Lower Salivary Flow Rate Research Articles

Can different stages of leprosy treatment influence the profile of oral health? Oral status in leprosy.

BackgroundThe aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects.Material and MethodsA sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA).ResultsThe data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment).ConclusionsIt was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals. Key words:Leprosy, Periodontal diseases, Halitosis, CPO Index.

Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD.

Objective:The aim of this study was to investigate the incidence of carious lesions, the amount of salivary flow rate and pH value in patients with asthma and chronic obstructive pulmonary diseases (COPD), using inhalation therapy. The obtained results were compared with the results of adult healthy subjects, forming a control group.Material and Methods:The study included 80 participants aging between 18 and 65 years. The experimental group (EG) was comprised of 40 participants, previously diagnosed with asthma or COPD undergoing inhalation therapy for more than five years. The control group (CG), comprised of 40 participants, mirrored the same age and gender status of the EG. Dental status was determined by decayed, missing, and filled teeth (DMFT index). Quantity and pH value of saliva were determined in the laboratory.Results:In the EG, the mean value of the salivary flow rate and pH value were statistically significantly lower than in the CG (p<0.001). Patients in the EG had a higher value of DMFT index when compared with the CG, although the difference was not statistically significant (p=0.199). Mean number of decayed teeth, as well as missing teeth, in the EG was statistically significantly higher than in the CG (p<0.001). Mean number of filled teeth in the EG was statistically significantly lower than in the CG (p<0.001).Conclusion:It was found that patients undergoing inhalation therapy face increasing risk of dental caries due to the lower salivary flow rate and pH value along with the inhalation therapy. They should receive intensive preventive care, including oral hygiene instruction and dietary advice.

Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus.

BackgroundDiabetes mellitus is one of the most prevalent metabolic diseases, with complications such as decreased salivary flow rate and xerostomia.ObjectiveThis study aimed to determine the salivary flow rate and xerostomia in type I and II diabetic patients in comparison with healthy controls.MethodsThis case-control study was performed on diabetic patients of a private office in Babol, Iran, between May 2015 and October 2016. This study involved two study groups (type I and II diabetes, with 40 in each group) and two control groups (control I and II, with 35 in each group) which were age- and sex-matched with the related study groups. They were all selected through simple sampling. Unstimulated whole saliva was collected through Navazesh method and the salivary flow rate was measured (ml/min). Xerostomia was evaluated via Fox’s test. Moreover, the patients’ data were recorded including age, sex, disease duration, type of diabetes, fasting blood glucose (FBG) and HbA1C. The obtained data were statistically analyzed by using SPSS version 17. Independent-samples t-test, Chi-square, Pearson correlation and multiple comparison post-hoc tests were employed as appropriated. p<0.05 was considered significant.ResultsThe mean salivary flow rate in type I diabetics (0.35±0.11 ml/min) was lower than that in control I (0.50±0.07 ml/min) (p=0.01). The same difference was observed between type II diabetics (0.37±0.13 ml/min) and control II groups (0.47±0.11 ml/min) (p=0.01). No significant difference was observed in the salivary flow rate between type I and II diabetics (p=0.345). Furthermore, xerostomia was higher in type I (2.70±2.50, 1.17±1.60) and II (2.65±2.20–1.62±1.50) diabetics compared with the related control groups (p=0.01), (p=0.02).ConclusionType I, II diabetic patients revealed lower salivary flow rate and higher xerostomia compared with healthy controls. The salivary flow rate and xerostomia had inverse correlation.

Children with a Higher Activity of Carbonic Anhydrase VI in Saliva Are More Likely to Develop Dental Caries

