TT-446 -- Tooth Decay, Ebiz news from Japan

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A weekly roundup of news & information from Terrie Lloyd.

General Edition Sunday, November 18, 2007 Issue No. 446


- What's new
- News
- Candidate roundup/Vacancies
- Upcoming events
- Corrections/Feedback
- News credits

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Back when we were kids, admittedly some time ago, going to
the dentist was a 6-monthly ritual that was dreaded.
Painkillers were reserved only for major surgery, and as a
result we would call the dental clinic the "murder house".
What a shame back then our parents didn't know what we know
today -- that tooth decay can be controlled or even
prevented, and that treatment can be humane. Certainly kids
today have it a lot better, as a visit to the annual Tokyo
Dental Show at BigSite this weekend confirmed. We joined
approximately 20,000 other professionals and curious laymen
crammed into the Higashi Number Two Hall, to see new
treatments, compounds, equipment, software, and other
paraphernalia which goes into making the dental industry
worth around JPY2.5trn a year.

Japan is very well serviced by dentists, and in 2004 there
were roughly 95,000 dentists, 230,000 dental nurses, and
73,000 dental hygienists looking after the nation's teeth.
This translates into about one dentist per 1,330 people.
The reason we have so many dentists, at a time when the
numbers of obstetricians and other medical professionals is
in decline, is probably because the profession is highly
profitable -- dentists are among the best-paid health
professionals covered by the national medical insurance
system -- with about 63% of dentists operating private

Being a dentist is also relatively clean and orderly,
perhaps providing the perfect channel for a national
obsession about germs and their control. An obsession
engendered, we think, by a generation of moms educated that
any germs are bad and need to be wiped out/away.

Whatever the reason, there are 29 dental schools churning
out about 3,000 dentists a year, 71 schools producing
around 10,000 dental nurses annually, and a surprisingly
high 134 schools producing dental hygienists. The number of
hygienists is expected to drop, however, as the national
curriculum is about to become tougher -- increasing the
average associate degree from the current 2 years to
3-4 years.

[Continued below...]

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[...Article continues]

While making it tougher to graduate for hygienists may seem
a retrograde step in a dental system that seems to be
working (i.e., if it ain't broke, don't fix it), industry
pundits tell us that in fact they believe the increase in
educational requirements will actually improve commercial
opportunities, since the better educated hygienists will be
able to get more involved in clinic purchases. Right now
the hygienists typically control the replacement of
consumables such as cements, swabs, scalers, bibs, masks,
gloves, etc., but they have very little influence over the
adoption of new and more complex products, which means
that it can take a a busy dentist a long time to take a
look at new technologies.

A good example of this is for dental implants, a procedure
which allows people to receive one or more false teeth
embedded into the jaw bone, and that over time bond with
the bone to create stable, permanent replacements. The
industry is dominated overseas by the inventors of the
titanium implant, Noble Biocare, but even with significant
marketing effort by the company here in Japan, as of
2003, only 10% of dentists were willing to do implants.
This is a wasted opportunity, because with the aging
population there are many more people who'd benefit from
getting it done.

So how is the oral health of Japanese kids? Those of us who
have kids here, or who have Japanese friends with kids, are
always surprised at how little attention seems to be paid
to oral health care -- especially considering all the fuss
by moms over other forms of hygiene. Candies for the kids
is a widely accepted way of keeping them quiet in public,
and once the kids get a taste for them, it's hard to keep
them quiet -- so a vicious circle of candy dependence is

It's no wonder then, that Japanese kids have a relatively
high incidence of dental caries and other tooth problems
(Decayed, Missing, and Filled teeth -- DMFT). According
to one study of 3,500 kids, the rate is around 50% by the
age of 3 and a half. But it used to be worse: back in the
early 1980's the rate of DMFT was around 80%.

Interestingly, a study of Brazilian nikkeijin (2nd and 3rd
generation Brazilian Japanese) kids living in Japan found
that the incidence of DMFT in those kids was surprisingly
low, with 35% of 12-year olds having no caries at all.
Given that these immigrant kids are living in similar
environments to their Japanese peers, scientists have
become interested in finding out what factors might be
contributing to the lower rate of cavities in their teeth.
They came up with some answers that go back not
just to diet but also to culture.

Apparently, besides feeding the kids candy, another
suspected cause of cavities in the Japanese family is
the habit of sharing food between parents and young
children, especially the habit of the mom or
grandmother pre-chewing the food for children under
3. It is already known that the presence of both the
S. mutans and S. sobrinus bacteria in a baby's
mouth will literally double the likelihood of that child
having a high proportion of caries later in life. DNA tests
have found that typically, little kids are most likely to
get these bacteria from their parents and grandparents.

So food sharing is da-a-me!

At the other end of the spectrum is dental care for the
aged -- obviously a growing market segment. The Ministry
of Health back in the early 2000's came up with a national
goal for oldies to have at least 20 teeth by the age of 80.
Leading causes of tooth decay in the aged are periodontal
disease through the gums, deep decay via damaged crowns,
and just generally poor diet.

The good news, though, is that overall, Japanese people are
finally starting to realize that dental hygiene and care is
important. Last year, the Ministry of Health said that for
the first time more than 70% of those surveyed in a
national poll said that they brush their teeth at least
twice a day. This has led to a boom in electric tooth
brushes, high-end toothpastes, and of course the continuing
success of xylitol-based and other sugar-free chewing gums.
As a result, the market for home-use dental hygiene
products, including toothpaste, floss, brushes, and
mouthwash rose 2.4% in 2005 to JPY84.1bn.

