Salivary Flow Research Articles

Can unstimulated whole salivary flow objectively classify salivary gland secretory function in Sjögren's syndrome?

The aim of this study is to investigate whether the testing time for unstimulated whole salivary flow (UWSF) can be shortened to 5min in patients with suspected Sjögren's syndrome (SjS); and which SjS patients can use UWSF to evaluate salivary gland (SG) secretory function. A diagnostic cohort comprising suspected SjS patients was conducted to investigate the correlation between UWSF measurements taken at 10min (UWSF_10min) and those taken at 5min (UWSF_5min). A group of SjS patients was enrolled for a comparison between UWSF and stimulated whole salivary flow (SWSF). In 734 suspected SjS patients, there was a remarkably high concordance between UWSF_10min and UWSF_5min (ICC 0.970, P < 0.001; r 0.973, P < 0.001). Reducing the testing time for UWSF to 5min resulted in a high PPV of 83.8% and an exceptionally high NPV of 98.7%. In 408 SjS patients, the cut-off values of UWSF_10min were investigated to classify SG secretory function. Using a threshold of > 0.2mL/min (36.8%, 150/408) instead of SWSF > 0.7mL/min (indicating mild secretory hypofunction), the specificity and PPV were found to be 94.2% and 94.0%, respectively; and using a threshold of < 0.05mL/min (16.9%, 69/408) instead of SWSF ≤ 0.7mL/min (indicating moderate to severe secretory hypofunction), the specificity was remarkably high at 97.6%, accompanied by a high PPV of 91.3%. This study supports the possibility of reducing UWSF testing time to 5min; and the SWSF test may be skipped for SjS patients with USWF > 0.2mL/min, indicating mild secretory hypofunction, or < 0.05mL/min, indicating moderate to severe secretory hypofunction. Key Points •A diagnostic cohort of 734 patients with clinical suspicion of SjS provides compelling evidence for the potential to reduce the testing time for UWSF from 10 to 5 min. •Our finding challenges the 2019 treatment recommendation for SjS, which does not require SWSF measurement in SjS patients with UWSF ≥ 0.1 mL/min. •We propose that it may be feasible to consider utilizing UWSF instead of SWSF test for objective classification of SG secretory function in over half of SjS patients.

Salivary Antimicrobial Peptide in Patients With Dementia Before and After Clinical Oral Rehabilitation Programme: A Randomised Controlled Trial.

Emerging evidence suggests a link between salivary metabolite changes and neurodegenerative dementia, with antimicrobial peptides (AMPs) implicated in its pathogenesis. We investigated the effects of a clinical oral rehabilitation programme tailored for dementia patients on salivary flow rate, AMP levels and oral health-related quality of life (OHRQoL). Eligible patients were randomly assigned to either the experimental group (EG; n = 28) or the control group (CG; n = 27). Both groups received a leaflet on oral health. In addition, the EG received an oral care intervention that included individual lessons on oral muscle exercises and oral self-care practices. Saliva samples and OHRQoL data were collected at baseline and follow-up visits. Generalised estimating equation models were used to analyse the changes over time. At the 3-month follow-up, EG showed significantly lower histatin 5 (HTN-5) levels (β = -0.08; effect size [ES] = 0.72) than CG. At 6 months, EG exhibited improved salivary flow rate (β = 0.89; ES = 0.89) and OHRQoL (β = 6.99; ES = 1.31) compared to CG. Changes in salivary flow rate (β = 4.03), HTN-5 level (β = -0.78) and beta-defensin 2 level (BD-2) (β = -0.91) at 3 months predicted improved OHRQoL at 6 months (all p < 0.05). Our clinical oral rehabilitation programme reduced the level of salivary HTN-5, increased salivary flow rate and enhanced OHRQoL in dementia patients. Furthermore, changes in salivary flow rate, HTN-5 level and BD-2 level were associated with improvements in patients' OHRQoL.

