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Spyraki F, Maniewicz S, Mojon P, Müller F. A novel test for hyposalivation using a sugar cube. J Oral Rehabil 2024. [PMID: 38685706 DOI: 10.1111/joor.13715] [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: 11/22/2023] [Revised: 01/28/2024] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Hyposalivation is a highly prevalent condition in old persons. OBJECTIVES The aim of this study was to assess a novel tool for the diagnosis of hyposalivation using a sugar cube and to compare its reliability to other validated test methods. METHODS Five tests were performed: unstimulated salivary flow test by draining method (USFT), oral moisture device Mucus® (MCS), sugar cube test (SCT), stimulated salivary flow test by chewing gum (CG) and Saxon test (SX). The sugar cube test consisted in measuring the time needed to disintegrate a standard-sized sugar cube N°4 (5.6 g) placed beneath the tongue. Bivariate correlation analyses were performed. ROC curve analysis and the Youden Index were used to determine the cut-off value. Sensitivity and specificity were calculated according to the determined cut-off point. RESULTS A total of 121 participants were recruited, with an average age of 49.8 ± 18.2 years. The USFT was best correlated with the SCT. No correlation was found between SCT and the stimulated saliva tests (CG, SX) as well as the MCS test. According to the Youden index, 140 s is appropriate to diagnose hyposalivation. Sensitivity of .64 and specificity of .91 were found for SCT using USFT as gold standard. The mean subjective evaluation score of the SCT was 3.1 ± 1, significantly higher than USFT 2.6 ± 1.1 (p < .05). CONCLUSIONS The sugar cube test proved to be a useful method for assessing unstimulated salivation, reducing test execution time and causing less participant discomfort than the gold standard unstimulated salivary flow test.
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Affiliation(s)
- Foteini Spyraki
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Philippe Mojon
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
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Yan GLK, Tan MN, Wong ML, Tay CM, Allen PF. Functional Dentition, Chronic Periodontal Disease and Frailty in Older Adults-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:502. [PMID: 36612820 PMCID: PMC9819030 DOI: 10.3390/ijerph20010502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The likelihood of experiencing the impact of chronic disease rises with age, and cumulative functional deficits over time increase the risk of frailty in older adults. The exact causes of frailty are not clear, and research is needed to identify appropriate intervention measures to reduce risk of developing frailty in old age. OBJECTIVE To review the evidence on the relationship between frailty, dental status and chronic periodontitis and to determine if improvements in oral health of older adults can contribute to reversal of frailty. RESULTS The oral cavity is the entry point to the gastro-intestinal tract, and natural teeth facilitate efficient mastication of food prior to swallowing and subsequent digestion. The loss of natural teeth, which is gradual and cumulative over the life course, is associated with diminished nutritional intake, especially in older adults. Furthermore, chronic periodontitis has been postulated as a risk factor for frailty. The evidence supporting a strong relationship between oral health status and frailty is not clearcut. Cross sectional studies suggest an association with missing teeth and chronic periodontal inflammation. However, there are very few longitudinal studies and accordingly, it is not currently possible to claim a causal relationship. As yet, there is no evidence to suggest that improvements in oral health contribute to reversal of frailty. CONCLUSION Longitudinal studies with robust designs are required to better inform the relationship across functional dentition, chronic periodontitis and frailty in older adults.
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Affiliation(s)
- Gabriel Lee Keng Yan
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Mei Na Tan
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Mun Loke Wong
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Chong Meng Tay
- National University Centre for Oral Health, Singapore 119085, Singapore
| | - Patrick Finbarr Allen
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
- Department of Restorative Dentistry, Cork Dental School and Hospital, University College Cork, T12 DC4A Cork, Ireland
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3
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Assapattarapun V, Talungchit S, Jirawechwongsakul P, Taebunpakul P. Evaluation of Oral Dryness and the Salivary-flow Rate in Patients with Oral Lichen Planus. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2210130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives:
Oral lichen planus (OLP) is a common T-cell-mediated inflammatory oral mucosal disease. One of the complaints among OLP patients is xerostomia. However, the relationship between oral dryness and a decreased salivary-flow rate in these patients is not yet conclusive. So, we investigated oral dryness and the salivary-flow rate in OLP patients using various measurements.
Material and Methods:
Thirty OLP patients and 30 controls were included. The oral-dryness symptoms were collected using the Xerostomia Inventory (XI) and Bother Index (BI). The salivary-flow rate was measured using a Modified Schirmer Test (MST) and the spitting method. The clinical signs of dry mouth were determined by the clinical oral-dryness score (CODS). The Thongprasom score was used to evaluate the severity of OLP. The data were analyzed using the Mann-Whitney U test and Spearman’s rank correlation coefficient.
Results:
The XI score and BI score in the OLP group were significantly higher than in the control group. However, CODS, MST, the unstimulated salivary-flow rate, and the stimulated salivary-flow rate were not significantly different between the two groups. There was no correlation between oral dryness and the salivary-flow rate in OLP patients. The severity of OLP was also not correlated to oral dryness and the salivary-flow rate.
Conclusion:
OLP patients had more complaints about mouth dryness than the controls. However, the salivary-flow rates between the two groups were not different. Additionally, the severity of OLP was not related to dry mouth or the salivary-flow rate. The possible reasons for oral dryness among people with OLP require further investigation.
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Mulheren R, Westemeyer RM, Dietsch AM. The effect of taste on swallowing: A scoping and systematic review. Crit Rev Food Sci Nutr 2022; 64:1256-1282. [PMID: 36036968 DOI: 10.1080/10408398.2022.2115003] [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] [Indexed: 11/03/2022]
Abstract
Consuming foods and liquids for nutrition requires the coordination of several muscles. Swallowing is triggered and modified by sensory inputs from the aerodigestive tract. Taste has recently received attention as a potential modulator of swallowing physiology, function, and neural activation; additionally, taste impairment is a sequela of COVID-19. This review presents factors impacting taste and swallowing, systematically summarizes the existing literature, and assesses the quality of included studies. A search was conducted for original research including taste stimulation, deglutition-related measure(s), and human participants. Study design, independent and dependent variables, and participant characteristics were coded; included studies were assessed for quality and risk of bias. Forty-eight articles were included after abstract and full-text review. Synthesis was complicated by variable sensory components of stimuli (taste category and intensity, pure taste vs. flavor, chemesthesis, volume/amount, consistency, temperature), participant characteristics, confounding variables such as genetic taster status, and methods of measurement. Most studies had a high risk of at least one type of bias and were of fair or poor quality. Interpretation is limited by wide variability in methods, taste stimulation, confounding factors, and lower-quality evidence. Existing studies suggest that taste can modulate swallowing, but more rigorous and standardized research is needed.
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Affiliation(s)
- Rachel Mulheren
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ross M Westemeyer
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Angela M Dietsch
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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5
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de Sire A, Ferrillo M, Lippi L, Agostini F, de Sire R, Ferrara PE, Raguso G, Riso S, Roccuzzo A, Ronconi G, Invernizzi M, Migliario M. Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review. Nutrients 2022; 14:nu14050982. [PMID: 35267957 PMCID: PMC8912303 DOI: 10.3390/nu14050982] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. “Sarcopenic dysphagia” is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people’s ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (A.d.S.); (M.F.)
