Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -22

12〈Special article〉――――――――――――――――――――――――――――――――――――――

Factors Related to Oral Health Status of Disaster Victims
9 Months after Great East Japan Earthquake
Mitsuo Kishi* Fumie Aizawa* Miki Matsui* Ruriko Suzuki**
Hiroyuki Miura*** Yukari Yokoyama**** Kiyomi Sakata***** Akira Ogawa*******Division of Preventive Dentistry, Department of Oral Medicine,
Iwate Medical University School of Dentistry**Faculty of Community Nursing, Iwate College of Nursing***Division of Orthodontics, Department of Oral Health Enhancement,
Iwate Medical University School of Dentistry**** Faculty of Social Welfare, Nihon Fukushi University*****Department of Hygiene and Preventive Medicine,
Iwate Medical University School of Medicine*******President of Iwate Medical University
東日本大震災 9 か月後の被災地住民の口腔の健康状態に関する要因
岸光男 *三浦廣行 ***

相澤文恵 *

横山由香里 ****

松井美樹 *

鈴木るり子 **

坂田清美 *****

小川 彰 ******* 岩手医科大学歯学部口腔医学講座予防歯科学分野** 岩手看護短期大学地域看護学専攻*** 岩手医科大学歯学部口腔保健育成学講座歯科矯正学分野**** 日本福祉大学社会学部社会福祉学科***** 岩手医科大学衛生学公衆衛生学講座****** 岩手医科大学理事長 学長＜ Abstract ＞
Nine months after the Great East Japan Earthquake, we performed an oral health survey including
questionnaire and oral examinations for 2001 individuals living in Otsuchi Town, one of the most severely
damaged municipalities by the disaster.
As compared with Japanese national survey, our subjects had greater numbers of decayed teeth andteeth with a periodontal pocket. Among 357 subjects who had visited dental facilities before the disaster,
the dental care remained interrupted in 35.6% at the time of the survey. Past and current oral conditions
were worse in subjects whose dental care remained interrupted or whose removable dentures had been lostor damaged as compared to others. In conclusions many living in a severely damaged area required dental
care at 9 months after the disaster. Providing continuous dental care was needed for people in the victim
area.

13

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -22＜要旨＞
東日本大震災から 9 か月後，我々は被災地の中でも最も震災被害が大きかった自治体の 1 つである大槌町において，2001 名の住民に対してアンケートと口腔診査による口腔保健調査を行った。その結果，同年行われた国の保健統計調査
である歯科疾患実態調査と比較して，調査対象集団において未処置歯，歯周ポケットを有する者の割合が高かった。また震災前に歯科受診していた 357 名のうち，35.6% の者が調査時点でいまだ歯科治療が中断されたままだった。歯科治療が中断されたままだった者および可撤性床義歯が紛失もしくは破損した者において，震災後に食事や会話に問題を感じた者が多く，かつ調査時点での口腔の主観的健康状態も不良であった。
結論として，震災から 9 か月経過した時点においても被災地住民は歯科保健医療を必要としていた。震災直後には多くの医療支援が行われたが，被害の大きい被災地域ではその後の継続的歯科保健医療の提供が必要である。

Keywords
dental treatment behavior

歯科受療行動community dentistry		

地域歯科保健disaster			

災害

oral health survey		

歯科保健調査epidemiology			

疫学Ⅰ．Introduction

oral as well as systemic health. However, it

On March, 11, 2011, a larger earthquake (Theis unclear how disaster-related subsequentGreat East Japan Earthquake) with a measuredchanges in lifestyle influence oral health, asmagnitude of 9.0 followed by a giant tsunami

few studies of post-disaster conditions of oral

struck the north-east area of Japan facing thehealth in victims have been reported.1,2) In the

Pacific Ocean, with many towns and cities

present study, we surveyed the oral healthsuffering catastrophic damage. Consequently,

conditions of community dwelling individuals

many functions of the administrative andin Otsuchi Town, which was severely affected

medical institutions in those communities wereby the disaster, 9 months after the earthquake.

lost, while most survivors were forced to livein shelters or temporary accommodations.

