Comparison of dental caries experience and salivary parameters among children with Down syndrome and healthy controls in Chennai, Tamil Nadu.

Background: Although there have been numerous studies on dental caries in children with Down syndrome, the reports are conflicting. Studies on salivary chemical composition of children with Down syndrome are limited. Aim: The study aims to evaluate and compare the dental caries experience, salivary flow rate, pH, buffering capacity, and concentration of sodium, potassium, calcium, phosphorus, total proteins, and sialic acid in children with Down syndrome and healthy controls. Settings and Design: This was a cross-sectional study. Materials and Methods: Forty subjects with Down syndrome aged 5-18 years fulfilling the eligibility criteria from six special schools were selected by snowball sampling. Sixty healthy controls from six neighborhood schools fulfilling the eligibility criteria were selected by simple random sampling by matching the age, gender, and socioeconomic status. Sociodemographic data, oral hygiene practices, diet history and dental caries experience were recorded. About 6 mL of stimulated whole saliva was collected. Salivary flow rate, salivary pH, buffering capacity, and the concentration of sodium, potassium, calcium, phosphorus, total proteins, and sialic acid were determined. Results: There was no significant difference in the mean proportional caries rate between the study and control group (P = 0.90). Salivary pH (P = 0.00) and salivary sodium concentration (P = 0.02) were significantly low in the study group than the control group. Salivary buffering capacity was significantly higher in the study group than the control group (P = 0.001). Conclusions: Dental caries experience of children with Down syndrome was similar to the healthy controls. School health programs could be implemented in special schools to improve oral and general health of special children.

Mindfulness training attenuates the increase in salivary cortisol concentration associated with competition in highly trained wheelchair-basketball players.

This study determined the effect of 8 wk of mindfulness training (MT) on salivary cortisol (sCort) and rate of salivary Immunoglobulin-A (sIgA) secretion in wheelchair-basketball players during a competition period. The mindful group completed 8 weeks of MT in addition to training and competition. sCort and rate of sIgA secretion were measured at baseline, at 2-week intervals, the end and 2 weeks following the intervention. A significant time and group interaction was observed for sCort (F = 3.297, P = 0.040, ES = 0.191); sCort increased in the control group from MT-BL to MT-2wk (P = 0.001) and remained significantly elevated at MT-4wk (P = 0.013) and MT-6wk (P = 0.002). sCort decreased from MT-6wk to MT-8wk (P < 0.001) and concentrations were not different at MT-8wk and Post-2wk to MT-BL (P > 0.05). Mindful group sCort increased from MT-BL to MT-2wk (P = 0.042) but decreased to concentrations no different to MT-BL for the rest of the intervention period (P > 0.05). There were no group differences in rate of sIgA secretion during the intervention (P = 0.810). It was concluded that 8 weeks of MT attenuated the increase in sCort associated with the competition period.

Expectation and expectoration: Information manipulation alters spitting volume, a common proxy for salivary flow.

Saliva is becoming an increasingly useful research material across multiple fields of inquiry, including biomedical, dental, psychological, nutritional, and food choice research. However, both the flow rate and protein composition of stimulated saliva differ as a function of the collection method. We hypothesized that the context in which a stimulus is presented to participants may alter salivation via top down cognitive effects and/or behavioral changes (i.e., spitting efficiency). We presented participants with one stimulus (commercially available green tea) in two distinct contexts, once where the tea was described as a food item ("tea") and once where it was described as a disgusting non-food item ("rabbit hair extract"). Saliva and the expectorated stimulus were collected following 15s of oral exposure in a crossover design with the identical stimulus presented in both contexts; saliva was also collected for 5min after stimulation while chewing a piece of wax. Participants also completed validated personality instruments to measure food involvement, sensation seeking, sensitivity to reward, and sensitivity to punishment. Our data suggest participants spat out more sample when told they received the 'non-food' stimulus compared to the 'food' stimulus, particularly when they were given the non-food stimulus first. Further, individuals who were higher in sensation seeking spat out more sample during the 'food' condition compared to individuals with lower sensation seeking scores, but this difference was absent in the 'non-food' condition. While consistent with a top down cognitive effect on salivary flow, we believe a greater motivation to spit out the 'non-food' stimulus is a more likely explanation. In either case, it is clear the context in which a stimulus is presented alters how much sample/saliva is expectorated, suggesting context needs to be carefully considered in future work on salivary flow.

