Caries affected by calcium and fluoride in drinking water and family income.

Water quality and socioeconomics influence caries in populations. This study broadens previous studies on how caries is associated with fluoride and calcium in drinking water and with family income by quantifying the combined effect of the three independent variables. The effects of calcium and fluoride can be described as independent effects of the two ions or, alternatively, in the form of saturation with respect to fluorite (CaF2). A general linear model describes this relationship with high significance and the model confirms the important protective effect of calcium and fluoride, independently against caries. From the model, the relative importance of fluoride and calcium to protect against caries is quantified. The relationship between caries and family income is also highly significant. It is illustrated how the linear model can be applied in planning and analyzing drinking water softening in relation to caries.

Incidence of sialolithiasis in Denmark: a nationwide population-based register study.

Sialolithiasis is a frequent disorder affecting the salivary glands. The incidence rate (IR) has been reported to be 2.9-5.5 per 100,000 person-years, but all previous studies have been based on selected hospital data. In this study, we conducted a population-based study evaluating the IR of sialolithiasis and the IR variation according to age, gender and geography in Denmark. We included data from hospitals as well as from private ear, nose and throat (ENT) clinics. The study was based on registry data on all sialolithiasis cases in Denmark between 2003 and 2009 extracted from the Danish National Patient Registry (hospital cohort) and the Danish Regions Centre for Healthcare Statistics (private ENT clinic cohort). To validate the diagnosis, the proportion of visually confirmed cases was estimated based on patient records from subsamples of the two cohorts. The IR was 7.27 and 14.10 per 100,000 person-years based on visually confirmed cases only and on all cases, respectively. The highest IR was observed among 60- to 70-year-olds, in the North Denmark region and among females. In the validation subsamples, 35% of assumed sialoliths were visually confirmed in the private ENT clinic cohort and 59% in the hospital cohort. In this first population-based study of IR on sialolithiasis, we found a substantially higher IR. With respect to both visually confirmed cases and all cases, this is higher than previously reported from studies based on selected hospital data.

Whole-Saliva Fluoride Levels and Saturation Indices in 65+ Elderly during Use of Four Different Toothpaste Regimens.

BACKGROUND: Elderly individuals suffering from subnormal saliva secretion combined with inadequate oral hygiene may develop rampant caries and caries in parts of the dentition not normally affected by caries if preventive measures are not undertaken. Such measures include elevating fluoride levels at the saliva/biofilm/tooth interface. AIM: To analyse whole-saliva fluoride levels and mineral saturation indices during different fluoride toothpaste regimens in home-living elderly. MATERIALS AND METHODS: Whole saliva was collected from 27 subjects (7 males and 20 females, mean age 73.5±6.1 years) at ten time points covering the whole day during five 2-week periods. During the first period, participants used their normal toothpaste without instructions (baseline). This was followed by TP1: 1,450-ppm NaF toothpaste; TP2: 1,450-ppm monofluorophosphate (MFP) toothpaste with addition of calcium; TP3: 5,000-ppm NaF toothpaste, and TP4: the same toothpaste with additional 'smearing' of toothpaste on the teeth, twice daily. During TP1-TP4, the participants were instructed to brush 3 times per day using 1.5 g of toothpaste without rinsing. RESULTS: Salivary fluoride levels increased with toothpaste fluoride content (p<0.001), although major interindividual and intraindividual variations were observed. The highest fluoride values appeared in the morning and at night (p<0.001). Saturation indices for calcium fluoride were affected by the fluoride content in pastes (p<0.05). Concerning hydroxyapatite and fluorapatite, indices were highest with the MFP toothpaste and extra calcium (NS to p<0.05). CONCLUSIONS: Use of a high-fluoride toothpaste resulted in significantly increased fluoride levels in whole saliva and mineral saturation indices were indeed influenced by choice of toothpaste.

Root caries, root surface restorations and lifestyle factors in adult Danes.

