Allan Bardow

Relationships between medication intake, complaints of dry mouth, salivary flow rate and composition, and the rate of tooth demineralization in situ.

The aim of this study was to describe the relationships between the rate of tooth demineralisation and medication intake, subjective feeling of dry mouth, saliva flow, saliva composition and the salivary level of lactobacilli. The study group consisted of 28 subjects that were divided into three groups according to their unstimulated whole saliva flow rate. Group 1 had an unstimulated saliva low rate < or =0.16 ml/min (n=10), group 2 had one from 0.17--0.30 ml/min (n=9), and group 3 had one >0.30 ml/min (n=9). The rate of tooth demineralization was determined as mineral loss assessed by quantitative microradiography of human root surfaces, exposed to the oral environment for 62 days in situ. The unstimulated and stimulated saliva flow rates, pH, bicarbonate, calcium, phosphate, and protein concentrations, as well as the degree of saturation of saliva with hydroxyapatite and the saliva buffer capacity were determined. The results showed that almost all subjects developed demineralization, albeit at highly varying rates. Eighty-five percent of the subjects in group 1, 33% of the subjects in group 2, and 0% of the subjects in group 3 developed mineral loss above the mean mineral loss for all the root surfaces in this experiment. Futhermore, group 1 differed significantly from groups 2 and 3 in having a higher medication intake, a more pronounced feeling of dry mouth, lower stimulated saliva flow rate, lower stimulated bicarbonate concentration, lower unstimulated and stimulated compositional outputs (bicarbonate, calcium, phosphate, and protein), and a higher Lactobacillus level. The best explanatory variable for high mineral loss in this study was a low unstimulated saliva flow rate. In conclusion, our results suggest that an unstimulated salivary flow rate < or =0.16 ml/min as described by Navazesh et al. (1992), is a better indicator of increased caries risk due to impaired salivation, than the currently accepted definition of hyposalivation (unstimulated saliva flow rate < or =0.10 ml/min), which relates to the function of the salivary glands (Sreebny, 1992).

The buffer capacity and buffer systems of human whole saliva measured without loss of CO2

The buffer capacity of unstimulated (UWS) and stimulated (SWS) whole-mouth saliva involves three major buffer systems. The aim was to determine the buffer capacity of UWS and SWS at specific pH in the interval from pH 7.5 down to pH 3.0. The contribution of each of the buffer systems was also determined under conditions resembling those in the mouth. UWS and SWS were collected from 20 healthy volunteers; the saliva was collected under paraffin oil in order to avoid loss of CO2. The buffer capacity of UWS and SWS in samples with and without bicarbonate (HCO3-) and CO2 were measured at various pH by acid titration in a closed system at 36 C. The mean concentrations of the buffer systems in UWS (mean flow rate 0.55 ml/min) were 4.4 mmol/l HCO3-, 4.5 mmol/l phosphate (of which 1.3 mmol/l was present in the form of HPO4(2-)), 1876 microg/ml protein; the saliva pH was 6.8 and the P(CO2) 29.3 mmHg. The corresponding mean concentrations in SWS (mean flow rate 1.66 ml/min) were 9.7 mmol/l HCO3-, 3.8 mmol/l phosphate (of which 1.9 mmol/l was present in the form of HPO4(2-)), 1955 microg/ml protein; pH 7.2 and P(CO2) 25.7 mmHg, The highest buffer capacity of UWS and SWS was 6.0 and 8.5 mmol H+ /(1 saliva*pH unit) at pH 6.25, respectively. At saliva pH in the range from pH 7 down to pH 5, the following had significant impact on buffer capacity: the HCO3- concentration (p < 0.001), the flow rate (p < 0.01), and the pH of the saliva (p < 0.05). At acidic pH in the range from pH 5 down to pH 4, however, only the protein concentration had a significant impact on buffer capacity (p < 0.01).

Immediate Erosive Potential of Cola Drinks and Orange Juices

Little is known about the erosive potential of soft drinks within the first minutes of exposure to teeth, and about the potentially protective role of salivary proteins. We hypothesized that the erosive potential is determined primarily by pH and decreases in the presence of salivary proteins. To investigate this, we first added uncoated hydroxyapatite crystals and, second, salivary-protein-coated hydroxyapatite crystals to 20 commercially available cola drinks and orange juices simultaneously, with pH recordings every 15 sec for 3 min. The amount of apatite lost per liter of soft drink per sec was calculated from titratable acidity values to each pH obtained by crystal addition. The erosive potential within the first minutes of exposure was determined solely by the pH of the drink, and the erosive potential was ten-fold higher in cola drinks compared with juices. However, salivary proteins reduced the erosive potential of cola drinks by up to 50%.

