Association of dental caries and salivary sIgA with tobacco smoking

Lifetime Exposure to Cigarette Smoke, B-Cell Tumor Immune Infiltration, and Immunoglobulin Abundance in Ovarian Tumors

BACKGROUND

Cigarette smoke exposure has been linked to systemic immune dysfunction, including for B-cell and immunoglobulin (Ig) production, and poor outcomes in patients with ovarian cancer. No study has evaluated the impact of smoke exposure across the life-course on B-cell infiltration and Ig abundance in ovarian tumors.

METHODS

We measured markers of B and plasma cells and Ig isotypes using multiplex immunofluorescence on 395 ovarian cancer tumors in the Nurses' Health Study (NHS)/NHSII. We conducted beta-binomial analyses evaluating odds ratios (OR) and 95% confidence intervals (CI) for positivity of immune markers by cigarette exposure among cases and Cox proportional hazards models to evaluate hazard ratios (HR) and 95% CI for developing tumors with low (

RESULTS

There were no associations between smoke exposure and B-cell or IgM infiltration in ovarian tumors. Among cases, we observed higher odds of IgA+ among ever smokers (OR, 1.54; 95% CI, 1.14-2.07) and ever smokers with no parental smoke exposure (OR, 2.03; 95% CI, 1.18-3.49) versus never smokers. Women with parental cigarette smoke exposure versus not had higher risk of developing ovarian cancer with low IgG+ (HR, 1.51; 95% CI, 1.10-2.09), whereas ever versus never smokers had a lower risk (HR, 0.74; 95% CI, 0.56-0.99).

CONCLUSIONS

Ever smoking was associated with increased odds of IgA in ovarian tumors.

IMPACT

IgA has been associated with improved ovarian cancer outcomes, suggesting that although smoking is associated with poor outcomes in patients with ovarian cancer, it may lead to improved tumor immunogenicity.

Collapse

Key Words Collapse

MESH Headings

• Humans
• Female
• Ovarian Neoplasms/immunology
• Ovarian Neoplasms/pathology
• Ovarian Neoplasms/epidemiology
• Middle Aged
• Adult
• B-Lymphocytes/immunology
• Immunoglobulins/blood
• Lymphocytes, Tumor-Infiltrating/immunology
• Aged
• Cigarette Smoking/adverse effects
• Cigarette Smoking/immunology

Collapse

Grants

• P01 CA087969 NCI NIH HHS
• 9JK02 Florida Department of Health (DOH)
• UM1 CA186107 NCI NIH HHS
• P01 CA87969 National Cancer Institute (NCI)
• U01 CA232758 NCI NIH HHS
• U01 CA176726 NCI NIH HHS

Collapse

Affiliation(s)

Cassandra A Hathaway Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
Mary K Townsend Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
Tianyi Wang Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
Christine Vinci Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
Danielle E Jake-Schoffman Department of Health Education and Behavior, University of Florida, Gainesville, Florida
Jonathan L Hecht Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
Daryoush Saeed-Vafa Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, Florida
Carlos Moran Segura Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, Florida
Jonathan V Nguyen Advanced Analytical and Digital Laboratory, Moffitt Cancer Center, Tampa, Florida
Jose R Conejo-Garcia Department of Immunology, Duke University School of Medicine, Durham, North Carolina
Brooke L Fridley Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
Shelley S Tworoger Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida Knight Cancer Institute and Division of Oncological Sciences, Oregon Health & Science University, Portland, Oregon

Collapse

Tobacco products and oral conditions among US adults: NHANES 2017-2020

OBJECTIVES

Smoking is a major global health problem with serious systemic and oral consequences. This study aims at assessing the influence of smoking cigarettes and other types of smoked tobacco on oral conditions (OCs) using a representative sample of US adults.

METHODS

Pre-pandemic data from the National Health and Nutrition Examination Survey 2017-2020 were utilized, and 7840 adults aged ≥30 years were included in our analyses. Descriptive statistics, logistic, and negative binomial regression models were performed to assess the relationship between tobacco products and OCs including, tooth loss (TL), coronal (CC) and root caries (RC).

RESULTS

Overall, 16.29% of our sample were current cigarette smokers (CCS). TL (17.25%) and untreated RC (28.26%) were more evident among CCS. In the adjusted regression models, smoking cigarettes was associated with RC (AOR: 3.20, 95% CI; 2.02, 5.09), untreated CC (IRR: 3.08, 95% CI: 1.50, 6.31), and TL (IRR: 2.18, 95% CI: 1.64, 2.88). Regarding the type of used tobacco product in the past 5 days, cigarettes were the most common type (15.03%). The adjusted model indicated that e-cigarette smokers had the highest odds of untreated RC (AOR: 5.17, 95% CI: 2.19, 12.23) and the highest rate of TL (IRR: 2.21, 95% CI: 1.45, 3.35). Further, cigar smokers had the highest rate of teeth with untreated CC (IRR: 3.25, 95% CI: 1.46, 7.25).

