3D radiotherapy in the parotid gland and its dosimetric relationship with salivary flow and quality of life in patients with head and neck cancer

Aim: Hyposalivation and dry mouth affect the quality of life in patients with Head and Neck Cancer, who did the treatment with radiotherapy. Thus this study has the objective to evaluate the dosimetric relationship between 3D radiotherapy and changes in salivary flow, xerostomia and quality of life in patients with head and neck cancer according to the volume of the irradiated parotid gland. Methods: 23 patients with cancer in the head and neck area and in need of 3D radiotherapy were followed up during radiotherapy treatment, and the parotid gland (PG) design was also performed in radiotherapy planning. Questionnaires were carried out to determine xerostomia and quality of life, while the salivary flow was determined through calculations regarding the collection and weighing of saliva. Such data were collected in three moments: before the beginning of the radiotherapy treatment (D0), in the middle of the treatment (D1) and at the end of it (D2). The numerical variables are represented by measures of central tendency and measures of dispersion. Results: when associating the salivary flow, the xerostomia questionnaire and the OHIP-14, a statistically significant difference was found (p-value <0.001), as well as when comparing some volumes of irradiated PG with the OHIP-14. However, no relationship was found between dosimetric data, xerostomia and hyposalivation. Conclusion: patients undergoing 3D radiotherapy for malignant neoplasms in the head and neck region had decreased salivary flow, increased complaints of dry mouth and decreased quality of life. However, it was not possible to establish a statistically significant correlation between these findings and the volumes of irradiated parotids

Factors Associated with Hyposalivation in Brazilian Adults

ABSTRACT Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes.

Virus SARS-CoV-2 y su impacto en el bruxismo / SARS-CoV-2 virus and its impact on bruxism

La cavidad oral se puede ver alterada a causa del virus SARS-CoV-2 de manera transitoria o permanente, lo que afecta a distintas partes de la cavidad oral incluyendo las glándulas salivales, esto causa xerostomía. La disgeusia es uno de los síntomas principales a lo largo de la enfermedad, nos enfocaremos en aquellas manifestaciones psicológicas como la ansiedad y el estrés en su interacción con la aparición del trastorno llamado bruxismo (AU)

The oral cavity can be altered by the SARS-CoV-2 virus in a transient or permanent manner, affecting different parts of the oral cavity including salivary glands causing xerostomia. Dysgeusia is one of the main symptoms throughout the disease, we will focus on those psychological manifestations such as anxiety and stress in their interaction with the appearance of the disorder called bruxism (AU)

Manejo de pacientes oncológicos na prática odontológica: uma revisão de literatura / Management of cancer patients in dental practice: a literature review / Manejo de pacientes con cáncer en la práctica odontológica: una revisión de la literatura

O manejo odontológico adaptado ao paciente que é diagnosticado com câncer é fundamental para a melhoria e manutenção da qualidade de vida dos mesmos. Esses indivíduos devem ser submetidos a uma avaliação odontológica prévia ao tratamento anticancerígeno, a fim de estabelecer as etapas necessárias às intervenções e o que pode ser realizado antes, durante e pós-tratamento, sendo essas fases executadas na clínica diária ou até mesmo no ambiente hospitalar, exercendo um trabalho multidisciplinar. A presente revisão de literatura tem como objetivo direcionar a atenção dos cirurgiões dentistas para o planejamento e atendimento personalizado dos pacientes oncológicos, de acordo com suas necessidades e particularidades.

Dental management adapted to patients diagnosed with cancer is essential for improving and maintaining their quality of life. These individuals must undergo a dental evaluation prior to anticancer treatment, in order to establish the necessary steps for interventions and what can be done before, during and after treatment, these phases being performed in the daily clinic or even in the hospital environment, exercising multidisciplinary work. This literature review aims to direct the attention of dentists to the planning and personalized care of cancer patients, according to their needs and particularities.

El manejo odontológico adaptado a los pacientes diagnosticados de cáncer es esencial para mejorar y mantener su calidad de vida. Estas personas deben someterse a una evaluación odontológica previa al tratamiento anticanceroso, con el fin de establecer los pasos necesarios para las intervenciones y lo que se puede hacer antes, durante y después del tratamiento, siendo estas fases realizadas en la clínica diaria o incluso en el ámbito hospitalario, ejerciendo un trabajo multidisciplinar. Esta revisión bibliográfica pretende dirigir la atención de los odontólogos a la planificación y atención personalizada de los pacientes con cáncer, de acuerdo con sus necesidades y particularidades.