Objective: This study aimed to analyze the concentration and activity of carbonic anhydrase (CA) VI in the saliva of school children. We investigated the relationship among caries, CA VI concentration/activity, flow rate, pH, and buffering capacity. Materials and Methods: Seventy-four school children were divided into a caries-free group and a caries group. Clinical examinations were conducted by one examiner according to World Health Organization criteria + early caries lesions. Salivary flow rate, pH, and buffering capacity were analyzed. Salivary CA VI concentration and activity were evaluated by ELISA and zymography, respectively. The data were analyzed using Student's t test and the Mann-Whitney test, and Pearson and Spearman correlation analyses were also done. In multivariate modeling, associations between variables were expressed as odds ratios. Results: The results showed that salivary flow rate, salivary pH, and BC were significantly higher in the saliva of caries-free children. Also, the salivary CA VI concentration was significantly higher in the saliva of caries-free children. The salivary CA VI activity was higher in children with caries. We found a negative correlation between BC and dental caries. Also, in the caries group we found a positive correlation between the concentration and the activity of CA VI and a negative correlation between BC and CA VI activity. A negative correlation between salivary pH and CA VI concentration was observed in the caries-free group. A high activity of CA and a low salivary flow rate were associated with dental caries. Conclusion: These results support the conclusion that dental caries is highly affected by the activity of CA VI in saliva as well as by the salivary flow rate.

Oral health in patients with renal disease: a longitudinal study from predialysis to kidney transplantation.

The aim of this longitudinal study was to compare the oral health of chronic kidney disease patients at the predialysis (baseline) and post-transplantation (follow-up) stages and to investigate differences in oral health between diabetic nephropathy and other kidney disease patients at follow-up. Fifty-three kidney disease patients (34 men) aged 31-86years were followed up to 157months. Clinical and radiological oral examinations, salivary and laboratory analyses, and oral health behavior questionnaires were conducted at the predialysis and follow-up stages at Helsinki University Hospital, Finland. Oral inflammatory burden was estimated by calculating deep periodontal pockets, periodontal inflammatory burden (PIBI), decayed, missing, and filled teeth (DMFT), and total dental indices (TDI). Results were analyzed using cross-tabulation Pearson chi-square or Fisher's exact test and the Mann-Whitney U test, and the McNemar and Wilcoxon signed-rank test. At the predialysis stage, patients more often had calculus and deep periodontal pockets; TDI, PIBI, number of teeth, and salivary flow rates were also statistically significantly higher compared to follow-up. At follow-up, diabetic nephropathy patients more often had Candida growth, more plaque, and used more drugs and had lower stimulated salivary flow than patients with other kidney diseases. Oral health was better at follow-up than at the predialysis stage; however, attention should be given to the lower salivary flow rate and higher number of drugs used at that stage. This study confirms the importance of treating oral infectious foci at the predialysis stage in order to prevent adverse outcomes after kidney transplantation.

Sa1677 - 24-h Esophageal PH/Impedance Monitoring Profiles in Patients with Normal Salivary Flow Rate and Low Salivary Flow Rate (Xerostomia) in Patients who were Suspected of Gerd

Sa1677 - 24-h Esophageal PH/Impedance Monitoring Profiles in Patients with Normal Salivary Flow Rate and Low Salivary Flow Rate (Xerostomia) in Patients who were Suspected of Gerd

Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia.

Background. Unstimulated salivary flow rate can be influenced by different factors. This study was undertaken to evaluate the effect of stress, anxiety and depression on unstimulated salivary flow rate in adults. Methods. A total of 247 adult subjects, randomly selected from patients referring to Zanjan Dental School, were included in this investigation. The study procedures consisted of collecting salivary samples (in 5 minutes), completing a form for feeling of xerostomia and completing Depression Anxiety Stress Scale (DASS) Questionnaire to assess the severity of stress, anxiety and depression. Based on the results, the patients were categorized in four groups: Low salivary flow rate plus xerostomia (group 1, n=60), normal salivary flow rate plus xerostomia (group 2, n=59), low salivary flow rate without xerostomia (group 3, n=60) and normal salivary flow rate without xerostomia (control group, n=68). Results. The frequencies of subjects with severe and major depression in groups 1, 2 and 3 were 31.4%, 11.7% and 8.5%, respectively, with 4.4% in the control group. The frequencies of subjects with severe stress in groups 1, 2 and 3 were 21.7%, 3.3% and 11.9%, respectively, with 1.5% in the control group. The frequencies of patients with severe anxiety in groups 1, 2 and 3 were 50%, 30% and 61.1%, respectively, with 4.4% in the control group. Stress, anxiety and depression exhibited a statistically significant relationship with unstimulated salivary flow rate and xerostomia (P<0.05). Conclusion. Stress, anxiety and depression can influence unstimulated salivary flow rate and lead to xerostomia.

