Abstract
IntroductionDryness is known to be associated with inflammatory diseases such as dry eye disease and atopic dermatitis. There is significant water loss from the oral cavity during mouth breathing. This study is conducted to estimate the influence of mouth breathing on the outcome of scaling and root planing (SRP) in chronic periodontitis (CP).Materials and methodsCP patients comprising of 33 mouth breathers (MBs) and 33 nose breathers (NBs) were recruited. Thirty patients in each group completed the study. At baseline, plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured. SRP was done in both groups. At the 4th, 8th, and 12th week, PI, GI, and BOP were recorded. PD and CAL were also assessed at the 12th week.ResultsAt the 12th week, there was significantly less improvement in GI at palatal sites of maxillary anterior and maxillary posterior teeth in MB group. Sixty-nine percent of BOP positive sites with PD >4 mm were converted into BOP negative sites with PD ≤4 mm in maxillary posterior palatal sites in NB. This success was 38% in MB.ConclusionControl of periodontal inflammation by SRP in CP patients is affected at palatal sites of mouth breathers.
Highlights
Dryness is known to be associated with inflammatory diseases such as dry eye disease and atopic dermatitis
Study population Of 208 patients screened from the outpatient department of Periodontics and Oral Implantology, the study was conducted in 66 chronic periodontitis (CP) patients (38 females and 28 males, aged 20 to 35 years; mean age: 31.30 ± 2.40 years) comprising of mouth breathers (MBs) (22 females and 11 males, mean age 31.21 ± 2.42 years) and nose breathers (NBs) (16 females and 17 males, mean age 31.39 ± 2.41 years)
Demographic characteristics and periodontal parameters of patients exhibited no significant difference except gingival index (GI) at lingual sites of mandibular anterior teeth and probing depth (PD) and clinical attachment level (CAL) at palatal sites of maxillary anterior teeth (Table 1)
Summary
Dryness is known to be associated with inflammatory diseases such as dry eye disease and atopic dermatitis. In dry eye disease, decreased formation of tears or increased rate of evaporation causes inflammation of the ocular surface and associated damage.[2] During exercise, lower airways are recruited in conditioning inspired air, especially at times of increased ventilation and prolonged duration of exercise.[3] This process of humidifying typically cold and dry air results in dehydration.[3] Dehydration evokes release of inflammatory mediators and thereby leads to exercise-induced bronchoconstriction and asthma.[4,5] Hydration status of the skin during wound healing influences expression of inflammatory signals in the epidermis with exaggerated response of pro-inflammatory cytokines in healing wounds under dry conditions compared to wounds that restore to normal healthy state in an optimally hydrated environment.[6] Application of emollients on dry skin in individuals with or at an increased risk for developing atopic dermatitis decreases transepidermal water loss as well as improving hydration status of skin[7,8] and providing relief in pruritis.[8]
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