dry mouth

[findadentist]

 Thanks for these tips. It will be helpful to us.

        

[drmithila]

 I encountered a female patient aged 24 years who came with a rather peculiar problem.She has no relevant medical history and her chief complaint was that every morning , till the time that she consumes her breakfast, she complains of her saliva gelating, that is her saliva turns into gelatin consistency.

 

A rather peculiar thing that i am absolutely not familiar with, kindly opine as to what should i advise her and what are the possible causes.

Currently i have asked her to use mouthwashes but i do not think that is going to make any difference

        

[drsushant]

 In context to this patient, are there any saliva thinning agents available in the market?

        

[Anonymous]

 i think you should refer the patient to a specialist.

regards,

veerendra darakh

        

[Drsumitra]

From what I know you can make saliva thinner by drinking more water. Having thick saliva is a sign that you are dehydrated and need to drink more water
AvoidFoods and drinks that contain caffeine such as coffee, colas, and chocolate.
Alcoholic beverages including beer, wine, and mixed drinks.
Dry foods including tough meats, raw vegetables, breads, pretzels, rice, chips, muffins, and cakes.
Commercial mouthwashes. These contain alcohol which will dry the mouth further.

Saliva stimulators includeExamples of these products include saliva stimulators such as Salagen® (pilocarpine hydrochloride); saliva replacers such as Xero-Lube®, Salivart®, Mouth Kote®, Moi-Stir®, Orex®, Salix, Optimoist®, Sage Moist Plus® spray, and Gelclair®; and mouth moisturizers such as Oral Balance® and Sage Mouth Moisturizer®.

 

        

[Drsumitra]

A new study indicates that some bacteria may be capable of grow an appendage and swimming to a new area. This activity has recently been seen in marine sponges.

This information is applicable to dentistry because it may aid the way harmful bacteria in the mouth are understood. It’s possible that the bacteria in the plaque on teeth and in other areas of the body could be treated in a different, more advanced manner.

Bacteria have the ability to communicate with other bacteria. When a critical mass of bacteria is present in a certain area, an appendage known as a flagellum appears and finds a way to swim to a new area. A new biofilm can then develop.

All things considered, there are more bacteria on earth than all other forms of life combined. The more that is understood about bacteria, the more chance there is that the bacteria will be combatted in a more educated way.

This new study by scientists from the University of Maryland Center for Environmental Science’s Institute of Marine and Environmental Technology, Indiana University, and University of Colorado Denver’s School of Medicine, appears in the September issue of Molecular Microbiology.

 

        

[drsushant]

Will oral health providers one day be able to scout for evidence of systemic disease in the time it takes to clean a patient’s teeth? It’s an ever-likely scenario, according to those at the forefront of salivary diagnostics research.
Clinical discoveries published in recent years have advanced the odds of salivary diagnostics becoming a chairside tool that could enhance the ability of dental practitioners to detect a spectrum of medical conditions.

Scientists working with saliva samples obtained from a group of Indian patients, for example, were able to validate the ability of portable electromechanical biosensor hardware technology to simultaneously analyze oral fluids for biomarkers thought to signal the pathogenesis of oral cancer (Clinical Cancer Research, July 1, 2009, Vol. 15:13, pp. 4446-4452).

A similar device developed by scientists and engineers in California sits at the cusp of commercialization (Annals of the New York Academy of Science, March 2007, Vol. 1098, pp. 401-410). The prototype Oral Fluid Nanosensor Test (OFNASET) awaits regulatory approval, with two contract manufacturing organizations waiting in the wings to begin commercialization.

And numerous studies funded by the National Institutes of Health (NIH) and others in 2009 and 2010 have pushed the salivary diagnostics envelope to its most advanced position yet, with molecular biomarkers being identified to monitor the systemic creep of breast, ovarian, pancreatic, and lung cancers.

And these advances represent just a portion of the salivary diagnostics portfolio. Combinations of analytes found in whole and ductal saliva are being characterized in ways that allow investigators to view them as molecular “proxies” for a host of systemic or systemic-related conditions, including periodontal infection, diabetes, human immunodeficiency virus (HIV), hepatitis, and cardiovascular disease.

In addition, investigators continue to refine ways to link the basic investigative tools of molecular biology — such as mass spectrometry and microarray analysis — with microfluidics and nanotechnology engineering, enabling them to develop portable salivary assay platforms for use in the dental operatory. If myriad challenges associated with regulatory approval, licensing, commercialization, and third-party reimbursement can be met, oral care providers may one day soon find themselves offering diagnostic health services that can identify life-threatening conditions.

        

[drsushant]

Salivary diagnostics goes commercial

Saliva’s potential as a keeper of secrets has unfolded slowly. In the 1970s and 1980s, researchers identified levels of serum albumin in saliva and cortisol concentrations in oral fluids (Helvetica Odontologica Acta, April 1970, Vol. 14:1, pp. 10-17; Annals of Clinical Biochemistry, November 1983, Vol. 20:Pt 6, pp. 329-335).

In the 1990s, researchers at the Naval Medical Center in Portsmouth, VA, and the University of Pennsylvania School of Dental Medicine described antibodies in saliva and an oral fluid test that can mark HIV with a specificity and sensitivity equal to that of blood serum (American Journal of Medicine, April 1, 1997, Vol. 102:4A, pp. 15-20; April 1997, Vol. 102:4A, pp. 9-14). Years later, the FDA-approved OraQuick Advance Rapid HIV-1/2 antibody test (OraSure Technologies) was introduced to the market.

