Statherin levels in saliva of patients with precancerous and cancerous lesions of the oral cavity: a preliminary report

OBJECTIVE: The aim of this study was to measure concentration of human salivary statherin in patients with oral cavity pathologies and salivary gland diseases. SUBJECTS AND METHODS: Levels of statherin were analysed with High Performance Liquid Chromatography (HPLC) in following groups of subjects: group A: 24 patients with neoplastic diseases of salivary glands, group B: 13 patients with inflammatory lesions of salivary glands, group C: 13 patients with precancerous and cancerous lesions of the oral cavity excluding salivary gland tumors, group D: 20 healthy volunteers (control group). RESULTS: Our preliminary data indicated a sensible reduction of the statherin level in the saliva of patients with precancerous and cancerous lesions of the oral cavity (group C) compared with the healthy subjects (group D). The statherin levels are not significantly reduced either in the inflammatory (group B) or in the salivary glands tumours (group A), compared with the healthy subjects (group D). CONCLUSION: Statherin could play a protective effect in oral cavity in association with its other functions.     

Impact of wearing an intra-oral lubricating device on oral health in dry mouth patients

OBJECTIVE: To establish whether an intra-oral lubricating device for dry mouth alters the oral environment. DESIGN: A single-blind randomized cross-over study. METHOD: Twenty-nine dentate subjects from the Sjogren's syndrome clinic attended on five occasions at 4-week intervals. They were randomized, having the device fitted on either the second or the fourth visit for the experimental period, whilst using their preferred method of lubrication throughout the rest of the study. The preferred methods of lubrication were either water (group 1, n = 10) or saliva substitute (group 2, n = 9) or sugar-free chewing gum (group 3, n = 10). At each visit microbiological, unstimulated and stimulated saliva samples were collected. Dry mouth score, speech test and periodontal indices were recorded. RESULTS: The water lubrication group (1) had a resting salivary flow greater than lubrication groups (2 and 3) by post-ANOVA contrasts (P < 0.001). The postdevice data also demonstrated a salivary flow greater than lubrication group (3) by post-ANOVA contrasts (P < 0.05). The epithelial cell count using the Spearman correlation was high, possibly reflecting increased viscosity of the saliva (P = 0.044). The speech test indicated that the experimental subjects had difficulty in speaking (P = 0.001). This was slightly easier postdevice wear. Streptococcus mutans (P = 0.009) and Lactobacillus (P = 0.058) increased in the saliva after wearing the device. Salivary flow rate, Candida albicans, oral dryness, speaking and periodontal indices were unchanged. CONCLUSIONS: The oral environment was altered by wearing a lubricating device with an increase in the numbers of Strep. mutans and Lactobacillus. Clinical dryness and speech test correlated with the mean whole salivary flow suggesting a screening method for xerostomia.     

A new device for measuring oral mucosal surface friction - reference values

Abstract— Sialometry and dryness measurements performed with a sliding friction instrument were carried out in healthy subjects and patients with oral dryness due to salivary gland diseases. The salivary flow rates were within normal reference values. The mean friction value in the healthy population was 1.73 ± 0.37 in the lip mucosa and 1.25 ± 0.32 in the buccal mucosa and did not show any age or sex differences. In the group of patients with salivary gland diseases, none produced measurable amounts of resting saliva but a few of them did produce small amounts of paraffin wax chewing-stimulated saliva. The friction instrument, proved to register lubrication produced even by these very small amounts of saliva.     

Oral mucosal friction and subjective perception of dry mouth in relation to salivary secretion

Assessment of oral mucosal friction and subjective perception of dry mouth was performed during treatment with the thiazide diuretic bendroflumethiazide (2.5 mg o.d.) or placebo in a randomized, double-blind, cross-over study (2 × 2 wk) in 34 healthy volunteers. Treatment with bendroflumethiazide was associated with a 10% reduction in the stimulated whole saliva secretion rate and a 15% reduction in the salivary sodium concentration, as compared with placebo. Oral mucosal friction was concomitantly measured on the buccal mucosa and on the mucosa of the lower lip by means of a newly developed sliding friction device. In addition, a questionnaire was used to evaluate how the treatment was subjectively perceived with regard to symptoms of dry mouth. Mucosal friction of the lower lip increased significantly during treatment with bendroflumethiazide, as compared with placebo. When the test subjects, regardless of pharmacologic treatment, were divided into groups according to subjective perception of dry mouth, the dry mouth group showed significantly lower resting and stimulated flow rate and higher mucosal friction in comparison to the nondry group. When, in addition, pharmacologic treatment was also considered, the differences between the dry and the nondry group were restricted to resting whole saliva flow rate and mucosal friction during bendroflumethiazide treatment. It is concluded that resting whole saliva flow rate is the best predictive factor for evaluating subjectively perceived dry mouth. However, the sensitivity of the developed sliding friction device is capable of detecting minor changes in salivary secretion rate. In addition, measurements of oral mucosal friction may serve as an easily available method to complement sialometry when evaluating, for example, drug-induced dryness of the mouth.     

