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Lopez-Garzon M, López-Fernández MD, Ruíz-Martínez AM, Galván-Banqueri P, Lozano-Lozano M, Tovar-Martín I, Postigo-Martin P, Ariza-Vega P, Artacho-Cordón F, Fernández-Lao C, Cantarero-Villanueva I, Fernández-Gualda MÁ, Arroyo-Morales M, Ruíz-Villaverde R, Galiano-Castillo N. Efficacy of photobiomodulation therapy combined with mobile health education in patients with head and neck cancer suffering from chronic xerostomia after radiotherapy: protocol for a three-arm, randomised, placebo-controlled, double-blinded study. BMJ Open 2024; 14:e078068. [PMID: 38267245 PMCID: PMC10824058 DOI: 10.1136/bmjopen-2023-078068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION The role of photobiomodulation (PBM) therapy for oral tissue damage induced by cancer treatment is currently unclear, and there is low-quality to moderate-quality evidence supporting the use of this approach for treating xerostomia and/or hyposalivation. Consequently, patients with head and neck cancer increasingly turn to basic oral hygiene to alleviate salivary gland dysfunction, and their adherence can be improved by mobile health (mHealth) education. The primary objective of this study will be to analyse the effects of different doses of PBM therapy (7.5 J/cm2 vs 3 J/cm2) plus mHealth education on quality of life (QoL), oral health, salivary secretion and salivary gland ultrasound assessment at postintervention and at the 6-month follow-up in patients with head and neck cancer after radiotherapy compared with those in control group. METHODS AND ANALYSIS A prospective, three-arm, randomised, placebo-controlled, double-blinded study will be conducted among patients with head and neck cancer suffering from chronic xerostomia. A total of 20 patients per arm will be included and randomly assigned to receive 7.5 J/cm2 of PBM, 3 J/cm2 of PBM or placebo therapy. PBM therapy will be applied during 24 sessions at 22 points extra and intraorally two times per week for 3 months, combined with a mobile application (https://www.laxer.es). The assessments will be recorded at the beginning of the study, at postintervention and at the 6-month follow-up. The primary outcomes will be QoL, oral health, salivary secretion and salivary gland ultrasound. The pain pressure threshold, functional performance, mood and sleep quality will be secondary indicators. ETHICS AND DISSEMINATION This study received ethics approval from the Andalusian Biomedical Research Ethics Portal (2402-N-21 CEIM/CEI Provincial de Granada) according to the Declaration of Helsinki for Biomedical Research. The results of this study will be presented at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT05106608.
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Affiliation(s)
- Maria Lopez-Garzon
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - María Dolores López-Fernández
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
| | - Alba Maria Ruíz-Martínez
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pilar Galván-Banqueri
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Mario Lozano-Lozano
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Isabel Tovar-Martín
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Paula Postigo-Martin
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Physical Activity for HEaLth Promotion (PA-HELP), Department of Physical and Sport Education, Sports Sciences Faculty, University of Granada, Granada, Spain
| | - Francisco Artacho-Cordón
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiology and Physical Medicine, Medicine Faculty, University of Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Carolina Fernández-Lao
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Irene Cantarero-Villanueva
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Miguel Ángel Fernández-Gualda
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
| | - Manuel Arroyo-Morales
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Ricardo Ruíz-Villaverde
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Medical Surgical Dermatology and Venereology, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Noelia Galiano-Castillo
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
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Faruque M, Nazmi K, van Splunter A, Laine ML, Bikker FJ. Sialagogic Effects Through Olfactory Stimulation with Mastic Resin and α-pinene Volatiles in vivo. Biomed Pharmacother 2023; 168:115699. [PMID: 37865987 DOI: 10.1016/j.biopha.2023.115699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Xerostomia, often associated with decreased saliva quality, poses challenges due to limited treatment efficacy. This study aimed to investigate alternative approaches to enhance saliva secretion through olfactory volatile stimulation with mastic resin and its main compound α-pinene, known for inhibiting acetylcholinesterase in vitro. METHODS The inhibitory effects of freshly prepared mastic resin extract oil and α-pinene oil on acetylcholinesterase (AChE) activity were measured in vitro. Eighty healthy participants were recruited and divided into two groups: exposed to mastic resin volatiles (n = 40) or α-pinene volatiles (n = 40). Saliva samples were collected pre, during and post exposure to analyze saliva flow rate, spinnbarkeit, ion composition and MUC5B levels. RESULTS Mastic resin extract oil and α-pinene oil inhibited AChE activity by 207 % and 22 %, respectively. Olfactory stimulation with these volatiles significantly increased saliva secretion rate without altering spinnbarkeit and ion composition. Salivary MUC5B concentration rose after exposure to mastic resin volatiles. CONCLUSIONS Olfactory stimulation with mastic resin and α-pinene volatiles demonstrated a bona fide in vivo effect on saliva secretion, confirming their sialagogic capability, potentially as a result of local glandular AChE inhibition. These findings highlight the therapeutic potential of both volatile compounds in treating patients with xerostomia and hyposalivation through olfactory exposure.