Correlation between Salivary Glucose and Blood Glucose and the Implications of Salivary Factors on the Oral Health Status in Type 2 Diabetes Mellitus Patients.

Aims and Objectives:The purpose of this study was to estimate and assess any correlation between random capillary blood glucose (RCBG) and unstimulated whole salivary glucose (UWSG), as well as to estimate various salivary parameters, such as flow rate, pH, buffering capacity, and the influence of these factors on the oral health status in type 2 diabetes mellitus (DM).Materials and Methods:Sixty individuals suffering from type 2 DM and 40 healthy individuals in the age group of 30–60 years were included in the study. RCBG was estimated using glucometer and UWSG was estimated using photocolorimeter. Salivary parameters such as flow rate, pH, and buffering capacity were assessed using GC® Saliva kit. Oral health status was recorded using the Russell's periodontal index (RPI) and the Decayed Missing Filled Teeth (DMFT) index. The Statistical Package for the Social Sciences version 16 was used for statistical analysis.Results:Type 2 diabetics had higher mean values for RCBG levels and UWSG. Type 2 diabetics had low mean salivary flow rate, pH, and buffering capacity. Type 2 diabetics had higher mean values for RPI.Conclusion:Among the salivary factors studied, salivary glucose significantly influenced the periodontal status in Type 2 diabetics.

OBESITY AND RELATED ORAL HEALTH VARIABLES AMONG A GROUP OF YOUNG ADOLESCENTS

INTRODUCTION: Obesity and dental caries both are multifactorial diseases that impact adolescent's health and psychosocial development. They both share common, modifiable, influences such as diet and lifestyle.OBJECTIVES: the aim of this study was to assess young adolescents' obesity and dietary habits association with dental caries experience and stimulated salivary flow rate.MATERIALS AND METHODS: In a cross-sectional comparative study designs, fifty obese adolescents with mean age of 13.0±0.54 years and fifty normal weight adolescents with mean age of 12.87±0.45 years were selected from preparatory schools in Alexandria. They were clinically examined with respect to dental caries, as well as answered a questionnaire concerning sociodemographic background, oral hygiene practice, 24-hour dietary recall and food frequency questionnaire. Body mass index (kg/m2) for age and flow rate of stimulated whole saliva (ml/min) was determined. Total cariogenic food exposure time was calculated.RESULTS: The obese subjects exhibited significant higher mean score of DMFS (4.84±3.65 for male - 5.00±2.04 for female) vs. 0.76±1.39 for male - 0.44±2.71 for female in normal weight group (p= 0.011) and (p= 0.001) respectively. Obese group had lower flow rate of stimulated whole saliva (1.74±0.75 ml/min for male-1.80±0.65 ml/min for female) vs 2.86±0.70 for males- 2.83±0.65 for females in normal weight group (p=0.001) and (p=0.018) respectively. Obese subjects exhibited significant higher cariogenic food total exposure time with mean of 155.60±59.56 min/day vs. 50.40±34.58 min/day (p < 0.001). No significant difference existed between the two groups regarding different food groups consumption except for grain group according to the American Academy of Pediatric Dentistry (AAPD) recommendations. In a multiple stepwise linear regression model for DMFS predictors, DMFS was significantly associated with lower flow rate of stimulated whole saliva (p < 0.001), cariogenic food total exposure time, added sugar and milk group consumption.CONCLUSIONS: Obese young adolescents are more likely to suffer from dental caries and lower salivary flow rate compared to normal weight ones. They are more liable to consume cariogenic snacks and grain group food items.

Low-Level Laser for Mitigation of Low Salivary Flow Rate in Head and Neck Cancer Patients Undergoing Radiochemotherapy: A Prospective Longitudinal Study.

