Short-term effect of a synbiotic in salivary viscosity and buffering capacity; a quasi-experimental study / Efecto a corto plazo de un simbiótico en la viscosidad y la capacidad tampón salival; un estudio cuasi experimental

Evaluate the effect of a synbiotic on salivary viscosity and buffer capacity. Materials and Methods: A follow-up one-week study was performed on 24 healthy volunteers in San Luis Potosí, Mexico, during July 2017. Volunteers must have had active tooth decay at the moment of study. All 24 patients were given a Lactiv® probiotic package, advising not to modify usual oral hygiene practices, and were followed up during 6 days. Primary output variable was salivary viscosity while the secondary was salivary buffer capacity. Salivary viscosity was assessed by using an Ostwald Pipette and buffer capacity with bromocresol purple. Results: A total of 8 male patients (33.3%) and 16 females (66.6%) patients were included, with an average age of 10.92 years. All the volunteers completed the study. Comparisons between pre- and post-treatment showed a decrease in salivary viscosity, while buffer capacity was showed to increase. Conclusion: The use of a synbiotic during a short period of time lowered the viscosity of saliva and increased salivary buffer capacity.

Evaluar el efecto de un sinbiótico sobre la viscosidad salival y la capacidad de tampón de la saliva. Materiales and Métodos: Se realizó un estudio de seguimiento de una semana en 24 voluntarios sanos en San Luis Potosí, México, durante julio de 2017. Los voluntarios cursaban caries dental activa en el momento del estudio. Los 24 pacientes recibieron un paquete de probióticos Lactiv®, fueron aconsejados a no modificar las prácticas habituales de higiene oral, y fueron seguidos durante 6 días. La variable primaria fue la viscosidad salival mientras que la secundaria fue la capacidad tampón. La viscosidad salival se evaluó usando una pipeta Ostwald y capacidad tampón con bromocresol púrpura. Resultados: Se incluyeron un total de 8 pacientes varones (33,3%) y 16 mujeres (66,6%), con una edad promedio de 10,92 años. Todos los voluntarios completaron el estudio. Las comparaciones entre el pretratamiento y el postratamiento mostraron una disminución de la viscosidad salival, mientras que se demostró que la capacidad del tampón aumentó. Conclusión: El uso de un sinbiótico durante un corto período de tiempo mostró un efecto sobre la disminución de la viscosidad y el aumento de la capacidad del tampón salival.

Evaluation of the Impact of Oral Hygiene and Chamomile Tea in the Development of Oral Mucositis: Pilot Study / Avaliação do Impacto da Higiene Oral Associada ao Uso do Chá de Camomila no Desenvolvimento de Mucosite Oral: Estudo-Piloto / Evaluación del Impacto de la Higiene Oral y el Té de Manzanilla en el Desarrollo de la Mucositis Oral: Estudio Piloto

Introduction: The oral mucositis (OM) represents a frequent inflammatory condition in cancer patients, and poor oral hygiene has been related as a predisposing factor for its onset. Chamomile tea has been studied as an adjunctive therapy in the management of OM due to its analgesic and anti-inflammatory properties. Objective: The objective of this study was to evaluate the influence of chamomile tea associated with a rigorous oral hygiene in the OM prevention. Method: Randomized pilot clinical study, with 35 patients assigned to two groups. The case-group underwent oral hygiene control associated with the use of chamomile tea before starting the first cycle of chemotherapy, while the control group, there were no previous guidelines and prescriptions. Data about sociodemographic characteristics, the type of neoplasm and the chemotherapy scheme proposed were collected. The variables OM, salivary flow and pain associated to the oral cavity were evaluated, and statistical analysis was performed with significance level p <0.05. Results: It was observed that the majority of the patients had a mean age of 50 years, breast (57%) was the most prevalent tumor site and cyclophosphamide (52%), the most frequently used drug In this sample, no statistically significant result was observed in the two groups for OM, salivary flow and pain variables (p> 0.05). Conclusion: These data suggest that the use of chamomile tea and the accuracy of oral hygiene were not sufficient to prevent OM.

