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Diep MT, Jensen JL, Skudutyte-Rysstad R, Young A, Sødal ATT, Petrovski BÉ, Hove LH. Xerostomia and hyposalivation among a 65-yr-old population living in Oslo, Norway. Eur J Oral Sci 2021; 129:e12757. [PMID: 33501713 PMCID: PMC7986810 DOI: 10.1111/eos.12757] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/11/2020] [Accepted: 11/20/2020] [Indexed: 12/11/2022]
Abstract
This study aimed to describe the prevalence and associated factors for xerostomia and hyposalivation in a young‐elderly population. A random sample of 460 65‐yr‐old people living in Oslo, Norway, answered a questionnaire and underwent a clinical examination (237 men and 223 women; response rate 58%). Ten percent of respondents reported xerostomia. The median Summated Xerostomia Index was 6 (interquartile range [IQR]: 5–7) and the median Clinical Oral Dryness Score was 2 (IQR: 1–3). The median unstimulated whole saliva (UWS) secretion rate was 0.34 (IQR: 0.20–0.53) mL min–1 and the median stimulated whole saliva (SWS) secretion rate was 1.74 (IQR: 1.24–2.38) mL min–1. In 8% of the study participants the UWS secretion rate was ≤0.1 mL min–1 and in 4% the SWS secretion rate was ≤0.7 mL min–1. Three percent of the study participants had both xerostomia and hyposalivation with respect to UWS. Xerostomia was significantly associated with medication use, having rheumatic disease, and having received radiation therapy to the head/neck region. Hyposalivation with respect to UWS and SWS was significantly associated with medication use and type II diabetes. Even though xerostomia and hyposalivation were not prevalent conditions in this population, clinicians should be especially aware of the salivary conditions in patients taking four or more medications, patients diagnosed with type II diabetes, and those who have undergone radiation therapy to the head/neck region.
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Affiliation(s)
- My Tien Diep
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Janicke Liaaen Jensen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Rasa Skudutyte-Rysstad
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Alix Young
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anne Thea Tveit Sødal
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Lene Hystad Hove
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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2
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Hyposalivation, oral health, and Candida colonization in independent dentate elders. PLoS One 2020; 15:e0242832. [PMID: 33237956 PMCID: PMC7688165 DOI: 10.1371/journal.pone.0242832] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Hyposalivation is an important problem in elders and could interfere with several oral functions and microbial ecology. While the number of independent elders who retain more natural teeth increases worldwide, few studies examined hyposalivation in this population. Thus, this study aims to examine relationships between hyposalivation, oral health conditions and oral Candida colonization in independent dentate elders and evaluate factors associated with salivary flow and Candida carriage. We conducted a cross-sectional study in fifty-three dentate elders (≥65 years old with at least 4 pairs of posterior occlusal contacts) with no, or well-controlled, systemic conditions. Participants were interviewed for medical history, subjective dry mouth symptoms, oral hygiene practices and denture information. Unstimulated and stimulated salivary flow rates, objective dry mouth signs, gingival, tongue-coating, and root-caries indices were recorded. Stimulated saliva was cultured on Sabouraud-dextrose agar for Candida counts. Candida species were identified using chromogenic Candida agar and polymerase chain reaction. Statistical significance level was set at p<0.05. The results showed that hyposalivation was associated with higher gingival and tongue-coating indices (p = 0.003 and 0.015, respectively), but not root-caries index. Hyposalivation was also associated with higher prevalence of oral Candida colonization (p = 0.010; adjusted OR = 4.36, 95% confidence interval = 1.29–14.72). These two indices and Candida load were negatively correlated with unstimulated and stimulated salivary flow rates. Interestingly, non-albicans Candida species were more prevalent in denture wearers (p = 0.017). Hence, hyposalivation is a risk factor for poorer oral health and oral Candida colonization in independent dentate elders. Because of its potential adverse effects on oral and systemic health, hyposalivation should be carefully monitored in elders.
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3
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Lam WY, Tse AK, Tew IM, Man WH, Botelho MG, Pow EH. Impact of hypo-salivation on severe tooth wear: A ten-year cohort of patients received radiotherapy for nasopharyngeal carcinoma. J Dent 2020; 97:103343. [DOI: 10.1016/j.jdent.2020.103343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022] Open
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Agostini BA, Cericato GO, Silveira ERD, Nascimento GG, Costa FDS, Thomson WM, Demarco FF. How Common is Dry Mouth? Systematic Review and Meta-Regression Analysis of Prevalence Estimates. Braz Dent J 2019; 29:606-618. [PMID: 30517485 DOI: 10.1590/0103-6440201802302] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/06/2018] [Indexed: 12/16/2022] Open
Abstract
The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition's measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.