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (A.d.S.); (M.F.)
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy;
| | - Roberto de Sire
- Department of Clinical Medicine and Surgery, University Federico II of Naples, 80126 Naples, Italy;
| | - Paola Emilia Ferrara
- University Polyclinic Foundation Agostino Gemelli IRCSS, Catholic University of Sacred Heart, 00168 Rome, Italy; (P.E.F.); (G.R.)
| | - Giuseppe Raguso
- Department of Otolaryngology-Head and Neck Surgery, University of Verona, 37129 Verona, Italy;
| | - Sergio Riso
- Dietetic and Clinical Nutrition Unit, Maggiore della Carità Hospital, 28100 Novara, Italy;
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland;
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Gianpaolo Ronconi
- University Polyclinic Foundation Agostino Gemelli IRCSS, Catholic University of Sacred Heart, 00168 Rome, Italy; (P.E.F.); (G.R.)
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Mario Migliario
- Dental Clinic, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy;
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Lackner A, Bosch P, Zenz S, Horwath-Winter J, Rabensteiner DF, Hermann J, Graninger W, Stradner MH. Go Ask Your Patients! PSS-QoL Reported Perception of Dryness Correlates With Lacrimal and Salivary Flow in Primary Sjögren's Syndrome. Front Med (Lausanne) 2021; 8:660580. [PMID: 33937295 PMCID: PMC8081854 DOI: 10.3389/fmed.2021.660580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction/Objectives: The patient perspective is an essential outcome parameter in the quest for effective therapy in primary Sjögren's Syndrome (PSS). The EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) is recommended by EULAR to quantify patient's symptom burden and has been used in several clinical trials. Surprisingly, the patient's perception of dryness quantified with ESSPRI does not correlate with objective measures of salivary or lacrimal flow. Thus, we evaluated a newly developed assessment tool-the Primary Sjögren's Syndrome Quality of Life Questionnaire (PSS-QoL)-for quantifying symptoms of dryness in comparison with the ESSPRI and objective measurements of salivary and lacrimal flow. Methods: Data of patients from the PSS registry of the Medical University of Graz fulfilling the 2016 ACR/EULAR classification criteria for PSS were analyzed. The patient perspective was analyzed by PSS-QoL, ESSPRI, Xerostomia Inventory (XI) and Ocular Surface Disease Index (OSDI). Sicca signs were measured with Schirmer's test, unstimulated salivary flow test (USF) and stimulated salivary flow test (SSF). ESSDAI (EULAR Sjögren's Syndrome Disease Activity Index) and EGA (Evaluator Global Assessment, numeric rating scale from 0 to 10) were obtained. In addition, free light chains (FLC) κ and λ, rheumatoid factor (RF) IgM and IgA were determined. Results: Data from 123 PSS patients were analyzed; 91.9% (n = 113) were female, with a mean disease duration of 6.2 (±5.3) years and mean age of 60.1 (±12.4) years. PSS-QoL-dryness revealed significant negative correlations with Schirmer's test (r = -0.31, p < 0.05) and SSF-test (r = -0.390, p < 0.01). In contrast, we found no significant correlation between ESSPRI-dryness and any objective dryness test. Lower perceived dryness was associated with higher immunological activity determined by increased levels of IgG, FLC and RF-IgA. Whereas patients with only subjective signs of dryness had lower immunological activity. Discussion: Patients' perception of dryness assessed by PSS-QoL correlates with objective measurements of salivary gland function while ESSPRI-dryness did not. Based on the PSS-QoL and objective measures of dryness two distinct groups of PSS patients could be distinguished, which may have implications in daily practice and future clinical studies.
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Affiliation(s)
- Angelika Lackner
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Philipp Bosch
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Sabine Zenz
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | | | | | - Josef Hermann
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Winfried Graninger
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
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Dakovic D, Mladenovic R, Ristic L, Jevtovic R, Videnovic N, Bukumiric Z. Effectiveness of an intraoral thermoformed splint with magnet device in patients with xerostomia and hyposalivation: A pilot study. J Oral Pathol Med 2020; 50:244-250. [PMID: 33230828 DOI: 10.1111/jop.13141] [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: 09/06/2020] [Revised: 09/26/2020] [Accepted: 10/23/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim of the study was to examine the effectiveness of intraoral thermoformed splint with a magnet device over a period of 3 months, that is, to assess acceptability of this method of treatment using both objective and self-reported measures. MATERIALS AND METHODS This study was designed as a prospective clinical pilot trial. 22 patients with xerostomia and hyposalivation were included. Xerostomia was assessed using a 4-question xerostomia questionnaire score and a test for unstimulated salivary flow rates. Evaluations were performed before the treatment and 3 months after the treatment using a thermoformed splint with a magnet device. RESULTS There was a significant reduction in subjective symptoms after using a thermoformed splint with a magnet device for 3 months. For all 4 scored items, there was a statistically significant difference (P < .001) in median VAS scores before and 3 months after treatment. There was also a statistically significant difference in USFR before (0,15 ± 0,04 ml/min) and after treatment (0,24 ± 0,03 mL/min). CONCLUSION Our findings indicate that the use of this device alleviated oral dryness and stimulated the function of the submandibular salivary gland. An intraoral thermoformed splint with a magnet device is safe, physiologically indifferent, useful, and effective in treating xerostomia and hyposalivation.
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Affiliation(s)
- Dragana Dakovic
- Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Rasa Mladenovic
- Faculty of Medicine, University of Pristina, Kosovska Mitrovica, Serbia
| | - Ljubisa Ristic
- Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | | | - Nebojsa Videnovic
- Faculty of Medicine, University of Pristina, Kosovska Mitrovica, Serbia
| | - Zoran Bukumiric
- Institute of Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia
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8
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Huang SH, de Almeida JR, Watson E, Glogauer M, Xu W, Keshavarzi S, O'Sullivan B, Ringash J, Hope A, Bayley A, Bratman SV, Cho J, Giuliani M, Kim J, Waldron J, Spreafico A, Goldstein DP, Chepeha DB, Li T, Hosni A. Short-term and long-term unstimulated saliva flow following unilateral vs bilateral radiotherapy for oropharyngeal carcinoma. Head Neck 2020; 43:456-466. [PMID: 33058305 DOI: 10.1002/hed.26496] [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: 06/22/2020] [Revised: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND We aimed to compare unstimulated saliva flow using 3-minute modified Schirmer test (MST) following bilateral vs unilateral radiotherapy (RT) in oropharyngeal carcinoma (OPC). METHODS We reviewed OPC patients treated with definitive intensity-modulated radiation therapy (IMRT) between 2011 and 2017. MST was measured at baseline, 1-/6-/12-/24-month post-RT. MST values were compared between bilateral-RT vs unilateral-RT groups. Multivariable logistic regression analysis (MVA) identified predictors of hyposalivation (MST < 25 mm). RESULTS Total 498 bilateral-RT and 36 unilateral-RT patients were eligible. The MST values at 1-/6-/12-/24-month post-RT were all significantly reduced from baseline for the entire cohort. Baseline unilateral-RT and bilateral-RT MST values (in mm) were similar (P = .2), but much higher for unilateral-RT 1-month (mean: 19.1 vs 13.0, P = .03), 6-month (20.5 vs 9.3, P < .001), 12-month (20.1 vs 11.9, P < .01), and 24-month post-RT (22.2 vs 13.9, P = .04). MVA confirmed that unilateral RT reduced the likelihood of hyposalivation vs bilateral RT (OR 2.36, P = .006). CONCLUSION Unilateral RT reduces unstimulated salivary flow in OPC patients.
