Impact of dry mouth conditions on oral health-related quality of life in older people

Objective: The aim of the present study was to evaluate the impact of dry mouth conditions on oral health‐related quality of life in frail old people, residents at community care centers. Further, reliability and validity of a visual analogue scale (VAS) for dry mouth symptoms were determined within the study cohort. Background: In old people functional, social and psychological impacts of oral conditions are associated with an overall sense of well being and general health. Subjective dry mouth and reduced saliva flow are common disorders in old people caused by disease and medication. Thus, dry mouth conditions may be determinants for compromised oral health‐related quality of life in old people. Method: In total, 50 old people living at service homes for the old people were asked to answer questionnaires on subjective dry mouth (VAS) and Oral Health Impact Profile (OHIP14) for oral health‐related quality of life. Saliva flow was estimated by absorbing saliva into a pre‐weighed cotton roll. Results: The final study cohort comprised 41 old people (aged 83–91 years). Significant associations were identified between both objective and subjective dry mouth and overall or specific aspects of oral health‐related quality of life. Conclusion: Dry mouth (objective and subjective) is significantly associated with oral health‐related quality of life strengthening the value of monitoring dry mouth conditions in the care of frail old people.     

Structure of the mouth of Hydra spp. A breach in the epithelium that disappears when it closes

Summary When the mouth of a hydra is not open, the ectodermal and endodermal epithelia are each continuous over the oral surface. All cells are joined to all neighboring cells by septate junctions. A mouth forms when muscles stretch the center of the oral region and pull several cells into a thin lamella. Finally, cell attachments break. Rapidly (within one second) this breach expands as a round opening until it is approximately half the diameter of the surrounding column. Considerable rearrangment of the central cells, and therefore of their septate junctions, likely takes place rapidly as the mouth expands. A few cells may be lost from the epithelia. Closure of the mouth is slow and results in irregular thickening and wrinkling of the tissue. Final closure to restore histological continuity resembles wound healing more than occlusion typical of the mouths of other animals. The lack of a permanent mouth may be a primitive character or an adaptation to a simple body plan, and is shared by many hydrozoan polyps but not by more complex cnidarians.     

Chemometric variance analysis of 1H NMR metabolomics data on the effects of oral rinse on saliva

Saliva is an easy to obtain bodily fluid that is specific to the oral environment. It can be used for metabolomic studies as it is representative of the overall wellbeing of an organism, as well as mouth health and bacterial flora. The metabolomic structure of saliva varies greatly depending on the bacteria present in the mouth as they produce a range of metabolites. In this study we have investigated the metabolomic profiles of human saliva that were obtained using ¹H NMR (nuclear magnetic resonance) analysis. 48 samples of saliva were collected from 16 healthy subjects over 3 days. Each sample was split in two and the first half treated with an oral rinse, while the second was left untreated as a control sample. The 96 ¹H NMR metabolomic profiles obtained in the dataset are affected by three factors, namely 16 subjects, 3 sampling days and 2 treatments. These three factors contribute to the total variation in the dataset. When analysing datasets from saliva using traditional methods such as PCA (principal component analysis), the overall variance is dominated by subjects’ contributions, and we cannot see trends that would highlight the effect of specific factors such as oral rinse. In order to identify these trends, we used methods such as MSCA (multilevel simultaneous component analysis) and ASCA (ANOVA simultaneous component analysis), that provide variance splits according to the experimental factors, so that we could look at the particular effect of treatment on saliva. The analysis of the treatment effect was enhanced, as it was isolated from the overall variance and assessed without confounding factors.

     

Screening of fluoride analysis as a biochemical parameter in the orthodontic treatment using fixed appliances

Saliva is a critical and useful biological fluid necessary for good health and for the appropriate execution of mouth activities. Orthodontic biomaterials have a complex relationship with many components, including the oral environment. Treatment with fixed orthodontic appliances may causes dental caries. As a result, it is necessary to comprehend how orthodontic therapy and various fluoride regimens affect the chances of developing dental cavities as well as individual risk factors. Usage of fluoride will tend to reduce the caries in the patients diagnosed with the fixed orthodontic treatment. The aim of this study was to screen the biochemical parameter of the fluoride levels in the patients undergone and completed the treatment of orthodontic fixed appliances. In this study, 35 patients have been visited on day 1 as well as day 35 and categorized as T₀ and T₁ groups. Saliva samples were collected and fluoride levels were measured between T₀ and T₁ groups. Using the fluoride kit with the spectrophotometer, fluoride levels were measured. The results confirmed similar fluoride levels between T₀ (26.11 ± 4.86) and T₁ (27.71 ± 4.40) groups. There was no significant association observed in this study (p = 0.56). Fluoride might have no role in the patients undergoing orthodontic treatment.     