Research progress in treatment of Sjögren's syndrome by traditional Chinese medicine / 中国中药杂志

Sj9gren's syndrome(SS) is an autoimmune disease with glandular dysfunction caused by the massive infiltration of the exocrine glands by lymphocytes. The pathogenesis of this disease is related to the chronic inflammatory response of the exocrine glands due to excessive activation of B cells and T cells. In addition to dry mouth and eyes, SS can also cause damage to other organs and systems in the human body, seriously affecting the quality of life of patients. Traditional Chinese medicine(TCM) has definite clinical efficacy in the treatment of SS as it can alleviate symptoms and regulate immune disorders without causing adverse reactions, demonstrating high safety. This paper reviews the current status of preclinical and clinical trials about the TCM treatment of SS in the past decade. TCM mainly mitigates SS symptoms such as dry mouth, dry eyes, dry skin, and joint pain and improves the prognosis and quality of life of patients by regulating the abnormally activated B cells and T cells, inhibiting the autoimmune response, restoring the balance between pro-inflammatory and anti-inflammatory cytokines, and reducing the pathological damage caused by immune complexes to exocrine glands and joints in SS patients.

Prevalence of oral injuries and salivary changes in patients with chronic renal failure on hemodialysis: systematic review and meta-analysis

The objective of this study was to evaluate whether individuals with chronic renal failure (CRF) undergoing hemodialysis treatment have more salivary and oral mucosa alterations when compared to healthy individuals, through a systematic review followed by meta-analysis. A systematic literature review was performed, evaluating randomized clinical trials found in the Proquest, Embase, Scopus, Cochrane Library, Web of Science, Lilacs and Pubmed databases, using MeSH terms and other keywords. Initially, 40 articles were included in the study and, after reading the complete articles, only 15 clinical trials that analyzed oral lesions and salivary changes in patients with CRF undergoing hemodialysis treatment were eligible. Most of the clinical studies included were cross-sectional and composed of a study group and a control group. The mean age of participants in the study group was 50.19 years and in the control group, 48.95 years. The most common oral alterations found in the CRF group in relation to the control group were xerostomia, uremic breath, dysgeusia, coated tongue, gingival bleeding and pale mucosa. The salivary flow of patients with CRF was 46.6% lower than the control group. The salivary pH in the study group was also more alkaline when compared to the control group. Greater amounts of urea, phosphate, C-reactive protein and total proteins were found in the saliva of individuals with CRF. Individuals with CRF undergoing hemodialysis are more prone to changes in both the quantity and quality of saliva, as well as having a greater amount of oral changes.

Xerostomia and dysgeusia in the elderly: prevalence of and association with polypharmacy

Xerostomia is defined as the perception of dry mouth, and dysgeusia, as a change in taste. Both are common complaints in the elderly, especially among those making use of polypharmacy drug combinations. Aim: This study aimed to determine the prevalence of xerostomia and dysgeusia and to investigate their association with polypharmacy in the elderly. Methods: older people under follow-up at the Multidisciplinary Elderly Center of the University Hospital of Brasília were interviewed and asked about health problems, medications used, presence of xerostomia and dysgeusia. Descriptive statistics were used to determine the prevalence of the symptoms surveyed. The chi-square test was used to investigate the relationship between xerostomia and dysgeusia and polypharmacy. Secondary associations were performed using binomial logistic regression. Results: Ninety-six older people were evaluated and of these, 62.5% had xerostomia and 21.1%, had dysgeusia. The average number of medications used was 4±3 medications per individual. Polypharmacy was associated with xerostomia but not dysgeusia. It was possible to associate xerostomia with the use of antihypertensive drugs. Conclusion: Xerostomia was a frequent complaint among elderly people making use of polypharmacy, especially those using antihypertensives. Antihypertensives and antidepressants were used most drugs by the elderly and exhibited interactions with drugs most prescribed in Dentistry. Two contraindications were found between fluconazole and mirtazapine; and between erythromycin and simvastatin

Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly: a cross-sectional study

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

Sjögren's syndrome: Epidemiology and clinical manifestations

Sjögren's syndrome is an entity of rheumatic origin, with complex autoimmune characteristics, in which the salivary and lacrimal glands are mainly compromised. It has two forms of presentation, one primary and the other secondary, and in both forms there is evidence of exocrine glands involvement. The clinical spectrum of Sjögren's syndrome is very heterogeneous and is classified into glandular and extra-glandular manifestations, but not mutually exclusive. It is recommended that all patients with parotid inflammation, purpura, hypergammaglobulinaemia, anti-SSa, and anti-SSb should be seen to have a greater risk of presenting with a severe systemic presentation, and it is recommended to carry out a more strict medical control. Population studies that have attempted to describe the incidence and prevalence of Sjögren's syndrome in various countries throughout the world are to some extent discordant between one registry and another. Although Sjögren's syndrome is more common in women, ocular involvement predominates in men, and it can occur in all ages, mainly between the third and fifth decades of life. In children it is rare. It is also considered as a common connective tissue disease, where the data on the global incidence rate and prevalence are underestimated.

El síndrome de Sjögren es una entidad de origen reumático, con características autoinmune complejas, en la que se ven comprometidas principalmente las glándulas salivales y las lagrimales. Tiene 2 formas de presentación, una primaria y otra secundaria, y en ambas se observa una afección de las glándulas exocrinas. El espectro clínico del síndrome de Sjögren es muy heterogéneo y se clasifica en manifestaciones glandulares y extraglandulares, no excluyentes entre sí. Se recomienda que se haga un control médico más estricto a todo paciente que curse con una inflamación parotídea, púrpura, hipergammaglobulinemia y anticuerpos anti-SSa, anti-SSb, puesto que presenta mayor riesgo de cursar con una presentación sistémica grave. Los estudios poblacionales que han intentado describir la incidencia y la prevalencia del síndrome de Sjögren en diferentes países son hasta cierto punto discordantes entre un registro y otro. El síndrome de Sjögren es más frecuente en mujeres, pero en hombres predomina más la afectación ocular; puede presentarse en todas las edades, principalmente entre la tercera y la quinta décadas de la vida; en niños es raro. Se considera además como una conectivopatía frecuente, en la cual los datos de la tasa de incidencia global y de prevalencia se encuentran subestimados.

Análise comparativa do tratamento do ardor bucal com terapia a laser de baixa intensidade e estimulação elétrica nervosa transcutânea: um ensaio clínico randomizado / Comparative analysis of the treatment of burning mouth with low-intensity laser therapy and transcutaneous electrical nerve stimulation: a randomized clinical trial

Introdução: O manejo de pacientes com ardor bucal é um desafio no cotidiano clínico da odontologia. Objetivo: Comparar o efeito da Terapia a Laser de Baixa Intensidade (LLLT) e da Estimulação Elétrica Nervosa Transcutânea (TENS) no tratamento do ardor bucal. Metodologia: Ensaio clínico randomizado constituído por 25 pacientes com ardor bucal que foram tratados por TENS (n=12) e por LLLT (n=13). Os protocolos de tratamento foram aplicados semanalmente por 8 semanas. O teste análise de variância (ANOVA) dois fatores foi usado para verificar se existia diferença significativa entre os tempos T0 (antes de iniciar o tratamento), T1 (após a 4ª sessão de tratamento), T2 (após a 8ª sessão de tratamento) e T3 (30 dias após o término do tratamento) em relação aos sintomas, analisados por meio da Escala Visual Analógica (EVA), fluxo salivar não estimulado, xerostomia e disgeusia com as intervenções de TENS e LLLT. Resultados: A maioria dos pacientes foi do sexo feminino no período pós-menopausa com média de idade no grupo TENS de 59,25 anos e no grupo LLLT de 62,08. Hipertensão e dislipidemia foram as alterações sistêmicas mais frequentes. Ansiedade e depressão foram os únicos transtornos psiquiátricos relados. A maioria dos pacientes fazia uso de medicamentos como anti-hipertensivos e antidepressivos. Não foram observadas variações expressivas no que se refere a xerostomia e a disgeusia nos dois grupos analisados. A TENS e a LLLT foram eficazes na redução dos sintomas relatados pelos pacientes (p˂0,001), entretanto, observou-se entre os tempos T2 e T3 que o grupo LLLT apresentou uma melhor resposta quando comparado ao TENS (p=0,003). Os pacientes do grupo TENS apresentaram aumento do fluxo salivar entre os tempos T1 e T2, enquanto o grupo LLLT apresentou uma diminuição (p=0,052). Conclusão: A TENS e a LLLT foram eficazes na redução dos sintomas do ardor bucal durante o tratamento e 30 dias após o término do tratamento, sendo que o grupo LLLT apresentou uma melhor resposta na sessão de acompanhamento pós-tratamento quando comparado ao grupo TENS (AU).

