Intraoral electrostimulator for xerostomia relief: a long-term, multicenter, open-label, uncontrolled, clinical trial.

OBJECTIVE: A previous sham-controlled multinational study demonstrated the short-term efficacy and safety for xerostomia treatment of an intraoral device that delivers electrostimulation to the lingual nerve. The objective of this study was to test the hypothesis that those beneficial effects would be sustained over an 11-month period. STUDY DESIGN: The device was tested on a mixed sample of 94 patients with xerostomia in an open-label, uncontrolled, prospective multicenter trial. Statutory outcome assessments were done at 5th, 8th, and 11th months and analyzed by multiple comparisons. RESULTS: Improvements achieved at month 5 from baseline were sustained throughout the follow-up period for the primary outcome, xerostomia severity, and the secondary outcomes resting whole salivary flow rate, xerostomia frequency, oral discomfort, and difficulties in speech, swallowing, and sleeping. No significant side effects were detected. CONCLUSIONS: The beneficial effects of a removable intraoral electrostimulating device were sustained for an 11-month period.

Efficacy and safety of an intraoral electrostimulation device for xerostomia relief: a multicenter, randomized trial.

OBJECTIVE: To evaluate the efficacy and safety of an intraoral electrostimulation device, consisting of stimulating electrodes, an electronic circuit, and a power source, in treating xerostomia. The device delivers electrostimulation through the oral mucosa to the lingual nerve in order to enhance the salivary reflex. METHODS: The device was tested on a sample of patients with xerostomia due to Sjögren's syndrome and other sicca conditions in a 2-stage prospective, randomized, multicenter trial. Stage I was a double-blind, crossover stage designed to compare the effects of the electrically active device with the sham device, each used for 1 month, and stage II was a 3-month open-label stage designed to assess the long-term effects of the active device. Improvement in xerostomia severity from baseline was the primary outcome measure. RESULTS: A total of 114 patients were randomized. In stage I, the active device performed better than the sham device for patient-reported xerostomia severity (P<0.002), xerostomia frequency (P<0.05), quality of life impairment (P<0.01), and swallowing difficulty (P<0.02). At the end of stage II, statistically significant improvements were verified for patient-reported xerostomia severity (P<0.0001), xerostomia frequency (P<0.0001), oral discomfort (P<0.001), speech difficulty (P<0.02), sleeping difficulty (P<0.001), and resting salivary flow rate (P<0.01). CONCLUSION: Our findings indicate that daily use of the device alleviated oral dryness, discomfort, and some complications of xerostomia, such as speech and sleeping difficulties, and increased salivary output. The results show a cumulative positive effect of the device over the period of the study, from baseline to the end of the trial.

Medication in elderly people: its influence on salivary pattern, signs and symptoms of dry mouth.

OBJECTIVE: To compare stimulated and non-stimulated salivary flow, pH, buffering capacity and presence of signs and symptoms of hyposialie and xerostomia in elderly patients, with senile dementia using medication and healthy elderly subjects not using medication. METHODS: Forty individuals (mean age: 68.5 years) were divided into two groups, according to the use (G1) or non-use (G2) of medication and the presence (G1) or absence (G2) of senile dementia. Data with reference to the general health condition, use of medication and the patient's complaints were collected during anamnesis. Clinical examination identified signs associated with hyposialie and xerostomia. Stimulated and non-stimulated saliva flow, pH and buffering capacity were verified. RESULTS: The stimulated saliva flow in both groups was below normal parameters. The drugs used by individuals in G1 showed xerostomic potential. Individuals with a higher consumption of xerostomic medication presented with dry and cracked lips. A significant negative relationship was found between drugs consumption and the buffering capacity (p < 0.001), and the resting saliva flow rate (p = 0.002). CONCLUSION: The use of medication increases the chance that an elderly person may present signs related to xerostomia and alterations in stimulated saliva flow and buffering capacity.

Avaliação da condição periodontal e da presença de biofilme lingual como indicadores de risco para halitose / Evaluation of periodontal condition and tongue coating as risk factors for halitosis

A capacidade olfativa como instrumento de diagnóstico não deve ser ignorada por aqueles que trabalham na área da saúde. O objetivo do trabalho foi apresentar um modelo de avaliação organoléptica do odor bucal e avaliar a presença de gengivite, periodontite crônica e do biofilme lingual como indicadores de risco da halitose. Foram selecionados 120 indivíduos, de ambos os gêneros e na faixa etária de 18 a 66 anos, com as seguintes características: 60 portadores de halitose, com ou sem doença periodontal, e 60 indivíduos sem halitose, com ou sem doença periodontal. Todos foram submetidos às seguintes avaliações: teste organoléptico, anamnese e exame clínico para detectar a presença de biofilme lingual e alterações periodontais. O estudo mostrou que não houve associação entre os escores organolépticos e as alterações periodontais. O teste organoléptico positivo foi estatisticamente associado apenas à presença do biofilme lingual, podendo assim considerá-lo como um indicador de risco para as alterações do odor bucal (p = 0,0001). O modelo apresentado para a realização do teste organoléptico mostrou-se clinicamente viável, de execução fácil e rápida. Em resumo, os presentes achados mostraram que a presença de biofilme lingual pode ser considerado como um fator de risco para a halitose.

The aim of the present study was to evaluate the presence of gingivitis, chronic periodontitis and tongue coating as possible indicators for halitosis. A total of 120 subjects of both genders aging from 18 to 66 years wereselected and allocated in 2 groups: 60 subjects diagnosed with halitosis and 60 subjects without halitosis. All subjectswere submitted to the organoleptic test, anamnesis and clinical examination to assess the presence of tongue coatingand periodontal diseases. The results showed no association between organoleptic scores and periodontal diseases (p>0.05). However, tongue coating was a highly related to thepresence of halitosis (p=0.0001). In addition, the organoleptic test was considered to be an easy and rapid procedure to evaluate the presence of halitosis. In conclusion, tongue coating can be a risk factor for halitosis.

Saliva e sua análise na prática clínica de um grupo de periodontistas: estudo transversal / Saliva and its analysis in the clinical practice of a peridontologist grup: a cross sectional study

O objetivo deste levantamento foi verificar a importância dada à saliva dentro do contexto clínico da Periodontia. A pesquisa foi realizada entre outubro e dezembro de 2006, por meio de uma entrevista telefônica feita com 10% dos cirurgiões-dentistas (58) associados e cadastrados na página eletrônica DA sobrape (Sociedade Brasileira de Periodontologia). A seleção foi feita por sorteio, incluindo profissionais de vários estados do Brasil. As entrevistas foram feitas por um único entrevistador, em abordagem única, por meio de questionário previamente elaborados, contendo sete perguntas objetivas tendo como opções de respostas: sim, não, ácido, básico e prefiro não responder. Os resultados demonstraram que embora 79% dos entrevistados acreditem que a saliva possa interferir no curso da doença periodontal, apenas 7% costumam avaliar os padrões salivares. Verificou-se que 53% dos participantes relacionaram a doença periodontal com o ph ácido da saliva. Não houve consenso, entre os entrevistados, quanto a relação entre viscosidade salivar e doença periodontal. Constatou-se que 69% dos respondentes não tiveram aula sobre saliva nos cursos de especialização e/ou mestrado. Conclui-se que existe uma necessidade de se discutir de maneira mais aprofundada e cientifica a relação entre saliva e doença periodontal nos cursos de pós-graduação de Periodontia.