muramidase and Xerostomia

Innate human salivary defence proteins, lysozyme, lactoferrin and peroxidase, are known to exert a wide antimicrobial activity against a number of bacterial, viral and fungal pathogens in vitro. Therefore, these proteins, alone or in combinations, have been incorporated as preservatives in foods and pharmaceuticals as well as in oral health care products to restore salivas' own antimicrobial capacity in patients with dry mouth. These antimicrobials used in oral health care products, such as dentifrices, mouth-rinses, moisturizing gels and chewing gums, have been purified from bovine colostrum. In this review I critically evaluate the clinical efficacy and safety of this kind of preventive approach against various oral diseases and symptoms.

Topics: Animals; Anti-Infective Agents, Local; Bacteria; Cattle; Colostrum; Complex Mixtures; Dentifrices; Drug Combinations; Drug Design; Female; Glucose Oxidase; Humans; Lactoferrin; Lactoperoxidase; Mouthwashes; Muramidase; Polymers; Pregnancy; Proteins; Saliva, Artificial; Salivary Proteins and Peptides; Thiocyanates; Xerostomia

The objective of this study was to assess the duration of effect of a single dose of Biotène Moisturizing Spray on xerostomia compared to water spray.. This double-blind randomized controlled crossover trial compared the duration of effect of 2 agents on relieving xerostomia in adult patients recruited through convenience sampling. Following a xerostomia questionnaire, qualifying patients with an unstimulated whole saliva flow rate of ≤0.20 mL/min rated their baseline level of discomfort from oral dryness and received a single dose (3 sprays) of Biotène Moisturizing Spray or water (active control). Patients indicated their level of oral discomfort every 15 min and the precise time when relief ceased. After a minimum 48-h washout, patients repeated the exercise with the alternative product.. The baseline severity of discomfort from oral dryness among qualifying patients was significantly related to their level of hyposalivation (P = .001). The mean duration of effect of Biotène Moisturizing Spray was 27 ± 25 min, which was not significantly different from that for water (26 ± 25 min; P = .88; n = 25).. Biotène Moisturizing Spray and water spray had variable durations of effect averaging approximately 30 min. The results of this pilot study provide guidance regarding anticipated usage and dispensing needs for patients with objective xerostomia. ClinicalTrials.gov NCT03663231.

Topics: Adult; Drug Combinations; Glucose Oxidase; Humans; Lactoperoxidase; Muramidase; Pilot Projects; Saliva; Xerostomia

The objective of this study is to determine the efficacy of GUM® Hydral versus Biotène® Oralbalance (both a mouthwash plus gel) on the subjective burden and clinical symptoms of patients with medication-induced xerostomia.. Subjects (N = 40) with medication-induced xerostomia (minimum 4/10 mm visual analog scale [VAS]) were randomized to treatment with GUM Hydral or Biotène Oralbalance mouthwash, both with gel, for 28 days. Subjects then entered a 21-day wash-out period, before crossing over to the other treatment for 28 days. Outcomes measured included the VAS, German Oral Health Impact Profile (OHIPG)-14, Xerostomia Questionnaire (XQ), after-use questionnaire, and clinical parameters.. Both GUM Hydral and Biotène Oralbalance significantly (p < 0.05) reduced VAS, OHIPG-14 total score and single items, and XQ Part 1 (oral dryness, oral pain, taste loss) and Part 2 items. GUM Hydral also significantly reduced the XQ Part 1 dysphagia score, while Biotène Oralbalance significantly reduced the halitosis organoleptic score and plaque index. Significant increases in saliva secretion did not reach clinical relevance. No significant between-group differences were observed, apart from OHIPG-14 items "trouble pronouncing words" and "uncertainty" in favor of GUM Hydral. No adverse effects were reported.. Both products effectively improve oral health and xerostomia-related quality of life. However, they cannot completely substitute the continuous in-mouth secretion of saliva, and symptomatic relief is temporary. Product selection will be based on personal preference.. Both products diminish xerostomic burden and should be part of the management strategy. Affected patients should be informed of these treatments, since no adverse effects were reported.