Salivary changes and dental caries as potential oral markers of autoimmune salivary gland dysfunction in primary Sjögren's syndrome

Backgroundthe classification criteria for primary Sjögrens syndrome (pSS) include a number of oral components. In this study we evaluated if salivary flow and composition as well as dental caries are oral markers of disease severity in pSS.Methodsin 20 patients fulfilling the American-European Consensus criteria for pSS and 20 age-matched healthy controls whole and parotid saliva flow rates and composition, measures of oral dryness, scores of decayed, missing and filled tooth surfaces (DMFS), periodontal indices, oral hygiene, and dietary habits were examined.Resultsin pSS, salivary flow rates, pH, and buffer capacities were lower, and DMFS, salivary sodium and chloride concentrations higher than in the healthy controls. DMFS also correlated inversely to salivary flow rates and positively to oral dryness. Apart from slightly increased gingival index, and more frequent dental visits in pSS, the periodontal condition, oral hygiene or sugar intake did not differ between these two groups. In pSS, findings were correlated to labial salivary gland focus score (FS) and presence of serum-autoantibodies to SSA/SSB (AB). The patients having both presence of AB and the highest FS (>2) also had the highest salivary sodium and chloride concentrations, the lowest salivary phosphate concentrations, lowest salivary flow rates, and highest DMFS compared to those with normal salivary concentrations of sodium and chloride at a given flow rate.Conclusionthe salivary changes observed in some pSS patients reflect impaired ductal salt reabsorption, but unaffected acinar transport mechanisms, despite low salivary secretion. Our results suggest that changes in salivary flow and composition as well as dental caries may serve as potential markers of the extent of autoimmune-mediated salivary gland dysfunction in pSS. The study also indicates that the ductal epithelium is functionally affected in some pSS patients, which calls for future pathophysiological studies on the mechanisms underlying this impaired salt reabsorption.

The bicarbonate concentration in human saliva does not exceed the plasma level under normal physiological conditions

Abstract Depending on the secretion rate and nature of the stimulus applied, the bicarbonate concentration ([HCO3–]) in human saliva has been shown to vary from 1 to 60 mM, with the highest values obtained in secretions from the parotid and submandibular glands. We conducted the present study on five healthy young males, in order to determine whether human saliva [HCO3–] can exceed the plasma level under normal physiological conditions, and applied a strategy in which we measured the secretory response to various stimulus intensities. Whole saliva stimulation was initiated by chewing paraffin (50–100 chewing cycles/min), parotid saliva stimulation by citric acid taste (0.2–4% citric acid solutions), and both secretions were also collected during systemic medication using pilocarpine (5 mg). Our results showed that the parotid and whole saliva flow rates were closely correlated to the intensity of the secretion-inducing stimulus applied (taste, chewing, and pilocarpine). This was also the case for saliva [HCO3–], all of which was present in the form of physically dissolved CO2, H2CO3, and HCO3–. The highest mean [HCO3–] (i.e. 37.75 mM) was found in parotid saliva after stimulation by pilocarpine in combination with 4% citric acid taste. Under normal physiological conditions (i.e. without pilocarpine) the saliva [HCO3–] was similar to or below the plasma level in both secretions.

Salivary Cortisol Level, Salivary Flow Rate, and Masticatory Muscle Activity in Response to Acute Mental Stress: A Comparison between Aged and Young Women

Background: Age-related effects on physiological stress reactions regarding changes in salivary cortisol concentration, saliva flow rate, and masticatory muscle activity, as well as the corresponding perceived mental stress and performance in response to acute stressors, have not yet been fully described. Objective: Thus, the aim of this study was to assess the age-related variations in these variables in response to minor acute and naturalistic stressors in terms of computer tasks. Methods: 13 aged (60–70 years old) and 13 young (20–30 years old) women with frequent practice and long experience with computer use were recruited by personal contact and flyers. The subjects were healthy and had full dental arches and no orofacial pain. The computer tasks were randomized and comprised a mentally demanding, modified Stroop colour-word test (CWT) and a less demanding reference test, both with a duration of 20 min and with equal physical demand. Visual analogue scales for global assessment of mental stress and perceived task difficulty and performance, measurements of saliva flow rate and cortisol concentration (unstimulated whole saliva), as well as surface electromyography of the temporalis and masseter muscles were used for assessment, and Spearman correlation analysis and Anova with repeated measures were used for statistical evaluation. Results: The perceived task-related stress and task difficulty were significantly higher and the personal satisfaction with the task performance significantly poorer in the aged women. The cortisol concentration, indicating the stress level, showed a small, but significant increase in response to the tasks. Also the saliva flow rate increased. This response was most pronounced in the aged and during the CWT. The average electromyogram varied significantly between age groups and tasks, with higher levels and shorter relative periods with gaps in the aged women and in the CWT. In addition, the peak activity of the jaw elevator muscles at mouse clicking was significantly elevated as a form of co-activation or attention-related activity. Conclusions: The study showed marked differences in the response to mental demands in aged as compared with young women. The mental stress, reflected by increases of salivary cortisol concentration, saliva flow rate, visual analogue scale ratings, and activity level of the jaw elevator muscles, was more pronounced in the aged women in response to the computer tasks.