Use of neostigmine to increase the rate of lung cancer detection by sputum cytology

Neostigmine induction was investigated as a method for increasing the rate of detection of lung cancer in respiratory cytology samples. Eleven patients with dry and essentially nonproductive cough were given neostigmine, 15 mg by mouth or 0.5 mg by hypodermic injection. The quality of sputum produced was increased in all cases; the sputum was also more easily expectorated. Eight patients suspected of having lung cancer had previously negative cytologic examinations of sputum obtained by conventional methods. Following the administration of neostigmine, malignant cells indicating squamous-cell carcinoma were found in the sputum samples of three of these patients while dysplastic cells were detected in the samples from two patients. It is postulated that neostigmine intake may increase the excretion of mucous glands in the bronchial submucosa as well as the bronchial epithelium itself.     

High-frequency chest compression: effect of the third generation compression waveform

High-frequency chest compression (HFCC) therapy has become the prevailing form of airway clearance for patients with cystic fibrosis (CF) in the United States. The original square waveform was replaced in 1995 with a sine waveform without published evidence of an equality of effectiveness. The recent development of a triangle waveform for HFCC provided the opportunity to compare the functional and therapeutic effects of different waveforms. Clinical testing was done in patients at home with therapy times recorded with all sputum collected in preweighed sealable vials. The eight study patients with CF were regular users of a sine waveform device. They produced sputum consistently and were clinically stable. They used their optimum frequencies for therapy for each waveform and, for one week for each waveform, collected all sputum during their twice-daily timed HFCC therapies. After collection, these vials were reweighed, desiccated, and reweighed to calculate wet and dry weights of sputum per minute of therapy time. Frequency associated vest pressures transmitted to the mouth, and induced airflows at the mouth were measured in healthy volunteers. The pressure waveforms produced in the vest were, in shape, faithfully demonstrable at the mouth. In the healthy subject the transmission occurred in 2 ms and was attenuated to about 75% of the vest pressure for the triangle waveform and 60% for the sine waveform. All patients produced more sputum with the triangle waveform than with the sine waveform. The mean increase was 20%+ range of 4% to 41%. P value was <.001. Future studies of HFCC should investigate the other effects of the sine and triangle waveforms, as well as the neglected square waveform, on mucus clearance and determine the best frequencies for each waveform, disease, and patient.     

The oral nerve plexus in amphioxus larvae: function,cell types and phylogenetic significance

Serial electron microscope reconstructions were used to examine the organization and cell types of the nerve plexus that surrounds the mouth in amphioxus larvae. The plexus is involved in a rejection response that occurs during feeding: a number of oral spines project across the mouth, and debris impinging on them triggers a contraction of the gill slit and pharyngeal musculature that forces water through the mouth, dislodging the debris. The oral spine cells are secondary sense cells that synapse with neurites belonging to a class of peripheral interneurons intrinsic to the oral nerve plexus. These in turn synapse with a second class of peripheral neurons with large axons that we interpret as sensory cells and which probably transmit signals to the nerve cord. The intrinsic cells also appear to synapse with each other, implying that local integrative activities of some complexity occur in the oral plexus. In comparative terms, the intrinsic neurons most closely resemble the Merkel-like accessory cells of vertebrate taste buds, and we postulate a homology between oral spine cells and taste buds, despite differences in function. There are also similarities between the amphioxus oral plexus and adoral nerves and ganglia of echinoderm larvae, suggesting homology of both the oral nerve plexus and the mouth itself between lower deuterostome phyla and chordates.     

Altered serum and salivary C-reactive protein levels in patients with oral premalignant lesions and oral squamous cell carcinoma

Chronic inflammation is associated with cancer development. C-reactive protein (CRP), an acute phase protein synthesized primarily in the liver, is a marker for inflammation and for the progression of many cancers. We compared serum and salivary CRP levels in 20 normal individuals, 20 patients with oral premalignant lesions and 20 patients with oral squamous cell carcinoma (OSCC) to assess its efficacy as a prognostic indicator for OSCC. Saliva and blood samples were obtained and evaluated for CRP levels. Mean CRP levels were higher in patients with oral premalignant lesions compared to controls. CRP levels in OSCC patients were elevated and were associated with advanced tumor stages.     

