1
|
Lee DS, Kim HE, Choi JS. Oral Health-Related Factors Associated with Dysphagia Risk among Older, Healthy, Community-Dwelling Korean Adults: A Pilot Study. Healthcare (Basel) 2024; 12:267. [PMID: 38275546 PMCID: PMC10815140 DOI: 10.3390/healthcare12020267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Most previous studies addressing dysphagia examined individuals who already had diseases causing dysphagia and did not pay much attention to oral health conditions as a risk factor. This pilot study investigated 62 healthy adults aged 65 years or older who were living independently in the community, performed basic activities of daily living independently, and had no history of a causative disease of dysphagia to identify the factors associated with dysphagia risk, especially oral health. The Dysphagia Risk Assessment Scale was used to screen the patients for dysphagia. Hyposalivation was diagnosed by evaluating the unstimulated salivary flow rate, and orofacial muscle strength (anterior tongue elevation, buccinator muscle, and lip strength) was quantitatively measured using the Iowa Oral Performance Instrument. To analyze the factors associated with dysphagia risk, the Mann-Whitney test, Kruskal-Wallis test, and multiple logistic regression analyses were conducted. In the final regression model adjusted for sociodemographic characteristics, the oral health-related factors independently associated with dysphagia risk were buccinator muscle strength, hyposalivation, and subjective masticatory discomfort (p < 0.05). Therefore, our findings suggest that weak buccinator muscle strength, hyposalivation, and subjective masticatory discomfort are valuable indicators for the early detection of dysphagia in older, healthy, independent, community-dwelling adults.
Collapse
Affiliation(s)
- Da-Som Lee
- Department of Dental Hygiene, Graduate School, Gachon University, Incheon 21936, Republic of Korea;
| | - Hee-Eun Kim
- Department of Dental Hygiene, College of Medical Science, Gachon University, Incheon 21936, Republic of Korea;
| | - Jun-Seon Choi
- Department of Dental Hygiene, College of Medical Science, Gachon University, Incheon 21936, Republic of Korea;
| |
Collapse
|
2
|
Flink H, Tegelberg Å, Arnetz JE, Birkhed D. Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults. Acta Odontol Scand 2020; 78:229-235. [PMID: 31729277 DOI: 10.1080/00016357.2019.1690677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective: The aim was to study prevalence of xerostomia, hyposalivation and quality of life among caries active younger adults.Materials and methods: A questionnaire regarding oral and general health, xerostomia and quality of life was mailed to 134 caries active (CA) and 40 caries inactive (CI) patients, 25-50 years of age (mean age 39.9 ± 6.2 years) treated at a Swedish Public Dental Service clinic, regarding oral and general health, xerostomia and quality of life. Caries data and unstimulated whole salivary flow rates were obtained from dental records.Results: The overall response rate was 69%. Dental records confirmed that CA patients had more decayed teeth over time than CI patients (p < .001). The CA group reported worse oral health (p < .001) and general health (p < .01), more xerostomia (p < .001) and lower salivary flow rate (p < .01) compared to CI patients. Xerostomia was inversely related to unstimulated whole salivary flow rates as well as to oral and general health (p < .01). There were no differences between groups in quality of life.Conclusion: Younger caries active adult patients reported significantly more xerostomia and hyposalivation compared to caries inactive patients. Xerostomia and hyposalivation were inversely related to perceptions of oral and general health, but not to quality of life.
Collapse
Affiliation(s)
- Håkan Flink
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
- Public Dental Clinic Sala, Public Dental Health Västmanland, Sala, Sweden
| | - Åke Tegelberg
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Judith E. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | | |
Collapse
|
3
|
Jin L, Zhang M, Xu J, Xia D, Zhang C, Wang J, Wang S. Music stimuli lead to increased levels of nitrite in unstimulated mixed saliva. Sci China Life Sci 2018; 61:1099-1106. [PMID: 29934916 DOI: 10.1007/s11427-018-9309-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/10/2018] [Indexed: 06/08/2023]
Abstract
Concentration of salivary nitrate is approximately 10-fold to that of serum. Many circumstances such as acute stress could promote salivary nitrate secretion and nitrite formation. However, whether other conditions can also be used as regulators of salivary nitrate/nitrite has not yet been explored. The present study was designed to determine the influence of exposure to different music on the salivary flow rate and nitrate secretion and nitrite formation. Twenty-four undergraduate students (12 females and 12 males) were exposed to silence, rock music, classical music or white noise respectively on four consecutive mornings. The unstimulated salivary flow rate and stimulated salivary flow rate were measured. Salivary ionic (Na+, Ca2+ Cl-, and PO43-) content and nitrate/nitrite levels were detected. The unstimulated salivary flow rate was significantly increased after classical music exposure compared to that after silence. Salivary nitrite levels were significantly higher upon classical music and white noise stimulation than those under silence in females. However, males were more sensitive only to white noise with regard to the nitrite increase. In conclusion, this study demonstrated that classical music stimulation promotes salivary nitrite formation and an increase in saliva volume was observed. These observations may play an important role in regulating oral function.
Collapse
Affiliation(s)
- Luyuan Jin
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
- Department of General Dentistry and Emergency Care, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Mengbi Zhang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Junji Xu
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Dengsheng Xia
- Department of General Dentistry and Emergency Care, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Chunmei Zhang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Jingsong Wang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China
| | - Songlin Wang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing, 100050, China.
- Department of Biochemistry and Molecular Biology, Capital Medical University School of Basic Medical Sciences, Beijing, 100069, China.
| |
Collapse
|
4
|
Lakshmi CR, Radhika D, Prabhat M, Bhavana SM, Sai Madhavi N. Association between genetic taste sensitivity, 2D:4D ratio, dental caries prevalence, and salivary flow rate in 6-14-year-old children: a cross-sectional study. J Dent Res Dent Clin Dent Prospects 2016; 10:142-7. [PMID: 27651879 PMCID: PMC5025214 DOI: 10.15171/joddd.2016.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/26/2016] [Indexed: 11/24/2022] Open
Abstract
Background. The aim of this study was to assess the relationship between genetic taste sensitivity, dietary preferences and salivary flow rate in 6‒14-year-old children for identification of individuals at higher risk of developing dental caries. Methods. A total of 500 children 6‒14 years of age, of both genders, who reported to the Department of Oral Medicine and Radiology, were included. Propylthiouracil (PROP) sensitivity test was carried out and the subjects whose perception was bitter were grouped as tasters, whereas those who were unable to perceive any taste were grouped as non-tasters. The 2D:4D ratio was obtained by measuring the length ratio of index finger to ring finger with the help of a digital Vernier caliper. Evaluation of dietary preferences was carried out using a 24-hour dietary recall and accordingly they were categorized as sweet likers and dislikers. The salivary flow rate was estimated by collecting unstimulated saliva by spitting method. Data were analyzed with Student’s t-test and chi-squared test. Results. The results suggested a positive relation between low digit ratio (2D:4D), non-tasters, sweet likers and high caries index among the participants with a highly significant statistical difference (P ≤ 0.000). Tasters had high mean of USSR (0.48) than non-tasters (0.29), which was statistically significant. Conclusion. The present research revealed a positive correlation between all the parameters evaluated. Therefore an individual considered as non-taster by PROP was a sweet liker with low 2D:4D ratio, reduced salivary flow rate and high caries index.
