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Jørgensen MR. Pathophysiological microenvironments in oral candidiasis. APMIS 2024. [PMID: 38571459 DOI: 10.1111/apm.13412] [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: 01/15/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024]
Abstract
Oral candidiasis (OC), a prevalent opportunistic infection of the oral mucosa, presents a considerable health challenge, particularly in individuals with compromised immune responses, advanced age, and local predisposing conditions. A considerable part of the population carries Candida in the oral cavity, but only few develop OC. Therefore, the pathogenesis of OC may depend on factors other than the attributes of the fungus, such as host factors and other predisposing factors. Mucosal trauma and inflammation compromise epithelial integrity, fostering a conducive environment for fungal invasion. Molecular insights into the immunocompromised state reveal dysregulation in innate and adaptive immunity, creating a permissive environment for Candida proliferation. Detailed examination of Candida species (spp.) and their virulence factors uncovers a nuanced understanding beyond traditional C. albicans focus, which embrace diverse Candida spp. and their strategies, influencing adhesion, invasion, immune evasion, and biofilm formation. Understanding the pathophysiological microenvironments in OC is crucial for the development of targeted therapeutic interventions. This review aims to unravel the diverse pathophysiological microenvironments influencing OC development focusing on microbial, host, and predisposing factors, and considers Candida resistance to antifungal therapy. The comprehensive approach offers a refined perspective on OC, seeking briefly to identify potential therapeutic targets for future effective management.
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Affiliation(s)
- Mette Rose Jørgensen
- Section of Oral Pathology and Oral Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Bergh H, Albrektson M, Kastberg C, Hedström L. Association of Sublingual Varices With Heart- and Cerebrovascular Disease. Int Dent J 2024; 74:216-222. [PMID: 37743138 PMCID: PMC10988254 DOI: 10.1016/j.identj.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE The aim of this research was to investigate whether sublingual varices (SV) are associated with new events of ischaemic heart disease (IHD) and new events of cerebrovascular disease. METHODS A prospective observational study was conducted amongst 1139 dental patients aged between 48 and 84 years across 2 cohorts (201 enrolled from 2010-2013 and 938 from 2018-2020). Participants provided baseline data on demographics, risk factors, and medical diagnoses, followed by an assessment of their tongue's ventral surface to classify veins as either having no sublingual varices (nSV) or having sublingual varices (SV). Information regarding medical diagnoses was gathered during the follow-up period from both participants and their medical records. The primary outcome variables were the onset of new IHD and new cerebrovascular disease events. Comparisons were made between participants with SV and nSV. RESULTS The study population comprised 54% women with an average age of 66 years. SV were present in 33% of participants. Those with SV predominantly were male, older, and smokers; had a higher body mass index, and exhibited more instances of hypertension, diabetes, and dyslipidaemia than those with nSV. New occurrences of IHD (4.5% vs 1.8%, P = .009) and cerebrovascular disease (4.2% vs 2.0%, P = .026) were more prevalent in the SV group compared with the nSV group. The link between SV and new IHD events persisted even after adjustments for sex, age, and smoking habits (OR, 2.26; 95% CI, 1.074.76), but not for new cerebrovascular disease events (OR, 1.77; 95% CI, 0.843.71). CONCLUSIONS Our study identifies a correlation between SV and new events of IHD, but not new events of cerebrovascular disease. The detection of SV occurred prior to the IHD events, suggesting a temporal relationship. This novel finding proposes a potential shared pathophysiology between IHD and SV.
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Affiliation(s)
- Håkan Bergh
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Research & Development Unit, Hospital Varberg, Region Halland, Halmstad Sweden.
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Eslami H, Halimi Milani F, Salehnia F, Kourehpaz N, Katebi K. Relationship between sublingual varices and hypertension: a systematic review and meta-analysis. BMC Oral Health 2024; 24:240. [PMID: 38360643 PMCID: PMC10868067 DOI: 10.1186/s12903-024-03982-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/04/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Previous research has investigated the connection between sublingual varices (SV) and cardiovascular disease, aging, and smoking. However, it is still unclear whether arterial hypertension affects the presence of SV. This meta-analysis aimed to investigate the relationship between hypertension and the presence of SV. METHODS The literature search was performed using PubMed, Web of Science, Scopus, Google Scholar, and Embase for cross-sectional studies until July 2023. PRISMA guidelines were used for article selection. A meta-analysis using standardized mean differences by a random effects model was conducted to pool studies. RESULTS A total of 568 articles were retrieved, of which twelve were included in the meta-analysis. Cumulatively, 2543 samples in the case group (1185 with hypertension) and 3897 samples (821 with hypertension) were studied in the control group. Using the random effects model, the pooled odds ratio (OR) revealed a significant association between hypertension and sublingual varices (OR = 2.66; 95% CI: 1.69-4.18). CONCLUSION The meta-analysis showed a significant and positive association between sublingual varices and hypertension. SV's presence could be used by dentists as a non-invasive indicator of hypertension screening.
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Affiliation(s)
- Hosein Eslami
- Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fatemeh Salehnia
- Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negar Kourehpaz
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Katayoun Katebi
- Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
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de Souto Medeiros MR, da Silva Barros CC, de Macedo Andrade AC, de Lima KC, da Silveira ÉJD. Antimicrobial photodynamic therapy in the treatment of oral erythematous candidiasis: a controlled and randomized clinical trial. Clin Oral Investig 2023; 27:6471-6482. [PMID: 37718381 DOI: 10.1007/s00784-023-05252-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To analyze the clinical and microbiological efficacy of antimicrobial photodynamic therapy (aPDT) in patients with erythematous candidiasis (EC). METHODS This study was a controlled and randomized clinical trial in patients diagnosed with EC, who were allocated into a control group (CG) and experimental group (EG) treated with nystatin oral suspension and aPDT with methylene blue 0.1%, respectively. A clinical index was used to classify the EC lesions from mild to severe and assess the treatment efficacy. Microbiological samples were collected before and after aPDT session and analyzed by counting colony-forming units (CFUs) of Candida and Staphylococcus sp. RESULTS A total of 41 patients (CG (n = 18); EG (n = 23)) were analyzed in our research. Of these, 16 (94.1%) of the CG and 16 (84.2%) of the EG exhibited complete remission of the lesions. Regarding the degree of the lesion, it was observed that the severe lesions were more difficult to present remission, while all the mild and moderate lesions showed complete regression (p = 0.001). The microbiological analysis showed that Candida albicans and Staphylococcus sp. were the most prevalent microorganisms, and the aPDT group showed a decrease in CFUs of these microorganisms after the first aPDT session (p < 0.05). CONCLUSIONS aPDT proved to be a clinically and microbiologically effective therapy for treating EC. TRIAL REGISTRATION Registered at ClinicalTrials.gov; Set 12th, 2019; No. RBR-8w8599. CLINICAL RELEVANCE aPDT is a promising alternative treatment since it presents satisfactory results and does not cause damage to oral tissues or develop resistance to the treatment.
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Affiliation(s)
- Maurília Raquel de Souto Medeiros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande Do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | - Caio César da Silva Barros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande Do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | - Ana Cláudia de Macedo Andrade
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande Do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | - Kenio Costa de Lima
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande Do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | - Éricka Janine Dantas da Silveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande Do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
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Demarchi LS, Vogel MT, Haubert G, Rigo L. Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly. BRAZILIAN JOURNAL OF ORAL SCIENCES 2023. [DOI: 10.20396/bjos.v22i00.8667543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Aim: To evaluate the impact of xerostomia, edentulism, use of dental prosthesis, and presence of chronic diseases on quality of life in relation to oral health in institutionalized elderly individuals. Methods: This is a cross-sectional study. A questionnaire was administered containing the following instruments: Oral Health Impact Profile (OHIP-14), which measures the quality of life related to oral health; the Summated Xerostomia Inventory questionnaire (SXI-PL) for evaluation of xerostomia, sociodemographic data, clinical description, and patient-reported factors was assessed (edentulism, use of dental prostheses, and chronic diseases). Results: Most elderly individuals did not have any teeth in their mouths and used dental prosthesis. The impact on quality of life, considering the mean of the OHIP-14 scores, was positive in 58.3% of the elderly. Those who used a dental prosthesis were three times more likely to have their oral health negatively impacted (OR=3.09; 95%CI =1.17 8.11), compared to those who did not use, and individuals with xerostomia were more likely to have their oral health negatively impacted (OR=1.57; 95%CI=1.25-1.98) compared to those without xerostomia. There was no difference in the quality of life of individuals with and without chronic diseases. Conclusions: The feeling of dry mouth and use of dental prostheses negatively impacted the quality of life in relation to oral health of the elderly.
