PHoral: Effects of carnosine supplementation on quantity/quality of oral salivae in healthy volunteer and in subjects affected by common oral pathologies.

BACKGROUND: Diseases of the oral cavity (OC) with an infectious trigger such as caries and periodontal disease are extremely common in the general population and can also have effects at the cardiovascular level. The oral salivary flow, with its buffering capacity, is able to regulate the pH of the OC and, therefore, significantly contribute to the ecological balance of the microenvironment in which the oral microbiome (OM) develops. On the other side, when the quality/quantity of salivary flow is altered it is supposed the disruption of this balance with the potential increase in oral pathogens and triggered diseases. Among the endogenous substances able to exert a significant effect on the salivary flow and its characteristics, carnosine (Car), a dipeptide originally isolated in skeletal muscle, represents, thanks to the known buffering properties, a promising principle. METHODS: We aimed this protocol to evaluate the quantitative/qualitative characteristics of the salivary flow in healthy volunteer subjects (n = 20) and in subjects suffering from common OC pathologies (n = 40), before and after 7 days of supplementation with SaliflussTM (Metis Healthcare srl, Milan, Italy), a Class I medical device on the market as 400 mg mucoadhesive oral tablets that has Car as the main ingredient. DISCUSSION: Combining the characteristics of saliva with the OM and comparing them with OC pathologies, we expect to clarify their reciprocal relationship and, using quantitative proteomics techniques, to help clarify the mechanism of action of Car.

Health effects of coconut oil: Summary of evidence from systematic reviews and meta-analysis of interventional studies.

BACKGROUND AND AIMS: Systemic review (SR) and meta-analysis (MA) of interventional studies are considered as the highest level of evidence for clinical decision making. Therefore, we systematically summarized all high-quality evidence on the usage of coconut oil for health-related benefits from SRs and MA. METHODS: PubMed®, Web of science®, SciVerse Scopus®, and EMBASE® databases were systematically searched to select SRs and SRs with MA of interventional studies reporting health-related clinical outcomes of coconut oil. Similar studies were grouped based on their respective clinical areas. A methodological quality appraisal was conducted for all included SRs and SRs with MA using the Critical Appraisal Checklist for Systematic Reviews. RESULTS: A total of seven papers were selected for inclusion in this review, consisting of three MA and one SR on cardio-metabolic health, one SR on oral health, and one SR and one MA each on skin health. Coconut oil significantly increases serum total cholesterol, low-density- and high-density- lipoprotein cholesterol levels compared to poly- and mono-unsaturated oils. Limited studies showed that topical use of coconut oil helps in the prevention and treatment of atopic dermatitis and oil pulling for the prevention of dental caries. All four studies on cardiometabolic health and the SR on oral health had a high score in the quality assessment, SR with MA on skin health fulfilled high-quality scoring whereas the SR on the same topic had a low-quality scoring. CONCLUSIONS: In summary, consistent and strong evidence shows that coconut oil has an adverse effect on the lipids parameters associated with cardio-metabolic health, with limited studies to conclude the effects of atopic dermatitis and oil pulling.

Relación entre la caries dental y la adherencia a la dieta mediterránea en niños / Relationship between dental caries and adherence to Mediterranean diet in a population of children

Introducción: La caries dental es una enfermedad infecciosa de origen multifactorial y representa un importante problema de salud a nivel mundial. El objetivo del presente estudio fue establecer la relación entre la caries dental y la adherencia a la dieta mediterránea mediante el cuestionario KIDMED en una muestra de niños de edades comprendidas entre 3 y 9 años. Métodos: Se llevó a cabo un estudio transversal en una muestra de 268 niños valencianos. En primer lugar, se realizó el cuestionario KIDMED para determinar la adherencia a la dieta mediterránea del paciente. En segundo lugar, se realizó una exploración clínica de los dientes temporales empleando el índice cod y cos. Se realizó un análisis estadístico descriptivo e inferencial, este último empleando la prueba de Kruskal-Wallis. Resultados: El 63,4% de la población estudiada presentaba caries, encontrando una media de cod de 0,234 y de cos de 0,098. El valor medio de índice KIDMED fue de 7,116 con unos valores que oscilaban entre -1 y 11. Se clasifico a los pacientes en alta adherencia a la dieta mediterránea (47,4%), adherencia media (47%) y baja adherencia a la dieta mediterránea (5,6%). Se observó una relación entre el índice cod y cos y una baja adherencia a la dieta mediterránea siendo estadísticamente significativa (p=0,000). Conclusiones: Se observó una asociación directa entre la caries dental en niños y la baja adherencia a la dieta mediterránea. (AU)

