Feeling Of Dry Mouth Research Articles

Clinical efficacy of casein phosphopeptide - amorphous calcium phosphate and casein phosphopeptide-amorphous calcium fluoride phosphate and their influence on the quality of life in patients with Sjögren’s syndrome

Introduction/Objective. The purpose of this study was to compare clinical efficacy of casein phosphopeptide ? amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) with 0.05% NaF, and to assess their influence on the quality of life among individuals with Sjogren?s syndrome. Methods. Thirty patients were randomized into three groups treated with different remineralizing agents: CPP-ACP, CPP-ACFP, and 0.05% NaF. Oral health was evaluated at the beginning of the study, after 28 days (short-term effects), and after six months. The diagnosis of dental caries was performed using the decayed, missing, and filled teeth (DMFT) / decayed and filled surfaces (DFS) criteria. Enamel demineralization was visually examined using the white spot lesion index (Gorelick). The gingival health was evaluated with the gingival index (Loe?Silness). Assessment of oral hygiene was done using the simplified oral hygiene index (Greene?Vermilion). The Xerostomia Inventory was used to quantify dry-mouth symptoms. The oral health-related quality of life was analyzed using the short form of the Oral Health Impact Profile (OHIP-14). Results. During the evaluation period, caries increment was not significant. Considerable regression of white spot lesions was noted in all three experimental groups (p < 0.001). No significant improvement in gingival health and oral hygiene was observed. Physical pain was decreased in all three experimental groups, and subjective feeling of dry mouth was reduced in CPP-ACP and CPP-ACFP groups. Conclusion. CPP-ACP and CPP-ACFP may reduce the caries activity and relieve the dry-mouth symptoms in patients with Sjogren?s syndrome.

Relationship between dry mouth, depression and systemic diseases in patients over 55 years of age from care homes and family homes

Abstract Introduction: Xerostomia (dry mouth, oral dryness) is the subjective sensation of dryness in the mouth. The gradual slight decrease in the secretion of saliva is physiologically related to aging of the body. Factors that predispose patients to the occurrence of dry mouth include systemic diseases, radiotherapy, anxiety and depression. The aim of this study was to analyse the relationship between dry mouth, depression and systemic diseases in respondents living in nursing homes (NH) and family homes (FH). Materials and methods: The study group comprised 226 respondents; 106 residents aged 55–101 years in two NH and 120 respondents living in FH. There were 110 men and 116 women. The study was based on the results of a diagnostic survey using an original questionnaire regarding general medical issues, and also the subjective feeling of dry mouth investigated with a standard Fox test. A shortened version of the Geriatric Depression Scale (GDS) was used to assess the wellbeing of patients and their state/sense of depression. The data obtained from the survey were analysed using Statistica 12 software (StatSoft Poland). Results: On the basis of the information and an analysis of the medical documentation of the NH group of patients, isolated systemic illness was found in only a limited number of patients. High blood pressure combined with heart disease was most frequently noted in NH (26.4%) and FH patients (25%). There was a significantly higher incidence of hypofunction and decreased secretion of saliva in NH patients (56.8%) than in FH patients (41.6%). No correlation between these symptoms and systemic diseases or depression was found in patients from either group. Conclusions: There was no correlation between the symptoms of dry mouth and the diagnosed systemic diseases in respondents from either group. The residents of NH were characterized by a worse mental state than those in FH. The symptoms of dry mouth were statistically significantly more frequent in residents of NH than in residents of FH. The residents of NH exhibiting worse mental state more often complained of a dry mouth sensation, however the difference was not statistically significant.

Investigation of the relationship between sleep disorders and xerostomia.