Oral Yeasts Carriage in Prediabetic Smokers and Nonsmokers

Habitual smoking and prediabetes are independent risk factors for increased oral yeasts carriage (OYC); however, no studies have compared OYC amongst cigarette smokers and nonsmokers with and without prediabetes. The aim was to fill this research gap. Ninety-two participants were included and categorised into 4 groups: group 1, prediabetic (haemoglobin A1c [HbA1c] levels, 5.7%-6.4%) cigarette smokers; group 2, cigarette smokers without prediabetes; group 3, prediabetic nonsmokers; and group 4, nonsmokers without prediabetes. Patient demographics and HbA1c levels were recorded. Data on duration of smoking habit (pack-years) and family history of smoking were collected. Information on daily toothbrushing and flossing and most recent visit to a dentist/dental hygienist was gathered. Clinical and radiographic periodontal examination was performed and unstimulated whole salivary flow rate (UWSFR) was determined. OYC was assessed using the oral rinse sampling method. Power analysis was done, and group comparisons were performed. Logistic regression analysis was performed and P values <5% reflected statistical significance. Respectively, 23, 24, 22, and 23 individuals with comparable mean ages were included in groups 1, 2, 3, and 4. In groups 1 and 2, participants had a smoking history of (mean ± SD) 24.7 ± 3.2 and 10.6 ± 2.5 pack-years. Plaque index, clinical attachment loss, and probing depth were higher in groups 1 (P < .05), 2 (P < .05), and 3 (P < .05) than in group 4. Number of missing teeth was significantly higher in group 1 compared with groups 2 (P < .05), 3 (P < .05), and 4 (P < .05). There was no difference in UWSFR amongst the groups. OYC was greater in group 1 than in groups 2 (P < .05), 3 (P < .05), and 4 (P < .05). OYC was greater in groups 2 (P < .05) and 3 (P < .05) than in group 4. In prediabetic cigarette smokers, OYC appears to be influenced by hyperglycaemia, whilst in nondiabetic smokers, the severity of periodontal inflammation appears to be the determining factor in OYC.

Use of the Oral Sialogogue “Oriza Tablet” in Reducing Drug-Induced Xerostomia in Patients with Overactive Bladder or Neurogenic Bladder: Randomized Clinical Study

Purpose Evaluate the clinical efficacy of “Oriza tablet” (OT) for patients with neurologic bladder or overactive bladder affected by xerostomia due to receiving antimuscarinic drugs. Material and methods This was a randomized clinical trial. Twenty-eight patients (median age = 64 years) with xerostomia were divided into two groups: OT (intervention group) and placebo (control) group. Both groups comprised 14 patients each. Objective We assessed severity using a questionnaire for the subjective evaluation of xerostomia. Objective evaluation was undertaken for the stimulated salivary flow rate (SSFR). Xerostomia evaluation took place before treatment (baseline) as well as 2 weeks and 4 weeks after treatment. Results The xerostomia score decreased significantly ( p &lt; 0.05) in the OT group compared to the placebo group, with scores of 2.75 versus 4.4 at 2 weeks and 2.19 versus 4.13 at 4 weeks, respectively. The SSFR increased significantly ( p &lt; 0.05) in the OT group compared to the placebo group, with SSFR of 2 versus 1.2 at 2 weeks and 1.85 versus 1.1 at 4 weeks, respectively. Throughout the trial, no patient discontinued taking antimuscarinic medications. There were no adverse effects noted. Conclusion Continuous daily use of OT for 4 weeks reduced xerostomia symptoms and increased saliva production in patients suffering from neurologic bladder or overactive bladder who received antimuscarinic medications. Clinical trial registration The study was registered with The Thai Clinical Trials Registry (TCTR). ID: TCTR20240715015.

The Impact of Nicotine Patches on Gingival and Oral Health: A Narrative Review.