CONCLUSIONS

Using tobacco products is associated with poor OCs. Dentists, being the primary oral health care providers, can play a crucial role in counseling and supporting smokers to quit as part of their routine dental examination.

Understanding the role of smoking and chronic excess alcohol consumption on reduced caloric intake and the development of sarcopenia

This narrative review provides mechanistic insight into the biological link between smoking and/or chronic excess alcohol consumption, and increased risk of developing sarcopenia. Although the combination of excessive alcohol consumption and smoking is often associated with ectopic adipose deposition, this review is focused on the context of a reduced caloric intake (leading to energy deficit) that also may ensue due to either lifestyle habit. Smoking is a primary cause of periodontitis and chronic obstructive pulmonary disease that both induce swallowing difficulties, inhibit taste and mastication, and are associated with increased risk of muscle atrophy and mitochondrial dysfunction. Smoking may contribute to physical inactivity, energy deficit via reduced caloric intake, and increased systemic inflammation, all of which are factors known to suppress muscle protein synthesis rates. Moreover, chronic excess alcohol consumption may result in gut microbiota dysbiosis and autophagy-induced hyperammonemia, initiating the up-regulation of muscle protein breakdown and down-regulation of muscle protein synthesis via activation of myostatin, AMPK and REDD1, and deactivation of IGF-1. Future research is warranted to explore the link between oral healthcare management and personalised nutrition counselling in light of potential detrimental consequences of chronic smoking on musculoskeletal health outcomes in older adults. Experimental studies should investigate the impact of smoking and chronic excess alcohol consumption on the gut-brain axis, and explore biomarkers of smoking-induced oral disease progression. The implementation of behavioural change interventions and health policies regarding smoking and alcohol intake habits may mitigate the clinical and financial burden of sarcopenia on the healthcare system.

Comparison of the Anti-bacterial Efficacy of Saussurea costus and Melaleuca alternifolia Against Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis: An in-vitro Study

The aim was to compare the in-vitro antibacterial effectiveness of two herbal extracts (a) Saussurea-costus (S. costus) and (b) Melaleuca-alternifolia (M. alternifolia) against Porphyromonas gingivalis (P. gingivalis), Streptococcus mutans (S. mutans) and Enterococcus faecalis (E. faecalis). Aqueous extracts from M. alternifolia were prepared by adding 2 grams of S. costus and M. alternifolia, respectively to 100 ml distilled water. Bacterial strains of P. gingivalis, E. faecalis and S. mutans were treated into 3 groups. In groups 1 and 2, bacterial strains were treated with aqueous extracts of S. costus and M. alternifolia, respectively. In the control-group, bacterial strains were exposed to distilled water. Antibacterial activity of the samples and nanoparticles was determined. The minimum-inhibitory-concentration (MIC) values were determined using the microdilution method. P < 0.01 was considered statistically significant. The MIC for all bacterial strains treated with S. costus was significantly higher than that of M. alternifolia (P < 0.001). There was no significant difference in MIC for strains of P. gingivalis, E. faecalis and S. mutans treated with S. costus. For bacterial strains treated with M. alternifolia, the MIC was significantly higher for P. gingivalis compared with E. faecalis and S. mutans strains (P < 0.01). There was no difference in MIC for E. faecalis and S. mutans strains treated with M. alternifolia. The in-vitro antibacterial efficacy of M. alternifolia is higher than S. costus against P. gingivalis, E. faecalis and S. mutans.

Dental Caries and Oral Health Status of Psychoactive Substance Abusers

Substance-abuse disorders are universally associated with comorbid illness. Tobacco is a widely abused substance across the globe and presents a critical public health problem. The precise correlation between tobacco use and dental caries remains unclear. Thus, the present study aimed to evaluate the correlation between tobacco use and dental caries.

METHODOLOGY

Based on selection criteria, a total of 270 (age 20-50 years) participants were included in the study, and were categorized as group A (n = 135), consisting of tobacco users, and group B (n = 135), comprising healthy controls (non-users). The Decayed, Missing, and Filled index (DMFT) was used to measure caries status. The Simplified Oral Hygiene index was used to evaluate oral health.

RESULTS

The tobacco group reported the use of cigarettes; smokeless tobacco in indigenous forms, such as gutka (areca nut, tobacco, and slaked lime), betel nut chewing; and a combination. Individuals with tobacco habits had a higher prevalence of dental caries (Mean DMFT 4.73 ± 4.32) compared to the non-habit group (Mean DMFT 3.17 ± 3.11 (p = 0.001). The Oral Hygiene index was significantly higher (indicating bad/poor oral hygiene) in tobacco abusers than those of non-users (p = 0.0001). Duration and frequency of tobacco use were correlated with the levels of moderate and severe caries (p = 0.001).

CONCLUSION

Psychoactive substance abuse, such as smoking/smokeless tobacco consumption, is associated with higher prevalence of dental caries.