To investigate the relationship between sleep disorders, morning hyposalivation, and subjective feeling of dry mouth. A cross-sectional, observational, clinical study was carried out in a homogenous population sample which consists of Greek male soldiers without any medical history. After the application of oral modified Schirmer test, the sample was divided into a study group (n = 63) (MST < 25mm/3min) and a control group (n = 110) (MST ≥ 25mm/3min). In order to assess daytime sleepiness, risk of obstructive sleep apnea (OSA), sleep quality, sleep bruxism (SB), and subjective feeling of dry mouth, all the participants filled in the following scales in Greek version: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire (BQ), a SB questionnaire, and Xerostomia Inventory (XI) respectively. In every subgroup that came of ESS, PSQI, BQ, and SB questionnaire scoring, subjective feeling of dry mouth was evaluated, based on XI values. Statistically significant difference (p < 0.001) through PSQI scores was found between the study and control group. In contrast, a statistically significant difference was not obtained for the scores of ESS (p = 0.293), BQ (p = 0.089), and SB questionnaire (p = 0.730). XI scores introduced statistically significant difference between the subgroups of PSQI (p < 0.001), BQ (p = 0.001), SB questionnaire (p = 0.004) and statistically weak between the subgroups of ESS (p = 0.049). This is the first research study so far suggesting that patients with morning hyposalivation exhibit poor sleep quality using an objective method. The present results have, also, shown that subjective feeling of dry mouth is related to excessive daytime sleepiness, poor sleep quality, high risk of obstructive sleep apnea, and sleep bruxism, but larger-scale studies are still needed. These findings should keep dentists aware of a possible association between xerostomia and sleep disorders and support larger-scale studies.

Anticholinergic Burden and Dry Mouth in Middle-Aged People.

Anticholinergic burden refers to the cumulative effect of taking 1 or more drugs with anticholinergic properties. At the moment, little is known about the association between the anticholinergic burden and dry mouth. The objective of this article was to study, whether an anticholinergic burden is associated with dry mouth among middle-aged people. The study population included 1,345 people aged 46 y from the Northern Finland Birth Cohort 1966 (NFBC1966) study, who took part in a clinical medical and dental examination during 2012-2013. Medication data comprised both self-reported drug use and information obtained from the national register. Anticholinergic burden was measured using 10 different anticholinergic scales. Dry mouth was defined on the basis of having either a subjective feeling of dry mouth (xerostomia) or objectively measured low unstimulated or stimulated whole salivary flow rates (hyposalivation). Poisson regression models with robust error variance were used to estimate relative risk (RR). Regression models were adjusted for sex, smoking, diabetes, rheumatoid diseases, depressive symptoms, anxiety, total number of drugs, and antihypertensive drugs. Approximately 14% of the participants reported having xerostomia and about 2% had hyposalivation. The RRs of different anticholinergic scales for xerostomia varied from 1.05 to 1.68. The scales' RRs were between 0.89 and 2.03 for low unstimulated whole salivary flow (<0.1 mL/min) and between 0.59 and 1.80 for low stimulated whole salivary flow (<0.7 mL/min). Seven of 10 studied anticholinergic scales associated statistically significantly with dry mouth, either with xerostomia or hyposalivation. Most of the anticholinergic scales were associated with dry mouth, either with xerostomia or hyposalivation. There was considerable variation in the strength of the associations between anticholinergic scales and dry mouth. The findings of this study suggest that dentists should take notice of the use of drugs with anticholinergic properties and their harmful effects among middle-aged people. Dentists should provide these patients with necessary guidance on how to cope with dry mouth and give them prophylactic measures against oral diseases associated with dry mouth.

The combined effect of individually tailored xerostomia and nutritional interventions on dry mouth among nutritionally compromised old home care clients.

To examine the effectiveness of tailored xerostomia and nutritional 6-month interventions on xerostomia among home care clients aged 75years or over who were malnourished or at risk of malnutrition. A subjective feeling of dry mouth (xerostomia) is common among older adults and affects their quality of life, nutrition and oral health. Medical conditions, polypharmacy, dehydration and malnutrition are often underlying causes of xerostomia. The data are based on the NutOrMed study with a dietary intervention group of 119 patients and control group of 97 patients. In-home interviews were carried out by home care nurses, nutritionists, dental hygienists and pharmacists and tailored interventions by nutritionist and dental hygienists. Xerostomia intervention included individual counselling on dry mouth care and was applied to all those suffering occasionally or continuously from xerostomia (57%, n=66) in the intervention group. Nutritional intervention was applied to all participants in the intervention group, and it included instructions on increasing the number of meals, energy, protein intake and liquid intake. Among participants who received both interventions, xerostomia decreased by 30% and malnutrition or risk of malnutrition decreased by 61%. The interventions were highly significant (OR 0.1, 95% CI: 0.06; 0.2) in reducing xerostomia. Home care clients suffering from xerostomia profited significantly from tailored xerostomia and dietary interventions. Evaluation and treatment of xerostomia are important among older persons who are malnourished or at risk of malnutrition as a part of a comprehensive health intervention to improve their nutrition and oral health.