Topics: Administration, Oral; Cross-Over Studies; Double-Blind Method; Drug Combinations; Female; Gels; Glucose Oxidase; Humans; Lactoperoxidase; Male; Middle Aged; Mouthwashes; Muramidase; Quality of Life; Surveys and Questionnaires; Xerostomia

This multicenter, randomized, parallel group study analyzed the effectiveness of an experimental oral gel, a commercially available oral rinse and a commercially available mouth spray versus water alone at relieving self-reported symptoms of dry mouth over a 28-day home use treatment period. The effects of the study treatments on dry mouth-related quality of life (QoL) were also investigated.. Eligible subjects were stratified by dry mouth severity (mild, moderate or severe) and randomized to receive one of the study treatments. Prior to first use they completed a questionnaire designed to assess their baseline dry mouth-related QoL. Following first use and on Day 8 (2 hours post-treatment only) and Day 29, subjects completed the modified Product Performance and Attributes Questionnaire (PPAQ) I at 0.5, 1, 2 and 4 hours post-treatment. Subjects further assessed treatment performance using the PPAQ II questionnaire on Days 8 and 29 and the dry mouth-related QoL questionnaire on Day 29.. In 396 randomized subjects almost all comparisons of responses to PPAQ I, including those for the primary endpoint (response to PPAQ I Question 1 'Relieving the discomfort of dry mouth' after 2 hours on Day 29), were statistically significant in favor of active treatment groups versus water (P < 0.05). All comparisons of responses to PPAQ II on Days 8 and 29 were statistically significant in favor of active treatments versus water (P < 0.05). Moreover, nearly all comparisons for dry mouth-related QoL scores on Day 29 were statistically significant in favor of the active treatments versus water. All the dry mouth management strategies in this trial were well tolerated.

Topics: Adult; Aerosols; Aged; Aged, 80 and over; Attitude to Health; Drug Combinations; Female; Follow-Up Studies; Gels; Glucose Oxidase; Humans; Lactoperoxidase; Lubricants; Male; Middle Aged; Mouthwashes; Muramidase; Quality of Life; Self Concept; Self Report; Treatment Outcome; Water; Xerostomia

The efficacy of stannous fluoride toothpastes is well established for reducing caries, plaque, and gingivitis and relieving the discomfort of dentin hypersensitivity. Management of dry mouth may include relief remedies in addition to usual oral hygiene methods to maintain oral health and improve quality of life. This 6-week, single-blind, randomized, two-period crossover clinical study was designed to evaluate the oral tolerance and potential of Enamelon® Preventive Treatment Gel (EPTG), with 0.4% stannous fluoride, to relieve subject-perceived dry-mouth symptoms in a self-reported dry-mouth population, after 14 days of use, compared to a marketed over-the-counter (OTC) artificial saliva gel product (Biotene® Oral Balance Gel [BOBG]).. Following a 7-day washout period, 52 qualified subjects with self-reported dry-mouth symptoms received EPTG or BOBG for once-daily use for 14 days. All subjects brushed each morning and evening with a standard fluoride toothpaste (Sensodyne® ProNamel). Each evening and following brushing with the Sensodyne ProNamel, subjects used their assigned gel product (EPTG or BOBG) as directed. On Days 1, 8, and 15, subjects received an oral examination and assessed relief of dry-mouth symptoms using a product-performance questionnaire (PPQ). Procedures were repeated with the alternate product for another 14-day period, following a 7-day washout. Data for each efficacy endpoint were analyzed using crossover ANOVA model.. No treatment-related adverse events were reported in this study, and both products were well tolerated by the subjects. Compared to pre-study ratings of usual dry-mouth remedies, both BOBG and EPTG significantly reduced dry-mouth symptoms following 14 days of use. BOBG was statistically significantly better than EPTG in relieving many of the principal dry-mouth symptoms such as providing immediate relief, having an immediate moisturizing and immediate lubricating effect, feeling comfortable in the mouth, soothing the mouth, effectively lubricating the mouth, and protecting the mouth from drying out (P < .05). Compared with subjects' ratings of their usual dry-mouth remedies, EPTG also provided relief of several dry-mouth symptoms at both Days 8 and 15 (P < .05).. Based on subjective measures of dry mouth and compared with pre-study ratings of usual remedies, subjects perceived that EPTG helped to manage symptoms such as relieving the discomfort of dry mouth, immediately moisturizing and lubricating, effectively lubricating, protecting from drying out, and providing long-lasting moisturization and long-lasting lubrication, and was not irritating to dry-mouth tissues. BOBG, the positive control, was significantly better than EPTG in relieving dry-mouth symptoms over a 2-week period and was not irritating.. Patients with dry-mouth symptoms may benefit from daily use of a non-irritating, OTC fluoride preventive treatment gel product to relieve symptoms while also reducing the risks of developing dental caries, demineralization, dentin hypersensitivity, and gingivitis.