Smoking significantly impacts oral health, causing periodontal disease, oral cancer, tooth discoloration, halitosis, and impaired wound healing. Nicotine replacement therapy (NRT), particularly nicotine patches, is widely used for smoking cessation. This review evaluates the literature regarding nicotine patches and their implications for oral and gum health. Nicotine patches deliver controlled nicotine doses transdermally, alleviating cravings and withdrawal symptoms. While nicotine can negatively affect oral health through vasoconstriction and reduced salivary flow, the overall impact of patches is generally positive compared to continued smoking. The primary benefit is the elimination of exposure to harmful chemicals and heat from cigarette smoke, significantly decreasing oral cancer risk and periodontal disease progression. Nicotine patches are associated with improved periodontal treatment outcomes, better wound healing, and potential anti-inflammatory effects. They may also promote improved oral hygiene practices. However, limitations include uncertain long-term effects and potential side effects like xerostomia. In conclusion, while nicotine patches may have some oral health effects, their use generally leads to significant improvements compared to continued smoking, making them valuable for promoting better oral health in individuals quitting smoking.

Tofacitinib alleviated salivary gland inflammation and reduced the percentages of effector T cells in murine Sjögren's disease.

The Janus kinases-signal transducer and activator of transcription (JAK-STAT) signalling pathway plays a crucial role in autoimmunity and the signalling pathways of many cytokines in Sjögren's disease (SjD). Therefore, the aim of this study was to investigate both the therapeutic and immunomodulatory effects of the oral JAK3/JAK2/JAK1 inhibitor tofacitinib in a murine model of SjD. Tofacitinib or vehicle was administered orally to the mice with SjD for 6 weeks. Salivary flow rate was measured every three weeks. Pathological changes of salivary gland were detected by haematoxylin-eosin staining, and the percentages of subsets of CD4+ T cells and B cells in the cervical lymph nodes (cLNs) and spleen was determined by flow cytometry. Tofacitinib significantly ameliorated submandibular gland inflammation compared to the control group, as evidenced by reduced lymphocytic infiltration. Salivary flow rates improved significantly in tofacitinib treated mice compared to controls, indicating restored salivary gland function. The treatment also led to a substantial decrease in follicular helper T (Tfh) cells and the Tfh/Treg ratio in both the spleen and cLNs. Additionally, the frequencies of T helper 1 (Th1) and T helper 17 (Th17) cells were reduced in the spleen and cLNs. Our data indicated that tofacitinib reduced percentages of effector T cells in an animal model of SjD. In addition, tofacitinib alleviated salivary gland inflammation and hypofunction, offering new insights into the clinical management of SjD.

Effect of smoking on salivary flow rate and oral candidiasis incidence

Background: The 2014 ASEAN Tobacco Control Atlas (SEACTA), provides evidence that the first country to have the highest number of smoker prevalence in ASEAN is Indonesia, which is 50.68%. Smoking is one of the main risk factors for various diseases. Cigarette smoke and the hot temperature of cigarettes exposed to the oral mucosa will cause tissue damage. This results in damage to taste receptors which affects the decrease in salivary sensitivity and productivity. Damage to oral tissue is one of the factors for the C. albicans fungus to colonize in the oral cavity and cause infection so that oral candidiasis appears. Objectives: To review and investigate the effect of smoking on salivary flow rate and oral candidiasis incidence Conclusion: There is an effect of smoking on Salivary Flow Rate and Oral Candidiasis Incidence. Smoking will result in decreased salivary secretion and become a factor in the onset of C. albicans colonies in the oral cavity.

Xerostomia and Salivary Dysfunction in Patients With Diabetes Mellitus. A Cross-Sectional Study.

Diabetes mellitus (DM) has been associated with salivary disorders such as xerostomia and hyposalivation. Theaim of this study was to determine the prevalence of these disorders and their risk factors in DM patients. DM patients from two health centers were included. Epidemiological and DM control-related variables were collected. Xerostomia Inventory was filled out by the patients and unstimulated whole salivary flow was collected. Logistic regression tests were performed. A total of 168 patients were included (46.4% men, 53.6% women, mean age 72.54 [SD 11.03 years]). Thirteen patients had Type 1 DM and 155 had Type 2 DM. 52.4% experienced xerostomia and 41.1% had unstimulated whole salivary flow hyposalivation. Women were more likely to suffer hyposalivation than men (OR 2.5, 95% CI 1.32-4.73; p = 0.005). Patients with T2DM were less likely to suffer UWS hyposalivation than T1DM patients (OR 0.28, 95% CI 0.08-0.95; p = 0.04). Glycemic control was not significantly worse in patients with xerostomia and hyposalivation. The drugs for the treatment of DM were not associated with salivary disorders. However, some drugs to treat other comorbidities such hypertension and neurological diseases were associated with xerostomia and hyposalivation. The prevalence of xerostomia and unstimulated whole salivary flow hyposalivation in patients with DM is high. Female sex, T1DM, and the use of certain non-antidiabetic drugs increased the risk of suffering these disorders. The possible association between DM, xerostomia, and/or hyposalivation is complex and may be influenced by multiple factors. Therefore, further studies are needed to evaluate whether DM influences these salivary disorders.