Prevalence of oral mucosal changes in type 2 diabetic patients attending diabetes mellitus center in Sulaimani city

Objective: Find the prevalence of possible changes seen in the oral mucosa of type 2 diabetes mellitus patients.&#x0D; Methods: Three hundred type 2 DM patients included in this study after taking their medical history and glycemic control level. Patients were asked for symptoms of dry mouth, burning sensation, pain and paresthesia and they were subjected to full oral mucosal examination. &#x0D; Results: Most patients had one or more subjective oral complain (83%). The predominant symptom was the feeling of dry mouth (80%) with no sex difference (P= 0.772). The mucosal pain reported in (12.7%) and significantly in males (P= 0.000). Gingival redness reported in (33.3%) and paresthesia in (8%). Nine (3%) patients had white buccal patches and six of them revealed lichenoid drug reaction. Dry mouth and oral burning sensation were shown to be unrelated to the glycemic control. Gingival redness was the most common lesion and correlated with poor glycemic control. Tongue was the second most commonly affected site in both sexes; however, the type of changes was sex and age-dependent. Denture stomatitis was seen in 4% and more frequent in females and in old age patients but did not relate to glycemic status. Lichenoid drug reaction was more prevalent among patients with poor glycemic control (6.3%) and who were above 50 years old. Buccal mucosal white patches were related to the glycemic control (P = 0.014).&#x0D; Conclusions: Dry mouth was the most common complaints of a diabetic patient in all levels of glycemic control. Gingival redness was frequent in diabetic patients and correlated with poor glycemic control. Buccal white patches were more prevalent in patients with poor glycemic control and who were above 50 years old.

Insufficient evidence for interventions to prevent dry mouth and salivary gland dysfunction post head and neck radiotherapy.