Collapse
Affiliation(s)
- Chintamaneni Raja Lakshmi
- Reader, Department of Oral Medicine and Radiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutpalli, Gannavaram Mandal-521286, India
| | - Doppalapudi Radhika
- Postgraduate Student, Department of Oral Medicine and Radiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutpalli, Gannavaram Mandal-521286, India
| | - Mpv Prabhat
- Professor and Head of the Department, Department of Oral Medicine and Radiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutpalli, Gannavaram Mandal-521286, India
| | - Sujana Mulk Bhavana
- Assistant Professor, Department of Oral Medicine and Radiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutpalli, Gannavaram Mandal-521286, India
| | - Nallamilli Sai Madhavi
- Assistant Professor, Department of Oral Medicine and Radiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutpalli, Gannavaram Mandal-521286, India
| |
Collapse
|
5
|
Sonthalia A, Chandrasekaran AP, Mhaske SP, Lau M, Joshy VR, Attokaran G. Comparative evaluation of effect of complete denture wears on the flow rate of saliva in both medicated and apparently healthy patients. J Int Soc Prev Community Dent 2016; 6:219-23. [PMID: 27382537 PMCID: PMC4916795 DOI: 10.4103/2231-0762.183103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/04/2016] [Indexed: 11/28/2022] Open
Abstract
Aim and Objectives: In the denture wearing people, saliva is necessary to create adhesion, cohesion, and surface tension that ultimately leads to the increased retention of the denture. Medications have some influence on the flow rate of saliva and denture retention. The present study evaluates the effect of complete denture wear on the flow rate of saliva in both medicated and apparently healthy patients. Materials and Methods: The participants were 42 edentulous individuals aged 35–70 years requiring complete denture prostheses. The participants were divided into two groups of medicated and unmedicated. Unstimulated whole saliva was collected at 24 h and 3 months after the insertion of new complete dentures in both the groups. The data obtained were analyzed using Student's paired t-test and unpaired t-test. Intergroup changes were compared with unpaired t-test. Intragroup changes were compared with paired t-test using the Statistical Package for Social Sciences, version 22.0. Results: In the unmedicated group, the mean salivary flow rate was high at 24 h after denture insertion when compared to before denture insertion (P = 0.001 VHS). In the medicated group, the observation was highly significant (P = 0.007 HS) 24 h after denture insertion and after 3 months (P = 0.02 S) when compared to before denture insertion. Conclusion: No significant difference in the salivary flow rate was found 3 months after denture insertion when compared to before denture insertion for both the medicated and unmedicated groups.
Collapse
Affiliation(s)
- Abhay Sonthalia
- Department of Prosthodontics, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Arun P Chandrasekaran
- Department of Prosthodontics, Faculty of Dentistry, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka, India
| | - Sheetal P Mhaske
- Department of Oral Pathology, MA Rangoonwala Dental College, Maharashtra, India
| | - Mayank Lau
- Department of Prosthodontics, Darshan Dental College, Udaipur, Rajasthan, India
| | - V R Joshy
- Department of Oral Pathology and Microbiology, PSM College of Dental Science and Research, Thrissur, Kerala, India
| | - George Attokaran
- Department of Prosthodontics, PSM College of Dental Science and Research, Thrissur, Kerala, India
| |
Collapse
|
6
|
Aminabadi NA, Najafpour E, Razavi Rohani Z, Sighari Deljavan A, Ghojazadeh M, Jamali Z. Linear reciprocal interaction between dental caries and salivary characteristics. J Oral Sci 2015; 55:337-42. [PMID: 24351922 DOI: 10.2334/josnusd.55.337] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Carious tooth surfaces can alter saliva in various ways. We investigated whether salivary parameters were affected by elimination of existing active dental caries in 99 children (age 6-12 years) with more than five carious tooth surfaces. Unstimulated saliva samples were obtained from each child, and salivary characteristics were evaluated. One month after caries treatment that eliminated all existing dental caries, saliva sampling and analysis were repeated. Saliva viscosity significantly decreased (P = 0.04), while pH and saliva buffering capacity significantly increased (P < 0.001). There was no significant difference in unstimulated salivary production at the start of the study and 1 month after caries elimination (P > 0.05). The relationship between dental caries and salivary condition is reciprocal. Treatment of existing dental caries can prevent future caries by improving saliva quality.
Collapse
Affiliation(s)
- Naser Asl Aminabadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Science
| | | | | | | | | | | |
Collapse
|
7
|
Lübbers HT, Kruse AL, Ettlin DA. Postradiation xerostomia and oral pain. J Am Dent Assoc 2014; 145:964-5. [PMID: 25170005 DOI: 10.14219/jada.2013.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
8
|
Kim JH, Ahn HJ, Choi JH, Jung DW, Kwon JS. Effect of 0.1% pilocarpine mouthwash on xerostomia: double-blind, randomised controlled trial. J Oral Rehabil 2013; 41:226-35. [PMID: 24527846 DOI: 10.1111/joor.12127] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2013] [Indexed: 11/28/2022]
Abstract
The objective of this study was to evaluate the effect of 0.1% pilocarpine mouthwash in xerostomic patients. Sixty volunteers were randomly allocated to two groups. The experimental group used 0.1% pilocarpine solution, and the control group used 0.9% saline. The short- and long-term effects of pilocarpine were investigated by measuring the severity of oral dryness, minor salivary flow rates and unstimulated whole salivary flow rate at predetermined times. The severity of oral dryness was decreased in both groups at 0, 30 and 60 min after mouthwashing, with no significant difference between the groups. Buccal and labial secretions were increased in both groups, but only the experimental group exhibited increased palatal secretion. Labial and palatal secretions, but not buccal secretion, differed between the groups. The unstimulated whole salivary flow rate was increased in the experimental group and differed from that in the control group. After 4 weeks, the severity of oral dryness was decreased in both groups and did not differ between them. The oral dryness at night or on awakening significantly decreased in both groups, with no significant difference between them, but the oral dryness at other times of the day and the difficulty in swallowing foods were not significantly changed in both groups. Minor salivary and unstimulated whole salivary flow rates did not increase in both groups. Until 1 h after mouthwashing, 0.1% pilocarpine mouthwash increased minor salivary and unstimulated whole salivary secretions, but was not superior compared with 0.9% saline at relieving subjective oral dryness.