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Affiliation(s)
- Mouri Faruque
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands; Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands.
| | - Kamran Nazmi
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Annina van Splunter
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Floris J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
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Assy Z, van Santen JS, Brand HS, Bikker FJ. Use and efficacy of dry-mouth interventions in Sjögren's disease patients and possible association with perceived oral dryness and patients' discomfort. Clin Oral Investig 2023; 27:5529-5537. [PMID: 37507599 PMCID: PMC10492750 DOI: 10.1007/s00784-023-05172-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES Sjögren's disease (SjD) patients use various interventions to relief their oral dryness. However, the use and efficacy of these interventions have only partially been evaluated. The present study aims to investigate whether there is an association between the perceived oral dryness and discomfort of SjD patients and their use of specific interventions. MATERIALS AND METHODS A cross-sectional study was performed among SjD patients, who completed several questionnaires to assess the severity of their oral dryness and an inventory of dry-mouth interventions. The perceived efficacy of each intervention was reported on a 5-point Likert-scale. RESULTS The questionnaires were returned by 92 SjD patients. For relief of oral dryness, they mostly used "eating fruit", "drinking tea", "moistening the lips", "drinking water, and "drinking small volumes" (> 50%). Three interventions had a frequency of use ranging from 2-6 times/day, whereas, "drinking water" and "drinking small volumes" showed higher frequencies (> 14). The highest overall efficacy (≥ 3.5) was reported for "chewing gum" and "using a mouth gel". Furthermore, various dry-mouth interventions showed significant associations with oral dryness scores and/or patients' discomfort. For example, "drinking small volumes" and "using XyliMelts" were associated with the Bother Index score. CONCLUSION Great variation was found in the use of dry-mouth interventions by the participants and the severity of the oral dryness and/or patients' discomfort seemed to affect their choice of intervention. Notably, the mostly used interventions did not show the highest reported efficacy. CLINICAL RELEVANCE These findings might help SjD patients and clinicians in their choice of effective dry-mouth interventions.
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Affiliation(s)
- Z Assy
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
| | - J S van Santen
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - H S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - F J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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Gulati A, Kidane J, Chang JL. Patient Reported Outcome Measures for Salivary Function: A Systematic Review. Laryngoscope 2023. [PMID: 36606658 DOI: 10.1002/lary.30550] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE A number of patient-reported outcome measures (PROMs) assess quality of life and symptom severity in patients with salivary gland dysfunction, but many vary in the extent of validation and domain types addressed. We identified PROMs validated to measure salivary gland function and analyzed key properties. DATA SOURCES PubMed, Web of Science, Embase, PsycInfo, and CINAHL. REVIEW METHODS A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Validated instruments with >1 item to assess salivary gland-related symptoms were included. PROMs were evaluated for developmental methodology, structure, validity, and reliability using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. RESULTS A total of 2059 abstracts were retrieved, and 133 full-text articles were reviewed. Sixteen PROMs assessing xerostomia (n = 7), sialadenitis (n = 4), Sjogren's syndrome (n = 2), Parkinson's-associated sialorrhea (n = 2), and oral systemic sclerosis (n = 1) were identified. Most (n = 15) were developed de novo, one was adapted from a pre-existing questionnaire. Eleven PROMs demonstrated "very good" analysis of internal consistency per COSMIN criteria, and 10 included test-retest data. Regarding content validity, four PROMs were developed with both patient and physician input, but none were rated as "adequate." All included comparisons against other questionnaires (n = 7), salivary flow rate (n = 9), and/or healthy controls (n = 3). The most rigorously developed PROM, the Xerostomia Inventory, was rated adequate in 6 out of 7 domains. CONCLUSIONS Several PROMs evaluate salivary function. The abilties of these PROMs to meet design and validation standards were variable, with notable limitations in content validity for all tools. New and updated PROMs assessing obstructive and inflammatory salivary symptoms should utilize patient and provider input. LEVEL OF EVIDENCE N/A Laryngoscope, 2023.