Enhanced salivary secretion by interferential current stimulation in patients with dry mouth: a pilot study.

OBJECTIVE: This pilot study tested the effects of submandibular and sublingual gland stimulation by interferential current stimulation (IFCS), a noninvasive mode of electrical stimulation. STUDY DESIGN: Three groups were enrolled in this study: 20 young adults, 19 older adults, and 21 patients with dry mouth. Four electrodes were attached to the submandibular area, and the secreted saliva was collected by using Salivette cotton rolls (Sarstedt K. K., Tokyo, Japan) for 15 minutes, either with or without IFCS. Patients were randomly chosen to receive IFCS. Each subject rated pain and discomfort on the Visual Analogue Scale (VAS) after each experiment. Saliva chromogranin A levels were measured as a stress marker. To compare data between conditions with and without IFCS, a two-sample Student t test analysis was performed. RESULTS: Saliva flow was slightly increased in those in the dry mouth group receiving IFCS compared with those who did not receive IFCS (approximately 130%). However, no such difference was found in the young and older adult groups. There was no significant difference in the VAS values of pain and discomfort or in the stress marker levels between patients who received or did not receive IFCS in the three groups. CONCLUSIONS: IFCS delivered to submandibular and sublingual glands may promote saliva secretion in persons who suffer from dry mouth in a manner that does not induce pain or physical stress.

The effect of 14 weeks of vitamin D3 supplementation on antimicrobial peptides and proteins in athletes.

Heavy training is associated with increased respiratory infection risk and antimicrobial proteins are important in defence against oral and respiratory tract infections. We examined the effect of 14 weeks of vitamin D3 supplementation (5000 IU/day) on the resting plasma cathelicidin concentration and the salivary secretion rates of secretory immunoglobulin A (SIgA), cathelicidin, lactoferrin and lysozyme in athletes during a winter training period. Blood and saliva were obtained at the start of the study from 39 healthy men who were randomly allocated to vitamin D3 supplement or placebo. Blood samples were also collected at the end of the study; saliva samples were collected after 7 and 14 weeks. Plasma total 25(OH)D concentration increased by 130% in the vitamin D3 group and decreased by 43% in the placebo group (both P = 0.001). The percentage change of plasma cathelicidin concentration in the vitamin D3 group was higher than in the placebo group (P = 0.025). Only in the vitamin D3 group, the saliva SIgA and cathelicidin secretion rates increased over time (both P = 0.03). A daily 5000 IU vitamin D3 supplement has a beneficial effect in up-regulating the expression of SIgA and cathelicidin in athletes during a winter training period, which could improve resistance to respiratory infections.

A CAMBRA Model For High Caries Risk Indian Children: A Pragmatic Comprehensive Tailored Intervention.

OBJECTIVE: To evaluate a CAMBRA based therapeutic and preventive model for high caries risk children in a pediatric dentistry clinic set-up. STUDY DESIGN: A total of 100 systemically healthy children aged 4-8 years with dmft/DMFT ≥ 5 and/or ≤ 20% magnitude of cariogram sector 'chance to avoid new cavities' were enrolled. The program comprised of following components i.e. caries risk assessment, customized preventive interventions (Motivational interviewing and counseling, oral prophylaxis, fluoride varnish, fissure sealants) and restorative procedures. The recall intervals were scheduled on the basis of caries risk i.e. every 1 month (≤ 40% chance to avoid new cavities) and 3 months (≥ 41% chance to avoid new cavities). The primary outcome measure was 'new carious lesions' at 12 months following achievement of 'termination levels' i.e. ≥ 41% magnitude of 'chance to avoid new cavities.' The secondary outcome measures were changes in cariogram parameters at termination and duration needed to achieve termination levels. RESULTS: The program showed 97% success rate as 3/100 subjects developed new carious lesions at 12 months follow up. Highly significant (p<0.001) favorable shift was achieved in cariogram parameters at termination. Termination levels were achieved in 2.71 ± 4.854 months. CONCLUSIONS: The present CAMBRA based program with customized intervention and recall schedules showed favorable results.

Impact on Dietary Intake of Removable Partial Dentures Replacing a Small Number of Teeth.