Introdução: A mucosite oral (MO) representa uma condição inflamatória frequente em pacientes oncológicos e uma higiene oral insatisfatória tem sido relacionada como fator predisponente para o seu surgimento. O chá de camomila vem sendo estudado como terapia adjuvante no manejo da MO em razão das suas propriedades analgésicas e anti-inflamatórias. Objetivo: Avaliar a influência do chá de camomila associada a uma rigorosa higiene oral na prevenção de MO. Método: Trata-se de um estudo-piloto clínico randomizado, no qual 35 pacientes foram alocados em dois grupos. O grupo-caso foi submetido ao controle de higiene oral associado ao uso do chá de camomila antes de iniciar o primeiro ciclo de quimioterapia; no grupo-controle, não houve orientações e prescrições prévias. Foram coletados dados referentes às características sociodemográficas, à neoplasia em questão e ao tipo de tratamento quimioterápico proposto. Foram avaliadas as variáveis MO, fluxo salivar e dor associada à cavidade oral, e realizada análise estatística com nível de significância p<0,05. Resultados: Observou-se que a maioria dos pacientes apresentava-se na quinta década de vida, a localização do tumor mais prevalente foi a mama (57%) e a droga mais utilizada por esses pacientes foi a ciclosfamida (52%). Nesta amostra, não foi observado resultado estatisticamente significativo entre os grupos, no que diz respeito às variáveis MO, fluxo salivar e dor (p>0,05). Conclusão: Os dados sugerem que o uso do chá de camomila e o rigor na higiene oral não foram suficientes para a prevenção da MO.

Introducción: La mucositis oral (MO) representa una afección inflamatoria frecuente en pacientes con cáncer, y la mala higiene bucal se ha relacionado como un factor predisponente para su aparición. El té de manzanilla se ha estudiado como una terapia adyuvante en el tratamiento de la OM debido a sus propiedades analgésicas y antiinflamatorias. Objetivo: El objetivo de este estudio fue evaluar la influencia del té de manzannilla asociado con una hygiene oral rigurosa en la prevención de la MO. Método: Fue un estudio clínico piloto aleatorizado, en el que treinta y cinco pacientes fueron asignados en dos grupos. El grupo de casos se sometió a un control de higiene oral asociado con el uso de té de manzanilla antes de comenzar el primer ciclo de quimioterapia, mientras que en el grupo de control, no había pautas ni recetas previas. Se recopilaron datos sobre las características sociodemográficas, el tipo de neoplasia y el esquema de quimioterapia propuesto. Se evaluaron las variables MO, flujo salival y dolor asociado a la cavidad oral, y se realizó un análisis estadístico con nivel de significancia p<0,05. Resultados: Se observó que la mayoría de los pacientes tenían una edad media de 50 años, el sitio del tumor más prevalente era la mama (57%) y el fármaco utilizado con mayor frecuencia era la ciclofamida (52%). En esta muestra, no se observaron resultados estadísticamente significativos entre los grupos con respecto a las variables MO, flujo salival y dolor (p>0,05). Conclusión: Estos datos sugieren que el uso de té de manzanilla y la precisión de la higiene oral no fueron suficientes para prevenir la MO.

Acción Inmediata de los Enjuagues Orales en la Saliva / Immediate Action of Mouthwashes on Whole Saliva

RESUMEN: Numerosos estudios confirman la efectividad de los enjuagatorios orales sobre la viabilidad de los microorganismos que producen gingivitis y halitosis, pero poco se conoce sobre la influencia de los mismos en el medio ambiente oral. El objetivo del siguiente trabajo fue analizar In vivo e In vitro el efecto de enjuagatorios orales sobre la saliva total no estimulada. Se trabajó con saliva de individuos sanos. Para el estudio in vivo se recogieron las muestras antes y después del enjuague oral a diferentes tiempos (1, 5, 10, 15, 30, 45 y 60 minutos). Para el ensayo in vitro, se incubó la saliva con igual volumen de la solución enjuagatoria a 37 ºC con agitación a diferentes tiempos (1, 5, 10 y 15 minutos). Se determinó pH inmediatamente recogidas las muestras. Posteriormente fueron centrifugadas y determinados flujo salival y proteínas totales. La separación de proteínas por electroforesis en SDS-PAGE se realizó solo en el ensayo in vivo. Los resultados mostraron que los enjuagatorios fluorurados poco alteran la fisiología oral a través de flujo salival, pH y proteínas totales. La combinación fluoruro de sodio/xilitol produjo mayor estimulación del flujo salival. La mezcla de aceites esenciales provocó un incremento del flujo salival y de pH, redujo el contenido de proteínas totales, evidenciando por SDS-PAGE que las comprometidas fueron particularmente las de mediano y bajo peso molecular. Clorhexidina debido a su elevada sustantividad, incrementó significativamente flujo salival y pH in vivo. In vitro, fuera del medioambiente oral, los enjuagatorios estudiados ejercieron un efecto similar sobre proteínas totales. Los enjuagatorios de uso frecuente alteraron parámetros salivales, por lo que podría estudiarse la acción que ejercen sobre otros componentes de la saliva con actividad biológica importante en cavidad oral.