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Affiliation(s)
- Shao Hui Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Erin Watson
- Department of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Michael Glogauer
- Department of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
| | - Sareh Keshavarzi
- Department of Biostatistics, Princess Margaret Cancer Centre / University of Toronto, Toronto, Ontario, Canada
| | - Brian O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Andrew Hope
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Andrew Bayley
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Scott V Bratman
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - John Cho
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Meredith Giuliani
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - John Kim
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - John Waldron
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Anna Spreafico
- Department of Medical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Douglas B Chepeha
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Tong Li
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
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Zanin MC, Garcia DM, Rocha EM, de Felício CM. Orofacial Motor Functions and Temporomandibular Disorders in Patients With Sjögren's Syndrome. Arthritis Care Res (Hoboken) 2020; 72:1057-1065. [PMID: 31207153 DOI: 10.1002/acr.24001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 06/11/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Sjögren's syndrome (SS) induces difficulty in chewing and swallowing due to low salivary flow. However, these symptoms may be associated with other factors, such as orofacial myofunctional disorders and temporomandibular disorder (TMD), which have not been comprehensively assessed in this population. The aims of this study were to investigate orofacial muscles and functions as well as the presence of TMD in patients with SS compared with a group without SS and to analyze whether the patients' experience of limitations in orofacial functioning is associated with the orofacial functional status and muscle pain related to TMD. METHODS Women with SS based on the 2002 American-European Consensus Group criteria and volunteers paired by age and sex were compared. The examinations included the orofacial myofunctional evaluation with scores (OMES) protocol, tongue and lip strength measures, and electromyography of the masticatory muscles. TMD investigations included clinical examination, self-report of symptoms, and assessment according to the Jaw Functional Limitation Scale. RESULTS Patients with SS present with impaired muscle and orofacial functions based on lower scores of all categories of OMES (P < 0.0001), tongue strength (P = 0.0003-0.0004), and masticatory muscle activity (P = 0.0002-0.007), as well as worse TMD signs and symptoms (P < 0.05) and jaw functional limitation (P < 0.0001-0.0003). CONCLUSION Patients' experiences with limitation in mastication and swallowing were associated with orofacial myofunctional status and muscle pain related to TMD. Those disorders should be monitored along with disease control and must be addressed in the clinical evaluation to prevent nutritional and metabolic comorbidities in patients with SS.
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10
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Letawsky VH, Schreiber AM, Skoretz SA. A Tutorial on Saliva's Role in Swallowing With a Focus on Sjögren's Syndrome. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1307-1319. [PMID: 32531172 DOI: 10.1044/2020_ajslp-19-00083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Saliva is integral to swallowing and necessary for oral health. Understanding saliva's origin and properties is important for swallowing assessment and management. Diseases such as Sjögren's syndrome (SS) can affect saliva negatively, often contributing to dysphagia. Our objectives are to (a) highlight saliva's fundamental role in swallowing, (b) provide a bibliometric overview of literature pertaining to SS pathophysiology and effects on saliva, (c) explore implications of salivary changes on swallowing and quality of life in SS and other populations, and (d) provide suggestions for systematic saliva assessment in practice. Method This tutorial reviews saliva production, composition, and involvement in swallowing within health and disease. Using rapid review methodology, we outline the effect of SS on saliva and describe SS etiology, diagnosis, and treatment. We discuss formal saliva assessments and a multidisciplinary approach. Results Saliva plays a vital role in swallowing, particularly lubrication, bolus formation, and oral health. SS affects the salivary glands altering salivary flow rate and composition. We identified 55 studies (N) measuring salivary changes, grouping them according to four strata demarcated by SS classification criteria updates. For some, xerostomia, dysphagia, and reduced life quality result. Formal saliva assessments include the Clinical Oral Dryness Score, Xerostomia Inventory, and Secretion Rating Scale. Multidisciplinary care is optimal for patients with salivary changes. Conclusion Understanding salivary changes in disease may enhance understanding of swallowing and inform dysphagia practice. Expanding swallowing assessments with formal saliva evaluations, and patient perspectives thereof, may aid in developing bespoke treatments, ultimately improving outcomes and quality of life. Supplemental Material https://doi.org/10.23641/asha.12456449.
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Affiliation(s)
- Veronica H Letawsky
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
| | - Ann-Marie Schreiber
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
| | - Stacey A Skoretz
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
- Department of Critical Care Medicine, University of Alberta, Edmonton, Canada
- Centre for Heart Lung Innovation, St. Paul's Hospital, Providence Health Care, Vancouver, Canada
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11
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Risk factors for caries development in primary Sjogren syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:117-122. [DOI: 10.1016/j.oooo.2019.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/25/2019] [Accepted: 04/20/2019] [Indexed: 01/21/2023]
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12
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Yoshimoto RU, Aijima R, Ohyama Y, Yoshizumi J, Kitsuki T, Ohsaki Y, Cao AL, Danjo A, Yamashita Y, Kiyoshima T, Kido MA. Impaired Junctions and Invaded Macrophages in Oral Epithelia With Oral Pain. J Histochem Cytochem 2018; 67:245-256. [PMID: 30452872 DOI: 10.1369/0022155418812405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Recurrent or chronic oral pain is a great burden for patients. Recently, the links between epithelial barrier loss and disease were extended to include initiation and propagation. To explore the effects of pathohistological changes in oral epithelia on pain, we utilized labial mucosa samples in diagnostic labial gland biopsies from patients with suspected Sjögren's syndrome (SS), because they frequently experience pain and discomfort. In most labial mucosa samples from patients diagnosed with SS, disseminated epithelial cellular edema was prevalent as ballooning degeneration. The disrupted epithelia contained larger numbers of infiltrating macrophages in patients with oral pain than in patients without pain. Immunohistochemistry revealed that edematous areas were distinct from normal areas, with disarranged cell-cell adhesion molecules (filamentous actin, E-cadherin, β-catenin). Furthermore, edematous areas were devoid of immunostaining for transient receptor potential channel vanilloid 4 (TRPV4), a key molecule in adherens junctions. In an investigation on whether impaired TRPV4 affect cell-cell adhesion, calcium stimulation induced intimate cell-cell contacts among oral epithelial cells from wild-type mice, while intercellular spaces were apparent in cells from TRPV4-knockout mice. The present findings highlight the relationship between macrophages and epithelia in oral pain processing, and identify TRPV4-mediated cell-cell contacts as a possible target for pain treatment.