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Affiliation(s)
- Arushi Gulati
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Joseph Kidane
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.,Surgery Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA
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Salivary film thickness and MUC5B levels at various intra-oral surfaces. Clin Oral Investig 2023; 27:859-869. [PMID: 35941397 PMCID: PMC9889518 DOI: 10.1007/s00784-022-04626-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES In this study, we investigated the salivary film thickness and the MUC5B levels at various intra-oral locations in healthy volunteers, with a focus on the palate. Besides, measurements of the palatal surface area were included to explore the possible relationships between the palatal surface area and the palatal salivary film and MUC5B levels. MATERIALS AND METHODS The salivary film thickness was determined using filter strips, which were pressed to the mucosal surfaces of five different intra-oral locations; conductance was then analysed using a Periotron. After elution of the strips, the MUC5B levels at various intra-oral locations were determined using ELISA. The palatal surface area was measured using an intra-oral scanner. The surface area was subsequently calculated using the software. RESULTS The anterior tongue had the thickest salivary film and also the highest levels of MUC5B, while the anterior palate had the thinnest salivary film and lowest MUC5B levels. There was no association between the palatal surface area and the salivary film thickness of the palate. CONCLUSION The salivary film and MUC5B levels are unequally distributed over the intra-oral regions of the soft tissues. The lack of association between the palatal surface area and the salivary film thickness indicates that a larger surface area is not associated with a relative thinner palatal salivary film. CLINICAL RELEVANCE The results of the current study increase our understanding of saliva distribution in the oral cavity and could be used as reference values for future studies.
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A review on the role of salivary MUC5B in oral health. J Oral Biosci 2022; 64:392-399. [DOI: 10.1016/j.job.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
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Schoppmeier CM, Helpap J, Hagemeier A, Wicht MJ, Barbe AG. Using the modified Schirmer test for dry mouth assessment: A cross-sectional study. Eur J Oral Sci 2022; 130:e12880. [PMID: 35692181 DOI: 10.1111/eos.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
Abstract
This study aimed to establish whether the modified Schirmer test could serve as a diagnostic tool for dry mouth, that is, whether it could reliably measure salivary film at selected locations within the oral cavity, and to identify levels of sensitivity/specificity and determine reference values. Therefore, a cross-sectional study (N = 120, mean age 63.5 [SD 13.9] years) was performed. The test was used at five locations (hard palate; buccal mucosa in molar region at 4 mm above occlusal plane; anterior tongue; lower lip; mouth floor), and results were recorded after 1, 2 and 3 min. A statistically significant discriminatory ability of the Schirmer test for the unstimulated salivary flow rates could be shown for the palate (at 3 min), buccal mucosa (at 1 min), mouth floor (at 1 min), and tongue (at 2 and 3 min) (areas under the curve 0.64-0.68), with individual sensitivity/specificity values depending on test location/time points. Thus, the modified Schirmer test has potential to become a simple and reproducible instrument for the detection of dry mouth based on low unstimulated salivary flow rates in dentistry and especially outreach care. Care must be taken concerning intraoral test location and measurement time.
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Affiliation(s)
- Christoph Matthias Schoppmeier
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
| | - Juliane Helpap
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
| | - Anna Hagemeier
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Michael Jochen Wicht
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
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The relationship between the severity of oral dryness and the use of dry-mouth interventions by various subgroups of dry-mouth patients. Clin Oral Investig 2022; 26:3097-3108. [PMID: 35006295 DOI: 10.1007/s00784-021-04292-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/10/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Dry-mouth patients use different interventions to relieve their oral dryness. As recent studies showed that various subgroups of dry-mouth patients perceived different intra-oral regions as most dry, the present study investigated whether the use of dry-mouth interventions by various subgroups of dry-mouth patients was related to the perceived oral dryness as well as salivary flow rate. MATERIALS AND METHODS Xerostomia Inventory (XI) scores, Regional Oral Dryness Score (RODI) scores and used dry-mouth interventions were extracted from the medical records of 528 patients visiting a saliva clinic. Based on their medical history, they were allocated into 6 subgroups. RESULTS The subgroups of dry-mouth patients used a wide range of interventions to relieve their oral dryness. Sjögren's syndrome patients used most interventions more frequently than patients with oral dryness due to use of a limited number of medications and controls. Patients using medications showed associations between the total XI score and dry-mouth interventions aimed at the entire mouth. In medication using patients and controls, the locally applied intervention "using mouth gel" was associated with RODI scores of the anterior tongue. CONCLUSION The use of dry-mouth interventions was associated with dry-mouth feelings. Use of interventions aimed to relieve dryness of the entire mouth was significantly associated with total XI score, while locally applied interventions were significantly associated with the severity of dryness at specific intra-oral regions, the anterior tongue in particular. CLINICAL RELEVANCE The results will help clinicians to advise dry-mouth patients about the most suitable interventions for relief of oral dryness complaints.