The aim of this study was to clarify the impact of wearing removable partial dentures (RPDs) replacing a small number of teeth on dietary intake. Participants had at least 20 teeth and were classified as Eichner B1 or B2. The participants underwent dental and oral examinations, and their dietary intake was assessed. Analysis of covariance showed that RPD wearers consumed more vegetables, n-3 fatty acids, calcium, vitamin A, and dietary fiber than nonwearers after adjusting for possible confounding factors. It is concluded that RPDs are effective for improving dietary intake even in participants who have lost a small number of teeth.

A Study on Duration of Effect of Transcutaneous Electrical Nerve Stimulation Therapy on Whole Saliva Flow.

BACKGROUND: Saliva is a complex fluid, whose important role is to maintain the well being of oral cavity. Salivary gland hypofunction or hyposalivation is the condition of having reduced saliva production which leads to the subjective complaint of oral dryness termed xerostomia.(7) Management of xerostomia includes palliative therapy using topical agents or systemic therapy. Electrostimulation to produce saliva was studied in the past and showed moderate promise but never became part of mainstream therapy. Hence, this study was undertaken to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) on whole salivary flow rate in healthy adults and to evaluate how long this effect of TENS lasts on salivary flow. MATERIALS AND METHODS: One hundred healthy adult subjects were divided into five age groups with each group containing 20 subjects equally divided into males and females in each group. Unstimulated saliva was collected using a graduated test tube fitted with funnel and quantity was measured. Transcutaneous electrical nerve stimulation unit was activated and stimulated saliva was collected. Saliva was again collected 30 minutes and 24 hours post stimulation. RESULTS: The mean unstimulated whole saliva flow rate for all subjects (n = 100) was 2.60 ml/5 min. During stimulation, it increased to 3.60 ± 0.39 ml/5 min. There was 38.46% increase in salivary flow. Ninety six out of 100 responded positively to TENS therapy. Salivary flow remained increased 30 minutes and 24 hours post stimulation with the values being 3.23 ± 0.41 ml/5 min and 2.69 ± 0.39 ml/5 min respectively. Repeated measures One way analysis of variance (ANOVA) test showed that the difference between these values were statistically significant. CONCLUSION: Transcutaneous electrical nerve stimulation therapy was effective for stimulation of whole saliva in normal, healthy subjects and its effect retained till 30 minutes and a little up to 24 hours. Transcutaneous electrical nerve stimulation may work best synergistically with other sialagogues and can be used for the management of xerostomia.

Effects of Multi-glycosides of Tripterygium wilfordiion in the Treatment of Sjögren's Syndrome in the Non-obese Diabetic Mouse Model.

OBJECTIVE: To investigate the effects of the multi-glycosides of Tripterygium wilfordii (GTW) on Sjögren's syndrome (SS) in the non-obese diabetic (NOD) mouse model. METHODS: Twenty-seven 8-week-old, female NOD mice were divided into the GTW group, the hydroxychloroquine (HCQ) group, and control (normal saline) group, and received corresponding treatment for 16 weeks. The treatment-induced changes in stimulated total saliva flow rate (STFR), level of serum anti-SSA/SSB, ratio of regulatory T (Treg) cells, histology of the submandibular gland (SMG) and the gene expression profile that is related to inflammation and autoimmunization were evaluated. RESULTS: Compared to the untreated (control) mice, STRF, SMG index and Treg/CD4+ cell ratio were significantly higher, whereas anti-SSA, anti-SSB and lymphoid foci were remarkably lower in GTW-treated mice. HCQ-treated mice showed similar results except SMG index was not different from the untreated mice. NOD mice showed 19.03% altered gene expression with maturation from the age of 8 weeks to 24 weeks. Treatment with HCQ and GTW reduced the change in gene expression to 13.09% and 7.14%, respectively. CONCLUSION: GTW is as effective as HCQ in the treatment of Sjögren's syndrome in the NOD mouse model.

Comparison between three different saliva substitutes in patients with hyposalivation.