Influence of Smoking Habits on the Prevalence of Dental Caries: A Register-Based Cohort Study

Objective This study aimed to evaluate the influence of smoking habit on the prevalence of dental caries lesions in a follow-up study.

Materials and Methods A total of 3,675 patients (2,186 females and 1,489 males) with an average age of 51.4 years were included. Outcome measures were the incidence of dental caries defined as incipient noncavitated, microcavitated, or cavitated lesions which had been diagnosed through clinical observation with mouth mirror and probe examination evaluating change of texture, translucency, and color; radiographic examination through bitewing radiographs; or secondary caries through placement of a new restoration during the follow-up of the study.

Statistical Analysis Cumulative survival (time elapsed with absence of dental caries) was estimated through the Kaplan–Meier product limit estimator with comparison of survival curves (log-rank test). A multivariable Cox proportional hazards regression model was used to evaluate the effect of smoking on the incidence of dental caries lesions when controlled to age, gender, systemic status, frequency of dental hygiene appointments, and socioeconomic status. The significance level was set at 5%.

Results Eight hundred sixty-three patients developed caries (23.5% incidence rate). The cumulative survival estimation was 81.8% and 48% survival rate for nonsmokers and smokers, respectively ( p < 0.001), with an average of 13.5 months between the healthy and diseased state diagnosis. Smokers registered a hazard ratio for dental caries lesions of 1.32 ( p = 0.001) when controlled for the other variables of interest.

Conclusion Within the limitations of this study, it was concluded that smoking habit might be a predictor for dental caries.

Association between salivary s-IgA concentration and dental caries: A systematic review and meta-analysis

OBJECTIVE

To determine the levels of s-IgA in saliva of caries patients and healthy controls, and to evaluate whether there is a correlation between it and caries by systematic review and meta-analysis.

METHODS

 Eight databases were searched initially in April 2020 and repeated in August 2020. Two independent evaluators screened the literature and extracted the data according to the inclusion and exclusion criteria. I2 test was commonly reflected the heterogeneity. Subgroup analysis and meta-regression analysis explore the sources of heterogeneity. Sensitivity analysis, funnel diagram, Begg's rank correlation and Egger's linear regression were used to determine the possibility of publication bias.

RESULTS

A total of 30 case-control studies were included, with a total sample size of 1545 patients, including 918 caries patients and 627 healthy controls. Salivary s-IgA levels in caries patients were significantly lower than those in healthy controls. In addition, the results of subgroup analysis showed that the significant decrease of salivary s-IgA level was correlated with children patients, mixed dentition and Asian people. The funnel diagram included in the study was symmetrically distributed, and the sensitivity analysis confirmed the robustness of the results.  Conclusion: Salivary s-IgA levels in caries patients were significantly lower than in healthy controls. It has also been demonstrated that salivary s-IgA may be used as an alternative measure to identify subjects at risk of caries susceptibility, suggesting that salivary s-IgA may be a protective factor for dental caries.

Prevalence of Dental Caries among Smoking and Smokeless Tobacco Users Attending Dental Hospital in Eastern Region of Uttar Pradesh

Introduction:

The relationship of tobacco use to dental caries is still unclear. The aim of this study is to assess the relationship between smoking and smokeless tobacco usage and prevalence of dental caries and its pattern in the Varanasi population.

Materials and Methods:

In this study, 472 elderly dentate and consenting individuals were included. Individuals were examined with the aid of mouth mirror, No. 23 explorer, and cotton rolls. The age of the study group ranged from 16 years to 75 years. Individuals were categorized as smoking tobacco users, smokeless tobacco users, and the combination of these two. Frequency and dosage of tobacco usage was recorded. Dental caries was measured using decayed, missing, and filled teeth (DMFT) index. Oral hygiene practices such as mode, material, and frequency of brushing were also recorded. Data were assessed using SPSS 17.0 using Chi-square, t-test, ANOVA test, and binary regression.

Results:

Caries rate was similar in both males and females (2.57 and 2.70), and the difference was not statistically significant. Caries was higher in individuals with habits when compared to those who were not having habits. There was no statistically significant association between individuals who were smokers, using smokeless tobacco, frequency, mode, and material of brushing with caries pattern. Among smokers, DMFT increased with frequency and duration of smoking, and it was statistically significant; however, in smokeless tobacco users, this was not the case. There was a positive correlation with DMFT and frequency of smoking.

Conclusion:

The study has shown that tobacco habit is a risk factor for increased caries activity, and it is higher in smokers as compared to smokeless tobacco chewers.

Association between Dental Caries and Passive Smoking and Its Related Factors in Children Aged 3-9 Years Old

Aims

Dental caries is the most common chronic and infectious childhood disease. Several studies have investigated the side effects of cigarette smoke on oral health. Caries appear to be higher in children exposed to environmental cigarette smoke, but this relationship has not yet been established. The purpose of this study was to investigate the relationship between dental caries and passive smoker children aged 3-9 years old.