Enhancing the quality of life in elderly women through a programme to improve the condition of salivary hypofunction

doi: 10.1111/j.1741‐2358.2011.00594.x Enhancing the quality of life in elderly women through a programme to improve the condition of salivary hypofunction Objective: The purposes of this study were to examine the effects of oral exercise intended to improve the function of the oral cavity in the elderly and their quality of life to pave the way for the development of oral‐health promotion programmes geared towards the elderly. Methods: The subjects were 78 female Koreans who resided in Seoul and were aged 65 years and older. During a 3‐month period, an oral function promotion programme was conducted twice a week, between 10.00 am and 12.00 pm , applying oral exercise suggested by a Japanese public health centre. A survey was conducted by interviewing the selected women to determine the state of their subjective dry mouth, quality of life related to oral health and jaw functional limitation. Their opening, unstimulated whole saliva and pronunciation speed were measured before and after the oral function exercise programme. Results: The subjects showed a significant improvement in subjective dry mouth symptoms, relevant behaviour, the level of discomfort caused by dry mouth and subjective jaw functional limitation during mastication and swallowing and emotional expression after receiving the oral exercise. After the oral exercise, there was a significant increase in mouth opening, unstimulated whole saliva and speaking speed (‘patakala’ pronunciation) after oral exercise. There was also significant progress in their quality of life related to oral health. Overall improvement in subjective dry mouth symptoms and relevant behaviour over time after oral exercise had a positive correlation with the level of improvement in discomfort triggered by dry mouth and mastication. The level of improvement in OHIP‐14 had a positive correlation with the level of overall improvement in dry mouth symptoms and behaviour, the level of improvement in discomfort by dry mouth and that in mastication and swallowing. Conclusion: This study showed the effects of the oral function promotion programme and correlation of oral condition and oral health‐related quality of life. It is suggested that this oral function promotion programme has positive effects on both objective and subjective oral conditions. It is strongly recommended that this programme, along with other oral health promotion programmes, be implemented to improve oral function and oral health‐related quality of life for the elderly.     

Hedgehog activity controls opening of the primary mouth

To feed or breathe, the oral opening must connect with the gut. The foregut and oral tissues converge at the primary mouth, forming the buccopharyngeal membrane (BPM), a bilayer epithelium. Failure to form the opening between gut and mouth has significant ramifications, and many craniofacial disorders have been associated with defects in this process. Oral perforation is characterized by dissolution of the BPM, but little is known about this process. In humans, failure to form a continuous mouth opening is associated with mutations in Hedgehog (Hh) pathway members; however, the role of Hh in primary mouth development is untested. Here, we show, using Xenopus, that Hh signaling is necessary and sufficient to initiate mouth formation, and that Hh activation is required in a dose-dependent fashion to determine the size of the mouth. This activity lies upstream of the previously demonstrated role for Wnt signal inhibition in oral perforation. We then turn to mouse mutants to establish that SHH and Gli3 are indeed necessary for mammalian mouth development. Our data suggest that Hh-mediated BPM persistence may underlie oral defects in human craniofacial syndromes.     

DNA methylation analysis from saliva samples for epidemiological studies

Saliva is a non-invasive, easily accessible tissue, which is regularly collected in large epidemiological studies to examine genetic questions. Recently, it is becoming more common to use saliva to assess DNA methylation. However, DNA extracted from saliva is a mixture of both bacterial and human DNA derived from epithelial and immune cells in the mouth. Thus, there are unique challenges to using salivary DNA in methylation studies that can influence data quality. This study assesses: (1) quantification of human DNA after extraction; (2) delineation of human and bacterial DNA; (3) bisulfite conversion (BSC); (4) quantification of BSC DNA; (5) PCR amplification of BSC DNA from saliva and; (6) quantitation of DNA methylation with a targeted assay. The framework proposed will allow saliva samples to be more widely used in targeted epigenetic studies.     