OBJECTIVE: The aim of the present study was to compare the efficiency of oral spray based on thermal spring water (Buccotherm®) versus commercial saliva substitute (Xeros®) and marshmallow root on the quality of life in patients with hyposalivation. MATERIALS AND METHODS: A total of 60 patients with unstimulated salivary flow rate <0.2 ml/min were randomized into three groups. In the first group, 30 patients were using Buccotherm®; in the second group, 15 patients were using Xeros®; and in the third group, 15 patients were using marshmallow root. Therapy lasted for 2 weeks; everyday, patients used one of the products four times a day. Quality of life was measured by the Croatian version of Oral Health Impact Profile 14 questionnaire, and visual analog scale was used to determine the intensity of dry mouth before and after therapy. Statistical analysis was performed by Wilcoxon signed-rank test and Kruskal-Wallis test. Standardized effect size was calculated for OHIP following treatment. RESULTS: Buccotherm® has shown the biggest effect on quality of life in patients with hyposalivation. Intensity of dry mouth was lower after the applied therapy whatever substitute patients used. CONCLUSIONS: We recommend the use of all three saliva substitutes for decreasing the intensity of dry mouth symptoms as well as improvement in the quality of life. CLINICAL RELEVANCE: Although all tested agents showed beneficial effect in alleviating hyposalivation symptoms, it seems that Buccotherm® was superior to Xeros® and marshmallow root.

In situ effect of a commercial CPP-ACP chewing gum on the human enamel initial erosion.

OBJECTIVE: This study evaluated the in situ rehardening effect of a commercial chewing gum containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) on initial erosion lesions. METHODS: Seventy-two human enamel blocks, after selection (initial surface hardness - SHi) and in vitro short-term acidic exposure (cola drink for 3 min - SHd) were randomly assigned to three groups. The factors under study were treatment (3 levels: GI chewing gum with CPP-ACP, GII chewing gum without CPP-ACP and GIII control group without gum) and intraoral period (2 levels: 2 and 24h). Twelve volunteers wore intraoral palatal devices for 24h in 3 crossover phases. On each phase, after 2h the surface hardness was assessed (SHf1) and the blocks were reinserted and the devices were used for additional 22 h (SHf2). In phases of GI and GII volunteers chewed the respective gum during 30 min, for 4 times with an interval of 4h. Percentage of surface hardness recovery (%SHR) was calculated after 2 and 24 h. The data were analysed by repeated measures ANOVA and Tukey's test. RESULTS: Chewing gum with CPP-ACP (2h=50.0%<24h=95.9%) showed higher hardness recovery than chewing gum without CPP-ACP (2h=30.0%<24 h=71.1%) and control (2 h=15.7%<24 h=40.9%) (p<0.05). CONCLUSIONS: The results suggest that saliva increased hardness of softened enamel after the use of conventional chewing gum (GII) and this effect was enhanced by the prolonged intraoral period (24 h) and by the use of CPP-ACP chewing gum (GI). CLINICAL SIGNIFICANCE: Since chewing gum is an alternative to enhance salivary defenses after erosive challenges, CPP-ACP chewing gum might be a supplementary strategy to potentiate the mineral precipitation of initial erosion lesions.

Composition of enamel pellicle from dental erosion patients.

Oral health is dependent upon a thin mobile film of saliva on soft and hard tissues. Salivary proteins adhere to teeth to form the acquired enamel pellicle which is believed to protect teeth from acid erosion. This study investigated whether patients suffering diet-induced dental erosion had altered enamel pellicles. Thirty patients suffering erosion were compared to healthy age-matched controls. Subjects wore a maxillary splint holding hydroxyapatite and human enamel blocks for 1 h. The acquired enamel pellicle was removed from the blocks and compared to the natural incisor pellicle. Basic Erosive Wear Examination scores confirmed that dental erosion was present in erosion patients and absent from healthy age-matched controls. Erosion patients had half the amount of proteins (BCA assay) within the acquired pellicle forming on splint blocks compared to normal controls (p < 0.05). In particular, statherin, a calcium-binding protein, was 35% less abundant (p < 0.05). Calcium concentration within the acquired pellicle was also reduced by 50% in erosion patients (p < 0.001). In contrast, the natural pellicle on the incisor had similar amounts of total protein in erosion patients and healthy controls. In summary, the formation of new acquired pellicles on surfaces was reduced in erosion patients, which may explain their greater susceptibility to acid erosion of teeth.

New and emerging regulators of intestinal lipoprotein secretion.