ABSTRACT: Numerous studies confirm the effectiveness of mouthwashes on the viability of microorganisms that produce gingivitis and halitosis, but little is known about their influence on the oral environment. The objective of the following work was to analyze In vivo and In vitro the effect of mouthwashes on total non-stimulated saliva. We worked with saliva from healthy individuals. For In vivo study, samples were collected before and after oral rinsing at different times (1, 5, 10, 15, 30, 45 and 60 minutes). For the In vitro assay, the saliva was incubated with equal volume of the rinse solution at 37 ° C with shaking at different times (1, 5, 10 and 15 minutes). PH was determined immediately collected samples. Subsequently they were centrifuged and determined salivary flow and total proteins. Separation of proteins by SDS-PAGE electrophoresis was performed only in the In vivo assay. The results showed that fluoridated rinses hardly alter oral physiology through salivary flow, pH and total proteins. The combination of sodium fluoride / xylitol produced greater stimulation of salivary flow. The mixture of essential oils caused an increase in salivary flow and pH, reduced the total protein content, evidencing by SDS-PAGE that those involved were particularly those of medium and low molecular weight. Chlorhexidine due to its high substantivity, significantly increased salivary flow and pH In vivo. In vitro, outside the oral environment, the rinses studied had a similar effect on total proteins. Rinses used frequently altered salivary parameters, so that the action they exert on other components of saliva with important biological activity in the oral cavity could be studied.

Effect of fluoride on salivary immunoglobulins and sialic acid

Summary Objective: The aim of our study was to evaluate the effect of fluoride on salivary immunoglobulin and sialic acid levels in children with dental fluorosis and healthy teeth who live in places with high fluoride concentration in drinking water. Method: Fifty-one (51) healthy children between 6 and 12 years old with no caries were randomly selected from primary schools enrolled in the dental-care program operated by the Department of Pediatric Dentistry. The children were divided into two groups: group I comprised 26 children with dental fluorosis [Thylstrup-Fejerskov Dental Fluorosis Index (TFI) = 4] who lived in Isparta (2.7-2.8 ppm), and group II consisted of 25 children without dental fluorosis who were born in low-fluoride areas and had lived in Isparta for only the previous two years. Stimulated and unstimulated saliva were collected and analyzed for fluoride, salivary immunoglobulins and sialic acid levels. Results: Sialic acid level was correlated negatively with age. Levels of secretory immunoglobulin A (sIgA) and secretory immunoglobulin G (sIgG) were higher in children with dental fluorosis compared with those in group II, although these differences were not significant. Conclusion: Increased sIgA and sIgG levels may arrest the progression of caries in subjects with dental fluorosis. Given the risks of dental fluorosis, further studies of the effects of different fluoride levels in drinking water on salivary composition of children with mixed dentition are needed to confirm the results of our study and to provide data for comparison.

Oral midazolam reduces cortisol levels during local anaesthesia in children: a randomised controlled trial

Little is known about whether midazolam sedation can reduce salivary cortisol levels and consequently influence children’s behaviour during dental treatment. The aim of this study was to evaluate the effect of midazolam sedation on salivary cortisol and its correlation with children’s behaviour during restorative dental treatment. Eighteen healthy children, aged two to five years, were randomly assigned to two dental treatment appointments, both with physical restraint: oral midazolam 1 mg/kg (MS) and placebo (PS). An observer assessed the children’s behaviour (videos) using the Ohio State University Behavioral Rating Scale (OSUBRS). The children’s saliva was collected just after waking up, on arrival at the dental school, 25 minutes after local anaesthesia, and 25 minutes after the end of the procedure. Salivary cortisol levels were determined using the enzyme-linked immunoabsorbent assay. The data were analysed by bivariate tests and multivariate analysis of variance (5% level). Salivary cortisol levels were lower in the MS group than in the PS group at the time of anaesthesia (p = 0.004), but did not vary during the appointment within sedation (p = 0.319) or placebo (p = 0.080) groups. Children’s behaviour was negative most of the time and did not differ between MS and PS; however, the behaviour (OSUBRS) did not correlate with salivary cortisol levels. Oral midazolam is able to control salivary cortisol levels during dental treatment of pre-schoolers, which might not lead to better clinical behaviour.