Updates on Caries Risk Assessment-A Literature Review.

This narrative review aims to provide an update on caries risk assessment (CRA) and the available CRA tools. CRA can be used to monitor the status of oral care, as well as for documentation and research purposes. Caries risk is determined by the interplay of risk and protective factors. Common risk factors include suboptimal oral hygiene practices, previous caries experience, low plaque acidity, frequent snacking, cariogenic diet, enamel defects, reduced salivary flow, polypharmacy, and radiotherapy experience. Caries risk can be reduced through some preventive measures, such as the use of fluoride, gum chewing, dental sealants. The CRA process can be categorized as single or multifactor tools. Single-factor CRA tools include diet analysis questionnaires, cariogenic bacteria testing and saliva testing kits, whereas multifactor CRA tools encompass Caries Management by Risk Assessment (CAMBRA), Cariogram, and PreViser. Some CRA tools may quantify risk and protective factors to compute caries risk. Additionally, they can generate visual and educational presentations that foster success in oral care. Clinicians consider CRA beneficial for developing personalized care plans. However, the literature fails to reflect this and reveals limited studies supporting its use as evidence-based practice for caries management.

A Comparative Evaluation of the Acidogenic Potential of Lactose-based, Soy-based, Protein Hydrolysate-based, and Iron-based Milk Formulas Based on Dental Plaque pH, Salivary pH, and Buffering Capacity: An In Vivo Study.

Breastfeeding is the gold standard nutrition for infants. However, the inability of infants to latch on, maternal complaints of sore or painful nipples, and insufficient milk supply frequently result in early breastfeeding cessation. Hence, milk has subsequently been replaced by infant formula milks of high quality, which serve as an alternate source of nutrition for infants. There also has been a rising concern among parents and caretakers regarding the cariogenic potential of the various milk formulas available in the market due to the presence of fermentable carbohydrates in them, leading to an increase in nursing caries or early childhood caries. Hence, this study aims to comparatively evaluate the acidogenic potential of four different milk formulas based on dental plaque pH, salivary pH, and buffering capacity. This cross-sectional study was carried out to assess the acidogenic potential of various infant milk formulas using three main parameters of measurement of caries: evaluation of salivary pH, plaque pH, and buffering capacity.Baseline plaque and salivary pH and postconsumption plaque pH and salivary pH were assessed after 5, 10, 15, 20, 30, and 60 minutes in 60 healthy children (15 in each study group) aged 7-12 years after rinsing with group I (lactose-based), group II (soy-based), group III (protein hydrolysate-based), and group IV (iron-based) milk formulas. The pH was assessed using a precalibrated digital pH meter. Plaque pH was also further assessed based on its buffering capacity. Soy-based and protein hydrolysate-based milk formulas were found to be most cariogenic in both saliva and plaque. Lactose-based formulas were found to be the least cariogenic of all the milk formulas. Parents and caretakers must be made aware of the various types of milk formulas available, their composition, as well as their relative cariogenic nature. Feeding should always be supervised, and infants should not be left with milk-containing bottles as comforters. Milk feeds at bedtime, when salivary flow is reduced, should be discouraged. Dentists and pediatricians should be aware of the caries-related risk associated with different milk formulas before recommending them to children. Knowledge and awareness among parents and caretakers regarding the cariogenicity of various milk formulas available in the market. Mahanta A, Yadav G, Saha S, et al. A Comparative Evaluation of the Acidogenic Potential of Lactose-based, Soy-based, Protein Hydrolysate-based, and Iron-based Milk Formulas Based on Dental Plaque pH, Salivary pH, and Buffering Capacity: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(8):851-859.

