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Yamakawa M, Ansai T, Kasai S, Ohmaru T, Takeuchi H, Kawaguchi T, Takehara T. Dentition status and temporomandibular joint disorders in patients with rheumatoid arthritis. Cranio 2002; 20:165-71. [PMID: 12150262 DOI: 10.1080/08869634.2002.11746207] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We compared dentition status and temporomandibular joint (TMJ) disorders in 142 women with rheumatoid arthritis (RA, ages, 40 to 69 years) and 143 women of similar age without RA. The RA group had significantly fewer remaining teeth than the non-RA group. Number of decayed, missing, and filled (DMF) teeth, number of edentulous subjects, and number of subjects with complete and removable partial dentures were significantly higher in the RA group. Among RA subjects, 1.4% had unprovoked TMJ pain, 4.9% had pain on mouth opening, and 14.8% noted difficulty with opening. In the RA group, TMJ tenderness was elicited in 9.2%, clicking in 12.7%, and crepitus in 35.9%, representing a significant excess occurrence of crepitus. The prevalence of TMJ disorders was 67.6% in the RA group and 32.9% in the non-RA group; degenerative joint disorders were particularly frequent. TMJ disorders correlated with Steinbrocker stage and the duration of RA.
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MESH Headings
- Adult
- Age Factors
- Aged
- Arthritis, Rheumatoid/classification
- Arthritis, Rheumatoid/complications
- Case-Control Studies
- Chi-Square Distribution
- DMF Index
- Denture, Complete
- Denture, Partial, Fixed
- Denture, Partial, Removable
- Facial Pain/complications
- Female
- Humans
- Jaw, Edentulous/complications
- Jaw, Edentulous, Partially/complications
- Mandible/physiopathology
- Middle Aged
- Osteoarthritis/complications
- Range of Motion, Articular/physiology
- Statistics as Topic
- Temporomandibular Joint Disorders/complications
- Time Factors
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Abstract
Dry mouth must not be considered a trivial problem in the population, since it constitutes a phenomenon with many aspects relative to oral function as well as quality of life. Up until today, no global consensus has been reached with regard to the terminology of dry mouth, creating a substantial problem for research, education, diagnosis, and therapy. In this report, salivary gland hypofunction has been selected as the overarching term for subjective symptoms and objective signs of dry mouth. Its different aspects--xerostomia, hyposalivation, and altered saliva composition--are reviewed with respect to prevalence, diagnosis, and etiology. It is concluded that these aspects of salivary gland hypofunction are separate entities, which in many respects are interrelated, constituting not merely a dental but also a medical and social concern.
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Affiliation(s)
- T Nederfors
- Oral Health Centre, Central Hospital, Halmstad, Sweden.
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Risheim H, Arneberg P. Salivary stimulation by chewing gum and lozenges in rheumatic patients with xerostomia. SCANDINAVIAN JOURNAL OF DENTAL RESEARCH 1993; 101:40-3. [PMID: 8441894 DOI: 10.1111/j.1600-0722.1993.tb01644.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The effect of chewing gum and lozenges in relieving the signs and symptoms of xerostomia was studied in a 2-wk cross-over clinical trial in 18 rheumatic patients with dry mouth symptoms and low salivary flow rates. Resting flow was measured before (PRESTIM) a chewing stimulated flow rate test (STIM), and also 5 min after (POSTSTIM). STIM flow (mean 1.0 ml/min) was not affected by the test regimens. In the lozenge regimen, mean PRESTIM flow in the group increased from 0.11 to 0.14 ml/min and POSTSTIM from 0.10 to 0.13. In the chewing gum regimen, PRESTIM flow (mean 0.13 ml/min) did not change, whereas POSTSTIM flow increased from 0.13 to 0.16 ml/min. In terms of patients' preferences, chewing gum and lozenges were ranked equal. Both these physiologic stimuli had few side-effects. Subjective symptoms were relieved in about one-third of the subjects, but relief was not always verified by improved flow rates. The regimens were not found to influence buffering capacity; salivary counts of mutans streptococci, lactobacilli, and candida; or oral sugar clearance time.
