Salivary flow-rate and composition in schizophrenic patients on clozapine: subjective reports and laboratory data.

The extent of hypersalivation was evaluated in a group of 25 schizophrenic patients on clozapine. A high prevalence of the complaint was detected by a questionnaire; up to 80% of the patients complained of hypersalivation at night. Salivary flow-rate and composition was examined in 17 patients who agreed to participate and in a matched group of healthy controls. No significant differences were detected in composition or flow-rates of resting and stimulated saliva. The salivary flow-rates in the schizophrenic patients on clozapine did not correlate with the subjective complaint of hypersalivation. Because the severity and prevalence of the complaint was higher at night, a possibility of an altered circadian rhythm of salivation might be suggested in these patients.

Oral side effects of head and neck irradiation: correlation between clinical manifestations and laboratory data.

Salivary flow rate and composition, oral microflora and clinical manifestations of radiation damage were studied in 32 patients treated with external irradiation to head and neck areas. Several parameters were investigated: field arrangement, amount of salivary glands irradiated, clinical manifestations such as dryness of the mouth, taste impairment, dysphagia, salivary secretion and composition, and oral yeast flora. The salivary glands have a greater sensitivity to radiation damage than the gustatory tissues. The decrease in salivary secretion is accompanied by a rise in salivary sodium concentration, and in oral yeast flora. The clinical symptomatology was correlated with the amount of salivary glands irradiated. We found that most of the parotids have to be outside of the treated volume, when the rest of the major salivary glands are irradiated, to prevent severe dryness phenomena.

Do cyclic AMP concentrations in saliva reflect PTH biologic activity?

The aim of this study was to investigate whether the concentration of cAMP in saliva might reflect the biologic activity of parathyroid hormone (PTH), as nephrogenous levels of cAMP reflect parathyroid function. Patients with primary hyperparathyroidism (HPT) with elevated levels of PTH, nephrogenous cAMP, and serum calcium were found to have cAMP levels not significantly different from control subjects. When the levels of these parameters were reduced following parathyroidectomy, salivary cAMP concentrations were not affected. Similarly, an oral calcium loading test (which decreased both PTH and nephrogenous cAMP in normal subjects) failed to influence salivary cAMP levels. Basal salivary cAMP concentrations were low in secondary hyperparathyroid patients due to chronic renal failure and rose almost fivefold following dialysis despite the stable plasma cAMP levels and salivary flow rate. We conclude that salivary cAMP concentrations do not appear to be influenced by changes in circulating biologically active PTH. However, salivary cAMP concentrations do change in response to certain perturbations; this suggests that they are regulated by some other modulator(s).

Effect of transdermal scopolamine on salivation.

The effect of transdermal scopolamine on salivary flow and composition was analyzed in 21 healthy volunteers. The flow rate of whole saliva was significantly lowered by transdermal scopolamine. Significant positive correlations were found between the placebo rate of flow and both the quantity and percentage decreases in response to transdermal scopolamine. The magnesium concentration was significantly increased during transdermal scopolamine administration, whereas the sodium, potassium, and calcium concentrations were not consistently altered. Accordingly, the magnesium secretion rate was unaltered, whereas sodium, potassium, and calcium secretion rates were significantly lowered by transdermal scopolamine administration.

Salivary and lacrimal secretions in patients on lithium therapy.

Salivary and lacrimal secretion rates and salivary composition were examined in 22 manic-depressive patients on lithium therapy and in 21 matched, healthy controls. Serum immunoglobulins (IgG and IgA) were measured in these patients. Their oral health was examined and found to be unimpaired. Significantly lowered tear secretion was detected in the patients, while their salivary secretion rates were normal. The salivary concentrations of NA, K and IgA were significantly elevated in whole saliva. In parotid saliva, the concentrations of K and IgA were elevated, while Na was in the normal range. A significant correlation between serum and salivary lithium concentrations was found, indicating the usefulness of salivary measurements for monitoring. Informed consent of the patients was obtained after the nature of the procedures had been fully explained.

Whole-saliva secretion rates in old and young healthy subjects.

Resting and stimulated whole-saliva secretion rates were compared in old and young healthy volunteers. The stimulated secretion rate was similar in both age groups, while the resting flow rate was significantly lower in the old females and males as compared with rates in the young.

Effect of exercise on salivary composition and cortisol in serum and saliva in man.

The effect of exercise on electrolytes and cortisol levels in serum and saliva was examined in 27 young, healthy male volunteers who performed graded submaximal cycle exercise for nine min at up to 85% of their age-predicted maximal heart rate. Seventeen men performed the Wingate anaerobic test for 30 s. A significant increase in pulse rate and systolic blood pressure and a decrease in diastolic blood pressure were found, and serum concentrations of Na+, K+, and lactate were significantly elevated immediately after exercise. A nonsignificant increase in saliva and serum cortisol levels was found. Significantly lowered salivary flow rate and elevated salivary K+, protein, and lactate concentrations were found within ten min after exercise. Salivary Mg2+ was significantly elevated after anaerobic exercise only.

Oral health and salivary composition in diabetic patients.