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Affiliation(s)
- Reiko U Yoshimoto
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Section of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Division of Histology and Neuroanatomy, Department of Anatomy and Physiology, Faculty of Medicine, Saga University, Saga, Japan
| | - Reona Aijima
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Yukiko Ohyama
- Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Junko Yoshizumi
- Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan
| | - Tomoko Kitsuki
- Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yasuyoshi Ohsaki
- Division of Histology and Neuroanatomy, Department of Anatomy and Physiology, Faculty of Medicine, Saga University, Saga, Japan
| | - Ai-Lin Cao
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Division of Histology and Neuroanatomy, Department of Anatomy and Physiology, Faculty of Medicine, Saga University, Saga, Japan
| | - Atsushi Danjo
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Yoshio Yamashita
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Tamotsu Kiyoshima
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Mizuho A Kido
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Division of Histology and Neuroanatomy, Department of Anatomy and Physiology, Faculty of Medicine, Saga University, Saga, Japan
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Heydarirad G, Rezaeizadeh H, Choopani R, Mosavat SH, Ameri A. Efficacy of a traditional Persian medicine preparation for radiation-induced xerostomia: a randomized, open-label, active-controlled trial. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 15:201-208. [PMID: 28494850 DOI: 10.1016/s2095-4964(17)60333-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Xerostomia is one of the most common side effects of radiation therapy among patients with head and neck cancers (HNC). However, conventional medicine lacks an effective treatment for radiation-induced xerostomia. OBJECTIVE Synthesizing the traditional use of Alcea digitata and Malva sylvestris with their known beneficial effects from recent studies, we evaluated the efficacy of the herbs in the quality of life (QOL) of HNC patients with radiation-induced xerostomia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS This study is a randomized, double-arm, open-label active-controlled clinical trial. We evaluated the effect of A. digitata and M. sylvestris on QOL of HNC patients with radiation-induced xerostomia compared with Hypozalix (artificial saliva). Patients were enrolled from the Imam Hossein Hospital's oncology clinic in Shahid Beheshti University of Medical Sciences, Tehran, Iran. MAIN OUTCOME MEASURES Primary outcome measures in this trial were changes in patients' QOL assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Head and Neck Module (EORTC QLQ-H&N 35). RESULTS Between-group analysis showed that the intervention group patients obtained significantly lower (better) total EORTC QLQ-H&N 35 scores as compared to the control group at the end of the intervention period (P = 0.007). Mean scores of dry mouth of EORTC QLQ-H&N 35 was also significantly lower (better) in the intervention group as compared to the control group (P = 0.017). CONCLUSION Traditional Persian medicine preparation of hollyhocks and common mallow should be considered as a suitable treatment for xerostomia and improving QOL in HNC patients with radiation-induced xerostomia. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov with Identifier: NCT02854358.
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Affiliation(s)
- Ghazaleh Heydarirad
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran 15167-45811, Iran
| | - Hossein Rezaeizadeh
- Department of Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Science, Tehran 16687-53961, Iran
| | - Rasool Choopani
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran 15167-45811, Iran
| | - Seyed Hamdollah Mosavat
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz 71356-44144, Iran.,Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz 71356-44144, Iran
| | - Ahmad Ameri
- Department of Radiation Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran 19946-15611, Iran
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14
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Multivariable model for predicting acute oral mucositis during combined IMRT and chemotherapy for locally advanced nasopharyngeal cancer patients. Oral Oncol 2018; 86:266-272. [PMID: 30409311 DOI: 10.1016/j.oraloncology.2018.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/25/2018] [Accepted: 10/05/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION/OBJECTIVE Oral and oropharyngeal mucositis (OM) represents amultifactorialand complexinterplayof patient-, tumor-, and treatment-related factors. We aimed to build a predictive model for acute OM for locally advanced nasopharyngeal carcinoma (NPC) patients by combining clinical and dosimetric factors. MATERIALS/METHODS A series of consecutive NPC patients treated curatively with IMRT/VMAT + chemotherapy at 70 Gy (2-2.12 Gy/fr) was considered. For each patient, clinical- tumor- and treatment-related data were retrospectively collected. oral cavity (OC) and parotid glands (PG, considered as a single organ) were selected as organs-at-risk (OARs). Acute OM was assessed according to CTCAE v4.0 at baseline and weekly during RT. Two endpoints were considered: grade ≥3 and mean grade ≥1.5. DVHs were reduced to Equivalent Uniform Dose (EUD). Dosimetric and clinical/treatment features selected via LASSO were inserted into a multivariable logistic model. Goodness of fit was evaluated through Hosmer-Lemeshow test and calibration plot. RESULTS Data were collected for 132 patients. G ≥ 3 and mean G ≥ 1.5 OM were reported in 40 patients (30%). Analyses resulted in a 3-variables model for G ≥ 3 OM, including OC EUD with n = 0.05 (OR = 1.02), PG EUD with n = 1 (OR = 1.06), BMI ≥ 30 (OR = 3.8, for obese patients), and a single variable model for mean G ≥ 1.5 OM, i.e. OC EUD with n = 1 (mean dose) (OR = 1.07). Calibration was good in both cases. CONCLUSION OC mean dose was found to impact most on OM duration (mean G ≥ 1.5), while G ≥ 3 OM was associated to a synergic effect between PG mean dose and high dose received by small OC volumes, with BMI acting as a dose-modifying factor.
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15
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Jager DHJ, Bots CP, Forouzanfar T, Brand HS. Clinical oral dryness score: evaluation of a new screening method for oral dryness. Odontology 2018; 106:439-444. [PMID: 29356914 PMCID: PMC6153998 DOI: 10.1007/s10266-018-0339-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 01/20/2023]
Abstract
The purpose of this study was to explore the association of the clinical oral dryness score (CODS) with salivary flow rates, xerostomia inventory (XI), and bother index (BI). 147 patients were screened using CODS, which determined 10 features of oral dryness. Each feature contributed 1 point, and the total score varied from 0 to 10. Unstimulated (UWS), chewing-stimulated (CH-SWS) and acid-stimulated (A-SWS) whole salivary flows and the XI and BI were measured. Associations were explored with a bootstrapped Spearman rank correlation test (1000 × bootstrapping). Based on unstimulated salivary flow, 55 patients were classified as hyposalivators, 31 as low salivators, 48 as normosalivators and 13 as high salivators. Median CODS in the hyposalivation group was 5 (IQR 3–6) compared with 3 (IQR 2–5) in the low salivation group, 2 (IQR 1–4) in the normal salivation group and 2 (IQR 1–2.5) in the high salivation group. Significant associations between CODS and the other parameters were only found in the hyposalivation group between CODS and UWS (ρ(53) = − 0.513; p < 0.01), between CODS and CH-SWS (ρ(53) = − 0.453; p < 0.01), between CODS and A-SWS (ρ(53) = − 0.500; p < 0.01), CODS and XI (ρ(53) = 0.343; p < 0.001) and between CODS and BI (ρ(53) = 0.375; p = 0.01). In patients with hyposalivation, CODS is associated with unstimulated and stimulated salivary flow and XI and BI. CODS alone or a combination of CODS with a subjective measure, such as the XI or BI, could be recommended during routine clinical assessment to detect hyposalivation.
