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Lipsky MS, Singh T, Zakeri G, Hung M. Oral Health and Older Adults: A Narrative Review. Dent J (Basel) 2024; 12:30. [PMID: 38392234 PMCID: PMC10887726 DOI: 10.3390/dj12020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Oral health's association with general health, morbidity, and mortality in older adults highlights its importance for healthy aging. Poor oral health is not an inevitable consequence of aging, and a proactive, multidisciplinary approach to early recognition and treatment of common pathologies increases the likelihood of maintaining good oral health. Some individuals may not have regular access to a dentist, and opportunities to improve oral health may be lost if health professionals fail to appreciate the importance of oral health on overall well-being and quality of life. The authors of this narrative review examined government websites, the American Dental Association Aging and Dental Health website, and the Healthy People 2030 oral objectives and identified xerostomia, edentulism, caries, periodontitis, and oral cancer as five key topics for the non-dental provider. These conditions are associated with nutritional deficiencies, poorer quality of life, increased risk of disease development and poorer outcomes for cardiovascular disease, diabetes, and other systemic conditions prevalent among older adults. It is important to note that there is a bi-directional dimension to oral health and chronic diseases, underscoring the value of a multidisciplinary approach to maintaining oral health in older adults.
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Affiliation(s)
- Martin S Lipsky
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
- College of Urban and Public Affairs, Portland State University, Portland, OR 97201, USA
| | - Tejasvi Singh
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Golnoush Zakeri
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
- Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA
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Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)-A Cross-Sectional Study. J Clin Med 2022; 11:jcm11113249. [PMID: 35683634 PMCID: PMC9181801 DOI: 10.3390/jcm11113249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: This study compared dental, periodontal, oral, and joint/muscle tenderness among Israeli combat-induced post-traumatic stress disorder (Ci-PTSD) war veterans to non-PTSD patients. Study design: This retrospective three-arm study compared oral and facial manifestations between 100 Israeli veterans with Ci- PTSD (study group) and 103 non-PTSD periodontal patients (Control group). The study group was further divided into two subgroups of individuals who received psychiatric medications (40 patients) or did not (60 patients). All patients underwent complete dental, oral, and periodontal examinations, including assessing signs of parafunction. Results: All PTSD patients had poor oral hygiene. The plaque index (PI) was higher in the PTSD group compared to the control group (0.72 ± 0.28 vs. 0.45 ± 0.29, respectively, p < 0.001). The decayed, missing, and filled teeth score (DMFt) was higher in the PTSD population than in the controls (19.97 ± 8.07 vs. 13.05 ± 6.23 p < 0.05). Severe periodontal disease was more common among the PTSD subgroup taking medications (med -group) (62.5%) compared to the nonmedicated group (non-med group) (30.0%) and the controls (27.2%) (p = 0.001). Heavy smoking was more prevalent in the medicated PTSD patients than in other groups. Conclusions: The present study shows higher morbidities in combat-induced PTSD patients, including oral, dental, and periodontal manifestations, especially in medicated patients.
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Care need and dry mouth as risk indicators for impaired taste and smell. Sci Rep 2021; 11:20419. [PMID: 34650210 PMCID: PMC8516854 DOI: 10.1038/s41598-021-99978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/05/2021] [Indexed: 12/04/2022] Open
Abstract
To identify whether reduced saliva secretion or xerostomia symptoms are risk indicators for impaired taste and smell, depending on age and care needs. This cross-sectional study evaluated taste and smell in patients categorized into different age groups (<65> years) and different care need, with and without dry mouth. Of the 185 patients included, 119 were classified as “dry mouth” and 66 as “without dry mouth”. Overall, 103 (55.7%) were female and 37 (20%) needed care. There was no difference between “dry mouth” and “without dry mouth” regarding identification of odors or tastes, but a difference in the number of correctly identified odors and tastes in favor of “without care need” patients (p < 0.05). The ability to identify smells and tastes was negatively influenced by age, number of medications, and number of comorbidities, but subjective dry mouth had no impact. According to our results, subjective dry mouth is not a risk factor for an impaired ability to recognize smells and tastes. However, care need representing age, the number of medications taken, and the number of chronic comorbidities is a risk indicator.