Salivary retention after application of fluoride gel using toothbrush or tray: a crossover trial

Currently, there are no studies in the literature evaluating salivary fluoride retention after small amounts of fluoride gel are applied to children's teeth. Therefore, the objective of the present study was to compare salivary retention after gel application using a toothbrush or by traditional application with trays. In this crossover study, children with active caries (n = 10) were randomized into one of the following treatment groups: a) application of fluoride gel using a tray (control), or b) application of fluoride gel with a toothbrush (treatment). After a 7-day washout period, the treatments were inverted. Unstimulated saliva samples were collected at baseline and 0.5, 5, 15, 30, 60 and 120 minutes after acidulated phosphate fluoride (APF) gel application in order to analyze fluoride retention in saliva. The area under the curve (AUC) was also calculated. There were no differences in fluoride retention after application of small amounts of APF with a toothbrush compared to traditional gel application using trays at all time points studied, and no differences in AUC were observed (Student t-test, p > 0.05). These results suggest that application of fluoride gel in children using a toothbrush can be utilized as an option rather than traditional trays, since the same salivary retention of fluoride is obtained using a lower dose.

Effects of milk curd on saliva secretion in healthy volunteer compared to baseline, 2% pilocarpine and equivalent pH adjusted acetic acid solutions.

Background: Dry mouth is a common clinical problem, and different products have been proposed to improve it. In this investigation, the effects of "milk curd" on the amount of saliva secretion were studied. Materials and Methods: A total of 32 patients (aged 20-30) were selected from healthy volunteers. Milk curd concentrations of 0.5, 1, 2 and 4%, and 2% pilocarpine were prepared as drops. The impact of the drugs on the saliva weight was assessed after 1-5 min. To determine the effects of the pH of the milk curd on the amount of saliva secretion, different concentrations of acetic acid were used. Results: At the end of the first minute, the differences between the data for all groups were statistically significant, and the difference between the 2% and 4% milk curd groups was higher than the others (P < 0.0001). The differences in the amount of the saliva secreted at the end of the second minute between the baseline and 4% milk curd groups and between the 0.5% and 4% MC groups were significant (P = 0.006 and P = 0.025, respectively). In total, there was no significant difference between the effect of various pH treatments and the amount of baseline saliva secretion. Conclusion: Milk curd has a significant local impact, and the saliva increase depends on the dose. It seems that this effect is not only related to its acidic taste. As a result, factors other than pH are involved in the effect.

Saliva and tongue coating pH before and after use of mouthwashes and relationship with parameters of halitosis

OBJECTIVES: The aim of this work was to evaluate saliva and tongue coating pH in oral healthy patients with morning bad breath before and after use of different oral mouthrinses. MATERIAL AND METHODS: Saliva and tongue coating pH of 50 patients allocated in 5 groups were measured respectively by a digital pHmeter and color pH indicators, before, immediately after and 30 min after rinsing 5 different mouthrinses: cetilpiridine chloride associated with sodium chloride, triclosan, enzymatic solution, essential oil and distilled water. RESULTS: Only triclosan and essential oil increased salivary pH immediately after rising. The enzymatic solution decreased salivary and tongue coating pH immediately after rinsing. CONCLUSIONS: Salivary pH tended to be acidic while tongue coating pH tended to be alkaline, even after rising. Triclosan and essential oil mouthrinses increased salivary pH immediately after rinsing. Enzymatic solution decreased saliva and tongue coating pH immediately after rising.