Introduction: The management of patients with burning mouth is a challenge in the clinical routine of dentistry. Objective: To compare the effect of Low Intensity Laser Therapy (LLLT) and Transcutaneous Electrical Nerve Stimulation (TENS) in the treatment of burning mouth. Methodology: Randomized clinical trial consisting of 25 patients with burning mouth who were treated with TENS (n=12) and LLLT (n=13). Treatment protocols were applied weekly for 8 weeks. The two-way analysis of variance (ANOVA) test was used to verify whether there was a significant difference between the times T0 (before starting treatment), T1 (after the 4th treatment session), T2 (after the 8th treatment session) and T3 (30 days after the end of treatment) in relation to symptoms, analyzed using the Visual Analogue Scale (VAS), unstimulated salivary flow, xerostomia and dysgeusia with TENS and LLLT interventions. Results: Most patients were female in the postmenopausal period, with a mean age of 59.25 years in the TENS group and 62.08 in the LLLT group. Hypertension and dyslipidemia were the most frequent systemic alterations. Anxiety and depression were the only psychiatric disorders reported. Most patients used drugs such as antihypertensives and antidepressants. Significant variations were not observed with regard to xerostomia and dysgeusia in the two groups analyzed. TENS and LLLT were effective in reducing the symptoms reported by patients (p˂0.001), however, it was observed between times T2 and T3 that the LLLT group showed a better response when compared to TENS (p=0.003). Patients in the TENS group showed an increase in salivary flow between times T1 and T2, while the LLLT group showed a decrease (p=0.052). Conclusion: TENS and LLLT were effective in reducing the symptoms of burning mouth during treatment and 30 days after the end of treatment, and the LLLT group showed a better response in the posttreatment follow-up session when compared to the TENS group (AU).

Síndrome da ardência bucal: relato de caso clínico / Oral burning syndrome: a clinical case report

O presente estudo teve como objetivo principal descrever por meio de um relato de caso clínico o diagnóstico e a conduta clínica de uma paciente portadora da Síndrome da Ardência Bucal (SAB). A SAB é definida como uma dor crônica e de difícil diagnóstico e difícil tratamento. O local mais acometido pela SAB é a língua, lábios e mucosa jugal, mas pode estar presente em qualquer parte da mucosa oral, causando desconforto e interferindo na qualidade de vida do paciente. Paciente do sexo feminino, leucoderma, 39 anos, sem histórico de doenças sistêmicas, saúde geral em bom estado, procurou atendimento no Centro Universitário da Serra Gaúcha ­ FSG por apresentar sensação de ardência recorrente na língua e na mucosa, que aumentava em momentos de estresse ou durante a ingestão de alimentos cítricos, picantes ou quentes. A paciente realizou exames complementares (hemograma completo, glicemia de jejum, exame de vitamina B12) e primeiramente, iniciou-se o tratamento com antifúngico tópico para remoção de uma camada esbranquiçada presente no dorso da língua. Após a remissão desta, foi utilizado AD-Muc tópico 2 vezes ao dia, durante 2 semanas e relatou ter reduzido seus sintomas em torno de 70%. A paciente ainda apresentava xerostomia e, então foi prescrita saliva artificial. A paciente teve a regressão total de seus sintomas. Pode-se concluir que diversos fatores etiológicos estão relacionados com a SAB, porém sua causa específica permanece desconhecida. O tratamento é paliativo, entretanto, o Ad-muc tópico se mostrou eficaz na redução da sintomatologia da SAB juntamente com o uso da saliva artificial(AU)