Data sourcesCochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, EBSCO (Cumulative Index to Nursing and Allied Health Literature, LILACS, BIREME, Virtual Health Library (Latin American and Caribbean Health Science Information database), Zetoc Conference Proceedings, the US National Institutes of Health Ongoing Trials Register, (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.Study selectionThe review included randomised controlled trials, irrespective of their language of publication or publication status. Participants could be outpatients or inpatients. The review included trials comparing any pharmacological agent regimen, prescribed prophylactically for salivary gland dysfunction prior to or during radiotherapy, with placebo, no intervention or an alternative pharmacological intervention. Comparisons of radiation techniques were excluded.Data extraction and synthesisStandard Cochrane methodological processes were followed.ResultsThirty-nine studies that randomised 3520 participants were included; the number of participants analysed varied by outcome and time point. The studies were ordered into 14 separate comparisons with meta-analysis only being possible in three of those. We found low quality evidence to show that amifostine, when compared to a placebo or no treatment control, might reduce the risk of moderate to severe xerostomia (grade 2 or higher on a 0 to 4 scale) at the end of radiotherapy (risk ratio (RR) 0.35, 95% confidence interval (CI) 0.19 to 0.67; P = 0.001, three studies, 119 participants), and up to three months after radiotherapy (RR 0.66, 95% CI 0.48 to 0.92; P = 0.01, five studies, 687 participants), but there is insufficient evidence that the effect is sustained up to 12 months after radiotherapy (RR 0.70, 95% CI 0.40 to 1.23; P = 0.21, seven studies, 682 participants). We found very low quality evidence that amifostine increased unstimulated salivary flow rate up to 12 months after radiotherapy, both in terms of mg of saliva per five minutes (mean difference (MD) 0.32, 95% CI 0.09 to 0.55; P = 0.006, one study, 27 participants), and incidence of producing greater than 0.1 g of saliva over five minutes (RR 1.45, 95%CI 1.13 to 1.86; P = 0.004, one study, 175 participants).However, there was insufficient evidence to show a difference when looking at stimulated salivary flow rates. There was insufficient (very low quality) evidence to show that amifostine compromised the effects of cancer treatment when looking at survival measures. There was some very low quality evidence of a small benefit for amifostine in terms of quality of life (ten-point scale) at 12 months after radiotherapy (MD 0.70, 95% CI 0.20 to 1.20; P = 0.006, one study, 180 participants), but insufficient evidence at the end of and up to three-month post radiotherapy. A further study showed no evidence of a difference at 6, 12, 18 and 24-month post radiotherapy.There was low quality evidence that amifostine is associated with increases in: vomiting (RR 4.90, 95% CI 2.87 to 8.38; P < 0.00001, five studies, 601 participants); hypotension (RR 9.20, 95% CI 2.84 to 29.83; P = 0.0002, three studies, 376 participants); nausea (RR 2.60, 95% CI 1.81 to 3.74; P < 0.00001, four studies, 556 participants); and allergic response (RR 7.51, 95% CI 1.40 to 40.39; P = 0.02, three studies, 524 participants).The authors founded insufficient evidence (that was of very low quality) to determine whether or not pilocarpine performed better or worse than a placebo or no treatment control for the outcomes: xerostomia, salivary flow rate, survival and quality of life. There was some low quality evidence that pilocarpine was associated with an increase in sweating (RR 2.98, 95% CI 1.43 to 6.22; P = 0.004, five studies, 389 participants).The authors found insufficient evidence to determine whether or not palifermin performed better or worse than placebo for: xerostomia (low quality); survival (moderate quality); and any adverse effects. There was also insufficient evidence to determine the effects of the following interventions: biperiden plus pilocarpine, Chinese medicines, bethanechol, artificial saliva, selenium, antiseptic mouthrinse, antimicrobial lozenge, polaprezinc, azulene rinse and Venalot Depot (coumarin plus troxerutin).ConclusionsThere is some low quality evidence to suggest that amifostine prevents the feeling of dry mouth in people receiving radiotherapy to the head and neck (with or without chemotherapy) in the short- (end of radiotherapy) to medium-term (three-month post radiotherapy). However, it is less clear whether or not this effect is sustained to 12-month post radiotherapy. The benefits of amifostine should be weighed against its high cost and side effects. There was insufficient evidence to show that any other intervention is beneficial.

A systematic review of the effects of acupuncture on xerostomia and hyposalivation

BackgroundSaliva is fundamental to our oral health and our well-being. Many factors can impair saliva secretion, such as adverse effects of prescribed medication, auto-immune diseases (for example Sjögren’s syndrome) and radiotherapy for head and neck cancers. Several studies have suggested a positive effect of acupuncture on oral dryness.MethodsPubmed and Web of Science were electronically searched. Reference lists of the included studies and relevant reviews were manually searched. Studies that met the inclusion criteria were systematically evaluated. Two reviewers assessed each of the included studies to confirm eligibility and assessing the risk of bias.ResultsTen randomized controlled trials investigating the effect of acupuncture were included. Five trials compared acupuncture to sham/placebo acupuncture. Four trials compared acupuncture to oral hygiene/usual care. Only one clinical trial used oral care sessions as control group. For all the included studies, the quality for all the main outcomes has been assessed as low. Although some publications suggest a positive effect of acupuncture on either salivary flow rate or subjective dry mouth feeling, the studies are inconclusive about the potential effects of acupuncture.ConclusionsInsufficient evidence is available to conclude whether acupuncture is an evidence-based treatment option for xerostomia/hyposalivation. Further well-designed, larger, double blinded trials are required to determine the potential benefit of acupuncture. Sample size calculations should be performed before before initiating these studies.