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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Chen GY, Tang ZQ, Bao ZX. Vitamin B12 deficiency may play an etiological role in atrophic glossitis and its grading: A clinical case-control study. BMC Oral Health 2022; 22:456. [DOI: 10.1186/s12903-022-02464-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/19/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Existing studies have reported the significant association between atrophic glossitis (AG) and hematinic deficiencies, including iron, folate and vitamin B12 deficiency. However, these findings were inconsistent. AG can be graded as partial or complete atrophy. It is still unclear whether hematinic deficiencies are associated with the grading of AG.
Methods
236 AG patients and 208 sex- and age-matched healthy controls were enrolled in this study. Hematological tests including complete blood count, and serum levels of folate, ferritin and vitamin B12 were performed. The AG group was divided into those with partial AG and those with complete AG according to the extent of papillary atrophy. Statistical analysis was performed to assess whether hematinic deficiencies are risk factors for AG and its grading.
Results
Compared with the healthy controls, AG patients had significantly higher frequencies of vitamin B12 deficiency (68.22%), ferritin deficiency (13.98%) and anemia (21.61%). The differences in hematinic deficiencies and anemia between AG patients and healthy controls changed according to gender and age. The frequencies of serum vitamin B12 deficiency and anemia in the complete AG subgroup were significantly higher than those in the partial AG subgroup. Logistic regression analysis revealed that vitamin B12 deficiency and anemia were significantly correlated with AG and its grading. The AG patients with vitamin B12 deficiency responded well to supplement therapy.
Conclusion
AG could be an important clinical indicator for potential vitamin B12 deficiency, especially when the degree of tongue atrophy more than 50% and complete atrophy. Vitamin B12 deficiency might play an etiological role in the development of AG.
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Jayasinghe TN, Harrass S, Erdrich S, King S, Eberhard J. Protein Intake and Oral Health in Older Adults-A Narrative Review. Nutrients 2022; 14:4478. [PMID: 36364741 PMCID: PMC9653899 DOI: 10.3390/nu14214478] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 08/31/2023] Open
Abstract
Oral health is vital to general health and well-being for all ages, and as with other chronic conditions, oral health problems increase with age. There is a bi-directional link between nutrition and oral health, in that nutrition affects the health of oral tissues and saliva, and the health of the mouth may affect the foods consumed. Evidence suggests that a healthy diet generally has a positive impact on oral health in older adults. Although studies examining the direct link between oral health and protein intake in older adults are limited, some have explored the relationship via malnutrition, which is also prevalent among older adults. Protein-energy malnutrition (PEM) may be associated with poor oral health, dental caries, enamel hypoplasia, and salivary gland atrophy. This narrative review presents the theoretical evidence on the impact of dietary protein and amino acid composition on oral health, and their combined impact on overall health in older adults.
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Affiliation(s)
- Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Sanaa Harrass
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Sharon Erdrich
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Shalinie King
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Bergh H, Kastberg C, Albrektson M, Hedström L. Persistence and stability of sublingual varices over time and their connection to underlying factors: an 8 year follow up study. BMC Oral Health 2022; 22:346. [PMID: 35953817 PMCID: PMC9373291 DOI: 10.1186/s12903-022-02379-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 08/04/2022] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate whether sublingual varices are constant or inconstant over time and whether this is connected to background variables, cardiovascular risk factors or disease. Design This longitudinal observational study was performed between 2010 and 2020 at the Public Dental Services Västra Vall, Varberg, Sweden. The study was based on 431 patients included in a previous study in which the relationship between sublingual varices and hypertension was examined. In connection to the annual dental examination, 281 patients were included in the follow-up study. They completed a questionnaire about background and health factors and diseases. Length and weight were measured. Two intraoral photos were taken with a digital camera. Two dentists independent of each other graded all photographs as none/few visible sublingual varices (nSV) or medium/severe sublingual varices (SV). Results The prevalence of SV was 25.6% at baseline and 30.6% at follow-up. At the follow up, a total of 76.5% had maintained their sublingual vascular status. Of those with nSV at baseline (n209), 80.9% still had nSV, and 19.1% had developed SV during the 8-year follow-up period. Of those 72 participants who had SV at baseline, 46 (63.9%) were unchanged at follow-up, and 26 (36.1%) were classified as nSV. Those who had developed SV at follow-up had a higher mean age (p = 0.003) and a higher prevalence of cardiovascular disease (CVD), 13.2% versus 3.0% (p = 0.021). This association with CVD did not persist after an adjustment for sex and age (OR 3.2, 95% CI 0.81–12.46). They exhibited more hypertension (35.0% vs. 22.5%) and diabetes type 2 (7.5% vs. 3.0%), but with no significant difference. Conclusions This study revealed that 76.5% of the participants had an unchanged status regarding sublingual varices during an 8-year period and that the development from nSV to SV was associated with advanced age.
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Affiliation(s)
- Håkan Bergh
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. .,Department of Research and Development Unit, Hospital Varberg, Region Halland, Halmstad, Sweden. .,, Hajvägen 37, 432 74, Varberg, Sweden.
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Bergh H, Albrektson M, Kastberg C, Baigi A, Hedström L. The Association Between Sublingual Varices and Cardiovascular Risk Factors. Vasc Health Risk Manag 2022; 18:319-327. [PMID: 35498559 PMCID: PMC9045594 DOI: 10.2147/vhrm.s354021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To study the association between sublingual varices (SV) and cardiovascular (CVD) risk factors. Methods A total of 989 consecutive dental patients aged 55-84 years participated in the study, which applied a survey about risk factors, diseases and medications. Digital photos of the lateral borders of the tongue, height, weight, waist, hip and blood pressure were registered, and blood samples were analyzed. Those with SV were compared with those without SV (nSV). Results Those with SV had more hypertension 41.8% vs 27.0% (p<0.0001), a higher systolic blood pressure (BP) 139.5 (SD 18.6) mmHg vs 134.3 (SD 18.8) mmHg (95% CI -7.73 ─ -2.72), more diabetes type 2 (DM-2) 7.4% vs 3.8% (p=0.014), a higher fasting plasma glucose 5.9 (SD 1.5) mmol/L vs 5.7 (SD 1.0) mmol/L (95% CI -0.42 ─ -0.05), more dyslipidemia 24.1% vs 17.7% (p=0.018), lower HDL 1.6 vs 1.7 (p=0.003), a greater waist circumference 97.0 cm vs 93.9 cm (95% CI -4.66 ─ -1.46), a greater waist/hip ratio 0.92 cm/cm vs 0.90 cm/cm (95% CI -0.03 ─ -0.01), and a higher BMI 26.6 kg/m2 vs 26.0 kg/m2 (95% CI -1.11 ─ -0.03). The following associations with SV were found in multivariate analysis: hypertension OR=1.6 (95% CI 1.19 ─2.13), a high systolic BP OR =1.5 (95% CI 1.11 ─2.13), a high fP-glucose OR= 1.8 (95% CI 1.03 ─3.21), a low HDL OR= 1.8 (95% CI 1.15 ─2.92), a greater waist circumference OR= 1.68 (95% CI 1.10 ─2.58), a greater waist/hip ratio OR=2.21 (95% CI 1.36 ─3.58), and a higher BMI OR=1.05 (95% CI 1.02 ─1.09). Conclusion This study shows an association between SV and a high BP, a high fP-glucose, hypertension, diabetes mellitus type 2, dyslipidemia, abdominal obesity, older age and smoking.
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Affiliation(s)
- Håkan Bergh
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Research & Development Unit, Hospital Varberg, Region Halland, Sweden
| | | | | | - Amir Baigi
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Research & Development Unit, Hospital Varberg, Region Halland, Sweden
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Mahdani FY, Parmadiati AE, Ernawati DS, Suryanijaya VE, Inastu CR, Radithia D, Ayuningtyas NF, Surboyo MDC, Pratiwi AS, Marsetyo RI. Prevalence of Oral Normal Variance in Healthy Elderly Patients: A Descriptive Study on Oral Pseudo Lesions. Int Arch Otorhinolaryngol 2022; 26:e671-e675. [DOI: 10.1055/s-0042-1742328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 10/17/2021] [Indexed: 10/18/2022] Open
Abstract
Abstract
Introduction The aging process in the elderly can change the condition of the oral cavity, regarding both clinical appearance and function. The oral mucosa becomes more susceptible to mechanical damage and irritant agents. Any changes in the oral mucosa, including normal variance, should be examined. This is especially true for the elderly, to improve oral health and prevent any abnormalities.
Objective To describe the prevalence of oral normal variance in healthy elderly patients.