Collapse
Affiliation(s)
- J H Kim
- Department of Orofacial Pain & Oral Medicine, Yonsei Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | | | | | | | | |
Collapse
|
9
|
Krunić J, Stojanović N, Ivković N, Stojić D. Salivary flow rate and decayed, missing, and filled teeth (DMFT) in female patients with schizophrenia on chlorpromazine therapy. J Dent Sci 2013; 8:418-24. [DOI: 10.1016/j.jds.2013.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
10
|
Jin L, Qin L, Xia D, Liu X, Fan Z, Zhang C, Gu L, He J, Ambudkar IS, Deng D, Wang S. Active secretion and protective effect of salivary nitrate against stress in human volunteers and rats. Free Radic Biol Med 2013; 57:61-7. [PMID: 23277147 PMCID: PMC4059197 DOI: 10.1016/j.freeradbiomed.2012.12.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 11/16/2012] [Accepted: 12/17/2012] [Indexed: 02/06/2023]
Abstract
Up to 25% of the circulating nitrate in blood is actively taken up, concentrated, and secreted into saliva by the salivary glands. Salivary nitrate can be reduced to nitrite by the commensal bacteria in the oral cavity or stomach and then further converted to nitric oxide (NO) in vivo, which may play a role in gastric protection. However, whether salivary nitrate is actively secreted in human beings has not yet been determined. This study was designed to determine whether salivary nitrate is actively secreted in human beings as an acute stress response and what role salivary nitrate plays in stress-induced gastric injury. To observe salivary nitrate function under stress conditions, alteration of salivary nitrate and nitrite was analyzed among 22 healthy volunteers before and after a strong stress activity, jumping down from a platform at the height of 68 m. A series of stress indexes was analyzed to monitor the stress situation. We found that both the concentration and the total amount of nitrate in mixed saliva were significantly increased in the human volunteers immediately after the jump, with an additional increase 1h later (p<0.01). Saliva nitrite reached a maximum immediately after the jump and was maintained 1h later. To study the biological functions of salivary nitrate and nitrite in stress protection, we further carried out a water-immersion-restraint stress (WIRS) assay in male adult rats with bilateral parotid and submandibular duct ligature (BPSDL). Intragastric nitrate, nitrite, and NO; gastric mucosal blood flow; and gastric ulcer index (UI) were monitored and nitrate was administrated in drinking water to compensate for nitrate secretion in BPSDL animals. Significantly decreased levels of intragastric nitrate, nitrite, and NO and gastric mucosal blood flow were measured in BPSDL rats during the WIRS assay compared to sham control rats (p<0.05). Recovery was observed in the BPSDL rats upon nitrate administration. The WIRS-induced UI was significantly higher in the BPSDL animals compared to controls, and nitrate administration rescued the WIRS-induced gastric injury in BPSDL rats. In conclusion, this study suggests that stress promotes salivary nitrate secretion and nitrite formation, which may play important roles in gastric protection against stress-induced injury via the nitrate-dependent NO pathway.
Collapse
Affiliation(s)
- Luyuan Jin
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Lizheng Qin
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Dengsheng Xia
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Xibao Liu
- Molecular Physiology and Therapeutics Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-1190, USA
| | - Zhipeng Fan
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Chunmei Zhang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
| | - Liankun Gu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, People’s Republic of China
| | - Junqi He
- Department of Biochemistry and Molecular Biology, Capital Medical University School of Basic Medicine, Beijing 100069, People’s Republic of China
| | - Indu S. Ambudkar
- Molecular Physiology and Therapeutics Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-1190, USA
| | - Dajun Deng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, People’s Republic of China
- Corresponding author. Fax: +86 10 88122437
| | - Songlin Wang
- Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China
- Department of Biochemistry and Molecular Biology, Capital Medical University School of Basic Medicine, Beijing 100069, People’s Republic of China
- Corresponding author at: Salivary Gland Disease Center and Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, People’s Republic of China. Fax: +86 10 67062012
| |
Collapse
|
11
|
Abstract
Sjögren's syndrome (SjS) is one of the most common autoimmune rheumatic diseases, clinically characterized by xerostomia and keratoconjunctivitis sicca. We investigated the following controversial topics: (i) Do we have reliable ways of assessing saliva production? (ii) How important are the quantity and quality of saliva? (iii) Are only anti-SSA/Ro and anti-SSB/La relevant for the diagnosis of SjS? (iv) Are the American-European Consensus criteria (AECC) the best way to diagnose SjS? Results from literature searches suggested the following: (i) Despite the fact that numerous tests are available to assess salivation rates, direct comparisons among them are scarce with little evidence to suggest one best test. (ii) Recent developments highlight the importance of investigating the composition of saliva. However, more research is needed to standardize the methods of analysis and collection and refine the quality of the accumulating data. (iii) In addition to anti-Ro/La autoantibodies, anti α-fodrin IgA and anti-MR3 autoantibodies seem to be promising diagnostic markers of SjS, but more studies are warranted to test their sensitivity and specificity. (iv) AECC are classification, not diagnostic criteria. Moreover, recent innovations have not been incorporated into these criteria. Consequently, treatment directed to patients diagnosed using the AECC might exclude a significant proportion of patients with SjS.
Collapse
Affiliation(s)
- D J Aframian
- Salivary Gland Clinic and Saliva Diagnostic Laboratory, Department of Oral Medicine, Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
| | | | | | | |
Collapse
|
12
|
Abstract
Introduction: Burning mouth syndrome is a chronic pain syndrome primarily affecting elderly women with hormonal changes or psychological disorders. It is multifactorial in origin, often idiopathic and its etiopathogenesis, majorly being neuropathic, largely remains enigmatic. Aim: To determine the prevalence of burning mouth symptom, in elderly women and evaluate local and systemic causes responsible for burning sensation. Materials and Methods: 100 elderly postmenopausal women were included in the study out of which 56 had a chief complaint of burning sensation. These patients were evaluated for the levels of anxiety and depression by means of questionnaire. The severity of burning and the response to the treatment was assessed with a five point Visual Analog Scale. The results were analyzed using “Chi-square test”. Results: There was statistically significant increase in the levels of anxiety and depression in the study group. Conclusion: The present study clearly indicates that most of the patients had moderate to severe levels of depression, which suggests that anxiety and depression are constant features in postmenopausal female patients.