Influence of habitual mouth breathing on taste sensation

PurposeAlthough habitual mouth breathing is recognized to cause various disorders of orofacial growth and function, including taste sensation, the relationship between habitual mouth breathing and taste disorders has not been investigated sufficiently. This study aimed to examine the influence of habitual mouth breathing on taste sensitivity and relevant factors such as salivation, oral moisture, and olfactory function. Materials and methodsThirty volunteers (male, 18; female, 12) aged 22–35 years participated in this study. On the basis of their responses to a questionnaire regarding habitual breathing, 15 subjects each were assigned to the mouth-breathing (MB) and control groups. Recognition thresholds for sweet, salty, sour, bitter, and umami tastes at the tip and root of the tongue were measured using the filter-paper disk method. Salivary flow and spinnbarkeit (viscosity), oral moisture, and olfactory function were also measured as factors related to taste sensitivity. Additionally, a questionnaire about dry mouth, nasal obstruction, snoring, and olfaction was implemented. ResultsThe MB group exhibited significantly higher recognition thresholds for sweetness and sourness at the tip and for bitterness and sourness at the root of the tongue compared with the control group. However, there was no significant intergroup difference in the threshold for salty or umami taste, salivary flow or spinnbarkeit, oral moisture, or olfactory function. The MB group exhibited a significantly higher subjective feeling of dry mouth, nasal obstruction, and snoring than the control group. ConclusionsMouth breathing habit poses a risk for taste deterioration without affecting salivary secretion and olfactory function.

Dietary nitrate protects submandibular gland from hyposalivation in ovariectomized rats via suppressing cell apoptosis

Xerostomia, a major oral symptom of menopause, is a subjective feeling of dry mouth associated with oral pain and difficulties in deglutition and speech, which significantly reduces patient's quality of life. Dietary nitrate, which can be converted to nitric oxide, has multiple physiological functions in the body, including antioxidant activity and vasodilatation; however, its protective effect against xerostomia remains poorly understood. The present study aimed to evaluate the effects of dietary nitrate on estrogen deficiency-induced xerostomia. We established an ovariectomized (OVX) rat model, which included five groups: sham-operated, OVX, OVX + 0.4 mM nitrate, OVX + 2 mM nitrate, and OVX + 4 mM nitrate (n = 6). After ovariectomy, animals in the nitrate treatment groups received appropriate amounts of sodium nitrate dissolved in distilled water for 3 months. The results showed that nitrate treatment reduced body weight and water intake, and increased serum nitrate and nitrite levels. Furthermore, nitrate uptake increased saliva secretion as evidenced by saliva flow rates and aquaporin 5 expression, and alleviated histological lesions as evidenced by reduction of the fibrotic area and cell atrophy in the salivary glands. Although protective effects of nitrate against estrogen deficiency-induced xerostomia were observed at all doses, treatment with 2 mM nitrate was more effective than that with 0.4 mM and 4 mM nitrate. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and caspase-3 expression analyses showed that nitrate also protected cells from apoptosis, possibly through upregulation of Cu-Zn superoxide dismutase (Cu-Zn SOD) known to inhibit oxidative stress-related apoptosis. Our findings indicate that nitrate could improve functional activity of the salivary glands in OVX rats by suppressing apoptosis and upregulating Cu-Zn SOD expression, suggesting that dietary nitrate may potentially prevent hyposalivation in menopausal women.

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy.

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy.

Effects of mouthwash interventions on xerostomia and unstimulated whole saliva flow rate among hemodialysis patients: A randomized controlled study