Materials and methods

This descriptive analytical study was performed on 75 children aged from 3 to 9 years. The study included two groups (first group: control, second group: passive smoker). Demographic data, frequency of toothbrushing and using toothpaste, sugar consumption, and number of dental visits were recorded in a questionnaire. Then, the children were examined, and dmft and DMFT index and plaque index were recorded. Children's saliva was then collected and sent to the laboratory for determination of cotinine levels. Then, the relationship between passive smoker and caries index and other factors were statistically analyzed.

Results

Studying dmft and DMFT, it was found that except for component M (Missing) which was zero in both groups, the other components of these two indices were significantly higher in the group exposed to passive smoker. Plaque index and salivary cotinine level were also significantly different in the two groups and were lower in the control group.

Conclusion

According to the results of this study, children exposed to passive smoker have a higher rate of caries than other children. It seems that it is primarily due to its effect on increasing plaque accumulation and then the effect of passive smoker on the physiological structures of the mouth and so on.

Clinical significance

We can perform preventive care for children if we know that passive smoking may cause more dental caries.

How to cite this article

Mosharrafian S, Lohoni S, Mokhtari S. Association between Dental Caries and Passive Smoking and Its Related Factors in Children Aged 3-9 Years Old. Int J Clin Pediatr Dent 2020;13(6):600-605.

Cigarette smoking differentially affects immunoglobulin class levels in serum and saliva: An investigation and review

The aim of the present study was to compare concentrations of IgG, IgA, IgM and IgD in both serum and saliva samples from smoking and non-smoking individuals using a protein microarray assay. The findings were also compared to previous studies. Serum and saliva were collected from 48 smoking male individuals and 48 age-matched never-smoker male individuals. The protein microarray assays for detection of human IgG, IgM, IgA and IgD were established and optimized using Ig class-specific affinity-purified goat anti-human Ig-Fc capture antibodies and horseradish peroxidase (HRP)-conjugated goat anti-human Ig-Fc detection antibodies. The Ig class specificity of the microarray assays was verified, and the optimal dilutions of serum and saliva samples were determined for quantification of Ig levels against standard curves. We found that smoking is associated with reduced IgG concentrations and enhanced IgA concentrations in both serum and saliva. By contrast, smoking differentially affected IgM concentrations-causing increased concentrations in serum, but decreased concentrations in saliva. Smoking was associated with decreased IgD concentrations in serum and did not have a significant effect on the very low IgD concentrations in saliva. Thus, cigarette smoking differentially affects the levels of Ig classes systemically and in the oral mucosa. Although there is variation between the results of different published studies, there is a consensus that smokers have significantly reduced levels of IgG in both serum and saliva. A functional antibody deficiency associated with smoking may compromise the body's response to infection and result in a predisposition to the development of autoimmunity.

The effect of smoking on caries-related microorganisms

INTRODUCTION

Epidemiological studies have shown a close relationship between smoking and dental caries. Bacteria are one of the essential factors of caries formation. The imbalance of cariogenic bacteria and commensal bacteria in dental plaque results in higher production of acid that can corrode dental hard tissue. The aim of our review is to summarize the effect of smoking on caries-related bacteria.

METHODS

English articles available in Pubmed and ScienceDirect databases and published before December 2018 were searched. A variety of evidence was collected including not only the influence of cigarette products on bacteria strains in vitro but also their effect on bacterial composition in saliva and dental plaque in vivo. We particularly emphasize the mechanisms by which nicotine acts on oral bacteria.

RESULTS

The components of cigarettes promote the growth of cariogenic microorganisms. The mechanisms of how nicotine enhances Streptococcus mutans, Lactobacilli, Streptococcus gordonii, Actinomyces and Candida albicans are described separately in detail. The commensal bacteria, Streptococcus sanguinis, show less competitive capability in the presence of nicotine. Smoking influences saliva by lowering the buffer capability, altering its chemical agent and bacterial components, and therefore promotes the formation of a caries-susceptible environment.

CONCLUSIONS

Cigarette smoking and nicotine exposure promote the cariogenic activity of oral microorganisms and the formation of a caries-susceptible environment. This suggests that smokers should quit smoking, amongst other health reasons, also for their oral health.

Tobacco use and caries increment in young adults: a prospective observational study

OBJECTIVE

Tobacco use has a negative influence on general and oral health but data concerning caries are mainly derived from epidemiological and cross-sectional studies. The aim of this study was to investigate smoking and use of smokeless tobacco (Swedish snus) as determinants of dental caries increment in young adults over 3 years. The baseline cohort consisted of 1295 19-year-olds registered at eight Public Dental Clinics representing socioeconomic strata. After 3 years, 982 of the patients could be reexamined (drop-out rate 24.2%). Caries was scored as decayed and filled surfaces according the WHO criteria and the individual caries increment was recorded by counting the number of surfaces that changed from "sound" to "decayed/filled" over the study period. Information on habitual tobacco use (smoking, snuffing) was collected from a structured questionnaire at baseline.