Anandamide injected into the lateral ventricle of the brain inhibits submandibular salivary secretion by attenuating parasympathetic neurotransmission

Our objective was to determine the effect of arachidonylethanolamide (anandamide, AEA) injected intracerebroventricularly (icv) into the lateral ventricle of the rat brain on submandibular gland (SMG) salivary secretion. Parasympathetic decentralization (PSD) produced by cutting the chorda tympani nerve strongly inhibited methacholine (MC)-induced salivary secretion while sympathetic denervation (SD) produced by removing the superior cervical ganglia reduced it slightly. Also, AEA (50 ng/5 µL, icv) significantly decreased MC-induced salivary secretion in intact rats (MC 1 µg/kg: control (C), 5.3 ± 0.6 vs AEA, 2.7 ± 0.6 mg; MC 3 µg/kg: C, 17.6 ± 1.0 vs AEA, 8.7 ± 0.9 mg; MC 10 µg/kg: C, 37.4 ± 1.2 vs AEA, 22.9 ± 2.6 mg). However, AEA did not alter the significantly reduced salivary secretion in rats with PSD, but decreased the slightly reduced salivary secretion in rats with SD (MC 1 µg/kg: C, 3.8 ± 0.8 vs AEA, 1.4 ± 0.6 mg; MC 3 µg/kg: C, 14.7 ± 2.4 vs AEA, 6.9 ± 1.2 mg; P < 0.05; MC 10 µg/kg: C, 39.5 ± 1.0 vs AEA, 22.3 ± 0.5 mg; P < 0.001). We showed that the inhibitory effect of AEA is mediated by cannabinoid type 1 CB1 receptors and involves GABAergic neurotransmission, since it was blocked by previous injection of the CB1 receptor antagonist AM251 (500 ng/5 µL, icv) or of the GABA A receptor antagonist, bicuculline (25 ng/5 µL, icv). Our results suggest that parasympathetic neurotransmission from the central nervous system to the SMG can be inhibited by endocannabinoid and GABAergic systems.

Effects of radiation and alpha-tocopherol on saliva flow rate, amylase activity, total protein and electrolyte levels in oral cavity cancer.

OBJECTIVE: The objective of the present study was to evaluate early and late effects of radiation and a-tocopherol on the secretion rate of saliva and on selected saliva salivary parameters in oral cavity cancer patients. PATIENTS & METHODS: Eighty-nine histologically confirmed oral cavity cancer patients (OCC) were enrolled in the study. Resting whole saliva was collected before, during and at the end of the radiation therapy (RT) and simultaneous supplementation with alpha - tocopherol to the radiation treated patients (RT + AT). RESULTS: Salivary flow rate, pH, amylase activity, total protein, sodium and potassium were analyzed. Increased pH, potassium and decreased flow rate, amylase activity, protein content and sodium were observed in 6 weeks of radiation treated patients when compared to OCC patients. A significant improvement of those parameters was observed on alpha - tocopherol supplementation in RT + AT patients. CONCLUSION: Supplementation with alpha - tocopherol improves the salivary flow rate thereby, maintains salivary parameters.

[Comparison of salivary fluoride rate between primary school children using Kimia and Shahre-Darou sodium fluoride mouthwashes]

Using fluoride mouthrinses is one of the most effective ways for prevention of dental caries. For obtaining this benefit, the ministry of health has started using sodium fluoride mouthrinse in primary school children. The aim of this study was evaluation and comparison of salivary fluoride after using Kimia and Share Daroo mouthrinse. In this experimental study, 42 physically and dentally healthy children, used 10 ml of 0.2% sodium fluoride mouthrinse for 1 minute and then expectorated it. Unstimulated whole saliva [in five minute intervals] was taken in baseline, and after 5, 15, 25 and 45 minutes. 7 days after taking the first test, the second test was taken by using the second mouthrinse. After the collection of all of samples, the content of fluoride and volume of samples was determined and the results were statistically analyzed by using the 2-way repeated measure ANOVA. Fluoride concentration of saliva after using Kimia mouthrinse was 0.95 +/- 0.17 and 0.198 +/- 0.18 after using Shahre Darou mouthrinse. Fluoride concentrations of saliva after using mouthrinse, was not statistically significant between the gender and the two ages. Results of this study showed that no statistically significant differences of fluoride retention in children's saliva exist between the two Iranian 0.2% sodium fluoride mouthrinses

[Effect of oral contraceptive pill on the amount of unstimulated saliva in females]

