Stimulated Salivary Flow Rate Research Articles

Antineoplastic therapy is an independent risk factor for dental caries in childhood cancer patients: a retrospective cohort study.

To evaluate the antineoplastic therapy (AT) as a risk factor for dental caries lesions independent of other risk factors such as income, family education, stimulated salivary flow rate, hygiene habits, frequency of sugar intake, and microbiota in childhood cancer (CC) patients. 72 individuals were divided into CC patients (n=36) and healthy individuals (control group - CT n=36). Demographic data, hygiene habits, frequency of sugar intake, CC type, and AT were collected. Stimulated salivary flow rate was measured and the presence and concentration of Streptococcus mutans were assessed using a real-time polymerase chain reaction (qPCR) technique. Clinical evaluations included plaque index (PI) and decayed-missing-filled-teeth index (dmft/DMFT). Descriptive statistics, T-test, Mann-Whitney test, chi-square test, Fisher's exact test, and two-way analysis of variance were used for data analysis (p<0.05). At the time of oral evaluation, both groups exhibited similar ages with means of 12.0±3.9 years old for CC and 12.0±4.0 years old for CT patients. All CC patients underwent chemotherapy with nine also undergoing radiotherapy. Significant differences were observed between the groups in terms of color/race, income, family education, and hygiene habits. However, no statistically significant differences were found between groups regarding the frequency of sugar intake, stimulated salivary flow rate, or the concentration of Streptococcus mutans (qPCR technique). For clinical parameters, the DMF (CC:1.80, CT: 0.75), decayed (CC: 0.88, CT: 0.19), missing (CC: 0.25, CT:0), and PI (CC: 30.5%, CT: 22.6%) were higher in the CC group (p<0.05). Childhood cancer (CC) patients undergoing antineoplastic therapy (AT) exhibit a higher prevalence of dental caries, regardless of income/education, frequency of sugar intake, stimulated salivary flow rate, and microbiota.

Association between dental caries experience and salivary profile among autoimmune thyroid disease subjects - a cross-sectional comparative study.

Background: Autoimmune thyroid disease (AITD) is an inflammatory condition that primarily affects women between the ages of 30 and 50. It has been hypothesised that AITD causes salivary glands to produce less saliva due to its endocrine effects. Studies showing the effect of AITD on salivary glands are very scarce. The aim of this study was to compare AITD patients with controls who were of a similar age and gender in terms of salivary metrics and the prevalence of dental caries. Methods: 200 subjects in Bangalore city (100 AITD subjects and 100 healthy subjects as controls) participated in a cross-sectional study. Subjective oral dryness was assessed using Farsi's criteria. Salivary parameters and caries were assessed using GC Saliva-Check BUFFER kit and WHO caries criteria respectively. Descriptive and analytical statistics were done. Significant data was defined as a p value of <0.05. Results: When compared to controls, the AITD group had substantially more subjective mouth dryness and dental caries. Unstimulated (USFR) and stimulated salivary flow rate (SFR), pH and buffering capacity were reduced in AITD group whereas viscosity was high. There was a significant negative correlation between USFR, SFR, subjective oral dryness and dental caries. In a linear regression, there was no association between age, gender, socioeconomic status (SES), thyroid stimulating hormone (TSH), salivary viscosity, pH, buffering capacity and dental caries. Dental caries, USFR and SFR demonstrated a substantial relationship. Conclusions: The present research may indicate an underlying association between thyroid and salivary gland dysfunction resulting in oral dryness and high dental caries experience.

Discordance between hyposalivation and xerostomia among community-dwelling older adults in Japan.

