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Association between frequency of laughter and oral health among community-dwelling older adults: a population-based cross-sectional study in Japan

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Abstract

Purpose

Oral health has been reported to have an impact on the activities of daily life such as chewing, eating, and laughing, while psychological factors such as depression and loneliness have been reported to affect oral health. Little is known, however, about the association between laughter and oral health in older adults. This study examined the bidirectional association between the frequency of daily laughter and oral health in community-dwelling older Japanese adults.

Methods

Our cross-sectional study employed data from the 2013 Japan Gerontological Evaluation Study’s self-reported survey, which included 11,239 male and 12,799 female community-dwelling independent individuals aged 65 years or older. We defined the oral health status by the number of remaining teeth. The association between the self-reported frequency of laughter (almost every day, 1–5 days per week, 1–3 days per month, or almost never) and oral health was examined using logistic regression analysis.

Results

The participants with 10 or more teeth were significantly more likely to laugh compared with the edentulous participants, after adjusting for all covariates. Compared with those who almost never laughed, those who laughed 1–5 days per week were significantly less likely to be edentulous. After stratifying by sex, similar results were found only in the men for both analyses.

Conclusion

There was a significant bidirectional association between frequency of laughter and oral health that was independent of socioeconomic and lifestyle factors among older adults.

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Data availability

Additional detailed data for this study are available upon reasonable written request to the corresponding author.

References

  1. Petersen, P. E., & Yamamoto, T. (2005). Improving the oral health of older people: The approach of the WHO global oral health programme. Community Dentistry and Oral Epidemiology, 33(2), 81–92.

    PubMed  Google Scholar 

  2. Dahl, K. E., Wang, N. J., & Ohrn, K. (2012). Does oral health matter in people’s daily life? Oral health-related quality of life in adults 35–47 years of age in Norway. International Journal of Dental Hygiene, 10(1), 15–21.

    CAS  PubMed  Google Scholar 

  3. Slade, G. D., & Spencer, A. J. (1994). Development and evaluation of the oral health impact profile. Community Dental Health, 11(1), 3–11.

    CAS  PubMed  Google Scholar 

  4. Muller, F., Naharro, M., & Carlsson, G. E. (2007). What are the prevalence and incidence of tooth loss in the adult and elderly population in Europe? Clinical Oral Implants Research, 18(Suppl 3), 2–14.

    PubMed  Google Scholar 

  5. Cademartori, M. G., Gastal, M. T., Nascimento, G. G., Demarco, F. F., & Correa, M. B. (2018). Is depression associated with oral health outcomes in adults and elders? A systematic review and meta-analysis. Clinical Oral Investigations, 22(8), 2685–2702.

    PubMed  Google Scholar 

  6. Peruzzo, D. C., Benatti, B. B., Ambrosano, G. M., Nogueira-Filho, G. R., Sallum, E. A., Casati, M. Z., & Nociti, F. H., Jr. (2007). A systematic review of stress and psychological factors as possible risk factors for periodontal disease. Journal of Periodontology, 78(8), 1491–1504.

    PubMed  Google Scholar 

  7. Monteiro da Silva, A. M., Oakley, D. A., Newman, H. N., Nohl, F. S., & Lloyd, H. M. (1996). Psychosocial factors and adult onset rapidly progressive periodontitis. Journal of Clinical Periodontology, 23(8), 789–794.

    CAS  PubMed  Google Scholar 

  8. Hybels, C. F., Bennett, J. M., Landerman, L. R., Liang, J., Plassman, B. L., & Wu, B. (2016). Trajectories of depressive symptoms and oral health outcomes in a community sample of older adults. International Journal of Geriatric Psychiatry, 31(1), 83–91.

    PubMed  Google Scholar 

  9. Rouxel, P., Tsakos, G., Chandola, T., & Watt, R. G. (2018). Oral health-A neglected aspect of subjective well-being in later life. Journals of Gerontology Series B Psychological Sciences and Social Sciences, 73(3), 382–386.

    Google Scholar 

  10. Yamamoto, T., Aida, J., Kondo, K., Fuchida, S., Tani, Y., Saito, M., & Sasaki, Y. (2017). Oral health and incident depressive symptoms: JAGES project longitudinal study in older Japanese. Journal of the American Geriatrics Society, 65(5), 1079–1084.