BackgroundDry mouth (xerostomia) is a common symptom in hemodialysis patients, which is associated with a reduced salivary flow. Xerostomia affects patients’ oral health and quality of life. ObjectivesThe aim of this study was to investigate using a mouthwash as a means to reduce xerostomia and improve saliva flow rates in hemodialysis patients. DesignA randomized controlled trial. Settings and methodsThree dialysis centers in Northern Taiwan served as the study sites. Patients were purposively sampled from three hemodialysis centers in Taiwan and randomly assigned to one of three groups: pure water mouthwash; n=41, licorice mouthwash; n=44, or no mouthwash (control); n=37. The Summated Xerostomia Inventory, and unstimulated whole salivary flow rate measured dry mouth and salivary flow, respectively. Data was collected at baseline, dialysis Day 5 and Day 10. ResultsOne hundred twenty-two patients participated in this study. Baselines were adjusted for any imbalances in variables and generalized estimating equations analysed the data. Compared to control, a pure water mouthwash resulted in an increase in the unstimulated salivary flow rate of 25.85×10−3mL/min and 25.78×10−3mL/min (p<0.05) at Day 5 and Day 10, respectively. The estimated effect size was 1.38. However, there was no significant decrease in Summated Xerostomia Inventory scores. The licorice mouthwash also significantly improved the unstimulated salivary flow rates to 114.92×10−3mL/min, and 131.61×10−3mL/min at Day 5 and Day 10, respectively (p< 0.001). However, in contrast to the pure water mouthwash, the licorice mouthwash resulted in a significant improvement in the scores for the Summated Xerostomia Inventory (p<0.001). ConclusionAlthough a pure water or a licorice mouthwash and improved the objective measure of salivary flow rate, only the licorice mouthwash provided subjective relief of xerostomia. This suggests the use of a licorice mouthwash may effectively relieve feelings of dry mouth in hemodialysis patients.

Low temperature cooking of pork meat — Physicochemical and sensory aspects

Low-temperature cooking is increasingly used in the food sector. This study compared three different low temperature heating methods and one conventional cooking procedure of pork meat in a combi steamer with special emphasis on sensory parameters. Low temperature, long time (LTLT) treatments over 20h at 53°C or 58°C (LTLT 53°C or 58°C) showed considerable effects on meat tenderization. Heating to a core temperature of 60°C (low temperature method=LT) at 60°C oven temperature resulted in less tender but clearly juicier meat. LTLT 53°C and LT were evaluated as being equally acceptable by the panelists. The tenderest meat (LTLT 58°C) was mainly rejected because of a crumbly and dry mouth feeling. Conventional heating to a core temperature of 80°C at 180°C oven temperature resulted in low eating quality due to high toughness and low juiciness.

Sensory quality of drinking water produced by reverse osmosis membrane filtration followed by remineralisation

Membrane filtration of ground, surface, or sea water by reverse osmosis results in permeate, which is almost free from minerals. Minerals may be added afterwards, not only to comply with (legal) standards and to enhance chemical stability, but also to improve the taste of drinking water made from permeate. Both the nature and the concentrations of added minerals affect the taste of the water and in turn its acceptance by consumers. The aim of this study was to examine differences in taste between various remineralised drinking waters.Samples selected varied in mineral composition, i.e. tap water, permeate, and permeate with added minerals (40 or 120 mg Ca/L, added as CaCO3, and 4 or 24 mg Mg/L added as MgCl2), as well as commercially available bottled drinking waters, to span a relevant product space in which the remineralised samples could be compared. All samples were analysed with respect to their physical–chemical properties. Sensory profiling was done by descriptive analysis using a trained panel.Significant attributes included taste intensity, the tastes bitter, sweet, salt, metal, fresh and dry mouthfeel, bitter and metal aftertaste, and rough afterfeel. Total dissolved solids (TDS) was a major determinant of the taste perception of water. In general, lowering mineral content in drinking water in the range examined (from <5 to 440 mg/L) shifted the sensory perception of water from fresh towards bitter, dry, and rough sensations. In addition, perceived freshness of the waters correlated positively with calcium concentration. The greatest fresh taste was found for water with a TDS between 190 and 350 mg/L. Remineralisation of water after reverse osmosis can improve drinking quality significantly.

Quality of life and oral health in elderly.