Individuals with an objective decrease in salivary flow (objective dry mouth) may not be aware of subjective dry mouth (xerostomia). However, no clear evidence exists to explain the discordance between subjective and objective dry mouth. Therefore, this cross-sectional study aimed to assess the prevalence of xerostomia and decreased salivary flow among community-dwelling elderly adults. In addition, this study assessed several potential demographic and health status determinants of the discrepancy between xerostomia and reduced salivary flow. The 215 participants in this study were community-dwelling older people aged 70 years and above who underwent dental health examinations between January-February 2019. Symptoms of xerostomia were collected in the form of a questionnaire. The unstimulated salivary flow rate (USFR) was measured by a dentist using visual inspection. The stimulated salivary flow rate (SSFR) was measured using the Saxon test. We identified 19.1% of participants as having mild-severe USFR decline with xerostomia and 19.1% as having mild-severe USFR decline without xerostomia. Additionally, 26.0% of participants had low SSFR and xerostomia, and 40.0% had low SSFR without xerostomia. Except for the age trend, no factors could be associated with the discordance between USFR measurement and xerostomia. Furthermore, no significant factors were associated with the discordance between the SSFR and xerostomia. However, females were significantly associated (OR = 2.608, 95% CI = 1.174-5.791) with low SSFR and xerostomia, as compared to males. Age was a factor that was also significantly associated (OR = 1.105, 95% CI = 1.010-1.209) with low SSFR and xerostomia. Our findings indicate that approximately 20% of the participants had low USFR without xerostomia, and 40% had low SSFR without xerostomia. This study showed that age, sex, and the number of medications may not be factors in the discrepancy between the subjective feeling of dry mouth and reduced salivary flow.

Factors Influencing the Survival Rate of Teeth and Implants in Patients after Tumor Therapy to the Head and Neck Region-Part 1: Tooth Survival.

We aimed to evaluate possible factors influencing the long-term survival of teeth after tumor therapy (TT) to the head and neck region with and without radiation. Between January 2019 and January 2020, patients who underwent TT for head and neck cancer and received dental treatment before and after TT at the Department of Prosthetic Dentistry of the Martin Luther University Halle-Wittenberg were enrolled in the study. Clinical examination with assessment of dental status and stimulated salivary flow rate (SFR) was performed and information about disease progression and therapy was retrieved from medical records. Of 118 patients (male: 70.3%; mean age: 63.2 ± 12.4 years), 95 received radiotherapy (RT), and 47 were administered radio-chemotherapy (RCT). The teeth of irradiated patients exhibited a lower 5-year survival probability (74.2%) than those of non-irradiated patients (89.4%). The risk of loss (RL) after RT increased with nicotine use, presence of intraoral defects, reduced SFR, RCT and regarding mandibular teeth, and decreased with crowning following TT. Lower SFR increased the RL even without RT. Consideration of patient’s treatment history, individual risk profile, and clinical findings during the prosthetic planning phase could enable earlier, more targeted dental treatment after TT (e.g., timely crowning).

Association of Hyper-Low-Density Lipoprotein and Hypo-High-Density Lipoprotein Cholesterolemia with Low Saliva Flow Rates in Japanese Community-Dwelling Elders.

Introduction The associations of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein (HDL-C) with reduced saliva flow rates have not been previously reported. Objective The present study aimed to assess the association of cholesterolemia with reduced saliva flow rates in community-dwelling elderly subjects. Methods The present study analyzed 342 participants (170 males and 172 females aged between 78 and 79 years old). Unstimulated salivary flow rate (USFR) was assessed using a cotton roll method. Low-USFR was defined as 0.10 g/30 seconds. Stimulated salivary flow rate (SSFR) was assessed by having the participants chew tasteless gum for 3 minutes. Low-SSFR was defined as 1.0 mL/minute. Blood samples were collected for the measurement of LDL-C, HDL-C, rheumatoid factor, hemoglobin A1c, and creatinine. To assess depression, the General Health Questionnaire 30 was used. A standardized questionnaire was completed, covering the current and previous medications of the participants and smoking status. We stratified the serum LDL-C levels of the participants as normal, moderate or severe hyper-LDL cholesterolemia and serum HDL-C levels as normal or hypo-HDL cholesterolemia. Multivariate logistic regression models were established and low-USFR or low-SSFR were set as dependent variables in the aforementioned models. Results After controlling for the effects of the other variables, the odds ratios (ORs) (95% confidence intervals [CIs]) for low-USFR were 2.25 (1.10-4.61) for moderate and 5.69 (1.55-20.8) for severe hyper-LDL cholesterolemia, while that of hypo-HDL cholesterolemia was 3.40 (1.33-8.69). Severe hyper-LDL cholesterolemia was also associated with low-SSFR with an OR of 3.89 (1.39-10.88). Conclusion Elderly patients with cholesterolemia have a risk of reduced salivary flow rate.

Impact on xerostomia for patients with nasopharyngeal carcinoma treated with superficial parotid lobe-sparing intensity-modulated radiation therapy (SPLS-IMRT): A prospective phase II randomized controlled study.