Salivary changes and dental erosion in bulimia nervosa.

OBJECTIVE Our aim was to study if bulimia nervosa (BN) has an impact on salivary gland function and if such changes are related to dental erosion. STUDY DESIGN Twenty women with BN and twenty age- and gender-matched controls participated. Flow rate and composition of whole and glandular saliva, as well as feeling of oral dryness were measured. Dental erosion was measured on casts. RESULTS Compared with control subjects, unstimulated whole saliva (UWS) flow rate was reduced in persons with BN, primarily owing to intake of medication (P = .007). No major compositional salivary changes were found. In the BN group, the dental erosion score was highest and complaints of oral dryness were more frequent. CONCLUSIONS The BN persons had impaired UWS, mainly owing to medication; increased feeling of oral dryness; and more dental erosion. Dental erosion was related to the duration of eating disorder, whereas no effect of vomiting frequency or intake of acidic drinks on reduced UWS was observed.

Release of peppermint flavour compounds from chewing gum: effect of oral functions

During chewing, the oral cavity functions like a bellow, forcing volatile flavour compounds into the exhaling air to the nasal compartment. Accordingly, we hypothesised that flavour release from chewing gum is predominantly governed by chewing frequency (CF), although other oral functions, like masseter muscle activity (MMA), chewing force (CFO), and saliva flow rate (SFR), may also play a role. In 10 healthy young males, the retronasal expired air of menthol and menthone from peppermint-flavoured (2%) chewing gum was determined as functions of CF, SFR, MMA, and CFO. The experimental setup comprised three separate series of a 4-min chewing period. These series differed only with respect to CF, i.e., habitual frequency, and 60 and 88 strokes/min. Results showed that more than 50% of the released menthol and menthone could be retrieved in the expired air and saliva. After 2-min of chewing, the concentration of flavour compounds in the expired air depended primarily on MMA and CF, becoming higher with increased MMA and CF. The concentration of flavour compounds in saliva depended primarily on SFR and the duration of the chewing task, becoming lower with high SFR and prolonged chewing duration. An increased volume of saliva in the mouth seemed to keep more flavour compounds in the aqueous phase, thereby diminishing the release via the retronasal route. In conclusion, flavour release to the retronasal compartment was dependent on MMA and CF and influenced by the volume of saliva present in the mouth.

X-linked hypohidrotic ectodermal dysplasia. Genetic and dental findings in 67 Danish patients from 19 families

This study aimed to investigate genotype and phenotype in males affected with X‐linked hypohidrotic ectodermal dysplasia (HED) and in female carriers, to analyse a possible genotype–phenotype correlation, and to analyse a possible relation between severity of the symptoms and the X‐chromosome inactivation pattern in female carriers. The study group comprised 67 patients from 19 families (24 affected males and 43 female carriers). All participants had clinical signs of ectodermal dysplasia and a disease‐causing EDA mutation. The EDA gene was screened for mutations by single‐stranded conformational polymorphism and direct sequencing. Multiplex ligation‐dependent probe amplification (MLPA) analysis was used to detect deletions/duplications in female probands. Sixteen different EDA mutations were detected in the 19 families, nine not described previously. The MLPA analysis detected a deletion of exon 1 in one female proband. No genotype–phenotype correlations were observed, and female carriers did not exhibit a skewed X‐chromosome inactivation pattern. However, in two female carriers with pronounced clinical symptoms, in whom the parental origin of each allele was known, we observed that mainly the normal allele was inactivated.

Temporal Stability of the Salivary Microbiota in Oral Health

Objectives Saliva is a biological fluid suitable for biomarker analysis, and differences in the salivary microbiota in oral health and disease have been reported. For such comparative analyses, time of sampling is critical since the bacterial composition may vary throughout the day, i.e., diurnal variation. The purpose of this study is to compare the salivary microbiome over time to determine the optimal time for sampling. Design Stimulated saliva samples were collected from 5 orally healthy individuals in 4 h intervals for 24 h, and collection was repeated 7 days later (number of samples per person, n = 12, total number of samples, n = 60). Salivary microbiota was analyzed using the Human Oral Microbe Identification using Next Generation Sequencing (HOMINGS), and statistical analysis was performed using the Kruskal-Wallis test with Benjamini-Hochberg’s correction for multiple comparisons, cluster analysis, principal component analysis and correspondence analysis. Results From a total of 60 saliva samples, 477 probe targets were collectively identified with a mean number of probes per sample of 207 (range: 153–307). Little or no variation in microbial profiles within subjects was observed over time. Conclusions Although there was considerable variation between subjects, microbial profiles within subjects were stable throughout a 24 hour period and after 1 week. Since there is little or no evidence of diurnal variation of the salivary microbiome, time of sampling of saliva is not critical for perturbation or other microbial studies.