Topics: Adult; Calcium Phosphates; Cross-Over Studies; Drug Combinations; Female; Fluorides; Gels; Glucose Oxidase; Humans; Lactoperoxidase; Male; Middle Aged; Muramidase; Self Report; Single-Blind Method; Toothpastes; Treatment Outcome; Xerostomia

The clinical efficacy, safety, and acceptability of a new oral saliva equivalent (Novasial) administered four times daily in the treatment of xerostomia in various medical conditions was compared with that of oxygenated glycerol triester oral spray (Aequasyal) and a moisturizing spray (Biotene) in a 2-week, multicenter, randomized, crossover study. Assessment included patient-based evaluation of mouth dryness score (primary endpoint) with a visual analog scale (VAS), blinded assessment of the oral tissue condition by a four-point ordinal scale, and patient-based assessment of tolerability and acceptability.. At day 14, Novasial decreased oral mouth dryness by 19.5%, (12.5 ± 22.6 mm, P < .0001 versus baseline), versus 10% (6.6 ± 17.9 mm with Aequasyal, P < .0001 versus Baseline; and P < .0156 versus Novasial) and 13% (8.6 ± 18.9 mm) with Biotene (P < .0001 versus baseline). The 50% decrease in the primary endpoint was not achieved, and the overall efficacy of Novasial and Aequasyal were similar with respect to xerostomia. Novasial was preferred to Aequasyal and Biotene in alleviating taste alteration and chewing difficulty. Treatment compliance was higher with Novasial (P = .0014 versus Aequasyal). The treatments improved the oral condition with equal efficacy and were safe and well tolerated (VAS 72-77 mm).. Novasial was a safe, well-tolerated, and acceptable treatment in patients with xerostomia induced by various treatments or pathologic conditions.

Topics: Administration, Oral; Aged; Cross-Over Studies; Drug Combinations; Egg White; Female; Glucose Oxidase; Humans; Lactoperoxidase; Male; Muramidase; Saliva, Artificial; Treatment Outcome; Triglycerides; Xerostomia

The objective of the present study was to evaluate the efficacy of Oral Balance saliva substitute in alleviating dry mouth symptoms in a sample of patients with secondary Sjögren's syndrome. Twenty-one consecutive secondary Sjögren's syndrome patients with dry mouth complaints and hyposalivation were included in this study. Patients used a lactoperoxidase-system-containing gel (Biotène Oral Balance) for 4 weeks. The effects on subjective oral symptoms were recorded by means of a 7-items questionnaire which contained questions regarding dry mouth sensation and its effect on chewing, swallowing, taste, speech, burning sensation and denture retention. The severity of symptoms was assessed using a visual analogical scale. Oral symptom scores and unstimulated whole salivary flow were recorded at baseline and after 4 weeks' use of the product. Two patients withdrew from the study, because of nausea and unpleasant taste caused by the product. Nineteen patients (all women, mean age 52.7 years) participated throughout the entire study. Wilcoxon signed-ranked tests indicated significant improvements in visual analogical scale scores posttreatment for 5 of the 7 items on the oral dryness questionnaire, although no increase in salivary flow was found. However, the improvement in certain variables did not take a positive course in all cases. Patients with lower salivary flow at baseline tended to have greater improvement in oral symptoms. The study suggests that the use of Oral Balance gel is effective in alleviating the dry mouth symptoms in secondary Sjögren's syndrome patients, but a randomized controlled trial is needed to assess the placebo effect.

Topics: Adult; Aged; Drug Combinations; Female; Glucose Oxidase; Humans; Lactoperoxidase; Middle Aged; Muramidase; Patient Satisfaction; Pilot Projects; Sjogren's Syndrome; Surveys and Questionnaires; Treatment Outcome; Xerostomia

Salivary gland impairment is a major problem that can result in hyposalivation and a decrease in quality of life. Causes for mouth dryness can be grossly classified into three major groups: iatrogenic, immunogenic, and metabolic. At present, insufficient therapies exist to ease morbidity in this growing number of affected individuals. A need for new products to relieve oral dryness is mandatory. The aim of this study was to evaluate a mucoadhesive lipid-based bioerodable tablet as a novel device to decrease signs and symptoms associated with mouth dryness.. Twenty xerostomic patients were divided into two groups. In group 1, the mucoadhesive tablet was applied to the hard palate, while in group 2, Biotène mouthwash was applied and served as a control. Sialometry measurements, as well as a questionnaire assessing mouth dryness, were obtained before and after treatment.. Application of the mucoadhesive tablets resulted in a significant reduction in the sensation of the mouth dryness (P = .016) compared to Biotène. Moreover, a 1.5-fold increase in unstimulated whole saliva flow was obtained after 30 minutes in the treatment group.. A lipid-based mucoadhesive tablet has a beneficial role in reducing the sensation of dryness in patients with xerostomia.