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Affiliation(s)
| | - Graziela Oro Cericato
- School of Dentistry, IMED - Instituto de Desenvolvimento Humano, Passo Fundo, RS, Brazil
| | | | | | - Francine Dos Santos Costa
- Post-Graduate Program in Epidemiology, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Post-Graduate Program in Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Flavio Fernando Demarco
- Post-Graduate Program in Epidemiology, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Post-Graduate Program in Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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5
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Stempniewicz A, Ceranowicz P, Warzecha Z. Potential Therapeutic Effects of Gut Hormones, Ghrelin and Obestatin in Oral Mucositis. Int J Mol Sci 2019; 20:ijms20071534. [PMID: 30934722 PMCID: PMC6479885 DOI: 10.3390/ijms20071534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022] Open
Abstract
Chemotherapy and/or head and neck radiotherapy are frequently associated with oral mucositis. Oral pain, odynophagia and dysphagia, opioid use, weight loss, dehydration, systemic infection, hospitalization and introduction of a feeding tube should be mentioned as the main determinated effect of oral mucositis. Oral mucositis leads to a decreased quality of life and an increase in treatment costs. Moreover, oral mucositis is a life-threatening disease. In addition to its own direct life-threatening consequences, it can also lead to a reduced survival due to the discontinuation or dose reduction of anti-neoplasm therapy. There are numerous strategies for the prevention or treatment of oral mucositis; however, their effectiveness is limited and does not correspond to expectations. This review is focused on the ghrelin and obestatin as potentially useful candidates for the prevention and treatment of chemo- or/and radiotherapy-induced oral mucositis.
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Affiliation(s)
- Agnieszka Stempniewicz
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Grzegórzecka 16 St., 31-531 Krakow, Poland.
| | - Piotr Ceranowicz
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Grzegórzecka 16 St., 31-531 Krakow, Poland.
| | - Zygmunt Warzecha
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Grzegórzecka 16 St., 31-531 Krakow, Poland.
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6
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Qiao F, Fu K, Zhang Q, Liu L, Meng G, Wu H, Xia Y, Bao X, Gu Y, Shi H, Sun S, Wang X, Zhou M, Jia Q, Song K, Niu K. The association between missing teeth and non-alcoholic fatty liver disease in adults. J Clin Periodontol 2018; 45:941-951. [PMID: 29779210 DOI: 10.1111/jcpe.12929] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2018] [Indexed: 12/31/2022]
Abstract
AIMS Long-term oral chronic inflammatory process is closely related to systemic inflammation, which is a main mechanism involved in non-alcoholic fatty liver disease (NAFLD). Tooth loss could reflect the accumulation of oral local inflammation, implying that number of missing teeth may associate with NAFLD. This study evaluated the association between missing teeth and presence of NAFLD in a general population. MATERIALS AND METHODS A cross-sectional study of 24,470 adults was carried out from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. The self-reported number of missing teeth (excluding third molars) was recorded and classified into four categories: 0, 1-2, 3-5, and ≥6. The NAFLD was diagnosed by the liver ultrasonography. Associations were analysed by adjusted multivariable logistic regression. RESULTS The multivariable-adjusted odds ratios (95% confidence interval) of NAFLD across the categories of missing teeth were as follows: in males, 1.00 (reference), 1.04 (0.93-1.16), 1.06 (0.90-1.24), and 1.40 (1.09-1.81) (p for trend = 0.04); in females, 1.00 (reference), 0.98 (0.83-1.15), 1.11 (0.90-1.37), and 1.07 (0.77-1.48) (p for trend = 0.45). CONCLUSIONS The number of missing teeth was associated with a higher presence of NAFLD in males but not females.