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Thakkar JP, Lane CJ. Hyposalivation and Xerostomia and Burning Mouth Syndrome: Medical Management. Oral Maxillofac Surg Clin North Am 2021; 34:135-146. [PMID: 34598858 DOI: 10.1016/j.coms.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this chapter, the authors review the benefits of saliva and the destructive consequences of its loss. It is hoped that this will help their colleagues identify and treat patients before development of symptoms. Xerostomia is the subjective complaint of dry mouth or sensation of oral dryness. Hyposalivation is the actual decrease in measured salivary outflow. The authors discuss a compiled list of highly cited medications commonly used today that are linked with xerostomia and hyposalivation. There are numerous treatment modalities that are present, such as saliva substitutes, mouth rinses, sugar-free candy, and pilocarpine among others.
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Affiliation(s)
- Jaykrishna P Thakkar
- Oral and Maxillofacial Surgery The Brooklyn Hospital -Brooklyn, 155 Ashland Place, Brooklyn NY 11201, USA.
| | - Christopher J Lane
- Oral and Maxillofacial Surgery, St. Barnabas Hospital, 4422 3rd Avenue, Bronx, NY 10457, USA
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Rai AV, Naik BD. The effect of saliva substitute on the color stability of three different nanocomposite restorative materials after 1 month: An in vitro study. J Conserv Dent 2021; 24:50-56. [PMID: 34475680 PMCID: PMC8378500 DOI: 10.4103/jcd.jcd_444_20] [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: 08/31/2020] [Revised: 10/21/2020] [Accepted: 01/29/2021] [Indexed: 11/19/2022] Open
Abstract
Context (Background): The color stability of an esthetic material like composite resin may be hampered, due to the constant presence of oral microflora, saliva, and the frequent intake of food. However, as the oral cavity has a dynamic environment, the color stability of these restorative materials has been a challenge to dentistry. Aim: The aim of this study was to evaluate the effect of a saliva substitute (SS) on the color stability of three different nanocomposite restorative materials. Materials and Methods: A total of 66 disc-shaped samples of test materials were prepared using a polycarbonate mold measuring 15 mm diameter and 2 mm height and were randomly assigned to three groups of 22 samples each based on the test material used: Group I – Estelite Sigma Quick, Group II – Solare sculpt, and Group III – Beautifil II LS. They were further divided into two subgroups A and B with 11 samples each based on the immersion solutions, namely distilled water (DW) and saliva substitute (SS), respectively. The samples were immersed for 30 days. Baseline and post immersion color analysis were done with a spectrophotometer. The CIE L*a*b* values were measured and CIE ΔE values obtained were tabulated. Data were analyzed using the two-way-ANOVA test and Tukey's multiple post hoc test. Results: The mean color difference (ΔE) among the three different nanocomposite restorative materials ranged from 4.0 ± 0.26 to 10.62 ± 1.92. Group I showed the lowest color change (7.80 ± 0.55 and 4.00 ± 0.26), followed by Group III (8.59 ± 0.29 and 6.24 ± 0.66) and Group II (10.62 ± 1.92 and 6.85 ± 0.46) when immersed in SS and DW, respectively. Conclusion: All the specimens when immersed in SS showed greater discoloration than compared to the specimens immersed in DW. Group I showed greater resistance to color change compared to other groups.