Topics: Acrylates; Adult; Aged; Analysis of Variance; Calcium Chloride; Cellulose; Delayed-Action Preparations; Drug Combinations; Female; Glucose Oxidase; Humans; Lactoperoxidase; Male; Middle Aged; Mouthwashes; Muramidase; Pilot Projects; Povidone; Saliva; Statistics, Nonparametric; Surveys and Questionnaires; Tablets; Triglycerides; Xerostomia

To evaluate the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lactoferrin and lysozyme, in a sample of elderly individuals with dry mouth.. Twenty elderly institutionalised subjects with dry mouth and with a certain degree of independence for daily life activities were included in this pilot study. A randomised, double blind and cross-over design was used. The study variables comprised subjective dry mouth sensation, the severity of discomfort assessed by means of a visual analogical scale (VAS), the Oral Health Impact Profile (OHIP), the presence of signs and symptoms of dry mouth, sialometry and Candida albicans culture. All the variables were recorded before and after each of the two periods of the study.. The 20 selected subjects we made up of 16 women and four men, with a mean age of 81.3 years. Improvement was observed on analysing the data between the first and second intervention period in terms of the OHIP values, the presence of dry mouth, and the need to drink fluids to swallow. However, the improvement in certain variables before and after treatment did not take a positive course in all cases, and some subjects even improved with placebo.. The evaluated mouthwash and oral gel improved some subjective and clinical aspects in elderly individuals with dry mouth, though a placebo effect cannot be entirely discarded.

Topics: Aged; Aged, 80 and over; Anti-Infective Agents; Cross-Over Studies; Dental Care for Aged; Double-Blind Method; Drug Combinations; Female; Glucose Oxidase; Humans; Lactoferrin; Lactoperoxidase; Male; Muramidase; Pilot Projects; Polymers; Quality of Life; Saliva, Artificial; Sickness Impact Profile; Xerostomia

The aging population is susceptible to developing dry mouth (xerostomia). Elderly patients present all of the major risk factors to acquiring dry mouth which include systemic diseases and disorders, such as diabetes and depression, and the use of numerous medications, including anti-hypertensives and anti-depressants. The consequences of untreated dry mouth are severe limitations of masticatory function and speech, and increased risk of developing caries, periodontal diseases and fungal infections. Assessment of xerostomia, which includes a set of signs and symptoms that impact on the individual, can only be fully explored through a thorough medical history, intra-oral examination and recording the subjective views of patients. This study suggests a methodology for the assessment of xerostomia through a xerostomia questionnaire, which was used to evaluate the effectiveness and acceptability of a saliva substitute product (Biotène) in the treatment of xerostomia in 20 elderly patients exhibiting both severe and moderate symptoms. Wilcoxon signed-ranked tests revealed significant improvements in the number and severity of symptoms between the pre-test and the post-test groups. Biotène products were also found to be effective in the treatment of both severe and moderate symptoms of xerostomia. Biotène saliva substitutes are an acceptable and effective method of treatment for elderly people suffering from dry mouth.

Topics: Aged; Delivery of Health Care; Drug Combinations; Glucose Oxidase; Humans; Lactoperoxidase; Muramidase; Pilot Projects; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome; Xerostomia

The aim of this study is to clarify the effects of cevimeline on various components in human saliva, such as immunoglobulin A (IgA), lysozyme, alpha-amylase and squamous cell carcinoma (SCC) antigen. Twelve female patients with Sjögren syndrome (SS) and 14 healthy women were enrolled. After the first saliva collection, one capsule (30 mg) of cevimeline was administered to each subject. Saliva was collected again after 90 min. The salivary flow rate and concentration of each component were measured. In both groups the salivary flow rate and amylase concentration were significantly increased by cevimeline. The lysozyme and IgA concentrations did not change significantly in both groups. The SCC antigen concentration did not change significantly in the SS group, but it decreased significantly in the control group. The secretion rates of amylase and IgA showed significant increases in both groups. The secretion rate of lysozyme significantly increased only in the control group, while the secretion rate of SCC significantly increased only in the SS group. Cevimeline augments not only the salivary flow rate but also the secretion rate of some digestive and/or defense factors from infections. It may be beneficial for SS patients to continue taking cevimeline to prevent oral infections, and other serious sequelae.

