Salivary acetaldehyde increase due to alcohol‐containing mouthwash use: A risk factor for oral cancer

Increasing evidence suggests that acetaldehyde, the first and genotoxic metabolite of ethanol, mediates the carcinogenicity of alcoholic beverages. Ethanol is also contained in a number of ready‐to‐use mouthwashes typically between 5 and 27% vol. An increased risk of oral cancer has been discussed for users of such mouthwashes; however, epidemiological evidence had remained inconclusive. This study is the first to investigate acetaldehyde levels in saliva after use of alcohol‐containing mouthwashes. Ready‐to‐use mouthwashes and mouthrinses (n = 13) were rinsed in the mouth by healthy, nonsmoking volunteers (n = 4) as intended by the manufacturers (20 ml for 30 sec). Saliva was collected at 0.5, 2, 5 and 10 min after mouthwash use and analyzed using headspace gas chromatography. The acetaldehyde content in the saliva was 41 ± 15 μM, range 9–85 μM (0.5 min), 52 ± 14 μM, range 11–105 μM (2 min), 32 ± 7 μM, range 9–67 μM (5 min) and 15 ± 7 μM, range 0–37 μM (10 min). The contents were significantly above endogenous levels and corresponding to concentrations normally found after alcoholic beverage consumption. A twice‐daily use of alcohol‐containing mouthwashes leads to a systemic acetaldehyde exposure of 0.26 μg/kg bodyweight/day on average, which corresponds to a lifetime cancer risk of 3E?6. The margin of exposure was calculated to be 217,604, which would be seen as a low public health concern. However, the local acetaldehyde contents in the saliva are reaching concentrations associated with DNA adduct formation and sister chromatid exchange in vitro, so that concerns for local carcinogenic effects in the oral cavity remain. © 2009 UICC     

Aerosol-generating procedures in head and neck surgery – can we improve practice after COVID-19?

The COVID-19 pandemic has had a dramatic impact on international medicine practice. The propensity for head and neck surgery to generate aerosols needs special consideration over and above simply adopting personal protective equipment. This study sought to interrogate the literature and evaluate whether which additional measures might provide benefit if routinely adopted in minimising viral transmission.     

不同菌斑控制方式在正畸患者中的临床效果比较

目的：检验漱口水在戴用固定矫治器的正畸患者中的临床效果。方法本实验为随机双盲自身对照临床实验,分别将45位受试者（男22人,女23人）平均分为漱口水组、清水漱口组和刷牙组,每组15人。实验开始10 d（基线）、1个月后分别进行记录并对照、分析牙龈指数、改良菌斑指数、龈沟出血指数。结果配对t检验显示：实验前后的龈沟出血指数差：在漱口水组（测量值-0．150±0．089）差异有显著性意义,而在其他两组差异无显著性意义（测量值分别为-0．055±0．195,-0．055±0．195）;牙龈指数差在3组中差异均无显著性意义;菌斑指数差：在漱口水组和清水漱口组测量值差异有显著性意义（测量值分别为-0．258±0．152,0．029±0．070）,而在刷牙组差异无显著性意义。结论漱口水能够有效地减小菌斑指数和龈沟出血指数,但对于牙龈指数,效果不明显。     

Reduction of FENO by tap water and carbonated water mouthwashes: magnitude and time course

Fractional exhaled nitric oxide (F_ENO) assesses eosinophilic inflammation of the airways, but F_ENO values are also influenced by oral nitric oxide (NO). The aim of this pilot study was to measure F_ENO and compare the effect of two different mouthwashes on F_ENO and analyse the duration of the effect. F_ENO was measured in 12 randomized volunteers (healthy or asthmatic subjects) with a NIOX VERO® analyser at an expiratory flow rate of 50?mL/s. After a baseline measurement, a mouthwash was performed either with tap water or carbonated water and was measured during 20?min in 2?min intervals. The procedure was repeated with the other mouthwash. We found that both mouthwashes reduced F_ENO immediately at the beginning compared to the baseline (p?mouthwash effect lasted 12?min (p ranging from?<0.001 to?<0.05). The tap water mouthwash reduced F_ENO statistically significantly only for 2?min compared with the baseline. We conclude that a single carbonated water mouthwash can significantly reduce the oropharyngeal NO contribution during a 12?min time interval.     