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Affiliation(s)
- Derk H Jan Jager
- Department of Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam Movement Sciences, Boelelaan 1118, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. .,Department of Oral Health Sciences, KU Leuven & University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
| | - Casper P Bots
- Dutch Institute for Salivary Research, Tuinfluiter 5, 3752 NA, Bunschoten, The Netherlands
| | - Tim Forouzanfar
- Department of Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam Movement Sciences, Boelelaan 1118, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Henk S Brand
- Department of Maxillofacial Surgery and Oral Pathology, VU University Medical Center, Amsterdam Movement Sciences, Boelelaan 1118, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Oral Biochemistry, Academic Center for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
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16
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Assessment of Microbial Growth and Salivary pH in Patients Wearing Fixed Partial Denture. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2017. [DOI: 10.22207/jpam.11.4.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Bezzina OM, Gallagher P, Mitchell S, Bowman SJ, Griffiths B, Hindmarsh V, Hargreaves B, Price EJ, Pease CT, Emery P, Lanyon P, Bombardieri M, Sutcliffe N, Pitzalis C, Hunter J, Gupta M, McLaren J, Cooper AM, Regan M, Giles IP, Isenberg DA, Saravanan V, Coady D, Dasgupta B, McHugh NJ, Young-Min SA, Moots RJ, Gendi N, Akil M, MacKay K, Ng WF, Robinson LJ. Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome: Capturing the Discrepancy. Arthritis Care Res (Hoboken) 2017; 69:1714-1723. [PMID: 27992710 PMCID: PMC5698764 DOI: 10.1002/acr.23165] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/06/2016] [Indexed: 12/26/2022]
Abstract
Objective To develop a novel method for capturing the discrepancy between objective tests and subjective dryness symptoms (a sensitivity scale) and to explore predictors of dryness sensitivity. Methods Archive data from the UK Primary Sjögren's Syndrome Registry (n = 688) were used. Patients were classified on a scale from −5 (stoical) to +5 (sensitive) depending on the degree of discrepancy between their objective and subjective symptoms classes. Sensitivity scores were correlated with demographic variables, disease‐related factors, and symptoms of pain, fatigue, anxiety, and depression. Results Patients were on average relatively stoical for both types of dryness symptoms (mean ± SD ocular dryness −0.42 ± 2.2 and −1.24 ± 1.6 oral dryness). Twenty‐seven percent of patients were classified as sensitive to ocular dryness and 9% to oral dryness. Hierarchical regression analyses identified the strongest predictor of ocular dryness sensitivity to be self‐reported pain and that of oral dryness sensitivity to be self‐reported fatigue. Conclusion Ocular and oral dryness sensitivity can be classified on a continuous scale. The 2 symptom types are predicted by different variables. A large number of factors remain to be explored that may impact symptom sensitivity in primary Sjögrenʼs syndrome, and the proposed method could be used to identify relatively sensitive and stoical patients for future studies.
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Affiliation(s)
- Oriana M Bezzina
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Peter Gallagher
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Sheryl Mitchell
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Simon J Bowman
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Bridget Griffiths
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Victoria Hindmarsh
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ben Hargreaves
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Elizabeth J Price
- Great Western Hospitals NHS Foundation Trust, Swindon, Wiltshire, UK
| | - Colin T Pease
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Peter Lanyon
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Michele Bombardieri
- Barts and the London NHS Trust and Barts and the London School of Medicine and Dentistry, London, UK
| | | | - Costantino Pitzalis
- Barts and the London NHS Trust and Barts and the London School of Medicine and Dentistry, London, UK
| | - John Hunter
- Gartnavel General Hospital, Glasgow, Scotland
| | | | | | - Anne M Cooper
- Royal Hampshire County Hospital, Winchester and Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | | | - Ian P Giles
- University College London Hospitals NHS Foundation Trust, London, UK
| | - David A Isenberg
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | | | - Neil J McHugh
- Royal National Hospital for Rheumatic Diseases, Bath, UK
| | | | | | | | | | | | - W Fai Ng
- Musculoskeletal Research Group, Institute of Cellular Medicine & Newcastle NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle University, and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Lucy J Robinson
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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18
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Veerabhadrappa SK, Chandrappa PR, Patil S, Roodmal SY, Kumarswamy A, Chappi MK. Evaluation of Xerostomia in Different Psychological Disorders: An Observational Study. J Clin Diagn Res 2016; 10:ZC24-ZC27. [PMID: 27790574 DOI: 10.7860/jcdr/2016/19020.8437] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/19/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Psychiatric diseases like anxiety, depression, schizophrenia and bipolar disorders are increasing at an alarming rate. These diseases can affect the quantity and quality of saliva leading to multiple oral diseases. Although many researchers have evaluated xerostomia in general population, its prevalence is not been assessed in patients suffering from different psychological disorders. AIM To investigate the prevalence of xerostomia and to assess the correlation between xerostomia and dryness of lip and mucosa in different psychological disorders. MATERIALS AND METHODS A cross-sectional observational study was conducted over a period of six months in Department of Psychiatry and Department of Oral Medicine. Patients with anxiety, depression, schizophrenia and bipolar disorder, as diagnosed by an experienced psychiatrist, were given a questionnaire to evaluate the xerostomia. Patients with symptoms of xerostomia were subjected to oral examination by a skilled oral diagnostician to check for dryness of lips and mucosa. One hundred patients from each group of psychiatric diseases were included in the study using a consecutive sampling technique. An equal number of healthy individuals reporting to oral medicine department for routine oral screening were included as control group after initial psychiatric evaluation. RESULTS In this study statistically significant increase in the xerostomia in psychiatric patients was recorded when compared to the control group (p<0.01). Xerostomia was significantly higher in anxiety patients (51%) followed by depression (47%), bipolar disorder (41%), schizophrenia (39%) and control group (27%). The majority of the psychiatric patients had 'moderate' to 'severe' xerostomia whereas the control group had 'mild' xerostomia. Xerostomia was significantly higher in younger age group (18-49 years) than in older age group and females patients had higher xerostomia than male patients. Psychiatric patients had significantly more dryness of lip and mucosa than healthy controls. A moderate to strong spearman correlation (r=0.72) was observed between xerostomia and psychological alterations. CONCLUSION A positive association was established between psychological alterations and xerostomia and dryness of lip and mucosa. Emotional alterations may act as a precipitating factor that could influence the salivary secretion resulting in multiple oral diseases. Psychiatrists can screen for xerostomia and collaborate with dentists for comprehensive management of xerostomia in psychiatric patients.
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Affiliation(s)
- Suresh Kandagal Veerabhadrappa
- Lecturer, SEGi University , No. 9, Jalan Teknologi, Taman Sains, Petaling Jaya, Kota Damansara, Selangor - 47810, Malaysia
| | - Pramod Redder Chandrappa
- Senior Lecturer, Department of Oral Pathology and Microbiology, College of Dental Sciences , Davangere, Karnataka, India
| | - Snehal Patil
- Assistant Professor, Department of Public Health Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University , Karad, Satara, Maharashtra, India
| | - Seema Yadav Roodmal
- Post graduate student, Department of Periodontology, Mahatma Gandhi Mission's Dental College and Hospital , Sector 1, Kamothe, Navi Mumbai, Maharashtra, India
| | - Akshay Kumarswamy
- Interim Chair Division of Periodontics, East Carolina University School of Dental Medicine , 1851 Macgregor Downs Rd, Mail Stop 701, Greenville NC 27834, USA
| | - Mounesh Kumar Chappi
- Reader, Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University , Karad, Satara, Maharashtra, India
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19
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Nejaim Y, I V Silva A, V Vasconcelos T, J N L Silva E, M de Almeida S. Evaluation of radioprotective effect of aloe vera and zinc/copper compounds against salivary dysfunction in irradiated rats. J Oral Sci 2016; 56:191-4. [PMID: 25231144 DOI: 10.2334/josnusd.56.191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this study was to evaluate the radioprotective and reparative effects of compounds based on aloe vera, zinc, and copper against salivary gland dysfunction in Wistar rats. A total of 150 Wistar rats were randomly divided into 12 groups, in which the animals received aloe vera and/or zinc and copper. In eight of these groups the animals were also subjected to irradiation before or after administration of the substances. After 27 days, sialometry tests were performed. Data were analyzed using ANOVA and the Tukey test (P < 0.05). Rats that had been administered aloe vera before or after irradiation showed a significantly higher salivary flow rate than rats that had been simply irradiated. When both substances were administered, a statistically significant difference in the salivary flow rate was observed in comparison with the irradiation alone group seven days after irradiation. The present results suggest that aloe vera exerts positive protective and reparative effects, and can be considered a potential radioprotective substance.