Collapse
Affiliation(s)
- Rohit Malik
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Modinagar, Kadrabad, India
| | | | | | | | | |
Collapse
|
13
|
Xu J, Wang D, Liu D, Fan Z, Zhang H, Liu O, Ding G, Gao R, Zhang C, Ding Y, Bromberg JS, Chen W, Sun L, Wang S. Allogeneic mesenchymal stem cell treatment alleviates experimental and clinical Sjögren syndrome. Blood 2012; 120:3142-51. [PMID: 22927248 DOI: 10.1182/blood-2011-11-391144] [Citation(s) in RCA: 198] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Sjögren syndrome (SS) is a systemic autoimmune disease characterized by dry mouth and eyes, and the cellular and molecular mechanisms for its pathogenesis are complex. Here we reveal, for the first time, that bone marrow mesenchymal stem cells in SS-like NOD/Ltj mice and human patients were defective in immunoregulatory functions. Importantly, treatment with mesenchymal stem cells (MSCs) suppressed autoimmunity and restored salivary gland secretory function in both mouse models and SS patients. MSC treatment directed T cells toward Treg and Th2, while suppressing Th17 and Tfh responses, and alleviated disease symptoms. Infused MSCs migrated toward the inflammatory regions in a stromal cell-derived factor-1-dependent manner, as neutralization of stromal cell-derived factor-1 ligand CXCR4 abolished the effectiveness of bone marrow mesenchymal stem cell treatment. Collectively, our study suggests that immunologic regulatory functions of MSCs play an important role in SS pathogenesis, and allogeneic MSC treatment may provide a novel, effective, and safe therapy for patients with SS.
Collapse
|
14
|
Ko JY, Park IH, Park HK, Kho HS. Outcome predictors of initial treatment with topical lubricant and parafunctional habit control in burning mouth syndrome (BMS). Arch Gerontol Geriatr 2011; 53:263-9. [DOI: 10.1016/j.archger.2010.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Revised: 10/12/2010] [Accepted: 10/15/2010] [Indexed: 10/18/2022]
|
15
|
Doornaert P, Verbakel WFAR, Rietveld DHF, Slotman BJ, Senan S. Sparing the contralateral submandibular gland without compromising PTV coverage by using volumetric modulated arc therapy. Radiat Oncol 2011; 6:74. [PMID: 21679401 PMCID: PMC3126722 DOI: 10.1186/1748-717x-6-74] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 06/16/2011] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Salivary gland function decreases after radiation doses of 39 Gy or higher. Currently, submandibular glands are not routinely spared. We implemented a technique for sparing contralateral submandibular glands (CLSM) during contralateral elective neck irradiation without compromising PTV coverage. METHODS Volumetric modulated arc therapy (RapidArc™) plans were applied in 31 patients with stage II-IV HNC without contralateral neck metastases, all of whom received elective treatment to contralateral nodal levels II-IV. Group 1 consisted of 21 patients undergoing concurrent chemo-radiotherapy, with elective nodal doses of 57.75 Gy (PTVelect) and 70 Gy to tumor and pathological nodes (PTVboost) in 7 weeks. Group 2 consisted of 10 patients treated with radiotherapy to 54.45 Gy to PTVelect and 70 Gy to PTVboost in 6 weeks. All clinical plans spared the CLSM using individually adapted constraints. For each patient, a second plan was retrospectively generated without CLSM constraints ('non-sparing plan'). RESULTS PTV coverage was similar for both plans, with 98.7% of PTVelect and 99.2% of PTVboost receiving ≥95% of the prescription dose. The mean CLSM dose in group 1 was 33.2 Gy for clinical plans, versus 50.6 Gy in 'non-sparing plans' (p < 0.001). In group 2, mean CLSM dose was 34.4 Gy for clinical plans, and 46.8 Gy for non-sparing plans (p = 0.002). CONCLUSIONS Elective radiotherapy to contralateral nodal levels II-IV using RapidArc consistently limited CLSM doses well below 39 Gy, without compromising PTV-coverage. Future studies will reveal if this extent of dose reduction can reduce patient symptoms.
Collapse
Affiliation(s)
- Patricia Doornaert
- Department of Radiation Oncology, VU University Medical Center, PB 7057, 1007 MB Amsterdam, The Netherlands
| | - Wilko FAR Verbakel
- Department of Radiation Oncology, VU University Medical Center, PB 7057, 1007 MB Amsterdam, The Netherlands
| | - Derek HF Rietveld
- Department of Radiation Oncology, VU University Medical Center, PB 7057, 1007 MB Amsterdam, The Netherlands
| | - Ben J Slotman
- Department of Radiation Oncology, VU University Medical Center, PB 7057, 1007 MB Amsterdam, The Netherlands
| | - Suresh Senan
- Department of Radiation Oncology, VU University Medical Center, PB 7057, 1007 MB Amsterdam, The Netherlands
| |
Collapse
|
16
|
Simões A, de Campos L, de Souza DN, de Matos JA, Freitas PM, Nicolau J. Laser Phototherapy as Topical Prophylaxis Against Radiation-Induced Xerostomia. Photomed Laser Surg 2010; 28:357-63. [DOI: 10.1089/pho.2009.2486] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alyne Simões
- Department of Dental Materials, Division of Oral Biology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luana de Campos
- Department of Dental Materials, Division of Oral Biology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Douglas Nesadal de Souza
- Department of Dental Materials, Division of Oral Biology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jonas Alencar de Matos
- Department of Dental Materials, Division of Oral Biology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Patricia Moreira Freitas
- Department of Restorative Dentistry, Special Laboratory of Lasers in Dentistry, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jose Nicolau
- Department of Dental Materials, Division of Oral Biology, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
17
|
Kim SY, Guevara JP, Kim KM, Choi HK, Heitjan DF, Albert DA. Hyperuricemia and coronary heart disease: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 2010; 37:185-93. [PMID: 20191515 DOI: 10.1111/j.1365-2842.2009.02037.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The role of serum uric acid as an independent risk factor for cardiovascular disease remains unclear, although hyperuricemia is associated with cardiovascular disease such as coronary heart disease (CHD), stroke, and hypertension. METHODS A systematic review and meta-analysis using a random-effects model was conducted to determine the risk of CHD associated with hyperuricemia in adults. Studies of hyperuricemia and CHD were identified by searching major electronic databases using the medical subject headings and keywords without language restriction (through February 2009). Only prospective cohort studies were included if they had data on CHD incidences or mortalities related to serum uric acid levels in adults. RESULTS Twenty-six eligible studies of 402,997 adults were identified. Hyperuricemia was associated with an increased risk of CHD incidence (unadjusted risk ratio [RR] 1.34, 95% confidence interval [95% CI] 1.19-1.49) and mortality (unadjusted RR 1.46, 95% CI 1.20-1.73). When adjusted for potential confounding, the pooled RR was 1.09 (95% CI 1.03-1.16) for CHD incidence and 1.16 (95% CI 1.01-1.30) for CHD mortality. For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR for CHD mortality was 1.12 (95% CI 1.05-1.19). Subgroup analyses showed no significant association between hyperuricemia and CHD incidence/mortality in men, but an increased risk for CHD mortality in women (RR 1.67, 95% CI 1.30-2.04). CONCLUSION Hyperuricemia may marginally increase the risk of CHD events, independently of traditional CHD risk factors. A more pronounced increased risk for CHD mortality in women should be investigated in future research.