Topics: alpha-Amylases; Antigens, Neoplasm; Female; Humans; Immunoglobulin A; Middle Aged; Muramidase; Muscarinic Agonists; Quinuclidines; Saliva; Salivation; Serpins; Sjogren's Syndrome; Thiophenes; Xerostomia

This study assessed the efficacy of the Bioxtra (BX) and Biotène Oralbalance (OB) systems in the treatment of post-radiotherapy xerostomia. In a double-blind, crossover study, 20 patients with post-radiotherapy xerostomia were randomly allocated to receive either OB then BX, or vice versa, each product for 2 weeks, with a 1 week wash-out period in between. Subject-based dry mouth scores derived from 100-mm visual analogue scales were recorded at days 0 and 14 of each 2-week period, together with subjective perception of changes in dry mouth symptoms. Both treatments were effective, resulting in reduction of visual analogue scale scores from day 0-14. Between-groups comparisons identified that BX achieved significantly better improvements compared with OB for the perception of dry mouth and improvements in speech and was also rated as more pleasant to use than OB (P < 0.05). In conclusion, both treatments were effective in alleviating the symptoms of post-radiotherapy xerostomia, although BX achieved superiority in some of the outcomes assessed compared with OB.

Topics: Administration, Oral; Adult; Aged; Complex Mixtures; Cross-Over Studies; Double-Blind Method; Drug Combinations; Female; Glucose Oxidase; Humans; Lactoperoxidase; Male; Middle Aged; Mouth; Muramidase; Proteins; Radiotherapy; Saliva; Surveys and Questionnaires; Treatment Outcome; Xerostomia

One of the major side effects of radical radiation therapy for head and neck malignancies is xerostomia, or dryness of the mouth. There is no clearly effective treatment for this condition, but we have observed that patients in our practice believe that their symptoms improve significantly when using two "over-the-counter" oral comfort products - Biotene (toothpaste, mouthwash and chewing gum) and Oralbalance gel. We decided to study these agents in a formal phase II study to evaluate their usefulness in patients with postirradiation xerostomia. Twenty-eight patients with post-irradiation xerostomia were entered on the study. All had biopsy-proven carcinoma of the nasopharynx, oropharynx, oral cavity, hypopharynx or larynx, and had received primary radiotherapy with curative intent (> or =50 Gy in 20 fractions) more than 4 months before study entry. More than 75% of both parotid glands were included in the primary radiation field. There was no clinical evidence of recurrent disease. Patients were provided with a 2-month supply of Biotene mouthwash, toothpaste, chewing gum and Oralbalance gel. Response was evaluated 1 and 2 months after study entry using a patient-completed visual analogue scale to assess the severity of xerostomia and its effects on quality of life. For analysis, the scored baseline was subtracted from the later scores to assess change. Patients with an increase of 10 mm from their baseline score on the visual analogue scale were classified as having responded to the treatment intervention, and those with an increase of > or =25 mm from their baseline score were classified as having experienced a major improvement in their symptoms. After 2 months of treatment, 15 patients (54%) reported an improvement in intraoral dryness and 10 of these patients (36%) reported a major improvement. Similar proportions of patients (46% some improvement, 25% major improvement) reported an improvement in their ability to eat normally. Seventeen patients (61%) reported an improvement in oral discomfort, and 12 of these (43%) had a major improvement in their symptoms. The results of this study suggest that the use of Biotene (mouthwash, toothpaste and chewing gum) and Oralbalance gel can improve many of the symptoms of radiation-induced xerostomia. A placebo effect could account for many of the observed improvements in symptoms, and in order to assess the role of these agents in the management of patients with postirradiation xerostomia a randomised phase III

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Anti-Infective Agents; Drug Combinations; Female; Glucose Oxidase; Head and Neck Neoplasms; Humans; Lactoperoxidase; Male; Middle Aged; Muramidase; Radiotherapy; Surveys and Questionnaires; Treatment Outcome; Xerostomia

This study evaluates the effects of two oral hygiene products containing nonimmunoglobulin antimicrobial agents on whole saliva and on subjective oral symptoms in patients with xerostomia. Twenty patients used a lactoperoxidase-system-containing toothpaste (Biotene) combined with the use of a mouthrinse (Biotene), comprising also lysozyme and lactoferrin, for 4 weeks. Saliva samples were collected at base line, after 4 weeks' use of the products, and at the end of a 4-week washout period. Samples were analyzed for selected biochemical and microbiologic factors. The effects on subjective oral symptoms were also recorded. A 4-week daily use of toothpaste and mouthrinse relieved the symptoms of oral dryness in 16 patients. The levels of salivary hypothiocyanite, lysozyme, lactoferrin, or myeloperoxidase activity did not change, but there was a significant decrease in salivary pH (P < 0.05), total peroxidase activity (P < 0.05), and total protein content (P = 0.01). In patients with the lowest salivary flow rates (n = 5) a significant (P > or = 0.04) increase was detected in salivary hypothiocyanite concentrations. No major changes occurred in salivary microflora. The products relieved subjective oral symptoms in most xerostomic patients, but this was not necessarily related to the presence of antimicrobial agents.