The Role of Gut Microbiome Alterations in the Pathogenesis and Management of Sjögren's Syndrome

Sjögren’s syndrome (SS) is a systemic autoimmune disorder characterized by inflammation and damage to the exocrine glands, leading to symptoms such as ocular and oral dryness, and a range of extraglandular manifestations including polyneuropathies, lung and kidney dysfunction, and systemic vasculitis. Although the exact etiology of SS remains unclear, recent research has highlighted the significant role of gut microbiota in its pathogenesis. Alterations in the gut microbiome, known as dysbiosis, have been implicated in the onset and progression of autoimmune diseases, including SS. This review synthesizes current research on the impact of microbiota on SS, focusing on microbial dysbiosis, its impact on disease severity, and potential therapeutic interventions. Evidence indicates that specific microbial changes, such as reductions in beneficial bacteria and alterations in short-chain fatty acid (SCFA) production, correlate with increased disease activity and systemic inflammation. Microbiome-targeted therapies, including probiotics, prebiotics, and fecal microbiota transplantation, have shown promise in improving SS symptoms and modulating immune responses. Notably, butyrate and specific probiotic strains have demonstrated potential in reducing inflammation and enhancing salivary flow in preclinical studies. However, further research is needed to validate these findings and assess long-term efficacy. This review underscores the importance of gut microbiota in SS and suggests that microbiome-focused treatments could offer new avenues for managing this condition, improving patient outcomes, and potentially preventing disease onset.

Volatile sulfur compounds, biofilm, and salivary parameters in patients with periodontal disease: a cross-sectional study.

This cross-sectional study aimed to evaluate the interplay between volatile sulfur compounds (VSC), biofilm, salivary parameters, and periodontal status in patients with and without periodontal disease. Sixty-four subjects diagnosed with periodontitis and 60 periodontally healthy individuals were included. Probing depth, clinical attachment level, bleeding on probing, tongue coating index, plaque index, number of teeth, spinnability of unstimulated whole saliva, and salivary flow rate were evaluated. The concentrations of VSC were quantified using a portable gas chromatograph. The mean differences in hydrogen sulfide, methyl mercaptan, salivary flow, spinnability, and plaque index did not exhibit statistically significant variances between the two groups. However, a pronounced tongue coating index and a diminished tooth count showed statistical significance in the periodontitis group (p = 0.039; p < 0.001). Unstimulated salivary flow rate less than 0.25mL/min was statistically significant in the periodontitis group (p = 0.032). After controlling for confounding factors, bleeding on probing remained significant. A positive correlation between periodontal parameters and VSC concentration was found. An inverse correlation was also noted between the spinnability of saliva and tongue coating index (-0.34; p < 0.001). Salivary parameters may contribute to the formation of tongue coating and are correlated with periodontal status. Bleeding on probing, clinical attachment level, and probing depth were identified as potential contributors to VSC formation.

The wettability of complete denture base materials constructed by conventional versus digital techniques: an in-vitro study