The distribution of oral mucosal pH values in healthy saliva secretors

OBJECTIVES: To establish the normal range of oral mucosal pH and to correlate these measurements to salivary flow rate in healthy individuals according to age and gender. SUBJECTS AND METHODS: Measurements of pH levels using a flat pH meter and salivary secretion rates were established in eight mucosal sites from a total of 50 healthy individuals. RESULTS: The mean pH (+/-s.d.) of all sites was 6.78 +/- 0.04 with significant differences between mean pH values in the palate (7.34 +/- 0.38), the floor of the mouth (6.5 +/- 0.3), the buccal mucosa (6.28 +/- 0.36) and the tongue (6.8 +/- 0.26). A significant correlation was found between age and pH at palatal and tongue sites but no gender effects were noted. CONCLUSIONS: This method is easy and relatively quick to manipulate, and may offer many diagnostic possibilities for oral related diseases and disorders such as oral malodour, mouth breathing, dysgeusia, acidic diet consumption and gastrointestinal disorders affecting the mouth.     

Evaluation of a new device for measuring oral mucosal surface friction

Abstract – For the objective measurement of oral mucosal dryness or moisture, a device registering oral mucosal surface slide friction has been developed. Two prototypes, Probe I and Probe II, have been tested. Probe I was constructed for initial testing of the method and was based on easily accessible electrical components. Probe I was computerized and developed for more accurate registration and also for easy handling. Reliability and validity tests were carried out on Probe I as well as on Probe II. In repeated in vitro measurements, the probes showed good reproducibility. Validity was assessed on healthy subjects injected with methylscopolamine nitrate submucosally in the labial sulcus. All subjects experienced a pronounced oral mucosal dryness within half an hour. Registration with the surface slide friction device showed maximum friction values 1-2 h after injection. These reliability and validity tests gave good results for both Probe I and Probe II, but Probe II had several practical advantages over Probe I. Both probes were considerably more sensitive to changes of the oral mucosal surface than the previously used simple friction test using the back of a mouth mirror.     

Evaluation of some electrical methods for objective assessment of oral mucosal dryness

Abstract – The aim of this study was to evaluate different electrical methods (resistance, capacitance and polarization resistance) for clinical and objective registration of dryness of the oral mucosa. Measurements were performed in the buccal and in the lip mucosa before and every 30 min after injection of 1.0 ml methylscopolamine nitrate submucosally in the labial sulcus in 10 healthy subjects. For comparison, a dental mirror sliding test was used. About 1 h after injection, all three methods showed statistically significant decreases, of values in the buccal as well as the lip mucosa except for polarization resistance, which showed such a difference only in the buccal mucosa. The deviations from initial values in the individual subject showed no agreement between measurements with the electrical instruments and oral mucosal dryness assessed with the mirror test. Neither was there any agreement between values registered with the three electrical methods. It seems that these electrical methods are not suitable for registration of individual variations in oral mucosal dryness.     

克罗恩病患者口腔黏膜损害研究

目的：探讨口腔黏膜病变在克罗恩病（CD）患者中的临床特征。方法：将诊断为CD的59例患者由消化内科医师分为口腔型及非口腔型,再经口腔科医师对全部CD患者的口腔黏膜情况进行专科检查,分析CD患者中的口腔黏膜病变特征,并对两组之间的肠道病变部位进行分析研究。结果：59例CD患者中口腔型CD（23／32）比非口腔型CD（7／27）有更多的病例表现为口腔方面症状,在32例口腔型CD患者中,最常见的口腔黏膜损害为卡他性牙龈炎（n＝19）,其次为复发性阿弗他溃疡（n＝8）,肉芽肿性病变（n＝4）,鹅卵石样改变（n＝3）,唇炎（n＝3）,增殖性化脓性口腔炎（n＝1）。口腔型CD患者合并有肛周疾病者占53％（17／32）,多于非口腔型CD患者的22％（6／27）。结论：口腔症状在CD患者的临床表现中占有较大比例,其中最为常见的口腔表现为卡他性牙龈炎,有口腔症状的CD患者更有可能合并有肛周病变。     