Background: Dental caries is a multifactorial infectious disease which represents an important health problem worldwide. The aim of the present study was to establish the relationship between dental caries and adherence to the Mediterranean diet through the KIDMED questionnaire in a population of 3-9 year old children. Methods: A cross-sectional study was conducted in a population of 268 Valencian children aged 3 to 9. First of all, questionnaire KIDMED was filled out by every patient/caregiver to determine the adherence of every patient to the Mediterranean diet. Afterwards, a clinical exploration of the temporary teeth was carried out using dmf and dmfs indexes. Descriptive and inferential statistical analysis were performed using Kruskal-Wallis test. Results: 63,4% of the studied population presented caries. The dmf and dmfs indexes obtained were 0,234 and 0,098 respectively. The mean value of the KIDMED index was 7,116 showing values from -1 to 11. Patients were classified as follows: High adherence to Mediterranean diet (47,4%), medium adherence (47%) and low adherence (5,6%). A statistically significant relationship was also found between dmf and dmfs indexes and a low adherence to the Mediterranean diet (p=0,000). Conclusions: A direct association was observed between dental caries in children and the low adherence to the Mediterranean diet. (AU)

The treatment of black stain associated with of iron metabolism disorders with lactoferrin: a litterature search and two case studies.

Among the various pathologies of the oral cavity, the formation of "unsightly black spots" on the surface of the tooth, universally known as Black Stain (BS) has recently been acquiring more interest. Usually BS is typically found in individuals in prepubertal age, even though it has been identified in adults associated with microbial exchange and / or with iron metabolism disorders. Microbial exchange concerns the possible exchange of bacteria between family members which can take place directly, through effusions, or indirectly, through brushes, cutlery or glasses. For this reason, it is recommended that toothbrushes of family members not be left damp and in contact with each other. The bathroom, being a warm-humid environment, is in fact an optimal habitat for microbial proliferation. Of specific importance in BS is the accumulation of iron in tissues and secretions which, together with chromogenic bacteria, are the primary cause of this pathology. In fact, among the metabolic products synthesized by bacteria in the oral cavity, hydrogen sulfide is of considerable interest, since upon reacting with iron available in saliva, in pathological conditions (iron metabolism disorders), it forms black precipitates consisting of ferric sulfide. These precipitates bind to the surface of the teeth, tending to form a stria that usually follows the contour of the gingiva, with an unsightly and variable chromatic intensity. In physiological situations, iron homeostasis is defined as the state of equilibrium between iron present in tissues and in secretions and that which is present in the circulation. Instead, in pathological conditions, defined as iron metabolism disorders, there is an accumulation of iron in tissues and secretions and a lack of it in the circulation. It is also important to remember that subjects affected by BS are more protected from carious processes than healthy subjects, probably due to a significant predominance of chromogenic bacteria compared to those responsible for caries. It should also be remembered that in young subjects BS tends to regress with pubertal development and the transition to adult life. In any case, using common professional hygiene procedures, it is possible to remove BS as well as plaque and tartar deposits. In particular, with ultrasonic scalers, polishing pastes and powders carried by air and water jets, the surfaces of the teeth can be restored to their natural healthy state. All the techniques for removing the precipitates, are not enough however, to fix and permanently eradicate their appearance, as these precipitates last only for short periods and recur very frequently. Due to the frequent recurrences, new oral microbiota control therapies are emerging; among these the use of lactoferrin (Lf) in the dental field and particularly in the treatment of BS appears to be very promising. Taken togheter, here the effect of Lf in subjects affected by BS has been investigated.

The effect of dietary intervention on paraffin-stimulated saliva and dental health of children participating in a randomized controlled trial.