RESULTS

The baseline prevalence of smoking and use of Swedish snus was 22.3% and 6.3% respectively. Smoking, but not snuffing, displayed a statistically significant relationship with caries increment over 3 years. For smoking, the relative risk was 1.5 (95% CI 1.2-1.7) and the number needed to harm 6.8 (95% CI 4.5-14.2). Thus, habitual smoking is a risk factor for caries in young adults and the findings reinforce arguments that dental health professionals should incorporate anti-smoking activities in their preventive strategies.

Association between exposure to household smoking and dental caries in preschool children: a cross-sectional study

BACKGROUND

We aimed to examine the association of exposure to environmental tobacco smoke with dental caries among preschool children. Exposure to environmental tobacco smoke was assessed in terms of urinary cotinine concentrations and pack-years of exposure to smoking by parents and other family members at home.

METHODS

This cross-sectional study included 405 preschool children aged 3-6 years from two preschools in Japan in 2006. Information on the smoking habits of family members living with the child was obtained from parent-administered questionnaires. Dental examination was conducted to assess dental caries, that is, decayed and/or filled teeth. Urinary cotinine levels were measured using first-void morning urine samples.

RESULTS

Overall, 31.1% of the children had dental caries, and 29.5% had decayed teeth. Exposure to current maternal and paternal smoking was positively associated with the presence of dental caries after controlling for covariates. More than three pack-years of exposure to maternal smoking and more than five pack-years of exposure to smoking by all family members were significantly associated with the presence of dental caries as compared with no exposure (odds ratio [OR] = 5.55, 95% confidence interval [CI] = 2.17-14.22, P for trend < 0.001 and OR = 2.00, 95% CI = 1.12-3.58, P for trend = 0.004, respectively). These exposure variables were similarly associated with the presence of decayed teeth (OR = 2.92, 95% CI = 1.23-6.96, P for trend = 0.01 and OR = 1.75, 95% CI = 0.96-3.20, P for trend = 0.03, respectively). As compared with lowest tertile of the urinary cotinine level, the highest tertile of the urinary cotinine level was significantly associated with the presence of dental caries as well as decayed teeth; the ORs for the highest vs. lowest tertile of urinary cotinine levels were 3.10 (95% CI = 1.71-5.63, P for trend = 0.012) and 2.02 (95% CI = 1.10-3.70, P for trend = 0.10), respectively.

CONCLUSIONS

These data suggest that exposure to tobacco smoke may have a dose-dependent influence on the development of caries.

Age-related changes in immune function (immune senescence) in caries and periodontal diseases: a systematic review

AIM

To systematically review the evidence regarding immune senescence in the pathogenesis of periodontitis and dental caries.

METHODS

A systematic search of electronic databases utilizing medical subject headings (MeSH terms) supplemented by screening of review articles and other relevant texts was undertaken.

RESULTS

Seventy-three articles were included (43 for periodontitis, 30 for caries). Study results were found to be generally heterogeneous. Regarding periodontitis, human studies suggest evidence for altered neutrophil function and increased production of pro-inflammatory mediators (e.g. interleukin-1β, interleukin-6 and prostaglandin E₂ ) in older compared to younger subjects, and animal experiments suggest increased expression of genes that contribute to a pro-inflammatory state in older compared to younger animals. Regarding dental caries, research relating to changes in immune functioning and the impact of ageing is in its infancy. A small number of studies have reported components of innate and adaptive immunity that affect the composition of saliva and dental biofilms with possible impacts on caries progression.

CONCLUSION

There is evidence that immune functioning related to periodontitis and (less investigated) dental caries alters with increasing age. In both conditions, age-associated mechanistic changes in immune functioning are complex and incompletely understood and it is not clear how these relate to disease susceptibility.

Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review

Many studies have been undertaken to reveal how tobacco smoke skews immune responses contributing to the development of chronic obstructive pulmonary disease (COPD) and other lung diseases. Recently, environmental tobacco smoke (ETS) has been linked with asthma and allergic diseases in children. This review presents the most actual knowledge on exact molecular mechanisms responsible for the skewed inflammatory profile that aggravates inflammation, promotes infections, induces tissue damage, and may promote the development of allergy in individuals exposed to ETS. We demonstrate how the imbalance between oxidants and antioxidants resulting from exposure to tobacco smoke leads to oxidative stress, increased mucosal inflammation, and increased expression of inflammatory cytokines (such as interleukin (IL)-8, IL-6 and tumor necrosis factor α ([TNF]-α). Direct cellular effects of ETS on epithelial cells results in increased permeability, mucus overproduction, impaired mucociliary clearance, increased release of proinflammatory cytokines and chemokines, enhanced recruitment of macrophages and neutrophils and disturbed lymphocyte balance towards Th2. The plethora of presented phenomena fully justifies a restrictive policy aiming at limiting the domestic and public exposure to ETS.