AIM: To investigate selected lifestyle factors in relation to active caries and restored root surface lesions in adults. MATERIALS AND METHODS: Based on clinical examinations and questionnaires, data on root caries, socioeconomic status, body mass index, dietary habits, alcohol consumption, tobacco use and oral hygiene routines were collected from 4369 adults aged 21-89 who took part in a survey covering 13 municipalities across Denmark. Uni- and multivariate logistic regression analyses were applied to analyse the relationship between the independent lifestyle variables and active caries and restored root surface lesions, respectively. RESULTS: The prevalence of active root caries was 4%, while 26% displayed restored root surfaces. The sugar intake was not related to root caries. A multivariate logistic regression analysis revealed that, in subjects aged 45 or over, smoking and wearing dentures were significantly associated with presence of active root caries (p<0.01). The intake of 15 drinks or more per week was associated with higher odds of root surface restorations compared with no alcohol intake (OR=1.7; p<0.001). CONCLUSIONS: Lifestyle factors such as tobacco use and alcohol consumption, as well as wearing dentures, were significantly associated with the occurrence of untreated caries and restored root surface lesions, especially in persons over 45. Thus, such lifestyle factors should be taken into consideration, identifying persons with a need of preventive dental services. In addition, oral health education should focus on the possible risks of smoking and a high alcohol intake.

Saliva composition in three selected groups with normal stimulated salivary flow rates, but yet major differences in caries experience and dental erosion.

OBJECTIVE: It was hypothesized that, by comparing matched subjects with major differences in these dental diseases, but yet normal saliva flow rates, it would be possible to obtain data on the effect of saliva composition on dental disease isolated from the effect of the flow rate. Thus, the aim of the study was to compare the major physicochemical characteristics of stimulated whole saliva in three groups of 85 subjects, each with normal saliva flow rates and at least 24 remaining teeth. MATERIALS AND METHODS: A group with very little dental disease (healthy), a group with dental erosion (erosion) and a group with very high caries experience (caries) were chosen. Furthermore, the aim was to determine whether differences among groups could also be found on an individual level. RESULTS: Although it was not possible to retrieve three groups whose members were completely identical, the present study points in the direction that, on a group level, subjects with very little dental disease seemed to have a more favorable physicochemical saliva composition with respect to higher calcium, phosphate, bicarbonate, pH, degree of saturation with respect to hydroxyapatite and a lower critical pH (p < 0.05 or less). However, on an individual level the explanatory power for the saliva composition was only 10% for caries experience and only 11% for dental erosion (p < 0.001). CONCLUSION: The compositional analyses performed in this study on stimulated whole saliva, including major physicochemical characteristics of saliva, will most likely have little predictive value for future dental caries and erosion in single individuals.

Saliva in relation to dental erosion before and after radiotherapy.

OBJECTIVE: Low saliva flow and abnormal saliva composition are common conditions after radiotherapy for oral cavity and pharyngeal cancer. Both conditions increase the susceptibility to dental caries and erosion, which may be further accelerated by changes in food preferences. The aim of this study was to determine changes in saliva flow and susceptibility to erosive challenges in pharyngeal cancer patients before and after radiotherapy to the head and neck. MATERIALS AND METHODS: The erosive potential of sucking acidic candies with and without calcium was determined in nine patients (50-68 years) before and after receiving a radiation dose of 66 Gy to the head and neck area. The erosive potential was evaluated from saliva degree of saturation with respect to hydroxyapatite (HAp) and by dissolution of HAp in candy-stimulated saliva. RESULTS: Sucking acidic candies increased saliva flow rates ≈ 17-fold before as well as after radiotherapy (p < 0.001). However, significantly lower unstimulated (p < 0.05) and stimulated (p < 0.01) saliva flow rates were obtained after radiotherapy. Also, saliva became more under-saturated with respect to HAp during (p < 0.01) and in a period after sucking the candies (p < 0.01). HAp dissolution was significantly lower with the candy containing calcium compared with the control candy, both before and after radiotherapy (p < 0.001 and p < 0.05). CONCLUSIONS: Radiotherapy to the head and neck area significantly reduced saliva flow and altered saliva composition in a way that may increase the susceptibility to dental disease. However, saliva could be stimulated by acidic candies, which could be made nearly non-erosive even in irradiated patients.

Findings from the oral health study of the Danish Health Examination Survey 2007-2008.