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Affiliation(s)
- H Risheim
- Department of Cariology, Dental Faculty, University of Oslo, Norway
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Arneberg P, Bjertness E, Storhaug K, Glennås A, Bjerkhoel F. Remaining teeth, oral dryness and dental health habits in middle-aged Norwegian rheumatoid arthritis patients. Community Dent Oral Epidemiol 1992; 20:292-6. [PMID: 1424551 DOI: 10.1111/j.1600-0528.1992.tb01702.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The aim of the study was to assess the effect of rheumatoid arthritis (RA) upon dental health. A questionnaire was mailed to all seropositive rheumatoid arthritis (RA) patients aged 44-56 yr in the files of the two main departments of rheumatology in South Eastern Norway. Data were obtained from 125 patients, constituting 91% of the target group. The number of remaining teeth in these patients was not related to disease duration or physical dysfunction, whereas a relationship to prolonged use of medication for pain relief was indicated. Factors known to affect tooth loss in the general population, such as smoking habits, dental attendance, interdental cleaning habits, previous dental disease, and place of residence were found to be important in RA patients as well. The RA patients from Oslo had a mean number of 25 remaining teeth, which is the same as reported for the general Oslo population at this age. Oral dryness was reported by more than 50% of the RA patients, but was not related to the number of teeth. The conclusion is that serious and long lasting rheumatoid arthritis had little influence on the number of remaining teeth in this middle-aged group of Norwegians.
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Affiliation(s)
- P Arneberg
- Dental Faculty, University of Oslo, Norway
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Risheim H, Kjaerheim V, Arneberg P. Improvement of oral hygiene in patients with rheumatoid arthritis. SCANDINAVIAN JOURNAL OF DENTAL RESEARCH 1992; 100:172-5. [PMID: 1631487 DOI: 10.1111/j.1600-0722.1992.tb01735.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Programs in power toothbrushing, manual toothbrushing with conventional fluoride toothpaste and with a chlorhexidine/fluoride gel has been evaluated for plaque removal in an observer blind cross-over clinical trial on 14 rheumatoid arthritis patients. All three regimens lead to considerable improvement in oral hygiene. The use of an electric toothbrush was slightly more effective than a manual brush. Brushing with a chlorhexidine/fluoride gel gave the best results, but its clinical use is limited by unacceptable taste, discoloration and possibly adverse soft tissue effects.
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Affiliation(s)
- H Risheim
- Department of Cariology, Dental Faculty, University of Oslo, Norway
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Ericson S, Zetterlund B, Ohman J. Recurrent parotitis and sialectasis in childhood. Clinical, radiologic, immunologic, bacteriologic, and histologic study. Ann Otol Rhinol Laryngol 1991; 100:527-35. [PMID: 2064262 DOI: 10.1177/000348949110000702] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Twenty children with juvenile recurrent parotitis, between 3 months and 16 years of age at onset, were followed up over a period of 7 to 22 years. Radiologic, histopathologic, cytologic, immunologic, and bacteriologic studies were performed to investigate the cause of sialectasis, commonly found in juvenile recurrent parotitis, and the pathogenesis of the disease. It was considered that a combination of a congenital malformation of portions of the salivary ducts and infections ascending from the mouth following dehydration of the children are contributory to the pathogenesis of the disease. The results of the investigations into the cause of the disease appear to exclude an auto-immunologic response or an allergic condition, an immature immune response, mumps, a sensitivity to upper respiratory tract infection, and familial factors.
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Affiliation(s)
- S Ericson
- Department of Dental and Maxillofacial Radiology, Institute for Postgraduate Dental Examination, Jönköping, Sweden
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Laurell L, Hugoson A, Håkansson J, Pettersson B, Sjöström L, Berglöf FE, Berglöf K. General oral status in adults with rheumatoid arthritis. Community Dent Oral Epidemiol 1989; 17:230-3. [PMID: 2791510 DOI: 10.1111/j.1600-0528.1989.tb00622.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The oral status of an adult population of 204 patients with rheumatoid arthritis (RA) was compared with that of an age and sex-matched random sample of non-rheumatic subjects. The percentage of edentulous subjects, number of existing teeth in dentate subjects, prevalence, and quality of fixed and removable prostheses and prevalence of disorders of the stomatognathic system was recorded. The percentage of edentulousness among RA-patients was 17% and among non-RA subjects 19%. Number of remaining teeth was equal. 75% of removable partial and 62% of complete dentures among RA-patients were considered unsatisfactory compared to 25% and 56% respectively among non-RA subjects. Disorders related to the TMJ occurred much more frequently among RA-patients than among non-RA subjects. It is suggested that thorough stomatognathic examination and TMJ-prophylaxis be included in the overall care of RA-patients.