Topics: Adult; Aged; Anti-Infective Agents, Local; Bacteria, Anaerobic; Candida; Colony Count, Microbial; Dentifrices; Female; Humans; Hydrogen Peroxide; Hydrogen-Ion Concentration; Lactoferrin; Lactoperoxidase; Male; Middle Aged; Mouthwashes; Muramidase; Palliative Care; Peroxidases; Saliva; Salivary Proteins and Peptides; Thiocyanates; Xerostomia

Tear secretion and lysozyme tear content were measured in 30 patients with Sjögren's syndrome after treatment with oral bromhexine, 32 mg/day. In 21 patients (70%) there was a marked increase in tear secretion and in lysozyme content. In patients with keratoconjunctivitis sicca (KCS) good results in clarifying the mucoid eye discharge were obtained. A remarkable amelioration of xerostomia was also noted. Six other patients, serving as controls, were given a placebo and bromhexine. The placebo had no influence on the rate of tear secretion, while bromhexine caused it to increase in 70% of the controls. This side effects of bromhexine treatment encountered in the present study were negligible and transient. We consider bromhexine to be the drug of choice in the treatment of Sjögren's syndrome.

Topics: Bromhexine; Clinical Trials as Topic; Humans; Muramidase; Sjogren's Syndrome; Tears; Xerophthalmia; Xerostomia

Radiotherapy and chemotherapy can impair salivary gland (SG) function, which causes xerostomia and exacerbate other side effects of chemotherapy and oral infection, reducing patients' quality of life. This animal study aimed to assess the efficacy of electroacupuncture (EA) as a means of preventing xerostomia induced by 5-fluorouracil (5-FU). A xerostomia mouse model was induced via four tail vein injections of 5-FU (80 mg/kg/dose). EA was performed at LI4 and LI11 for 7 days. The pilocarpine-stimulated salivary flow rate (SFR) and salivary glands weight (SGW) were recorded. Salivary immunoglobulin A (SIgA) and lysozyme were determined via enzyme-linked immunosorbent assay (ELISA). SG was collected for hematoxylin and eosin staining to measure acini number and acinar cell size.

Topics: Animals; Antineoplastic Agents; Electroacupuncture; Fluorouracil; Immunoglobulin A, Secretory; Mice; Muramidase; Pilocarpine; Quality of Life; Salivary Glands; Tumor Necrosis Factor-alpha; Xerostomia

Elderly individuals with dry mouth wearing dentures require an appropriate denture adhesive. The purpose of this study was to evaluate the in vitro properties of a newly developed denture adhesive for patients with dry mouth and compare these with those of a currently available adhesive and oral moisturizing agent.. We developed a new gel-type denture adhesive with physical properties suitable for patients with dry mouth (DM). We subsequently performed in vitro comparisons among DM, New Poligrip (NP), and Biotene Oralbalance Gel (BT) with regard to the following properties: retention force, resistance to squeezing, and ease of removal. In accordance with the standards of the International Organization for Standardization (ISO10873:2010), the retention force was measured for dry samples (no water exposure, severe dry mouth model) and for samples exposed to water for 10min (normal model) and 1min (moderate dry mouth model). The resistance to squeezing was evaluated by pushing the samples out of syringes, while the ease of removal was evaluated by measuring the time required to wash the material from a polymethyl methacrylate plate.. In the severe dry mouth model, DM exhibited greater retention force than did NP and BT. Moreover, the resistance to squeezing was significantly lower for DM than for NP. Both BT and DM showed better ease of removal than did NP. NP was the most difficult to wash out with water.. Our findings suggest that the newly developed denture adhesive DM is suitable for use in patients with dry mouth.