    PubMed  Google Scholar 

  11. Chida, Y., & Steptoe, A. (2008). Positive psychological well-being and mortality: A quantitative review of prospective observational studies. Psychosomatic Medicine, 70(7), 741–756.

    PubMed  Google Scholar 

  12. Pressman, S. D., & Cohen, S. (2005). Does positive affect influence health? Psychological Bulletin, 131(6), 925–971.

    PubMed  Google Scholar 

  13. Blazer, D. G., & Hybels, C. F. (2004). What symptoms of depression predict mortality in community-dwelling elders? Journal of the American Geriatrics Society, 52(12), 2052–2056.

    PubMed  Google Scholar 

  14. Hirosaki, M., Ishimoto, Y., Kasahara, Y., Konno, A., Kimura, Y., Fukutomi, E., et al. (2013). Positive affect as a predictor of lower risk of functional decline in community-dwelling elderly in Japan. Geriatrics and Gerontology International, 13(4), 1051–1058.

    PubMed  Google Scholar 

  15. Ostir, G. V., Markides, K. S., Peek, M. K., & Goodwin, J. S. (2001). The association between emotional well-being and the incidence of stroke in older adults. Psychosomatic Medicine, 63(2), 210–215.

    CAS  PubMed  Google Scholar 

  16. Finlayson, T. L., Williams, D. R., Siefert, K., Jackson, J. S., & Nowjack-Raymer, R. (2010). Oral health disparities and psychosocial correlates of self-rated oral health in the national survey of American life. American Journal of Public Health, 100(Suppl 1), S246-255.

    PubMed  PubMed Central  Google Scholar 

  17. Locker, D. (2009). Self-esteem and socioeconomic disparities in self-perceived oral health. Journal of Public Health Dentistry, 69(1), 1–8.

    PubMed  Google Scholar 

  18. Sanders, A. E., & Spencer, A. J. (2005). Childhood circumstances, psychosocial factors and the social impact of adult oral health. Community Dentistry and Oral Epidemiology, 33(5), 370–377.

    PubMed  Google Scholar 

  19. Martin, R. A. (2010). The psychology of humor: An integrative approach. New York, NY: Elsevier.

    Google Scholar 

  20. Devereux, P. G., & Ginsburg, G. P. (2001). Sociality effects on the production of laughter. The Journal of General Psychology, 128(2), 227–240.

    CAS  PubMed  Google Scholar 

  21. Mora-Ripoll, R. (2010). The therapeutic value of laughter in medicine. Alternative Therapies in Health and Medicine, 16(6), 56–64.

    PubMed  Google Scholar 

  22. Gonot-Schoupinsky, F. N., & Garip, G. (2018). Laughter and humour interventions for well-being in older adults: A systematic review and intervention classification. Complementary Therapies in Medicine, 38, 85–91.

    CAS  PubMed  Google Scholar 

  23. Hayashi, K., Kawachi, I., Ohira, T., Kondo, K., Shirai, K., & Kondo, N. (2015). Laughter and subjective health among community-dwelling older people in Japan: Cross-sectional analysis of the Japan gerontological evaluation study cohort data. Journal of Nervous and Mental Disease, 203(12), 934–942.

    Google Scholar 

  24. Hayashi, K., Kawachi, I., Ohira, T., Kondo, K., Shirai, K., & Kondo, N. (2016). Laughter is the best medicine? A cross-sectional study of cardiovascular disease among older Japanese adults. Journal of Epidemiology, 26(10), 546–552.

    PubMed  Google Scholar 

  25. Atsumi, T., Tonosaki, K., & Fujisawa, S. (2008). Salivary free radical-scavenging activity is affected by physical and mental activities. Oral Diseases, 14(6), 490–496.

    CAS  PubMed  Google Scholar 

  26. Toda, M., & Ichikawa, H. (2012). Effect of laughter on salivary flow rates and levels of chromogranin A in young adults and elderly people. Environmental Health and Preventive Medicine, 17(6), 494–499.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Kondo, K., Rosenberg, M., World Health, O. (2018). Advancing universal health coverage through knowledge translation for healthy ageing: Lessons learnt from the Japan gerontological evaluation study. World Health Organization. Retrieved date from 6 September 2020. https://apps.who.int/iris/handle/10665/279010.