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Affiliation(s)
- L Laurell
- Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden
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Glass BJ, Van Dis ML, Langlais RP, Miles DA. Xerostomia: diagnosis and treatment planning considerations. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1984; 58:248-52. [PMID: 6592521 DOI: 10.1016/0030-4220(84)90146-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Long-term xerostomia results in a poor prognosis for the remaining dentition, existing restorations, and denture acceptance. The dentist must be able to recognize xerostomia by the clinical signs and the potential for xerostomia on the basis of a medical history, since xerostomia may not always be the patient's chief complaint. A literature review concerning the etiology, diagnosis, and management of xerostomia is presented.
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Abstract
The histopathological diagnosis 'benign lympho-epithelial lesion' characterizes the major salivary gland disease in Sjögren's syndrome. It is not known if all cases with microscopically diagnosed benign lympho-epithelial lesion are variants of Sjögren's syndrome. The present clinical investigation showed that in 19 patients with the microscopical diagnosis of lympho-epithelial lesion, 84% fulfilled all criteria of Sjögren's syndrome. The rheumatoid factor and/or antinuclear factor was found in 84% and M-component was present in 16%. Sialography revealed sialectasis in all parotid glands. Salivary gland enlargement was found in 79%, and keratoconjunctivitis sicca in 89% of the patients. Systemic disease was found in 32%. The disease in the 2 patients with M-component took a malignant course, culminating in immunoblastic sarcoma and myelomatosis. The clinical diagnosis 'autoimmune sialadenitis' is proposed for the oral and salivary gland component is Sjögren's syndrome.
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Abstract
Secretion rates and the composition of isolated parotid saliva samples were samples were examined in 51 patients suffering from chronic recurrent parotitis, sialosis, or Sjögren's syndrome, and in 17 healthy controls. Evaluation of the results indicated that sialochemical examination may provide a valuable help in the differential diagnosis of parotid diseases characterized by swelling of the gland. Chronic parotitis is characterized by a significantly decreased flow rate, extremely high sodium and protein concentration and lack of secretory response to stimulation. In Sjögren's syndrome the low flow rate was found to be associated with a decreased potassium secretion rate as well as decreased flow rate and decreased sodium concentration after stimulation. In sialosis, where flow rates display a considerable individual variation, a significant increase in potassium secretion rate could be revealed.
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Ben-Aryeh H, Nahir M, Scharf Y, Gutman D, Laufer D, Szargel R. Sialochemistry of patients with rheumatoid arthritis. Electrolytes, protein, and salivary IgA. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1978; 45:63-70. [PMID: 271289 DOI: 10.1016/0030-4220(78)90224-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sialochemistry was undertaken to detect subclinical involvement of salivary glands in patients with rheumatoid arthritis (RA). The concentrations of salivary sodium and IgA were significantly elevated in 24 percent of the RA patients. Eighty per cent of the patients with elevated sodium and IgA concentrations had keratoconjunctivitis sicca as well. No correlation between serum and salivary IgA levels was found. The results indicate that salivary sodium and IgA levels can be used for detection of subclinical salivary gland involvement and for follow-up of RA patients.
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Eneroth CM, Lind MG. Radiosialometry. 1. A method for evaluation of salivary gland disorders. Acta Otolaryngol 1976; 81:130-40. [PMID: 1251704 DOI: 10.3109/00016487609107487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The temporal course of the total 99Tcm40 acumulation in the parotoid glad after fast intravenous injection of the readionucleotide, is studied by examination with quantitative radiosialometry. The method adopted is based on the use of two collimated, symmetrically located and opposite placed NaI-detectors. The normal ranges of five evaluation parameters are obtained from a control material of 100 parotoid glands in 50 individuals without disorders of the parotoid glands. The reproducibility of these five evaluation parameters is estimated and the sensitivity and the detectability of the parameters as well as different sources of variation are discussed. Classification boundaries between normal and abnormal valves values are arbitrarily chosen form the normal ranges.
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