Methods An observational descriptive study with a cross-sectional design with total sampling conducted from March to April 2020.
Results Among the 117 elderly patients who participated in this study, 58 were described as healthy without any comorbidities. From those subjects, there were 117 cases of normal variance in the oral mucosa. The three most prevalent issues were fissured tongue (93.1%), coated tongue (58.62%), and crenated tongue (27.59%).
Conclusion Fissured tongue is a normal variance of the oral mucosa that is commonly found in healthy elderly patients.
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Affiliation(s)
- Fatma Yasmin Mahdani
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Diah Savitri Ernawati
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Vint Erawati Suryanijaya
- Bachelor of Dental Science, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Candrika Ramya Inastu
- Bachelor of Dental Science, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Desiana Radithia
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | | | - Aulya Setyo Pratiwi
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Riyan Iman Marsetyo
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
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Clinical Study of Oral Mucosal Lesions in the Elderly-Prevalence and Distribution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052853. [PMID: 35270543 PMCID: PMC8910280 DOI: 10.3390/ijerph19052853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The aim of the study was to determine the prevalence, pattern, and distribution of oral mucosa lesions in elderly patients attending an outpatient oral pathology clinic. METHODS A retrospective analysis of 2747 patients' medical files was performed. Of these, 1398 (50.6%) belonged to seniors. The mean age was 69.8 ± 7.1, and women were in the majority. RESULTS Among the entire group of patients, the three most common mucosal lesions were: oral lichenoid diseases (OLDs), lingual changes, and small nodules. In the female group, the most common diagnoses were: OLDs, lingual changes, and oral candidiasis; in the male population, the most common diagnoses were: lingual changes, small nodules, and OLDs. Those suffering from OLDs were the youngest patients, and those with focal oral mucosa erosions and ulcerations were the oldest patients. In the groups aged 60-70 and 71-80 years old, the most common diagnoses were OLDs, and in the oldest group (+80 years old), they were lingual lesions. CONCLUSIONS Oral health has an obvious impact on the functional, psychological, and behavioral quality of life. There is a small number of publications concerning the prevalence and distribution of oral mucosa lesions in the senior population of European countries. Our study is filling in that void.
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Barzideh N, Alaee A, Azizi A. The Relationship between Smoking and Sublingual Varices in the Elderly. Oman Med J 2021; 36:e288. [PMID: 34405056 PMCID: PMC8358402 DOI: 10.5001/omj.2021.94] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/08/2020] [Indexed: 11/06/2022] Open
Abstract
Objectives We investigated the existence of any connection between smoking and sublingual varices (SLV) in the older population. Methods This case-control study was conducted in 2019 on adults > 65 years old at Kahrizak Charity Nursing Home, Alborz, Iran. We conducted clinical examination and inspection of 222 elderly patients. Both the case group and control group contained the same number of patients (n = 111). SLV were classified as grade 0 (few or none visible) and grade 1 (moderate or severe). The case group included patients with SLV and the control group consisted of those older adults without SLV and who were matched with the case group based on age, gender, blood pressure, denture wearing, and varicose veins in their legs. Cigarette smoking habits were investigated in both groups. Smokers were considered those who smoked at least one cigarette per day for more than six months. Chi-square and odds ratio (OR) were used to statistically analyze the exposure of participants to smoking in both groups. Results Among 222 participants, 21.6% and 5.4% were smokers in the case and control groups, respectively. The results of our data analysis revealed that SLV were significantly associated with smoking (p < 0.001, OR = 4). Conclusions Elderly patients with SLV are more likely to be cigarette smokers. Therefore, cigarette smoking cessation programs are recommended for older adults in society.
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Affiliation(s)
- Niusha Barzideh
- Oral Medicine Department, Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University,
Tehran, Iran
| | - Arezoo Alaee
- Oral Medicine Department, Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University,
Tehran, Iran
| | - Arash Azizi
- Oral Medicine Department, Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University,
Tehran, Iran
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Older age, smoking, tooth loss and denture-wearing but neither xerostomia nor salivary gland hypofunction are associated with low intakes of fruit and vegetables in older Danish adults. J Nutr Sci 2021; 10:e47. [PMID: 34267893 PMCID: PMC8256315 DOI: 10.1017/jns.2021.38] [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: 01/26/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022] Open
Abstract
Xerostomia and salivary gland hypofunction are prevalent conditions in older people and may adversely influence the intake of certain foods, notably fruit and vegetables. Here, we aimed to investigate whether xerostomia and salivary gland hypofunction were associated with a lower intake of fruit and vegetables. The study included 621 community-dwelling adults, mean age 75⋅2 ± 6⋅4 years, 58⋅9 % female, who had participated in the Copenhagen City Heart Study follow-up, and undergone interviews regarding food intake (preceding month), oral and general health (xerostomia, taste alterations, diseases, medication, alcohol consumption and smoking), clinical oral examination and measurements of unstimulated and chewing-stimulated whole saliva flow rates. The average total energy intake (8⋅4 ± 2⋅7 MJ) and protein energy percentage (14⋅8 ± 3⋅1 %) were slightly below recommendations. The average fruit (234⋅7 ± 201⋅2 g/d) and vegetables (317⋅3 ± 157⋅4 g/d) intakes were within recommendations. Xerostomia and hyposalivation were more prevalent in women than in men (16⋅4 v. 7⋅1 %, P < 0⋅001 and 40⋅7 v. 27⋅5 %, P < 0⋅001). Multiple linear regression analyses revealed that older age (β -0⋅009, se 0⋅003, P = 0⋅005), smoking (β -0⋅212, se 0⋅060, P = 0⋅0005) and wearing complete dentures/being partially or fully edentulous (β -0⋅141, se 0⋅048, P = 0⋅003), but neither xerostomia nor salivary flow rates were associated with an inadequate fruit and vegetable intake, after adjustment for covariates. Older age, smoking, tooth loss and denture-wearing were stronger determinants of low fruit and vegetable intakes than xerostomia and salivary hypofunction supporting the importance of dietary counselling and maintenance of oral health and an adequate masticatory performance.
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15
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Barreto JO, do Nascimento FBSA, Fonseca SGDC, Serpa Sampaio L, da Silva CR, de Andrade Neto JB, Júnior HVN, Regis RR. Microbiological evaluation of an experimental denture cleanser containing essential oil of Lippia sidoides. BIOFOULING 2021; 37:117-130. [PMID: 33593175 DOI: 10.1080/08927014.2021.1885649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
The antimicrobial activity of an experimental solution containing essential oil of Lippia sidoides for denture cleaning was evaluated by (1) minimum inhibitory (MIC) and fungicidal/bactericidal concentration (MFC/MBC) tests against Candida albicans, Staphylococcus aureus, and Pseudomona aeruginosa; (2) the metabolic activity of C. albicans biofilm formed on flat-bottom microplates and denture base specimens based on the reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT); and (3) scanning electron microscopy, to evaluate the fungal biofilm morphology. The solution showed antimicrobial action against the pathogens tested (C. albicans - MIC and MFC: 19.53 µg ml-1, S. aureus - MIC and MBC: 78.12 µg ml-1, P. aeruginosa - MIC: 625 µg ml-1, MBC: 2,500 µg ml-1), reduced the metabolic activity of C. albicans biofilm up to 97%, and caused cell wall damage at low concentrations (195.3-390.6 µg ml-1) and in short time periods (20 min). Therefore, the experimental solution has the potential to be used as an alternative in the prevention and treatment of denture-induced infections.