6059 Background: In the intensity-modulated radiation therapy (IMRT) era, xerostomia remains one of the most common radiation-induced toxicities in nasopharyngeal carcinoma (NPC) patients. We first proposed the superficial parotid lobe–sparing IMRT (SPLS-IMRT) technique in NPC, which has been proved to significantly reduce the mean doses of bilateral entire parotid glands and superficial parotid lobes. To further validate its clinical benefits, we conducted a prospective phase II randomized controlled study to compare the incidence of xerostomia in NPC patients treated with SPLS-IMRT and conventional IMRT (C-IMRT). Methods: Patients with histologically confirmed NPC who met the eligibility criteria were randomly assigned in a 1:1 ratio to receive either SPLS-IMRT or C-IMRT. The V36 (the percentage volume receiving a dose of 36 Gy) of the entire parotid gland was constrained to be less than 40% in both groups. Additionally, V26 (the percentage volume receiving a dose of 26 Gy) of the superficial parotid lobe was constrained to be less than 30% in the SPLS-IMRT group. The primary endpoint was the incidence of xerostomia at 12 months post-IMRT. The secondary endpoints included the xerostomia questionnaire (XQ) score, unstimulated salivary flow rate (USFR), stimulated salivary flow rate (SSFR), and survival outcomes. Results: From January 2018 to September 2018, 90 patients were enrolled (45 per group). Eighty-two patients were included for xerostomia analysis (42 in the SPLS-IMRT group and 40 in the C-IMRT group). At 12 months post-IMRT, the incidence of xerostomia in the SPLS-IMRT group was significantly lower than that in the C-IMRT group (83.4% vs. 95.0%; P = 0.007), especially the grade 3 xerostomia (0% vs. 12.5%; P &lt; 0.001). However, the median change in XQ score (XQchange) was similar between the two groups (11.9 points vs. 14.1 points; P = 0.194). Moreover, there was a significantly higher median fractional USFR (0.67 vs. 0.35; P = 0.024) and SSFR (0.66 vs. 0.32; P = 0.021) in the SPLS-IMRT group than the C-IMRT group. All 90 patients were included for survival analysis. With a median follow-up time of 37.8 months (IQR, 33.9–38.5 months), the 3-year locoregional relapse-free survival, distant metastasis-free survival, and overall survival in the SPLS-IMRT and C-IMRT groups were 92.5% vs. 90.9% (hazard ratio [HR], 1.84; P = 0.477), 83.8% vs. 81.7% (HR, 1.13; P = 0.816), and 88.9% vs. 88.2% (HR, 0.96; P = 0.949), respectively. Conclusions: SPLS-IMRT significantly reduced the incidence of xerostomia at 12 months post-IMRT in NPC by recovering parotid gland function earlier than C-IMRT, without compromising survivals. Phase III clinical trials are needed to confirm this result. Clinical trial information: NCT05020067.

Effect of 635nm Diode Laser on Radiation Induced Xerostomia Patients

Background: Xerostomia, one of the most major side effects of radiotherapy in patients with oropharyngeal cancer, has a compromising effect on the quality of life. The aim of this study was to evaluate the effect of 635nm low-level laser on salivary flow rate and quality of life (QoL) in post-radiotherapy oropharyngeal cancer patients. Methods: A prospective study was conducted on patients (n=34) with persistent post-radiotherapy xerostomia received low level laser therapy (LLLT) (635nm) on the three major salivary glands twice a week for 12 weeks. For each point, dose was 18.75 J/cm2, irradiation time was 15 s, energy was 1.5 J. Energy for each session was 33 J and laser tip diameter was 0.08cm2. Extra oral points were marked over the parotid gland (6 points), submandibular (3points) and sublingual gland (2 points). Unstimulated and stimulated salivary flow rate (SFR) and quality of life (QoL) using University of Washington (UW) QoL questionnaire were assessed. Unstimulated SFR and QOL scores were normally distributed and hence paired t-test was used. A p-value ≤0.05 was considered as statistically significant. Results: The mean unstimulated SFR was significantly increased by 0.16 units after LLLT (p=0.001). Similarly, the median stimulated SFR significantly increased by 0.45 units post LLLT respectively (p=0.001). The mean QoL was significantly increased by 591.32 units after LLLT (p≤0.05). Conclusion: Low level laser therapy (LLLT) demonstrates to be effective in increasing salivary flow rate and the QoL scores hence mitigating salivary hypofunction and improving overall quality of life of patients. Keywords: Low-Level Laser Therapy; Xerostomia.