The present study aimed to assess the impact of low-level laser (LLL) on low salivary flow rate in patients undergoing radiochemotherapy (RT-CT) for head and neck cancer. LLL has shown efficiency in preventing hyposalivation in patients under different pathological conditions, including those undergoing RT-CT. During all RT-CT, 17 patients received laser therapy and 10 received clinical care only. An Indium-Gallium-Aluminum-Phosphorus diode laser was punctually used for intraoral (660 nm, 40 mW, 10 J/cm(2), illuminated area 0.04 cm(2), 10 sec) and extraoral irradiation (780 nm, 15 mW, 3.8 J/cm(2), illuminated area 0.04 cm(2), 10 sec), three times a week and on alternate days, for a total of 21 sessions. Unstimulated salivary flow rate was assessed before the first RT session (N0), at the 15th RT session (N15), at the last RT session (Nf), and at 30 (N30) and 90 days after the end of the oncologic treatment (N90). At N15, Nf, and N30, patients treated with LLL showed significantly higher averages of salivary flow rate when compared with patients receiving clinical care only. LLL seems to be an efficient tool for mitigation of salivary hypofunction in patients undergoing RT for head and neck cancer.

Low-level laser therapy for the prevention of low salivary flow rate after radiotherapy and chemotherapy in patients with head and neck cancer.

ObjectiveTo determine whether low-level laser therapy can prevent salivary hypofunction after radiotherapy and chemotherapy in head and neck cancer patients.Materials and MethodsWe evaluated 23 head and neck cancer patients, of whom 13 received laser therapy and 10 received clinical care only. An InGaAlP laser was used intra-orally (at 660 nm and 40 mW) at a mean dose of 10.0 J/cm2 and extra-orally (at 780 nm and 15 mW) at a mean dose of 3.7 J/cm2, three times per week, on alternate days. Stimulated and unstimulated sialometry tests were performed before the first radiotherapy and chemotherapy sessions (N0) and at 30 days after the end of treatment (N30).ResultsAt N30, the mean salivary flow rates were significantly higher among the laser therapy patients than among the patients who received clinical care only, in the stimulated and unstimulated sialometry tests (p = 0.0131 and p = 0.0143, respectively).ConclusionLow-level laser therapy, administered concomitantly with radiotherapy and chemotherapy, appears to mitigate treatment-induced salivary hypofunction in patients with head and neck cancer.

Effect of TENS on stimulation of saliva in postmenopausal women with or without oral dryness – An interventional study

BackgroundDecreased estrogen levels in postmenopausal women may cause an increase in oral symptoms including dry mouth, burning sensation of the mouth, and taste alterations. Management of salivary gland hypofunction by various modalities had been tried with variable results and associated side effects or discomfort. AimTo evaluate the effects of transcutaneous electric nerve stimulation (TENS) on whole salivary flow rate in postmenopausal females with and without oral dryness. MethodsFifty postmenopausal women, based on their response to Xerostomia Inventory, were divided into 2 groups of 25 each; group 1 were postmenopausal women with oral dryness (PMD+OD) and group 2 were postmenopausal women without oral dryness (PMD−OD). Unstimulated whole saliva collection was done by low forced spitting method. External salivary stimulation of parotid gland by electrodes of TENS unit was done and sialometry was repeated. The salivary flow rates were compared within both groups before and after stimulation and between the two groups. ResultsThe mean salivary flow rates at baseline were statistically significantly lower in the PMD+OD group than the PMD−OD group. There was a mean increase of 0.33ml and 0.46ml with TENS stimulation in PMD+OD and PMD−OD groups, respectively. ConclusionPostmenopausal women with perception of oral dryness had lower salivary flow rates. 90% of the subjects, irrespective of oral dryness status, responded to TENS therapy. TENS stimulation resulted in a statistically significant increase in the quantity of whole saliva flow rate in postmenopausal women with or without oral dryness.

Prevalence of Candida spp. in Healthy Oral Mucosa Surfaces with Higher Incidence of Chronic Hyperplastic Candidosis.