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Affiliation(s)
- Feng Qiao
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tianjin Medical University, Tianjin, China.,Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kaiyu Fu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tianjin Medical University, Tianjin, China.,Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yang Xia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xue Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongbin Shi
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
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7
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Cavalcante DDS, Pinto-Quidute AR, Alves-Martins MR, Walter-de-Aguiar AS, Lima-Cid AMP, Silva PGB, Cavalcante RF, Costa FWG. Dental status, salivary flow, and sociodemographic aspects in Sheehan Syndrome patients. Med Oral Patol Oral Cir Bucal 2018; 23:e436-e442. [PMID: 29924763 PMCID: PMC6051684 DOI: 10.4317/medoral.22377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/25/2018] [Indexed: 11/17/2022] Open
Abstract
Background Sheehan’s syndrome (SS) is one of the leading causes of hypopituitarism in developing countries. It occurs after postpartum necrosis of the pituitary gland, and it is considered a significant public health problem. This paper, apparently unpublished, aimed to perform an analysis on oral aspects in patients with SS. Material and Methods A cross-sectional study was performed with 23 women diagnosed with SS at the Division of Endocrinology and Diabetes (Walter Cantídio University Hospital, Fortaleza, Brazil). Results Data on sociodemographic, dental and salivary flow aspects were collected through a clinical approach and a panoramic radiograph request. The mean age was 64 ± 11.5 years old, with the sample consisting mainly of married women (56.5%), socioeconomic class C2 or D / E (78.2%) and years of education up to 8 years (69.5%). The presence of horizontal bone loss (p<0.001) and bilateral pneumatization of the maxillary sinus (p=0.015) were significant data. The mean number of absent teeth considering all subjects was 23.17±9.7, being statistically significant (p<0.001). In relation to age, the mean number of missing teeth was higher in individuals over 65 years old (p=0.048). Reduced salivary flow was observed in 78.3% of the patients. In a bivariate analysis, considering the outcome variables “missing teeth” and “reduced salivary flow”, it was observed that economic class (p<
0.001), family income (0.037) and maxillary sinus pneumatization (0.032) were statistically significant. Conclusions In brief, patients with SS showed severe teeth loss, reduced salivary flow, and low educational status. This study addressed important aspects regarding oral findings in SS and highlighted the importance of researches in oral medicine. Key words:Sheehan’s Syndrome, hypopituitarism, tooth loss, salivary flow.
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Affiliation(s)
- D-D-S Cavalcante
- Alexandre Barauna, 949 Rodolfo Teofilo, 60430-160 Fortaleza, Ceara, Brazil, Federal University of Ceara, Department of Clinical Dentistry, School of Dentistry,
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Muñoz-González C, Vandenberghe-Descamps M, Feron G, Canon F, Labouré H, Sulmont-Rossé C. Association between Salivary Hypofunction and Food Consumption in the Elderlies. A Systematic Literature Review. J Nutr Health Aging 2018; 22:407-419. [PMID: 29484355 DOI: 10.1007/s12603-017-0960-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This systematic literature review aims to summarize the existing scientific evidence about the association between a reduced salivary function and food consumption in elderly people. METHODS A validated search strategy in two databases (PubMed and ISI Web of Knowledge) was carried out and retrieved papers together with their reference lists were screened by two independent reviewers. The quality of the included studies was critically appraised via the Quality Assessment Criteria for Evaluating Primary Research Papers. RESULTS From the originally identified studies (n=391), only 15 articles (all cross-sectional studies) met the pre-fixed inclusion/exclusion criteria. The methodological quality of the included studies was in general good, although only 3 from 15 obtained the maximum score. The control of confounding factors was the quality variable more poorly rated in the selected studies. Salivary hypofunction was associated with a decrease of the objective chewing and swallowing abilities and taste perception. Moreover, most of the selected studies showed a relationship between salivary hypofunction and food consumption (in terms of appetite loss, unbalanced dietary intake and malnutrition), although no causality could be established. CONCLUSIONS This study highlights the fact that salivary hypofunction definition and measurements are different across the studies. Therefore, future research efforts should focus on establishing a gold standard to define and identify salivary hypofunction throughout life and on performing longitudinal studies controlling for confounding factors to establish causality.
