Variations of salivary flow rates in Brazilian school children

The salivary flow rate (SFR) in healthy individuals may vary according to different factors. There is a scarcity of studies from different geographical areas that analyze SFR variations in children. The aim of this study was to verify stimulated salivary flow rate (SFR) variations in 6 to 12-year-old children, from four different public schools of Rio de Janeiro and correlate these data to gender, age, type of dentition, and health status. Clinical data were taken from the children's medical records that were kept at those schools. Oral examination and sialometry were performed in every child. Salivary flow rate was obtained by chewing-stimulated whole saliva under standard conditions. There were significant differences in SFR according to age (p = 0.0003). Six and 12-year-old children showed the lowest SFR, and when they were excluded from the analysis, no significant differences were found (p = 0.21). There were also significant differences in SFR among children from different public schools (p = 0.0009). The gender did not show any correlation to SFR, even when children were stratified by age (p = 0.36). Correlation between SFR and deciduous, mixed or permanent dentition was not found as well. These results show that the analyzed clinical variables did not seem to influence SFR in this children population.     

Evaluation of saliva flow rates, Candida colonization and susceptibility of Candida strains after head and neck radiation

Hyposalivation is a long-term effect in patients receiving head and neck radiation. Radiotherapy can predispose oral colonization by Candida species of the mucosa. This study aims to evaluate the correlation between hyposalivation, measured by unstimulated saliva flow rates (SFR) and fungal colonization of the oral cavity, and also the resistance of isolated Candida strains to antimicrobial therapy. Fifty-three consecutive patients with radiotherapy were examined for late radiation damage on dental hard tissue and the salivary glands (SFR over a period of 5 min). The SFR were divided into three different values of hyposalivation: grade I (SFR 0.1-0.25 ml/min), grade II (SFR ≤0.1 ml/min), and grade III (SFR = 0.0 ml/min). Candidal colonization was defined using Sabouraud agar and identified using API 20C AUX (biomerieux) in the patients' rinsing water. Susceptibility was tested with Etest (amphotericin B, ketoconacole, voriconacole, and fluconacole). Hyposalivation grade I was detected in 23% (9.1 × 10(1) colony forming units (cfu); range, 200-5,900 cfu), hyposalivation grade II in 26% (4.3 × 10(1) cfu; range, 110-3,300 cfu), and hyposalivation grade III in 51% (2.0 × 10(3) cfu; range, 300-19,475 cfu) of patients. A significant correlation between the SFR and candidal colonization and clinical presentation (European Organization for Research and Treatment of Cancer (EORTC) score) was detected (Mann-Whitney test, p = 0.031). Twenty Candida albicans and 27 non-albicans species were identified. The resistance of C. albicans was higher than that of non-albicans strains against antimicrobial agents. By comparison, amphotericin B showed the greatest and fluconazole the least effect. A higher value of hyposalivation correlates with a higher risk of candidal colonization in patients who have received radiotherapy and also with a higher EORTC score. The spectrum of Candida is wide and susceptibility against antifungal therapy differs. In long-term examinations of patients with xerostomia after radiotherapy, the EORTC score can be used to measure hyposalivation. Reduced susceptibility of C. albicans might introduce complications to therapy. Findings of more non-albicans strains show a change in colonization which should be examined in further studies.     

A preliminary study on the relationship between stimulated saliva and periodontal conditions in community-dwelling elderly people

OBJECTIVES: The purpose of this study was to explore the relationship between flow rate and spinnbarkeit of stimulated whole saliva and periodontal conditions in healthy elderly people. METHODS: Three hundred and fifty-five dentate subjects aged 76 years were included. The pocket probing depth (PD), attachment level (AL), and bleeding on probing (BOP) were measured. Stimulated whole saliva was collected and the salivary flow rate (SFR) was calculated. Then, salivary spinnbarkeit (SS) was immediately measured. RESULTS: The mean SFR and SS were 1.44 ml/min and 1.91 mm, respectively. SFR was not significantly related to each periodontal parameter. On the other hand, subjects with SS2.00 mm exhibited a significantly higher mean PD (p<0.05), % of sites with PD>or=4mm (p<0.05), mean AL (p<0.01), % of site with AL>or=4mm (p<0.05) and % of sites with AL>or=6mm (p<0.01) than subjects in the other three groups (one-way ANOVA). In the logistic regression analysis, the factors significantly associated with the highest quintile of PD>or=4mm were: the low salivary flow and the high salivary spinnbarkeit (OR 3.84), current smokers (OR 5.08), cleaning interdental spaces rarely/never (OR 2.12), and frequent BOP (OR 5.20). CONCLUSION: These findings suggest that high salivary spinnbarkeit in addition to a low salivary flow rate might be a high risk for periodontal disease in elderly people.     