Salivary glands secrete a liquid known as saliva which plays an important role in oral homeostasis. Quantitative and qualitative variation in salivary secretion can cause dental caries and periodontal disease. The decrease of saliva may be caused by some diseases and drugs such as sjogren syndrome, and antidepressant drugs. The purpose of this study was to evaluate the effects of oral contraceptive pills on the volume of unstimulated saliva in healthy women. In this experimental study, 85 healthy females including 35 study cases and 50 controls with the mean age of 18-25 years, referred to Ahwaz dental school, were selected. The study group had been taking oral contraceptive pill for at least 6 months, but the control group had not been taking this kind of drugs. Subjects with no past medical history, no use of medications, and no history of depression were selected as study subjects. The 2 minutes amount of collected saliva of the subjects in both groups was measured and recorded. The results were analyzed using T-test. The mean age of the study and control group was 24.42 and 24.78 years, respectively. The mean unstimulated volume of the saliva in the study group was 1.11 [ml]/2minute, while in the control group it was 1.53 [ml]/2minute. There was a significant difference in the amount of salivary secretion between the two groups [p<0.001]. According to this study, it can be concluded that, use of oral contraceptive pills can cause reduction in unstimulated salivary secretion. Therefore, good oral and dental hygiene instructions should be emphasized for these patients

Use of an aqueous extract of Terminalia chebula as an anticaries agent: a clinical study.

Plant-derived medicines have been a part of our traditional health care system, and the antimicrobial properties of plant-derived compounds are well documented. The purpose of this study is to evaluate the effect of an aqueous extract of Terminalia chebula (a medicinal plant) on salivary samples and its potential for use as an anticaries agent in the form of mouthwash. A concentrated aqueous extract was prepared from the fruit of T. chebula . A mouth rinse of 10% concentration was prepared by diluting the extract in sterile distilled water. The efficacy of the mouth rinse was assessed by testing on 50 salivary samples. Salivary samples were collected from subjects assessed to be at high risk for caries. Salivary pH, buffering capacity, and microbial activity were assessed before rinsing, immediately after, and 10 min, 30 min, and 1 h after rinsing. There was an increase in the pH and buffering capacity and decrease in microbial count. An aqueous extract of T. chebula used as a mouth rinse seems to be an effective anticaries agent.

Effect of Cha-em Thai mouthwash on salivary levels of mutans streptococci and total IgA.

The aim of this study was to investigate the effect of Cha-em Thai (Albizia myriophylla) mouthwash on the mutans streptococci (MS) and immunoglobulin A (IgA) level in saliva. Sixty-seven schoolchildren, age 6-12 years, with MS more than 1x10(5) cfu per milliliter of saliva were entered in this study. They were divided into two balanced groups according to their baseline MS counts (> or = 10(5) cfu/ml). Each group was randomly assigned to use either the Cha-em Thai mouthwash or the placebo mouthwash. After twice daily rinses with their mouthwash for 2 weeks, stimulated saliva were collected and analysed. The MS counts and IgA levels for the two groups were compared. Those rinsing with Cha-em Thai mouthwash showed a significant reduction in MS counts (p<0.05), but the IgA levels were not different. Those rinsing with the placebo mouthwash showed no statistically significant differences in the MS counts or the IgA levels (p>0.05). The results indicate that twice daily use of Cha-em Thai mouthwash can reduce the levels of MS in saliva.

Effect of habitual arecanut chewing on resting whole mouth salivary flow rate and pH.

BACKGROUND: Resting whole mouth salivary flow rate (SFR) and pH play a significant role in pathogenesis of various oral diseases and conditions. AIM: To observe the effect of habitual use of arecanut and various arecanut containing products (AN) on SFR and pH. DESIGN: Cross sectional. SETTING: Outpatient Department of Dental College. PARTICIPANTS: AN chewers and non-chewers attending Dental college. MEASUREMENTS: SFR and pH. VARIABLES: Type, frequency, duration and exposure time of AN, Smoking and Alcohol habit. MATERIALS AND METHODS: Subjects study was divided into chewers (n=110) and non- chewers (n=50). The SFR (expressed in mL/10min) and pH measured. RESULTS: The difference between the mean SFR for chewers and non-chewers was not statistically significant. The difference between mean pH of chewers and non-chewers was statistically significant. (P=0.02). Difference in pH was statistically significant among the different types of AN chewers (P=0.024). With chewing raw AN, an increase in frequency and exposure time increased SFR and pH respectively. In processed AN chewers, increase in duration and frequency of consumption increased SFR and decreased pH respectively. For chewers with betel quid with tobacco, increase in duration was significantly associated with decrease in salivary pH. CONCLUSION: SFR and pH are altered in AN chewers, rendering the oral mucosa vulnerable to the toxic effects of AN.