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Affiliation(s)
- Joel Oliveira Barreto
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry, and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Francisca Bruna Stefany Aires do Nascimento
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Brazil
| | | | - Letícia Serpa Sampaio
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Brazil
| | - Cecília Rocha da Silva
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Brazil
| | - João Batista de Andrade Neto
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Brazil
| | - Hélio Vitoriano Nobre Júnior
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Brazil
| | - Rômulo Rocha Regis
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry, and Nursing, Federal University of Ceará, Fortaleza, Brazil
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Oivio UM, Pesonen P, Ylipalosaari M, Kullaa A, Salo T. Prevalence of oral mucosal normal variations and lesions in a middle-aged population: a Northern Finland Birth Cohort 1966 study. BMC Oral Health 2020; 20:357. [PMID: 33298037 PMCID: PMC7727189 DOI: 10.1186/s12903-020-01351-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/30/2020] [Indexed: 11/12/2022] Open
Abstract
Background In this cross-sectional study we investigated the oral mucosal changes in a middle-aged Finnish population. We analyzed the prevalence of potentially malignant disorders and the influence of smoking, snuff and alcohol use on the mucosal changes. Methods Of the 12,068 members of the NFBC 1966, a total of 1961 participants (16.2%) constituted the study population. Mucosal changes were diagnosed and photographed by seven general dentists, and two specialists re-analyzed all the diagnoses based on the documentation Cross-tabulation with Chi-square tests and logistic regression analysis were used to analyze the data. Results Of the participants, 10.5% had some mucosal changes, of which 81.8% were diagnosed as oral mucosal lesions (OML) and 18.2% as normal variations. Of the normal variations, the most common were Fordyce granules (1.2%), fissured tongue (1.1%) and geographic tongue (0.9%). The most common OMLs were white lesions (6.5%), of which oral lichen planus (OLP) and lichenoid reactions (OLR), grouped as oral lichenoid diseases, were present in 3.5%, males more often (3.8% vs. 3.1%). OLP was found in 1.5% of all participants, females more often (1.8% vs. 1.2%), while OLR was more common in males (2.7% vs. 1.3%). Leukoplakia was identified in 0.5% of the population; twice more often in males (0.6% vs. 0.3%). Erythroplakia was not found. Current smokers had higher risk for oral mucosal changes than former or non-smokers (OR 3.0, 95% CI 2.11–4.28), and snuff, used occasionally or regularly, also raised the risk (OR 2.6, 95% CI 1.48–4.70). Conclusions In the middle-aged northern Finland population, 4% of OMLs were potentially malignant disorders, including OLR (2%), OLP (1.5%) and leukoplakia (0.5%). In particular, smoking and snuff use increased the risk for having any oral mucosa changes.
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Affiliation(s)
- Ulla-Maija Oivio
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5281, 90014, Oulu, Finland
| | - Paula Pesonen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Merja Ylipalosaari
- Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014, Oulu, Finland
| | - Arja Kullaa
- Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Department of Oral Diagnostics, Educational Dental Clinic, Kuopio University Hospital, Yliopistonranta 1 C, 70210, Kuopio, Finland
| | - Tuula Salo
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5281, 90014, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5281, 90014, Oulu, Finland. .,Institute of Oral and Maxillofacial Disease, University of Helsinki, 00014, Helsinki, Finland. .,HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland.
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17
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Santos Sousa TM, Rodrigues de Farias O, Dantas Batista AU, Souto de Medeiros E, Santiago BM, Cavalcanti YW. Effectiveness of denture microwave disinfection for treatment of denture stomatitis: A systematic review and meta-analysis. Int J Dent Hyg 2020; 19:62-77. [PMID: 33022878 DOI: 10.1111/idh.12477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis. METHODS This review identified studies comparing the efficacy of microwave prosthesis disinfection (I) to topical antifungal therapy (C) in the treatment of denture stomatitis (O), which included only individuals who used complete dentures and presented with denture stomatitis (P). The search was performed in six databases and identified 1524 records; after the removal of duplicates, 816 articles remained. Three articles were selected for qualitative synthesis and two for meta-analysis. Random-effects meta-analysis estimated the polled effects of microwave disinfection and antifungal therapy on the Candida counts and clinical manifestation of denture stomatitis. The GRADE approach was used to estimate the certainty of evidence. RESULTS All included studies reported significant reductions in Candida counts and the frequency of denture stomatitis of groups subjected to microwave disinfection of dentures and topical antifungal therapy with nystatin. Significative differences between treatments were only detected for Candida quantification in the palate, within 90 days follow-up period (SMD = 0.47, 95% CI = 0.02-0.91). Meta-analyses did not show any further differences between treatments (p > .05), considering the Candida quantification in dentures and the frequency of clinical signs of denture stomatitis. The certainty of the evidence was considered as low, according to GRADE approach. CONCLUSION Microwave disinfection of complete dentures can be considered as efficient as antifungal therapy for the treatment of denture stomatitis. However, further well-designed studies are necessary to confirm such evidence.
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Affiliation(s)
- Taisa Mara Santos Sousa
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Ohana Rodrigues de Farias
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - André Ulisses Dantas Batista
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Department of Restorative Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Eliton Souto de Medeiros
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Materials Engineering Department, Technology Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Bianca Marques Santiago
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Clinical and Social Dentistry Department, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Yuri Wanderley Cavalcanti
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Clinical and Social Dentistry Department, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
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Pina GDMS, Mota Carvalho R, Silva BSDF, Almeida FT. Prevalence of hyposalivation in older people: A systematic review and meta-analysis. Gerodontology 2020; 37:317-331. [PMID: 32965067 DOI: 10.1111/ger.12497] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/16/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The proportion of elders is increasing worldwide, and hyposalivation has been associated with the ageing process. Therefore, there has been growing interest in the frequency of hyposalivation in older people since it can cause transient or permanent problems that could affect oral health. OBJECTIVE To determine the prevalence of hyposalivation in older people (aged ≥ 60 years). METHODS The review was registered at Prospero - International Prospective Register of Systematic Reviews under number CRD42018106322. The search was performed in six electronic databases (Embase, LILACS, Medline, PubMed, Web of Science and Abstracts in Social Gerodontology) and grey literature (Google Scholar) for articles published up to February 2019. The methodology of selected studies was evaluated using the Meta-Analysis of Statistics Assessment and Review (MAStARI) risk of bias checklist. Meta-analyses were performed using Medcalc and Stata 15. RESULTS Thirteen studies totalising 3,885 individuals (≥60 years) were included in this systematic review. The meta-analysis showed an overall hyposalivation prevalence of 33.37% (95% confidence interval [CI] 23.90 - 43.57, P < .0001, n = 3,447). The prevalence of hyposalivation for unstimulated and stimulated methods was 33.39% (95% CI 21.08 - 46.96, P < .0001, n = 2,425 individuals) and 30.47% (95% CI 22.53-39.04, P < .0001, n = 1,495 individuals), respectively. Most of the studies were evaluated as low risk of bias. Some study limitations were related to the observational studies potential risk of bias, and different criteria to measure saliva flow rate. CONCLUSION This study suggests that the overall prevalence of hyposalivation in older people is 33.37%. When considering stimulated methods, the prevalence of hyposalivation was slightly lower (30.47%).
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Kesmez Ö, Frøjk MJ, Eidemak I, Jensen SB, Kragelund C. Oral symptoms and pathologies in Danish patients with chronic kidney disease- a pilot study. APMIS 2020; 128:401-405. [PMID: 32202674 DOI: 10.1111/apm.13042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/04/2020] [Indexed: 01/07/2023]
Abstract
The aim was to investigate oral health in randomly selected patients with chronic kidney disease (CKD). Data obtained by structured interview (self-reported lifestyle, oral symptoms and regularity of dental visits) and oral examination of patients with CKD from the Copenhagen University Hospital. Fourteen patients with CKD were screened. Only half of the patients reported regular dental visits and poor dental status was registered in half of the patients. Oral mucosal changes were registered in thirteen patients (93%). Eleven patients (79%) had gingival inflammatory disease. Twelve patients (86%) were carriers of Candida, and three (21%) had oral candidosis. Six patients (43%) had low whole saliva flow rate. Twelve patients (86%) reported at least one oral symptom. Overall, there was no differences in oral symptoms or findings related to kidney transplanted or not transplanted patients. The small sample size most likely influences the results. However, the vast majority of patients with CKD reported oral symptoms and only half consulted a dentist regularly. Poor dental status, oral mucosal changes and gingival disease were prevalent findings. Patients with CKD need focus on daily oral healthcare and regular dental visits. Interdisciplinary cooperation could encourage patients with CKD to focus on oral health.
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Affiliation(s)
- Özlem Kesmez
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Metha Juhl Frøjk
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Inge Eidemak
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Siri Beier Jensen
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Camilla Kragelund
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Important oral care needs of older French people: A cross-sectional study. Rev Epidemiol Sante Publique 2020; 68:83-90. [DOI: 10.1016/j.respe.2020.01.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 12/09/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
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Matsumura M, Shigeishi H, Su CY, Nishimura R, Ohta K, Sugiyama M. High Rate of Oral Candida Detection in Dependent Japanese Older People. Geriatrics (Basel) 2020; 5:geriatrics5010021. [PMID: 32213908 PMCID: PMC7151096 DOI: 10.3390/geriatrics5010021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/18/2020] [Accepted: 03/22/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to clarify the association between oral Candida detection and the dependency status of older people. This study included 31 older people aged ≥70 years who had a certified need for long-term care or support and received care in a local day care center; it also included 27 independent older patients aged ≥70 years who visited Hiroshima University Hospital. Oral Candida was detected by a polymerase chain reaction using swab samples from the tongue surface. Oral moisture was significantly reduced in dependent older people, compared with independent older people (p = 0.003). There was a weak negative relationship between numbers of bacteria and levels of oral moisture (Spearman's rank correlation coefficient; R = -0.29, p = 0.01). Dependent older people exhibited a significantly higher rate of Candida albicans detection (35.5%) compared with independent older people (11.1%). Dependent older people also exhibited a higher rate of concurrent detection of both C. albicans and Candida glabrata (32.3%) compared with independent older people (11.1%), but this difference was not statistically significant. Thus, dependent older people may be more susceptible to oral C. albicans infection, compared with independent older people. Good oral hygiene is necessary to prevent oral Candida infection in dependent older people.