BackgroundDecreased salivary flow can make the patients uncomfortable with their complete dentures and affects the retention of the dentures. Milling and 3D printing have become an alternative to conventional denture construction techniques. The goal of this study was to evaluate the effect of conventional and digital techniques of the complete denture construction on the denture surface wettability with distilled water and saliva substitute before and after thermocycling.MethodsA total of 30 specimens were utilized in the present study. Specimens were divided according to the construction techniques into 3 groups (n = 10 each). Group I: Heat-polymerized polymethylmethacrylate (PMMA) group, group II: Milled group, and group III: 3-dimensional (3D)-printed group. All the specimens were subjected to 2000 cycles of thermal aging in a thermocycler. The wettability of all specimens to water and saliva substitute was measured via a contact angle goniometer (Olympus TGHM, Rame-hart Inc, USA) before and after thermocycling. Descriptive statistical analysis, plots, and the Shapiro-Wilk test were used to verify normality for each variable. One-way ANOVA was used to compare the 3 study groups, while paired samples t-test was used to compare the differences within each group (P < .05).ResultsThe smallest contact angle of drop of water to the denture base specimens before and after thermocycling were recorded in the milled group (53.0 ± 4.77 and 50.27 ± 2.30, respectively), followed by the heat polymerized PMMA group (85.65 ± 4.71 and 65.06 ± 2.27, respectively), and the 3D-printed group (91.34 ± 6.74 and 90.86 ± 8.57, respectively). While the smallest contact angle of drop of saliva substitute to denture base specimens was recorded in the milled group (56.82 ± 2.29 and 34.85 ± 7.51, respectively), followed by the 3D-printed group (72.87 ± 4.83 and 58.14 ± 9.58, respectively) and the heat polymerized PMMA group (83.62 ± 4.12 and 67.82 ± 4.93, respectively). There was statistically significant difference between the groups (P < .05). A significant decline in the average contact angle of drop of saliva has been reported in all groups after thermocycling. The contact angle values differed significantly between saliva substitute and distilled water in both 3D-printed and milled groups after thermocycling (P < .001).ConclusionsThe milled denture base material presented the best wettability to water and saliva substitute than the 3D-printed and the heat-polymerized PMMA materials. Saliva substitutes improve the wetting ability of denture base materials manufactured by CAD/CAM compared with water.

Hypophysitis and central nervous system involvement in association with Sjögren’s syndrome along with hypoparathyroidism: a case report

BackgroundPatients with autoimmune diseases can develop multiple autoimmune diseases over a long period of time, and the presence of more than one autoimmune disease in a single patient is defined as polyautoimmunity. Polyautoimmunity may be clinical evidence that autoimmune diseases share similar immunological mechanisms.Case presentationWe report a 30-year-old woman with a unique combination of autoimmune diseases predominantly affecting the central nervous system, with hypoparathyroidism, hypophysitis, medulla involvement, and pons and temporal lobe involvement associated with primary Sjögren's syndrome (pSS), occurring independently over a long period. The patient who had a history of muscle cramps and one seizure incident, presented with vomiting and blurred vision. She was diagnosed with hypophysitis and hypoparathyroidism with calcifications in the basal ganglia and cerebellum. She recovered after four months of corticosteroid treatment for hypophysitis and was started on treatment for hypoparathyroidism. Eight months later, she developed vomiting, hiccups, vertigo, and ataxia with a focal lesion in the medulla. She recovered with immunosuppressive treatment for 2 years. Fifty-eight months after the onset of hypophysitis, she developed diplopia and dry mouth and eyes. MRI showed infiltrative lesions in the left pons and left temporal lobe. Based on positive anti-Sjögren's syndrome-related antigen A antibodies and low unstimulated whole salivary flow rate, pSS was diagnosed. She received corticosteroids and continued mycophenolate mofetil treatment with recovery of neurological symptoms.ConclusionThis case highlights the need for long-term follow-up to detect autoimmune disease processes involving various organs.

Salivary flow rate, subjective oral dryness and dental caries 5 years after haematopoietic cell transplantation