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Affiliation(s)
- C Muñoz-González
- Claire Sulmont-Rossé, INRA, CSGA, 17 rue Sully, F-21000 Dijon, France, Telephone: +33 380 69 32 71, E-mail address:
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9
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Shimazaki Y, Fu B, Yonemoto K, Akifusa S, Shibata Y, Takeshita T, Ninomiya T, Kiyohara Y, Yamashita Y. Stimulated salivary flow rate and oral health status. J Oral Sci 2016; 59:55-62. [PMID: 28049967 DOI: 10.2334/josnusd.16-0372] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study examined the relationship between stimulated salivary flow rate and oral health status in an adult population. Multinomial multivariate logistic regression analysis was used to examine the associations of salivary flow rate with dental caries status and periodontal status at the individual level among 2,110 Japanese adults with ≥10 teeth. Then, a spline model was used to examine the nonlinear relationship between salivary flow rate and teeth with dental caries or periodontal disease in multilevel analysis. Odds ratios were calculated for a 1.0-mL/min reduction in salivary flow rate at a point. After adjusting for confounding variables, participants with a flow rate ≤3.5 mL/min had significantly higher odds ratios for high caries status, and participants with a flow rate ≤1.4 mL/min had a higher odds ratio for broad periodontal disease, than did those with a flow rate >3.5 mL/min. In spline models, the odds ratio for teeth with dental caries or periodontal disease increased with reduced saliva secretion. The present findings suggest that decreased saliva secretion affects both dental caries and general periodontal health status.
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Affiliation(s)
- Yoshihiro Shimazaki
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
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10
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Amarasena N, Ekanayaka AN, Herath L, Miyazaki H. Socio-Demographic Risk Indicators for Tooth Mortality in Rural Sri Lankans. Asia Pac J Public Health 2016; 15:105-10. [PMID: 15038684 DOI: 10.1177/101053950301500206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To explore the socio-demographic factors associated with tooth loss in rural inhabitants of Sri Lanka, a random sample of 2178 males aged 20-60 years was selected using multistage cluster sampling procedure. The number of missing and present teeth was recorded excluding third molars and the subjects were interviewed to elicit socio-demographic information as well as oral hygiene and tobacco consumption habits. The mean number of teeth lost in the sample was 5.17±5.43. Tooth loss increased significantly with age. Sinhalese had significantly fewer lost teeth (5.05±5.38) compared to Tamils (6.54±6.18) and Muslims (6.02±5.21) whereas education, income, oral hygiene practices and tobacco use were significantly associated with tooth loss in the bivariate analysis. A forward stepwise multiple regression analysis revealed that age, Muslim ethnicity and quantified tobacco use were positively associated with tooth loss while better socio-economic conditions and good oral hygiene habits were negatively linked with tooth mortality independent of other factors. Age, Muslim ethnicity, quantified tobacco use, income, education, brushing frequency and substance used for cleaning had significantly affected tooth loss. Quantified tobacco use and oral hygiene may be regarded as modifiable socio-demographic risk indicators associated with tooth mortality in Sri Lankans. Asia Pac J Public Health 2003; 15(2): 105-110.
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Affiliation(s)
- N Amarasena
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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11
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Vandenberghe-Descamps M, Labouré H, Prot A, Septier C, Tournier C, Feron G, Sulmont-Rossé C. Salivary Flow Decreases in Healthy Elderly People Independently of Dental Status and Drug Intake. J Texture Stud 2016. [DOI: 10.1111/jtxs.12191] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Hélène Labouré
- Centre des Sciences du Goût CNRS, INRA, Univ. Bourgogne Franche-Comté; F-21000 Dijon France
- AgroSup Dijon; F-21000 Dijon France
| | - Aurélie Prot
- Centre des Sciences du Goût CNRS, INRA, Univ. Bourgogne Franche-Comté; F-21000 Dijon France
| | - Chantal Septier
- Centre des Sciences du Goût CNRS, INRA, Univ. Bourgogne Franche-Comté; F-21000 Dijon France
| | - Carole Tournier
- Centre des Sciences du Goût CNRS, INRA, Univ. Bourgogne Franche-Comté; F-21000 Dijon France
| | - Gilles Feron
- Centre des Sciences du Goût CNRS, INRA, Univ. Bourgogne Franche-Comté; F-21000 Dijon France
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût CNRS, INRA, Univ. Bourgogne Franche-Comté; F-21000 Dijon France
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12
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Outcome-Based Quality Control by a Dental Reference Profile of a Population-Based Study (SHIP-0). INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2015; 2015:794769. [PMID: 27347549 PMCID: PMC4897377 DOI: 10.1155/2015/794769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/09/2015] [Accepted: 06/14/2015] [Indexed: 11/18/2022]
Abstract
Objectives. The aim was to develop an instrument for quality control in dental practices. We compared the number of teeth of subjects of the Study of Health in Pomerania (SHIP-0) with those from patients of dental practices. Methods. Patients from seven dental practices (n = 1,497) were randomly sampled by age strata and gender for a period of two years. Dental status derived from patient files was transformed into practice profiles using age-specific number of teeth as a parameter. Practice profiles were compared with a nomogram, which was based on the age-specific number of teeth of 3,990 SHIP-0 participants regularly visiting the dentist. Further, negative binomial regression models were evaluated to model associations between the number of teeth with age and dental practices, including interactions. Results. The practice profiles ranged between the 45th and 95th quantile curves of the reference population SHIP-0. The rate ratios (RR) for the number of missing teeth ranged from 0.37 to 0.67 (p < 0.001) between the different dental practices, indicating lower risk for higher numbers of missing teeth in comparison to SHIP-0. Conclusions. This study showed considerable differences between dental practices and the reference population of SHIP-0 regarding the pattern of tooth loss and confirms the value of nomograms to compare age-specific numbers of teeth between patients of dental practices and a population-based-study as a tool for quality control. For further analyses, the socioeconomic status of patients and relevant risk factors will be used to adjust for structural differences in order to improve the validity of the comparisons.