OBJECTIVE: The aims of the oral part of the Danish Health Examination Survey (DANHES 2007-2008) were (1) to establish an oral health database for adult Danes and (2) to explore the influence of general diseases and lifestyle on oral health. This paper presents the study population, examination methods, questionnaire and baseline results. MATERIALS AND METHODS: The study population comprised 4402 subjects, aged 18-96, consecutively enrolled from 18 065 DANHES participants from 13 municipalities in Denmark. The oral part consisted of a validated questionnaire and a clinical examination, carried out in mobile units by three trained and calibrated dental hygienists. The data were processed with descriptive statistics and mono- and bivariate analyses. RESULTS: The mean age was 54.1 years and 60% were women. The mean number of natural teeth was 26.6; the mean DMFT/DMFS values were 18.9 and 61.0, and varied with age (DMFT 8.7-24.3). A higher proportion of females suffered from dental erosion in the younger age groups. Forty per cent of all subjects had a mean clinical attachment loss ≥ 3 mm, varying from 4% among those aged 18-34 to 80% in those over 75. A sub-optimal saliva secretion rate was more common among females than males (17.7% vs 10.4%) and this was reflected by the reported frequency of dry mouth. CONCLUSION: This extensive cross-sectional study provides a platform for obtaining future knowledge of the impact of health- and lifestyle-related factors on oral diseases. The validated questionnaire and the clinical characteristics enable robust analyses, although the conclusions may be hampered by limited external validity.

Effect of chewing gums containing the probiotic bacterium Lactobacillus reuteri on oral malodour.

OBJECTIVE: To evaluate the effect of chewing gums containing probiotic bacteria on oral malodour. The null hypothesis was that no difference would be displayed compared with placebo gums. MATERIALS AND METHODS: Twenty-five healthy young adults with self-reported malodorous morning breath completed this randomized double-blind placebo-controlled cross-over trial. The design included run-in and wash-out periods interspersed by two intervention periods of 14 days each. The subjects were instructed to chew one gum in the morning and one in the evening containing either two strains of probiotic lactobacilli (L. reuteri DSM 17938 and L. reuteri ATCC PTA 5289) or placebo. The outcome measures were (i) organoleptic scores (0-5) by a certified test panel, (ii) concentration of volatile sulphur compounds (VSC) measured with a Halimeter and (iii) concentration of VSC after a cysteine rinse. Registrations were made at baseline and after each intervention period. Differences between the groups were assessed by non-parametric paired statistics and chi-square test. RESULTS: The median organoleptic score was similar (score 2) in both groups at baseline. After 14 days of treatment, the organoleptic scores were significantly lower in the probiotic group compared with the placebo group (p < 0.05). Assessments of the VSC levels displayed no significant differences between the groups, either before or after rinsing with L-cysteine. No adverse effects were registered. CONCLUSION: The results demonstrated that probiotic chewing gums may have some beneficial effect on oral malodour assessed by organoleptic scores. The results indicate that the probiotic gum may affect bacteria that produce malodourous compounds other than VSCs.

Amount and type of alcohol consumption and missing teeth among community-dwelling older adults: findings from the Copenhagen Oral Health Senior study.

OBJECTIVES: To study if an association between total weekly intake of alcohol, type-specific weekly alcohol intake, alcoholic beverage preference, and the number of teeth among older people exists. METHODS: A cross-sectional study including a total of 783 community-dwelling men and women aged 65-95 years who were interviewed about alcohol drinking habits and underwent a clinical oral and dental examination. Multiple regression analyses were applied for studying the association between total weekly alcohol consumption, beverage-specific alcohol consumption, beverage preference (defined as the highest intake of one beverage type compared with two other types), and the number of remaining teeth (≤ 20 versus >20 remaining teeth). RESULTS: The odds ratio (OR) of having a low number of teeth decreased with the total intake of alcohol in women, with ORs for a low number of teeth of 0.40 [95 percent confidence interval (CI) 0.22-0.76] in women drinking 1-14 drinks per week and 0.34 (95 percent CI 0.16-0.74) in women with an intake of more than 14 drinks per week compared with abstainers. Similar relations could also be obtained for type-specific alcohol intake of wine and for wine and spirits preference among women. Men who preferred beer showed a decreased risk for a low number of teeth compared with men with other alcohol preferences. CONCLUSION: In this study, alcohol consumption, wine drinking, and wine and spirits preference among women were associated with a higher number of teeth compared with abstainers. Among men, those who preferred beer also had a higher number of teeth.

