ABSTRACT
The aims of this systematic review are (1) to compare the prevalence of xerostomia and hyposalivation between patients taking antihypertensive drugs with a control group (CG), (2) to compare salivary flow rate between patients treated with a CG, and (3) to identify which antihypertensives produce xerostomia. This systematic review was carried out according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. To evaluate methodological quality of the eligible studies Cochrane Collaboration tool for assessing the risk of bias for clinical trials and the modified Newcastle-Ottawa scale case-control studies were used. The databases were searched for studies up to November 19th 2019. The search strategy yielded 6201 results and 13 publications were finally included (five clinical trials and eight case-control studies). The results of the included studies did not provide evidence to state that patients taking antihypertensives suffer more xerostomia or hyposalivation than patients not taking them. With regard to salivary flow, only two clinical studies showed a significant decrease in salivary flow and even one showed a significant increase after treatment. The case-control studies showed great variability in salivary flow, but in this case most studies showed how salivary flow is lower in patients medicated with antihypertensive drugs. The great variability of antihypertensive drugs included, the types of studies and the outcomes collected made it impossible to study which antihypertensive drug produces more salivary alterations. The quality assessment showed how each of the studies was of low methodological quality. Therefore, future studies about this topic are necessary to confirm whether antihypertensive drugs produce salivary alterations.
Subject(s)
Antihypertensive Agents , Xerostomia , Adult , Aged , Antihypertensive Agents/adverse effects , Case-Control Studies , Double-Blind Method , Female , Humans , Male , Middle Aged , Prevalence , Saliva/metabolism , Xerostomia/chemically induced , Young AdultABSTRACT
El objetivo de este trabajo es realizar una re- visión de los anticoagulantes orales directos comparándolos con los clásicos, y establecer una guía para el manejo de los pacientes ancianos anticoagulados durante el tratamiento dental. Los anticoagulantes orales directos parecen seguros y efectivos. Estos fármacos facilitan el manejo de los pacientes de edad avanzada en la consulta dental ya que tienen menos interacciones y no requieren monitorización periódica. Generalmente, no es necesario suspender su administración para procedimientos dentales invasivos, ni la realización de pruebas anticoagulantes preoperatorias, aunque se deberá manejar cada caso de forma individualizada. Sin embargo, aunque los anticoagulantes orales directos poseen ventajas frente a los clásicos, son necesarios más estudios para instaurar un procedimiento de cara al tratamiento odontológico del paciente anciano. No obstante, se pueden establecer una serie de recomendaciones que permitan su manejo dental, siempre y cuando cada caso se trate de forma particular (AU)
The objective of the present study is to carry out a review of direct oral anticoagulants in comparison with the classics ones and to establish a guide for the management of anticoagulated patients during dental treatment. Direct oral anticoagulants appear safe and effective. These drugs facilitate the management of elderly patients in the dental office and have fewer interactions and do not require periodic monitoring. In general, it is not necessary to suspend its administration for invasive dental procedures or to perform preoperative anticoagulant tests, although it is decided to handle each case individually. however, although direct oral anticoagulants have advantages over the classic ones, more studies are necessary to establish a procedure for the dental treatment of the elderly patient. Nevertheless, a series of recommendations can be established that allow its dental management, as long as each case is treated in a particular way (AU)
Subject(s)
Humans , Anticoagulants/therapeutic use , Health of the Elderly , Stomatognathic Diseases/therapy , Blood Coagulation , Dental Care/methods , Oral Health , Dabigatran/therapeutic use , Rivaroxaban/therapeutic use , Hemorrhage/drug therapy , Hemorrhage/prevention & controlABSTRACT
El consumo de tabaco y, en concreto las formas de éste sin humo, son determinantes en el desarrollo de carcinoma en cavidad oral y fibrosis oral submucosa, entre otras entidades. El objetivo de este trabajo es hacer una revisión de la literatura sobre las diferentes formas de consumo de tabaco sin humo y el desarrollo de lesiones orales asociadas a su uso continuado. Se estima que el 90% de los consumidores de las formas de tabaco sin humo se encuentran en el Sur de Asia, lo que supone una cifra de 100 millones de personas. En general, el tabaquismo comienza a una edad joven y se sabe que aumenta el riesgo de padecer enfermedades crónicas durante toda la vida (AU)
Tobacco consumption and, in particular, smokeless forms are determinant in the development of oral carcinoma and oral submucosal fibrosis, among other entities. The aim of this paper is to review the existing literature on the different forms of smokeless tobacco use and the development of oral lesions associated with its continued use. It is estimated that 90% of consumers of smokeless tobacco are found in South Asia, which represents a figure of 100 million people. In general, smoking begins at a young age and is known to increase the risk of chronic diseases throughout life (AU)
Subject(s)
Humans , Tobacco, Smokeless/adverse effects , Mouth/pathology , Carcinoma/epidemiology , Oral Submucous Fibrosis/pathology , Mouth Neoplasms/epidemiology , Tobacco Smoke Pollution , Tobacco, Smokeless , Periodontal Diseases/pathologyABSTRACT
BACKGROUND: Dabigatran is a newly commercialized drug that is replacing other anticoagulants in the prevention of venous thromboembolism, stroke and systemic arterial valve embolism. It acts directly on thrombin presenting in a dynamic and predictable way, which does not require monitoring these patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment. MATERIAL AND METHODS: We performed a systematic review with a bibliographic search in PubMed/Medline along with the Cochrane Library. We excluded articles dealing with all anticoagulants other than dabigatran, and works about surgical treatments in anatomical locations other than the oral cavity. RESULTS: We included a total of 13 papers of which 1 was a randomized clinical trial, 9 narrative literature reviews, 1 case series, 2 clinical cases and 1 expert opinion. Because we did not obtain any properly designed clinical trials, we were unable to conduct a meta-analysis. CONCLUSIONS: Currently, there is no consensus on the procedure to be followed in patients taking dabigatran. However, all authors agree to treat each case individually in accordance to the risk of embolism, postoperative bleeding and renal function. Also, it is necessary to perform minimally invasive interventions, and take the appropriate local anti-hemolytic measures