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Affiliation(s)
- Mari Matsumura
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (M.M.); (K.O.); (M.S.)
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (M.M.); (K.O.); (M.S.)
- Correspondence: ; Tel.: +81-82-257-5945; Fax: +81-82-257-5945
| | - Cheng-Yih Su
- Department of Oral Health Management, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Rumi Nishimura
- Department of Oral Epidemiology, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (M.M.); (K.O.); (M.S.)
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (M.M.); (K.O.); (M.S.)
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Serrano J, López-Pintor RM, Fernández-Castro M, Ramírez L, Sanz M, Casañas E, García JA, Recuero S, Bohorquez C, Hernández G. Oral lesions in patients with primary Sjögren's syndrome. A case-control cross-sectional study. Med Oral Patol Oral Cir Bucal 2020; 25:e137-e143. [PMID: 31880282 PMCID: PMC6982992 DOI: 10.4317/medoral.23254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/07/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To evaluate the presence of oral lesions in a group of patients with primary Sjögren's syndrome (pSS) and compare these results with a matched control group (CG). MATERIAL AND METHODS An observational cross-sectional study was conducted. 61 pSS patients (60 women, 1 man, mean age 57.64±13.52) diagnosed according to the American European Criteria (2002), and 122 matched control patients (120 women, 2 men, mean age 60.02±13.13) were included. Demographic and medical data, oral lesions and salivary flow rate were collected. RESULTS Compared with the controls, pSS patients were 3.95 more likely to have oral lesions (OR 3.95; 95% CI 2.06-7.58; p=0.0001). 57.4% pSS patients presented oral lesions compared to 25.4% in CG. The most common were candidiasis (13.1% vs 2.5%), traumatic lesions (13.1% vs 4.1%), apthae (8.2% vs 0), and fissuration of the tongue (8.2% vs 0.8%). pSS patients with oral lesions had lower salivary flow levels (stimulated and unstimulated), although these differences were not significant. Significant associations were found between the presence of oral lesions and systemic manifestations and history of parotid gland enlargement in pSS patients. CONCLUSION pSS patients suffer more oral lesions than general population and these lesions may aggravate the pSS disease.
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Affiliation(s)
- J Serrano
- Departamento de Especialidades Clínicas Odontológicas Facultad de Odontología Universidad Complutense de Madrid Plaza Ramón y Cajal s/n, 28040 Madrid. Spain
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Yoo MH, Rhee Y, Jung J, Lee S, Moon J, Mo J, Chung P. TRPV1 regulates inflammatory process in the tongue of surgically induced xerostomia mouse. Head Neck 2019; 42:198-209. [DOI: 10.1002/hed.25980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 08/20/2019] [Accepted: 09/25/2019] [Indexed: 11/05/2022] Open
Affiliation(s)
- Min H. Yoo
- Department of Innovative Toxicology ResearchKorea Institute of Toxicology Daejeon Republic of Korea
| | - Yun‐Hee Rhee
- Laser Translational Clinical Trial CenterDankook University Hospital Cheonan Republic of Korea
- Beckman Laser Institute Korea, Dankook University Cheonan Republic of Korea
| | - JaeYun Jung
- Beckman Laser Institute Korea, Dankook University Cheonan Republic of Korea
- Department of OtorhinolaryngologyCollege of Medicine, Dankook University Cheonan Republic of Korea
| | - Sang‐Joon Lee
- Department of OtorhinolaryngologyCollege of Medicine, Dankook University Cheonan Republic of Korea
| | - Jung‐Hwan Moon
- Laser Translational Clinical Trial CenterDankook University Hospital Cheonan Republic of Korea
- Beckman Laser Institute Korea, Dankook University Cheonan Republic of Korea
- Department of OtorhinolaryngologyCollege of Medicine, Dankook University Cheonan Republic of Korea
| | - Ji‐Hun Mo
- Laser Translational Clinical Trial CenterDankook University Hospital Cheonan Republic of Korea
- Beckman Laser Institute Korea, Dankook University Cheonan Republic of Korea
- Department of OtorhinolaryngologyCollege of Medicine, Dankook University Cheonan Republic of Korea
| | - Phil‐Sang Chung
- Laser Translational Clinical Trial CenterDankook University Hospital Cheonan Republic of Korea
- Beckman Laser Institute Korea, Dankook University Cheonan Republic of Korea
- Department of OtorhinolaryngologyCollege of Medicine, Dankook University Cheonan Republic of Korea
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Does oral dryness influence pressure pain sensitivity in the oral mucosa of removable denture wearers? Clin Oral Investig 2019; 24:2603-2609. [DOI: 10.1007/s00784-019-03118-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
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25
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Oral health status of patients with multiple myeloma. Hematol Transfus Cell Ther 2019; 42:166-172. [PMID: 31582338 PMCID: PMC7248491 DOI: 10.1016/j.htct.2019.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/04/2019] [Accepted: 01/31/2019] [Indexed: 12/04/2022] Open
Abstract
Objective To describe the oral health status of patients with multiple myeloma and compare to a control group. Materials and methods The medical history of the studied subjects was obtained from the medical records and through interviews. Trained examiners evaluated the oral mucosa, teeth, periodontium and imaging aspects. The dental status was evaluated by the decayed, missing and filled teeth index. The presence of bone lesions was investigated with cone beam computer tomography images of the jaws. Results The most common oral mucosa features were paleness (31%) and coated tongue (14.3%) in the multiple myeloma group (N = 42); and coated (21.4%) and fissured tongue (10.7%) in the control group (N = 28). The mean DMFT index of patients with multiple myeloma was high, but not significantly different from controls (14.57 versus 19.69, p = 0.975). Hypodense lesions suggestive of multiple myeloma were observed in the jaws of 73.8% of the patients. Hypodense lesions related to teeth were detected in 33.3% of the patients and in 53.6% of the controls (p = 0.832). Conclusions The studied population of multiple myeloma patients presented many oral health issues that needed attention. Thus, oral care should be included in the routine treatment to improve the quality of the oral status in these patients.
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Fattori E, Teixeira DS, de Figueiredo MAZ, Cherubini K, Salum FG. Stomatological disorders in older people: An epidemiological study in the Brazil southern. Med Oral Patol Oral Cir Bucal 2019; 24:e577-e582. [PMID: 31433386 PMCID: PMC6764713 DOI: 10.4317/medoral.22966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/08/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of this retrospective, cross-sectional and observational study was to perform a survey of the stomatological conditions of elderly patients seen in a period of 40 years at a Stomatology Service in Southern Brazil. MATERIAL AND METHODS A total of 24,347 medical records were reviewed, of which 5,063 belonged to elderly patients aged 60 to 97 years. The stomatological conditions, systemic conditions, and smoking and alcohol drinking habits as well were recorded. RESULTS The mean age of the patients was 69.29 years, 67.1% were female and 32.9% were male. Variations of normality accounted for 44.5% of the cases. The most prevalent disorders were fungal infections (26.1%), reactive inflammatory lesions (24.6%), burning mouth syndrome (14.9%), benign neoplasms (12.4%), autoimmune disorders (12.3%), premalignant lesions (10.2%) and malignant epithelial neoplasms (7.2%). Regarding biopsied lesions, squamous cell carcinoma was the most prevalent at 30.2%, followed by hyperplasic lesions (28.2%). CONCLUSIONS Knowledge of these physiological and pathological conditions in the oral cavity of the older people is essential for early diagnosis and preventive and therapeutic measures when necessary.
