing. Beginning withthe 65th such event in 2008, it has also been delivered simultaneously over theInternet, making it easier for people to participate.
countries, beginning with Taiwan in 1984, followed by South Korea, China, thePhilippines, Vietnam, Thailand, Malaysia and Indonesia. Participation in the Oraland at the 72nd such event held in 2015, in addition to 1,287 schools from Japan,
15 schools from seven different countries and regions in Asia also participated. The
total number of participating schools reached 1,302. Therefore, the training has
grown into a large, international event. With delivery over the Internet, students
can participate from their own country and school using the same teaching materials. This event has been highly praised by officials as "a fun way to learn about the

The future envisioned by Lion

Health Event of Tooth Brushing for Children is thereby increasing year by year,

Chapter 5

Lion has also expanded its oral health activities overseas with a focus on Asian

health of the mouth and teeth." Lion's goal is to have one million children from
20,000 schools in Japan, and 500,000 children from 5,000 schools overseas participate in the event. Our motivation to improve children's health continues to grow.
69

The Touch and UnderstandToothbrushing Book witheasy-to-understand 3D
representations (left) andKidzania Tokyo (right).

Meeting the challenge ofmaking information barrier-free
Bringing oral health activities to everyone
At Lion we are diversifying our delivery of information to bring our various oral health initiatives to more and more people.
To provide barrier-free information for the visually impaired, we issue
product information twice a year in Braille and large print, and have been
providing dental instruction to people with disabilities since 1994. We
also created the Touch and Understand Toothbrushing Book in 2004, as a
Chapter 5
The future envisioned by Lion70

way of deepening understanding of oral hygiene. The book uses pictures
and tactile three-dimensional representation techniques such as those usedat schools for the blind, as using the sense of touch apparently makes
learning much easier.
In addition, in 2006, the 110th anniversary of its first toothpaste for sale,
Lion set up a mock dental clinic at the work experience theme park forchildren, Kidzania Tokyo. Trying out a dentist's job in a simulated work
environment is a fun way to teach children about the importance of teeth.

COI: The Center of Innovation Program

Working to extend healthy
life expectancy
Taking part in a national project for the future
Lion is taking on the challenge of participating in the Ministry of Education, Culture, Sports, Science and Technology's Center of Innovation Program (COI STREAM). For this national project, government, industry, andacademia collaborate on an innovative research agenda for the future. Joining a team based around Hirosaki University, Lion is developing methodsof predicting and preventing diseases such as lifestyle-related illnesses that
medical data (big data) gathered from citizens of Hirosaki over many years.
Many research institutions and private enterprises also joining the teamLion aims to clarify the relationship between dental diseases and metabolic
syndrome. In this program, medicine and dentistry are joined in unusual
ways, and expectations are growing for the research to yield groundbreaking results.
Since 1913, Lion's oral health initiatives have consistently taken on thechallenges of the times. We will tirelessly address challenges in the future

The future envisioned by Lion

address the challenges from different perspectives. As part of this initiative,

Chapter 5

influence healthy life expectancy. The project is using huge amounts of

to make people happier through oral health.

71

ation:next gener
e
th
f
o
s
e
g
the challen
Taking onm
Symposiu
The LDHThe symposium was held at the
Toranomon Hills Forum in Tokyo,
with the backing of organizations
such as the Japan Dental
Association, the 8020 Promotion
Foundation, and the Japan
Dental Hygienists’ Association.

Aiming for dental care that makes
greater contributions to healthy longevity● Symposium held for dental care workers
On June 26, 2016, the Lion Foundation for Dental Health held a symposium with thetheme of “The mission and possibilities of dental care aimed at extending healthy life
expectancy”, in which researchers, dentists, and others who are active in the forefrontof the dental care field gathered for lectures and comprehensive discussions. Taking
the stage for the keynote address was former American Academy of Periodontology
president Joan Otomo-Corgel, who stressed the importance of that mission: “In the
U.S., there are reports on the relationships between periodontal disease and diabetes,
heart disease, osteoporosis, respiratory illness, and more. Now more than ever, dental
Chapter 5care workers are standing as the front line of defense for overall health.” Furthermore,
Professor Ichiro Tsuji of the Tohoku University Graduate School asserted that coordination between medical and dental care is essential to extending healthy life expectancy, and that implementing such cooperation is a matter of urgent importance. Pro-

The future envisioned by Lion

fessor Atsuo Amano of the Osaka University Graduate School explained the mechanism by which periodontal disease bacteria have a negative impact on the entire
body, and emphasized the necessity of oral health maintenance throughout one’s
lifetime. In addition, panel discussions, which were also joined by private practitioners,
developed into heated debates. There was a shared recognition between participantsthat in order to overcome periodontal disease, which is said to be humanity’s mostwidespread infectious disease, there is a need for cutting-edge treatments as well as
long-term preventive dental care from regional dental clinics. The discussions becamea meaningful opportunity to shed light on the best path for the future of dental care.

72

fosters
LDH booke
ing cultur
toothbrush“A 100-Year Tale ofToothbrushing”, B5
softcover, 258 pages
Edited: Lion Foundation
for Dental HealthPublished: Diamond, Inc.

How did the custom of people brushing
their teeth come to be?
● LDH publishes "A 100-Year Tale of Toothbrushing"
When did people first start brushing their teeth, and how did it become an everyday
custom? In 2017, the Lion Foundation for Dental Health published the book “A
100-Year Tale of Toothbrushing” which puts the focus on toothbrushing, the mostfundamental activity for promoting oral health, and introduces its history and the progress made by activities that helped to spread and establish it.
The first chapter looking back on history is a fascinating introduction to toothbrushing customs from before the modern era, combining historical records that begin withthe toothpastes used in ancient Egypt and the Roman era, along with the toothbrushpicks, and the Edo-period Japanese method of rubbing the teeth with sand and salt.
Chapter 2 covers Japan’s Meiji era onward and goes into details about the progress

Chapter 5

ing methods of the upper class in Japan’s Heian period which made use of tooth-

made through oral health promotion activities by Lion and other private enterprises
habit in Japan. Then, Chapter 3 presents an overview of the many diverse and ingenious efforts that went into producing unique advertisements and promotions as well
as books, picture books, movies, and events for informing large numbers of people
about the importance of toothbrushing. Chapter 4 is titled “Brushing your teeth isbrushing up your health” and it explains toothbrushing’s newly recognized role as acontributor to overall health and healthy longevity. From start to finish, the book’s

The future envisioned by Lionalong with dentist organizations to help toothbrushing become an established daily

pages are filled with rich visuals and it’s easy for anyone to read. It’s a book thatserves as a truly valuable resource regarding cultural and lifestyle history.

73