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13
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Syrjälä AMH, Raatikainen L, Komulainen K, Knuuttila M, Ruoppi P, Hartikainen S, Sulkava R, Ylöstalo P. Salivary flow rate and periodontal infection - a study among subjects aged 75 years or older. Oral Dis 2010; 17:387-92. [DOI: 10.1111/j.1601-0825.2010.01764.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Wiener RC, Wu B, Crout R, Wiener M, Plassman B, Kao E, McNeil D. Hyposalivation and xerostomia in dentate older adults. J Am Dent Assoc 2010; 141:279-84. [PMID: 20194383 PMCID: PMC2899485 DOI: 10.14219/jada.archive.2010.0161] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Older adults are susceptible to reduced saliva production related to certain medications, radiation and chronic conditions. Many of these people have many physical and oral health problems and limited access to dental care. The use of effective screening tools for xerostomia and hyposalivation would be helpful in identifying those at risk. The authors conducted a study to investigate the association between three measures of oral dryness: hyposalivation (low unstimulated salivary flow), self-reported xerostomia and clinically assessed dry mouth. METHODS The authors included a convenience sample of 252 nondemented and dentate West Virginia participants 70 years and older who were part of a larger study on oral health and cognition among older adults. Participants completed a self-reported xerostomia index, provided an unstipulated salivary sample and underwent an oral assessment for the study. RESULTS Twenty-eight participants (11.1 percent) had hyposalivation, eight of whom reported having xerostomia (sensitivity=28.6 percent). Of the 43 participants who reported having xerostomia, only eight had hyposalivation (positive predictive value=18.6 percent). Hyposalivation and self-reported xerostomia were not significantly related. Clinically assessed dry mouth correlated modestly, but significantly, with hyposalivation and self-reported xerostomia. CONCLUSIONS Obtaining routine unstimulated salivary flow rates in addition to self-reported information and oral evaluations may increase early detection of oral dryness, which would assist in implementing early interventions to improve patients' quality of life. CLINICAL IMPLICATIONS Visually inspecting oral tissues for dryness and asking a patient if his or her mouth is dry are insufficient measures for clinicians to use to determine if the patient has hyposalivation. The authors recommend that clinicians determine the patient's unstimulated salivary flow rate.
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Affiliation(s)
- R Constance Wiener
- Department of Dental Practice and Rural Health, School of Dentistry, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA.
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15
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Yoshihara A, Hirotomi T, Takano N, Kondo T, Hanada N, Miyazaki H. Serum markers of chronic dehydration are associated with saliva spinability. J Oral Rehabil 2008; 34:733-8. [PMID: 17824885 DOI: 10.1111/j.1365-2842.2007.01732.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Findings of a relationship between saliva and dehydration have been observed, but the precise nature of these relationships is unclear and no evidence of a direct link has been found. In particular, no study reports a relationship between chronic dehydration and saliva conditions in community-dwelling older adults. This study aimed to identify whether salivary conditions are sensitive to body hydration markers in an elderly population. A total of 403 subjects aged 76 years participated in the study. Stimulated saliva flow rate and spinability of saliva were measured. In addition, determinations of serum levels of uric acid, blood urea nitrogen (BUN), creatinine, sodium and potassium were made. Dehydration was defined as uric acid >/= 7 mg dL(-1) according to the standard value. The salivary spinability were significantly associated with the concentration of uric acid (OR=2.06, P=0.044) according to multiple logistic regression analysis. In addition, after adjusting for gender, the uric acid concentration and the salivary spinability was significantly associated with BUN, potassium and creatinine levels. The subjects with high uric acid levels (>/= 7 mg dL(-1)) had the most elastic saliva. Both BUN and serum creatinine are the most commonly used indicators of renal function. Therefore, our findings might demonstrate that older adults who are dehydrated showed highly elastic saliva, which was associated with renal function. In conclusion, this study suggests that there is a significant relationship between chronic dehydration status and salivary spinability level.
