Dental Disorders and Salivary Changes in Patients with Laryngopharyngeal Reflux

Background: Laryngopharyngeal reflux (LPR) is a common inflammatory condition of the upper aerodigestive tract tissues related to the effects of gastroduodenal content reflux, characterized by a wide variety of clinical manifestations. The aim of our study was to evaluate the possible association between dental disorders and LRP, focusing on the role of salivary changes. Methods: Patient’s dental status was evaluated according to Schiff Index Sensitivity Scale (SISS), Basic Erosive Wear Examination (BEWE) and Decayed, Missing, and Filled Teeth (DMFT) scores. Reflux-associated symptoms were assessed according to Reflux symptom index (RSI). A qualitative and quantitative examination of saliva was performed. Results: Patients suffering from LPR had a higher incidence of dental disorders, regardless the presence of salivary pepsin, and thus, statistically significant higher scores of RSI (p = 0.0001), SISS (p = 0.001), BEWE (p < 0.001) and VAS (p < 0.001). Moreover, they had lower salivary flow compared with healthy patients. Conclusions: The finding of demineralization and dental caries on intraoral evaluation must raise the suspicion of LRP. Reflux treatments should also be aimed at correcting salivary alterations, in order to preserve the buffering capacity and salivary pH, thus preventing mucosal and dental damage.

Polydatin Alleviates Diabetes-Induced Hyposalivation through Anti-Glycation Activity in db/db Mouse

Polydatin (resveratrol-3-O-β-mono-D-glucoside) is a polyphenol that can be easily accessed from peanuts, grapes, and red wine, and is known to have antiglycation, antioxidant, and anti-inflammatory effects. Diabetes mellitus is a very common disease, and diabetic complications are very common complications. The dry mouth symptom is one of the most common oral complaints in patients with diabetes mellitus. Diabetes mellitus is thought to promote hyposalivation. In this study, we aimed to investigate the improvement effect of polydatin on diabetes-induced hyposalivation in db/db mouse model of type 2 diabetes. We examined salivary flow rate, TUNEL assay, PAS staining, and immunohistochemical staining for AGEs, RAGE, HMGB1, 8-OHdG, and AQP5 to evaluate the efficacy of polydatin in the submandibular salivary gland. Diabetic db/db mice had a decreased salivary flow rate and salivary gland weight. The salivary gland of the vehicle-treated db/db mice showed an increased apoptotic cell injury. The AGEs were highly accumulated, and its receptor, RAGE expression was also enhanced. Expressions of HMGB1, an oxidative cell damage marker, and 8-OHdG, an oxidative DNA damage marker, increased greatly. However, polydatin ameliorated this hypofunction of the salivary gland and inhibited diabetes-related salivary cell injury. Furthermore, polydatin improved mucin accumulation, which is used as a damage marker for salivary gland acinar cells, and decreased expression of water channel AQP5 was improved by polydatin. In conclusion, polydatin has a potent protective effect on diabetes-related salivary gland hypofunction through its antioxidant and anti-glycation activities, and its AQP5 upregulation. This result suggests the possibility of the use of polydatin as a therapeutic drug to improve hyposalivation caused by diabetes.

An ingenious technique for functional palatal reservoir construction in complete dentures

The retention, stability and comfort of wearing denture is greatly influenced by the flow, quantity and consistency of saliva. Insufficient salivary output results especially in old-aged edentulous patients may result in denture sores because of lack of lubrication by saliva, thus, reducing patient’s ability to retain the prosthesis. Various approaches have been concernes with the use of reservoir with holes have been described in the literature. However the flow of salivary substitute is very difficult to control. Moreover the frequent cleaning of the denture required to maintain the patency of the reservoir holes poses various challenges to the patient. This article explains a novel technique for the incorporation of a reservoir with controlled salivary flow in complete denture to enhance the retention of the prosthesis and thus, improving the comfort of wearing denture and the speech of patient.