Collapse
Affiliation(s)
- Seo Young Kim
- Brigham and Women's Hospital, Boston, Massachusetts, USA.
| | | | | | | | | | | |
Collapse
|
18
|
Simões A, Platero MD, Campos L, Aranha AC, Eduardo CDP, Nicolau J. Laser as a therapy for dry mouth symptoms in a patient with Sjögren's syndrome: a case report. Spec Care Dentist 2009; 29:134-7. [PMID: 19938253 DOI: 10.1111/j.1754-4505.2009.00078.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This clinical case study reports on dry mouth symptoms in a patient with Sjögren's syndrome (SS) who was treated with laser phototherapy (LPT). A 60-year-old woman diagnosed with SS was referred to the laboratory for lasers in dentistry to treat her severe xerostomia. A diode laser (780 nm, 3.8 J/cm2, 15 mW) was used to irradiate the parotid, submandibular, and sublingual glands, three times per week, for a period of 8 months. The salivary flow rate and xerostomia symptoms were measured before, during, and after LPT. Dry mouth symptoms improved during LPT. After LPT, the parotid salivary gland pain and swelling were no longer present. Treatment with LPT was an effective method to improve the quality of life of this patient with SS.
Collapse
Affiliation(s)
- Alyne Simões
- Oral Biology Research Center, Department of Biomaterials and Oral Biochemistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | | | | | | | | | | |
Collapse
|
19
|
Li Y, Hu B, Liu Y, Ding G, Zhang C, Wang S. The effects of fixed orthodontic appliances on saliva flow rate and saliva electrolyte concentrations. J Oral Rehabil 2009; 36:781-5. [PMID: 19744263 DOI: 10.1111/j.1365-2842.2009.01993.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fixed appliance orthodontic treatment may affect local saliva secretion; however, there is limited information available about this respect in the literature. Understanding how fixed appliance orthodontic treatment affects local saliva secretion could provide insight on possible contributions of salivary changes towards decalcification. In this study, we found that during the first month of fixed orthodontic treatment, the whole saliva flow rate, upper labial saliva flow rate and concentrations of whole saliva sodium and chlorine increased significantly, while the concentrations of calcium, phosphorous and potassium in whole saliva decreased. However, all these were in normal levels after 3 months. This study demonstrated that saliva flow rate was increased and saliva electrolytes were changed at early stage when placing fixed orthodontic appliances, which was considered due to increased mechanosensation.
Collapse
Affiliation(s)
- Y Li
- Salivary Gland Disease Center and the Molecular Laboratory for Gene Therapy & Tooth Regeneration, Beijing 100050, China
| | | | | | | | | | | |
Collapse
|
20
|
Kanehira T, Yamaguchi T, Takehara J, Kashiwazaki H, Abe T, Morita M, Asano K, Fujii Y, Sakamoto W. A pilot study of a simple screening technique for estimation of salivary flow. ACTA ACUST UNITED AC 2009; 108:389-93. [DOI: 10.1016/j.tripleo.2009.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 04/06/2009] [Accepted: 04/09/2009] [Indexed: 10/20/2022]
|
21
|
Flink H, Bergdahl M, Tegelberg Å, Rosenblad A, Lagerlöf F. Prevalence of hyposalivation in relation to general health, body mass index and remaining teeth in different age groups of adults. Community Dent Oral Epidemiol 2008; 36:523-31. [DOI: 10.1111/j.1600-0528.2008.00432.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
22
|
Oh D, Lee J, Kim Y, Kho H. Effects of carboxymethylcellulose (CMC)-based artificial saliva in patients with xerostomia. Int J Oral Maxillofac Surg 2008; 37:1027-31. [DOI: 10.1016/j.ijom.2008.06.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2007] [Revised: 12/14/2007] [Accepted: 06/05/2008] [Indexed: 11/19/2022]
|
23
|
Longman LP, McCracken CF, Higham SM, Field EA. Clinical Oral Medicine: The clinical assessment of oral dryness is a significant predictor of salivary gland hypofunction. Oral Dis 2008; 6:366-70. [PMID: 11355268 DOI: 10.1111/j.1601-0825.2000.tb00128.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare subjective complaints of xerostomia and salivary gland dysfunction and a clinical assessment of oral dryness with an objective measurement of salivary gland dysfunction, in a group of UK patients attending a Dry Mouth Clinic. The aim of the study was to identify signs and symptoms that may be of predictive value for salivary gland hypofunction (SGH) in clinical practice. METHODS This prospective study investigated 214 patients who attended a Dry Mouth Clinic, held at Liverpool University Dental Hospital. Patients gave a history of xerostomia for a minimum of 6 months and were asked standardised questions to subjectively assess oral dysfunction. The oral mucosa was then clinically assessed for dryness and sialometry was performed. Unstimulated whole saliva flow rates (UFR) of < 0.2 ml min-1 were considered to be indicative of SGH. RESULTS One or more symptoms of oral dysfunction were reported in 178 (83%) patients, in addition to xerostomia. The clinician diagnosed oral dryness in 105 patients. Objective evidence of SGH was found in 125 (58%) of patients. The clinicians' subjective assessment of oral dryness was indicative of a reduced UFR (P < 0.0001) and a significant predictor of an UFR < 0.2 ml min-1 using logistic regression analysis (odds ratio 9.6; 95% CI 4.8 and 19.3). The mean UFR of patients who reported symptoms of oral dysfunction was significantly lower than the mean UFR of patients who reported no oral dysfunction. Using logistic and multiple regression analyses, symptoms of oral dysfunction were not found to be significant predictors of either an UFR < 0.2 ml min-1 or a reduced UFR. CONCLUSIONS The clinical assessment of oral dryness was a significant predictor of SGH, in this selected group of patients. Patients who complain of xerostomia may have additional symptoms of oral dysfunction indicative of a reduced UFR.