Overproduction of hepatic apoB100-containing VLDL particles has been well documented in animal models and in humans with insulin resistance such as the metabolic syndrome and type 2 diabetes, and contributes to the typical dyslipidemia of these conditions. In addition, postprandial hyperlipidemia and elevated plasma concentrations of intestinal apoB48-containing chylomicron and chylomicron remnant particles have been demonstrated in insulin resistant states. Intestinal lipoprotein production is primarily determined by the amount of fat ingested and absorbed. Until approximately 10 years ago, however, relatively little attention was paid to the role of the intestine itself in regulating the production of triglyceride-rich lipoproteins (TRL) and its dysregulation in pathological states such as insulin resistance. We and others have shown that insulin resistant animal models and humans are characterized by overproduction of intestinal apoB48-containing lipoproteins. Whereas various factors are known to regulate hepatic lipoprotein particle production, less is known about factors that regulate the production of intestinal lipoprotein particles. Monosacharides, plasma free fatty acids (FFA), resveratrol, intestinal peptides (e.g. GLP-1 and GLP-2), and pancreatic hormones (e.g. insulin) have recently been shown to be important regulators of intestinal lipoprotein secretion. Available evidence in humans and animal models strongly supports the concept that the small intestine is not merely an absorptive organ but rather plays an active role in regulating the rate of production of chylomicrons in fed and fasting states. Metabolic signals in insulin resistance and type 2 diabetes and in some cases an aberrant intestinal response to these factors contribute to the enhanced formation and secretion of TRL. Understanding the regulation of intestinal lipoprotein production is imperative for the development of new therapeutic strategies for the prevention and treatment of dyslipidemia. Here we review recent developments in this field and present evidence that intestinal lipoprotein production is a process with metabolic plasticity and that modulation of intestinal lipoprotein secretion may be a feasible therapeutic strategy in the treatment of dyslipidemia and possibly prevention of atherosclerosis.

Erosion protection by calcium lactate/sodium fluoride rinses under different salivary flows in vitro.

This study investigated the effect of a calcium lactate prerinse on sodium fluoride protection in an in vitro erosion-remineralization model simulating two different salivary flow rates. Enamel and dentin specimens were randomly assigned to 6 groups (n = 8), according to the combination between rinse treatments - deionized water (DIW), 12 mM NaF (NaF) or 150 mM calcium lactate followed by NaF (CaL + NaF) - and unstimulated salivary flow rates - 0.5 or 0.05 ml/min - simulating normal and low salivary flow rates, respectively. The specimens were placed into custom-made devices, creating a sealed chamber on the specimen surface connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min, followed by artificial saliva (0.5 or 0.05 ml/min) for 60 min. This cycle was repeated 4×/day for 3 days. Rinse treatments were performed daily 30 min after the 1st and 4th erosive challenges, for 1 min each time. Surface loss was determined by optical profilometry. KOH-soluble fluoride and structurally bound fluoride were determined in specimens at the end of the experiment. Data were analyzed by 2-way ANOVA and Tukey tests (α = 0.05). NaF and CaL + NaF exhibited significantly lower enamel and dentin loss than DIW, with no difference between them for normal flow conditions. The low salivary flow rate increased enamel and dentin loss, except for CaL + NaF, which presented overall higher KOH-soluble and structurally bound fluoride levels. The results suggest that the NaF rinse was able to reduce erosion progression. Although the CaL prerinse considerably increased F availability, it enhanced NaF protection against dentin erosion only under hyposalivatory conditions.

Efecto inmediato de infusiones de consumo habitual en las propiedades salivales / Immediate effect of commonly consumed infusions in the salivary properties

Gran cantidad de población consume cotidianamente infusiones, como el Té, Manzanilla y Yerba Mate. Diferentes estudios han determinado sus efectos benéficos en los seres humanos, razón por la cual, para este estudio se han seleccionado aquellas infusiones de uso habitual con el fin de caracterizar sus efectos inmediatos sobre las propiedades de la saliva. Con grupos de 37 sujetos sanos, entre 18-23 años, de bajo riesgo cariogénico se obtuvieron 3 muestras de saliva no estimulada: Basal; Post-ingesta de Agua Destilada (Placebo) y Post-ingesta Infusión (Té Negro, Té Verde, Mate, Manzanilla y Manzanilla con Endulzante), respectivamente. Todas las pruebas fueron realizadas bajo condiciones estándar. Se determinó el flujo salival (ml/min), pH mediante pH-metro (PL-600, GOnDO Electronics Co, TW) y capacidad buffer mediante método de Ericsson. Todos los datos se procesaron mediante la prueba ANOVA con el programa Origin 6.0. El promedio de Flujo Salival Basal (0,51 ml/min) tiende a aumentar destacando el efecto de la Manzanilla con Endulzante (0,63 ml/min); el pH basal (7,25) se mantuvo relativamente constante, y la Capacidad Buffer (4,38) también tiende a aumentar destacando la Manzanilla (5,01). El efecto de algunas infusiones es positivo sobre las propiedades salivales, destacando la Infusión de Manzanilla, Manzanilla con Endulzante y Yerba Mate las cuales aumentan significativamente el flujo y la capacidad buffer salival, lo cual sugiere un efecto benéfico en la prevención de caries.