The present study aimed to describe, through a clinical case report, the diagnosis and clinical conduct of a patient with Burning Mouth Syndrome (BMS). BMSis defined as chronic pain that is difficult to diagnose and difficult to treat. The site most affected by BMS is the tongue, lips, and cheek mucosa, but it can be present in any part of the oral mucosa, causing discomfort and interfering with the patient's quality of life. Female patient, leucoderma, 39 years old, with no history of systemic diseases, general health in good condition, sought care at the Centro Universitário da Serra Gaúcha - FSG for presenting a recurrent burning sensation in the tongue and mucosa, which increased in times of stress or while eating citrus, spicy or hot foods. The patient underwent complementary tests (complete blood count, fasting blood glucose, vitamin B12 test) and first, treatment with topical antifungal was started to remove a whitish layer present on the back of the tongue. After remission, topical AD-Muc was used twice a day for 2 weeks and reported to have reduced his symptoms by around 70%. The patient still had xerostomia and then artificial saliva was prescribed. The patient had a total regression of her symptoms. It can be concluded that several etiological factors are related to SAB, but its specific cause remains unknown. Treatment is palliative, however, topical Ad-muc is effective in reducing the symptomsof BMS also with the use of artificial saliva(AU)

El pH salival y microbiota oral: influencia en la salud bucodental de mujeres de 45 a 55 años / Salivary pH and oral microbiota: influence on women 45 to 55 years old oral health

Nuestra cavidad bucal cuenta con características particulares como ecosistema y microbiota. Este hábitat de microorganismos es uno de los más diversos de cualquier comunidad microbiana asociada a los humanos, y además cumple ciertas funciones en los procesos biológicos y digestivos del hospedante. Aunque muchos de estos microorganismos residentes aportan beneficios, en condiciones de sinergia y exacerbación, el predominio de algunos géneros puede influir en el desarrollo de enfermedades periodontales. Se realizó una investigación cuantitativa, exploratoria, descriptiva y transversal en el de Centro de Salud de Latacunga, provincia de Cotopaxi, en Ecuador, en mujeres cuya edad oscilaba entre 45 y 55 años. Se estableció una relación lineal negativa entre la edad y el pH salival, es decir, que al aumentar la edad aumentó la acidez bucal de las pacientes. De manera similar, el pH salival influyó inversamente en la disponibilidad microbiótica, pues en las cavidades bucales más ácidas el índice de detección fue más alto en 18/25 microorganismos. Las proporciones de afecciones en la salud bucodental encontradas en las pacientes como caries (96%), gingivitis (67%), halitosis (78%) y xerostomía (56%), indican la no exclusión y superposición de las mismas, pudiendo presentarse patologías combinadas en un mismo paciente, haciendo necesario explorar de qué manera los niveles de pH y la diversidad microbiótica oral encontrados se interrelacionan, y a su vez como estas nosologías podrían tener determinantes similares(AU)

Our oral cavity has particular characteristics such as ecosystem and microbiota. This habitat of microorganisms is one of the most diverse of any microbial community associated with humans, and also fulfills certain functions in the biological and digestive processes of the host. Although many of these resident microorganisms provide benefits, under conditions of synergy and exacerbation, the predominance of some genera can influence the development of periodontal diseases. A quantitative, exploratory, descriptive and cross-sectional investigation was carried out in the Latacunga Health Center, Cotopaxi province, Ecuador, in women whose age ranged between 45 and 55 years. A negative linear relationship was established between age and salivary pH, that is, with increasing age the oral acidity of the patients increased. Similarly, salivary pH inversely influenced microbiotic availability, since in the more acidic oral cavities the detection rate was higher in 18/25 microorganisms. The proportions of conditions in oral health found in patients such as caries (96%), gingivitis (67%), halitosis (78%) and xerostomia (56%), indicate their non-exclusion and overlap, and pathologies may occur combined in the same patient, making it necessary to explore how the pH levels and oral microbiotic diversity found are interrelated, and in turn, how these nosologies could have similar determinants(AU)

Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study

ABSTRACT BACKGROUND: Dry mouth syndrome or xerostomia is defined as decreased salivary flow or hypofunction of salivary glands. Its origins are multicausal and might be the result of a change in the salivary glands or a systemic imbalance. OBJECTIVE: To ascertain the prevalence of self-reported xerostomia and to identify associated factors. DESIGN AND SETTING: Cross-sectional study on the entire population of 293 elderly people over 60 years of age living in a Brazilian municipality. METHODS: Data were gathered from a questionnaire that asked about demographic data, chronic diseases and use of continuous medications, and which used the Xerostomia Inventory (XI) to evaluate dry mouth sensation. Our analysis consisted of multivariate regression and estimation of odds ratios (OR) and their respective 95% confidence intervals (CI) in binary logistic regression models. RESULTS: The prevalence of self-reported xerostomia was 19.1%. Elderly people with diabetes had higher odds of having self-reported xerostomia (OR: 3.59; 95% CI: 1.48-8.68; P < 0.001) as did those who had chronic diseases and used continuous medication (OR: 2.3; 95% CI: 1.19-4.67; P = 0.009). Elderly people who used continuous medication for the gastrointestinal tract were more likely to have xerostomia (OR: 2.14; 95% CI: 1.03-1.44; P = 0.030). CONCLUSIONS: Elderly people with diabetes and chronic diseases who were using continuous medication were more likely to have dry mouth. Use of continuous medications for the gastrointestinal tract led to a greater chance of having self-reported xerostomia.

Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults

ABSTRACT Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults. Material and Methods: Thirty subjects with a history of xerostomia and subjects withunstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student's t-test (unpaired and paired) was performed for group-wise comparisons. Results: In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p<0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p<0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p<0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was notstatistically significant in both groups (p<0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.

Caracterização do perfil alimentar e nutricional dos sobreviventes de câncer de cavidade oral e grau de adesão às recomendações de prevenção ao câncer emitidas pelo Fundo Mundial de Pesquisa de câncer e Instituto Americano de Pesquisa de Câncer / Characterization of the food intake and nutritional profile of oral cavity cancer survivors and the adherence degree to cancer prevention recommendations issued by the World Cancer Research Fund and the American Institute for Cancer Research Institute

Introdução: Sobreviventes do câncer de cavidade oral (SCCO) em controle normalmente apresentam inúmeras sequelas derivadas do tratamento oncológico, o que pode comprometer sua alimentação e, por extensão, o atendimento às diretrizes de alimentação e peso adequado emitidas pelo Fundo Mundial para Pesquisa do Câncer/Instituto Americano de Pesquisa para o Câncer (WCRF/AICR). Objetivo: Avaliar o perfil alimentar e o estado nutricional de sobreviventes de câncer de cavidade oral e verificar o grau de sua adesão, as diretrizes de alimentação saudável e peso corporal emitidas pela WCRF / AICR. Método: Estudo transversal que avaliou o estado nutricional pela Avaliação Subjetiva Global produzida pelo paciente (ASG-PPP) e índice de massa corporal (IMC) de 20 pacientes. Dados como condição social e histórico clínico foram coletados em prontuário. O consumo alimentar foi avaliado por meio de um diário alimentar de 30 dias. Os dados alimentares e o peso corporal receberam um escore de pontos conforme maior ou menor grau de adesão às recomendações WCRF / AICR. Resultados: 80% dos pacientes encontravam-se com desnutrição moderada ou suspeita de desnutrição pela ASG-PPP. Pelo IMC, 10% dos participantes estavam desnutridos, 45% eutróficos e 35% apresentavam sobrepeso. Foi encontrado escore médio 2,64 ±0.55 de adesão às recomendações de peso adequado e alimentação saudável, demonstrando atendimento de menos de 50% das recomendações WCRF / AICR. Conclusão: Os pacientes SCCO do presente estudo apresentam risco de desnutrição ou estão com desnutrição moderada; e possuem alta sintomatologia, que impacta negativamente na ingestão alimentar e na adesão às recomendações da WCRF / AICR. (AU)