Collapse
Affiliation(s)
- L P Longman
- Department of Clinical Dental Sciences, University of Liverpool School of Dentistry, Liverpool L69 3BX, UK.
| | | | | | | |
Collapse
|
24
|
Affiliation(s)
- Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| |
Collapse
|
25
|
Abstract
The purpose of this study was to investigate the relationship between whole salivary flow rate and dry mouth-related subjective symptoms and behaviours in patients with dry mouth. Seventy-eight patients (13 men and 65 women, 58.2 +/- 13.5 years) with dry mouth were asked a standardized series of questions concerning dry mouth-related symptoms and behaviours. Whole salivary flow rates were measured under unstimulated and stimulated conditions. The effect of oral dryness on daily life was significantly associated with the flow rate of stimulated whole saliva (r(s) = -0.30, P < 0.01) and frequency of oral dryness (r(s) = 0.46, P < 0.01). Dry mouth-related symptoms and behaviours were significantly associated with the whole salivary flow rate and the correlation was more remarkable with respect to stimulated whole saliva. The most common dry mouth-associated complaint was sensation of burning mouth. The effect of oral dryness on daily life was significantly affected by the presence of taste disturbances. Collectively, dry mouth-related symptoms and behaviours were significantly associated with whole salivary flow rate. Moreover, the severity of dry mouth-related symptoms was more closely correlated with the flow rate of stimulated saliva, compared with the unstimulated flow rate.
Collapse
Affiliation(s)
- K-I Suh
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | | | | | | | | |
Collapse
|
26
|
Anand AK, Jain J, Negi PS, Chaudhoory AR, Sinha SN, Choudhury PS, Kumar R, Munjal RK. Can dose reduction to one parotid gland prevent xerostomia?--A feasibility study for locally advanced head and neck cancer patients treated with intensity-modulated radiotherapy. Clin Oncol (R Coll Radiol) 2006; 18:497-504. [PMID: 16909975 DOI: 10.1016/j.clon.2006.04.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIMS Dryness of the mouth is one of the most distressing chronic toxicities of radiation therapy in head and neck cancers. In this study, parotid function was assessed in patients with locally advanced head and neck cancers undergoing intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Parotid function was assessed with the help of a questionnaire and parotid scintigraphy, especially with regards to unilateral sparing of the parotid gland. MATERIALS AND METHODS In total, 19 patients were treated with compensator-based IMRT between February 2003 and March 2004. The dose to the clinical target volume ranged between 66 and 70 Gy in 30-35 fractions to 95% of the isodose volume. Ipsilateral high-risk neck nodes received an average dose of 60 Gy and the contralateral low-risk neck received a dose of 54-56 Gy. Eight of 19 patients also received concomitant chemotherapy. RESULTS Subjective toxicity to the parotid glands was assessed with the help of a questionnaire at 0, 3 and 6 months and objective toxicity was assessed with parotid scintigraphy at 0 and 3 months. The mean dose to the ipsilateral parotid gland ranged from 19.5 to 52.8 Gy (mean 33.14 Gy) and the mean dose to the contralateral gland was 11.1-46.6 Gy (mean 26.85 Gy). At a median follow-up of 13 months, 9/19 patients had no symptoms of dryness of the mouth (grade I), 8/19 had mild dryness of the mouth (grade II) and only 2/19 had grade III xerostomia, although the parotid gland could only be spared on one side in most of the patients. CONCLUSIONS Minimising the radiation dose to one of the parotid glands with the help of IMRT in patients with advanced head and neck cancers can prevent xerostomia in most patients and parotid scintigraphy is a useful method of documenting xerostomia.
Collapse
Affiliation(s)
- A K Anand
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Flink H, Tegelberg A, Thörn M, Lagerlöf F. Effect of oral iron supplementation on unstimulated salivary flow rate: a randomized, double-blind, placebo-controlled trial. J Oral Pathol Med 2006; 35:540-7. [PMID: 16968234 DOI: 10.1111/j.1600-0714.2006.00450.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND No treatment is known to permanently increase salivary flow in patients with hyposalivation. The objective of this study was to investigate the effect of iron supplementation on salivary flow rate. METHODS A double-blind, randomized, placebo-controlled trial was carried out on 50 individuals with a low unstimulated whole salivary flow rate and low serum ferritin. Half the individuals received 60 mg iron orally twice a day for 3 months, while the other half received placebo. RESULTS No statistically significant difference was found between the groups after treatment for the unstimulated flow rate and in the subjective assessments of oral dryness. The serum ferritin values increased significantly in the iron group but not in the placebo group. CONCLUSION Oral supplementation with iron for 3 months has no effect on salivary flow rate among individuals with hyposalivation and low serum ferritin values.
Collapse
Affiliation(s)
- Håkan Flink
- Centre for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden.
| | | | | | | |
Collapse
|
28
|
Sung JM, Kuo SC, Guo HR, Chuang SF, Lee SY, Huang JJ. The role of oral dryness in interdialytic weight gain by diabetic and non-diabetic haemodialysis patients. Nephrol Dial Transplant 2006; 21:2521-8. [PMID: 16720594 DOI: 10.1093/ndt/gfl236] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Factors influencing the percentage of daily interdialytic weight gain (IDWG%) and their interactions in haemodialysis (HD) patients have not been well-defined, especially in diabetic patients. We analysed contributing factors for the increase of IDWG%, particularly xerostomia (oral dryness), among diabetic and non-diabetic HD patients. METHODS We collected 3 month prospective data in 184 stable HD patients (116 non-diabetic and 68 diabetic), including assessments of xerostomia by 100 mm visual analog scales (VASs), and the unstimulated whole salivary (UWS) flow rate was measured in 91 patients by a spitting method. RESULTS Diabetic patients have higher IDWG% (P = 0.042) and VAS oral dryness score (P = 0.021), whereas, have lower UWS (P = 0.032). In non-diabetic patients, the VAS oral dryness score, age, Kt/V and blood urea nitrogen (BUN) level correlated independently with IDWG%. In diabetic patients, the haemoglobin A(1C) (HbA(IC)) correlated significantly with IDWG% after controlling for age, Kt/V and BUN level; however, when VAS oral dryness score was introduced into the regression model, the effect of HbA(IC) became marginally significant (P = 0.073) while the VAS oral dryness score became significantly correlated with IDWG%. The increases in IDWG% per unit change in VAS oral dryness score did not show significant difference between the non-diabetic and total diabetic patients; however, it was larger in patients with HbA(IC) >or=9%. CONCLUSIONS Xerostomia plays a significant role in increasing IDWG% among diabetic and non-diabetic HD patients. In diabetic patients, the increased IDWG% associated with the increasing HbA(1C) level is largely dependent on the severity of xerostomia, and we speculate that insulin deficiency may operate synergistically with xerostomia in increasing IDWG% in patients with HbA(1C) >or=9%.