Predisposing factors in chronic hyperplastic candidosis (CHC) have been poorly recognized. This study aimed at assessing the prevalence of Candida spp. in areas of the oral mucosa showing greater prevalent rate of CHC, such as the retrocomissural area, the lateral borders of the tongue, and the hard-palate mucosa in four groups of individuals presenting predisposing factors as follows: Smoking habits (group I); patients with low salivary flow rate (SFR) (hyposalivation - group II); patients with loss of vertical dimension of occlusion (LVDO -group III); and control subjects (group IV). A total of 44 individuals (age 4090 years, mean: 55.8 years) were divided into four groups: Group I (11 smokers); group II (10 hyposalivation patients); group III (10 LVDO patients); and group IV (control, 13 healthy subjects). All individuals were tested for Candida-pseudohyphae form by direct examination and for Candida spp. culture growth in samples obtained from the retrocomissural, tongue's lateral border, and hard-soft palatal mucosa. Direct examination showed a statistically significant prevalence rate for pseudohyphae (p < 0.05) on the retrocomissural and on tongue's lateral borders of individuals with LVDO. A statistically significant (p < 0.05) culture growth for Candida spp. was found on the retrocomissural areas of those with hyposalivation and with LVDO, and on the palate mucosa and on the tongue's lateral borders in the smokers and in the individuals with LVDO when compared with those of the control group. While direct examination is effective for detecting pseudohyphae, LVDO and tobacco smoking seem to be factors of relevance to the development of CHC. Since CHC has been linked to a high rate of malignant transformation, this study analyzes some clinical (and exogenous) factors that may contribute to the development of CHC and addresses some preventive measures to reduce its incidence.

The Influence of Low Salivary Flow Rates on the Absorption of a Sublingual Fentanyl Citrate Formulation for Breakthrough Cancer Pain

ContextSalivary gland hypofunction may affect the absorption of drugs through the oral mucosa, which in turn may affect their clinical efficacy (e.g., onset of action). ObjectivesThe aim of this study was to assess the pharmacokinetics of a sublingual fentanyl orally disintegrating tablet (Abstral®, Prostrakan Inc.) in a group of cancer patients with salivary gland hypofunction. MethodsNine cancer patients with salivary gland hypofunction underwent a series of three pharmacokinetic studies with the sublingual fentanyl orally disintegrating tablet. In the first phase, the patients received no pretreatment; in the second phase, the patients were allowed to moisten the oral cavity before dosing; in the third phase, the patients were given pilocarpine hydrochloride (saliva stimulant) before dosing. Fentanyl concentrations were measured using a method of high-performance liquid chromatography with validated tandem mass spectrometric detection. ResultsThe Tmax was longer, the Cmax was lower, the AUC0-30 lower, and the AUClast lower in the phase involving no pretreatment; the Tmax/Cmax/AUC0-30/AUClast were similar in the phase involving moistening of the oral cavity and the phase involving giving pilocarpine hydrochloride. ConclusionThe pharmacokinetics of the sublingual fentanyl orally disintegrating tablet appear to be negatively affected by the presence of salivary gland hypofunction, although the moistening of the oral cavity before dosing results in a pharmacokinetic profile similar to that seen with the giving of pilocarpine hydrochloride.

Susceptibility of restorations and adjacent enamel/dentine to erosion under different salivary flow conditions