终末期肾脏病病人的唾液流率、pH值和缓冲能力与龋病的关系

目的:调查行血液透析治疗的终末期肾脏病病人的龋病状况和唾液性质,并分析两者的关系。方法:比较病患组(76例)和对照组(76例)的龋病状况、唾液流率、pH值和缓冲能力;并通过Pearson相关性检验分析病患组龋失补指数值与其唾液性质的关系。结果:两组间的龋病指标值无显著差异(P>0.05),病患组的唾液流率显著低于对照组、pH值和缓冲能力显著高于对照组,差异均有统计学意义(P<0.05),同时病患组中的龋失补指数值与唾液流率和pH值呈负相关,但无显著性(P>0.05),与唾液缓冲能力呈显著负相关(r=-0.322,P=0.005)。结论:终末期肾脏病病人,唾液缓冲能力的增加可能是其患龋病率相对较低的重要因素。     

A comparison of salivary IgA in children with Down syndrome and their family members

The aim of this study was to compare total IgA in the whole saliva of children with Down syndrome with levels in sibling and parent groups. IgA measurements were presented as the concentration in saliva (μg/ml) and also adjusted for salivary flow rate (SFR; μg/min). Twenty children with Down syndrome, ten siblings and twenty parents were recruited. Stimulated whole saliva was collected from the participants and SFR calculated. The measurement of salivary IgA (sIgA) was carried out using an indirect competitive Enzyme-Linked Immunosorbent Assay. The difference in the mean SFR between children with Down syndrome, parents and siblings were not statistically significant. The mean salivary concentration of IgA was higher in children with Down syndrome (95.1 μg/ml) compared with siblings (48.3 μg/ml; p = 0.004). When adjusted for SFR children with Down syndrome had mean sIgA levels of 98.8 μg/min and the siblings 48.6 μg/min (p = 0.008). The children with Down syndrome had sIgA levels similar to those of the parents (92.5 μg/ml; 93.2 μg/min). There was a positive correlation between age and sIgA concentration in the siblings (p = 0.008) but not for children with Down syndrome (p = 0.363). This suggests that under similar environmental influences, the levels of sIgA in children with Down syndrome are higher than in the siblings, from a very young age.     

Age- and sex-related differences in masseter size and its role in oral functions

Background

The masseter muscle plays a key structural and functional role in the stomatognathic system. Researchers’ cumulative evidence has suggested that the variation in the size of a person’s masseter muscle may be a critical factor related to individual differences in oral functions. However, researchers have not yet investigated systematically the effect of a person’s age and sex on masseter muscle size and the association of masseter muscle size with other clinical metrics, including masticatory performance (MP) and salivary flow rate (SFR). Using T1-weighted magnetic resonance imaging (MRI) data provides a noninvasive method for assessing masseter muscle volume (MMV).

Prevalence of Candida spp., xerostomia,and hyposalivation in oral lichen planus – A controlled study

Objective

To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non‐OLP group), and subjects without oral mucosal lesions (control group).

Material and methods

Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non‐OLP lesions (28 patients), and healthy subjects (32 subjects).

Results

There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non‐OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp.

Conclusions

Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.     

Effects of total glucosides of paeony for delaying onset of Sjogren's syndrome: An animal study

ObjectiveTo investigate the effectiveness of total glucosides of paeony (TGP) on Sjogren's syndrome (SS) using non-obese diabetic (NOD) mice model.Study designTwenty-seven 8-week-old female NOD mice were assigned into TGP group, hydroxychloroquine (HCQ) group and normal saline (NS) group, receiving corresponding drugs respectively and sacrificed at 24-week-old. Saliva flow rate (SFR), ration of regulatory T cells, level of anti-SSA/SSB, histological changes in submandibular glands (SMG) and microarray analysis were assessed. The data were analyzed using SPSS.ResultsCompared to NS group, in TGP group, SFR, SMG index and the ration of regulatory T cells were significantly higher, while anti-SSA/SSB and lymphocytic foci were significantly lower. HCQ group demonstrated similar results except SMG index. Altered gene expression was found in 10.71% of TGP and 13.09% of HCQ of the profile.ConclusionTGP demonstrated a similar effectiveness as HCQ in delaying the onset of SS-like disease in NOD mice.     

The prevalence of periodontal disease in children and young adults in Yugoslavia

The prevalence of periodontal disease and its severity in children and young adults in the republics of the SFR Yugoslavia have been assessed. Although some regional differences have been reported the overall pattern is that periodontal disease in Yugoslavia has similar characteristics to the disease found elsewhere in Europe. Data for tooth loss indicate the importance of periodontal disease as a reason for extractions in those who are over 35 years of age. A nationwide survey of the prevalence of gingivitis and periodontitis was begun in 1984 and the results are awaited with interest. The recent improvement in dentist:population ratio in Yugoslavia will favour prevention and allow disease to be combatted at an earlier age. The steps required are outlined.     