Estudo comparativo do pH e do volume salivar em indivíduos com laringofaringite crônica por doença do refluxo gastroesofágica antes e após o tratamento / Comparative study of salivary pH and volume in adults with chronic laryngopharyngitis by gastroesophageal reflux disease before and after treatment

INTRODUÇÃO: A Doença do Refluxo Gastroesofágico (DRGE) é a doença digestiva mais prevalente da atualidade e, recentemente, tem sido implicada em uma gama de alterações do seguimento laringofaríngeo (RLF). No entanto, pouco se sabe dos mecanismos fisiopatológicos destas manifestações supraesofágicas da DRGE. Os achados clínicos contraditórios e recentes pesquisas sugerem haver deficiências na capacidade de defesa deste seguimento. Uma das principais responsáveis pela homeostase da mucosa oral e do trato digestivo é a saliva com seu conteúdo orgânico e inorgânico. Tanto alterações do pH quanto do volume salivar já foram correlacionados com os sintomas e sinais sugestivos da DRGE e RLF. Estudo recente de nossa autoria demonstra diminuição estatisticamente significante do pH salivar de indivíduos com RLF quando comparado a controles sem a doença. Outro estudo constatou correlação entre a redução do volume X pH da saliva em indivíduos com DRGE, estando esta redução diretamente relacionada aos níveis de pH esofágico constatados durante pH-metria esofágica de 24 horas. OBJETIVOS: Avaliar como se comportam o pH e volume da saliva em um mesmo indivíduo com DRGE e RLF antes e após o tratamento clínico. MATERIAL E MÉTODO: Vinte e três pacientes com RLF tiveram o pH e volume da saliva total testados antes e após receberem tratamento com droga bloqueadora de bomba de prótons durante 12 semanas. RESULTADOS: Houve uma diferença estatisticamente significante (p<0,001) entre o pH da saliva antes e após o tratamento, estando este maior após o controle clínico da doença. O volume de saliva no paciente tratado foi significativamente maior do que no paciente pré-tratamento (p=0.009). DISCUSSÃO: Os achados sugerem que o pH salivar é influenciado pela presença de refluxo gastroduodenal à região laringofaríngea. Caso estudos futuros com populações maiores realmente comprovem esta correlação, poderemos cogitar a possibilidade de usar a mensuração do pH salivar, que é feita de forma rápida e não invasiva, como um meio de diagnosticar e avaliar o comportamento e controle do Refluxo Laringofaríngeo.

INTRODUCTION: Gastroesophageal Reflux Disease (GERD) is the most prevalent digestive disease of the modern society and has been associated with abnormalities in the larynx and pharynx (LPR). Nonetheless, little is known about the mechanisms involved in this atypical form of the disease. Contradictory clinical data suggest a defense deficit at this segment. Saliva with its organic and inorganic components is responsible for the homeostasis of the oral mucosa and the digestive tract. Salivary pH and volume abnormalities have been linked to laryngopharyngeal symptoms of GERD and LPR. In a recent study we demonstrated significant salivary pH reduction in patients with LPR. Another study found correlation between reduced salivary pH and volume directly related to esophageal pH-metry results. AIM: To evaluate salivary pH and volume before and after clinical treatment of LPR. MATERIAL AND METHOD: Twenty-three adults with LPR had total fasting saliva tested before and after a 12-week course of oral proton pump inhibitor. RESULTS: A statistically significant difference was found in salivary pH before and after treatment with increase of pH values after control of the disease (p<0.001). Salivary volumes of treated patients were also significantly higher than in pre-treated patients (p=0.009). DISCUSSION: These findings suggest that salivary pH and volume are influenced by the presence of gastroesophageal contents and that salivary pH monitoring can potentially become a cost-effective method for diagnosing and controlling LPR.