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Affiliation(s)
- Amulya Vittal Rai
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, A Constituent College of Sri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
| | - Balaram Damodar Naik
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, A Constituent College of Sri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
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Non-allergy-related dental and orofacial findings in 625 patients reporting on adverse effects from dental materials. Dent Mater 2021; 37:1402-1415. [PMID: 34218932 DOI: 10.1016/j.dental.2021.06.012] [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: 03/29/2021] [Accepted: 06/19/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In a cohort of 500 patients complaining about adverse effects from dental materials, allergies were found to be contributing to the patients' subjective complaints in only about 14% of the cases. Therefore, the aim of this retrospective study was to investigate an enlarged cohort of 625 patients reporting on adverse effects from dental materials on non-allergy-related dental or orofacial findings with relevance for their subjective complaints. METHODS 625 patients visiting a specialized consultation on suspected adverse effects from dental materials were characterized regarding age and sex distribution, subjective complaints, allergies, and dental and orofacial findings with relevance for their subjective complaints. RESULTS This cohort comprised about 81% females and the median age was 58 years. The most often reported subjective complaints were burning mouth (43.8%), taste disorders (28.8%) and dry mouth (22.7%). Allergies toward dental materials were found in 12.3%. In 28.0% of the patients, no dental or orofacial findings with relevance for the subjective complaints expressed by the patients could be found. 19.8% of the patients exhibited relevant functional symptoms, 16.2% relevant orofacial diseases, 15.2% relevant mechanical irritations, 10.1% or 9.4% relevant tooth-related or plaque-related symptoms, respectively, 9.4% hyposalivation, and in 7.2% relevant manufacturing faults were found. SIGNIFICANCE In patients complaining about adverse effects from dental materials, a wide variety of dental or orofacial findings need to be considered despite allergies, although a quarter of the patients did not present any relevant dental or orofacial finding. Therefore, specialized consultations and close collaboration with experts from other fields are eligible.
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Bento RF. Sialendoscopy for Improvement of Salivary Flow in Patients with Sjögren Syndrome - Comparative Analysis of Intraglandular Washing Solutions. Int Arch Otorhinolaryngol 2021; 25:e1-e7. [PMID: 33391395 PMCID: PMC7850891 DOI: 10.1055/s-0040-1716574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/29/2020] [Indexed: 10/31/2022] Open
Abstract
Introduction Among the potential diseases that present altered salivary flow and activity is Sjögren syndrome. Sialendoscopy seems to be an important therapeutic option. Objective To compare the results obtained with sialendoscopy for improving salivary flow measured by scintigraphy in patients with primary Sjögren syndrome to those obtained with other intraglandular washing solutions. Methods Patients from our institution's rheumatology clinic diagnosed with primary Sjögren syndrome underwent parotid scintigraphy prior to the sialendoscopy procedure. During the sialendoscopy procedure, one of the parotid glands was randomized to receive a wash with saline while the other was washed with a corticosteroid solution. After 1 month, a new scintigraphy examination of the parotid glands was performed to observe the salivary flow for comparison. Results A total of 13 female patients with mean age of 53.38 years (range, 27-76 years) were included in this study. After sialendoscopy, 10 patients (76.92%) were observed to have improvement in salivary excretion with radiopharmaceutical during scintigraphy. When analyzing each gland that was treated separately (26 glands), after sialendoscopy, improvement was observed in 18 glands (69.23%), 8 treated with dexamethasone and 10 with saline solution in the wash. There was no improvement in 8 glands (30.77%). Conclusion This study demonstrates that sialendoscopy is as an important tool to improve salivary flow measured by scintigraphy in patients with primary Sjogren syndrome, increasing salivary excretion through dilation and consequent unblocking of the ducts. These data suggest that there is no statistically significant difference between intraductal washing solutions using saline or dexamethasone solution.
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Affiliation(s)
- Ricardo Ferreira Bento
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
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Goldinova A, Tan CX, Bouma G, Duijvestein M, Brand HS, de Boer NK. Oral health and salivary function in ulcerative colitis patients. United European Gastroenterol J 2020; 8:1067-1075. [PMID: 32878578 PMCID: PMC7724544 DOI: 10.1177/2050640620957138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Although ulcerative colitis primarily involves the colon, extra-intestinal
manifestations are common and oral and dental complaints are no
exception. Objective This study aims at evaluating oral and dental health problems and salivary
function and composition in ulcerative colitis patients and its correlation
with disease activity. Methods Xerostomia Inventory score, (unstimulated/stimulated) salivary flow rates,
salivary amylase and mucin/ Mucin 5B levels, self-reported oral and dental
complaints, the oral health related quality of life, Simple Clinical Colitis
Activity Index and inflammatory bowel disease-specific health related
quality of life were determined. Results The cohort consisted of 51 ulcerative colitis patients. Hyposalivation was
experienced by 16% of patients under resting conditions and 24% under
chewing-stimulated conditions. Xerostomia was not correlated with salivary
flow rates. Disease activity did not influence salivary amylase and Mucin 5B
concentrations. The Xerostomia Inventory score was correlated with the
Simple Clinical Colitis Activity Index (p = 0.042) and
inflammatory bowel disease-specific health related quality of life
(p = 0.001). Most reported oral health problems were
halitosis (29%) and aphthae (28%). Frequently reported dental problems were
cavities (35%) and gum problems (31%). Patients with active disease
experienced significantly more oral and dental complaints. The number of
oral problems was positively correlated with the Simple Clinical Colitis
Activity Index (p = 0.045) and negatively correlated with
the inflammatory bowel disease-specific health related quality of life
(p = 0.005). Conclusion The subjective feeling of a dry mouth (xerostomia) is related to disease
activity and disease activity-associated quality of life in ulcerative
colitis patients, whereas the objective saliva secretion rate is not. Oral
and dental health problems are frequently observed in patients with
ulcerative colitis, especially during active disease.