Collapse
Affiliation(s)
- Junne-Ming Sung
- Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Rd, Tainan 70428, Taiwan, ROC
| | | | | | | | | | | |
Collapse
|
29
|
Abstract
Parotid salivation is known to be influenced by the temperature of liquids moved around the mouth. Here we investigated the ability of non-liquid thermal stimuli to change the rate of salivation. Unilateral parotid saliva was collected using a Lashley Cup from 12 normally hydrated subjects. Thermal stimuli were delivered through a copper tube, in which temperature-controlled water flowed, resting statically on the anterior tongue. During separate trials, the tube was 10, 22, or 44 degrees C, or the resting temperature of the tongue (or hypothenar of the hand, the control site). On each trial, the unstimulated salivation rate was first measured for 6 min while the subject remained seated with the mouth closed. Subsequently, salivation was measured for 6 min during application of the thermal stimulus. The tube was then removed for 1-2 min before the next trial. During the trials, subjects repeatedly rated the subjective temperature of the tongue (or hypothenar) and its perceived wetness/dryness. Stimulated salivation, expressed as a proportion of the previously measured unstimulated salivation, differed among body sites and temperatures (P<0.03). A significant increase in salivation was seen only for the 10 degrees C stimulus applied to the tongue. Wetness ratings and salivation rates were positively correlated, albeit weakly. These results demonstrate that temperature-evoked changes in parotid salivation do not require the unique spatiotemporal dynamics of the tongue and jaw movements in wetting the oral mucosa.
Collapse
Affiliation(s)
- Andy Lee
- Department of Biochemistry, North Carolina State University, Raleigh, NC, USA
| | | | | |
Collapse
|
30
|
Sung JM, Kuo SC, Guo HR, Chuang SF, Lee SY, Huang JJ. Decreased Salivary Flow Rate as a Dipsogenic Factor in Hemodialysis Patients: Evidence from an Observational Study and a Pilocarpine Clinical Trial. J Am Soc Nephrol 2005; 16:3418-29. [PMID: 16177001 DOI: 10.1681/asn.2005040346] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Decreased salivary flow rate causes xerostomia (symptoms of oral dryness) in patients who undergo hemodialysis (HD); however, whether it thus contributes to thirst and excess interdialytic weight gain (IDWG) remains undetermined. In the observational study, 3 mo of data of 90 stable HD patients were collected, and sensations of thirst and xerostomia were assessed by 100-mm visual analog scales (VAS). Multivariate analyses revealed that the VAS oral dryness score was an independent determinant for thirst, daily IDWG, and IDWG%. Unstimulated whole salivary flow rate (UWS) was measured in 45 participants and was negatively correlated with VAS oral dryness score (r = -0.690, P <or= 0.001), daily IDWG (r = -0.361, P = 0.016), and daily IDWG% (r = -0.302, P = 0.045). In the interventional trial, the test drug was 5 mg of oral pilocarpine solution or placebo. Sixty hyperdipsic HD patients (IDWG% > 2%/d) were randomly assigned to either the sequence pilocarpine (2 wk)-washout (3 wk)-placebo (2 wk)-washout (2 mo)-placebo (3 mo) or placebo (2 wk)-washout (3 wk)-pilocarpine (2 wk)-washout (2 mo)-pilocarpine (3 mo) with 35 participants completing the trial. During the 2-wk crossover period (the first to seventh weeks), pilocarpine increased UWS and decreased xerostomia and thirst. The IDWG(2d) decreased (by approximately 0.2 kg; P = 0.013) but not IDWG(3d). During the 3-mo interventional period, pilocarpine increased UWS but decreased both IDWG(2d) (by 0.76 kg; P = 0.021) and IDWG(3d) (by 1.07 kg; P = 0.007). It also modestly increased serum albumin and decreased mean BP. Pilocarpine-related adverse effects were generally mild. In conclusion, decreased salivary flow is a dipsogenic factor in HD patients, and pilocarpine can alleviate it.
Collapse
Affiliation(s)
- Junne-Ming Sung
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
| | | | | | | | | | | |
Collapse
|
31
|
|
32
|
Liquidato BM, Filho IB. Evaluation of sialometry and minor salivary gland biopsy in classification of Sjögren's Syndrome patients. Braz J Otorhinolaryngol 2005; 71:346-54. [PMID: 16446940 PMCID: PMC9450548 DOI: 10.1016/s1808-8694(15)31334-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
33
|
Abstract
In this study, effects on both stimulated and non-stimulated salivary flow as well as salivary components of different antidepressant drugs were compared. Rats received imipramine (IMI; 10mg/ml), fluoxetine (FLU; 20 mg/ml) or moclobemide (MOC; 30 mg/ml) by gavage. The drugs were administered 24, 5 and 1 h before saliva collection (sub-acute treatment) or as a once a day treatment for 14 days (chronic treatment). Animals were sedated with thiopental and saliva was collected using pre-weighed cotton balls inserted in the mouth for 1 min before and after pilocarpine stimulus. Pilocarpine-stimulated saliva was also collected for biochemical assays of total proteins, amylase, phosphate and calcium, performed through automated colorimetric methods. Non-stimulated salivary flow was decreased by sub-acute IMI 10 mg/kg treatment. Pilocarpine-stimulated salivary flow was significantly increased by acute treatments with IMI, FLU and MOC in comparison to the control group. The same opposite pattern of effects on non-stimulated and pilocarpine-stimulated salivation was seen after chronic treatment with the antidepressants. Increased levels of calcium following sub-acute treatment with IMI and after prolonged treatment with FLU and MOC were detected. In the assayed samples, phosphate was found to be increased following chronic treatment with FLU or MOC. These results may explain the discrepant effects of the antidepressants on salivation described in pre-clinical and clinical studies.