BackgroundWe want to assess quality of life in elderly patients in relation to the number of remaining teeth, the number of ingested drugs and xerostomía and to determine the correlation between an increased intake of drugs and a greater feeling of dry mouth and to know the most commonly used measures to control xerostomia.Material and Methods30 subjects aged between 65 and 95 years (14 males, 16 females) completed the OHIP questionnaire to determine quality of life. For oral status, the number of remaining teeth according to WHO criteria and xerostomia using the xerostomia index (XI) were studied. In cases of dry mouth sensation, the measures to alleviate it were asked.ResultsThe average quality of life according to the OHIP rate is 19.23 (Dt = 10.58), being 56 the worst quality of life. The Pearson correlation coefficient indicates that quality of life is not related to the number of remaining teeth (r = -0.046; p = 0.810) nor the number of ingested drugs (r = 0.226; p = 0.23) but a greater sensation of dry mouth is related to a poorer quality of life (r = 0.678; p = 0.230). There is no association between the number of ingested drugs and the xerostomia index (r = 0.144; p = 0.447). The most frequently measures used against dry mouth were drinking water (21 subjects) and sugarless candies (15 subjects).ConclusionsQuality of life is not related to the number of remaining teeth nor the number of ingested drugs. However, a higher level of xerostomia was significantly associated with a poorer quality of life. There is no association between the number of drugs ingested and xerostomia index. Sugarless candies and drinking water are the more frequently used measures to alleviate dry mouth. Key words:Quality of life, oral health, elderly.

The Oral Cavity State in Renal Transplant Recipients.

Patients with a solid organ transplant can have many different complications in the mouth, as a result of immunosuppression and side effects of drugs. The aim of this study was to examine the frequency and type of oral lesions in renal transplant patients, dental status, oral hygiene, oral lesions related to drugs which patients take and the time of transplantation as well as the frequency of patient's visits to the dentist in the post-transplant period. The study was performed in a period of two years and included 100 subjects with a renal transplant during their regular control visits to the Department of Nephrology and Dialysis, Clinical Hospital Centre Zagreb and the Department of Oral Medicine, School of Dental Medicine, University of Zagreb and 100 randomly selected control subjects at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb. Results showed a significantly higher incidence of oral lesions in patients with renal transplant (31%) compared to control subjects. The most frequent were erythematous (inflammatory changes), keratotic lesions and gingival hyperplasia. The average DMFT index was significantly lower in patients with renal transplant than in the control group. One third of patients had a subjective feeling of dry mouth. Oral hygiene was poor overall, and only a small number of subjects used the additional sustainers for oral hygiene. Most patients did not visit the dentist after the transplantation. Renal transplant patients need a comprehensive and regular dental care during the pre- and post-transplant period and a doctor of dental medicine should be part of a multidisciplinary team of medical specialists.

Oral health-related quality-of-life and mental health in individuals with chronic obstructive pulmonary disease (COPD)

Objectives. To investigate the association between oral health, oral health-related quality-of-life (OHRQoL) and mental health-related quality-of-life (QoL) in persons with chronic obstructive pulmonary disease (COPD) with respect to demographic, social and clinical oral health variables. Materials and methods. One hundred participants were included in a cross-sectional study at a hospital in Norway. Data were collected via the Oral Health Impact Profile (OHIP-14), the SF-36v2 Health Survey Mental Component (MCS), other self-reported factors, an interview and a clinical examination. Multiple regression analyses were performed. The Regional Committee for Medical and Health Research Ethics approved the study. Results. Higher education (p < 0.01), being a smoker (p < 0.05) and experience of oral health problems (p < 0.001) were significantly associated with oral health-related quality-of-life (OHRQoL). Furthermore, those with feelings of dry mouth (p < 0.05) and impaired OHRQoL (p < 0.001) experienced more mental health problems. Conclusions. This study demonstrated that oral health and personal factors are related to mental health-related QoL and OHRQoL in individuals with COPD. This finding shows the need to focus on oral care.

Astringency Is a Trigeminal Sensation That Involves the Activation of G Protein-Coupled Signaling by Phenolic Compounds

Astringency is an everyday sensory experience best described as a dry mouthfeel typically elicited by phenol-rich alimentary products like tea and wine. The neural correlates and cellular mechanisms of astringency perception are still not well understood. We explored taste and astringency perception in human subjects to study the contribution of the taste as well as of the trigeminal sensory system to astringency perception. Subjects with either a lesion or lidocaine anesthesia of the Chorda tympani taste nerve showed no impairment of astringency perception. Only anesthesia of both the lingual taste and trigeminal innervation by inferior alveolar nerve block led to a loss of astringency perception. In an in vitro model of trigeminal ganglion neurons of mice, we studied the cellular mechanisms of astringency perception. Primary mouse trigeminal ganglion neurons showed robust responses to 8 out of 19 monomeric phenolic astringent compounds and 8 polymeric red wine polyphenols in Ca(2+) imaging experiments. The activating substances shared one or several galloyl moieties, whereas substances lacking the moiety did not or only weakly stimulate responses. The responses depended on Ca(2+) influx and voltage-gated Ca(2+) channels, but not on transient receptor potential channels. Responses to the phenolic compound epigallocatechin gallate as well as to a polymeric red wine polyphenol were inhibited by the Gαs inactivator suramin, the adenylate cyclase inhibitor SQ, and the cyclic nucleotide-gated channel inhibitor l-cis-diltiazem and displayed sensitivity to blockers of Ca(2+)-activated Cl(-) channels.