BackgroundThe aim of this study was to describe salivary flow rate, subjective oral dryness and dental caries 5 years post haematopoietic cell transplantation (HCT).MethodsHCT survivors of a previous longitudinal observational cohort study in the Netherlands (the H-OME study) were invited to participate in this additional follow-up after 5 years (the HOME2 study). During the additional follow-up appointment, stimulated (SWS) and unstimulated whole saliva (UWS) was collected, participants rated subjective oral dryness on a 0 – 10 scale, and caries lesions were assessed. Furthermore, dental records, including treatments and radiographs, were requested for the 5 years preceding and the 5 years following transplantation. Paired t-tests were performed to determine changes in UWS and SWS flow rates and subjective oral dryness from pre-HCT, and to compare the number of caries-related dental treatments (restorations, endodontic treatments or extractions) before and after HCT. Hyposalivation of UWS (< 0.2 mL/min) and SWS (< 0.7 mL/min) at 3 and 12 months, was used to explore the predictive potential of hyposalivation on a high dental treatment need (> 3 treatments) over the 5 years post-HCT.ResultsFive years post-HCT, 39 HCT survivors were included. The mean UWS flow rate was 0.36 mL/min (SD 0.26) and the mean SWS flow rate 1.02 (SD 0.57); survivors were diagnosed with a median of 0 dentine lesions (range 0 – 12) and 73% reported a subjective oral dryness score ≥ 1. Survivors underwent a median of 3 (range 0 – 20) dental treatments during the 5 years following transplantation. The mean difference in UWS 5 years post-HCT compared to pre-HCT was 0.03 (95% CI: -0.07 – 10.12), the mean difference for SWS was -0.18 (95% CI: -0.45 – 0.08) and for subjective oral dryness 1.2 (95% CI: 0.2 – 2.1). In the 5 years post-HCT, non-significantly more treatments were performed compared to the 5 years pre-HCT (mean difference: 0.5, 95%CI: -1.2 – 2.2). Seventy eight percent of patients with hyposalivation of SWS at 12 months had a high dental treatment need, compared with 38% with no hyposalivation.ConclusionsFive years post-HCT, mean UWS and SWS flow rates were not significantly different from pre-HCT levels but subjective oral dryness scores were elevated.

Dental caries status and treatment need among pregnant women attending antenatal clinics in Dar-Es-Salaam region, Tanzania

BackgroundLiterature shows that pregnant women are more susceptible to dental caries due to several reasons, including changes in salivary flow, reduced pH in the oral cavity, and sugary dietary cravings. The unmet need for care is of special concern, as the failure to obtain treatment can affect the health status of the mother and her unborn child.ObjectivesTo determine dental caries status and treatment needs among pregnant women attending antenatal clinics in the Dar-es-Salaam region.Materials and methodsA descriptive cross-sectional hospital-based study was conducted among 461 pregnant women aged 14–47 years. Informed consent was obtained from participants during data collection. Dental caries status and treatment need were diagnosed according to the WHO criteria. The Data collected was cleaned and analyzed using SPSS version 23.0 software for generating frequency distribution tables, chi-square tests, and logistic regression analysis. The Confidence Interval was 95% (p < 0.05).ResultsThe overall prevalence of dental caries was 69%, with a mean DMFT score of 2.86 (± 3.39). Untreated dental decay was observed in 60.5% of study participants, which needed more restorative treatment (fillings & RCT) than a tooth extraction. Caries experiences differed significantly among the pregnant women in various gravidity. In logistic regression, dental caries experience was significantly higher among multigravida respondents (p-values = 0.04) (OR: 1.840, CI 1.021–3.319).ConclusionThis study demonstrated a high level of dental caries experience and the presence of treatment needs. Multiple pregnancies were a major factor that contributed to high levels of dental caries.

Impact of salivary flow inhibition on masticatory behaviours in healthy individuals.

It remains unclear how the salivary flow and the fat content of food affect bolus formation during mastication. We aimed to clarify: (1) how hyposalivation affects jaw-closing and hyoid-elevating muscle activities in bolus formation, and (2) if the effect of hyposalivation on muscle activity depends on the fat content of food. Eighteen healthy male volunteers were instructed to freely ingest four test foods: Plain, Fat without seasoning, Fat with seasoning, and Soft rice crackers. Masseter and suprahyoid electromyographic activities were recorded before and 30 min after the administration of atropine sulfate, a muscarinic receptor antagonist that induces hyposalivation. Hyposalivation extended the masticatory duration significantly in all the test foods except Fat with seasoning. Masticatory cycle time was significantly longer with vs without hyposalivation for the Soft (p = .011). Suprahyoid activity/cycle was significantly greater with vs without hyposalivation (p = .013). Masticatory cycle time was significantly longer at the late stage with vs without hyposalivation for the Soft (p < .001). Suprahyoid activity/cycle was significantly greater at the middle (p = .045) and late stages (p = .002) with vs without hyposalivation for the Soft and greater at the late stage with vs without hyposalivation for the Plain (p = .043). Changes in masticatory cycle time and suprahyoid activity/cycle for these foods had significantly positive relationship (p < .001). Hyposalivation-induced changes in masticatory behaviours resulted from the middle and late stage suprahyoid activity. Fat content and seasoning compensate for salivary flow inhibition.