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Affiliation(s)
- E Fattori
- Serviço de Estomatologia - Hospital São Lucas, PUCRS, Av. Ipiranga, 6690 Room 231, CEP: 90610-000 - Porto Alegre, RS, Brazil,
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Yamazaki T, Ushikoshi-Nakayama R, Shirone K, Suzuki M, Abe S, Matsumoto N, Inoue H, Saito I. Evaluation of the effect of a heat-killed lactic acid bacterium, Enterococcus faecalis 2001, on oral candidiasis. Benef Microbes 2019. [DOI: 10.3920/bm2018.0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The effect of a preparation of heat-killed Gram-positive lactic acid bacteria Enterococcus faecalis 2001 (EF-2001) on oral candidiasis was evaluated by two studies. An in vitro study was performed to assess the inhibitory effect on mycelial growth of Candida strains isolated from a patient with oral candidiasis, and a clinical study was done in patients with oral candidiasis. In the in vitro study, EF-2001 inhibited mycelial growth of IT-1, a Candida strain isolated from a patient with oral candidiasis, at concentrations ≥2.34×109 cells/ml. An open clinical study was performed in 13 patients with oral candidiasis. The subjects took a powder containing 7.5×1011 heat-killed EF-2001 once a day before bedtime for seven consecutive days. In 11 of the 12 patients available for analysis (92%), the oral Candida load (cfu/swab) showed a significant decrease (P=0.01079, d=-0.437). There was a 55% decrease of Candida albicans and a 93.8% decrease of Candida glabrata. The following symptoms showed significant improvement: tinnitus (P=0.048, d=-0.462), cold feeling (P=0.048, d=-0.463), and depression (P=0.019, d=-0.34). In addition, 4 out of 26 oral symptoms tended to improve. These results suggest that EF-2001 significantly decreased the oral Candida load in patients with oral candidiasis by inhibiting mycelial growth and that EF-2001 is an effective treatment for oral candidiasis.
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Affiliation(s)
- T. Yamazaki
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa 230-8501, Japan
| | - R. Ushikoshi-Nakayama
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa 230-8501, Japan
| | - K. Shirone
- Shirone Dental Clinic, 276-1 Fushimi Shinmachi, Kanazawa-shi, Ishikawa Prefecture 921-8172, Japan
| | - M. Suzuki
- Teikyo University Institute of Medical Mycology, 359 Otsuka, Hachioji, Tokyo 192-0395, Japan
| | - S. Abe
- Teikyo University Institute of Medical Mycology, 359 Otsuka, Hachioji, Tokyo 192-0395, Japan
| | - N. Matsumoto
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa 230-8501, Japan
| | - H. Inoue
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa 230-8501, Japan
- Department of Pharmacotherapy, Nihon Pharmaceutical University, 10281 Komuro, Ina-machi, Kita-Adachi-gun, Saitama 362-0806, Japan
| | - I. Saito
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa 230-8501, Japan
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Jones RJ, Johnson IG, Morgan MZ. Family and friends: Supporting oral care in care homes. Gerodontology 2019; 36:258-266. [PMID: 30994206 PMCID: PMC7328849 DOI: 10.1111/ger.12404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 02/21/2019] [Accepted: 02/26/2019] [Indexed: 11/30/2022]
Abstract
Objective To consider the role of family and friends in supporting oral care. Background People who live in care homes are susceptible to oral health problems, which can be detrimental to their health and personal and social well‐being. External support from family members and friends has been indicated as being important for maintaining oral health for this vulnerable group of care home residents. Materials and methods Qualitative one‐to‐one interviews were undertaken with care home residents, in Cardiff, UK. Further interviews were undertaken with care home personnel with responsibility for oral health care in order to contextualise residents’ interview data. Interviews were audio recorded, transcribed and analysed using a thematic approach. Results A total of 26 interviews were conducted with care home residents and four interviews with care home personnel, across five care homes. Three main themes emanated from the data relating to co‐supporting oral care: supplying oral care products; accessing dental care and enabling self‐management of oral care problems. There were no spouse caregivers; family and friends acted as co‐supporters of oral care providing a link to residents’ pre‐care home lives by informing the care home personnel of their relatives’ normal routines. An overarching theme “balancing roles – maintaining the equilibrium” emerged from the data reflecting the roles that both care home personnel and family and friends had in balancing the needs, care and well‐being of the resident. Conclusion This study suggests that there are opportunities to improve oral health by providing support for family and friends of those people who are living in care, especially in relation to supplying oral care products, enabling self‐management of oral care problems and accessing dental care.
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Affiliation(s)
- Rhiannon J Jones
- Department of Education, Scholarship and Innovation (DESI), Cardiff University School of Dentistry, Cardiff, UK
| | - Ilona G Johnson
- Applied Clinical and Public Health Research, Cardiff University School of Dentistry, Cardiff, UK
| | - Maria Z Morgan
- Applied Clinical and Public Health Research, Cardiff University School of Dentistry, Cardiff, UK
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Yeast Species in the Oral Cavities of Older People: A Comparison between People Living in Their Own Homes and Those in Rest Homes. J Fungi (Basel) 2019; 5:jof5020030. [PMID: 31013697 PMCID: PMC6617379 DOI: 10.3390/jof5020030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022] Open
Abstract
Oral candidiasis is prevalent among older people due to predisposing factors such as impaired immune defenses, medications and denture use. An increasing number of older people live in rest home facilities and it is unclear how this institutionalized living affects the quantity and type of fungi colonizing these people's oral cavities. Smears and swabs of the palate and tongue and saliva samples were taken from participants residing in rest homes (RH; n = 20) and older people living in their own homes (OH; n = 20). Yeast in samples were quantified and identified by culturing on CHROMagar Candida and sequencing the ITS2 region of rDNA. A higher proportion of RH residents had Candida hyphae present in smears compared to OH participants (35% vs. 30%) although this difference was not statistically significant (p = 0.74). RH residents had, on average, 23 times as many yeast per mL saliva as OH participants (p = 0.01). Seven yeast species were identified in OH samples and only five in RH samples, with Candida albicans and Candida glabrata being the most common species isolated from both participant groups. The results indicate that older people living in aged-care facilities were more likely to have candidiasis and have a higher yeast carriage rate than similarly aged people living at home. This may be due to morbidities which led to the need for residential care and/or related to the rest home environment.
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Oliveira MB, Lopes FF, Rodrigues VP, Alves CMC, Hugo FN. Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly. CIENCIA & SAUDE COLETIVA 2018; 23:3663-3674. [PMID: 30427439 DOI: 10.1590/1413-812320182311.26182016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 11/15/2016] [Indexed: 12/22/2022] Open
Abstract
This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.
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Affiliation(s)
- Marisa Borges Oliveira
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Fernanda Ferreira Lopes
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Vandilson Pinheiro Rodrigues
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Claudia Maria Coelho Alves
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Fernando Neves Hugo
- Centro de Pesquisas em Odontologia Social, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Reinhardt LC, Nascente PDS, Ribeiro JS, Etges A, Lund RG. A single-center 18-year experience with oral candidiasis in Brazil: a retrospective study of 1,534 cases. Braz Oral Res 2018; 32:e92. [PMID: 30231172 DOI: 10.1590/1807-3107bor-2018.vol32.0092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 07/25/2018] [Indexed: 11/22/2022] Open
Abstract
Despite the large number of published studies about oral candidiasis and associated risk factors, reports of large single-center retrospective studies on the prevalence of oral candidiasis, risk factors, and the oral candidiasis types diagnosed more frequently in oral diagnostic reference centers are scarce. The objective of the present study was to retrospectively survey the demographic and clinical profiles of 1,534 patients diagnosed with candidiasis and treated at the Center for Diagnosis of Oral Diseases (CDOD), Pelotas Dental School, Federal University of Pelotas between 1997 and 2014. Using a retrospective, cross-sectional, epidemiological design, data on race, gender, age, systemic diseases, oral candidiasis type and location, symptoms, and harmful habits such as smoking and alcohol consumption were collected. The statistical analysis was performed using STATA version 13.1. Risk factors for chronic atrophic candidiasis (CAC) were evaluated using Poisson regression with robust variance (p ≤ 0.05). The majority of patients with oral candidiasis seen at the CDOD over the 18-year period of analysis were Caucasian women, aged 51-60 years, nonsmokers, and nondrinkers, with no systemic disease, and who wore some form of dental prostheses. CAC was the single most common clinical type of candidiasis detected, and the most frequently affected oral site was the palate. These data from a large single-center in Brazil agree with previous evidence about the clinical and demographic profiles of patients with oral candidiasis.