OBJECTIVES: The aim was to study the impact of dietary intervention on the properties of paraffin-stimulated saliva, and on dental caries. STUDY DESIGN: At 7 months of age 1062 infants (540 intervention; 522 controls) started in the prospective, randomized Special Turku Intervention Project (STRIP) aimed at restricting the child's saturated fat and cholesterol intake to prevent atherosclerosis of adult age (www.clinicaltrials.gov NCT 00223600). At 3 years of age, every fifth child was invited to an oral sub-study, and 148 (78 boys) children attended. At 6, 9, 12 and 16 years of age 135, 127, 114 and 88 children were restudied, respectively. Dietary intakes of carbohydrates, protein, saturated fat, calcium, phosphate, and fibre were regularly recorded using 4-day food records. Height and weight were regularly monitored. Paraffin-stimulated saliva samples were collected at 6, 9, 12 and 16 years of age, and analyzed for flow rate, buffer capacity, calcium, phosphate and proteins. Dental health was recorded and expressed as d3mft/D3MFT, and as time of caries onset. RESULTS: Dietary intakes of calcium, phosphate and fibre, and salivary flow rate increased with time in both groups (p<0.001, GLM for repeated measures). Fibre intake and salivary flow rate were higher in the intervention than in the control group (p=0.042 and p=0.0394, respectively, GLM for repeated measures). There were no correlations between dietary intakes and salivary concentrations of calcium or phosphate. Children who did not have caries experience (d3mft/D3MFT=0) during the entire follow-up had higher salivary calcium than those who had caries already at 3 years of age. The association between salivary calcium and caries onset was significant up to 12 years of age. Toothbrushing frequency was statistically significantly associated with caries-onset at ages 6 (gamma statistic 0.457, p=0.046) and 12 years (gamma statistic 0.473, p=0.019). CONCLUSIONS: The current long-term dietary intervention increased children's paraffin-stimulated salivary flow rate. The concentration of salivary calcium was directly correlated to dental health. Higher salivary flow rate in the intervention group is believed to be due to higher fibre intake in the intervention group.

Functional foods and strategies contrasting bacterial adhesion.

Antibacterial strategies targeting bacterial adhesion to substrates are considered a valuable alternative to traditional antibiotic therapy, in view of the great advantage they bring in combating the infectious process at the very early stage without selecting for drug resistant cells. Amongst bioactive compounds with activity against bacterial adhesion, several are found in natural food and beverages, such as cranberry, tea, coffee, wine and milk. For the analysis of their anti-infective potential, successful experimental models can be conducted using different substrates from the oral cavity. Studies conducted so far in this field allowed the discovery of a variety of anti-adhesive fractions and compounds proven to be effective against bacterial traits involved in the development of oral pathologies such as caries and gingivitis/periodontitis. Discovering new anti-adhesive compounds from natural products, unravelling and testing their prophylactic and therapeutic values, and improving their use in the general population are promising new frontiers in the global fight against human infectious diseases.

Food components with anticaries activity.

Caries is the most common oral infectious disease in the world. Its development is influenced also by diet components that interfere with pathogen mutans group Streptococci (MGS) activity. A very active research to identify functional foods and their components that are generally recognised as safe has been ongoing, with the aim of developing alternative approaches, to the use of synthetic chlorhexidine, and at the reduction or prevention of caries. Until now convincing evidence exists only for green tea as a functional food for oral health, partly owing to its high content of catechins, especially epigallocatechin-gallate. A number of other foods showed potential anticaries activity. Some other foods able to act against MGS growth and/or their virulence factors in in vitro tests are: apple, red grape seeds, red wine (proanthocyanidins), nutmeg (macelignan), ajowan caraway (nafthalen-derivative), coffee (trigonelline, nicotinic and chlorogenic acids, melanoidins), barley coffee (melanoidins), chicory and mushroom (quinic acid). In vivo anticaries activity has been shown by cranberry (procyanidins), glycyrrhiza root (glycyrrhizol-A), myrtus ethanolic extract, garlic aqueous extract, cocoa extracts (procyanidins), and propolis (apigenin, tt-farnesol).

Emerging science in the dietary control and prevention of dental caries.

The key environmental factor involved in caries incidence is fermentable carbohydrates. Because of the high costs of caries treatment, researchers continue to explore dietary control as a promising preventive method. While dietary change has been demonstrated to reduce Streptococcus mutans, a preventive role is expected for "functional foods" and dietary habit alterations. The authors consider how recent advances in the understanding of caries pathology can reveal dietary control as a valuable method in promoting a healthy dentition.

Consumo de alimentos ricos em açúcar e cárie dentária em pré-escolares / Consumption of sugar-rich foods and dental caries in preschool children