An assessment of periodontal health in patients with schizophrenia and taking antipsychotic medication

Abstract: Background and objective: Severe periodontal disease is prevalent among patients with schizophrenia and is caused by the side effect of their medication, poor dental hygiene and smoking. The objective of this study was to evaluate whether the rate of periodontal disease could be modulated by changing the salivary flow rate (SFR) because of the use of antipsychotic medications in patients with schizophrenia. Methods: Group A (n = 33) included patients who used medications that may cause xerostomia, or dry mouth and Group B (n = 20) included patients who used medications that may cause sialorrhea, an excessive secretion of saliva. The participants’ periodontal status was assessed using the plaque index (PI), assessing bleeding on probing (BoP), probing pocket depth (PPD) and clinical attachment levels (CAL). Results: The mean of PI and BoP was significantly higher in Group A than in Group B (P < 0.001), but the PPD, CAL and decayed, missing and filled teeth (DMFT) scores were not significantly different in the two groups according to the statistical results (P > 0.05). Conclusions: The researcher concluded that there is a high risk of periodontal disease among patients with schizophrenia, and there is an even higher risk of periodontal disease induced by medication that increased SFR. Preventive dental protocol should be increased during the dental health care of this disadvantaged patient group.     

The influence of parotid gland sparing on radiation damages of dental hard tissues

Objective

The aim of the present study was to evaluate whether radiation damage on dental hard tissue depends on the mean irradiation dose the spared parotid gland is subjected to or on stimulated whole salivary flow rate.

Material and methods

Between June 2002 and October 2008, 70 patients with neck and cancer curatively irradiated were included in this study. All patients underwent dental treatment referring to the guidelines and recommendations of the German Society of Dental, Oral and Craniomandibular Sciences prior, during, and after radiotherapy (RT). During the follow-up period of 24 months, damages on dental hard tissues were classified according to the RTOG/EORTC guidelines. The mean doses (D _mean) during spared parotid gland RT were determined. Stimulated whole saliva secretion flow rates (SFR) were measured before RT and 1, 6, 12, 24 months after RT.

Results

Thirty patients showed no carious lesions (group A), 18 patients developed sporadic carious lesions (group B), and 22 patients developed general carious lesions (group C). Group A patients received a D _mean of 21.2?±?11.04 Gy. Group B patients received a D _mean of 26.5?±?11.59 Gy and group C patients received a D _mean of 33.9?±?9.93 Gy, respectively. The D _mean of group A was significantly lower than the D _mean of group C (p?<?0.001). Additionally, the mean SFR 6 months after RT of group A was significantly higher than the mean SFR of group C (p?<?0.01).

Conclusions

Irradiation damage on dental hard tissue correlates with increased mean irradiation doses as well as decreased salivary flow rates.

Clinical relevance

Parotid gland sparing resulting in a dose below 20 Gy reduces radiation damage on dental hard tissues, and therefore, the dose may act as a predictor for the damage to be expected.     

Correlation between oral parafunction and temporomandibular disorders and emotional status among saudi children.

Studies on association between temporomandibular disorders and oral parafunction in preschool children are few. The aim of the present study is to investigate the relationship between the subjective and objective signs and symptoms of temporomandibular disorders (TMD), oral parafunction and emotional status in preschool children. The study is based on a clinical examination and questionnaire. Five hundred and two Saudi children aged 3 to 7 years were examined for different signs and symptoms of TMD. In addition, the parents of the children were given a questionnaire to investigate the existence of oral parafunction and evaluate the emotional status of children. The results of the study showed significant association between attrition and temporomandibular joint (TMJ) pain, muscle tenderness and restricted opening, (P Values were 0.008, 0.019, 0.037 respectively). Significant association was found between habit of grinding and pain, while eating or opening the mouth (P<0.012). Significant association was found between emotional status and multiple signs and symptoms of TMJ tenderness, TMJ pain and muscle tenderness (P<0.042). Significant association was found between emotional status and pain, while eating or opening of the mouth (P<0.048). Close to positive association was found between oral parafunction and jaw lock. The association between TMD and oral parafunction as well as emotional status should direct the attention of the dentist to the importance of considering the emotional status, oral parafunction and TMD when examining and formulating treatment plan for the child patient.     