Exploratory study on reduction of the incidence of hyperhidrosis by oral pilocarpine

PurposeAn exploratory study on the effect of a low-dose divided dosing regimen of pilocarpine hydrochloride was performed to examine the effect of this regimen on reduction of the incidence of hyperhidrosis, an adverse effect of the drug. In the test regimen, the single dose was reduced and the dosing frequency was increased to 4 times a day. MethodsA single-blind randomized controlled study was performed in 40 patients with xerostomia associated with Sjögren's syndrome. The test group (n=20) received 2.5mg of pilocarpine hydrochloride orally 4 times a day after each meal and before going to bed, while the control group (n=20) took 5mg of pilocarpine hydrochloride 3 times a day after each meal. The incidence of Grade 2 or more severe hyperhidrosis on CTCAE in patients who requested discontinuation of treatment was compared between the two groups. The duration of administration was 12 weeks. ResultsThe incidence of Grade 2 or more severe hyperhidrosis was 10.0% (2 patients) in the test group and 40.0% (8 patients) in the control group, with no significant difference between the groups (p=0.065). However, the low-dose divided dosing regimen significantly decreased the incidence of all grades of hyperhidrosis and significantly improved the saliva secretion rate and feeling of dry mouth compared to those before treatment. ConclusionThe results suggest that the low-dose divided dosing regimen does not reduce the incidence of Grade 2 or more severe hyperhidrosis, but reduces the incidence of all grades of hyperhidrosis.

Self-Reported Oral Symptoms and Signs in Liver Transplant Recipients and a Control Population

Recipients of liver transplantation (LT) receive lifelong immunosuppression, which causes side effects. We investigated self-reported oral symptoms and associated risk factors with the following hypothesis: symptoms and signs would differ between LT recipients of different etiology groups and also between LT recipients and a control population. Eighty-four LT recipients (64 with chronic liver disease and 20 with acute liver disease) were recruited for clinical oral and salivary examinations (median follow-up = 5.7 years). A structured questionnaire was used to record subjective oral symptoms. Matched controls (n = 252) came from the National Finnish Health 2000 survey. The prevalence of symptoms was compared between the groups, and the risk factors for oral symptoms were analyzed. Xerostomia was prevalent in 48.4% of the chronic LT recipients and in 42.1% of the acute LT recipients. This subjective feeling of dry mouth was only partly linked to objectively measured hyposalivation. The chronic transplant recipients had significantly lower unstimulated salivary flow rates than the acute transplant recipients (0.34 ± 0.31 versus 0.61 ± 0.49 mL/minute, P = 0.005). Among the chronic transplant recipients, hyposalivation with unstimulated salivary flow was associated with fewer teeth (17.7 ± 8.2 versus 21.9 ± 8.4, P = 0.047) and more dentures (33.3% versus 12.2%, P = not significant). The chronic patients reported significantly more dysphagia than their controls (23.4% versus 11.5%, P = 0.02). Increases in the number of medications increased the symptoms in all groups. In conclusion, dysphagia was significantly more prevalent among the chronic LT recipients versus the controls. The number of medications was a risk factor for dry mouth-related symptoms for both the LT recipients and the controls. The chronic transplant recipients presented with lower salivary flow rates than the acute transplant recipients. Hyposalivation correlated with generally worse oral health among the chronic transplant recipients. These differences between the chronic and acute LT recipients may have been due to differences in their medical conditions due to the different etiologies.