实时荧光定量PCR技术在检测复发性口腔溃疡患者口腔微生物菌群改变中的应用

目的 研究实时荧光定量PCR法在检测复发性口腔溃疡患者口腔微生物菌群改变中的应用。方法 取一般口腔溃疡患者和复发性口腔溃疡患者的唾液样本,分别使用涂片、革兰染色鉴定和实时荧光定量PCR法进行检测,比较检测方法是否存在差异。结果 复发性口腔溃疡患者口腔中革兰阴性球菌的数量要低于一般口腔溃疡患者（t=0.9841,P=0.0251）,其他类型的细菌则没有明显改变。细菌计数发现复发性口腔溃疡患者口腔链球菌、韦荣球菌、奈瑟菌明显低于一般口腔溃疡患者（t=0.997 4,P=0.004 0;t=0.976 7,P=0.036 6;t=0.998 4,P=0.002 6）。实时荧光定量PCR则进一步证实这个结果。结论 实时荧光定量PCR可应用于检测复发性口腔溃疡患者口腔中的菌群变化,为临床治疗和合理用药提供依据。     

Bacteriophage isolation from human saliva

AIMS: To detect bacteriophages for Gram-positive oral pathogens in human saliva. METHODS AND RESULTS: Saliva samples from 31 donors were screened for the presence of bacteriophages for Streptococcus sobrinus, Streptococcus mutans, Streptococcus salivarius, Actinomyces viscosus and Enterococcus faecalis. Bacteriophages for Enterococcus faecalis were found in seven samples. Enterococcus faecalis phages were still present in saliva re-collected from one donor one month, and one year after initial saliva collection. CONCLUSIONS: The presence and stability of the Enterococcus faecalis bacteriophages in human saliva suggests a possible role of these bacteriophages in the oral ecosystem. SIGNIFICANCE AND IMPACT OF THE STUDY: Phage therapy as a way to control oral bacteria might be considered.     

Plaque Formation by Streptococci in an Artificial Mouth and Factors Influencing Colonization

The plaque-producing properties of Streptococcus sanguis, Streptococcus salivarius, Streptococcus mutans, Streptococcus mitis and Streptococcus faecalis were investigated in an artificial mouth with continuous supply of nutrient. Attention was focused on the role of salivary factors and sucrose in tooth colonization. Plaque formation by single cultures depended on the ability to produce tenacious extracellular polysaccharide or to cohabit the tooth with an organism having this property. Sucrose was the only essential additive to nutrient broth necessary for plaque formation and could not be substituted by sterile natural saliva. Saliva neither facilitated colonization by Strep. mitis nor prevented colonization by Strep. salivarius as may have been supposed from previous reports.     

Plasticity and constraints on feeding kinematics in anuran larvae.

Tadpoles of the majority of anuran species have tiny, anatomically complex mouths. In most species the larval jaws are keratinized sheaths (beaks) overlying infrarostral cartilages. Surrounding the beak is a flexible oral disc and transverse rows of small, keratinized denticles. We used high-speed videography (250, 500 and 1000 frames per second) of Rana catesbeiana tadpoles to observe the kinematics of these mouthparts in feeding and breathing. Tadpoles can protract and retract their jaws as well as make them wider and narrower with each gape cycle. We demonstrate that during air-breathing, movement of the oral disc helps surfacing tadpoles to capture air quickly by preventing water from coming into the mouth. For our feeding study, we observed tadpoles as they grazed on both clean and algal covered glass surfaces. As the jaws close, the lower beak narrows to a greater degree when it encounters resistance. The denticle rows are used to both anchor the mouth and rasp surfaces during feeding. The hyperkinetic mouth parts of tadpoles permit grazing on non-planar surfaces of variable resistance. A trade-off in having such mobile jaws is loss of stability; no generalized tadpoles can generate great forces with their jaws, which would be necessary to subdue and dismember large tough prey. The feeding system of tadpoles is built out of soft tissues (such as cartilage and keratin) that can be shed (the keratinized sheaths) or remodeled (the underlying infrarostral cartilage) quickly, thus facilitating metamorphosis.     

Evolutionary modification of mouth position in deuterostomes

In chordates, the oral ectoderm is positioned at the anterior neural boundary and is characterized by pituitary homeobox (Pitx) and overlapping Dlx and Six3 expressions. Recent studies have shown that the ectoderm molecular map is also conserved in hemichordates and echinoderms. However, the mouth develops in a more posterior position in these animals, in a domain characterized by Nkx2.1 and Goosecoid expression, in a manner similar to that observed in protostomes. Furthermore, BMP signaling antagonizes mouth development in echinoderms and hemichordates, but seems to promote oral ectoderm specification in chordates. Conversely, Nodal signaling appears to be required for oral ectoderm specification in sea urchins but not in chordates. The Nodal/BMP antagonism at work during ectoderm patterning thus seems to constitute a conserved feature in deuterostomes, and mouth relocation may have been accompanied by a change in the influence of BMP/Nodal signals on oral ectoderm specification. We suggest that the mouth primordium was located at the anterior neural boundary, in early chordate evolution. In extant chordate embryos, subsequent mouth positioning differ between urochordates and vertebrates, presumably as a consequence of surrounding tissues remodelling. We illustrate these morphogenetic movements by means of morphological data obtained by the confocal imaging of ascidian tailbud embryos, and provide a table for determining the tailbud stages of this model organism.     