A great number of the population consumes daily a variety of infusions such as Tea, Chamomile and Mate Herb. Different studies have determined their favorable effects in human beings, for this reason those infusions habitually used have been selected for this study, in order to characterize their immediate effects on the saliva properties. We studied groups of 37 healthy subjects, between 18-23 years of age, with low caries risk, and obtained 3 samples of non-stimulated saliva: Basal; Post-ingestion of Distilled Water (Placebo); Post-ingestion of Infusion (Black Tea, Green Tea, Mate Herb, Chamomile and Chamomile with Sucralose). All the tests were realized under standard conditions. We measured, salivary flow (ml/min); pH with pH-meter (PL-600, GOnDO Electronics Co, TW) and buffer capacity with Ericsson's method. All the information was processed with Anova Test in Origin 6.0. Our results showed the average of Salivary Basal Flow (0.51 ml/min) tends to increase standing out the effect of Chamomile with Sucralose (0.63 ml/min), the basal pH (7.25) was maintained relatively constant, and finally the Buffer Capacity (4.38) also tends to increase, emphasizing Chamomile (5.01). The effect of some infusions is positive on the salivary properties, emphasizing the Infusion of Chamomile, Chamomile with Sucralose and Mate Herb, which increase significantly the flow and the salivary buffer capacity. This suggests a favorable effect in the prevention of caries.

Differential effects of continuous exposure to the investigational metastin/kisspeptin analog TAK-683 on pulsatile and surge mode secretion of luteinizing hormone in ovariectomized goats.

The aim of the present study was to determine if the estradiol-induced luteinizing hormone (LH) surge is influenced by the constant exposure to TAK-683, an investigational metastin/kisspeptin analog, that had been established to depress the pulsatile gonadotropin-releasing hormone (GnRH) and LH secretion in goats. Ovariectomized goats subcutaneously received TAK-683 (TAK-683 group, n=6) or vehicle (control group, n=6) constantly via subcutaneous implantation of an osmotic pump. Five days after the start of the treatment, estradiol was infused intravenously in both groups to evaluate the effects on the LH surge. Blood samples were collected at 6-min intervals for 4 h prior to the initiation of either the TAK-683 treatment or the estradiol infusion, to determine the profiles of pulsatile LH secretion. They were also collected at 2-h intervals from -4 h to 32 h after the start of estradiol infusion for analysis of LH surges. The frequency and mean concentrations of LH pulses in the TAK-683 group were remarkably suppressed 5 days after the start of TAK-683 treatment compared with those of the control group (P<0.05). On the other hand, a clear LH surge was observed in all animals of both groups. There were no significant differences in the LH concentrations for surge peak and the peak time of the LH surge between the TAK-683 and control groups. These findings suggest that the effects of continuous exposure to kisspeptin or its analog on the mechanism(s) that regulates the pulsatile and surge mode secretion of GnRH/LH are different in goats.

Effect of swallowing exercises in independent elderly.

The aim of this study was to investigate the effects of swallowing exercises on oral function in independent elderly patients visiting the Department of Prosthodontics at Tokyo Dental College Chiba Hospital. Twenty-nine patients aged over 65 years (15 men and 14 women; mean age, 75.0 years) in whom treatment was completed at this college were enrolled in the study. The patients were instructed on how to perform swallowing exercises monthly (including at baseline) for the first 2 months from the start of the study and asked to perform those exercises at least once daily. At the beginning and end of the study (a 3-month study period), the Repetitive Saliva Swallowing Test was conducted and occlusal force, oral diadochokinesis, unstimulated whole saliva flow rate, stimulated whole saliva flow rate, salivary pH at rest, and salivary buffering capacity measured to determine the effects of the exercises on oral function. Analyses demonstrated significant increases in diadochokinesis rate (/ta/ and /ka/) and unstimulated whole saliva flow rate (p<0.05), suggesting that the swallowing exercises promote the maintenance and improvement of oral function in the independent elderly.