Comparison of the composition of oral mucosal residual saliva with whole saliva

OBJECTIVE: Compared with whole saliva, residual saliva comprising the oral mucosal film shows a high protein concentration. The purpose of this study was to compare the composition of residual saliva with unstimulated and stimulated whole saliva in normosalivators. MATERIALS AND METHODS: The composition of oral mucosal residual saliva in 30 healthy individuals was investigated and compared with that of whole saliva. The concentrations of total protein, secretory immunoglobin A (sIgA), lactoferrin, total carbohydrate, and sialic acid were examined. The activities of peroxidase, lysozyme and alpha-amylase were determined. RESULTS: Residual saliva had higher levels of total protein and carbohydrate than whole saliva, with a higher carbohydrate to protein ratio in the residual saliva suggesting that salivary glycoproteins are concentrated on the oral mucosal surface. sIgA, lactoferrin and sialic acid were present as highly concentrated forms in residual saliva. The enzymatic activity of peroxidase in residual saliva was higher than that of whole saliva. CONCLUSIONS: These concentrated carbohydrate and antimicrobials on the oral mucosal surface work for mucosal defence and could be used for targeting sites for the delivery of therapeutic agents.     

Feeling of dry mouth in relation to whole and minor gland saliva secretion rate

Previous reports indicate an association between whole saliva secretion rate and xerostomia, but the association is not always found in individuals complaining of dry mouth. In the present study, we hypothesised that the minor salivary gland secretions could affect subjective feelings of oral dryness in individuals with normal or low whole saliva secretion rate. 142 individuals, aged 18-82 years, participated in the study. Feelings of oral dryness were assessed separately for day- and nighttime by visual analogue scales. Resting and stimulated whole saliva flow rates were measured by conventional methods, and minor palatal, buccal and labial saliva secretion rates by the Periotron method. Twenty-three percent of the women and 15% of the men reported feelings of dry mouth during day and night. The results showed statistically significant lower resting and stimulated whole and minor labial gland saliva secretion rates in subjects reporting oral dryness during both day and night compared with non-complainers. In groups of individuals with normal simulated whole saliva secretion, those who complained from dry mouth both day and night had statistically significant lower labial secretion rate compared with those who had no complaints. Although not statistically significant, this difference was seen also in the groups with fewer individuals who had low whole saliva flow. In summary, our findings suggested that the labial gland saliva might affect subjective feelings of dry mouth both in individuals with normal and subnormal whole saliva flow.     

Analysis of residual saliva and minor salivary gland secretions in patients with dry mouth

The importance of oral mucosal wetness in the condition of dry mouth and the role of salivary proteins in proper oral function are acknowledged. A negative correlation between mucosal wetness and the protein concentration of residual saliva has been reported in normosalivators. Here, to examine the suggestion that a reduction in residual salivary volume leads to a concomitant elevation of its protein concentration, the amount of residual saliva and minor salivary gland secretions, and their protein concentrations, were measured in hyposalivators and normosalivator controls. A Periotron 8000 micro-moisture meter was used to measure the thickness of the mucosal film at six selected mucosal surfaces and the minor salivary gland secretion rate at two mucosal surfaces. The unstimulated whole salivary flow rate was measured by the spitting method. The total protein concentration of all salivary samples was measured by bicinchoninic acid assay. The hyposalivators had significantly lower amounts of residual saliva and minor salivary gland secretions than the normosalivators at all selected mucosal sites except the soft palate. In both groups, the site with the thinnest coat of residual saliva was the anterior hard palate and the wettest site was the anterior dorsal mucosa of the tongue. The protein concentration of residual saliva was significantly higher in hyposalivators than normosalivators. In the minor salivary gland secretions there was no significant difference in protein concentration between the normo- and hyposalivators. When the hyposalivators were divided into two subgroups according to their severity of dryness, the reduction of residual salivary volume and the elevation of protein concentration were more apparent in the group with the more severe dry mouth. Collectively, these results indicate that oral mucosal wetness is associated with the flow rate of unstimulated whole saliva. The function of the minor salivary glands was less affected and relatively well preserved in patients with dry mouth. The increased protein concentration of residual saliva in the hyposalivators appeared to be the result of decreased salivary volume.     