The impact of head and neck radiotherapy on salivary flow and quality of life: Results of the ORARAD study

ObjectivesSalivary hypofunction and xerostomia, are common side effects of radiotherapy, negatively impacting quality of life. The OraRad study presents results on the longitudinal impact of radiotherapy on salivary flow and patient-reported outcomes. Patients and MethodsProspective, multicenter cohort study of 572 patients receiving curative-intent head and neck radiotherapy (RT). Stimulated salivary flow (SSF) rate and patient-reported outcomes were measured prior to RT and at 6- and 18-months post-RT. Linear mixed effects models examined the relationship between RT dose and change in salivary flow, and change in patient-reported outcomes. Results544 patients had baseline salivary flow measurement, with median (IQR) stimulated flow rate of 0.975 (0.648, 1.417) g/min. Average RT dose to parotid glands was associated with change in salivary flow post-RT (p < 0.001). Diminished flow to 37% of pre-RT level was observed at 6 months (median: 0.358, IQR: 0.188 to 0.640 g/min, n = 481) with partial recovery to 59% of pre-RT at 18 months (median: 0.575, IQR: 0.338 to 0.884 g/min, n = 422). Significant improvement in patient-reported swallowing, senses (taste and smell), mouth opening, dry mouth, and sticky saliva (p-values < 0.03) were observed between 6 and 18 months post-RT. Changes in swallowing, mouth opening, dry mouth, and sticky saliva were significantly associated with changes in salivary flow from baseline (p-values < 0.04). ConclusionSalivary flow and patient-reported outcomes decreased as a result of RT, but demonstrated partial recovery during follow-up. Continued efforts are needed to improve post-RT salivary function to support quality of life.

Oral conditions and salivary analysis in HIV-uninfected subjects using preexposure prophylaxis.

Background New prevention strategies have been advocated to control the progression of HIV/AIDS, such as preexposure prophylaxis (PrEP). The aim of this study is to evaluate the potential changes in the oral and salivary conditions of HIV-uninfected subjects using PrEP.Material and Methods Subjects were evaluated before beginning the medication (T0), at the first follow-up (T1), and at the second follow-up (T2). Xerostomia, presence of untreated cavitated caries, oral hygiene habits, taste, gingival and plaque index, stimulated salivary flow rate (SSFR), and salivary concentrations of calcium, glucose, urea, and total proteins were evaluated. Data obtained were analyzed using statistical tests (p<0.05).Results Forty-seven participants (41 men; 6 women) were evaluated at T0. Thirty (28 men; 2 women) and 17 men were reassessed at T1 and T2, respectively. There was no difference between the SSFR and oral and salivary conditions between T0, T1, and T2 (p>0.05), except for the salivary calcium concentration, that increased at T2 compared to T1 (p=0.02). There was significant difference between taste and xerostomia at T1 (p=0.017), and the need to drink to swallow at T2 (p=0.015). There was significant correlation between the reported amount of saliva and taste (p=0.039, r=-0.378) at T1.Conclusions The prolonged use of PrEP seems to be associated with reports of dry mouth and worsening of taste, possibly associated with increased salivary calcium concentration. Key words:Antiretroviral agents, pre-exposure prophylaxis, saliva, oral health.

Evaluation of Halitosis and Sialometry in Emirati Diabetic Patients before and after Periodontal Treatment