After-brush rinsing protocols, frequency of toothpaste use: fluoride and other active ingredients.

The intra-oral retention or substantivity of active ingredients in toothpastes is important for their effectiveness, and this is influenced by product-related and user-related factors. Product-related factors include the formulation and the compatibility of active and other agents in the toothpaste and the concentration of the active ingredient. User-related factors include biological aspects such as salivary flow and salivary clearance, and behavioural aspects, such as frequency and duration of brushing, amount of toothpaste used and post-brushing rinsing behaviour. To date, product-related factors have dominated the research agenda for toothpastes, but user-related factors have the potential to significantly enhance or reduce the effectiveness of toothpaste. In this chapter, we will focus on two of the user-related factors that have been most widely studied: (1) frequency of toothbrushing and (2) post-brushing rinsing behaviour. We will then provide an overview of how evidence on these two behaviours has been used to produce guidance both for the profession and for the public, and make suggestions for the future direction of research in this area.

[Alteration of biological rhythms causes metabolic diseases and obesity]. / La alteracion de los ritmos biologicos causa enfermedades metabolicas y obesidad.

The incidence of obesity worldwide has become a serious, constantly growing public health issue that reaches alarming proportions in some countries. To date none of the strategies developed to combat obesity have proved to be decisive, and hence there is an urgent need to address the problem with new approaches. Today, studies in the field of chronobiology have shown that our physiology continually adapts itself to the cyclical changes in the environment, regard-less of whether they are daily or seasonal. This is possible thanks to the existence of a biological clock in our hypothalamus which regulates the expression and/or activity of enzymes and hormones involved in regulating our metabolism, as well as all the homeostatic functions. It has been observed that this clock can be upset as a result of today's modern lifestyle, which involves a drop in physical activity during the day and the abundant ingestion of food during the night, among other factors, which together promote metabolic syndrome and obesity. Hence, the aim of this review is to summarise the recent findings that show the effect that altering the circadian rhythms has on the metabolism and how this can play a part in the development of metabolic diseases.

TITLE: La alteracion de los ritmos biologicos causa enfermedades metabolicas y obesidad.La incidencia de la obesidad a escala mundial se ha convertido en un grave y creciente problema de salud publica, que alcanza en algunos paises proporciones alarmantes, y hasta el momento ninguna de las estrategias desarrolladas para combatir la obesidad se ha demostrado resolutiva, por lo que es urgente abordar el problema con nuevos enfoques. Actualmente, en el estudio de la cronobiologia se ha demostrado que nuestra fisiologia se adapta continuamente a los cambios ciclicos del ambiente, sean estos diarios o estacionales, debido a la presencia de un reloj biologico en nuestro hipotalamo que regula la expresion y actividad de enzimas y hormonas implicadas en la regulacion del metabolismo, asi como de todas las funciones homeostaticas. Se ha observado que este reloj puede alterarse debido al estilo de vida moderno, que implica una baja actividad fisica durante el dia e ingesta abundante de comida durante la noche, entre otros factores, que promueven todos ellos el sindrome metabolico y la obesidad. Por lo tanto, el objetivo de esta revision es resumir los hallazgos recientes que demuestran el efecto de la alteracion circadiana sobre el metabolismo y como esta puede participar en el desarrollo de enfermedades metabolicas.

Salivary cortisol, salivary alpha amylase, and the dental anxiety scale.

The aim of this study was to investigate the correlation between dental anxiety, salivary cortisol, and salivary alpha amylase (sAA) levels. Furthermore, the aim was to look into individual differences such as age, race, gender, any existing pain, or traumatic dental experience and their effect on dental anxiety. This study followed a cross-sectional design and included a convenience sample of 46. Every patient was asked to complete the Dental Anxiety Scale (DAS) and a basic demographic/dental history questionnaire. A saliva sample, utilizing the method of passive drooling, was then collected in 2-mL cryovials. Samples were analyzed for salivary cortisol and sAA levels by Salimetrics. Significant associations were observed between DAS scores and presence of pain and history of traumatic dental experience. However, no significant correlations were observed between DAS, cortisol, and sAA levels. Our study reconfirms that dental anxiety is associated with presence of pain and a history of traumatic dental experience. On the other hand, our study was the first to our knowledge to test the correlation between the DAS and sAA; nevertheless, our results failed to show any significant correlation between dental anxiety, cortisol, and sAA levels.