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Assy Z, Bikker FJ, Picauly O, Brand HS. The association between oral dryness and use of dry-mouth interventions in Sjögren's syndrome patients. Clin Oral Investig 2021; 26:1465-1475. [PMID: 34374853 PMCID: PMC8816756 DOI: 10.1007/s00784-021-04120-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022]
Abstract
Objective Sjögren’s syndrome patients use different dry-mouth interventions for the relieve of their oral dryness. Recently, it was shown that patients with dry-mouth complaints have regional differences in perceived intra-oral dryness. Therefore, the aim of the present study was to investigate whether the use of dry-mouth interventions is related to the perceived regional oral dryness. Materials and methods A cross-sectional study was performed among Sjögren’s patients. Volunteers could anonymously administer various questionnaires, including the Regional Oral Dryness Inventory (RODI), Xerostomia Inventory (XI), Bother Index (BI) and a list of dry-mouth interventions. Results Sjögren’s syndrome patients use a wide variety for the relieve of oral dryness. “Drinking water’’ and “moistening the lips’’ were used most frequently. Dry-mouth interventions, “drinking water’’, “rinsing of the mouth”, and “drinking small volumes” had significant associations with the RODI-scores of the posterior palate, and anterior and posterior tongue, respectively. On the other hand, “using mouth gel’’ had a significant association with the RODI-scores of the inside cheeks. Conclusion Sjögren’s syndrome patients are more likely to use mouth gels when their inside cheeks were experienced as most dry, while they drank water, rinsed their mouth or drank small volumes if the posterior palate, and anterior and posterior tongue were considered as dry. It can be concluded that intra-oral dryness affects dry-mouth perception and thereby also the use of the various dry-mouth interventions. Clinical relevance The therapeutic choice of dry-mouth interventions by Sjögren’s syndrome patients seems to some extent to be related to dryness at specific intra-oral regions.
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Affiliation(s)
- Z Assy
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands.
| | - F J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands
| | - O Picauly
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands
| | - H S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands
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Differences in perceived intra-oral dryness in various dry-mouth patients as determined using the Regional Oral Dryness Inventory. Clin Oral Investig 2021; 25:4031-4043. [PMID: 33496869 PMCID: PMC8137633 DOI: 10.1007/s00784-020-03734-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/04/2020] [Indexed: 01/20/2023]
Abstract
Objectives Recently, it was shown that the Regional Oral Dryness Inventory (RODI) could determine differences in dry-mouth perception at different intra-oral locations. The main aim of this study was to determine whether the RODI might help to discriminate between various causes of oral dryness in dry-mouth patients. The second aim was to ascertain whether the RODI could become an additional diagnostic tool in dry-mouth patients. Materials and methods Data were collected retrospectively from patients who visited a specialized saliva clinic. Salivary flow rates, Xerostomia Inventory scores, and RODI scores were extracted from the medical records. Patients were stratified into subgroups according to their health status. Results Five hundred twenty-eight patients participated in this study (mean age of 59.6 ± 16.0 years; 68.4% female). Specific patient groups differed with regard to the region of the mouth they experienced as the most and least dry. The posterior palate was the area perceived as most dry by controls and Sjögren patients. In patients using limited or multiple medications, it was the anterior tongue. RODI scores also differed significantly among dry-mouth patient groups: whereas controls and patients using limited medication had the lowest RODI scores and experienced less intra-oral dryness, Sjögren patients had the highest RODI scores. Conclusion Our use of the RODI questionnaire showed that perceived intra-oral dryness differed between the various dry-mouth patients. Clinical relevance The RODI can be a valuable clinical diagnostic tool in dry-mouth diagnostics, in which it can be used to discriminate between the various causes of oral dryness in patients.
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