A cárie dentária, uma das doenças mais comuns entre crianças brasileiras, interferindo na qualidade de vida por causar dor e sofrimento. O presente estudo objetivou investigar a experiência de cárie dentária e o consumo de alimentos ricos em açúcar em pré-escolares atendidos em uma instituição filantrópica. A amostra foi constituída por 56 pré-escolares na faixa etária de 36 a 78 meses, regularmente matriculados em uma creche de Teresina-PI. Foram obtidas informações sobre dieta e hábitos de higiene bucal das crianças e realizado exame bucal dos pré-escolares na própria instituição, por um único examinador, para a determinação do índice ceo-d. A análise estatística foi realizada por meio da Análise de Variância (ANOVA) e teste posthoc de Tukey. A proporção de pré-escolares livres de cárie foi de 19,6%. Quanto à alimentação, mais de 90,0% das crianças consumiam alimentos ricos em açúcar extrínseco. Houve associação positiva entre a frequência do consumo de açúcar extracelular não-lácteo e a média do ceo-d (p<0,01). Observou-se que mais de 89,0% dos pré-escolares escovavam os dentes duas ou mais vezes por dia. Cerca de 44,6% não tinham a ajuda de um adulto para isso. Além disso, mais de um terço das crianças nunca foi submetida a um atendimento odontológico. Conclui-se, a partir de então, que a média do ceo-d dos pré-escolares estudados foi maior que a observada no Brasil. A proporção de crianças livres de cárie foi menor que as metas estabelecidas pela Organização Mundial de Saúde para o ano 2000 e 2010. Os alimentos ricos em açúcar extrínseco eram consumidos por quase todos as crianças. O ceo-d aumentou com o consumo do açúcar extracelular não lácteo e apesar do relativo cuidado com a higiene bucal, muitos pré-escolares não tinham acesso adequado aos serviços odontológicos.

A doença cárie como preditora de cárie em dentes decíduos e permanentes / Carie disease as carie predictors in deciduos and permanent teeth

Vários sinais têm sido relacionados como preditores de cárie nos dentes decíduos e permanentes. Dieta cariogênica e ausência de higienização são fortemente relacionados com a presença de cárie dentária, mas a cárie em dentes decíduos tem sido apontada como forte preditora da doença nos dentes permanentes. O presente trabalho teve como objetivo relacionar a cárie nos dentes decíduos anteriores como preditora de cárie nos molares decíduos, e estes como preditores de cárie nos primeiros molares permanentes...

Many signs have been identified as carie predictors in deciduous and permanent teeth. The purpose of this work is to report on carie disease in anterior deciduous teeth as carie predictors in deciduous molars as well as on the presence of the disease in deciduous molars as carie predictors in first permanent molars...

[Analysis of the dependence between milk and dairy products consumption, and dental caries observed in group of children and teenagers]. / Analiza zaleznosci miefdzy spozyciem mleka i produktów mlecznych a zmianami próchnicowymi u dzieci i mlodziezy.

The aim of this research was evaluation of influence of milk and dairy products consumption on advance of dental caries observed in the group of children and teenager. The dependences between milk and dairy products (dairy beverages, cottage cheese and other kinds of cheese) consumption and advance of dental caries were analyzed. The objects of the research were 44 patients aged 7-18 years. Elements of the research were the questionnaire survey and the assessment of the patients diet. The statistical analysis was conducted using the Kolmogorov-Smirnov test and Kruskall-Wallis test as far as the coefficient of correlations by Pearson. In the research it was found that cheese consumption contributes to decrease of dental caries coefficient. The need to provide children and teenagers commonly the nutritional education, concentrating on proper model of the diet and systematic consumption of milk and dairy products, was proved.

Sugar use and nursing practices associated with dental caries increment in brasilian children between 12 and 30 months of age: a longitudinal study / Uso do açucar e práticas de aleitamento associados ao incremento de cárie dental em crianças brasileiras de 12 a 30 meses de idade: um estudo longitudinal

The aim of this was to investigate the association between dental caries increment after a year with sugar use and nursing practices. This prospective study was accomplished with a sample of 186 children who were 12 to 30 months at the beginning of the study, from Feira de Santana-Bahia, Brasil, which has a fluoridated water supply. Information was collected through a questionnaire applied at the initial exam...

[Monitoring of fluoride levels in children receiving fluorinated milk for a long time and time course of their permanent teeth]. / Monitoring postupleniia ftorida v organizm detei, dlitel'noe vremia poluchaiushchikh ftorirovannoe moloko, i dinamika kariesa ikh postoiannykh zubov.

Measurements of fluorine concentrations in 1320 urine samples collected from 440 children in the city of Maikop showed low levels of fluorine (0.43-0.72 mg) in this group in comparison with the groups receiving prophylactic treatment with optimal safe doses of fluorine with milk (0.88-1.19 mg). Consumption of physiological amounts of fluorine does not lead to its accumulation in the body even after long (up to 5 years) consumption of fluorinated milk. Permanent ratio between the values in the control and prophylactic groups allows less frequent monitoring of fluorine levels: during the first month of prevention and then after 2 and 4 years of prophylaxis with fluorinated milk. Clinical evaluation of anticaries efficiency of fluorinated milk in 920 children aged 6-8 years (309 in the control and 611 in prophylactic groups) showed a significant decrease of caries prevalence (by 12.5-24.5%) and intensity in permanent teeth (by 50.6-56.7% by the CDL index and by 47.6-52.9% by the CDLp index) after 3-5 years of regular consumption of fluorinated milk.