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Affiliation(s)
- Ariana Goldinova
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
| | - Christopher Xw Tan
- Departments of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC/Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Gerd Bouma
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
| | - Marjolijn Duijvestein
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Nanne K de Boer
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AGEM institute, Amsterdam, The Netherlands
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Factors affecting decision making at reassessment of periodontitis. Part 3: interpretation of clinical findings - local factors. Br Dent J 2019; 227:869-874. [PMID: 31758121 DOI: 10.1038/s41415-019-0941-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper is the third in a four-part series outlining treatment planning at periodontal reassessment. The first article focused on the information that should be gathered at the reassessment appointment. The second article discussed systemic factors that can relate to residual periodontal probing depths. This article outlines local factors that need to be assessed when faced with residual periodontal probing depths. Treatment can involve a range of non-surgical and surgical approaches. A variety of general, practical and local site factors can affect the choice of one option over another in choosing the most predictable treatment option.
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de Vries SAG, Tan CXW, Bouma G, Forouzanfar T, Brand HS, de Boer NK. Salivary Function and Oral Health Problems in Crohn's Disease Patients. Inflamm Bowel Dis 2018; 24:1361-1367. [PMID: 29718221 DOI: 10.1093/ibd/izy017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In Crohn's disease (CD) patients, many oral complaints have been reported. The aim of this study was to determine whether salivary function is contributing to reduced oral health in CD. Oral and dental complaints in patients were explored. The prevalence of xerostomia in conjunction with salivary flow rates and biochemical saliva composition was studied. METHODS The Xerostomia Inventory score (XI-score), the salivary flow rates, the concentrations of salivary amylase and mucin 5B, and the type of oral and dental complaints were evaluated. These outcomes were stratified by disease activity, using the Harvey Bradshaw Index (HBI) and the Inflammatory Bowel Disease Questionnaire (IBDQ-9). RESULTS Fifty-three CD patients in a Dutch tertiary referral hospital were included. Of the patients evaluated, 9.4% had hyposalivation under resting conditions, and 28.3% had hyposalivation under chewing stimulated conditions. Saliva secretion rates were not correlated to XI-scores. Median XI-score was 25 (11-45). XI-scores were correlated to the IBDQ scores (r = -0.352, P = 0.010). Salivary mucin 5B was correlated to disease activity (r = 0.295, P = 0.04). Regarding the number of oral complaints, a correlation with disease activity (HBI r = 0.349, P = 0.011) and experienced xerostomia (r = -0.554, P = 0.000) was observed. Oral and dental problems like oral ulcers (37.7%) and cavities (46%) occurred more frequently in CD patients, especially when compared with a non-IBD population. CONCLUSIONS Oral and dental complaints are common in CD patients. Xerostomia is correlated with disease activity-associated quality of life and with the number of oral and dental complaints. Changes in salivary function may contribute to reduced oral health in CD patients. 10.1093/ibd/izy017_video1izy017.video15776803023001.