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Affiliation(s)
- Yuri Nejaim
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas
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20
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The effect of clinical setting on the unstimulated salivary flow rate. Arch Oral Biol 2016; 69:7-12. [PMID: 27187143 DOI: 10.1016/j.archoralbio.2016.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/20/2016] [Accepted: 05/02/2016] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Unstimulated whole saliva (UWS) sialometry uses the spitting method to assess occurrence of hyposalivation. This study compares the UWS flow rates in volunteers sitting in a laboratory or in a clinical setting, in order to evaluate the influence of environment on salivary secretion. DESIGN 25 healthy volunteers were recruited and divided into two groups to perform UWS sialometry under the two different settings (T1). Eleven weeks later, the participants repeated the same test (T2). At a unique time point and under the clinical setting, 18 patients complaining of xerostomia also performed the UWS sialometry; these values were used as control to corroborate findings. RESULTS Different scenarios - laboratory one vs. clinical one - did not affect measurements of mean UWS flow rates. Both intra- and inter-individual variabilities, reported as standard error of the mean (SEM) and within-subject variance (WSV), resulted below the threshold of 0.1g/min. A significant difference was found between UWS flow rates from healthy volunteers and those from patients with xerostomia (p<0.05). Test/retest reliability showed a moderate correlation of datasets collected at the two time points from healthy volunteers (T1 vs. T2, 11 weeks later): under laboratory and clinical settings, Pearson's coefficients of correlation were r=0.62 and r=0.32, respectively. CONCLUSIONS Type of environment did not influence UWS sialometry via spitting method, which appeared reliable for intra-day analysis of the salivary flow rate, although prone to physiological variations over time.
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Aliko A, Wolff A, Dawes C, Aframian D, Proctor G, Ekström J, Narayana N, Villa A, Sia YW, Joshi RK, McGowan R, Beier Jensen S, Kerr AR, Lynge Pedersen AM, Vissink A. World Workshop on Oral Medicine VI: clinical implications of medication-induced salivary gland dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:185-206. [DOI: 10.1016/j.oooo.2014.10.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/12/2014] [Indexed: 10/23/2022]
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22
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Deep neck infections originating from the major salivary glands. Am J Otolaryngol 2015; 36:559-64. [PMID: 25630849 DOI: 10.1016/j.amjoto.2015.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 01/06/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Before the widespread use of antibiotics, most deep neck infections (DNIs) stemmed from complicated pharyngeal infections. Nowadays, they seem to be due mainly to dental infections. In 2010, our group reported that DNIs originated from a major salivary gland in 14% of cases. The main endpoint of the present investigation was to review our experience of the diagnosis and treatment of DNIs of salivary gland origin. We also compared the characteristics of DNIs originating from salivary glands with those originating elsewhere. METHODS Between 2000 and 2011, 44 patients were treated for DNIs of salivary origin at our institution. These patients were compared with 191 cases of DNI diagnosed as having other sites of origin. RESULTS/CONCLUSIONS In the present series, DNIs originating from a major salivary gland accounted for 19% of all cases of DNI of known origin. Patients with DNI of salivary gland origin were more likely to be elderly than those whose DNI originated from elsewhere (p=0.000). Our multivariate statistical model showed that comorbidities (p=0.051, statistical trend) and the need for surgical treatment (p=0.028) independently predicted long-term hospitalization for DNIs originating from a major salivary gland.
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Fox NF, Xiao C, Sood AJ, Lovelace TL, Nguyen SA, Sharma A, Day TA. Hyperbaric oxygen therapy for the treatment of radiation-induced xerostomia: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:22-8. [DOI: 10.1016/j.oooo.2015.03.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/09/2015] [Accepted: 03/11/2015] [Indexed: 01/07/2023]
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24
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Villa A, Wolff A, Aframian D, Vissink A, Ekström J, Proctor G, McGowan R, Narayana N, Aliko A, Sia YW, Joshi RK, Jensen SB, Kerr AR, Dawes C, Pedersen AML. World Workshop on Oral Medicine VI: a systematic review of medication-induced salivary gland dysfunction: prevalence, diagnosis, and treatment. Clin Oral Investig 2015; 19:1563-80. [DOI: 10.1007/s00784-015-1488-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 05/04/2015] [Indexed: 01/12/2023]
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Lapiedra RC, Gómez GE, Sánchez BP, Pereda AA, Turner MD. The Effect of a Combination Saliva Substitute for the Management of Xerostomia and Hyposalivation. J Maxillofac Oral Surg 2015. [PMID: 26225058 DOI: 10.1007/s12663-015-0752-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the difference between the combination agent of xylitol, beatine and olive oil in a chewable capsule versus the control agent of a sorbitol tablet in subjects with hyposalivation and xerostomia. MATERIALS AND METHODS The subjects had xerostomia over 3 months and a measured hyposalivation. The study was 3 weeks in duration, with 2 treatment phases of 1 week and a 7 day wash out period in between. At the end of each treatment phase, subjects returned for a follow up evaluation. At this visit they were given the subjective sensation questionnaire, as well as their unstimulated whole salivary flow and stimulated whole salivary flow were measured. RESULTS There was a greater increase in the unstimulated and stimulated whole salivary flow rate, although the results were not statistically significant. The subjective evaluation as measured by the questionnaire showed that both agents reduced the mean score as compared to the baseline, although only the findings in the active agent was statistically significant (p = 0.0015). CONCLUSION The significant conclusions found in this study were that the active agent provided a significant subjective improvement in speech, swallowing, and decreased subjective xerostomia as compared to the control tablet. CLINICAL RELEVANCE This combination agent has a significant effect on patients with subjective xerostomia but does not have a significant effect on objective hyposalivation.