Halitosis is an important social complaint which affects both healthy and periodontally diseased individuals.Oral malodor is mainly caused by a microbial degradation of both sulfur-containing and nonsulfur-containingamino acids into volatile, bad-smelling gases. Anaerobic gram-negative bacteria, the same species that havebeen linked to periodontal diseases, are especially involved in this process, explaining the link between oralmalodor with periodontitis. The following study was done to investigate the parameters of halitosis andsialometry of Emirati diabetic patients in correlation with oral concentration of volatile sulfur compounds(VSC), salivary flow rate before and after non-surgical periodontal treatment (scaling &amp; root planning) forpatients having moderate Generalized and/localized chronic periodontitis.Subjects and Methods: Eighty-one (81) Emirati subjects volunteers were recruited from the dental hospital,with average age 38-49 years. They have been divided into in three groups: Group I (negative control),Group II, and Group III and Group IIIa. Halitosis measurements for all volunteers had been recorded usingGas Chromatography. For group III samples were collected before periodontal treatment, and subsequentlyat two- &amp; four-weeks following start of non-surgical periodontal treatment (Scaling &amp; root planning).Results: There were 54 patients participated in this study. Of the 54, 27 were control and the remainingwere controlled DM. The mean and SD of all variables before and after the intervention showed that thevalues of all variables reducing after the intervention. All the difference observed was statistically significant(P&lt;0.001). This study observed that the mean value of unstimulated salivary flow rate and stimulated salivaryflow rate was less in the controlled DM group compared to control group, but for probing picker depth, CALand average bone loss was more in controlled DM group compared to control group.Conclusion: Based on the findings, it can be stated that diabetes is a major risk factor for periodontitis, andthe risk of periodontal disease increases if glycemic control is poor; it was also proved beyond doubt thatpeople with poorly controlled diabetes are at an increased risk of periodontal disease and loss of alveolarbone. Controlling diabetes by successfully improving glycemic control will reduce the risk and severity ofperiodontal diseases.

Oral Health Status and The Body Mass Index in Young Adults

Poor oral health has been reported to correlate to the body mass index (BMI) of the overweight and the obesity groups. These has yet widely studied in Indonesia. The aim of this study was to analysed the oral health, socioeconomy factors (FSE) and the BMI in the seemingly healthy university students in Kediri aged 18-21 years old. This cross-sectional study was conducted amongst male and female students of IIKBW, Kediri, Indonesia (n=150). We analysed their BMI from the body weight and height (kg/m2). Their oral health was determined by the DMFT index (decayed missing filled teeth index), the stimulated salivary flow rate (SSFR) and the gingival index (GI). FSE studied include father’s highest education and monthly income, tooth brushing frequency in a day and dental floss habitual use. Data was analysed using SPSS 17 with level of significance of p&lt;0.05. No significant differences in BMI, DMFT index, SSFR and GI respectively (p=0.411;p=0.037, p=0.880, p=0.142) between male and female groups. No significant corelation BMI with DMFT index, SSFR and GI, respectively (p=0.340, p=0.420, p=0,446). FSE are not significantly correlated to either the BMI, DMFT index, SSFR orGI (p &gt; 0.05). There were 41.8% of males and 57.8% of females have “bad” score of DMFT and 98.6% of males and 92.1% of females have “bad” score of GI; 4.1% of males and 2.6% of females have low score of SSFR.Although we found no significant differences in the BMI and oral health parameters between genders, in the seemingly healthy young adults oral health hygiene could be compromised as found in the current study indicated by bad scores of DMFT, SSFR or GI. Here we found that either BMI or FSE was not significantly correlated to any of oral health parameters measured in the current study.

Salivary glands involvement: a new indicator of juvenile idiopathic oligoarticular arthritis (preliminary results).

Early diagnosis is critical to reduce long-term disability in patients with JIA by ensuring prompt treatment. The aim of this cross-sectional study was to evaluate the salivary gland function in JIA, addressing specifically oligoarticular (JIA1) and polyarticular (JIA2) subtypes, compared with healthy controls. This may contribute to the identification of salivary risk indicators of the disease that may help diagnosis at an early stage or even before the onset of other clinical evidence. Twenty-eight patients with JIA1, 28 patients with JIA2, according to the ILAR criteria, and 28 healthy controls (C) were included in the study. Exclusion criteria were any concurrent medical condition. Data on medication, dietary and oral hygiene habits were collected using a questionnaire. All patients underwent oral examination and saliva measurement. While stimulated salivary flow rate (SFR) was significantly lower in JIA1 compared with JIA2 and C (P < 0.001), both salivary buffer capacity and pH were similar in the two JIA groups but statistically different from C (P = 0.002 and P = 0.010, respectively). Children with very low SFR (<3.5 ml) exhibited a 16-fold higher likelihood of being affected by JIA1 rather than JIA2 (P = 0.003), while no association was observed between low flow rate and JIA subtype (P = 0.744). These preliminary data suggest impairment of salivary gland function as a risk indicator for JIA1 with no association with dietary habits and drug intake.