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Affiliation(s)
- Silvia A G de Vries
- Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam.,Department of Oral Biochemistry, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA)
| | - Christopher X W Tan
- Departments of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA)
| | - Gerd Bouma
- Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam
| | - Tim Forouzanfar
- Departments of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA)
| | - Henk S Brand
- Department of Oral Biochemistry, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA)
| | - Nanne K de Boer
- Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam
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Foraida ZI, Kamaldinov T, Nelson DA, Larsen M, Castracane J. Elastin-PLGA hybrid electrospun nanofiber scaffolds for salivary epithelial cell self-organization and polarization. Acta Biomater 2017; 62:116-127. [PMID: 28801269 PMCID: PMC5646366 DOI: 10.1016/j.actbio.2017.08.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/21/2017] [Accepted: 08/07/2017] [Indexed: 01/24/2023]
Abstract
Development of electrospun nanofibers that mimic the structural, mechanical and biochemical properties of natural extracellular matrices (ECMs) is a promising approach for tissue regeneration. Electrospun fibers of synthetic polymers partially mimic the topography of the ECM, however, their high stiffness, poor hydrophilicity and lack of in vivo-like biochemical cues is not optimal for epithelial cell self-organization and function. In search of a biomimetic scaffold for salivary gland tissue regeneration, we investigated the potential of elastin, an ECM protein, to generate elastin hybrid nanofibers that have favorable physical and biochemical properties for regeneration of the salivary glands. Elastin was introduced to our previously developed poly-lactic-co-glycolic acid (PLGA) nanofiber scaffolds by two methods, blend electrospinning (EP-blend) and covalent conjugation (EP-covalent). Both methods for elastin incorporation into the nanofibers improved the wettability of the scaffolds while only blend electrospinning of elastin-PLGA nanofibers and not surface conjugation of elastin to PLGA fibers, conferred increased elasticity to the nanofibers measured by Young's modulus. After two days, only the blend electrospun nanofiber scaffolds facilitated epithelial cell self-organization into cell clusters, assessed with nuclear area and nearest neighbor distance measurements, leading to the apicobasal polarization of salivary gland epithelial cells after six days, which is vital for cell function. This study suggests that elastin electrospun nanofiber scaffolds have potential application in regenerative therapies for salivary glands and other epithelial organs. STATEMENT OF SIGNIFICANCE Regenerating the salivary glands by mimicking the extracellular matrix (ECM) is a promising approach for long term treatment of salivary gland damage. Despite their topographic similarity to the ECM, electrospun fibers of synthetic polymers lack the biochemical complexity, elasticity and hydrophilicity of the ECM. Elastin is an ECM protein abundant in the salivary glands and responsible for tissue elasticity. Although it's widely used for tissue regeneration of other organs, little is known about its utility in regenerating the salivary tissue. This study describes the use of elastin to improve the elasticity, hydrophilicity and biochemical complexity of synthetic nanofibers and its potential in directing in vivo-like organization of epithelial salivary cells which helps the design of efficient salivary gland regeneration scaffolds.
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Affiliation(s)
- Zahraa I Foraida
- Colleges of Nanoscale Science and Engineering, SUNY Polytechnic Institute, United States
| | - Tim Kamaldinov
- Colleges of Nanoscale Science and Engineering, SUNY Polytechnic Institute, United States
| | - Deirdre A Nelson
- Department of Biological Sciences, University at Albany, State University of New York, United States
| | - Melinda Larsen
- Department of Biological Sciences, University at Albany, State University of New York, United States.
| | - James Castracane
- Colleges of Nanoscale Science and Engineering, SUNY Polytechnic Institute, United States.
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Ho A, Affoo R, Rogus-Pulia N, Nicosia M, Inamoto Y, Saitoh E, Green S, Fels S. Inferring the effects of saliva on liquid bolus flow using computer simulation. Comput Biol Med 2017; 89:304-313. [DOI: 10.1016/j.compbiomed.2017.07.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/15/2017] [Accepted: 07/26/2017] [Indexed: 01/13/2023]
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Donath F, Tonner F, Chavda R, Gatignol J, Bouyrie J. Randomized trial of the efficacy and safety of a new oral spray for drug-induced xerostomia. Clin Exp Dent Res 2016; 2:112-120. [PMID: 29744157 PMCID: PMC5839221 DOI: 10.1002/cre2.29] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/24/2016] [Accepted: 03/14/2016] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to evaluate the efficacy, safety, and tolerability of three formulations of DC161 oral spray, a saliva substitute, and a comparator in relieving drug-induced xerostomia. This was an open-label, randomized, 4-period, cross-over study in adult subjects with drug-induced xerostomia and documented hyposalivation. During each of the four 1-day periods, one product (one of three DC161 formulations or the comparator) was applied at T0 and then at T4h (before a meal). Mouth dryness and related symptoms were evaluated by the subject on a 100-mm visual analog scale. The primary efficacy criterion was the area under the curve of the dry mouth evaluation (baseline to T4h) after the first application. The oral mucosa was examined by a dental specialist; tolerability and product acceptability were assessed by the subject. Twenty-four subjects were randomized and completed the study. Despite large variability in data among the products, the selected aqueous formulation - DC161-DP0292 - reduced the intensity of dryness of mouth at least as well as the comparator; DC161-DP0292 provided a fast relief and a long-lasting effect on mouth dryness. Both products improved other symptoms such as swallowing and speaking, even when applied just prior to a meal. DC161-DP0292 was well tolerated and rated by subjects as providing a slightly higher acceptability of taste/aftertaste, texture, and lubricating effect than the comparator. No clinically relevant signs were reported for any product following the oral examination. DC161-DP0292 provides fast and long-acting symptomatic relief and is a relevant new treatment for drug-induced xerostomia.