ObjectivesThe aim of this study was to investigate the effect of erosion on direct tooth-coloured restorations and adjacent enamel/dentine under low and normal simulated salivary flow rates. MethodsBovine enamel and dentine specimens were prepared (n=16) and restored with the following materials: resin composite (FiltekZ250), resin-modified glass ionomer cement (Fuji II LC), high-viscosity glass ionomer cement (Fuji IX), and conventional glass ionomer cement (Fuji II). They were submitted to in vitro erosion–remineralisation cycling simulating normal (0.5ml/min) and low (0.05ml/min) salivary flow rates, for 5 days. The restorative material, enamel and dentine substrates were assessed with optical profilometry for surface loss. Mixed-model ANOVAs were used for statistical comparisons (alpha=0.05). ResultsLow-salivary flow significantly increased surface loss for all tested substrates (p<0.05), except FiltekZ250. Surface loss (mean±SD, in micrometres) under low-salivary flow was significantly higher in enamel (19.75±4.27) and dentine (23.08±3.48) adjacent to FiltekZ250 compared to Fuji II LC (16.33±2.30 and 20.47±2.58, respectively) and Fuji IX (15.79±2.41 and 20.63±2.34, respectively). Restoration surface degradation was significantly lower for Fuji II LC (2.17±0.73) than for both Fuji II (13.03±6.79), and Fuji IX (16.74±7.72) under low-salivary flow condition; whereas FiltekZ250 exhibited no meaningful surface loss (−0.35±0.19). ConclusionLimited to these in vitro conditions, low-salivary flow promoted higher erosive conditions for teeth and restorations. Some fluoride-containing restorative materials may reduce erosive wear on adjacent enamel and dentine. FiltekZ250 resisted erosive surface loss. Fuji II LC showed both reduced acid degradation and protection of adjacent dental surfaces to erosion. Clinical significancePatients at risk for erosion and in need of restorations may benefit from fluoride-containing restorative materials that resist erosive degradation. The data of this study suggest that resin-modified glass ionomer may be a suitable restoration for patients at higher risk of erosion with low exposure to fluoride.

Oral mucosal lesions in older people: relation to salivary secretion, systemic diseases and medications.

To determine the prevalence of oral mucosal lesions in a sample of older Danish people and to investigate their associations with age, gender, systemic diseases, medications, xerostomia and salivary secretion. A total of 668 community-dwelling individuals aged 65-95 years underwent a clinical examination, measurements of unstimulated and stimulated whole and labial salivary flow rates and an interview regarding xerostomia, general health, medication, tobacco and alcohol habits. Seventy-five per cent of all participants and 70% of the non-medicated ones had one or more oral mucosal lesions. The most prevalent lesions were lingual varicosities (28.3%), denture stomatitis (12.7%), candidiasis (11.8%), fissured tongue (9.1%) and frictional keratosis (8.4%). Lesions were generally associated with smoking and xerostomia. Varicosities were more common in participants with systemic diseases and medication intake, particularly with cardiovascular diseases and agents. Fissured tongue and atrophic tongue were associated with female gender, xerostomia and low unstimulated whole and labial salivary secretion. Oral candidiasis was associated with older age; being male; current smoker; having >3 diseases, intake of medications and low salivary flow rates; and identified in relation to denture stomatitis, fissured tongue and atrophic tongue and median rhomboid glossitis. Oral mucosal lesions are prevalent in older Danish people and generally associated with changes in both local and systemic factors. Tongue lesions in particular appeared as indicators that may identify patients with specific need of oral intervention.

Sialometry, sialochemistry and oral manifestations in type 2 diabetes mellitus patients—a clinical and biochemical study

Diabetes mellitus, a complex metabolic disorder, is a syndrome characterised by abnormalities in carbohydrate, lipid, and protein metabolism. Type 2 diabetes mellitus accounts for approximately 95 % of all cases of diabetes, and it usually affects people aged over 45 years. Without a proper diagnosis, these individuals are at significant risk for life-threatening and oral complications like xerostomia, increased incidence of caries, infection, poor healing and periodontal disease owing to structural modifications of salivary glands. Salivary diagnosis is an increasingly important field in dentistry, endocrinology, immunology and forensic medicine as a number of drugs, hormones and antibodies can be reliably monitored in saliva, which is an easily obtainable, noninvasive diagnostic medium and salivary composition may correspond to the systemic state of the patient rather than the oral health. Thus, this study was undertaken to determine the quantitative and qualitative changes of saliva in type 2 diabetes mellitus patients and to correlate the oral manifestations with the salivary disturbances. The study consisted of two groups, one control and one study group, each with 50 subjects. Sialometry and sialochemistry of all salivary samples were carried out and oral manifestations recorded. The observations of the study were subjected to statistical analysis using SPSS software version 12. Sialometry showed a significantly lower salivary flow rate and higher occurrence of oral manifestations in the diabetics. From the clinical standpoint, it may be reasonable to conclude that sialometry and sialochemistry can be a useful indicator of progression of diabetes mellitus.

Oral health and depression in older Japanese people.