Ⅱ．Methods

According to TV and newspaper reports

1. Subject town

immediately after the disaster, water

Otsuchi Town, located on the Pacific Ocean

availability was insufficient, and meals were

coast of Iwate Prefecture, Japan, sufferedmainly from freeze-dried pouches or masssome of the most severe damage in The Great

production bread. Therefore, the oral hygiene

East Japan Earthquake (Figure 1). The mainof the victims likely deteriorated, as lack ofindustries in the area are fisheries and fisherywater can reduce oral care performance, andrelated businesses such as processing andfoods containing abundant sugar and caking

services. The main administration, commerce,

additives can easily stagnate in the oralsightseeing, and inhabitable areas were locatedcavity and on tooth surfaces. Furthermore, an

primarily along the coastline, and inundated

unbalanced diet may adversely affect the oral

by a giant tsunami. Dental facilities were

mucosa and periodontal tissue. Hence, there

exclusively located in this area (Figure 2). Prior

was community concern about decreases into the disaster, there were 6 dental offices

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -22

14

Pacific ocean

岩手県

Iwate Pref.

Otsuchi town

Otsuchi bay
1 km
Tsunami inundated area
Locations of dental clinics before the disasterFigure 2 Tsunami inundated area of
Otsuchi town.

Prior to the examinations, town officials

Figure 1 Location of Otsuchi town in
Iwate Prefecture

notified all inhabitants 18 years old or older
and recommended their participation. Elevenvenues for the check-up examinations werein the town, all of which were destroyed. At

prepared during the 15-day survey period

the time of our survey (9 months after the(December 8-22, 2011), since Otsuchi Town

disaster), dental services were being provided

consists of an amalgamation of several smaller

by a temporary dental clinic.

and geographically separate communities. At

Pacific ocean

the reception for the check-up in each venue,
2. Subjects

informed
consent to participate was obtained
Otsuchitown

The pre-disaster population of Otsuchi

from the subjects. Finally, 2001 individuals

Town in 2010 was 15,300. According to theparticipated in our study, with age and genderreport of the town administration in Octobersummarized in Table 1.

2011, the total number of dead and missing

Otsuchi bay

1 km

This study was approved by the Medical

Tsunami inundated areain the disaster was 1322 (8.6% of population).
Ethics Committee of Iwate Medical University
Locations of dental clinics before the disasterIn addition, a large number had evacuated(H23-69) and conducted in accordance with theand were living elsewhere. Consequently

guidelines of the Declaration of Helsinki.

the population at the time of our survey wasdecreased to approximately13,000.

3. Data collection

We attempted to investigate the oral health

Geographic data for subject homes before

status and oral health-related experiences

disaster were obtained from the town

following the disaster of all adult dwellers

administration. To classify damage levelsof Otsuchi Town 18 years old or older. Ourcaused by the disaster, the subjects weresurvey was planned to be performed at

divided into 3 groups based on the degree

the same time of systemic health check-up

of destruction of their home, as follows: 1. no

examinations, which were conducted by thedamage, 2. partially destroyed or flooded, 3.

town government as a public health service.

entirely destroyed.

15

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

Field surveys including questionnaire

12 -22each subject into 4 levels; “very good” (score 1),

surveys and oral examinations were“good” (2), “not so good” (3), and “bad” (4).

performed from December 8-22, 2011. For

To complete the questionnaire, interviewsthe questionnaire surveys we used a custom

were done by public nurses or dental

designed questionnaire, consisting of thehygienists. After the questionnaire survey, oral

following items. First, we queried experiences

examinations were performed. Dental caries

with dental care. The subjects were asked

status was assessed according to the method

whether there was an interruption of dentalof the World Health Organization (WHO).

therapy being received before the disaster.

Subsequently, periodontal conditions were

The answer choices were “no dental care wasassessed using a community periodontal index

being received before the disaster”, “care is(CPI) based on procedures and diagnostic

continuing”, “care was interrupted and has

criteria recommended by the WHO.3)

been resumed,” and “care remains interrupted.”
4. Data analyses

We also asked regarding loss or fracture ofa plate denture as a result of the disaster,

Descriptive statistics were produced toand the answer choices were “yes”, “no,” andreveal the oral health status of the subjects“wearing no dentures”. If the respondent choseand compare them with national averages.