Use of low-level laser therapy on children aged 1 to 5 years with energy-protein malnutrition: A clinical trial

BACKGROUND

Episodes of malnutrition in early childhood can produces alterations in the salivary glands. The investigation of mechanisms that can reduce the impact of malnutrition on the defenses of the organism is of the utmost important and interest to public health. The aim of this study is to evaluate the effect of low-level laser on the saliva of children aged 1 to 5 years with energy-protein malnutrition.

METHODS

Mandatory inclusion criteria are diagnosis of malnutrition. The sample will consist of 50 men and women malnourished children aged 12 to 71 months. Saliva will be collected and the volume of saliva will be measured and the salivary flow rate will be determined (mL/min). Concentrations of salivary IgA in all samples will be measured using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. Low-level laser (laser diode) will be administered in the region of the parotid glands bilaterally as well as in the regions of the submandibular and sublingual glands.

DISCUSSION

This study will be the first that investigate the effects of local laser therapy on the salivary glands of malnourished children.

TRIAL REGISTRATION

Clinical.trials.gov as NCT03355313, first received in 21 November 2017.

Preliminary findings on the correlation of saliva pH, buffering capacity, flow rate and consistency in relation to waterpipe tobacco smoking

The aim of the present comparative study was to compare some salivary characteristics between exclusive waterpipe smokers (EWPS) and non-smokers. 72 males (36 EWPS) were recruited. The volume of stimulated saliva was determined and divided by the duration of saliva collection. The pH was measured directly using a pH meter. The buffering capacity was determined using a quantitative method which involved the addition of 10 µl HCl. Up to a total of 160 µL was titrated up to obtain a pH titration curve. At 50 µL of titrated HCl, buffering capacity was ranked into three categories: high, medium and low. EWPS and non-smoker groups had similar flow rates (1.81 ± 0.79 and 1.78 ± 1.14 mL min-1) and similar baseline pH (6.60 ± 0.37 and 6.76 ± 0.39). Statistically significant differences in the two groups' pH were observed from 30 to 160 µL of titrated up HCl. At 50 µL of titrated up HCl, the EWPS group compared to the non-smoker group had a significantly higher pH (4.79 ± 0.72 vs. 5.32 ± 0.79). To conclude, waterpipe tobacco smoking alters the buffering capacity but does not alter either salivary flow rates or the baseline pH and consistency.

"Meth Mouth": An Interdisciplinary Review of a Dental and Psychiatric Condition

OBJECTIVE

Chronic methamphetamine (MA) users experience many dental problems, a condition characterized as "meth mouth." These devastating effects on dentition is the main reason why many seek professional help. Here, we discuss the effects of MA on oral health and advocate for improved collaboration between dentists and mental health providers. We also introduce a dental evaluation tool with the goal of improving the quality of care for this often-marginalized patient population.

METHODS

A Medline literature search (1985-2016) was conducted with keywords "meth mouth," "methamphetamine AND oral health"; "methamphetamine AND dental"; "methamphetamine AND dentist." Results were supplemented by references gleaned from recent reviews, credible online sources, and citations of search returns.

RESULTS

MA predisposes users to tooth decay. They are also more likely to have missing dentition with a linear relationship correlating the number of years of use. A constellation of dental symptoms resulting from chronic MA use has been described in literature: gingival inflammation, excessive tooth wear, decreased salivary output, and severe dental caries. With continued use, mucosal lesions may appear on the lips and the gingival tissue may recede. MA can trigger bruxism, resulting in severe wear patterns and even cracked teeth.

CONCLUSIONS

Users of MA have many unmet medical and mental health needs. An interdisciplinary approach between dentists and mental health providers can improve outcomes. The dental evaluation tool described here can improve the bidirectional collaboration between mental health and dentistry. Dental professionals are in a unique position to identify users and can facilitate referral to substance abuse treatment. Likewise, mental health providers can identify, assess severity, and prompt users for medical and dental attention.

Effects of Tobacco on Salivary Antioxidative and Immunologic Systems

Background: Tobacco use is a harmful habit that causes adverse effects on oral health and plays a most important role in cancer development. Saliva is the first fluid that is exposed to tobacco and its antioxidant system plays an important role in anti-cancer potential; therefore, this study was designed to compare the antioxidant activity and immunologic system of saliva in tobacco users (smokers and smokeless tobacco users) and non-users. Materials and Methods: In this cross-sectional study, unstimulated saliva samples of 75 healthy individuals from three equal groups were investigated. Participants in group A had no periodontal disease and never smoked. Group B had no periodontal disease, never used smokeless tobacco, but had 3 years history of smoking at least 10 cigarettes daily. The twenty-five participants in group C had no periodontal disease and had 1 year history of chewing a 10-g tobacco packet daily. Activity of salivary superoxide dismutase (SOD), salivary glutathione peroxide, and salivary IgA concentration was evaluated. Data were analyzed using SPSS (version 18) and running Kruskal-Wallis test. Statistical significance was set at p<0.05. Results: There were significant differences in the activities of the two enzymes and salivary IgA levels among the three groups. Activity of glutathione peroxide was higher in smokeless tobacco users. (P<0.001) while that of superoxide dismutase was higher in non-tobacco users than users (P<0.001). Salivary IgA levels were higher among smokeless tobacco users (p=0.04). Conclusion: Based on the results of the present study, the use of tobacco products decreases the antioxidative activity of the saliva and increases salivary IgA levels at the same time.