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Affiliation(s)
- R C Lapiedra
- Department of Oral Medicine & Orofacial Surgery, University Complutense of Madrid, Madrid, Spain
| | - G E Gómez
- Department of Oral Medicine & Orofacial Surgery, University Complutense of Madrid, Madrid, Spain
| | - B P Sánchez
- Department of Oral Medicine & Orofacial Surgery, University Complutense of Madrid, Madrid, Spain
| | | | - M D Turner
- Division of Oral and Maxillofacial Surgery, NY Center for Salivary Gland Diseases, Mount Sinai Beth Israel Medical Center NY, New York, NY USA
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Han P, Suarez-Durall P, Mulligan R. Dry mouth: A critical topic for older adult patients. J Prosthodont Res 2015; 59:6-19. [DOI: 10.1016/j.jpor.2014.11.001] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 11/05/2014] [Indexed: 11/24/2022]
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Dyasanoor S, Saddu SC. Association of Xerostomia and Assessment of Salivary Flow Using Modified Schirmer Test among Smokers and Healthy Individuals: A Preliminutesary Study. J Clin Diagn Res 2014; 8:211-3. [PMID: 24596777 DOI: 10.7860/jcdr/2014/6650.3846] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 10/19/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Several oral diseases such as dental caries, periodontitis and oral infections can be a major concern in patients suffering from mouth dryness. Whole mouth salivary flow is affected by many factors which may include habits like smoking. The aim of the present study was to investigate the incidence of xerostomia and hyposalivation among smokers. MATERIALS AND METHODS The study groups included 60 smokers and 60 healthy non-tobacco users as case and control groups respectively. A questionnaire was used to collect the smoking habits and symptoms associated with xerostomia. Measurement of unstimulated whole mouth salivary flow for 3 minutesutes was performed using modified Schirmer test. The results were subjected to statistical analysis. RESULTS The prevalence of xerostomia symptom was 37% in smokers and it was 13% in non-smokers, with a statistically significant difference between groups (p=0.003). The prevalence of hyposalivation was 43% in smokers, whereas it was only 8% in the control group (p< 0.001). CONCLUSION Xerostomia symptoms with significant reduction in unstimulated whole mouth salivary flow were associated with long term smoking.
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Affiliation(s)
- Sujatha Dyasanoor
- Professor, Department of Oral Medicine and Radiology, The Oxford Dental College, Hospital and Research Centre , Bommanahalli, Hosur road, Bangalore-560068, Karnataka, India
| | - Shweta Channavir Saddu
- Post Graduate, Department of Oral Medicine and Radiology, The Oxford Dental College, Hospital and Research Centre , Bommanahalli, Hosur road, Bangalore-560068, Karnataka, India
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Pastana SDG, Cantisano MH, Bianchini EMG. Queixas fonoaudiológicas e verificação da fala de indivíduos com diagnóstico de ardência bucal e xerostomia. AUDIOLOGY - COMMUNICATION RESEARCH 2013. [DOI: 10.1590/s2317-64312013000400017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Investigar as queixas das funções orais em presença dos sintomas de ardência e secura bucal e analisar as alterações da fala em seu aspecto articulatório. MÉTODOS: Foram avaliados 66 indivíduos com idade entre 30 e 78 anos, divididos em três grupos: grupo ardência bucal, grupo xerostomia e grupo sem sintomas bucais. Foram realizadas entrevistas, exame clínico da cavidade oral e gravação da fala, com utilização de fichário evocativo. RESULTADOS: A característica comum nos dois primeiros grupos foi a presença do sintoma de secura bucal. Na localização dos sintomas, o grupo xerostomia apresentou maior quantidade de estruturas afetadas pelo sintoma. As queixas mais referidas por esse grupo foram cansaço e força na fala e força e engasgos à deglutição. A queixa de força foi significativa, na comparação com grupo de ardência bucal, com aumento do sintoma provocado pela função de fala. Dos sujeitos que se queixaram de boca seca, como sintoma principal, ou associado, a maioria apresentou ruídos durante a fala. O grupo xerostomia apresentou maior ocorrência desse ruído. Não foram evidenciadas alterações fonéticas nos grupos de sintomas bucais. CONCLUSÃO: Das queixas envolvendo as funções orais, falar e deglutir com força foram as mais referidas pelos indivíduos do grupo xerostomia. Observou-se a presença de estalidos na fala da maioria dos sujeitos com o sintoma de secura bucal. Apesar das sintomatologias apresentadas e do número de estruturas orais afetadas, não houve evidência de alteração fonética nos indivíduos com sintomas bucais.
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van der Putten GJ, De Visschere L, van der Maarel-Wierink C, Vanobbergen J, Schols J. The importance of oral health in (frail) elderly people – a review. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
Sjögren's syndrome (SjS) is one of the most common autoimmune rheumatic diseases, clinically characterized by xerostomia and keratoconjunctivitis sicca. We investigated the following controversial topics: (i) Do we have reliable ways of assessing saliva production? (ii) How important are the quantity and quality of saliva? (iii) Are only anti-SSA/Ro and anti-SSB/La relevant for the diagnosis of SjS? (iv) Are the American-European Consensus criteria (AECC) the best way to diagnose SjS? Results from literature searches suggested the following: (i) Despite the fact that numerous tests are available to assess salivation rates, direct comparisons among them are scarce with little evidence to suggest one best test. (ii) Recent developments highlight the importance of investigating the composition of saliva. However, more research is needed to standardize the methods of analysis and collection and refine the quality of the accumulating data. (iii) In addition to anti-Ro/La autoantibodies, anti α-fodrin IgA and anti-MR3 autoantibodies seem to be promising diagnostic markers of SjS, but more studies are warranted to test their sensitivity and specificity. (iv) AECC are classification, not diagnostic criteria. Moreover, recent innovations have not been incorporated into these criteria. Consequently, treatment directed to patients diagnosed using the AECC might exclude a significant proportion of patients with SjS.
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Affiliation(s)
- D J Aframian
- Salivary Gland Clinic and Saliva Diagnostic Laboratory, Department of Oral Medicine, Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
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Deboni ALDS, Giordani AJ, Lopes NNF, Dias RS, Segreto RA, Jensen SB, Segreto HRC. Long-term oral effects in patients treated with radiochemotherapy for head and neck cancer. Support Care Cancer 2012; 20:2903-11. [DOI: 10.1007/s00520-012-1418-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Accepted: 02/14/2012] [Indexed: 11/24/2022]
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van der Putten GJ, Brand HS, De Visschere LMJ, Schols JMGA, de Baat C. Saliva secretion rate and acidity in a group of physically disabled older care home residents. Odontology 2011; 101:108-15. [DOI: 10.1007/s10266-011-0054-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 11/10/2011] [Indexed: 11/28/2022]
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Abstract
Dry mouth can be caused by medication, CPAP use, radiation treatment and a variety of connective tissue diseases, with the prevalence increasing with age. In most individuals, daytime dryness is easily managed. However, except for a new product tested in this study, there is no product lasting longer than an hour that can be used at night to reduce the perception of oral dryness while sleeping. The purpose of this study was to assess whether a self-adhering, slowly dissolving disc that time-releases 500 mg of xylitol, cellulose gum (lubricant and humectant) and mild mint flavour (XyliMelts for Dry Mouth, OraHealth Corp.) used during sleep would reduce perceived morning oral dryness and discomfort. Fifteen subjects self-identified as having morning oral dryness were evaluated first without treatment and again with the use of XyliMelts for Dry Mouth. Measures of initial morning discomfort and perceived wetness demonstrated significant improvement. Perceived oral wetness scores increased more than threefold with the use of XyliMelts for Dry Mouth while sleeping. These findings suggest that XyliMelts for Dry Mouth may be an effective strategy for managing oral dryness that occurs at night.
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Affiliation(s)
- J Burgess
- Oral Care Research Associates, Seattle, WA 98115, USA.