Topics: Chemical Phenomena; Dental Cements; Dental Materials; Denture Retention; Denture, Complete; Device Removal; Drug Combinations; Gels; Glucose Oxidase; Humans; In Vitro Techniques; Lactoperoxidase; Models, Dental; Muramidase; Polymethyl Methacrylate; Xerostomia

The aim of this study was to assess the relationship between complaints of xerostomia in patients with rheumatoid arthritis (RA) with the total output of the salivary proteins of innate and adaptive immunity.. The salivary output and specific activity of peroxidase and specific contents of lysozyme, lactoferrin, and secretory immunoglobulin A (sIgA) were determined in xerostomic RA patients, nonxerostomic RA patients, and healthy control subjects.. Compared with nonxerostomic RA and healthy control groups, xerostomic RA patients had significantly decreased output of saliva and protein, decreased peroxidase activity, and a significantly lower specific content of peroxidase and sIgA. Compared with the RA control group, xerostomic RA patients had significantly lower specific content of all salivary proteins examined.. The results indicate that xerostomia in patients with RA may be a harbinger of diminished saliva production regarding quantity and quality, and may be indicative of impairment of the salivary immune system of the oral cavity in xerostomic RA patients.

Topics: Adaptive Immunity; Adult; Arthritis, Rheumatoid; Blood Sedimentation; C-Reactive Protein; Case-Control Studies; DMF Index; Female; Humans; Immunity, Innate; Immunoglobulin A, Secretory; Immunologic Factors; Lactoferrin; Middle Aged; Muramidase; Oral Hygiene Index; Periodontal Index; Peroxidases; Rheumatoid Factor; Saliva; Salivary Proteins and Peptides; Secretory Rate; Xerostomia

Xerostomia is a common complication of radiotherapy for head and neck cancer. Symptomatic treatment consists of stringent oral hygiene to prevent oral infections and saliva substitutes to increase comfort. The aim of the study was to evaluate the clinical effectiveness of the BioXtra (BX) dry mouth care system.. A xerostomia questionnaire consisting of 3 parts (xerostomia symptom score, quality of life (QoL) survey and visual analogue scale (VAS)) was completed by 34 patients suffering from radiation-induced xerostomia, before and after 4 weeks of treatment with the BioXtra moisturizing gel, toothpaste and mouthwash.. The BioXtra products significantly diminished the most common symptoms of xerostomia. Mean VAS score at the start of treatment was 59.8. After treatment, this decreased to 36.4 (p < 0.001). Twenty-six patients (77%) responded to treatment, 11 of these patients (32%) reported a major improvement. Quality of life significantly improved under treatment: mean QoL score at the start was 59.4; this increased to 70.5 (p < 0.001). None of the 34 patients reported any adverse effects and all but 1 patient found the BX dry mouth care system easy to use.. The results of this study suggest that the BioXtra dry mouth care system is effective in reducing the symptoms of radiation-induced xerostomia and improving the quality of life of xerostomia patients, even if a proportion of the benefit is due to a placebo effect. However, further research is necessary to evaluate the efficacy of BioXtra on oral health.

Topics: Aged; Aged, 80 and over; Complex Mixtures; Female; Head and Neck Neoplasms; Health Surveys; Humans; Lactoferrin; Lactoperoxidase; Male; Middle Aged; Muramidase; Pain Measurement; Proteins; Psychological Tests; Psychometrics; Quality of Life; Radiation Injuries; Radiation Oncology; Radiotherapy; Radiotherapy Dosage; Risk Factors; Saliva; Salivation; Surveys and Questionnaires; Xerostomia; Xylitol

Salivary gland agenesis is a rare condition. It can be associated with some equally rare syndromes so that diagnosis can be delayed.. The authors describe a case report. A 3-year-old girl, presented with dry mouth, carious teeth, recurrent herpes labialis and tonsillitis to Newcastle Dental Hospital. This case highlights the diagnostic and therapeutic challenges posed by 'salivary gland agenesis'.. Primary and secondary paediatric healthcare professionals should be aware of the possibility of salivary gland agenesis in the setting of the 'non drooling baby'. Early detection of 'salivary gland agenesis' would do much to prevent the deleterious oral affects which follow the absence of salivary protection in the oral cavity.