Collapse
Affiliation(s)
- Luciane Kopittke
- Division of Pharmacology, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Rua Sarmento Leite 245, 3rd Floor, 90050-170 Porto Alegre, RS, Brazil
| | | | | |
Collapse
|
34
|
Brand HS, Ligtenberg AJM, Bots CP, Nieuw Amerongen AV. Secretion rate and buffer capacity of whole saliva depend on the weight of the mechanical stimulus. Int J Dent Hyg 2004; 2:137-8. [PMID: 16451478 DOI: 10.1111/j.1601-5037.2004.00081.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry (ACTA), van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
35
|
Castro J, Jiménez-Alonso J, Sabio JM, Rivera-Cívico F, Martín-Armada M, Rodríguez MA, Jáimez L, Castillo MJ, Sánchez-Román J. Salivary and serum beta2-microglobulin and gamma-glutamyl-transferase in patients with primary Sjögren syndrome and Sjögren syndrome secondary to systemic lupus erythematosus. Clin Chim Acta 2003; 334:225-31. [PMID: 12867296 DOI: 10.1016/s0009-8981(03)00162-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sialochemistry has been proposed as a simple and useful tool for the diagnosis of Sjögren syndrome (SS). Although many changes have been detected in several constituents of saliva from patients with SS, none are individually sensitive or specific enough for diagnosing SS. The aim of this study was to assess the value of the combined determination of beta2-microglobulin (beta2m) and gamma-glutamyl-transferase (GGT) activity in serum and saliva as a diagnostic instrument for differentiating primary and secondary [to systemic lupus erythematosus (SLE)] SS patients from normal subjects. METHODS Nineteen primary SS (pSS) patients, 15 patients with SS secondary to SLE, and 25 SLE patients without SS were studied. Thirty healthy subjects were included in the study as control group. RESULTS By means of a mathematical model, (a) 84.1%, (b) 85.7%, and (c) 87.0% of patients were correctly classified as SS or normal when (a) salivary beta2m and GGT values, (b) serum beta2m and salivary GGT values, and (c) salivary beta2m and GGT along with serum beta2m values, respectively, were considered. To differentiate between pSS and sSS by means of the mathematical model, the combination of serum beta2m and salivary GGT values achieved that 81.8% of the patients were correctly classified. CONCLUSION Since sialochemistry is an easy, safe and reliable test, the combined determination of beta2m and GGT in saliva and serum was useful for differentiating SS patients from normal subjects, but not excessively good for differentiating pSS from sSS patients.
Collapse
Affiliation(s)
- José Castro
- Services of Internal Medicine, Virgen de las Nieves University Hospital, Jefe de Servicio de Medicina Interna, Avda. Fuerzas Armadas, 2, 18014, Granada, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Batchelor HK, Banning D, Dettmar PW, Hampson FC, Jolliffe IG, Craig DQM. An in vitro mucosal model for prediction of the bioadhesion of alginate solutions to the oesophagus. Int J Pharm 2002; 238:123-32. [PMID: 11996816 DOI: 10.1016/s0378-5173(02)00062-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This paper discusses the development of an in vitro model utilised to assess the adhesion of alginate solutions to porcine oesophageal tissue. The methodology involved the construction of retention apparatus onto which sections of tissue were mounted. Fluorescently labelled alginate solutions of known rheological profile were dispensed onto the tissue at a concentration of 2% w/v. A washing solution was applied at a specified rate to mimic saliva flow and the eluted material collected. Fluorimetric analysis allowed dose retention to be assessed as a function of time. The effect of the nature of the washing solution and the choice of alginate were investigated. It was found that after 30 min up to 20% of the applied alginate dose remained associated with the tissue, regardless of the alginate selected from the range examined. The nature of the washing medium did not have a significant effect on retention, irrespective of the inherent mucin concentration. Overall this study indicated that the technique presented offers a viable means of studying bioadhesion of liquids and also demonstrates that alginate solutions may have an application as bioadhesive agents for localisation within the oesophagus.
Collapse
Affiliation(s)
- H K Batchelor
- The School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX, UK.
| | | | | | | | | | | |
Collapse
|
37
|
Affiliation(s)
- J A Ship
- Department of Oral Medicine and The Bluestone Center for Clinical Research, New York University College of Dentistry, New York 10010-4046, USA.
| |
Collapse
|
38
|
Ferreiro MC, Prieto MH, Rodríguez SB, Vázquez RL, Iglesias AC, Dios PD. Whole stimulated salivary flow in patients with chronic hepatitis C virus infection. J Oral Pathol Med 2002; 31:117-20. [PMID: 11896834 DOI: 10.1046/j.0904-2512.2001.00185.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Salivary gland disorders have been included among the extra-hepatic manifestations related to HCV infection. METHODS The whole stimulated salivary flow rate (spitting technique) was studied in 74 HCV infected patients to evaluate salivary gland dysfunction. RESULTS The salivary flow of the patients with chronic HCV infection was similar to that of the healthy controls. The association between subjective xerostomia salivary flow was seen to be very weak. No significant associations were found between salivary flow and age, sex, risk factor of acquired infection, ALT, AST, GGT, ALP values, time lapsed since the diagnosis or HCV-RNA detection in saliva. CONCLUSIONS Although the functional repercussion of hepatitis C related lymphocytic sialoadenitis remains unclear, we did not find a significant reduction in the whole stimulated salivary flow in HCV infected patients.
Collapse
Affiliation(s)
- M Castro Ferreiro
- School of Dentistry Medicine, Santiago de Compostela University, Spain
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
The aim of the study was to investigate the features of xerostomia in patients with advanced cancer. The protocol involved completion of the Memorial Symptom Assessment Scale, and measurement of the unstimulated whole salivary flow rate (UWSFR) and the stimulated whole salivary flow rate (SWSFR). One hundred twenty patients participated in the study. Xerostomia was the fourth most common symptom (78% of patients). It was associated with a poor performance status (P = 0.01). The usual cause of xerostomia was drug treatment. There was an association with the total number of drugs prescribed (P = 0.009): the median number of xerostomic drugs prescribed was 4. Xerostomia was ranked the third most distressing symptom. Its severity was correlated with the severity of oral discomfort, dysgeusia, dysmasesia, dysphagia, dysphonia, and anorexia. The UWSFR was a relatively sensitive, but nonspecific, investigation. In contrast, the SWSFR was a relatively specific, but insensitive, investigation.
Collapse
Affiliation(s)
- A N Davies
- Heart of Kent Hospice, Aylesford, Kent, United Kingdom
| | | | | |
Collapse
|
40
|
Dawson LJ, Holt DJ, Higham SM, Longman LP, Field EA. A comparison of salivary gland hypofunction in primary and secondary Sjögren's syndrome. Oral Dis 2001. [DOI: 10.1034/j.1601-0825.2001.70106.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
41
|
Lähteenmäki MT, Salo MS, Tenovuo JO, Helminen AV, Vilja PJ, Huupponen RK. The Effects of Glycopyrrolate on Oral Mucous Host Defenses in Healthy Volunteers. Anesth Analg 2000. [DOI: 10.1213/00000539-200008000-00045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|