The market for products to sell dentists is pretty well
saturated, and for the time-being the only real growth
stories are to be found in products sold as add-ons, the
occasional breakthrough technology, and high-tech toys to
delight the 82% of dentists who are male. Naturally, these
dentists have the money to make such purchases. At the
Tokyo Dental Show this weekend, we saw some
top-of-the-line in-clinic x-ray units that rotate and whizz
around the head while pushing data out to a computer.
These babies cost a cool JPY20m each, and the booths
were packed with interested punters.

Another product which seems to be doing well and certainly
is a bit more pragmatic, is a software application (sold as
SaaS) pre-loaded with pedestrian flow data for dozens of
office locations around the Kanto (primarily Tokyo and the
surrounding 4 major cities). The software lets dentists
figure out where to locate a new office for maximum
exposure. The company back in June said that 340 dentists
had already signed up for the service so far and that it
expects to crack the 1,000 mark around March 2008.

Other innovative products include a breath odor sensor that
gauges the concentration of methyl mercaptan, which is
produced by bacteria in the mouth, and thus indicates the
likelihood of periodontal disease.

One product not at the show yet, but we hope to see it
soon is the nano-processed hydroxyapatite toothpaste
announced to the world in 2005. Described as a
wonder-product it supposedly heals small cavities in teeth
by remineralizing them. A lot of us are hoping that this
technology will eventually put dentists out of business!
Perhaps better, we won't need to be dumping the
controversial compound Fluoride into our water supply,

For details on the toothpaste, see:
For the inventor's white paper, see: Now, for some
reason we haven't heard any more about the product, other
than that it was in medical trials in Japan in 2006 and
many people are excited to find out if it works. We'd like
to hear from any readers who might know if this product is
now generally available?

Not all the innovation is in products. A company called
Team Work 28 has gone into the teeth brushing and gum
massaging business, to help office workers get some oral
care on the way home from work. The company started in
2006, shortly after the dental law changed in July 2005.
Whereas it was previously illegal for anyone other than
dentists and hygienists to perform non-surgical work on
people's mouths, the cleaning field is now wide open to
unlicenced workers. Team Work 28 reckons it will have
about 200 franchised locations by 2009.

A gum massage from Team Work 28, in case you
should need one, is JPY4,500. Our thinking is that
investing in an ultrasonic tooth brush might be a better

...The information janitors/


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+++ NEWS

- ASEAN investments fall
- Matsushita ramps up lithium ion battery production
- Japan signs rare metals contract with South Africa
- Sanyo water kills germs
- 10% of large buildings need replacement or renovation

-> ASEAN investments fall

An announcement by the Bank of Japan makes it clear that
Japanese investment in Asean countries is falling off
as compared to the previous two years. Apparently the
Number One investment destination this year, Thailand,
which was second after Malaysia last year, has seen
Japanese investment fall from US$1.98bn in the 2005 to
US$1.19bn in 2006. (Source: TT commentary from, 18 Nov, 2007)

-> Matsushita ramps up lithium ion battery production

Lithium batteries may still have a cloud of doubt about
their safety hanging over them, but this won't stop the
world from buying about 230m Li-ion batteries in 2008.
Matsushita Battery has announced that it is going to
significantly ramp up its production facilities, with a
view to producing 37m batteries annually in 2009 and
thereby secure about 15% market share globally. ***Ed:
Clearly Li-ion is here to stay. We would hazard a guess
that a lot of this activity is in anticipation of electric
cars, starting with the Mitsubishi MIEV, scheduled to hit
the streets in 2009. (Source: TT commentary from,
Nov 14, 2007)

-> Japan signs rare metals contract with South Africa

Although rare metals aren't all that rare, about 90% of
what Japan imports comes from China, which has started
throttling off Japanese supply. Since rare metals are
commonly used in many areas of electronics and automobiles,
it has become a national priority to secure an alternative
supply. Accordingly, the government has already signed a
metals search agreement with South Africa and plans to sign
another this coming week with Botswana. Japan plans to use
advanced satellite imagery to locate possible deposits.
(Source: TT commentary from Nov 17, 2007)

-> Sanyo water kills germs

Sanyo Electric has come up with a new air purifier that
electrolysises water in a unique way to create an active
steam cloud to kill germs in communal rooms. The steam
contains a mild form of hypochlorus acid, which has a
disinfecting action. Sanyo says that used in classrooms,
within 2 hours of the room being vacated, the air-borne
bacterial levels are cut by 93%. ***Ed: While these units
may be helpful in public spaces such as hospitals, we wonder
if sanitizing the air we breathe with slightly acidic vapor
is such a good idea. Sanyo reckons it has conducted tests
on rooms full of people serviced by the device, but we
suspect that negative effects will show up later rather
than sooner.** (Source: TT commentary from, Nov
15, 2007)

-> 10% of large buildings need replacement or renovation

Given the massive slowdown in building starts recently,
those authorities involved in real estate are working hard
to put out feel-good press releases. The latest one is from
the Japan Real Estate Institute, which reckons that around
10% of large office buildings in Tokyo, Osaka and Nagoya
are older than 40 years, and are ready to be destroyed or
renovated. (Source: TT commentary from, Nov
16, 2007)

NOTE: Broken links
Many online news sources remove their articles after just a
few days of posting them, thus breaking our links -- we
apologize for the inconvenience.


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is actively marketing the following positions for market
entry customers setting up in Japan, as well as other
employers of bilinguals.


Global business software solutions company is seeking a
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Successful candidates will have strong communication skills and
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* Bilingual American Network Engineer in early 40's who has
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