Evaluation of the salivary parameters in facial mask wearers during Covid-19 pandemic

Introduction The COVID-19 pandemic situation forced governments to impose various measures to reduce the spread of the virus. The most used method is to wear facial masks, which can be found under several commercial forms. Wearing facial masks has caused a lot of controversy and rumors. Among them, many patients and practitioners have complained of a dry mouth after wearing different types of facial masks for a variable period of time. The aim of this study was to analyze the quantitative (un-/stimulated salivary flow rate) and qualitative (pH and buffer capacity) changes in saliva in mask wearers. Methodology Forty subjects were selected for this study. All of them wore alternatively no mask, a surgical mask for 2 hours, and FFP2 mask for 2 hours (groups 1, 2, and 3). Saliva samples were collected from all the subjects in the groups and analyzed to determine the values of un-/stimulated salivary flow rate, the pH, and buffer capacity using GC Saliva-Check Buffer (GC Corporation, Japan). Descriptive and analytical statistics were performed using ANOVA and Bonferroni post-hoc test. Results For unstimulated saliva samples, between groups 1 and 3, statistically significant differences were recorded, with a significance level of 0,02&lt;p=0,05. For stimulated saliva, salivary pH or buffer samples, no significant differences were found between groups. Conclusion Wearing FFP2 masks for two hours showed a reduction in salivary flow rate compared to subjects who did not wear facial masks. Wearing surgical masks did not produce changes in salivary flow rates, pH or buffer capacity.

Interventions for the treatment of xerostomia: A randomized controlled clinical trial.

BackgroundXerostomia or dry mouth sensation corresponds to a common clinical problem that can significantly impair the oral health related quality of life (OHRQoL). Currently, there is a large variety of local agents available for the treatment of xerostomia, but there is a lack robust evidence supporting the use of one treatment over another. We aimed to compare the effectiveness of a 1% malic acid salivary stimulant spray with a 1.33% betaine-based saliva substitute mouthwash in the improvement of xerostomia. Material and MethodsFifty-one participants with drug induced or idiopathic xerostomia were randomly allocated into three groups, two intervention and one control group (placebo). OHRQoL and severity of xerostomia were assessed with the OHIP-14sp questionnaire and a visual analogue scale (VAS) respectively. Stimulated and non-stimulated salivary flow rates before and after treatments were also measured. ResultsAll three groups reported a significantly improvement in the dry mouth sensation and non-stimulated salivary flow rates, but only the malic acid spray and the betaine-based mouthwash significantly improved the OHRQoL. There were no significant differences between both intervention groups. ConclusionsThis study provides evidence that both tested agents are comparable in improving the dry mouth sensation and OHRQoL of patients with drug induced and idiopathic xerostomia. Key words:Xerostomia, dry mouth, malic acid, betaine, oral-health related quality of life.

Oral Health Status and The Body Mass Index in Young Adults

Poor oral health has been reported to correlate to the body mass index (BMI) of the overweight and the obesity groups. These has yet widely studied in Indonesia. The aim of this study was to analysed the oral health, socioeconomy factors (FSE) and the BMI in the seemingly healthy university students in Kediri aged 18-21 years old. This cross-sectional study was conducted amongst male and female students of IIKBW, Kediri, Indonesia (n=150). We analysed their BMI from the body weight and height (kg/m2). Their oral health was determined by the DMFT index (decayed missing filled teeth index), the stimulated salivary flow rate (SSFR) and the gingival index (GI). FSE studied include father’s highest education and monthly income, tooth brushing frequency in a day and dental floss habitual use. Data was analysed using SPSS 17 with level of significance of p&lt;0.05. No significant differences in BMI, DMFT index, SSFR and GI respectively (p=0.411; p=0.037, p=0.880, p=0.142) between male and female groups. No significant corelation BMI with DMFT index, SSFR and GI, respectively (p=0.340, p=0.420, p=0,446). FSE are not significantly correlated to either the BMI, DMFT index, SSFR or GI (p &gt; 0.05). There were 41.8% of males and 57.8% of females have “bad” score of DMFT and 98.6% of males and 92.1% of females have “bad” score of GI; 4.1% of males and 2.6% of females have low score of SSFR. Although we found no significant differences in the BMI and oral health parameters between genders, in the seemingly healthy young adults oral health hygiene could be compromised as found in the current study indicated by bad scores of DMFT, SSFR or GI. Here we found that either BMI or FSE was not significantly correlated to any of oral health parameters measured in the current study.