Treatment of severe drooling with botulinum toxin in amyotrophic lateral sclerosis and Parkinson's disease: efficacy and possible mechanisms.

OBJECTIVE: Drooling in neurodegenerative diseases is associated with social impediment. Previous treatments of drooling have little effect or are effective but with severe side effects. Therefore, there is a need to test new methods such as the use of botulinum toxin type A (BTX-A). MATERIAL AND METHODS: This open, prospective study deals with treatment of drooling in 12 patients with amyotrophic lateral sclerosis and three with Parkinson's disease. Injections of BTX-A (Botox) were given into the parotid (25-40 units) and submandibular (15-30 units) glands with ultrasonographic guidance. After BTX-A treatment, the patients were followed for 2 months with evaluations every second week by means of self-assessed rating scales for drooling intensity, discomfort and treatment effect, and determination of unstimulated whole saliva (UWS) flow rate, and inorganic and organic UWS composition. The treatment was repeated up to four times, but seven patients dropped out shortly after the first treatment due to marked worsening of their disease-related condition. RESULTS: Drooling and flow were reduced (P < 0.05) 2 weeks after treatment, without side-effects. The maximal reductions during the observation period were 40% for drooling and 30% for flow. There was a systematic variation in flow during the observation period, with an initial decrease and then an increase followed by a second decrease. Amylase activity and total protein concentration generally increased with decreasing flow (P ≤ 0.03). CONCLUSION: Inhibition of acetylcholine release from postganglionic parasympathetic nerve endings by injection of BTX-A into salivary glands seemed useful for secondary sialorrhoea, although cyclic variations in flow may occur, possibly due to transitory sprouting and regeneration.

The Copenhagen Oral Health Senior Cohort: design, population and dental health.

BACKGROUND: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. OBJECTIVES: To describe the design, measurement procedures, and baseline values for COHS including spatial distribution of restorations and dental caries as well as reasons for non-participation. MATERIALS AND METHODS: Seven hundred and eighty-three individuals aged 65 years or older, from a total of 1918 invited elderly people, underwent an interview regarding oral health-related behaviour and a clinical oral examination including measurement of unstimulated whole saliva flow rate. RESULTS: Twelve percent of the COHS was edentulous. The number of dental restorations was higher for women compared to men; however, men had more caries than women. Coronal caries was most frequent on mesial and distal surfaces and on the maxillary incisors and canines; root caries was most frequent on labial surfaces and evenly distributed within the dentition. Only 41% of all invited elderly people accepted the invitation, with old age and poor health being the primary reasons for non-participation. CONCLUSION: The baseline values for COHS show that a substantial proportion of the participants had retained a natural dentition and that dental caries was prevalent with the anterior maxillary teeth being most affected.

Erosive potential of calcium-modified acidic candies in irradiated dry mouth patients.

PURPOSE: Patients who have received irradiation therapy on the head and neck area are known to suffer from reduced saliva flow and may therefore use acidic candies to relieve symptoms of dry mouth. However, such acidic candies have erosive potential even among healthy individuals. Therefore, the aim of the present study was to determine if calcium-modified acidic candies have reduced erosive potential in irradiated cancer patients. MATERIALS AND METHODS: Nineteen cancer patients (26 to 70 years) ipsilaterally irradiated on the head and neck area sucked control and calcium-modified acidic candies, while their whole saliva was collected into a closed system. The erosive potential of both candies was evaluated from saliva degree of saturation with respect to hydroxyapatite and by dissolution of hydroxyapatite (HAp) directly in candy-stimulated saliva. The results were compared to normative data that were previously obtained on 20 healthy test persons (21 to 29 years). RESULTS: No significant difference was obtained in the saliva flow rates between control and calcium-modified candy. However, the saliva became significantly less undersaturated with respect to HAp when sucking calcium-modified compared to control candy (P < 0.001) and more undersaturated for both candies in ipsilaterally irradiated cancer patients compared to normative data (P < 0.001). HAp dissolution was found to be significantly lower in patients sucking the modified candy compared to the control candy (P < 0.01) and, surprisingly, slightly lower in patients compared to normative data. CONCLUSIONS: Modified acidic candy with calcium has reduced erosive potential in patients irradiated on the head and neck area and could therefore be used as a favourable stimulant for relief of dry mouth.

