Experts Warn of Periodontal Disease Risk in Teens: Proposing Self-Care at School, Nationwide 'Outreach Classes' for High School Students Begin Again This Year to Improve Health Literacy

Daiichi Sankyo Healthcare Co., Ltd. (Headquarters: Chuo-ku, Tokyo; hereinafter 'the Company'), in conjunction with 'Dental and Oral Health Week' (June 4-10), is issuing a warning about the risk of periodontal disease among young people. It will also provide commentary from experts on the signs and causes of periodontal disease, as well as information on self-care practices that can be incorporated into daily life. Furthermore, with the aim of improving health literacy (the ability to find, obtain, and utilize accurate health information) among young people, the Company has relaunched its 'outreach class' program for high school students this year. A video summarizing last year's sessions has been produced and is being released today on the Company's website. (Website: https://www.daiichisankyo-hc.co.jp/wellness-for good/our-activity/self-care-academy.html) The Company promotes sustainability activities with the goal of realizing a future where people, society, and the planet remain healthy 100 years from now. As part of this, it is expanding its efforts to convey the importance of learning proper self-care 'now' to protect one's future health, targeting young people living in an era of changing lifestyles and information overload. ■ Summary 1. Periodontal disease is not just an adult disease 2. 'Outreach classes' for high school students to learn proper self-care 3. Quiz: What are the symptoms suggestive of periodontal disease? (with expert commentary) 4. Self-care recommendations from expert Dr. Atsuo Amano: For lifelong health 1. Periodontal disease is not just an adult disease In recent years, the number of cases of periodontal disease progressing in young people has been increasing. A survey by the Ministry of Health, Labour and Welfare showed that more than one in five (21.2%) individuals aged 15-19 (n=144) have progressing periodontal disease (having periodontal pockets of 4mm or deeper), revealing that periodontal disease, traditionally considered a 'disease of middle-aged and older adults,' is spreading among younger generations. Background factors include changes in living environment such as increased stress, lack of sleep, and mouth breathing, as well as insufficient habituation of self-care like not using interdental brushes or dental floss, and low rates of dental checkups. Additionally, some periodontal disease bacteria prefer female hormones. During puberty, when female hormones begin to be produced (especially in teenage girls experiencing a surge in female hormones), symptoms of periodontal disease are more likely to appear, a condition known as 'pubertal gingivitis.' Given this background, early awareness and establishment of preventive behaviors among young people are becoming more important than ever. [Figure 1] Percentage of people with periodontal pockets (4mm or deeper) by age group (15 years and older) [Source: 2024 'Survey of Dental Diseases' (Ministry of Health, Labour and Welfare)] (n=8,020) 2. 'Outreach classes' for high school students to learn proper self-care The Company has been conducting 'outreach classes' to teach proper self-care to high school students since 2025. This year, starting with a session at Otemon Gakuin Otemae High School in Osaka on Thursday, May 7th, sessions are planned at eight locations nationwide (Aomori, Chiba, Tokyo, Shizuoka, Fukui, Osaka, Hiroshima, Saga). The 'outreach class' program consists of 12 sessions. High school students learn proper self-care and information acquisition methods, become 'Self-Care Ambassadors' who spread the importance of self-care to their peers, and create and present videos summarizing the knowledge they have learned. Amidst the proliferation of fake and misleading information due to the spread of SNS and generative AI, the program aims to cultivate the ability to discern and obtain accurate information without being misled by false information, as well as to foster each individual's ability to act as an information disseminator. *Conducted at 5 schools in Tokyo, Fukui, Shizuoka, Osaka, and Fukuoka, with approximately 250 participants - 'It was an opportunity to learn the correct way to brush my teeth, something I took for granted.' - 'I was interested in medicine but thought it seemed difficult and troublesome. Through the program, I learned that it is something familiar.' - 'I thought it was important to judge whether information is correct.' - 'By outputting (through video creation) what I learned (input), it left a stronger impression on my memory.' You can watch a video of last year's 'outreach class'. ▷ https://youtu.be/kCwgzl5ya94 (approx. 3 minutes 46 seconds) 3. Quiz: What are the symptoms suggestive of periodontal disease? (with expert commentary) At the beginning of the 'outreach class,' a quiz is conducted to measure the students' 'self-care ability.' Below is an actual quiz question. Which of the following is a symptom suggestive of periodontal disease? ① Bleeding gums when brushing ② Sticky feeling in the mouth in the morning ③ Often told you have bad breath ④ All of the above (①-③) ④ All of the above (Bleeding gums when brushing. Sticky feeling in the mouth in the morning. Bad breath.) [Expert Commentary] What is periodontal disease? Cavities are a disease of the teeth; periodontal disease is a disease of the gums. Periodontal disease is caused by accumulated plaque (dental biofilm) causing inflammation in the gums. Subjective symptoms include swollen gums and bleeding when brushing. As long as the accumulated plaque and tartar are not removed, the inflammation will not stop. If left untreated, bad breath begins, the bone supporting the teeth decreases, teeth become loose, and eventually, teeth may fall out. Cavities are painful, but periodontal disease often has little to no pain, so it can go unnoticed. [Source: Kusuri to Kenko no Johokyoku (Daiichi Sankyo Healthcare) Causes of Periodontal Disease] Symptoms: ●Mild to moderate: Red, swollen gums, bleeding when brushing, bad breath, receding gums causing sensitivity to cold ●Severe: Loose teeth, dull pain when chewing If left untreated: Persistent severe bad breath, swollen gums, bleeding, tooth loss, inability to eat anything other than soft foods without dentures, leading to malnutrition and health deterioration. Furthermore, inflammatory substances and periodontal disease bacteria from the gums can spread throughout the body, triggering or worsening systemic diseases. Main diseases reported to be associated include diabetes, cardiovascular disease, rheumatoid arthritis, dementia, and aspiration pneumonia. Quiz Explanation ① Why gums bleed when brushing in periodontal disease The cause of periodontal disease, plaque, is a mass of bacteria. Bacteria constantly reside in the human mouth, skin, and intestines, and cannot be completely eliminated. If self-care is insufficient, plaque bacteria multiply, exhibit pathogenicity, and cause inflammation in the gums. Inflamed gums have increased blood flow, dilated capillaries, and become thin and fragile. Furthermore, the gum epithelium partially peels away, creating wounds. As a result, the bristles of the toothbrush damage the capillaries in the wound, causing bleeding. ② Why the mouth feels sticky in the morning with periodontal disease During sleep, saliva production decreases significantly, making it easier for 'impurities' that would normally be washed away by saliva to remain in the mouth. Even if you brush your teeth thoroughly before bed, if you have periodontal disease, impurities such as inflammatory proteins and immune substances from the gums, as well as proliferated periodontal disease bacteria and viscous substances produced by bacteria, accumulate. This makes the saliva sticky and gives it an unpleasant taste. ③ Why bad breath occurs with periodontal disease The food source for periodontal disease bacteria is protein. The gas produced when they break down proteins from the gums and blood is the cause of bad breath.