Salivary secretory IgA concentration and dental caries in children with Down syndrome

PURPOSE

To evaluate the relationship between salivary secretory immunoglobulin A (sIgA) concentration and dental caries in children with Down syndrome (DS) and compare it with findings in non-DS children.

METHODS

The sample comprised 61 DS children and 52 non-DS children, aged 6 to 14 years. Caries experience, plaque index (PI), and gingival bleeding index (GBI) were recorded. Saliva samples were collected from all children. Total salivary sIgA concentrations were determined using an enzymatic assay method.

RESULTS

Caries experience in primary and permanent dentitions were similar in DS and non-DS children. However, PI and GBI values were significantly lower in DS compared to non-DS children. DS children had higher salivary sIgA concentrations compared to non-DS children. No difference in sIgA concentration was observed between children with and without caries experience in either group.

CONCLUSIONS

DS children have higher salivary sIgA concentrations than non-DS children. However, this finding did not correlate with caries experience in the study population.

Impacts of cigarette smoking on immune responsiveness: Up and down or upside down?

Cigarette smoking is associated with numerous diseases and poses a serious challenge to the current healthcare system worldwide. Smoking impacts both innate and adaptive immunity and plays dual roles in regulating immunity by either exacerbation of pathogenic immune responses or attenuation of defensive immunity. Adaptive immune cells affected by smoking mainly include T helper cells (Th1/Th2/Th17), CD4+CD25+ regulatory T cells, CD8+ T cells, B cells and memory T/B lymphocytes while innate immune cells impacted by smoking are mostly DCs, macrophages and NK cells. Complex roles of cigarette smoke have resulted in numerous diseases, including cardiovascular, respiratory and autoimmune diseases, allergies, cancers and transplant rejection etc. Although previous reviews have described the effects of smoking on various diseases and regional immunity associated with specific diseases, a comprehensive and updated review is rarely seen to demonstrate impacts of smoking on general immunity and, especially on major components of immune cells. Here, we aim to systematically and objectively review the influence of smoking on major components of both innate and adaptive immune cells, and summarize cellular and molecular mechanisms underlying effects of cigarette smoking on the immune system. The molecular pathways impacted by cigarette smoking involve NFκB, MAP kinases and histone modification. Further investigations are warranted to understand the exact mechanisms responsible for smoking-mediated immunopathology and to answer lingering questions over why cigarette smoking is always harmful rather than beneficial even though it exerts dual effects on immune responses.

Salivary IgA versus HIV and Dental Caries

INTRODUCTION

The inter-relationship of Human Immunodeficiency Virus (HIV) infection and dental caries as well as Salivary Immunoglobulin-A (S-IgA) level appear to remain under explored while a manual and electronic search of the literature was made. Hence, the present study was undertaken to assess the relationship of S-IgA and dental caries status in HIV positive children.

AIM

The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV positive and negative children and determine the dental caries status in HIV positive and HIV negative children, which may help in treatment planning and prevention of the same.

MATERIALS AND METHODS

A total of 28 HIV positive children aged between 6-14 years and 28 age matched HIV negative children were included in this study and both samples were randomly selected from the same Non-Governmental Organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. Only 2cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to WHO criteria (1997) using a flat mouth mirror and CPI probe.

RESULTS

In HIV +ve group mean S-IgA level was calculated as 81.61 ± 6.20 μg/ml, mean DMFT was 3.86 ± 3.37, mean deft was 4.75 ± 2.86. In HIV -ve group mean S-IgA level was calculated as 145.57 ± 17.83μg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong-ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, p < 0.001) and negative but Not Significant (N.S.) correlation (r = -0.19, t = 0.99, p > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, p < 0.001), S-IgA and deft (r = -0.942, t =14.32, p=<0.001) was found in HIV-ve group.

CONCLUSION

This study suggests that the individuals who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.

Relationship between salivary stress biomarker levels and cigarette smoking in healthy young adults: an exploratory analysis

Background

This study investigated the relationships among salivary stress biomarkers, cigarette smoking, and mood states.

Methods

The study population comprised 49 healthy sixth-year dental students at Fukuoka Dental College (39 men, 10 women; age, 23–31 years). Lifetime exposure to smoking was calculated using the Brinkman index (BI). Resting saliva samples were collected, and concentrations of cortisol, secretory immunoglobulin A (SIgA), interleukin (IL)-1β, interleukin-6, and tumor necrosis factor (TNF)-α were determined. Mood states (tension-anxiety, depression-dejection, anger-hostility, fatigue, confusion, and vigor) over the previous week were assessed using the Profile of Mood States - Brief Japanese Version.