Surgical risk factors and maxillary nerve function after Le Fort I osteotomy.

PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes with a number of possible intraoperative risk factors. PATIENTS AND METHODS: Twelve men and 13 women (mean +/- standard deviation: aged 25+/-10 years) participated in 4 sessions: 1 before LFO (baseline), and the rest at 3, 6, and 12 months after LFO. At each session, somatosensory sensitivity was assessed for the skin, oral mucosa, and teeth, using quantitative sensory tests at either 1 cutaneous point or on a 5 x 5 point matrix reproduced on the skin. In addition, all patients were asked to report their perceived differences in somatosensory sensitivity and their overall satisfaction with the LFO. RESULTS: The thresholds of tactile stimuli on the gingiva and palate were increased 12 months after LFO (P< .001). Significant increases in 2-point discrimination detection thresholds (P< .01) and increased sensitivity to heat (P< .01) and cold (P< .001) in the infraorbital region were also recorded 12 months after LFO. Correspondingly, self-reported complaints of changed sensation under the eyes (P< .01), upper lip (P< .01), gingiva (P< .001), palate (P< .01), and teeth (P< .01) were reported during the entire postoperative period. Intraoperative risk factors were identified and correlated with postoperative changes in somatosensory sensitivity. Segmentation of the maxilla was associated with an increase in tactile thresholds at the palate and gingiva (P< .05), as were self-reported complaints involving the palate and gingiva (P< .001), whereas maxillary impaction was related to lower-tooth pulp pain thresholds when compared with maxillary lowering (P< .01). All patients expressed satisfaction with LFO, despite signs of somatosensory disturbances in up to 64% of patients. CONCLUSION: Numerous changes in postoperative somatosensory function are to be expected after LFO. In most patients, these changes are minor, and some are dependent on intraoperative procedures. Nonetheless, all patients reported satisfaction with the surgical results, and would recommend the procedure to others.

Meal-induced compositional changes in blood and saliva in persons with bulimia nervosa.

BACKGROUND: Binge eating episodes in persons with bulimia nervosa may to some extent be a result of disturbed sensations of hunger and satiety. It has been hypothesized that abnormal appetite sensations may be due to bulimia nervosa-related alterations in the release of hormones that are known to be involved in the physiologic regulation of appetite and metabolism. OBJECTIVE: The objective was to investigate whether circulating concentrations of the appetite-regulating peptides leptin and ghrelin and markers of metabolism (glucose and insulin) are different in persons with bulimia nervosa than in controls before and after intake of a meal and whether these changes may be reflected in saliva. DESIGN: Twenty women with bulimia nervosa and 20 age- and sex-matched healthy controls participated. After an overnight fast, the subjects ate a standardized carbohydrate-rich breakfast. Whole saliva and blood were collected, and visual analogue scales for hunger and satiety were completed once before and continuously for 5 h after the breakfast. RESULTS: A lower pre- and postprandial whole saliva flow rate was found in subjects with bulimia nervosa, which might have been attributable to a concomitant intake of potentially xerogenic medication. Subjects with bulimia nervosa experienced reduced hunger, which could not be explained by pre- or postprandial alterations in circulating ghrelin, leptin, insulin, or glucose concentrations. CONCLUSIONS: There were no apparent differences in the composition of blood and saliva between bulimia nervosa and control subjects, and meal-induced compositional changes in blood were not directly mirrored in saliva composition.

Risk factors affecting somatosensory function after sagittal split osteotomy.