Introduction: Survivors of oral cavity cancer (OCC) under control usually have numerous sequelae resulting from oncological treatment, which can compromise their diet and, by extension, meet the guidelines for diet and proper weight issued by the World Cancer Research Fund International-WCRF and the American Institute for Cancer Research-AICR. Objective: To evaluate the dietary profile and nutritional status of oral cancer survivors and verify the degree of their adherence, the guidelines for healthy eating and body weight issued by WCRF/AICR. Method: Cross-sectional study which assessed the nutritional status by the Subjective Global Assessment produced by the patient (PG-SGA) and body mass index (BMI) of 20 patients. Data such as social condition and clinical history were collected from medical records. Food consumption was assessed using a 30-day food diary. Food data and body weight received a score of points according to a greater or lesser degree of adherence to WCRF/AICR recommendations. Results: 80% of patients were moderately malnourished or suspected of malnutrition by PG-SGA. According to BMI 10% of participants were malnourished, 45% eutrophic and 35% were overweight. An average score of 2.64 ± 0.55 adherence to the recommendations of adequate weight and healthy eating was found, showing compliance with less than 50% of the WCRF/AICR recommendations. Conclusion: Survivor patients of OCC patients from the present study are at risk of malnutrition or have moderate malnutrition; and have high symptomology, which negatively impacts food intake and adherence to recommendations of WCRF/AICR. (AU)

Photobiomodulation in the treatment of xerostomia associated with hyposalivation in a pediatric patient with systemic scleroderma

Scleroderma is a rare autoimmune disease characterized by excessive collagen production. The oral manifestations of the patient with scleroderma can include microstomia, xerostomia, and changes in the resorption teeth. We report the case of a 7-year-old female patient diagnosed with systemic scleroderma where photobiomodulation therapy was used to treat xerostomia associated with hyposalivation. She attended a pediatric clinic and presented with dry and rigid facial skin, trismus, xerostomia, malocclusion, and difficulty swallowing. Stimulated salivary flow was assessed before, during, and after treatment. Photobiomodulation therapy was conducted at four points at the sublingual glands with 660 nm, 100 mW, and 0.8 J/cm2 to each point; eight points at the parotid glands; and six points at the submandibular glands with 808 nm, 100 mW, and 0.8 J/cm2 for 8 seconds at each point. After this therapy, an increase in salivary flow, remission of the xerostomia, and an improvement in mastication and swallowing were observed. Photobiomodulation therapy was effective in controlling xerostomia in this pediatric patient, resulting in increased salivary flow and an improvement in her quality of life.

Xerostomia e câncer de mama / Xerostomia and breast cancer / Xerostomía y cáncer de mama

Objetivo: Identificar os estudos que descrevem a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia. Método: Revisão integrativa, partindo da questão norteadora << Quais as evidências científicas sobre a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia? >>. Foi realizada uma busca nas bases de dados: US National Library of Medicine and National Institute of Health, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scientific Electronic Library Online por meio dos Descritores em Ciências da Saúde. Foram encontrados 63 artigos, analisados por dois pesquisadores seguindo os critérios de inclusão e exclusão. Resultados: A prevalência de xerostomia foi descrita em 10 artigos que utilizaram como método de avaliação escalas, questionários com respostas dicotômicas e sialometria. Conclusão: Identificou-se uma prevalência de 47% a 77,3% de xerostomia durante a quimioterapia

Objective: To identify studies describing the prevalence of xerostomia in breast cancer patients undergoing chemotherapy. Method: Integrative review based on the guiding question << What is the scientific evidence on the prevalence of xerostomia in breast cancer patients undergoing chemotherapy? >>. We searched the US National Library of Medicine and National Institute of Health, Latin American and Caribbean Health Sciences Literature and Scientific Electronic Library Online databases using the Health Sciences Descriptors. We found 63 articles, which were analyzed by two researchers, following the inclusion and exclusion criteria. Results: The prevalence of xerostomia was described in 10 articles that used scales, questionnaires with dichotomous answers, and sialometry as evaluation methods. Conclusion: A prevalence of 47% to 77.3% of xerostomia during chemotherapy was identified

Objetivo: Identificar estudios que describen la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia. Método: Revisión integradora, basada en la pregunta guía << ¿Cuál es la evidencia científica sobre la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia? >>. Se realizaron búsquedas en las bases de datos US National Library of Medicine and National Institute of Health, Literatura Latino-Americana y del Caribe en Ciencias de la Salud y Scientific Electronic Library Online utilizando los Descriptores de Ciencias de la Salud. Encontramos 63 artículos, que fueron analizados por dos investigadores siguiendo los criterios de inclusión y exclusión. Resultados: La prevalencia de xerostomía se describió en 10 artículos que utilizaron escalas, cuestionarios con respuestas dicotómicas y sialometría como método de evaluación. Conclusión: Se identificó una prevalencia de xerostomía del 47% al 77,3% durante la quimioterapia