Triphala,a New Herbal Mouthwash for the Treatment of Gingivitis: A Randomized Controlled Clinical Trial

Background: An antiplaque agent with minimal side effects that can be used as an effective adjunct to mechanical plaque control is needed. The current study is designed to evaluate efficacy of triphala (TRP) mouthwash in reduction of plaque and gingivitis. Methods: Ninety individuals with chronic generalized gingivitis were randomly assigned to three groups: 1) group I, placebo mouthwash; 2) group II, TRP mouthwash; and 3) group III, chlorhexidine (CHX) mouthwash. All individuals were instructed to rinse with their respective mouthwash twice daily. 1) Plaque index (PI); 2) gingival index (GI); 3) oral hygiene index‐simplified (OHI‐S); and 4) microbiologic colony counts were recorded at baseline and at 7, 30, and 60 days. Results: All three groups showed gradual reduction in PI, GI, and OHI‐S levels from baseline to 7, 30, and 60 days. There was also significant reduction in microbial counts in all groups at all time intervals except in group I. A significant difference was noticed with respect to reduction in PI, GI, OHI‐S, and microbiologic counts in group I compared with groups II and III. However, no significant differences were found between groups II and III for any parameters at any time intervals. Conclusions: TRP mouthwash was found to decrease inflammatory parameters from baseline to follow‐up intervals. Because improvement in gingivitis was comparable with that of CHX mouthwash, TRP mouthwash can be considered a potential therapeutic agent in the treatment of gingivitis.     

Effect of Terminalia chebula Extract and Chlorhexidine on Salivary pH and Periodontal Health: 2 Weeks Randomized Control Trial

A double blind, randomized, controlled study with three parallel treatment groups was done to evaluate the efficacy of a Terminalia chebula 10% mouth rinse compared with chlorhexidine 0.12% mouth rinse, applied two times daily for 2 weeks, in the treatment of dental plaque and gingivitis. Seventy‐eight patients were included in the study. The efficacy variables were periodontal indices on days 0, 7 and 14 after commencement of therapy. Twenty six patients received chlorhexidine mouth rinse, twenty six Terminalia chebula mouth rinse and twenty six received saline solution. The clinical parameters were significantly reduced by both chlorhexidine and Terminalia chebula mouth rinse although no significant difference was seen between the two groups (P > 0.05). This study demonstrated that Terminalia chebula mouth rinse is effective in reducing microbial plaque, gingival inflammation and neutralizing salivary pH. Copyright © 2013 John Wiley & Sons, Ltd.     

Converting FENO by different flows to standard flow FENO

In clinical practice, assessment of expiratory nitric oxide (F_ENO) may reveal eosinophilic airway inflammation in asthmatic and other pulmonary diseases. Currently, measuring of F_ENO is standardized to exhaled flow level of 50 ml s^?1, since the expiratory flow rate affects the F_ENO results. To enable the comparison of F_ENO measured with different expiratory flows, we firstly aimed to establish a conversion model to estimate F_ENO at the standard flow level, and secondly, validate it in five external populations. F_ENO measurements were obtained from 30 volunteers (mixed adult population) at the following multiple expiratory flow rates: 50, 30, 100 and 300 ml s^?1, after different mouthwash settings, and a conversion model was developed. We tested the conversion model in five populations: healthy adults, healthy children, and patients with COPD, asthma and alveolitis. F_ENO conversions in the mixed adult population, in healthy adults and in children, showed the lowest deviation between estimated from 100 ml s^?1 and measured F_ENO at 50 mL s^?1: ?0·28 ppb, ?0·44 ppb and 0·27 ppb, respectively. In patients with COPD, asthma and alveolitis, the deviation was ?1·16 ppb, ?1·68 ppb and 1·47 ppb, respectively. We proposed a valid model to convert F_ENO in healthy or mixed populations, as well as in subjects with obstructive pulmonary diseases and found it suitable for converting F_ENO measured with different expiratory flows to the standard flow in large epidemiological data, but not on individual level. In conclusion, a model to convert F_ENO from different flows to the standard flow was established and validated.