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Lone MA, Shaikh S, Lone MM, Afaq A, Lone MA. Association of salivary gland hypofunction with diabetes mellitus and drugs among the elderly in Karachi, Pakistan. ACTA ACUST UNITED AC 2016; 8. [PMID: 26825515 DOI: 10.1111/jicd.12209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/14/2015] [Indexed: 01/07/2023]
Abstract
AIM Studies from Pakistan on salivary dysfunction are lacking, and the Pakistani elderly population is rapidly growing. Among the most common problems in the elderly that could have a deleterious impact on their quality of life are salivary gland hypofunction (SGH), diabetes mellitus (DM), and the intake of drugs with adverse effects on salivary function. In the present study, we aimed to find the association of SGH with DM and drugs among the elderly in Karachi, Pakistan. METHODS The inclusion criterion was affirmative answers to a series of standardized questions related to the symptoms of dry mouth. A total of 110 individuals were selected from a convenience sample of 200 people aged between 60 and 70 years. Diabetes, drug use, and SGH in the participants were determined by detailed medical and drug history, clinical examination, and sialometry. RESULTS Similar to their international counterparts, the majority of the study participants demonstrated objective evidence of SGH. More importantly SGH was found to be statistically significant with respect to DM and medication (P < 0.05). For participants on medication, the minimum and maximum salivary flow rates were found to be 0.09 mL/min and 0.3 ml/min, respectively, whereas the minimum and maximum salivary flow rates in diabetic participants were 0.01 mL/min and 0.09 mL/min, respectively. CONCLUSION In the present study, the majority of elderly participants whose presenting complaint was oral dryness was found to have objective evidence of SGH, with a statistically-significant association with DM and drugs.
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Affiliation(s)
- Muneeb Ahmed Lone
- Department of Prosthodontics, Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Sameer Shaikh
- Department of Oral Diagnosis and Oral Medicine, University of Ha'il, Ha'il, Saudi Arabia
| | - Maham Muneeb Lone
- Department of Operative Dentistry, Aga Khan University Hospital, Karachi, Pakistan
| | - Ashar Afaq
- Department of Community Dentistry, Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Mohid Abrar Lone
- Department of Oral Pathology, Altamash Institute of Dental Medicine, Karachi, Pakistan
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TINÓS AMFG, SALES-PERES SHDC. Xerostomia related to HIV infection /AIDS: a critical review. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/rou.2014.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: The presence of oral manifestations in HIV positive individuals is quite common. Xerostomia appears as one of the most frequent problems and may lead to a reduction in the quality of life of this population. Objective: This study was a critical review of the relationship between xerostomia and HIV infection, to attract the attention of dentists on the importance of dental care to these patients. Material and method: We included articles published between 2000 and 2009, indexed in PUBMED database. The descriptors used were "HIV" and "xerostomia", the exclusion criteria adopted were: the absence of these descriptors associated, non-location of the full-text, articles based on case studies or case series and the absence of the abstract in the database. Result: Based on studies in the review, it can be said that the xerostomia is a common manifestation of HIV infection, predisposing the patient to several other oral problems. Among the risk factors for its occurrence it was reported: low counts of CD4+ T cells, high plasma viral load, the use of some medications and antiretroviral therapy. Conclusion: The HIV/AIDS can change the salivary glands, and were considered important risk factors for the occurrence of xerostomia the presence of didanosine and the drug class which corresponds to protease inhibitors in antiretroviral therapy.