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Affiliation(s)
- A Yoshihara
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Medical and Dental Sciences, Niigata University, Gakkocho-Dori, Niigata, Japan.
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16
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A preliminary study on the relationship between stimulated saliva and periodontal conditions in community-dwelling elderly people. J Dent 2006; 34:692-8. [DOI: 10.1016/j.jdent.2006.01.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2005] [Revised: 12/28/2005] [Accepted: 01/04/2006] [Indexed: 11/22/2022] Open
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17
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Abstract
Despite decades of research, much remains unanswered about the epidemiology of dry mouth. This review aims to provide an overview of the condition's epidemiology and the issues to consider when planning an epidemiological study of dry mouth. The latter can be broadly grouped into: study design; sampling and statistical power considerations; the measurement of dry mouth; and the selection, nature and measurement of relevant exposure measures, including medications and potential confounding variables. Each of these is discussed, in order to provide guidance for prospective researchers based on experience with past research. Finally, an agenda for further epidemiological research into dry mouth is proposed.
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Affiliation(s)
- W Murray Thomson
- Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand.
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Atkinson JC, Grisius M, Massey W. Salivary hypofunction and xerostomia: diagnosis and treatment. Dent Clin North Am 2005; 49:309-26. [PMID: 15755407 DOI: 10.1016/j.cden.2004.10.002] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Salivary gland hypofunction and complaints of xerostomia are common in elderly patients, irrespective of their living situation. Medication use is frequently related to dry mouth symptoms and reductions in salivary flow rates. Patients with reduced salivary flow are at increased risk for caries, oral fungal infections, swallowing problems, and diminished or altered taste. Oral health care providers should institute aggressive preventive measures and recommend palliative care for patients with significant reduction in salivary gland function. The systemic agents pilocarpine and cevimeline may help selected patients. Selective use of fluoride-releasing restorative materials and conservative treatment plans are recommended for this patient group.
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Affiliation(s)
- Jane C Atkinson
- Comprehensive Care and Therapeutics, University of Maryland Dental School, 666 West Baltimore Street, 3E-32, Baltimore, MD 21201-1586, USA.
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19
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Mahay S, Pariente JA, Lajas AI, Adeghate E, Rolph CE, Singh J. Effects of ageing on morphology, amylase release, cytosolic Ca2+ signals and acyl lipids in isolated rat parotid gland tissue. Mol Cell Biochem 2005; 266:199-208. [PMID: 15646043 DOI: 10.1023/b:mcbi.0000049158.85447.4f] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Xerostomia (oral dryness sensation) is due to dryness of the oral cavity and it is more prevalent in the elderly. This study investigated the effect of ageing on parotid gland structure and function of control (2-6 months) and aged (12, 16-18 and 22-24 months) rats employing light microscopic, colorimetric, gas chromatographic and microspectrofluorimetric methods to investigate the morphological changes of the parotid glands, amylase release, endogenous lipid distribution and cytosolic free calcium levels, respectively. When compared to controls, age-related changes were apparent in glands obtained from rats aged 16-18 and 22-24 months, which included reduced acinar cell distribution, enlarged parotid ducts with fatty and connective tissue and mast cell infiltrations. Parotid acini from 12, 16-18 and 22-24-month-old glands showed significant (p < 0.05) age-related decreases in amylase release, compared to controls when challenged with acetylcholine (ACh). No change in basal calcium signals was observed in parotid acini from 2-6 to 16-18-month-old-animals. However, stimulation of 16-18-month-old parotid acini with 10(-5)M ACh resulted in a significant (p < 0.001) decrease in both peak and plateau phases of the cytosolic Ca2+ signal when compared to control. Gas chromatography of de novo and essential acyl lipids revealed no changes in the amount of either acyl lipid group in glands obtained from 2-6 to 22-24-month-old animals. Lipid analysis of phospholipid associated acyl chains showed a higher relative proportion of linoleic acid in older glands. The results reveal that ageing is associated with marked and distinct morphological changes including infiltrations of lipids and mast cells of the parotid gland and decreases in amylase release and cytosolic Ca2+ signals.