Results

Salivary IL-1β levels were significantly higher in smokers than non-smokers (P = 0.044), regardless of the BI or mood state. A significant positive correlation was evident between the TNF-α level and the BI (P = 0.036), and the SIgA level was positively correlated with the BI (P = 0.067) but did not reach statistical significance. In terms of mood states, higher fatigue scores and lower vigor scores were observed in smokers. The TNF-α level and vigor score were negatively correlated (r = –0.229, P = 0.135), but the correlation did not reach statistical significance. However, the SIgA level and fatigue score were significantly positively correlated (r = 0.410, P = 0.005).

Conclusions

The TNF-α and SIgA levels were both positively correlated with the BI. Furthermore, the TNF-α level was negatively correlated with the vigor score, whereas the SIgA level was positively correlated with the fatigue score. Thus, salivary levels of TNF-α and SIgA may be used as biomarkers of mood states in healthy young smokers.

Describing the role of Australian community pharmacists in oral healthcare

OBJECTIVES

To investigate community pharmacist's attitudes, beliefs and practices towards oral health in the Australian setting, describe the frequency and nature of consumer enquiries relating to oral health, and gain insight regarding smoking cessation support for people experiencing oral health problems.

METHODS

An online questionnaire was developed based on previous research, validated to ensure accuracy and reliability, and convenience sampling used to advertise across major pharmacy organisational websites and newsletters to maximise community pharmacist responses.

KEY FINDINGS

One hundred and forty-four valid community pharmacist responses were descriptively analysed. The majority of pharmacists (93%) believed it was their role to deliver oral health advice in the community and almost all (97%) pharmacists believed further education would benefit their practice. The top four consumer enquiries pharmacists reported confidence in handling related to analgesic medication to relieve oral-related pain (95.8%), mouth ulcers (95.1%), oral thrush (94.4%) and toothache (93.8%); and the most frequently reported consumer enquires were those where the majority of pharmacists reported high confidence in handling. A small proportion of pharmacists (8%) always enquired about patient smoking status, and nearly all pharmacists (97%) desired further education and training to benefit their practice in oral healthcare.

CONCLUSION

This study highlights that Australian pharmacists have an important role in oral health and there is opportunity to enhance this role, and address risk factors such as smoking with further training, support and education. The findings from this study can guide future research into the development of appropriate training programmes, standards, and best oral healthcare practices for Australian pharmacists.

The relationship between unspecific s-IgA and dental caries: a systematic review and meta-analysis

OBJECTIVES

This systematic review and meta-analysis is focused on evaluating the possible association of s-IgA levels and dental caries.

DATA

The inclusion criteria comprised the clinical investigations with case and control groups, a caries diagnostic method, and evaluation of unspecific s-IgA concentration by using tests for both groups in humans, healthy subjects, and with statistical analyses. Quality assessment and data extraction of the included articles were performed. Meta-analysis of pooled data was performed through RevMan software after a sensitivity analysis.

SOURCES

An electronic and manual search was performed in PubMed, ISI Web of Science, Scopus, Cochrane Library, and Lilacs, with a supplemental hand search of the references of retrieved articles.

STUDY SELECTION

From 314 abstracts, 14 fulfilled the inclusion criteria. After reading the full articles, one of them was excluded due to the lack of a control group. Seven studies were included in the meta-analysis, and the heterogeneity among the studies (I(2)) was 41%. The pooled meta-analysis demonstrated higher levels of s-IgA in the caries active group (p<0.00001) than in the control group with a mean difference and confidence interval of 0.27 [0.17-0.38].

CONCLUSIONS

Based on these findings, there is evidence that supports the presence of increased s-IgA levels in caries-active subjects.

CLINICAL SIGNIFICANCE

Dental caries is a multifactorial disease that comprehends intrinsic and extrinsic factors. The risk factors and events related to dental caries are overlooked in the literature. Additionally, it is also important to understand the host response against this disorder. Since the studies are contradictory in this field, we conducted a systematic review followed by meta-analysis to present the immunological host response evidence-based.

Implications of tobacco smoking on the oral health of older adults

Cigarette smoking is the foremost health risk issue affecting individuals of all age groups globally. It specifically influences the geriatric population as a result of chronic exposure to toxins. Its role in various systemic and oral diseases including cancer, premalignant lesions, periodontitis, tooth loss, dental caries and implant failures is well established. Smoking causes immuno-inflammatory imbalances resulting in increased oxidative stress in the body. The latter hastens the immunosenescence and inflammaging process, which increases the susceptibility to infections. Thus, implementation of smoking cessation programs among older adults is imperative to prevent the development and progression of oral and systemic diseases. The present review focuses on smoking-associated oral health problems in older adults, and the steps required for cessation of the habit.