“yes,” they were subsequently asked whether

To compare proportions between subjects

they had received a re-restoration or repair

and national survey results, Fisher's exactof the denture prior to the day of the survey.

test was used, while a t test was used to

Next, we queried the history of oral status.

compare averages between those. To examine

The subjects were asked whether oral-healththe relationships of age and damage level

related problems occurred after the disaster,with oral health condition, a chi-squared test

such as “difficulty with eating”, “difficulty withfollowed by a multiple comparisons test using

speaking,” and “ashamed to laugh”. In addition,

the Ryan method was performed. 4) Similarly,

current oral-health status was assessed bya chi-squared test was used for analyses ofTable 1 Numbers of subjects by age and genderAge group (in years)
18-29
Male

Female

Total

a

30-39

40-49

50-59

60-69

70-79

≥80

Total

Populationa

628

689

792

1019

1118

798

366

5410

No. of subjects(percent)
Average ageb

22
(3.50)
24.1±4.4

48(6.97)
35.2±2.7

66(8.33)
44.2±2.7

97(9.52)
55.1±2.8

245(21.9)
64.9±2.7

236(29.6)
73.9±2.8

55(15.0)
82.3±2.0769(14.2)
62.9±14.2

Populationa

635

603

812

953

1176

1131

777

6087

No. of subjects(percent)
Average ageb

37
(5.83)
24.9±3.2

101(16.7)
34.4±2.8

131(16.1)
44.6±3.8

196(20.6)
55.1±2.8

406(34.5)
64.3±2.9283(25.0)
73.8±2.6

78(10.0)
82.5±2.7

1232(20.2)
60.4±14.5

Populationa

1263

1292

1604

1972

2294

1929

1143

11497

No. of subjects(percent)
Average ageb

59
(4.67)
24.6±3.7

149(11.5)
34.7±2.8

197(12.3)
44.4±3.4

293(14.9)
55.1±2.8

651(28.4)
64.5±2.9

519(26.9)
73.8±2.7

133(11.69)82.4±2.4

2001(17.4)
61.4±14.4

Source: Government of Otsuchi Town. Population numbers for subjects 18-20 years old were estimated from the values for the age group
15-19 years old.
b
Values show average age in years ± standard deviation.

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -2216

the relationships among responses to our

decayed teeth in our subjects as compared

questionnaire. In addition, to compare averages

with those obtained in the National Survey ofamong multiple groups, Sheffe’s multiple

Dental Health in 2011.5) Data are summarized

analyses of variance (ANOVA) was utilized.

by age and gender in Table 2. In subjects

Statistical analyses were performed using theaged 40 years and older, there were lower

software package SPSS 19.0 for Windows (SPSS

numbers of present teeth as compared with

Inc., Chicago, IL, USA).

the national averages for both gender groups.
Also, a comparison of the numbers of decayed

Ⅲ．Results

teeth between our subjects and the national

1. Comparisons of oral conditions between

averages showed that the present subjects

subjects and national survey

in the 40s and 50s age groups had greaternumbers of decayed teeth. On the contrary, for

The average numbers of present andTable 2 Average numbers of present and decayed teeth in subjects bygender and age groupa
Table 2. Average numbers of present and decayed teeth in subjects by gender and age groupa

Age group (in years)
Male

Female

18-29

30-39

40-49

50-59

60-69

70-79

≥80

Present28.6±1.06(28.9)

27.9±3.18(28.5)

24.6±4.68**(27.4)

19.9±8.46**(25.0)

16.5±9.79**(22.0)

12.1±10.1**(16.6)

9.60±10.1*(12.4)

Decayed1.45±2.54(1.44)

2.21±3.77(1.25)

2.95±4.16**(0.91)

1.52±2.28(1.17)

1.12±2.24(1.12)

1.02±2.27(1.24)

0.84±1.78**(1.50)

Present28.5±1.74(28.1)
0.49±1.04(0.87)

28.1±2.23(28.4)
1.29±2.29*(0.81)

25.5±3.97**(27.5)
1.85±3.13**(1.09)

20.3±7.12**(25.1)
1.34±2.81*(0.85)

13.7±9.68**(21.8)
0.74±1.59*(0.91)

7.45±9.18**(16.5)
0.45±1.19**(0.77)

5.60±7.21**(9.92)
0.42±0.96**(0.93)

28.5±1.51(28.4 )
0.85±1.80(1.08)

28.0±6.43(28.4)
1.58±2.87*(0.98)