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Gomes SGF, Cury AADB, Garcia RCMR. Effect of hyposalivation on mastication and mandibular movements during speech. Braz Oral Res 2011; 25:351-6. [PMID: 21755259 DOI: 10.1590/s1806-83242011005000013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 05/04/2011] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate whether patients with hyposalivation present damaged mastication or mandibular movements during speech. Forty subjects composed 2 groups: control and hyposalivation. Masticatory performance was assessed with a silicon-based artificial material and a 10-sieve method. Mandibular movements during speech were observed with a 3D jaw-tracking device. Data were analyzed with Student's t-test or the Mann-Whitney method (P < 0.05). The masticatory performance (mm) of control and hyposalivation were 4.40 ± 0.62 and 4.74 ± 1.34, respectively. Outcomes for speech movements (mm) were as follows: maximum vertical opening amplitude (10.8 ± 4.2; 9.9 ± 2.7) and displacements to the right (1.0 ± 0.8; 0.5 ± 0.6), left (1.8 ± 1.4; 2.3 ± 1.2), or anterior-posterior (2.8 ± 1.1; 2.9 ± 1.0) for control and hyposalivation, respectively. No statistical difference was found between groups for any variable. The results indicated that hyposalivation did not affect masticatory performance or mandibular movements during speech.
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A comparison of salivary substitutes versus a natural sialogogue (citric acid) in patients complaining of dry mouth as an adverse drug reaction: a clinical, randomized controlled study. ACTA ACUST UNITED AC 2011; 112:e15-20. [DOI: 10.1016/j.tripleo.2011.01.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Revised: 01/22/2011] [Accepted: 01/27/2011] [Indexed: 11/18/2022]
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Palaniyandi S, Odaka Y, Green W, Abreo F, Caldito G, Benedetti AD, Sunavala-Dossabhoy G. Adenoviral delivery of Tousled kinase for the protection of salivary glands against ionizing radiation damage. Gene Ther 2010; 18:275-82. [DOI: 10.1038/gt.2010.142] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Marioni G, Rinaldi R, Manzato E, Sari M, Prosenikliev V, Accordi D, Staffieri C, Giacomelli L, Staffieri A. Aging and deep neck infection. The experience of a tertiary referral center (2000-2009). J Am Geriatr Soc 2010; 58:1609-11. [PMID: 20942885 DOI: 10.1111/j.1532-5415.2010.03000.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Park JW, Lee BJ, Bu YM, Yeo IK, Kim JS, Ryu BH. Effects of Korean Red Ginseng on Dry Mouth: A Randomized, Double-Blind, Placebo-Controlled Trial. J Ginseng Res 2010. [DOI: 10.5142/jgr.2010.34.3.183] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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van der Putten GJ, Brand HS, Schols JMGA, de Baat C. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. Clin Oral Investig 2010; 15:185-92. [PMID: 20165967 PMCID: PMC3056013 DOI: 10.1007/s00784-010-0382-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Accepted: 01/07/2010] [Indexed: 02/07/2023]
Abstract
The study objective was to explore the diagnostic suitability of the Xerostomia Inventory and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. A cross-sectional study was carried out in 50 physically impaired nursing home residents (20 men) with a mean age of 78.1 years (range, 53–98) in The Netherlands. The Xerostomia Inventory-Dutch version was completed for all residents and the data were subjected to exploratory factor analysis to determine the diagnostic suitability. Residents’ data on xerostomia, whole saliva secretion rates and hyposalivation-related medications used were collected and statistically analyzed. The diagnostic suitability of the Xerostomia Inventory-Dutch version appeared restricted. The prevalence of xerostomia was 52%, without gender and age difference. The prevalence of hyposalivation was 24% for resting, 60% for chewing-stimulated and 18% for acid-stimulated whole saliva. All whole saliva secretion rates were significantly lower in women than in men and in older than in younger residents. Forty-four percent of all medications used were hyposalivation-related and women used significantly more medications than men. Xerostomia was significantly negatively correlated with the resting whole saliva secretion rate. The number of hyposalivation-related medications used was not significantly correlated with the various whole saliva secretion rates. In nursing home residents, xerostomia, hyposalivation and using hyposalivation-related medications seem common and partially associated features.
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Affiliation(s)
- Gert-Jan van der Putten
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group and Zorgaccent Amersfoort, Amersfoort, The Netherlands
| | - Henk S. Brand
- Department of Dental Basic Sciences, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Jos M. G. A. Schols
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group and Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - Cees de Baat
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group and Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Higashi K, Yoshida M, Igarashi A, Ito K, Wada Y, Murakami S, Kobayashi D, Nakano M, Sohda M, Nakajima T, Narita I, Toida T, Kashiwagi K, Igarashi K. Intense correlation between protein-conjugated acrolein and primary Sjögren's syndrome. Clin Chim Acta 2009; 411:359-63. [PMID: 19968980 DOI: 10.1016/j.cca.2009.11.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 11/28/2009] [Accepted: 11/30/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND We recently found that an increased plasma concentration of protein-conjugated acrolein is a good biomarker for stroke. Therefore we determine whether the concentration of protein-conjugated acrolein is increased in saliva from patients with primary Sjögren's syndrome. METHODS Stimulated whole-mixed saliva was collected from 10 patients and 13 control subjects. The concentration of protein-conjugated acrolein in saliva and plasma was measured by either Western blotting or enzyme-linked immunosorbent assay. RESULTS The concentration of protein-conjugated acrolein, especially albumin-conjugated acrolein, was greatly increased in saliva from patients with primary Sjögren's syndrome (p<0.001). The concentration of protein-conjugated acrolein was inversely correlated with the flow rate of saliva. CONCLUSION The results indicate that the concentration of protein-conjugated acrolein, a marker of cell or tissue damage, in saliva is well correlated with seriousness of primary Sjögren's syndrome.
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Affiliation(s)
- Kyohei Higashi
- Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8675, Japan
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Grundmann O, Mitchell G, Limesand K. Sensitivity of salivary glands to radiation: from animal models to therapies. J Dent Res 2009; 88:894-903. [PMID: 19783796 PMCID: PMC2882712 DOI: 10.1177/0022034509343143] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 12/01/2008] [Accepted: 12/05/2008] [Indexed: 12/18/2022] Open
Abstract
Radiation therapy for head and neck cancer causes significant secondary side-effects in normal salivary glands, resulting in diminished quality of life for these individuals. Salivary glands are exquisitely sensitive to radiation and display acute and chronic responses to radiotherapy. This review will discuss clinical implications of radiosensitivity in normal salivary glands, compare animal models used to investigate radiation-induced salivary gland damage, address therapeutic advances, and project future directions in the field.
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Affiliation(s)
- O. Grundmann
- Department of Nutritional Sciences and Cancer Biology Program, 1177 E 4 St., Shantz 421, PO Box 210038, Tucson, AZ 85721, USA
| | - G.C. Mitchell
- University of Arizona, 1177 E 4 St., Shantz 421, PO Box 210038, Tucson, AZ 85721, USA
| | - K.H. Limesand
- Department of Nutritional Sciences and Cancer Biology Program, 1177 E 4 St., Shantz 421, PO Box 210038, Tucson, AZ 85721, USA
- University of Arizona, 1177 E 4 St., Shantz 421, PO Box 210038, Tucson, AZ 85721, USA
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