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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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Berti-Couto SDA, Couto-Souza PH, Jacobs R, Nackaerts O, Rubira-Bullen IRF, Westphalen FH, Moysés SJ, Ignácio SA, Costa MBD, Tolazzi AL. Clinical diagnosis of hyposalivation in hospitalized patients. J Appl Oral Sci 2012; 20:157-61. [PMID: 22666830 PMCID: PMC3894756 DOI: 10.1590/s1678-77572012000200006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Accepted: 01/27/2011] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of clinical criteria for the diagnosis of hyposalivation in hospitalized patients. MATERIAL AND METHODS A clinical study was carried out on 145 subjects (48 males; 97 females; aged 20 to 90 years). Each subject was clinically examined, in the morning and in the afternoon, along 1 day. A focused anamnesis allowed identifying symptoms of hyposalivation, like xerostomia complaints (considered as a reference symptom), chewing difficulty, dysphagia and increased frequency of liquid intake. Afterwards, dryness of the mucosa of the cheeks and floor of the mouth, as well as salivary secretion during parotid gland stimulation were assessed during oral examination. RESULTS Results obtained with Chi-square tests showed that 71 patients (48.9%) presented xerostomia complaints, with a significant correlation with all hyposalivation symptoms (p <0.05). Furthermore, xerostomia was also significantly correlated with all data obtained during oral examination in both periods of evaluation (p<0.05). CONCLUSION Clinical diagnosis of hyposalivation in hospitalized patients is feasible and can provide an immediate and appropriate therapy avoiding further problems and improving their quality of life.
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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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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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Kharevich O, Shipman B, Goldman BM, Nahon M. Salese to Buffer Saliva in Elderly Patients with Xerostomia: a Pilot Study. J Prosthodont 2011; 20:135-8. [DOI: 10.1111/j.1532-849x.2010.00680.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Martins FM, Casseb J, Penalva-de-Oliveira AC, de Paiva MFRM, Watanuki F, Ortega KL. Oral manifestations of human T-cell lymphotropic virus infection in adult patients from Brazil. Oral Dis 2010; 16:167-71. [DOI: 10.1111/j.1601-0825.2009.01638.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Van Zyl AW, Van Heerden WFP. Mouthwash: A review for South African health care workers. S Afr Fam Pract (2004) 2010. [DOI: 10.1080/20786204.2010.10873950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] 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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Qi B, Narita T, Sugiya H, Murakami M. Pilocarpine-induced salivary fluid secretion in the perfused submandibular gland of the rat. THE JOURNAL OF MEDICAL INVESTIGATION 2009; 56 Suppl:281-3. [PMID: 20224203 DOI: 10.2152/jmi.56.281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Xerostomia is the symptom of dry mouth often seen in patients who receive head and neck radiation therapy or in patients who have Sjögren's syndrome. The primary treatment to relieve xerostomia symptom is oral administration of pilocarpine, a parasympathomimetic agent with muscarinic action. Increase in salivary secretion induced by systemic administration of pilocarpine is considered to be mediated by actions on muscarinic cholinergic receptors in the central nervous system and salivary glands. In this study, we investigated the direct effect of pilocarpine on salivary fluid secretion in the isolated, perfused rat submandibular gland. Pilocarpine provoked salivary fluid secretion in a dose-dependent manner. The Na(+)-channel blocker tetrodotoxin had almost no effect on the pilocarpine-induced salivary fluid secretion, indicating that pilocarpine directly stimulates submandibular gland. Pilocarpine induced an increase in intracellular Ca(2+) concentration in dispersed submandibular gland cells at 37 degrees C, but not 25 degrees C. The salivary fluid secretion induced by pilocarpine was consisted of a rapid and transient phase and a subsequent sustained phase, which profile was different from that evoked by carbachol, another typical muscarinic agonist. Pilocarpine also induced Lucifer yellow secretion via paracellular route.
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Affiliation(s)
- Bing Qi
- Department of Physiology, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
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