PURPOSE: The aim of this study was to evaluate potential individual and intraoperative risk factors associated with bilateral sagittal split osteotomy (BSSO) and to correlate the findings with postoperative changes in somatosensory function. PATIENTS AND METHODS: A total of 18 men and 29 women (mean age, 31 +/- 10 years) scheduled for BSSO participated in 1 session before BSSO and 5 sessions after BSSO (at 2 and 14 days and 3, 6, and 12 months). At each session, subjective oral sensation was scored and quantitative sensory tests were performed. RESULTS: The results showed that complete exposure and free dissection of the inferior alveolar nerve during BSSO increased self-reported changes in lower lip sensation and lower lip tactile threshold after BSSO (P < .01). Long surgical movements reduced self-perceived jaw-opening function and impaired 2-point discrimination (P < .05). Significant correlations were noted between preoperative values for somatosensory function and changes in these variables after BSSO. Patients with low sensory thresholds before BSSO experienced more impairment than those patients with higher preoperative sensory thresholds. CONCLUSION: These findings imply that somatosensory function after BSSO is dependent on both intraoperative risk factors and preoperative sensation levels.

Comparison of Glycomacropeptide with Phenylalanine Free-Synthetic Amino Acids in Test Meals to PKU Patients: No Significant Differences in Biomarkers, Including Plasma Phe Levels.

INTRODUCTION: Management of phenylketonuria (PKU) is achieved through low-phenylalanine (Phe) diet, supplemented with low-protein food and mixture of free-synthetic (FS) amino acid (AA). Casein glycomacropeptide (CGMP) is a natural peptide released in whey during cheese-making and does not contain Phe. Lacprodan® CGMP-20 used in this study contained a small amount of Phe due to minor presence of other proteins/peptides. OBJECTIVE: The purpose of this study was to compare absorption of CGMP-20 to FSAA with the aim of evaluating short-term effects on plasma AAs as well as biomarkers related to food intake. METHODS: This study included 8 patients, who had four visits and tested four drink mixtures (DM1-4), consisting of CGMP, FSAA, or a combination. Plasma blood samples were collected at baseline, 15, 30, 60, 120, and 240 minutes (min) after the meal. AA profiles and ghrelin were determined 6 times, while surrogate biomarkers were determined at baseline and 240 min. A visual analogue scale (VAS) was used for evaluation of taste and satiety. RESULTS: The surrogate biomarker concentrations and VAS scores for satiety and taste were nonsignificant between the four DMs, and there were only few significant results for AA profiles (not Phe). CONCLUSION: CGMP and FSAA had the overall same nonsignificant short-term effect on biomarkers, including Phe. This combination of FSAA and CGMP is a suitable supplement for PKU patients.

Safety and Efficacy of Mesenchymal Stem Cells for Radiation-Induced Xerostomia: A Randomized, Placebo-Controlled Phase 1/2 Trial (MESRIX).

BACKGROUND: Salivary gland hypofunction and xerostomia are major complications to head and neck radiotherapy. This trial assessed the safety and efficacy of adipose tissue-derived mesenchymal stem cell (ASC) therapy for radiation-induced xerostomia. PATIENT AND METHODS: This randomized, placebo-controlled phase 1/2 trial included 30 patients, randomized in a 1:1 ratio to receive ultrasound-guided transplantation of ASCs or placebo to the submandibular glands. Patients had previously received radiotherapy for a T1-2, N0-2A, human papillomavirus-positive, oropharyngeal squamous cell carcinoma. The primary outcome was the change in unstimulated whole salivary flow rate, measured before and after the intervention. All assessments were performed one month prior (baseline) and one and four months following ASC or placebo administration. RESULTS: No adverse events were detected. Unstimulated whole salivary flow rates significantly increased in the ASC-arm at one (33%; P = .048) and four months (50%; P = .003), but not in the placebo-arm (P = .6 and P = .8), compared to baseline. The ASC-arm symptom scores significantly decreased on the xerostomia and VAS questionnaires, in the domains of thirst (-22%, P = .035) and difficulties in eating solid foods (-2%, P = .008) after four months compared to baseline. The ASC-arm showed significantly improved salivary gland functions of inorganic element secretion and absorption, at baseline and four months, compared to the placebo-arm. Core-needle biopsies showed increases in serous gland tissue and decreases in adipose and connective tissues in the ASC-arm compared to the placebo-arm (P = .04 and P = .02, respectively). MRIs showed no significant differences between groups in gland size or intensity (P < .05). CONCLUSIONS: ASC therapy for radiation-induced hypofunction and xerostomia was safe and significantly improved salivary gland functions and patient-reported outcomes. These results should encourage further exploratory and confirmatory trials.