25.2±4.23**(27.5)
2.22±3.53**(1.02)

20.1±7.58**(25.1)
1.40±2.64**(0.98)

14.7±9.81**(21.9)
0.88±1.87(1.00)

9.55±9.90**(16.6)
0.71±1.79**(0.99)

7.26±8.72**(11.0)
0.59±1.37**(1.18)

Decayed

Total

Present
Decayeda

Values are shown as the average ± standard deviation.
Values in parentheses are averages from the National survey conducted in 2011.
*p<.05, **p<.01; significantly different from National survey result (t test). The age group of 18-29 years was compared with that of
20-29 years in the National survey.

aTable
3 Numbersubjects with a periodontal pocket
Table 3. Number of subjects
with a periodontal
pocketofa

Age group (in years)
18-29

30-39

40-49

50-59

60-69

Male

2/22 (9.09)
18.2

21/48 (43.8)
26.0

27/66 (40.9)
35.3

56/89 (62.9)
46.4

115/202 (56.9) 94/164 (57.3)
59.9
61.8

21/32 (65.6)
69.3

Female4/37 (10.8)
11.2

18/100 (18.0)
19.5

64/132 (48.5)* 78/184 (42.4)
23.9
38.0

145/306 (47.4) 62/133 (46.6)
45.5
49.6

19/32 (59.4)
55.7

Total

6/53 (11.3)
13.7

39/148 (26.4)
22.0

91/198 (46.0)* 134/273 (49.1) 260/508 (51.2) 156/297 (52.5) 40/64 (62.5)
28.0
41.3
51.5
55.1
62.0

a

70-79

≥80

Data for subjects with at least 1 index tooth in the CPI (n=1547).
Numerator/denominator: number with a periodontal pocket/number of subjects excluding those with no index tooth (percent rate).
Lower number: Percent rate of subjects with a periodontal pocket among those with no index tooth from the National survey in 2011.
*Significantly different (p<.05) as compared with the National survey result (Fisher's exact test).

2

17

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -22the group aged over 60 and over, the number

visited a dental clinic for treatment prior toof decayed teeth in our subjects was less thanthe disaster. The lowest rate was observed in

the national average.

the age group less than 40 years old (13.8%),

CPI results showed that the proportion

while the highest was the 50s group (23.5%).

of subjects in the 40s age group with a

For the 357 subjects, 10.6% did not have careperiodontal pocket (code 3 and 4) was higher

interrupted by the disaster, 53.8% had carein our subjects than in those in the national

interrupted and then resumed, and dental caresurvey. However, there was no difference

for 35.6% remained interrupted at the time of

between age groups 50 years old and older

our investigation. A chi-squared test results(Table 3).

showed that there were significant differences
regarding the proportion of subjects whose

2. Experienceswith dental care before anddental care remained interrupted among theafterthe disasterage groups. The proportion with interrupted

For this section, we categorized the subjects

care was highest in the youngest age groupaged 18-29 years old and those in their 30s(less than 40 years) and decreased gradually

into a single group of less than 40 years old,with age until the 60s, then increased again in

because no difference was found regarding thethe 70s and 80s. A multiple comparisons test

responses to the questionnaire between thoseshowed that the proportion of subjects who

2 age groups.

had interrupted dental care was significantly

Among our subjects, 357 (17.8% of all) had

higher in the youngest age group as comparedTable
4 Experiencescare after disaster by age group
Table 4. Experienceswith dental
care before and afterwith
disasterdental
by age groupAge group (in years)
<40

40-49

50-59

60-69

70-79

≥80

Total

p-value eWithout interruption

4 (13.3)

2 (6.1)6 (8.7)16 (13.2)

9 (11.4)

1 (4.0)38 (10.6)< 0.001

Once interrupted and resumed

8 (26.7)

12 (36.4)

33 (47.8)

78 (48.5)

49 (62.0)

12 (48.0)

192 (53.8)

Still interrupted

18 (60.0)*

19 (57.6) §30 (43.5)

27 (22.3)

21 (26.6)

12 (48.0)

127 (35.6)

Total

30 (100)

33 (100)

69 (100)

121 (100)

79 (100)

25 (100)

357 (100)-

38 (84.4)

107 (95.5)

342 (80.5)369 (87.4)

105 (86.1)

961 (84.6)