The salivary composition and flow rate were examined in 20 patients with insulin-dependent diabetes mellitus (IDDM) and in 19 patients with non-insulin-dependent diabetes mellitus (NIDDM) and compared with 20 healthy controls. Resting and stimulated whole and submandibular saliva was analyzed. Significantly lower resting salivary flow rates were found in the IDDM patients as compared to the NIDDM group. In the IDDM patients potassium concentration in resting saliva was significantly higher compared with healthy controls and in stimulated whole saliva compared with NIDDM patients. No difference in salivary total protein, amylase, lactoferrin, or lysozyme was found among the three groups examined. The IgA concentration of the IDDM patients was significantly higher in whole resting saliva compared with controls and in the submandibular saliva compared with both NIDDM patients and controls. No difference was found between controls and the diabetic patients examined in prevalence of complaint of dry mouth. The salivary flow rates, however, were significantly lower in the three subgroups with dry mouth compared with the subgroups without this complaint. Caries were detected in 100% of the diabetic patients and controls. No correlation was observed between the incidence of caries and any of the salivary parameters examined. A higher prevalence and severity of periodontal disease was detected in the diabetic patients as compared to the controls. A significant positive correlation was found between the gingival index and the concentrations of total protein, albumin, lysozyme, and lactoferrin in whole resting saliva in the three groups examined.

Oral complaints related to menopause.

OBJECTIVES: The purpose of the present study was to correlate oral and systemic symptoms of menopause and the oral health and salivary composition and flow rate in a group of women in menopause prior to hormone replacement therapy. METHODS: One-hundred fifty-four women attending a menopause clinic were divided into two groups. Group A, 58 women, without any systemic disease or treatments, and Group B,96 women with diseases and on various medications. They answered a questionnaire on their general health and oral and systemic complaints related to menopause. Fifty-four of the women agreed to have an oral examination and saliva analysis. Whole resting and submandibular (SM-SL) stimulated saliva were analyzed. RESULTS: The oral discomfort complaint was found in 45% in Group A and in 60% in Group B. 74% complained of climacteric symptoms in Group A and 63% in Group B. The odds ratio (OR) between oral discomfort and climacterics complaints of menopause was 8.03 in Group A and 4.08 in Group B. The salivary composition and flow rates did not differ significantly between the groups of menopausal women. However the salivary total protein and IgA concentrations were significantly higher in comparison to healthy young controls. CONCLUSIONS: The present study reports a high prevalence of oral discomfort in the women attending a menopause clinic. A highly significant odds ratio between systemic and oral complaints of menopause was found. The significantly altered salivary composition in these women might point to sympathetic activation due to psychological stress.

The effect of smoking and periodontal treatment on salivary composition in patients with established periodontitis.

BACKGROUND: The purpose of this study was to evaluate the effect of smoking on the periodontal status and the salivary composition in subjects with established periodontitis before and after periodontal therapy. METHODS: Our study group included 26 healthy subjects, 12 smokers and 14 non-smokers with established periodontitis. Clinical measurements and non-stimulated whole saliva were obtained and analyzed at baseline and after scaling and root planing. Smokers presented at baseline with significantly greater probing depth (4.16+/-0.26) compared to non-smokers (3.52+/-0.32) which was statistically significant (P = 0.0268); likewise, baseline clinical attachment level was greater in smokers (4.49+/-0.31 compared to non-smokers 3.87+/-0.13; P = 0.0620). Mean plaque index was also greater in smokers compared to non-smokers (0.86 and 0.65, respectively; P = 0.0834). Baseline pretreatment sodium values were significantly greater in non-smokers (14.36 mEq/l compared to 9.31 mEq/l in smokers; P = 0.0662); likewise non-smokers exhibited 50% greater salivary calcium levels (6.04 mg/100 ml compared to 4.32 mg/100 ml in smokers; P = 0.0133). RESULTS: Post-treatment probing depth and clinical attachment level were not different between smokers and non-smokers; this in spite of significant difference in plaque index in smokers (0.35 compared to 0.13 in non-smokers; P = 0.0135). Post-treatment, smokers had reduced calcium concentration (3.58 mg/100 ml compared to 5.11 mg/100 ml in non-smokers; P = 0.0438). Treatment affected albumin level in smokers only, consequently non-smokers had significantly greater salivary albumin concentration (1.1 mg/100 ml compared to 0.38 mg/100 ml in smokers; P = 0.0274). CONCLUSIONS: Subjects with established periodontitis exhibited elevated concentrations of salivary electrolytes and proteins. Within this study group, smokers exhibited greater disease level but reduced sodium, calcium, and magnesium concentrations. Smokers responded favorably to treatment. The clinical improvement eliminated the differences in salivary composition.

The relationship between antigenaemia and excretion of hepatitis B surface antigen in human whole saliva and in gingival crevicular fluid.

Hepatitis B surface antigen (HBsAg) was detected in whole saliva and in gingival crevicular fluid of 28 (90 per cent) of 31 seropositive patients. No correlation was found between the presence of the antigen and blood in saliva or with the gingival state of health. Thus, HBsAg appears to reach saliva via the crevicular fluid.