Minimizing Complications of Aging That Lead to Dry Mouth and Poor Oral Health

Poor oral health causes severe pain and untreated infections to spread throughout the body. For older adults, the prevalence of root decay exceeds that of any other medical condition. Our research shows tooth loss and edentulousness were associated with increased mortality and inversely associated with BMI, waist circumference, blood pressure, and fasting blood glucose. Our Stop-it study found people who lost bone density had fewer teeth, problems chewing, and involuntary weight loss and frailty. 88% of the elderly take medications that cause loss of saliva. Sjögren’s and radiation therapy for head and neck cancer patients heighten risk. Without saliva, patients have increased tooth decay, periodontal disease and fungal infections, salivary gland blockage, and problems swallowing and speaking. Dry mouth leads people to suck on candy that further increase caries. Substituting sugarfree gum for candy increases salivary flow and reduces dental caries. Brushing, flossing, and limiting sugar also lessen tooth decay.

Protease inhibitor concentrations in the saliva of individuals experiencing oral dryness

Background Oral dryness is a common symptom that may interfere with swallowing, chewing, and taste. The most common reason for oral dryness is hyposalivation. Some individuals experiencing oral dryness do not have hyposalivation, however, and the reverse is also true. Here, we focused on healthy individuals with a lower salivary flow rate and evaluated the relationship between the perception of oral dryness and salivary parameters to clarify the cause underlying the perception of oral dryness. Methods A total of 59 participants were divided into 2 groups with a lower or higher salivary flow rate according to the median salivary flow rate. In participants with a lower salivary flow rate, we assessed salivary bacterial counts, protease activities, protein concentrations, oral parameters, and the subjective perception of oral dryness. Results Protease activities and concentrations of protease inhibitors such as cystatin-D and cystatin-SA in the saliva of participants experiencing oral dryness were significantly higher and lower, respectively, than in those not experiencing oral dryness, even though no difference in the salivary flow rate was detected. Salivary cystatin-D and cystatin-SA concentrations correlated negatively with salivary protease activities. Conclusions The composition of salivary protease inhibitors and increased protease activities affect the subjective perception of oral dryness.

Salivary Flow Rate Before, During and After Insertion of Complete Denture in Different Age Group: a Comparative study

Background: Increase in salivary flow accompanying complete denture insertion is a well-known phenomenon. Complete dentures act as a mechanical stimulant, increasing salivary flow after insertion. This study compares unstimulated and stimulated salivary flow rates before, during, and after insertion of a complete denture in different age groups.Method: Forty subjects meeting inclusion criteria were selected. Unstimulated saliva was collected first. Stimulation was produced by chewing paraffin wax and collected of saliva in a graduated container. This procedure was carried out before insertion, during insertion, 24 hours after, and 7 days after insertion of complete dentures. The study data were entered, edited, and coded in Microsoft Excel. The unstimulated and stimulated salivary flow rate was compared at different time intervals.Result: Unstimulated salivary rate was lowest before denture insertion with mean values of 0.27ml/minute. The highest flow rate was recorded during denture insertion (mean values of 0.60 ml/minute). The mean unstimulated salivary flow rate 24 hours after denture insertion was higher than 7 days after denture insertion. The mean stimulated salivary rate was lowest before denture insertion (mean values of 0.59 ml/minute). The highest flow rate was recorded during denture insertion (mean values of 0.93 ml/minute). There was a declining trend in salivary flow rate after denture insertion i.e. 0.86 ml/minute to 0.75ml/min after 24 hours and 7 days of denture insertion. A gradual decrease in salivary flow rate with an increase in age was noted but the association of age with salivary flow rates was not statistically significant.Conclusion: There was an increase in both unstimulated and stimulated salivary flow rate after insertion of complete denture and age does not affect salivary flow rates before, during (immediately after), 24 hours after, and 7 days after denture insertion.