  28. Matsui, D., Yamamoto, T., Nishigaki, M., Miyatani, F., Watanabe, I., Koyama, T., et al. (2016). Validity of self-reported number of teeth and oral health variables. BMC Oral Health, 17(1), 17.

    PubMed  PubMed Central  Google Scholar 

  29. Hirosaki, M., Ohira, T., Yasumura, S., Maeda, M., Yabe, H., Harigane, M., et al. (2018). Lifestyle factors and social ties associated with the frequency of laughter after the great east Japan earthquake: Fukushima health management survey. Quality of Life Research, 27(3), 639–650.

    PubMed  Google Scholar 

  30. Matsuyama, Y., Fujiwara, T., Aida, J., Watt, R. G., Kondo, N., Yamamoto, T., et al. (2016). Experience of childhood abuse and later number of remaining teeth in older Japanese: A life-course study from Japan gerontological evaluation study project. Community Dentistry and Oral Epidemiology, 44(6), 531–539.

    PubMed  Google Scholar 

  31. Tamada, Y., Takeuchi, K., Yamaguchi, C., Saito, M., Ohira, T., Shirai, K., & Kondo, K. (2020). Does laughter predict onset of functional disability and mortality among older Japanese adults? The JAGES prospective cohort study. Journal of Epidemiology. https://doi.org/10.2188/jea.JE20200051.

    Article  PubMed  Google Scholar 

  32. Kim, E. J., & Jin, B. H. (2018). Comparison of oral health status and daily nutrient intake between elders who live alone and elders who live with family: Based on the Korean national health and nutrition examination survey (KNHANES VI) (2013–2015). Gerodontology, 35(2), 129–138.

    PubMed  Google Scholar 

  33. Sakurada, K., Konta, T., Watanabe, M., Ishizawa, K., Ueno, Y., Yamashita, H., & Kayama, T. (2020). Associations of frequency of laughter with risk of all-cause mortality and cardiovascular disease incidence in a general population: Findings from the Yamagata study. Journal of Epidemiology, 30(4), 188–193.

    PubMed  PubMed Central  Google Scholar 

  34. Takeuchi, K., Aida, J., Kondo, K., & Osaka, K. (2013). Social participation and dental health status among older Japanese adults: A population-based cross-sectional study. PLoS ONE, 8(4), e61741.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Arora, M., Schwarz, E., Sivaneswaran, S., & Banks, E. (2010). Cigarette smoking and tooth loss in a cohort of older Australians: The 45 and up study. Journal of the American Dental Association, 141(10), 1242–1249.

    PubMed  Google Scholar 

  36. Kisely, S., Sawyer, E., Siskind, D., & Lalloo, R. (2016). The oral health of people with anxiety and depressive disorders: A systematic review and meta-analysis. Journal of Affective Disorders, 200, 119–132.

    PubMed  Google Scholar 

  37. Mauri-Obradors, E., Estrugo-Devesa, A., Jane-Salas, E., Vinas, M., & Lopez-Lopez, J. (2017). Oral manifestations of diabetes mellitus. A systematic review. Medicina Oral Patologia Oral y Cirugia Bucal, 22(5), e586–e594.

    CAS  Google Scholar 

  38. Dai, R., Lam, O. L., Lo, E. C., Li, L. S., Wen, Y., & McGrath, C. (2015). A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke. Journal of Dentistry, 43(2), 171–180.

    CAS  PubMed  Google Scholar 

  39. Niino, N., Imaizumi, T., & Kawakami, N. (1991). A Japanese translation of the geriatric depression scale. Clinical Gerontologist, 10, 85–87.

    Google Scholar 

  40. Greenberg, S. A. (2007). How to try this: The geriatric depression scale: Short form. American Journal of Nursing, 107(10), 60–69.

    Google Scholar 

  41. Koyama, S., Aida, J., Kondo, K., Yamamoto, T., Saito, M., Ohtsuka, R., et al. (2016). Does poor dental health predict becoming homebound among older Japanese? BMC Oral Health, 16(1), 51.

    PubMed  PubMed Central  Google Scholar 

  42. Rodrigues, S. M., Oliveira, A. C., Vargas, A. M., & Moreira, A. N. (2012). Implications of edentulism on quality of life among elderly. International Journal of Environmental Research and Public Health, 9(1), 100–109.