Caries Risk Assessment in Adults with Highlights to Nutrigenomics and Nutrigenetics

Abstract Caries risk assessment and caries management by risk assessment cannot be related only to children and their parents' answers. Camra and Cariogram have been working for decades in few countries. Prediction and preventive measures are especially important for young adults (16-25 years old), young professionals (25-35 years old), before pregnancy and during menopause. Aim To develop a card for an easy caries risk assessment with chair-aside questions, clinical examination and salivary tests. To draw up a protocol for patient treatment and follow-up related to the caries risk. Methodology It is based on the data of 1,167 participants in 6 different clinical studies conducted within various research trials, granted programmes and projects during the 30-year period from 1988 to 2018. Prediction of risk can be useful if 4 groups, i.e. low risk, moderate risk, high risk and very high risk groups are evaluated. Results Packages of measures were targeted for each group. Among the important factors were the type, habits and frequency of nutrition, detected with 6 targeted questions, lifestyle hygiene with 5 questions, dental status with 6 parameters (DMFT scores, gingival status, size of teeth, etc.) and oral hygiene. Biochemical patterns of saliva, i.e. salivary flow rate and pH, with and without stimulation were included. Low risk and Moderate risk groups of different ages do not need further tests. High risk and Very high risk groups can be additionally tested with chair-aside tests for Streptococcus mutans and Lactobacilli counts and oral sucrose clearance for preventive evaluation of dental caries management. The card validation and tests last no longer than 40 minutes, 1 page for a single patient. Conclusions Caries risk in adults can be measured, assessed and predicted in relation to nutrigenomics. Treatment behaviour can be managed and targeted for each patient, according to the group for long, lifetime saving of natural teeth in the mouth. In the last 100 years, concentrated and refined foods have decreased all sizes of the upper first and second incisors as a natural physiological response and a change has been observed in the anatomy of canines, making them stronger via enlargement of their MD sizes. From this current academic year, "Caries risk" is included into our new lecture programme.

An Overview of Prosthetic Implant Attachments in EdentulousPatients

Edentulism is an unresolved health care issue of sustained significance and prevalence in the aged population. Adaptation to wearing complete dentures is a complex process and must be considered from both somatic and psychological standpoints. The difficulties of wearing dentures have been attributed to deficiencies of the denture-bearing tissues, reduced salivary flow,vulnerable tissue and severe ridge resorption. The prosthetic management of the edentulous patient has always been a major challenge. Complete maxillary and mandibular dentures have been the traditional treatment option. However, most of the patients report problems adapting to the mandibular denture due to lack of comfort, retention and stability. It is well known that implantretained/supported overdentures provide improved retention, support, stability, function, and comfort for patients

The effect of using the CAMBRA mobile application on dental caries management in children and adolescents

Objectives: This study aimed to evaluate the effectiveness of the CAMBRA-students application by assessing the changes in dental caries risk factors and management effectiveness in elementary and middle school students. Methods: This study was conducted between July 2023 and May 2024 and included 113 participants (55 experimental and 58 control participants). Participants used the CAMBRA-students application to enter the protective and risk factors. Clinicians recorded the disease indicators and classified the participants into risk groups. Only the experimental group received the tailored dental caries management program, with feedback provided via the applicationat each intervention stage. Results: The pre- and postintervention assessments revealed an increase in the high-risk group and a decrease in the extremehigh-risk group. Conversely, the control group exhibited a decrease in the high-risk group and an increase in the extreme high-risk group. The DMFT index and rateand salivary flow rate increased in both groups. The Simple Hygiene Score and ΔR decreased and increased in the experimental and control groups, respectively, with no statistically significant differences. Conclusions: The CAMBRA-students application effectively prevented dental caries in children and adolescents. The future development of personalized oral care programs tailored to different life stages is recommended.