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Affiliation(s)
- Leandro Calcagno Reinhardt
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
| | - Patricia da Silva Nascente
- Department of Microbiology and Parasitology, Institute of Biology, Universidade Federal de Pelotas - UFPel, Capão do Leão, RS, Brazil
| | - Juliana Silva Ribeiro
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
| | - Adriana Etges
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
| | - Rafael Guerra Lund
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
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Poor oral health and risk of incident myocardial infarction: A prospective cohort study of Swedish adults, 1973-2012. Sci Rep 2018; 8:11479. [PMID: 30065312 PMCID: PMC6068156 DOI: 10.1038/s41598-018-29697-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 07/11/2018] [Indexed: 12/31/2022] Open
Abstract
Previous studies provide conflicting evidence as to whether there is an association between poor oral health and an increased risk of myocardial infarction. The aim of the study was to deepen knowledge of the association between oral health and myocardial infarction risk using a large (n = 20,133), prospective, and population-based cohort in Uppsala, Sweden. Oral health was determined during a clinical dental examination at entry into the cohort in 1973/74. Individuals were followed through linkage with the Swedish National Patient Register, Cause of Death Register and Emigration Register. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) for total, non-fatal and fatal myocardial infarction events. Increased risks of total, non-fatal and fatal myocardial infarction events among individuals with fewer reference teeth at examination, more dental plaque and a borderline significant increased risk among individuals with oral lesions were observed. Adjustment for multiple potential confounding factors did not change the results appreciably. However, the observed HRs generally decreased towards one when the analysis was confined to non-tobacco users only. The results from this study indicate that poor oral health is associated with a slightly increased risk of myocardial infarction; however, these results may be partly explained by residual confounding.
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Pedersen AML, Sørensen CE, Proctor GB, Carpenter GH, Ekström J. Salivary secretion in health and disease. J Oral Rehabil 2018; 45:730-746. [PMID: 29878444 DOI: 10.1111/joor.12664] [Citation(s) in RCA: 217] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2018] [Indexed: 12/16/2022]
Abstract
Saliva is a complex fluid produced by 3 pairs of major salivary glands and by hundreds of minor salivary glands. It comprises a large variety of constituents and physicochemical properties, which are important for the maintenance of oral health. Saliva not only protects the teeth and the oropharyngeal mucosa, it also facilitates articulation of speech, and is imperative for mastication and swallowing. Furthermore, saliva plays an important role in maintaining a balanced microbiota. Thus, the multiple functions provided by saliva are essential for proper protection and functioning of the body as a whole and for the general health. A large number of diseases and medications can affect salivary secretion through different mechanisms, leading to salivary gland dysfunction and associated oral problems, including xerostomia, dental caries and fungal infections. The first part of this review article provides an updated insight into our understanding of salivary gland structure, the neural regulation of salivary gland secretion, the mechanisms underlying the formation of saliva, the various functions of saliva and factors that influence salivary secretion under normal physiological conditions. The second part focuses on how various diseases and medical treatment including commonly prescribed medications and cancer therapies can affect salivary gland structure and function. We also provide a brief insight into how to diagnose salivary gland dysfunction.
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Affiliation(s)
- A M L Pedersen
- Oral Medicine, Oral Pathology & Clinical Oral Physiology, University of Copenhagen, Copenhagen, Denmark
| | - C E Sørensen
- Oral Biochemistry, Cariology & Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G B Proctor
- Mucosal & Salivary Biology Division, King's College London Dental Institute, London, UK
| | - G H Carpenter
- Mucosal & Salivary Biology Division, King's College London Dental Institute, London, UK
| | - J Ekström
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Pedersen A, Sørensen CE, Proctor GB, Carpenter GH. Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. Oral Dis 2018; 24:1399-1416. [PMID: 29645367 DOI: 10.1111/odi.12867] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 04/03/2018] [Indexed: 12/18/2022]
Abstract
Saliva exerts multiple functions in relation to the initial digestive processes taking place in the upper parts of the gastrointestinal tract. Ingestion of food and beverages, in turn, is a strong stimulus for secretion of saliva with a differential composition depending on the neuronal stimulation pattern. This review paper provides insight into the mechanisms by which saliva acts in relation to taste, mastication, bolus formation, enzymatic digestion and swallowing. Also, the protective functions of saliva including maintenance of dental and mucosal integrity will be discussed as they indirectly influence the digestive process. The final part of this study focuses on the implications of xerostomia and salivary gland dysfunction on gastrointestinal functions.
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Affiliation(s)
- Aml Pedersen
- Section 1, Oral Medicine, Oral Pathology & Clinical Oral Physiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - C E Sørensen
- Section of Oral Biochemistry, Cariology & Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G B Proctor
- Mucosal & Salivary Biology Division, King's College London Dental Institute, Guy's & St Thomas' Hospitals, London, UK
| | - G H Carpenter
- Mucosal & Salivary Biology Division, King's College London Dental Institute, Guy's & St Thomas' Hospitals, London, UK
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Campos-de Sales S, Kato CNADO, de Noronha MS, Castro WH, Mesquita RA. Gingival varices treated with monoethanolamine oleate: A rare case report. J Clin Exp Dent 2018; 10:e192-e195. [PMID: 29670740 PMCID: PMC5899791 DOI: 10.4317/jced.53893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 12/06/2017] [Indexed: 11/08/2022] Open
Abstract
Varices are benign blood vessel lesions that are common in the head and neck regions. The aim of this case report is to highlight an uncommon case of gingival varices and its diagnosis and management. This is the second time that a case of varices has been reported at this site. Monoethanolamine oleate (MO) at a 2.5% concentration was used as the treatment. A 66-year-old woman presented spontaneous gingival bleeding in the region of the mandibular first and second left molars. A macula and gingival enlargement on the interproximal papillae were observed. No bleeding was observed during the oral examination. The clinical diagnosis was varices. The patient was given two sessions of sclerotherapy with 2.5% MO applied to the lesion, with 15 days between applications. The lesion showed total clinical resolution, and the patient is in follow-up. This paper reports a rare case of varices in the gingival mandible, with the diagnosis based on the patient’s age, time evolution of the lesion’s, and its clinical characteristics. The concentration of 2.5% MO is safe and efficient, a conservative treatment, and easy to apply.
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Affiliation(s)
- Sarah Campos-de Sales
- DDS, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
| | | | - Mariana-Saturnino de Noronha
- DDS, Msc student, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
| | - Wagner-Henriques Castro
- Professor, Msc, PhD, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
| | - Ricardo-Alves Mesquita
- Professor, Msc, PhD, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal of Minas Gerais, Belo Horizonte, Brasil
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36
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MacEntee MI, Donnelly LR. Oral health and the frailty syndrome. Periodontol 2000 2018; 72:135-41. [PMID: 27501496 DOI: 10.1111/prd.12134] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 12/27/2022]
Abstract
The frailty syndrome is an ever-growing area of study among older adults because of its association with an increased risk of falls, hospitalization, institutionalization, dependency and mortality. Frailty is neither a disease nor a disability but is better understood as a medical syndrome of multisystem dysregulation that results in a diminished ability to overcome everyday stressors. The prevalence of frailty in any given population can vary widely, in part because of the way in which it is defined and measured, but in general it is higher among women and in those with advanced age and declining health. Whilst it is largely understood that older adults will differ biologically, psychologically and socially, and that each of these domains can impact oral health, we are only beginning to investigate how the mouth is affected in frailty. Given that both hard and soft structures contribute to oral health and disease status among older adults with varying degrees of impairment and disability, frailty adds yet another dimension to be considered. This paper will discuss how frailty can influence and be influenced by oral disorders, as well as the potential relationship to oral neglect and the resultant consequences among this vulnerable population.
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Abstract
Although the surfaces of both the skin and oral mucosa are protected by squamous epithelial cells and fall within the scope of dermatologic practice, the oral cavity contains highly specialized structures and functions distinct from other skin biology and pathologic conditions and are also the purview of clinicians who care for patients with skin and mucosal diseases. We describe the distinct features of the tongue, mucosa, and salivary glands. In particular, we examine the composition and function of the saliva, with special focus on salivary biomarkers. Within the oral cavity, saliva shows great promise as a noninvasive and sensitive marker for many systemic diseases. Biomarkers are being used as diagnostic or monitoring tools for a wide variety of diseases, including systemic lupus erythematosus, Sjögren disease, Behçet disease, and autoimmune blistering disorders, as well as premalignant and malignant lesions of the mouth.