Experiences with dental care
Dental care before disastera, b

Loss or fructure of denture

a, c

No
Yes

-

Total
Re-restoration or repair of denture

7 (15.6)

15 (13.4)

83 (19.5)

53 (12.6)

17 (13.9)

175 (15.4)

45 (100)

122 (100)425 (100)422 (100)

122 (100)

1,136 (100)

d

No

-

4 (57.1)

6 (42.9)20 (25.6)

10 (20.4)

3 (17.6)

43 (26.1)Yes-

3 (42.9)

8 (57.1)

58 (74.4)

39 (79.6)

14 (82.4)

122 (73.9)7(100)

14(100)78 (100)49 (100)

17 (100)

165(100)

Total

0.054

0.136

a

Numbers of subjects are shown in respective age groups (percent rate). Subjects with no record were excluded from analysis.

bData for 357 individuals who had visited a dental clinic for treatments before the disaster.
Data for 1136 individuals who had worn a plate denture before the disaster. We excluded the less than 40 years age group from analysis
since there was no subject wearing a plate denture.

cdData for 165 individuals excluding non-respondents from 175 who had corrupted or lost dentures.

eChi-squared test
*Significantly higher rate than that in 50s and 60s age groups by multiple comparison tests (p<.01).
§
Significantly higher rate than that in 60s age group by multiple comparison test (p<.01).

4

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -2218

Table
5 Comparison of oral status and experiences with dental care by level of damage
Table 5. Comparison of oral status and experiences with dental care by level of damage caused by the disastera
Damage level
Oral status and experiences 1 (no damage)with dental care

2 (partially destroyed 3 (entirely destroyed)or flooded)

Total

p-value

No. of present teethb

16.2±10.8

15.5±10.4

16.4±10.8

16.1±10.7

0.303

1.05±2.06

1.00±2.41

1.13±2.36

1.08±2.30

0.565

179/389 (46.0)

190/372 (51.1)

346/767 (45.1)

715/1528 (46.8)

0.157

No. of decayed teethbWith a periodontal pocketcInterruption of dental care
Lost or fractured dentureed30/88 (34.1)

35/94 (37.2)

61/172 (35.5)

126/354 (35.6)

0.906

36/287 (12.5)

41/290 (14.1)

95/576 (16.5)

172/1159 (14.8)

0.281

a

Data was obtained from available geographic data.

b

Average ± standard deviation. The numbers of subjects in the respective damage level groups were as follows; 512 for level 1, 481 for level2, and 980 for level 3.

cData for subjects with 1 or more CPI index tooth (n=1528). Values indicate number of subjects with a periodontal pocket/all subjects in eachdamage level group (percentage).

dData for subjects who had visited a dental clinic for treatment before the disaster.Values indicate number of subjects with interrupted care/number of subjects in damage level group (percentage).
eData for subjects who were wearing a plate denture before disaster and available from geographic data.

to those in the 50s and 60s age groups. In

condition

addition, the proportion in the 40s group was

Next, we examined the relationships

significantly higher as compared with thebetween dental care-related experiences and

60s group. On the other hand, there were no

oral health status in subjects 40 years old andsignificant differences among the age groups

older. Chi-squared test results indicated thatin regard to the proportion of subjects who

the proportion of subjects with a history of

had experienced denture loss or fracture anddifficulty with eating was significantly different

subsequent re-restoration or repair (Table 4).

based on dental care-related experiences.

5

Multiple comparison tests also showed
3. Comparisons of oral conditions anddifferences between subjects who had notexperiences with dental care based on level

received dental treatment before the disasterof home damage

and those who had their dental treatments

We compared oral status and experiencesinterrupted. Similarly, a history of difficultywith dental care among the 3 groups classified

with eating was related to experiencesby damage level caused by the disaster (Table

with fractured or lost dentures. Subjects

5). There were no differences regardingwith a history of difficulty with eating were

the numbers of present or decayed teeth.

more frequently found among those with

Similarly, the proportions of subjects withexperiences with fractured or lost dentures asperiodontal pockets did not differ by damage

compared to those who did not wear dentures.

level. Furthermore, experiences with dental

Furthermore, difficulty with eating was morecare after the disaster and loss or fracture of

frequently reported by subjects who had

denture by the disaster occurred with similar

undergone re-restoration or repair of dentures

frequencies among the 3 groups.

as compared to those without fractured orlost dentures. There was also a relationship

4. Relationships between experiences with

between experiences with dental care anddental care and historical/current oral

history of difficulty with speaking (Table 6).