Hepatitis C virus infection and lichen planus: a short review

OBJECTIVE: To review the current literature regarding the association of lichen planus (LP) and liver disease, with particular attention to the association of the oral variant of the disease with hepatitis C virus (HCV) infection.
MATERIALS AND METHODS: Available literature of the possible association of LP with systemic disorders, in particular chronic hepatic disease, has been reviewed. RESULTS: LP is sometimes associated with infectious or autoimmune disease and/or neoplasia, however an aetio-logical association between LP and these disorders seems unlikely. A more consistent association exists between LP and chronic hepatic disease. The precise cause of this association is not known. However, in the last 6 years a notable association between HCV infection and LP has been observed, particularly in patients in Spain, Italy and Japan. The pathogenesis of this possible HCV-associated LP is not known, but it may involve a cell mediated response to an altered epithelial antigen.
CONCLUSION: There is now evidence to suggest a significant association between HCV infection and LP in some groups of patients.     

Confounding and effect modification: possible explanation for variation in the results on the association between oral and systemic diseases

OBJECTIVES: There is large variation in the results of studies on the association between periodontitis and systemic diseases. The variation might be explained by the fact that the association between periodontitis and systemic diseases is confounded, or the association might be modified by extraneous factors. In this article, we show, using simple examples, how confounding and effect modification may cause variation in results. In addition, these examples show that uncontrolled or partially controlled confounders can induce spurious associations. CONCLUSION: Confounding and effect modification may explain the variation in the results of studies on the association between periodontitis and systemic diseases.     

Association between serum lipid levels and periodontal infection

Objective: The aim of the study was to investigate the association between serum lipids and periodontal infection and the role of serum lipids in the association between body weight and periodontal infection. Material and Methods: The Health 2000 Health Examination Survey, which included 8028 subjects aged 30 or older living in continental Finland. This study was based on a subpopulation of dentate, non‐diabetic subjects who had never smoked and were aged under 50 years (n=1297). Periodontal infection was defined as the presence of teeth with deepened periodontal pockets. Serum levels of triglycerides, high‐density lipoprotein (HDL)‐cholesterol and low‐density lipoprotein (LDL)‐cholesterol were analysed enzymatically. Results: We found no consistent association between serum lipid levels and periodontal infection among normoweight subjects. There was an association of high serum triglycerides and low HDL with periodontal infection among obese subjects. The association between body mass index and periodontal infection was not essentially affected by serum lipids. Conclusion: In this study population serum lipid levels were not associated with periodontal infection among normoweight subjects. Obese subjects with a high serum triglyceride level and/or a low HDL‐cholesterol level could be at higher risk of periodontal infection. Our results suggest that the association between body weight and periodontal infection was mainly mediated through a mechanism other than serum lipids.     

The relationship of occlusion, parafunctional habits and recent life events to mandibular dysfunction in a non-patient population

This study investigated the association between occlusion, oral habits and stress relative to the level of mandibular dysfunction in the total population and in specific diagnostic subgroups (normal, joint disorder, muscle disorder and joint/muscle disorder). A total of 269 nursing students were given a questionnaire and examination. The questionnaire included items to calculate an oral habit index and a social readjustment rating scale. The examination included items to calculate an occlusal index, two craniomandibular indices and a diagnostic criteria for specific subgroups. In the total population there was a positive association between mandibular dysfunction and three postulated risk factors. The total population was then divided into diagnostic subgroups. There was a positive association between the degree of mandibular dysfunction and parafunctional habits for normals, muscle disorders and joint/muscle disorders. There was a positive association between mandibular dysfunction and occlusion for normals only. Finally there was a positive association between mandibular dysfunction and stress for muscle disorders only. The results suggest that associations between postulated aetiologic factors and mandibular dysfunction vary depending on whether the subjects have a muscle and/or joint disorder. Since all associations were weak, other possible risk factors need to be investigated.     

Stress and periodontal disease

Stress is an association of physiological and psychological reactions of a person confronted to a change of situation he cannot face. The relationship between stress and any disease is explained by hormonal modifications and behavioural changes induced by the stress. The evidence of such an association between stress and periodontal disease will be evaluated. The purpose of the present review article is to differentiate between old feelings and knowledge, and present findings which show that a lot of prospective studies are still needed for a more defined role of stress and periodontal disease.     

Association between cigarette smoking and prevalence of oral mucosal lesions among Malaysian army personnel

The association between cigarette smoking and the prevalence of oral mucosal lesions was examined in 495 Malaysian army personnel. No associations between cigarette smoking and recurrent aphthous ulcerations, pre-leukoplakia and frictional keratosis could be obtained in this study. Positive associations were found between cigarette smoking and leukoedema as well as denture stomatitis. There was a negative association between cigarette smoking and the presence of coated tongue.     

Association between convergence insufficiency and temporomandibular disorder cross-sectional study

Clinical Oral Investigations - Evaluate whether there is an association between convergence insufficiency and temporomandibular disorder (TMD) and whether there is an association between pain and...