Additional chairside products have been introduced to detect hormones in saliva (ZRT Laboratory) and identify the type of oral human papillomavirus for evaluating head and neck cancer risk (OralDNA Labs). OralDNA also offers bacterial and genomic biomarker tests for periodontal disease, while OraSure markets saliva-based screening tests for alcohol and substance abuse.

        

[drmithila]

Gene therapy may be safely used to study human salivary glands, according to a new study.

Scientists at the National Institute of Dental and Craniofacial Research, which is part of the National Institute of Health, stated that the phase 1 study of gene therapy in the human salivary gland displayed positive results. The information appeared in the Proceedings of the National Academy of Sciences.

Based on the study, the transferred gene, known as Aquaporin-1 could aid people who survived head and neck cancer who have problems with chronic dry mouth.

Aquaporin-1 encodes a protein that facilitates the flow of fluid in the cells. This process is similar to the way in which the salivary glands enable more studies to be conducted in this general vicinity. Salivary glands haven’t been studied closely in the past but the location, combined with the accessibility, makes these glands well-suited for gene therapy.

Bruce Baum was the lead author of the study. He’s been interested in information like this since he treated head and neck cancer survivors in the 1980s. His ideas for gene therapy began in 1991.

Many people have overcome cancer only to deal with chronic dry mouth problems. There aren’t many solutions. That’s why these studies in the salivary glands commenced in 2008.

There were 11 people studied to compile the data. Five of these people demonstrated an increase in saliva secretion and six people had no side effects.

More research is necessary to confirm these positive results.

        

[drsnehamaheshwari]

Spanish researchers have confirmed the effectiveness of a spray containing 1% malic acid, which improves xerostomia caused by antidepressant drugs, according to a study in Depression and Anxiety (February 2013, Vol. 30:2, pp. 137-142).

 

The product, combined with xylitol and fluorides in a spray format, stimulates saliva production in patients with xerostomia, improving their quality of life, according to the researchers from the University of Granada.

 

One of the main causes of xerostomia stems from taking medications. More than 500 drugs, belonging to 42 pharmacological groups, can cause xerostomia as a side effect, the researchers noted. Most of the drugs are antidepressants. Since the drugs have been prescribed more in recent years, it has resulted in more patients developing xerostomia, especially among 45- to 50-year-old people.

 

The researchers performed a double-blind randomized clinical trial on 70 patients diagnosed with antidepressant-induced xerostomia, split into two groups. The first group (n = 35) took a sialogogue mouth spray (1% malic acid), while the second group (n = 35) received a placebo. Both products were applied on demand over two weeks.

 

Dry mouth symptoms improved after 1% malic acid topical spray application (p < 0.05), the study authors reported. After two weeks of 1% malic acid application, unstimulated and stimulated salivary flows rates increased significantly (p < 0.05), they added.

 

Previous studies have described citric and malic acid as salivary stimulants, although for years their use was rejected due to the possible demineralizing effect on tooth enamel, the researchers noted. However, recent research has shown a reduction in the potential demineralizing effect of malic acid when used in the correct concentration and when combined with xylitol and fluorides. 

        

[drsnehamaheshwari]

 

Xerostomia (dry mouth) is a condition commonly encountered in clinical practice that can lead to multiple oral and systemic health problems. This condition has several potential etiologies, including medications, advancing age, head and neck radiation, and systemic diseases. Individuals with xerostomia are at increased risk for dental caries, infections of the oral cavity, generalized oral pain, poor nutrition intake, and significantly reduced quality of life. Topical sialogogues may be of limited benefit for patients with this condition, and systemic medications may be necessary to achieve improved clinical outcomes.

A pilot study by Brimhall and colleagues compared the efficacy of pilocarpine and cevimeline in the secretion of saliva and evaluated side effects of both medications. Pilocarpine is a cholinergic agonist that promotes generalized fluid secretion by acting on systemic muscarinic-cholinergic receptors. Cevimeline, another systemic agent that promotes fluid secretion, has higher affinity for muscarinic receptors located on lachrymal and salivary gland epithelium and is thought to produce fewer side effects than pilocarpine.

Twelve patients with moderate to severe xerostomia were included in the final analysis of this crossover, double-blind, randomized study. One half of the patients were randomly selected to receive cevimeline 30 mg 3 times daily for 4 weeks. This was followed by a 1-week washout period and initiation of therapy with pilocarpine 5 mg 3 times daily for 4 weeks. The other half of the patients were randomly selected to take pilocarpine first, followed by cevimeline in the same way as described previously.

Patients were evaluated by clinicians 3 times throughout the study: at baseline for informed consent, after the first 4 weeks of therapy, and then 5 weeks later (after the 1-week washout period and 4 weeks of the second medication course). Unstimulated and stimulated salivary flow measurements were obtained at each visit using standard techniques. Patients completed a weekly questionnaire about side effects of therapy, and the questionnaires were evaluated at each visit.

The results of the study were as follows:

Most cases of xerostomia (58%) in this cohort were caused by medications;

Although there was an overall increase in production of both unstimulated and stimulated saliva in patients taking either cevimeline and pilocarpine, the medications did not differ statistically in this regard; and

Patient-reported side effects of both medications included increased sweating, watering eyes, headache, nausea, stomach upset, diarrhea, and pain around the eyes; however, there was no statistical difference between the medications in the frequency or severity of side effects.

 

        

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