Saliva: a powerful diagnostic tool for minimal intervention dentistry

Saliva plays a vital role in oral health as patients strive to maintain a healthy dentition throughout their lives. It is natures primary defense mechanism for the oral environment, and is particularly important for protecting exposed tooth surfaces. While internal protection for dentin comes from odontoblasts and the dental pulp, the body's external protection for enamel comes from saliva. The noninvasive nature of salivary testing has made it an effective alternative to blood and urine testing and home testing kits have made it possible for people to monitor their own health using this diagnostic medium. This paper presents what saliva can reveal about general and oral health as well as highlights the current use and potential clinical and research applications, of diagnostics based on oral fluids. CLINICAL SIGNIFICANCE: Early detection always minimizes the need for more invasive treatment. It prevents oral health disease at an early stage and provides a good oral health in rejuvenated state. If you stick and follow regular professional care, prevention maintenance appointments, prevention counseling, good home care and oral hygiene, diet habits you will be free from oral health illness and you can experience the harmonious and rejuvenated state of good oral health.     

Influence of cigarette smoking on blood and salivary super oxide dismutase levels among smokers and non‐smokers

Aim: To determine the influence of smoking on the blood and salivary superoxide dismutase levels among smokers, and to demonstrate the significance in alterations in the levels of superoxide dismutase in association with patient age, periodontal disease status, and duration and smoking frequency. Methods: Sixty healthy male patients (aged 20–60 years) constituted the target population. Blood and saliva samples were collected, and the periodontal index was measured using a Community Periodontal Index probe. Blood and salivary superoxide dismutase levels were calculated with the reagents prepared, and values were measured in a UV spectrophotometer. Results: There was a significant decrease in mean superoxide dismutase levels with an increase in age and smoking duration and frequency (0.23–0.05 U/mL). There was a range of 0.31–0.06 U/mL variation in the mean superoxide dismutase levels as the periodontal disease condition deteriorated. Conclusions: There was a significant reduction in the superoxide dismutase levels in the blood and saliva of smokers with increased duration and frequency of smoking, and as the periodontal disease condition worsened. Thus, this study emphasizes the importance of saliva as an easy, non‐invasive procedure in the diagnosis of patients who are more prone to precancerous lesions and conditions, and its importance in patient education and motivation programs for smoking cessation.     

Unusual presentation of Rapunzel syndrome

Background

The Rapunzel syndrome is an unusual form of trichobezoar found in patients with a history of psychiatric disorders, trichotillomania (habit of hair pulling) and trichophagia (morbid habit of chewing their hair) who subsequently develop gastric bezoars. The principal symptoms are vomiting and epigastric pain.

Case presentation

A 15-year-old female presented with a two-month history of continuous dull aching epigastric pain, vomiting, loss of appetite and weight loss. Further examination and imaging showed a large trichobezoar. Nevertheless, the patient refused any intervention. A few days later, she presented to the emergency department with features of peritonitis. After adequate resuscitation, she was taken for exploratory laparotomy. Her postoperative course was uneventful.

Conclusion

Delayed treatment of Rapunzel syndrome can lead to a complication such as gastric perforation which albeit extremely rare, could prove catastrophic.     

Unusual adverse consequence of reverse ventricular remodelling following cardiac resynchronization therapy

Cardiac resynchronization therapy has been shown to produce reverse ventricular remodelling in patients with severe heart failure. We report an unusual case of T-wave oversensing, most likely as a consequence of reverse ventricular remodelling resulting in change of the implantable cardioverter-defibrillator lead redundancy.