Aplicação de toxina botulínica tipo A para reduzir a saliva em pacientes com esclerose lateral amiotrófica / Application of botulinum toxin to reduce the saliva in patients with amyotrophic lateral sclerosis

OBJETIVO: Demonstrar o efeito da aplicação local Botox® em glândulas salivares de pacientes com diagnóstico de esclerose lateral amiotrófica (ELA), seguindo nosso protocolo institucional de tratamento da sialorréia de 2002. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Cinco pacientes com ELA avaliados na Clínica de Otorrinolaringologia da AACD (Associação de Assistência à Criança Deficiente) foram submetidos à aplicação tópica de Botox® nas glândulas salivares e acompanhados por um ano. O protocolo consiste num questionário clínico sobre as habilidades de deglutir saliva e as repercussões na qualidade de vida. Os pacientes deveriam ter tratamento odontológico prévio, intolerância aos efeitos adversos dos anti-colinérgicos, e ausência de aplicação de. Botox® em outros sítios por pelo menos seis meses. A aplicação foi guiada por ultra-sonografia para as glândulas submandibulares e a dose administrada foi de 30U em um ponto, e 20U em cada glândula parótida distribuída em dois pontos, após anestesia tópica com prilocaína. RESULTADOS: Cinco pacientes com ELA, com idade entre 45 e 59 anos foram submetidos ao tratamento de redução de saliva pela aplicação de Botox® em glândulas salivares. Nós observamos que os sintomas de sialorréia melhoraram dramaticamente em quatro pacientes. Três pacientes permaneceram quatro meses sem queixas, com acentuada melhora na qualidade de vida. Nenhum paciente apresentou efeitos colaterais locais ou sistêmicos com a aplicação de Botox® em glândulas salivares. Nós observamos que os sintomas de sialorréia melhoraram dramaticamente em quatro pacientes. Três pacientes permaneceram quatro meses sem queixas, com acentuada melhora na qualidade de vida. Nenhum paciente apresentou efeitos colaterais locais ou sistêmicos com a aplicação de Botox® em glândulas salivares.

Comparative evaluation of efficacy of sodium fluoride, chlorhexidine and triclosan mouth rinses in reducing the mutans streptococci count in saliva : an in vivo study.

The primary objective of this study was to compare the efficacy of sodium fluoride (0.05%), chlorhexidine (0.12%) and triclosan (0.3%) mouth rinses in reducing the mutans streptococci count in saliva. 60 subjects in the age group of 12 to 14 years were selected from the schools of Mumbai and were equally divided into 4 groups. First 3 groups were test groups and the 4th group was control group. The subjects were instructed to rinse one full marked measure of mouth rinse for 1 minute, twice daily. Salivary samples were collected at baseline and after 2 weeks and cultured on M.S.B.agar. The number of mutans streptococci colonies were counted on agar medium. The results of the study confirmed that chlorhexidine mouth rinses are more efficient in reducing mutans streptococci count in saliva as compared to other mouth rinses.

Avaliaçäo in vitro de anti-sépticos bucais sobre a microbiota da saliva / In vitro evaluation of the effects of antiseptic mouthrinses on the microflora from saliva

O objetivo do presente estudo foi avaliar a eficácia de diversos anti-sépticos bucais na reduçäo da microbiota da saliva visualizando-se in vitro a sua atividade antimicrobiana. os anti-sépticos avaliados foram: Kolynos, da Kolynos do Brasil; Oral-B, da Gillette do Brasil; Cepacol, da Hoechst Marion Roussel; Periogard, da Colgate-Palmolive; Flogoral, da Asta Médica; Malvatricin, do Laboratório Daudt Oliveira Ltda.; Fluordent, da Johnson e Johnson; Wash, da Abbott Laboratórios do Brasil Ltda.; Plax, da Pfizer do Brasil (atualmente da Colgate-Palmolive) e Listerine, da Warner Lambert. Foram selecionadas 50 amostras de saliva de indivíduos com idade variando de 19 a 54 anos. Após o cultivo dos microrganismos das amostras, procedeu-se à inoculaçäo dos dez diferentes anti-sépticos, em três dosagens (10 µl, 20 µl, 25 µl). Os resultados revelaram que o Periogard se apresentou mais eficaz na reduçäo da microbiota da saliva e que os anti-sépticos Listerine e Flogoral mostram ser ineficazes com relaçäo à atividade antimicrobiana das amostras estudadas