Is parotid saliva sterile on entry to the oral cavity?

CONCLUSION: The present study indicates that parotid saliva is sterile on entry to the oral cavity. OBJECTIVES: The objective was to investigate if parotid saliva is sterile on entry to the oral cavity and, thus, prior to contamination by oral bacteria. METHOD: Forty healthy volunteers were included in sterile parotid saliva collection. Parotid saliva was collected using a sterile Lashley cup, placed over the papilla of the Stensen´s duct, as well as sterile tubes and syringes for collection. All collections were followed by collection of a positive control sample where some of the sterile obtained parotid saliva had been exposed to the contralateral mucosal membranes. All samples parotid saliva, as well as the positive controls, were cultivated, and 10 randomly selected parotid saliva samples underwent polymerase chain reaction (PCR) analyses. RESULTS: In 33 of 40 parotid saliva samples there were no cultivable bacteria, whereas bacteria were cultivated in all positive control samples. In eight of 10 PCR samples no bacterial DNA was detected. The most frequent bacteria in the remaining non-sterile parotid saliva samples and positive control samples were non-haemolytical streptococci and the coagulase negative staphylococci.

Salivary microbiota in individuals with different levels of caries experience.

This study compared salivary bacterial profiles in two groups having a 10-fold difference in levels of caries experience, as it was hypothesized that the composition of the salivary microbiota might associate with the levels of caries experience. Bacterial profiles in stimulated saliva samples from 85 individuals with low levels of caries experience (healthy group) and 79 individuals with high levels of caries experience (caries group) were analyzed by means of the Human Oral Microbiome Identification Next Generation Sequencing (HOMINGS) technique. Subsequently, saliva samples from caries-free individuals in the healthy group (n = 57) and the caries group (n = 31) were compared. A significantly higher α-diversity (p < 0.0001) and a twofold higher relative abundance of Neisseria, Haemophilus, and Fusobacterium were recorded in saliva samples from the healthy group compared with the caries group. Differences observed were more pronounced when limiting the analyses to caries-free individuals in each group. Data from this cross-sectional analysis suggest that low levels of caries experience might associate with a characteristic salivary bacterial composition different from that in individuals with high caries experience. Consequently, longitudinal studies are required to determine if the composition of the salivary microbiota might be a predictive factor of caries risk at the individual level.

First-in-man mesenchymal stem cells for radiation-induced xerostomia (MESRIX): study protocol for a randomized controlled trial.

BACKGROUND: Salivary gland hypofunction and xerostomia are major complications following radiotherapy for head and neck cancer and may lead to debilitating oral disorders and impaired quality of life. Currently, only symptomatic treatment is available. However, mesenchymal stem cell (MSC) therapy has shown promising results in preclinical studies. Objectives are to assess safety and efficacy in a first-in-man trial on adipose-derived MSC therapy (ASC) for radiation-induced xerostomia. METHODS: This is a single-center, phase I/II, randomized, placebo-controlled, double-blinded clinical trial. A total of 30 patients are randomized in a 1:1 ratio to receive ultrasound-guided, administered ASC or placebo to the submandibular glands. The primary outcome is change in unstimulated whole salivary flow rate. The secondary outcomes are safety, efficacy, change in quality of life, qualitative and quantitative measurements of saliva, as well as submandibular gland size, vascularization, fibrosis, and secretory tissue evaluation based on contrast-induced magnetic resonance imaging (MRI) and core-needle samples. The assessments are performed at baseline (1 month prior to treatment) and 1 and 4 months following investigational intervention. DISCUSSION: The trial is the first attempt to evaluate the safety and efficacy of adipose-derived MSCs (ASCs) in patients with radiation-induced xerostomia. The results may provide evidence for the effectiveness of ASC in patients with salivary gland hypofunction and xerostomia and deliver valuable information for the design of subsequent trials. TRIAL REGISTRATION: EudraCT, Identifier: 2014-004349-29. Registered on 1 April 2015. ClinicalTrials.gov, Identifier: NCT02513238 . First received on 2 July 2015. The trial is prospectively registered.