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Affiliation(s)
- Sukhbinder Mahay
- Department of Biological Sciences, University of Central Lancashire, Prestonn, UK
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Haugejorden O, Klock KS, Trovik TA. Incidence and predictors of self-reported tooth loss in a representative sample of Norwegian adults. Community Dent Oral Epidemiol 2003; 31:261-8. [PMID: 12846848 DOI: 10.1034/j.1600-0528.2003.00004.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the self-reported 12-month incidence of tooth loss among Norwegian adults and to assess the association between tooth loss and some predictor variables. METHODS Of a two-stage nation-wide, representative random sample (n = 3958), information was obtained from 2682 subjects aged 20-79 years and the response rate was 68%. Telephone or face-to-face interviews by interviewers employed by the Central Bureau of Statistics (CBS) of Norway. Information was collected about demographic characteristics, the number of natural teeth present, the number of teeth lost during the last 12 months, and belief in keeping natural teeth for life. The present analyses are based on 2520 persons 20-79 years of age. RESULTS The proportion of respondents who reported losing one or more teeth was 6.45% (95% confidence limits (CL) = 5.49, 7.41). The participants who reported extractions had lost on average 1.54 (range 1-9) teeth. Multiple logistic regression analysis revealed a borderline significant effect of the level of education (OR = 0.68, 95% CL = 0.46, 1.00), i.e. the odds of losing one or more teeth during the last 12 months were lower among persons with more than 12 years of education than among persons with less education. The explained variance was 1.9%. CONCLUSION The annual incidence rate of tooth loss among Norwegian adults was found to lie within the range reported from other industrialized countries. After controlling for socio-demographic variables and the number of teeth present, the only borderline significant predictor of the incidence of tooth loss was the level of education.
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Affiliation(s)
- Ola Haugejorden
- Department of Odontology - Community Dentistry, University of Bergen, Norway.
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Ikebe K, Sajima H, Kobayashi S, Hata K, Morii K, Nokubi T, Ettinger RL. Association of salivary flow rate with oral function in a sample of community-dwelling older adults in Japan. ACTA ACUST UNITED AC 2002. [DOI: 10.1067/moe.2001.124001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ikebe K, Nokubi T, Sajima H, Kobayashi S, Hata K, Ono T, Ettinger RL. Perception of dry mouth in a sample of community-dwelling older adults in Japan. SPECIAL CARE IN DENTISTRY 2001; 21:52-9. [PMID: 11484581 DOI: 10.1111/j.1754-4505.2001.tb00225.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to examine the prevalence of perceived dry mouth among a group of independently-living elderly persons in Japan, and to determine its association with general disease, medication, and dental status, as well as its effect on oral function. The study population consisted of participants of the Senior Citizens' College. The subjective sensations of oral dryness on waking and while eating a meal were measured by a questionnaire. The number of usable questionnaires was 1003 or 77.9%. The mean age of the subjects was 66.3 +/- 4.2 years, and 53.0% were male. More than one-third (37.8%) of the subjects reported oral dryness on waking. Only 9.1% of them noticed a subjective feeling of dry mouth during eating. Persons who had at least one of these symptoms made up 41.0%. A multiple stepwise logistic regression analysis indicated the following results: Perception of dry mouth on waking was more frequent among males (p < 0.001), persons who had a low BMI (p < 0.05), and those taking two or more prescribed drugs (p < 0.01). Sensation of dry mouth when eating was more frequent among subjects with a low BMI (p < 0.001) and those who wore a denture in the maxillary arch (p < 0.05). Perception of dry mouth when eating was associated with self-assessed chewing ability (p < 0.01) and dissatisfaction with speaking clearly (p < 0.05), as well as dental status. However, dissatisfaction with tasting a meal had a significant relationship with the reports of mouth dryness on waking (p < 0.01). Our findings suggest that a substantially higher percentage of persons have the perception of dry mouth on waking than when eating, which was associated with medications, being male, and having a low BMI. This perception may influence oral function, especially the reported dissatisfaction with tasting foods.
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Affiliation(s)
- K Ikebe
- Department of Removable Prosthodontics, Osaka University Faculty of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
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