19

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -22

Table 6 Relationships between experiences with dental care with historical andcurrent oral condition( ≥ 40 years old)
Current
Historical oral statusc
Difficulty with eating

Difficulty with speaking

Ashamed to laughExperienced NeverExperienced NeverExperienced NeverWas not receiving care

325 (22.5)

1122 (77.5)

39 (2.7)1408 (97.3)

No interruption

7 (20.6)

27 (79.4)

1 (2.9)33 (97.1)

Interrupted and resumed

74 (40.2)

110 (59.8)

17 (9.2)

Remained interrupted

39 (36.1)

69 (63.9)

Total

445 (25.1)

1328 (74.9)

p-value< 0.001

Experiences with dental careoral

condition
AveragescoredInterruption of dental care**

29 (11.4)

1418 (4.0)

2.18

1 (62.0)33(48.0)

2.26

167 (90.8)

9(26.6)175 (48.0)

2.29

7 (6.5)101 (93.5)

2 (100)106(100)

2.71

64 (3.6)

1709 (96.4)

41 (2.3)

1732 (97.7)

-

**

0.103

< 0.001*****< 0.001(No record = 11)a
Lost or fractured denture
Wearing no denture

140 (21.7)

504 (78.3)

No

232 (24.1)

729 (75.9)

Yes

76 (43.4)

Total

448 (25.2)

p-value< 0.001(No record = 4)

14 (2.2)

630 (97.8)

35 (3.6)926 (96.4)

99 (56.6)

15 (8.6)

160 (91.4)

1332 (74.8)

64 (3.6)

1716 (96.4)

**

**
*

< 0.00117 (2.6)

627 (97.4)

2.25

17 (1.8)944 (98.2)

2.17

7 (4.0)168 (96.0)

2.42

41 (2.3)

1739 (97.7)-*< 0.001

0.151

aRe-restoration or repair ofdentureNeither fractured nor lostbNo

372 (23.3)

1224 (76.7)

Yes

17 (32.1)

36 (67.9)

Total

56 (45.2)
445 (25.1)

p-value(No record =11)a

48 (3.0)1548 (97.0)

5 (9.4)48 (90.6)

68 (54.8)

11 (8.9)113 (91.1)

1328 (74.9)

48 (3.6)

1709 (96.4)<0.001

0.190<0.001*****34 (2.1)

1562 (97.9)

2.20

3 (5.7)50 (94.3)

2.28

4 (3.2)120 (96.8)

2.70

41 (2.3)

1732 (97.7)***< 0.001a

Subjects with no record were excluded from analyses.

b

Number including subjects who did not wear a denture.
For comparison, a chi-squared test followed by Ryan’s multiple comparison of proportions were used.

cd

For comparisons, ANOVA followed by Sheffe’s multiple comparison test were used. *p<.05, **p<.001

On the other hand, history of feeling ashamedof subjects. In addition, current oral status

to laugh was not related to dental care

was significantly worse in subjects with a lost

experience.

or fractured denture as compared with those

Current oral status values assessed by thewhose denture had not been lost or fractured.

4 levels are shown as averages also in Table

Furthermore, subjects who did not undergo

6 (higher values indicate worse oral status).

re-restoration or repair even though theirAnalysis with ANOVA revealed that current

denture was lost or fractured reported worse

oral status differed based on experience withoral conditions on the day of our investigation

dental care. In findings of multiple comparisonas compared to the other subjects.

tests regarding the interruption of dental
treatments, subjects who had dental care

Ⅳ．Discussion

remaining interrupted were more conscious

Our oral examination results revealed thatof worse oral conditions than all other groups

our subjects had more decayed teeth and more

6

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

12 -2220

teeth with a periodontal pocket than subjects

present teeth than the national average (Tablein the national survey. In addition, many teeth

2) and consequently they frequently wore

were lost in the higher aged subjects (Tables

removable dentures, with the proportion of

2 and 3). Although lower numbers of decayed

denture wearers in their 40s, 50s, 60s, 70s,

teeth were found in subjects aged 50 years

and 80s shown to be 13%, 31%, 55%, 74%, andand older, that was not considered to indicate