The aim of this study was to investigate the relationship between oral dysfunction and depressive symptoms in Japanese community-dwelling seniors. Participants included 351 community-dwelling seniors (189 men, 162 women) aged 77years. During dental examination, teeth and periodontal condition, including number of teeth, number of dental caries, pocket depth and clinical attachment level, were assessed, and unstimulated and stimulated salivary flow rates were measured. The General Health Questionnaire 30 (GHQ-30) was used to assess depression. The Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence was used to assess activities of daily living. Multiple logistic regression analysis revealed that gender (odds ratio [OR] = 2.3), low unstimulated salivary flow rate (OR = 2.1), 'Complaint of mouth pain' (OR = 2.4), 'Complaint of physical disorders' (OR = 2.1), and the total TMIG Index of Competence score (OR = 2.0) were positively associated with the high GHQ-30 score. Subjective and objective oral dryness and oral pain are associated with depressive symptoms.

Activation in the hypothalamic-pituitary-adrenocortical axis and sympathetic nervous system in women with carpal tunnel syndrome.

The aim of this study is to investigate the differences in salivary cortisol (hypothalamic-pituitary-adrenocortical [HPA] axis), α-amylase activity (sympathetic nervous system [SNS]), and immunoglobulin A (IgA; immune system) concentrations between women with carpal tunnel syndrome (CTS) and healthy women. A cross-sectional study. Activation of HPA, SNS, and immune system in CTS has not been clearly determined. One hundred two women (age: 45 ± 7 years) with electrodiagnostic and clinical diagnosis of CTS and 102 matched healthy women. The intensity of the pain was assessed with a Numerical Pain Rating Scale (0-10), and disability was determined with Boston Carpal Tunnel Questionnaire. Salivary cortisol concentration, α-amylase activity, salivary flow rate, and IgA concentration were collected from nonstimulated saliva. Women with CTS exhibited lower salivary flow rate (P < 0.001) and higher α-amylase activity (P < 0.01) than controls. No significant differences for cortisol and IgA concentrations (P > 0.2) were found between groups as a total. Women with severe CTS exhibited lower salivary flow rate (P < 0.001), higher α-amylase activity (P = 0.002), and higher cortisol concentration (P = 0.03) than healthy women and than those with minimal/moderate CTS (P < 0.05). Within women with CTS, significant positive associations between α-amylase activity and the intensity of pain were found: the highest the level of pain, the higher the α-amylase activity, i.e., higher SNS activation. These results suggest that women with severe CTS exhibit changes in activation in the HPA axis and SNS but not in the humoral immune system. Activation of the SNS was associated with the intensity of pain. Future studies are needed to elucidate the direction of this relationship.

Selected antibacterial factors in the saliva of diabetic patients

ObjectiveDiabetes mellitus leads to many systemic complications, including changes in the morphology, function of the salivary glands, and the composition of saliva. DesignThe study comprised a randomly selected 156 adults, of both genders, aged from 21 to 79, out of which patients with diabetes type 1 and 2, and healthy subjects forming two control age- and gender matched to the ill subjects. In unstimulated mixed saliva, total protein, peroxidase, myeloperoxidase and immunoglobulin A were measured as well as salivary flow rate. The periodontal condition was assessed with the use of GI, mSBI and PSR index. The obtained data were analysed with the use of U Mann–Whitney's test, Spearman's rang correlation and Chi-square test at a significant level of p<0.05 with use of Statistica 9.0 software. ResultsType 1 diabetics in comparison to healthy age and gender matched control group had a lower salivary flow rate (p<0.01), a higher content of total protein (p<0.01), myeloperoxidase (p<0.001) and immunoglobulin A (p<0.001). Similarly, type 2 diabetics in comparison to control subjects had a higher level of total protein concentration (p<0.01), myeloperoxidase (p<0.05) and immunoglobulin A (p<0.001). We also found worse periodontal condition. ConclusionWithin the limitation of the study it may be stated that diabetes type 1 and 2 can cause abnormalities in salivary glands function resulting in the diminishing of salivary flow rate and the increase in total protein content. Higher levels of myeloperoxidase and IgA in the saliva can be linked to worse periodontal condition in the diabetic patients.