Hematological parameters, obesity, stress and oxidant - antioxidant indicators in patients with or without recurrent aphthous stomatitis: A case control study.

INTRODUCTION: Recurrent Aphthous Stomatitis (RAS) is a frequent chronic disease of the oral cavity that affects 5-25 % of the population with a plethora of predisposing factors. Despite its equivocal etiology, immune alterations, hematologic deficiencies and oxidative stress has been reported to be significant etiologic factors. Stress and obesity are other environmental factors that have been studied to understand associations with RAS. OBJECTIVES: This study investigated the association of stress, hematologic parameters, oxidative indices and other selected salivary factors in a case control study on RAS Methods: Twenty-two participants each in both case and control groups were recruited with saliva and serum samples collected from them after a self-administered Recent Life Changing Questionnaire (RLCQ). OHI-S and salivary flow rate (SFR) were calculated with selected hematologic parameters and oxidative indices such as Total oxidant (TOS) and anti-oxidant (TAS) levels and their ratio - Oxidative Stress Index (OSI). Anti-oxidative indices of Ferric-Reducing Antioxidant Power (FRAP) and Glutathione Peroxidase Activity (GsPHx) were also estimated. RESULTS: The RAS group had a significantly higher RLCQ scores at a median of 145 more than the control (57.5). There was no significant in their obesity indices, however there was a significant higher mean in the ESR (p< 0.0001) and Vit B12 (p = 0.0001); OHI-S was also significantly higher in the RAS group with a median of 1.65. Both the salivary and serum TOS were significantly higher in the RAS (10.0 ± 3.8, 15.4 ± 8.9) compared to the control group (7.92 ± 1.49, 9.56 ± 3.5). GsPHx activity was significantly higher in both the saliva and serum in the control group (0.08 ± 0.08, 0.19 ± 0.11) while nil significant difference was found in the FRAP activity. Regression showed most important variables to be the salivary GsPHx activity, followed by serum OSI and GsPHx activity. CONCLUSION: The oxidative indices of TOS, TAS and GsPHx can serve as significant biomarkers in detecting RAS. This further corroborates the role of immune dysregulation in the etiology and predisposition to RAS.

Salivary Bacterial Count and its Implications on the Prevalence of Oral Conditions.

AIM: To determine the relationship between salivary bacterial count and some oral lesions. MATERIALS AND METHODS: This research was designed as a cross- sectional study assessing the mean bacterial count in the saliva of Nigerians in Ile-Ife who has no history of medical illness. Subjects were randomly selected from consenting staffs and students of Obafemi Awolowo University, Ile-Ife, Nigeria. Oral examinations were done and their saliva collected using spitting method. The bacterial count was determined in the laboratory by culture the bacteria after which the counting was done using colony counter. Data analysis was done using STATA 13 software. RESULTS: A total of sixty participants were recruited for the study, 41 males and 19 females, their mean age was 23.12+3.8 years. The mean salivary bacteria count among the participants was 8.41 × 108 + 1.06 × 109 per mL. The salivary bacterial count is highest among those with poor oral hygiene (1.89 × 109) and also increases with age. Males have a higher bacterial load compared to female. Subjects with periodontitis have the highest bacterial load and are significantly higher in patients with periodontitis in comparison with those who do not have periodontitis p = 0.03 Conclusion: Periodontitis is associated with the significantly higher salivary bacterial load. Male sex and increasing age were also associated with increased bacterial load in saliva. CLINICAL SIGNIFICANCE: This study showed another potential role of saliva as a reliable diagnostic tool to monitor the severity of oral infections. It also showed the association between salivary bacterial count and some oral lesions further substantiating the possibility of using saliva to monitor disease progression and treatment responses.

Oral findings in chronic kidney disease: implications for management in developing countries.

BACKGROUND: The importance of oral health care in the management of patients with systemic diseases including chronic kidney disease (CKD) has been affirmed. Many CKD patients have related oral lesions, however, attention to oral health care has been lacking, especially in the developing countries with higher burden of renal diseases. METHODS: One hundred and eighty patients, 90 cases and 90 controls were recruited, interviewed and examined. Oral mucosa assessment was based on the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. Urinalysis and blood creatinine levels were determined. Glomerular filtration rate (GFR) of each patient was calculated from the blood creatinine using Cockcroft and Gault formula. RESULTS: Oral lesions were present in 86 out of 90 (96.5%) CKD patients compared with 15 out of 90 (16.7%) controls (p < 0.001). Abnormal lip hyperpigmentation was the most frequently seen lesion in 81 out of 90 (90%) CKD patients. Other significant findings were gum bleeding, xerostomia, candidiasis, burning mouth and abnormal taste. In the controls (without CKD), the mean GFR was lower in subjects with oral lesions compared with those without oral lesions p < 0.001. CONCLUSIONS: CKD and reduced GFR in subjects without CKD are risk factors for oral lesions. The higher prevalence of oral lesions in CKD patients necessitates mandatory oral screening to identify patients with deteriorating renal function. The management of such lesions will enhance the overall well-being of CKD patients in developing countries.