84%, respectively (data not shown in Results

wellness of their oral condition, as it could

section). Among subjects who live in ruralalso show a low susceptibility to dental caries

areas and frequently depend on removablecaused by lack of present teeth. Based on our

dentures for their oral functions, many

findings, we concluded that our subjects had

individuals may be at risk of developing oral

worse oral health conditions than the general

problems after such a disaster. On the otherJapanese population.

hand, in denture wearers who did not lose or

On the other hand, our survey revealed

fracture their dentures during the disaster,that dental and periodontal conditions did

the proportion of those who had experienced

not differ with different damage levels (Table

oral troubles was not different as compared5), which suggests that dental disease status

with non-denture wearers. In addition, current

does not rapidly change even after such aoral status was reported as best by denturedisaster, as dental caries and periodontitis are

wearers without lost or fractured dentures,

6-8)

Furthermore,

and worst by those who had lost or fractured

Otsuchi Town is located in a remote area

dentures (Table 6). These results indicate thatof Iwate Prefecture (Figure 1). Previous

denture nonconformance occurred with very

studies of geographic variations in oral healthlow frequency as a result of this large-scale

have shown that the oral status of residents

disaster.

generally chronic conditions.

living in rural or remote areas were mostly

Among subjects with lost or fractured

worse than those of residents living in urban

removable denture, those with oral trouble

9-13)

Therefore, it was very likely that theunderwent re-restoration or repair moreoral status of our subjects observed in thisfrequently than those without such troubles

study was primarily related to natural oral

(Table 6). This finding suggests thatcharacteristics present before the disaster,

individuals with high needs for dental care willthough there could be some influences ofmake an effort to treat their problems eventhe disaster. Nevertheless, the long-term

after experiencing a disaster. Also, subjects

influence of the earthquake and tsunami

who underwent re-restoration or repair of

remain unknown, thus it will be important totheir dentures had worse oral conditions as

continuously observe the oral health status ofcompared to those who did not recieve re-these subjects in the future.

restoration or repair (Table 6). Removableareas.

Our questionnaire survey also revealed that

dentures usually require periodic adjustments.

subjects with lost or fractured removable

Kivovics et al. reported that 87% of new

dentures more frequently experienced oral

complete dentures required adjustment at

problems such as difficulties with eating andleast once.

speaking as compared to the other denture

dental resources in the disasterareas prevented

wearers (Table 6). Our subjects also had fewer

these subjects from undergoing adequate

14)

Thus, we consider that a lack of

21

Kishi et al ／ Journal of the Japan Academy for Health Behavioral Science 29（1）,2014

adjustments after re-restoration or repair.

12 -22care service, but were restricted by limited

Difficulties with eating and speaking weretime and transportation.

also frequently reported by subjects who had
dental care interrupted, includingdenture

Ⅴ．Conclusion

treatments (Table 6). Hence, for victims who

Following a severe disaster, limited dental

have been receiving dental care, it is importantresources are needed, mainly for local

to resume dental care as soon as possible

inhabitants whose dental care have been

after a disaster, which can be amajorinhibitor

interrupted, or have lost or damaged dentures,of community oral health, since individuals

as their oral health is likely impaired. In

living in fullydeveloped countries generally

addition, in order to protect the oral healthhave ample opportunities to receive dentalof victims of such a disaster, it is necessarycare. Actually, approximate 18% of all of ourto quickly establish facilities or systems that

subjects had received dental care before theprovide continuous dental care in residential

disaster.

areas.

As shown in Table 4, in the younger (under
50 years old) and the older ages (70 years or

Acknowledgement

older), the proportion of subjects who received

This study was supported by a Grant indental care was lower than the middle ages

Aid from the Ministry of Health, Labor and(50-69 years old) after the disaster. As for the

Welfare, and Health and Labor Sciences

younger ages, we speculated that they had no

Research Grants, Japan (H23-Tokubetsu-

time to receive dental care, as they spent much

Shitei-002; H24-Kenki-Shitei-001).

time in reconstruction of their daily life. As for

thank all of the staff of Otsuchi Town for their

the elderly groups, the lack of post-disasterparticipation.

We sincerely

dental treatment may have been caused bypoor accessibility to dental facilities. Elderly

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