Composition of whole unstimulated saliva of human infants.

Whole unstimulated saliva of 168 infants aged 3 days to 12 months was analysed. The concentration of Ca, Mg and Cl was higher in the saliva of infants than in adults. The concentration of phosphate, IgA, amylase and pH was lower in infants; Na, K and total protein did not differ significantly. A wide range of all the concentrations was observed in the saliva of infants. No significant difference was found between the salivary composition of male versus female or of breast-fed as compared to bottle-fed infants. No difference before and after eruption of teeth was detected. Significant differences between different age groups were observed in the concentrations of Na, K, Cl, phosphate, protein, amylase and pH. No significant differences were found in Ca, Mg and IgA concentrations within the first year. A negative correlation between the age of the infants and the concentrations of Na, K, Cl and total protein was observed. A positive correlation was found for phosphate and amylase as a function of age.

Composition of whole unstimulated saliva of healthy children: changes with age.

Whole unstimulated saliva was collected from 136 healthy subjects divided into 5 groups according to age: (1) 25 infants, 7-11 months old; (2) 28 toddlers, 2-3 yr old; (3) 28 children, 6-8 yr old; (4) 28 adolescents, 12-14 yr old; (5) 27 adults, 25-63 yr old. The concentrations of Na, K, total protein, IgA and amylase activity were measured. A significant ascending linear correlation with age was found for concentrations of Na, total protein, IgA and amylase activity. There were significant differences between age groups in K and IgA concentrations. Salivary amylase activity was very variable, and a significant difference was found between infants and toddlers only. Salivary composition thus changes significantly during childhood, implying a process of development and maturation of the salivary glands and indicating the need of age-matched controls for the clinical use of saliva.

The effect of low-dose interleukin-2-based immunotherapy on salivary function and composition in patients with metastatic renal cell carcinoma.

One of the side-effects accompanying low-dose recombinant interleukin-2 (rIL-2)-based immunotherapy is salivary hypofunction. We evaluated the functional and compositional whole salivary profile at both resting and stimulated conditions in 10 renal cell carcinoma patients who received prolonged low-dose rIL-2-based immunotherapy. Following the termination of 4 weeks of the combined administration of rIL-2 and recombinant interferon-alpha (rIFN-alpha), we found significant reductions of salivary flow rates at resting condition, accompanied by significant multiple compositional alterations, including increases in calcium, magnesium and phosphate concentrations, and significant reductions in total protein concentration. In contrast, no flow rate reduction was noted under stimulated condition, and the only significant altered compositional component was the phosphate. We recommend salivary-supporting therapies and anticariogenic treatments for patients undergoing low-dose rIL-2-based immunotherapy.

The concentration of salivary IgA in whole and parotid saliva and the effect of stimulation.

The concentration of salivary IgA was measured in 24 healthy volunteers. The resting salivary IgA (n = 19) was 14.5 +/- 7.5 mg/dl in parotid saliva and 6.5 +/- 3.6 mg/dl in whole saliva. After stimulation (n = 5), parotid IgA decreased to 6.8 +/- 5.0 mg/dl and whole-saliva IgA to 3.1 +/- 2.22 mg/dl. Freezing caused a diversified decrease in IgA concentration.

Salivary secretion and seasickness susceptibility.

The salivary flow rate and composition of 2 groups of 31 subjects, one group at each extreme of the seasickness susceptibility scale, were compared. No significant differences were found between the two groups in flow rates and electrolyte concentrations of whole resting and stimulated saliva. Amylase activity and rate of secretion in resting saliva were significantly higher in subjects susceptible to seasickness as compared with nonsusceptible subjects. Also, the total protein rate of secretion in resting saliva was significantly higher in the susceptible group. The present findings could be explained in terms of higher sympathetic tone in subjects susceptible to seasickness, and salivary amylase levels might be recommended as an additional parameter in the evaluation of seasickness susceptibility.

Seasickness susceptibility, personality factors, and salivation.

The present study investigates the possible relationship between motion sickness susceptibility, personality factors and salivation. Personality factors, as evaluated by the Eysenck Personality Questionnaire, and salivary composition and flow were measured in a group of 29 subjects highly susceptible to seasickness and in a group of 25 non-susceptible subjects. The non-susceptible group had significantly higher psychoticism scores and significantly lower salivary amylase levels compared to the highly susceptible group. A significant positive correlation was found between psychoticism scores and the amount of the increase in salivary flow in response to gustatory stimulation. These results provide more data in support of a connection between motion sickness susceptibility, personality, and the autonomic nervous system.

[Salivary tests as a diagnostic tool in oral disease management].

Saliva plays an important role in maintaining the oral and the dental health, by lubricating the mucosae and protecting the teeth from caries attack. Furthermore, saliva participates in the taste sensation and recognition processes and is a central component in the first stage of the food digestion. Saliva collection, either in the pure or in the whole form, is a relatively easy procedure. Since the collection is non invasive, it is not harmful to the patient and has no complications. The paper discusses the use of saliva in the diagnosis of oral and systemic diseases and in monitoring the levels of molecules like hormones and medicines. The experience accumulated in our department in that field is also presented.