Efficacy of gel-based artificial saliva on Candida colonization and saliva properties in xerostomic post-radiotherapy head and neck cancer patients: a randomized controlled trial

ObjectiveTo evaluate the efficacy of an edible artificial saliva gel, oral moisturizing jelly (OMJ), and a topical commercial gel (GC dry mouth gel) on Candida colonization and saliva properties.Materials and methodsThis study was a secondary analysis of a single-blinded randomized controlled trial conducted in xerostomic post-radiotherapy head and neck cancer patients. Candida colonization, stimulated salivary flow rate (SSFR), saliva pH, and buffering capacity (BC) were measured at 0, 1, and 2 months after each intervention. Candida colonization was quantified by colony counts and species identified by Candida Chromagar, polymerase chain reaction, and API 20C AUX system. Statistical significance level was 0.05.ResultsA total of 56 participants in OMJ (N = 30) and GC (N = 26) groups completed the study. OMJ significantly increased saliva pH (p = 0.042) and BC (p = 0.013) after 1-month use, while GC only improved saliva pH (p = 0.027). Both interventions tended to increase SSFR but only GC had a significant increase at 2 months (p = 0.015). GC and OMJ significantly decreased the number of Candida species at 1 and 2 months, respectively. Both groups tended to reduce Candida counts but not significant.ConclusionsBoth OMJ and GC saliva gels could improve saliva pH and decrease the number of Candida species. OMJ is superior to GC in its buffering capacity, while GC may better improve salivary flow rate. Long-term and large-scale study is warranted to test the efficacy of artificial saliva in oral health improvement.Clinical relevanceOMJ and GC gel could decrease the number of Candida species and improve saliva properties in post-radiation xerostomic patients.Trial registration numberClinicaltrials.gov NCT03035825. Date of registration: 25th January 2017.

Assessment of Salivary Flow Rate in Edentulous Patient

Background: Complete denture help to re-establish the occlusion and aesthetic to such extent it mimic the previously missing teeth and other features which may be lose over the time. In a complete denture wearer, saliva is responsible for the retention of the prosthesis due to its lubricating function. It also aid in integrity, adhesion and stabilisation of dentures in position after the placement. It act as interposed salivary film which allowed the prosthesis to lie on the film rather than on the bare mucosa. This would help to protect the tissues from the hydration and forces of the denture base that acting on it. Therefore, maintaining normal pH and salivary flow rate is required, in order to achieve a better retention of denture as well as good oral health. Aim: To investigate the relationship between the salivary flow rate before and after the placement of complete denture. Materials and Method: There were 15 participants in the age group of 55 to 70 years old, which required complete denture prosthesis for the first time. The unstimulated or resting whole saliva and stimulated whole saliva was collected by using spitting method. Saliva production was stimulated by chewing paraffin wax. The time taken for saliva collection of 5 mL was recorded by using stopwatch. The data obtained was analysed by using paired t-test. Results: There was significant difference between the unstimulated whole salivary flow rate and stimulated whole salivary flow rate before the placement of the denture, which was by 0.20 mL/min. Whereas, the difference between the unstimulated whole salivary flow rate and stimulated whole salivary flow rate after the placement also show significant changes which was about 0.14 mL/min. Chewing of paraffin wax as well as placement of denture act as stimulatory agents in production of saliva. Conclusion: Stimulated salivary flow rate were higher than the unstimulated salivary flow rate which obtained before and immediately after the placement of complete denture. There was significant differences of the salivary flow rate before and after the placement of denture.

The efficacy of xylitol based oral hygiene products on salivary parameters – An invivo study

Xylitol, a five-carbon sugar polyol, is a white crystalline carbohydrate known since a century ago. The objective is to assess the efficacy of xylitol based oral hygiene products (chewing gum, mouthwash, and toothpaste) on salivary parameters - pH, Resting Salivary Flow Rate (RFR) and Stimulated Salivary Flow Rate (SFR) among subjects with medium cariogenic risk. The study recruited sixty participants who were divided into 3 groups of 20 individuals each. Subjects in Group I, Group II, Group III were given xylitol toothpaste, xylitol mouth-wash &amp; toothpaste, and xylitol chewing-gum &amp; toothpaste respectively for 3 weeks. The salivary parameters - RFR, SFR, and pH were assessed before and after the use of xylitol-based products. All three groups showed an increase in the RFR, SFR, and pH after three weeks. RFR was found to be statistically significant in Group I (p=0.006), Group II (p=0.000), and Group III (p=0.000). SFR was found to be statistically significant in Group II (p=0.000) and Group III (p=0.000). pH was found to be statistically significant in Group I (p=0.002) and Group III (p=0.003). Xylitol is a well-known anti-caries agent, and it has been well documented in the prevention of caries. The present study was conducted in the light of these facts to compare the efficacy of different xylitol products concludes that chewing-gum is comparatively more effective than mouthwash and toothpaste.