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Thanakun S, Pornprasertsuk-Damrongsri S, Izumi Y. Increased oral inflammation, leukocytes, and leptin, and lower adiponectin in overweight or obesity. Oral Dis 2017; 23:956-965. [DOI: 10.1111/odi.12679] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/19/2017] [Accepted: 04/05/2017] [Indexed: 12/15/2022]
Affiliation(s)
- S Thanakun
- Department of Oral Medicine and Periodontology; Faculty of Dentistry; Mahidol University; Bangkok Thailand
| | | | - Y Izumi
- Department of Periodontology; Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
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Wolff A, Joshi RK, Ekström J, Aframian D, Pedersen AML, Proctor G, Narayana N, Villa A, Sia YW, Aliko A, McGowan R, Kerr AR, Jensen SB, Vissink A, Dawes C. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Drugs R D 2017; 17:1-28. [PMID: 27853957 PMCID: PMC5318321 DOI: 10.1007/s40268-016-0153-9] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Medication-induced salivary gland dysfunction (MISGD), xerostomia (sensation of oral dryness), and subjective sialorrhea cause significant morbidity and impair quality of life. However, no evidence-based lists of the medications that cause these disorders exist. OBJECTIVE Our objective was to compile a list of medications affecting salivary gland function and inducing xerostomia or subjective sialorrhea. DATA SOURCES Electronic databases were searched for relevant articles published until June 2013. Of 3867 screened records, 269 had an acceptable degree of relevance, quality of methodology, and strength of evidence. We found 56 chemical substances with a higher level of evidence and 50 with a moderate level of evidence of causing the above-mentioned disorders. At the first level of the Anatomical Therapeutic Chemical (ATC) classification system, 9 of 14 anatomical groups were represented, mainly the alimentary, cardiovascular, genitourinary, nervous, and respiratory systems. Management strategies include substitution or discontinuation of medications whenever possible, oral or systemic therapy with sialogogues, administration of saliva substitutes, and use of electro-stimulating devices. LIMITATIONS While xerostomia was a commonly reported outcome, objectively measured salivary flow rate was rarely reported. Moreover, xerostomia was mostly assessed as an adverse effect rather than the primary outcome of medication use. This study may not include some medications that could cause xerostomia when administered in conjunction with others or for which xerostomia as an adverse reaction has not been reported in the literature or was not detected in our search. CONCLUSIONS We compiled a comprehensive list of medications with documented effects on salivary gland function or symptoms that may assist practitioners in assessing patients who complain of dry mouth while taking medications. The list may also prove useful in helping practitioners anticipate adverse effects and consider alternative medications.
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Affiliation(s)
- Andy Wolff
- Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
- Saliwell Ltd, 65 Hatamar St, 60917, Harutzim, Israel.
| | - Revan Kumar Joshi
- Department of Oral Medicine and Radiology, DAPMRV Dental College, Bangalore, India
| | - Jörgen Ekström
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | | | - Anne Marie Lynge Pedersen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gordon Proctor
- Mucosal and Salivary Biology Division, Dental Institute, King's College London, London, UK
| | - Nagamani Narayana
- Department of Oral Biology, University of Nebraska Medical Center (UNMC) College of Dentistry, Lincoln, NE, USA
| | - Alessandro Villa
- Division of Oral Medicine and Dentistry, Department of Oral Medicine Infection and Immunity, Brigham and Women's Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - Ying Wai Sia
- McGill University, Faculty of Dentistry, Montreal, QC, Canada
| | - Ardita Aliko
- Faculty of Dental Medicine, University of Medicine, Tirana, Albania
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | | | - Siri Beier Jensen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Colin Dawes
- Department of Oral Biology, University of Manitoba, Winnipeg, MB, Canada
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Hilgert JB, Giordani JMDA, de Souza RF, Wendland EMDR, D'Avila OP, Hugo FN. Interventions for the Management of Denture Stomatitis: A Systematic Review and Meta-Analysis. J Am Geriatr Soc 2016; 64:2539-2545. [DOI: 10.1111/jgs.14399] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Juliana Balbinot Hilgert
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Postgraduate Program in Epidemiology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | | | - Raphael Freitas de Souza
- Department of Dental Materials and Prosthetics; University of São Paulo; Ribeirão Preto Brazil
- Division of Oral Health and Society; McGill University; Montreal Québec Canada
| | | | - Otavio Pereira D'Avila
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Fernando Neves Hugo
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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41
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Erriu M, Pili FMG, Cadoni S, Garau V. Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review. Open Dent J 2016; 10:619-635. [PMID: 27990187 PMCID: PMC5123136 DOI: 10.2174/1874210601610010619] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 10/09/2016] [Accepted: 10/15/2016] [Indexed: 12/16/2022] Open
Abstract
Atrophic glossitis is a condition characterised by absence of filiform or fungiform papillae on the dorsal surface of the tongue. Consequently, the ordinary texture and appearance of the dorsal tongue, determined by papillary protrusion, turns into a soft and smooth aspect. Throughout the years, many factors, both local and systemic, have been associated with atrophic glossitis as the tongue is currently considered to be a mirror of general health. Moreover, various tongue conditions were wrongly diagnosed as atrophic glossitis. Oral involvement can conceal underlying systemic conditions and, in this perspective, the role of clinicians is fundamental. Early recognition of oral signs and symptoms, through a careful examination of oral anatomical structures, plays a crucial role in providing patients with a better prognosis.
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Affiliation(s)
- M Erriu
- Department of Surgical Sciences, Cagliari University, Cagliari, Italy
| | - F M G Pili
- Department of Surgical Sciences, Cagliari University, Cagliari, Italy
| | - S Cadoni
- Digestive Endoscopy Unit, S. Barbara Hospital, Iglesias (CA), Italy
| | - V Garau
- Department of Surgical Sciences, Cagliari University, Cagliari, Italy
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42
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Al-Imam H, Benetti AR, Özhayat EB, Pedersen AML, Johansen JD, Thyssen JP, Jellesen MS, Gotfredsen K. Cobalt release and complications resulting from the use of dental prostheses. Contact Dermatitis 2016; 75:377-383. [PMID: 27385620 DOI: 10.1111/cod.12649] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cobalt release from dental prostheses has been shown to elicit allergic reactions in cobalt-allergic patients. It is therefore important to investigate whether these prostheses are possible sources of sensitization. OBJECTIVES To assess (i) cobalt release from dental prostheses and (ii) allergic reactions to components of dental prostheses, and (iii) to investigate the oral mucosa for inflammation 1-5 years after insertion of the prostheses. METHOD Clinical oral examination was conducted in 66 patients with 84 dental prostheses. Cobalt release from 84 functional (used) and 32 non-functional (new) prostheses was investigated with the cobalt spot test. Contact allergy was assessed by patch testing. Smear tests for Candida spp. were performed in patients showing signs of inflammation of the oral mucosa. The prostheses were assessed for biological and technical complications. RESULTS None of the functional prostheses released cobalt, whereas this was observed in 24 of 32 non-functional prostheses. None of the patients had contact allergy to cobalt. Of the 66 patients, 11 showed signs of inflammation of the oral mucosa, 2 had oral candidiasis, 16 had ill-fitting prostheses, and all had insufficient oral hygiene. CONCLUSIONS Dental prostheses released cobalt during the fabrication stages, but not 1-5 years after insertion. No allergic reactions were observed. Signs of inflammation were related to candidiasis, insufficient oral hygiene, and ill-fitting prostheses.
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Affiliation(s)
- Hiba Al-Imam
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Ana R Benetti
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Esben B Özhayat
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Anne M L Pedersen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Jeanne D Johansen
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital, Herlev-Gentofte, 2900, Denmark
| | - Jacob P Thyssen
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital, Herlev-Gentofte, 2900, Denmark
| | - Morten S Jellesen
- Department of Mechanical Engineering, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
| | - Klaus Gotfredsen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
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Zhang LW, Fu JY, Hua H, Yan ZM. Efficacy and safety of miconazole for oral candidiasis: a systematic review and meta-analysis. Oral Dis 2015; 22:185-95. [PMID: 26456226 DOI: 10.1111/odi.12380] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 09/07/2015] [Accepted: 10/04/2015] [Indexed: 11/29/2022]
Abstract
The objective of this study is to assess the efficacy and safety of miconazole for treating oral candidiasis. Twelve electronic databases were searched for randomized controlled trials evaluating treatments for oral candidiasis and complemented by hand searching. The clinical and mycological outcomes, as well as adverse effects, were set as the primary outcome criteria. Seventeen trials were included in this review. Most studies were considered to have a high or moderate level of bias. Miconazole was more effective than nystatin for thrush. For HIV-infected patients, there was no significant difference in the efficacy between miconazole and other antifungals. For denture wearers, microwave therapy was significantly better than miconazole. No significant difference was found in the safety evaluation between miconazole and other treatments. The relapse rate of miconazole oral gel may be lower than that of other formulations. This systematic review and meta-analysis indicated that miconazole may be an optional choice for thrush. Microwave therapy could be an effective adjunct treatment for denture stomatitis. Miconazole oral gel may be more effective than other formulations with regard to long-term results. However, future studies that are adequately powered, large-scale, and well-designed are needed to provide higher-quality evidence for the management of oral candidiasis.
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Affiliation(s)
- L-W Zhang
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - J-Y Fu
- Department of stomatology, Peking University International Hospital, Changping District, Beijing, China
| | - H Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - Z-M Yan
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
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