Suckermouth armored catfish resolve the paradox of simultaneous respiration and suction attachment: a kinematic study of Pterygoplichthys disjunctivus

Suckermouth armored catfishes (Loricariidae) use their suckermouth for inspiration, feeding, and attachment to substrates. The sucker consists of a pre-valvular cavity, formed by a modified lip disc, and is separated from the larger post-valvular buccal cavity by a muscular oral valve. The combination of respiration and suction attachment seems paradoxal, as a properly functioning suction device would need a sucker without leakage (yet inspiration must occur via the sucker), and continuous subambient pressure in the sucker cavity (even during expiratory mouth floor elevation). In the loricariid Pterygoplichthys disjunctivus, the anatomy of the suckermouth structures was examined, and a kinematic analysis was performed to acquire insights into how respiration and attachment are combined. High-speed external and X-ray recordings show that suckermouth attachment influences respiratory parameters such as decreasing excursion amplitudes of mouth floor elements, and the way water enters the mouth via furrows in the lip disc. Respiration, however, continues during attachment and is not blocked. Our data show that the muscular oral valve actively separates the post-valvular buccal cavity from the pre-valvular sucker cavity. Volume changes of this pre-valvular cavity are opposite to those of the post-valvular cavity and assure sucker function even during expiration. These volume changes are caused by movements of the lower lip, the lower jaws, and the oral valve. The lateral inflow furrow openings, controlled by the maxillary barbels, can occur unilaterally. Morphological and kinematic data also show that the opercle is anatomically and functionally decoupled from the gill opening.     

Oral Region Homologies in Paleozoic Crinoids and Other Plesiomorphic Pentaradial Echinoderms

The phylogenetic relationships between major groups of plesiomorphic pentaradial echinoderms, the Paleozoic crinoids, blastozoans, and edrioasteroids, are poorly understood because of a lack of widely recognized homologies. Here, we present newly recognized oral region homologies, based on the Universal Elemental Homology model for skeletal plates, in a wide range of fossil taxa. The oral region of echinoderms is mainly composed of the axial, or ambulacral, skeleton, which apparently evolved more slowly than the extraxial skeleton that forms the majority of the body. Recent phylogenetic hypotheses have focused on characters of the extraxial skeleton, which may have evolved too rapidly to preserve obvious homologies across all these groups. The axial skeleton conserved homologous suites of characters shared between various edrioasteroids and specific blastozoans, and between other blastozoans and crinoids. Although individual plates can be inferred as homologous, no directly overlapping suites of characters are shared between edrioasteroids and crinoids. Six different systems of mouth (peristome) plate organization (Peristomial Border Systems) are defined. These include four different systems based on the arrangement of the interradially-positioned oral plates and their peristomial cover plates, where PBS A1 occurs only in plesiomorphic edrioasteroids, PBS A2 occurs in plesiomorphic edrioasteroids and blastozoans, and PBS A3 and PBS A4 occur in blastozoans and crinoids. The other two systems have radially-positioned uniserial oral frame plates in construction of the mouth frame. PBS B1 has both orals and uniserial oral frame plates and occurs in edrioasterid and possibly edrioblastoid edrioasteroids, whereas PBS B2 has exclusively uniserial oral frame plates and is found in isorophid edrioasteroids and imbricate and gogiid blastozoans. These different types of mouth frame construction offer potential synapomorphies to aid in parsimony-based phylogenetics for exploring branching order among stem groups on the echinoderm tree of life.     

口臭微生态治疗技术研究进展

口臭是指呼吸时排出挥发性硫化物等臭味气体,主要由口腔微生态失调引起,具体为生理性菌群数目减少,产臭类菌群种类和数目增加。口臭是局部口腔或全身系统不良代谢状况的一种表现,临床可根据口腔异味来诊断疾病,并通过口腔微生态的调整来治疗口臭。本研究从口臭与微生态的关系、口臭主要相关微生物等方面进行分析,综述机械、化学和中医药等方法调整口腔微生态来治疗口臭的进展。