Topics: Child, Preschool; Dental Caries; Drug Combinations; Female; Glucose Oxidase; Herpes Labialis; Humans; Lactoperoxidase; Muramidase; Recurrence; Saliva, Artificial; Salivary Glands; Tonsillitis; Xerostomia

In the current study, we performed taste and salivary analysis on patients suffering from burning mouth syndrome and xerostomia or taste disturbances.. A total of 180 patients who complained of idiopathic burning mouth syndrome (BMS) and taste aberrations and/or xerostomia that may accompany BMS were evaluated. These patients were compared with 90 healthy, age- and sex-matched controls. Salivary flow rate, biochemical and immunological analysis and taste acuity by the forced-choice drop technique were performed for all subjects. These analyses were found to be conclusive in distinguishing controls from patients with complaints.. The great similarity of both salivary and taste analysis in the BMS, taste aberration and xerostomia groups, which were significantly different from the results obtained in the control group, was found to be the most striking result. Higher salivary concentrations in the experimental group were consistent with a lower saliva (water) flow rate.. An oral neuropathy and/or neurological transduction interruption induced by salivary compositional alterations is suggested as the possible aetiology for the complaints. This report may add an important objective diagnostic tool to the clinician treating these patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Albumins; Burning Mouth Syndrome; Female; Humans; Immunoglobulins; Male; Middle Aged; Muramidase; Saliva; Salivary Proteins and Peptides; Salivation; Sodium; Taste; Taste Disorders; Xerostomia

The purpose of this investigation was to study oral health and salivary aspects of the frail elderly. The study hypothesis was that elderly patients with many concomitant diseases and drugs would have different salivary secretion rates and biochemical constituents than healthier patients.. The stimulated flow, pH buffering capacity, and biochemical constituents were analyzed from salivas of 169 elderly subjects (51 men and 118 women, mean age 81.2 years, range 69 to 96 years) admitted to an acute geriatric ward because of sudden worsening of their health. Common statistical methods were used to analyze the differences among patient groups. The patients were grouped according to the number of concomitant diseases and daily used drugs and on the basis of salivary flow rate values.. Reduced salivary flow (< 0.7 ml/min) was found in 48% of the men and 62.5% of the women, and a low buffering capacity was found in 31.9% of the men and 36.7% of the women. Age did not significantly affect the salivary flow rate. The factors that showed the strongest influence on salivary flow were endocrinologic diseases, ophthalmologic and respiratory drugs, and potassium chloride. Salivary immunoglobulin A and immunoglobulin M concentrations were significantly higher in older patients. Immunoglobulin A, lysozyme, and amylase concentrations were significantly higher in older patients taking many drugs. Patients with many concomitant diseases had significantly higher salivary urea concentrations than healthier patients. Edentulous patients had significantly higher salivary immunoglobulin A, immunoglobulin M, lysozyme, and amylase concentrations.. In this study, hyposalivation was a frequent observation, and the elderly who took many drugs and had several systemic diseases had higher concentrations of most of the analyzed biochemical constituents.

Topics: Aged; Aged, 80 and over; Amylases; Buffers; Disease; Drug-Related Side Effects and Adverse Reactions; Endocrine System Diseases; Female; Frail Elderly; Geriatrics; Health Status; Hospital Units; Humans; Hydrogen-Ion Concentration; Immunoglobulin A, Secretory; Immunoglobulin M; Male; Mouth, Edentulous; Muramidase; Ophthalmic Solutions; Potassium Chloride; Referral and Consultation; Respiratory System Agents; Saliva; Salivation; Secretory Rate; Sex Factors; Urea; Xerostomia

Saliva and serum lysozyme, immunoglobulin, albumin, and total protein levels were monitored in thirty patients with cancer of the head or neck before, during, and after radiotherapy and compared with those of a group of non-irradiated noncancer control subjects. The mean volume-based saliva lysozyme and total protein concentrations were significantly higher in the cancer patients before radiotherapy than in the control group. During radiotherapy, the mean volume-based concentrations of all protein components assayed increased as the saliva flow rate decreased. Protein-based ratios of saliva albumin, IgG, and lysozyme and the ratio of IgG/IgA increased as the xerostomia intensified. Ratios of saliva total protein and IgA to flow rate paralleled the flow rate decrease. Such increased concentrations in saliva immunoproteins were offset, however, by a greater than 93 per cent reduction in total saliva output. This reduced saliva output, therefore, resulted in an immunoprotein deficit. There were no significant differences between the mean serum lysozyme levels of the cancer and control groups at any point of comparison. The mean serum immunoglobulin concentrations in the cancer patients before radiotherapy were significantly higher than those in the control group. During radiotherapy, there was a decrease in the mean serum total protein, albumin, and immunoglobulin levels which reverted toward the pretreatment values during the postirradiation period.

Topics: Adult; Blood; Blood Proteins; Female; Humans; Immunoglobulins; Male; Middle Aged; Muramidase; Radiotherapy; Saliva; Xerostomia