Oral disorders in patients with newly diagnosed haematological diseases

This study aimed to examine saliva flow rates and prevalence of dental and periodontal diseases of patients with newly diagnosed severe haematological diseases and compare these findings with age-matched controls of normal population. A total of 149 patients diagnosed with haematological diseases aimed to be treated with haematological stem cell transplantation between 2008 and 2018 and 154 controls were included in the study. A dental examination was performed for patients within a maximum of 6months after diagnosis. Differences were compared in terms of the stimulated salivary flow rate (SSFR); decayed, missing and filled teeth (DMFT) index; number of teeth; caries prevalence; presence of periodontitis and acute infections. The mean SSFR of the patient group was significantly lower (1.1ml/min ± 0.7ml/min) than the mean SSFR of the controls (1.3ml/min ± 0.5ml/min; p = 0.004). The number of caries lesions was significantly higher in the patient group (mean ± SD, 1.1 ± 1.9) than in the control group (mean ± SD, 0.4 ± 1.2; p < 0.001). There were fewer teeth and a higher DMFT index in the patient group compared to the control group, but the differences were not significant. Acute symptomatic infections were observed in eight (5.4%) patients and in none of the controls (p < 0.01). Oral examinations in patients with newly diagnosed severe haematological disease demonstrated a higher prevalence of caries, acute infections and lower mean SSFR compared with the controls. These findings support the recommendations for early dental examination at the time of diagnosis.

ROLE OF PHOTOBIOMODULATION OF MAJOR SALIVARY GLANDS IN PATIENTS WITH CHRONIC RENAL FAILURE IN THE SALIVARY FLOW RATE

Objective To evaluate the effects of low-level laser photobiomodulation on the major salivary glands in patients with chronic renal failure. Study Design After the ethics board approved the protocol, 38 patients with chronic renal failure (CRF) on hemodialysis were enrolled into this prospective study (21 included in the study group and 17 in the control group, randomly). All patients were submitted to oral clinical examination anamnesis and physical examination. Stimulated and nonstimulated salivary flow rate were collected before and after photobiomodulation with low-level laser application. Laser application comprised 3 points extraorally and intraorally in each parotid gland, 1 point in each submandibular, and 1 point in the sublingual glands. Salivary flow rate was collected before photobiomodulation and after 3 applications (weekly). Results Nonstimulated salivary flow rate in study group was 3.06 mL/min and 3.83 mL/min (P = .02) before and after photobiomodulation, while stimulated salivary flow rate in study group was 3.5 mL/min and 4.4 mL/min (P = .01) before and after photobiomodulation. Comparison between placebo group and study group did not show differences. Conclusion Low-level laser photobiomodulation of the major salivary glands increased around 25% of salivary flow rate in CRF patients. To evaluate the effects of low-level laser photobiomodulation on the major salivary glands in patients with chronic renal failure. After the ethics board approved the protocol, 38 patients with chronic renal failure (CRF) on hemodialysis were enrolled into this prospective study (21 included in the study group and 17 in the control group, randomly). All patients were submitted to oral clinical examination anamnesis and physical examination. Stimulated and nonstimulated salivary flow rate were collected before and after photobiomodulation with low-level laser application. Laser application comprised 3 points extraorally and intraorally in each parotid gland, 1 point in each submandibular, and 1 point in the sublingual glands. Salivary flow rate was collected before photobiomodulation and after 3 applications (weekly). Nonstimulated salivary flow rate in study group was 3.06 mL/min and 3.83 mL/min (P = .02) before and after photobiomodulation, while stimulated salivary flow rate in study group was 3.5 mL/min and 4.4 mL/min (P = .01) before and after photobiomodulation. Comparison between placebo group and study group did not show differences. Low-level laser photobiomodulation of the major salivary glands increased around 25% of salivary flow rate in CRF patients.