Prevalence of hyposalivation and associated factors in survivors of head and neck cancer treated with radiotherapy

Abstract Hyposalivation and sensation of dry mouth (xerostomia) are one of the most common adverse effects in the treatment of patients with head and neck cancer. Objective: This study evaluates the prevalence of late hyposalivation and associated factors in survivors of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx treated with radiotherapy with or without concomitant chemotherapy. Methodology: A cross-sectional study was conducted with 88 patients who had concluded radiotherapy at least three months before the study, at a referral center for the treatment of head and neck cancer in the Southern region of Brazil. Hyposalivation was evaluated based on the stimulated salivary flow rate using the spitting method. Multivariate analysis using binary logistic regression was performed to determine the associations between hyposalivation and clinical and demographic variables. Results: Hyposalivation was found in 78.41% of the sample and the mean radiation dose was 63.01 Gy (±9.58). In the crude model of the multivariate analysis, hyposalivation was associated with higher doses of radiation (p=0.038), treatment with concomitant radiotherapy and chemotherapy (p=0.005), and time elapsed since the end of radiotherapy (p=0.025). In the adjusted model of the multivariate analysis, hyposalivation was only associated with dose and time elapsed. Patient who received higher doses of radiation had a 4.25-fold greater chance of presenting hyposalivation, whereas a longer time elapsed since the end of radiotherapy exerted a 75% protective effect against the occurrence of hyposalivation. Conclusion: Hyposalivation is a highly prevalence late-onset side effect of radiotherapy in patients treated for head and neck cancer, with a greater chance of occurrence among those who received higher doses of radiation and those who ended therapy less than 22 months before our study. Concomitant chemotherapy and radiotherapy does not seem to increase the chances of hyposalivation compared to radiotherapy alone.

Unstimulated whole salivary flow in Sjögren's Syndrome: systematic literature review and meta-analysis

Abstract Background: Sjögren's Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The Unstimulated Salivary Flow rate (UWSF) is used to quantify saliva production. There is no objective evidence to differentiate the values in patients with Sjögren's versus healthy people or patients with non-Sjögren's sicca. The objective of the present review was to evaluate the UWSF in patients with Sjögren's syndrome in comparison to controls (healthy and non-Sjögren's sicca patients). Methods: A systematic literature review was carried out (PRISMA guidelines). Analytical observational studies of cases and controls, cross-sectional studies, cohort studies and randomized clinical trials (including healthy controls) were considered. The Medline/OVID, Lilacs, Embase, and Cochrane/OVID databases were consulted. MeSH, DeCS, keywords, and Boolean operators were used. The meta-analysis (RevMan 5.2) was done through the random-effects model [mean difference (MD)]. Level and quality of evidence were evaluated by the Oxford Center Levels of Evidence and Joanna Brigs list respectively. Results: Thirty-two articles were included (20 were case-control studies,6 were cross-sectional,2 prospective cohort,2 retrospective cohort, and2 studies were abstracts) and 28 were meta-analyzed. The unstimulated whole salivary flow rate in the Sjögren's group was lower than in controls (healthy and patients with non-Sjögren Sicca syndrome) (MD-0.18 ml/min; 95% CI, −0.24 to −0.13; chi2-P-value <0.00001). Heterogeneity was 97% and there was publication bias (funnel plot). The level of evidence was mostly3 or 4. The quality of evidence was met (97% of items valued). Conclusion: For the first time, the unstimulated whole salivary flow rate is found to be lower in patients with Sjögren's syndrome compared to controls (healthy and non-SS sicca) through a meta-analysis. (AU)

Advances on mechanism and treatment of salivary gland in radiation injury / 华西口腔医学杂志

Oral squamous cell carcinoma (OSCC) is the most frequent tumour in head and neck malignant. The current treatment is mainly based on surgery therapy, radiation therapy and chemical therapy. Meanwhile, there are many a defect in the treatment. For example, there are many defects in radiotherapy. Radioactive salivatitis is the most common. In addition, there are a series of changes such as dry mouth, oral mucositis, rampant dental caries, and radioactive osteomyelitis of jaw, which cause swallowing, chewing problems, and taste dysfunction. Currently, the research on radioactive salivatitis is progressing rapidly, but its mechanism is more complication. This paper review aims to summarize the research progress in this field.