Comparison between new saliva stimulants in patients with dry mouth: a placebo-controlled double-blind crossover study

Two new saliva stimulants: V6 and a mucin containing chewing gum were tested in this placebo-controlled double-blind crossover study. Forty-three patients (mean age 63 yr) complaining of dry mouth participated. The products were administered in a randomized order, and used for 2 wk each. The effect was evaluated by interviews and by determining changes in stimulated and unstimulated saliva flow rates. A positive effect was reported by 64%, 44%, and 26% of the patients using the mucin chewing gum, V6, and the placebo, respectively. More than 2/3 of the patients found the mucin chewing gum efficient at various times and situations. Sixty-one percent of the patients preferred the mucin chewing gum, 21% V6, and 5% the placebo product. Fifty percent of the patients had an increase in unstimulated salivary secretion rate from all products after 14 days regular use indicating a long-term effect.     

Evaluation of oral wetness using an improved moisture-checking device for the diagnosis of dry mouth

Purpose

In 2013, we reported the results of a third-generation oral moisture-checking device in a multicentre clinical study involving patients with dry mouth and healthy volunteers. Subsequently, several improvements have been made to the third-generation device, and a fourth-generation device is now commercially available. This study aimed to confirm the usefulness of this improved fourth-generation device in the diagnosis of dry mouth and to assess the physiological wetness of lingual mucosa by using this device.

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口腔念珠菌病(oral candidosis)是由真菌--念珠菌属感染所引起的口腔黏膜疾病。近年来,随着获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)的蔓延,肿瘤化疗、器官移植的开展,广谱抗菌素和免疫抑制剂的大量应用,导致口腔念珠菌病的发病率亦逐年上升。尽管抗真菌新药在不断研发上市,但用于治疗     

Primary Sjögren's syndrome: salivary gland function and clinical oral findings

OBJECTIVE: To evaluate salivary gland function, saliva composition and oral findings in patients with primary Sjogren's syndrome (pSS) subdivided into patients with and without focus score ≤1 (FS) and/or antibodies to SSA/SSB (AB) as well as in healthy controls. SUBJECTS AND METHODS: Unstimulated (UWS) and chewing stimulated (SWS) whole saliva, and stimulated parotid saliva (SPS) were collected in 16 patients fulfilling the European classification criteria for pSS subdivided into those with FS and/or AB (n= 8) and those without FS and AB (n= 8), and in age-matched (n= 14) and young healthy controls (n= 13).UWS and SWS were analysed for Na⁺ and K⁺.SPS was analysed for Na⁺, K⁺, statherin, and proline-rich proteins (PRPs).Sicca symptoms, DMFT/DMFS, plaque (PI) and gingival (GI) scores, periodontal pocket depth (PPD), and mucosal status were recorded. RESULTS: The young healthy controls had lower UWS as compared to the aged controls (P= 0.03).However, the aged controls had higher DMFT/DMFS (P < 0.001) and PI, GI and PPD (P < 0.01).Patients with FS and/or AB generally had lower saliva secretory rates than patients without FS and/or AB (P= 0.01 for UWS and SPS) and age-matched healthy controls (P= 0.001). There was no significant difference in the content of Na⁺ and K⁺, statherin and PRPs between groupS. Patients with FS and/or AB had the highest frequency of oral mucosal changes and higher DMFT/DMFS than patients without FS and/or AB and healthy controls (P < 0.01).However, PI, GI, and PPD did not differ significantly. CONCLUSION: Patients with FS and/or AB had lower salivary secretory rates, higher DMFT/DMFS, and more oral mucosal changes than patients without FS and/or AB.Additionally, data suggest that salivary gland function in healthy individuals do not decrease with age.     

Study of oral changes in patients with eating disorders

Abstract: Background: The prevalence of eating disorders is very high in industrialized countries, especially in young women. The principal orodental manifestations are erosion of the dental enamel, caries and dental sensitivity. Objectives: Our aim was to study oral complications in female with eating disorders. Methods: We study oral complications (dental, mucosal and salivary) in 17 female patients from the Hospitalized Patients Eating Disorders Unit. Results: We found alterations in salivary flow and pH, as well as salivary gland enlargement. Conclusions: A significant alteration in oral tissue occurs; this has an adverse impact on oral health, producing an accumulation of local irritants which favour the appearance of oral diseases. Preventative measures are therefore recommended for this group of patients.