    PubMed  PubMed Central  Google Scholar 

  43. Tran, T. D., Krausch-Hofmann, S., Duyck, J., de Almeida Mello, J., De Lepeleire, J., Declerck, D., et al. (2018). Association between oral health and general health indicators in older adults. Scientific Reports, 8(1), 8871.

    PubMed  PubMed Central  Google Scholar 

  44. Bennett, M. P., Zeller, J. M., Rosenberg, L., & McCann, J. (2003). The effect of mirthful laughter on stress and natural killer cell activity. Alternative Therapies in Health and Medicine, 9(2), 38–45.

    PubMed  Google Scholar 

  45. Sauter, D. A. (2017). The nonverbal communication of positive emotions: An emotion family approach. Emotion Review, 9(3), 222–234.

    PubMed  PubMed Central  Google Scholar 

  46. Batra, M., Tangade, P., Rajwar, Y. C., Dany, S. S., & Rajput, P. (2014). Social capital and oral health. Journal of Clinical and Diagnostic Research, 8(9), ZE10-11.

    PubMed  Google Scholar 

  47. Tsakos, G., Sabbah, W., Chandola, T., Newton, T., Kawachi, I., Aida, J., et al. (2013). Social relationships and oral health among adults aged 60 years or older. Psychosomatic Medicine, 75(2), 178–186.

    PubMed  Google Scholar 

  48. Ylostalo, P. V., Ek, E., Laitinen, J., & Knuuttila, M. L. (2003). Optimism and life satisfaction as determinants for dental and general health behavior-oral health habits linked to cardiovascular risk factors. Journal of Dental Research, 82(3), 194–199.

    CAS  PubMed  Google Scholar 

  49. Talhelm, T., Oishi, S., & Zhang, X. (2019). Who smiles while alone? Rates of smiling lower in China than U.S. Emotion, 19(4), 741–745.

    PubMed  Google Scholar 

  50. van der Wal, C. N., & Kok, R. N. (2019). Laughter-inducing therapies: Systematic review and meta-analysis. Social Science and Medicine, 232, 473–488.

    PubMed  Google Scholar 

  51. Pitiphat, W., Garcia, R. I., Douglass, C. W., & Joshipura, K. J. (2002). Validation of self-reported oral health measures. Journal of Public Health Dentistry, 62(2), 122–128.

    PubMed  Google Scholar 

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Acknowledgements

We would like to express our appreciation for all the study participants and the staff of JAGES.

Funding

This study was supported by the Research and Development Grants for Longevity Science from Japan Agency for Medical Research and development (AMED) (JP19dk0110034, JP20dk0110034), Grants from Japan Science and Technology Agency (JST-OPERA: JPMJOP1831), the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology (20–19), Health Labor Sciences Research Grants (19FA1012) from the Ministry of Health, Labor and Welfare, Japan, and Grant-in-Aid for challenging Exploratory Research (18K19688, 20K21719) from Japan Society for the Promotion of Science.

Author information

Authors and Affiliations

  1. Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan

    Mayumi Hirosaki & Tetsuya Ohira

  2. Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan

    Mayumi Hirosaki

  3. Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan

    Tetsuya Ohira & Kokoro Shirai

  4. School of Public Health, The University of Tokyo, Tokyo, Japan

    Naoki Kondo

  5. Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

    Jun Aida

  6. Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan

    Jun Aida

  7. Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Kanagawa, Japan

    Tatsuo Yamamoto

  8. Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan

    Kenji Takeuchi

  9. Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan

    Katsunori Kondo

  10. Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan

    Katsunori Kondo

Authors
  1. Mayumi Hirosaki
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  2. Tetsuya Ohira
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  3. Kokoro Shirai
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  4. Naoki Kondo
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  5. Jun Aida
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  6. Tatsuo Yamamoto
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  7. Kenji Takeuchi
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  8. Katsunori Kondo
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Contributions

MH analyzed the data and wrote the manuscript. MH, TO, NK, JA, TY, and KT contributed to the design of the study. KS, NK and KK contributed to the data collection. All authors interpreted the results and have approved the final manuscript.

Corresponding author

Correspondence to Mayumi Hirosaki.

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Hirosaki, M., Ohira, T., Shirai, K. et al. Association between frequency of laughter and oral health among community-dwelling older adults: a population-based cross-sectional study in Japan. Qual Life Res 30, 1561–1569 (2021). https://doi.org/10.1007/s11136-020-02752-7

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