H.S. Brand

Psychological stress as a determinant of protein levels and salivary-induced aggregation of Streptococcus gordonii in human whole saliva

Several pathologies of the oral cavity have been associated with stress, so we investigated salivary-induced aggregation during psychological stress. In addition, salivary total protein, alpha-amylase, and secretory immunoglobulin A (s-IgA) were assessed. In this longitudinal study, 28 dental students provided unstimulated whole saliva during 10 minutes before an academic examination and subsequently 2 weeks and 6 weeks later in a nonstress situation. The effect of whole saliva on the aggregation of Streptococcus gordonii (HG 222) was determined spectrophotometrically. The results show a significant stress-mediated increase of salivary total protein concentration, alpha-amylase activity, amylase/protein ratio, alpha-amylase output, s-IgA concentration, and s-IgA output. There was also a trend for increased total protein output, whereas salivary flow rate was unchanged. The aggregation of S. gordonii in whole saliva collected before examination was 13.1%, whereas the aggregation in whole saliva collected during nonstress was 23.3%. This reduction was statistically significant (p <.01). Furthermore, the decrease in bacterial aggregation was related to the increase in state-anxiety (p <.05). The reduction in aggregation of S. gordonii under stress was not correlated with changes in salivary flow rate, s-IgA concentration, total protein concentration, or alpha-amylase activity. These results suggest that acute psychological stress exerts its influence on both salivary composition and salivary function. Reduced bacterial aggregation may be a contributing factor in the often reported relationship between stress and impaired oral health.

Oral and salivary changes in patients with end stage renal disease (ESRD): a two year follow-up study

Objectives To compare oral health, salivary flow rate, xerostomia and thirst in end stage renal disease (ESRD) patients remaining on dialysis treatment and after renal transplantation. Design Longitudinal observation. Setting ESRD patients recruited from dialysis centres in Amsterdam, The Hague and Utrecht, The Netherlands. Method At baseline and after two years, salivary flow rates, xerostomia and thirst were determined in 43 ESRD patients. The number of decayed missing filled teeth/surfaces (DMFT/DMFS) was recorded, and periodontal status assessed. Results After renal transplantation (n = 20), the salivary flow rate increased significantly from UWS = 0.30 ± 0.21 ml/min to 0.44 ± 0.29 ml/min (p <0.001) and the level of xerostomia and thirst decreased. After two years, the percentage of bleeding on probing in dialysis patients (n = 23) decreased from 29.5 ± 25.4% to 10.3 ± 12.3%, (p <0.05). No differences in DMFT and DMFS were observed between dialysis and renal transplant patients. Conclusions DMFT, dental plaque, gingival bleeding and periodontal indices did not change remarkably after two years, comparing dialysis and renal transplant patients. Renal transplantation enhances salivary flow and decreases symptoms of xerostomia and thirst, and hence enhances the potential to improve the quality of life of affected individuals.

Dental erosion in the 21st century: what is happening to nutritional habits and lifestyle in our society?

Several developments in Western Europe may have contributed to the increased prevalence of dental erosion during the last decades. Exposing children to sour taste at an early age increases the preference for acidic food and drinks later in life. Acidic fruits and beverages became widely available due to economic prosperity. New types of acidic candies were developed, some of which are kept in the mouth for very long times. Children are exposed to intense marketing of these acidic products, which are widely available in supermarkets and school canteens. In the meantime, much less attention has been paid to the development and marketing of less erosive food products.

Interference of electrical dental equipment with implantable cardioverter-defibrillators

Objective To determine whether electromagnetic interference with implantable cardioverter-defibrilllators (ICDs) occurs during the use of electrical dental equipment.Material and methods Ten different electrical dental devices were tested for their ability to interfere with the function of three types of ICDs at different intervals for 90 seconds, during which the ICD activity was monitored by telemetry.Results Only one ultrasonic bath cleaner interfered with two of the ICDs tested up to a distance of 12.5 cm, both during continuous use and intermittent operation. In contrast, the dental chair, electrosurgical unit, both handpieces, ultrasonic tooth scaler, both amalgamators and two other types of ultrasonic bath cleaners failed to produce interference at the minimum distance of 2.5 cm.Conclusion Our results suggest that normal clinical use of dental electrical equipment does not have significant effects on the ICDs tested.

Acute effects of hemodialysis on salivary flow rate and composition.

AIMS To evaluate acute effects of hemodialysis (HD) on the salivary flow rate, pH and biochemical composition before, during and after completion of a dialysis session. MATERIAL AND METHODS Unstimulated whole saliva (UWS) and chewing-stimulated whole saliva (CH-SWS) were collected in 94 HD patients. Salivary flow rate, pH, concentrations of total protein, albumin, cystatin C, secretory immunoglobulin A (S-IgA) and of sodium, potassium and urea were measured. RESULTS HD had an acute stimulating effect on the salivary flow rate (UWSbefore = 0.30+/-0.22 ml/min, UWSduring = 0.39+/-0.25 ml/min, p < 0.005). The mean pH of UWS showed a small but significant increase during HD mainly due to an increased watery secretion from the salivary glands. The salivary biochemical constituents changed markedly, but no significant difference in output was found. The electrolyte concentration did not change significantly during dialysis. The level of urea in CH-SWS declined to 40% (Ureabefore = 25.+/-6.4 mmol/l, Ureaduring = 15.3+/-4.5 mmol/1). CONCLUSIONS This study shows that HD has significant acute effects on both salivary secretion rate and protein concentrations in saliva. We conclude that the observed changes in salivary concentrations and proteins are mainly due to an increased watery secretion from the salivary glands.

The erosive potential of candy sprays

Objective To determine the erosive potential of seven different commercially available candy sprays in vitro and in vivo.Material and methods The erosive potential was determined in vitro by measuring the pH and neutralisable acidity. The salivary pH and flow rate were measured in healthy volunteers after administration of a single dose of candy spray.Results Candy sprays have an extremely low pH (1.9–2.3) and a neutralisable acidity varying between 0.8–1.6 ml of 0.25M NaOH. In vivo, candy sprays induced a short-term 3.0 to 5.8-fold increase in salivary flow rate with a concomitant drop in salivary pH to values between 4.4 and 5.8.Conclusion All candy sprays tested have an erosive potential. This information is of use for clinicians counselling juvenile patients with dental erosion.

Soft drink, software and softening of teeth: a case report of tooth wear in the mixed dentition due to a combination of dental erosion and attrition

This case report describes a 9-year-old boy with severe tooth wear as a result of drinking a single glass of soft drink per day. This soft drink was consumed over a period of one to two hours, while he was gaming intensively on his computer. As a result, a deep bite, enamel cupping, sensitivity of primary teeth and loss of fillings occurred. Therefore, dentists should be aware that in patients who are gaming intensively, the erosive potential of soft drinks can be potentiated by mechanical forces leading to excessive tooth wear.

Beer: Effects on Saliva Secretion and Composition

We investigated the effects of beer consumption on salivary secretion rate, pH, uric acid and amylase concentration. Ten healthy volunteers consumed either 300 ml top-fermented beer or the same volume of non-alcoholic beer at 1 week intervals. The consumption of beer induced a transient reduction in the volume of chewing-stimulated whole saliva after 15 min. No significant changes were observed in the salivary pH and concentrations of uric acid and amylase.