-
1.
Bite or brain: Implication of sensorimotor regulation and neuroplasticity in oral rehabilitation procedures.
Kumar, A, Kothari, M, Grigoriadis, A, Trulsson, M, Svensson, P
Journal of oral rehabilitation. 2018;(4):323-333
Abstract
Tooth loss, decreased mass and strength of the masticatory muscles leading to difficulty in chewing have been suggested as important determinants of eating and nutrition in the elderly. To compensate for the loss of teeth, in particular, a majority of the elderly rely on dental prosthesis for chewing. Chewing function is indeed an important aspect of oral health, and therefore, oral rehabilitation procedures should aim to restore or maintain adequate function. However, even if the possibilities to anatomically restore lost teeth and occlusion have never been better; conventional rehabilitation procedures may still fail to optimally restore oral functions. Perhaps this is due to the lack of focus on the importance of the brain in the rehabilitation procedures. Therefore, the aim of this narrative review was to discuss the importance of maintaining or restoring optimum chewing function in the superageing population and to summarise the emerging studies on oral motor task performance and measures of cortical neuroplasticity induced by systematic training paradigms in healthy participants. Further, brain imaging studies in patients undergoing or undergone oral rehabilitation procedures will be discussed. Overall, this information is believed to enhance the understanding and develop better rehabilitative strategies to exploit training-induced cortical neuroplasticity in individuals affected by impaired oral motor coordination and function. Training or relearning of oral motor tasks could be important to optimise masticatory performance in dental prosthesis users and may represent a much-needed paradigm shift in the approach to oral rehabilitation procedures.
-
2.
Salivary secretion in health and disease.
Pedersen, AML, Sørensen, CE, Proctor, GB, Carpenter, GH, Ekström, J
Journal of oral rehabilitation. 2018;(9):730-746
Abstract
Saliva is a complex fluid produced by 3 pairs of major salivary glands and by hundreds of minor salivary glands. It comprises a large variety of constituents and physicochemical properties, which are important for the maintenance of oral health. Saliva not only protects the teeth and the oropharyngeal mucosa, it also facilitates articulation of speech, and is imperative for mastication and swallowing. Furthermore, saliva plays an important role in maintaining a balanced microbiota. Thus, the multiple functions provided by saliva are essential for proper protection and functioning of the body as a whole and for the general health. A large number of diseases and medications can affect salivary secretion through different mechanisms, leading to salivary gland dysfunction and associated oral problems, including xerostomia, dental caries and fungal infections. The first part of this review article provides an updated insight into our understanding of salivary gland structure, the neural regulation of salivary gland secretion, the mechanisms underlying the formation of saliva, the various functions of saliva and factors that influence salivary secretion under normal physiological conditions. The second part focuses on how various diseases and medical treatment including commonly prescribed medications and cancer therapies can affect salivary gland structure and function. We also provide a brief insight into how to diagnose salivary gland dysfunction.
-
3.
[Radiation-associated changes in salivation of patients with cancer of maxillofacial region].
Bykov, IM, Izhnina, EV, Kochurova, EV, Lapina, NV
Stomatologiia. 2018;(1):67-70
Abstract
The radiation has an antitumor effect and causes radiation reactions and damage to surrounding tissues within the framework of combined antitumor treatment of patients with cancer of maxillofacial region. It also has an irreversible effect on the production of saliva by large and small salivary glands, and this must be taken into account when planning radiation therapy for this group of patients.
-
4.
Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis.
Sroussi, HY, Epstein, JB, Bensadoun, RJ, Saunders, DP, Lalla, RV, Migliorati, CA, Heaivilin, N, Zumsteg, ZS
Cancer medicine. 2017;(12):2918-2931
Abstract
Patients undergoing radiation therapy for the head and neck are susceptible to a significant and often abrupt deterioration in their oral health. The oral morbidities of radiation therapy include but are not limited to an increased susceptibility to dental caries and periodontal disease. They also include profound and often permanent functional and sensory changes involving the oral soft tissue. These changes range from oral mucositis experienced during and soon after treatment, mucosal opportunistic infections, neurosensory disorders, and tissue fibrosis. Many of the oral soft tissue changes following radiation therapy are difficult challenges to the patients and their caregivers and require life-long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. We discuss the presentation, prognosis, and management strategies of the dental structure and oral soft tissue morbidities resulting from the administration of therapeutic radiation in head and neck patient. A case for a collaborative and integrated multidisciplinary approach to the management of these patients is made, with specific recommendation to include knowledgeable and experienced oral health care professionals in the treatment team.
-
5.
Age-related changes in mastication.
Peyron, MA, Woda, A, Bourdiol, P, Hennequin, M
Journal of oral rehabilitation. 2017;(4):299-312
Abstract
The paper reviews human mastication, focusing on its age-related changes. The first part describes mastication adaptation in young healthy individuals. Adaptation to obtain a food bolus ready to be swallowed relies on variations in number of cycles, muscle strength and volume of emitted saliva. As a result, the food bolus displays granulometric and rheological properties, the values of which are maintained within the adaptive range of deglutition. The second part concerns healthy ageing. Some mastication parameters are slightly modified by age, but ageing itself does not impair mastication, as the adaptation possibilities remain operant. The third part reports on very aged subjects, who display frequent systemic or local diseases. Local and/or general diseases such as tooth loss, salivary defect, or motor impairment are then indistinguishably superimposed on the effects of very old age. The resulting impaired function increases the risk of aspiration and choking. Lastly, the consequences for eating behaviour and nutrition are evoked.
-
6.
The influence of oral processing, food perception and social aspects on food consumption: a review.
Pereira, LJ, van der Bilt, A
Journal of oral rehabilitation. 2016;(8):630-48
Abstract
Eating is an essential activity to get energy and necessary nutrients for living. While chewing, the food is broken down by the teeth and dissolved by saliva. Taste, flavour and texture are perceived during chewing and will contribute to the appreciation of the food. The senses of taste and smell play an important role in selecting nutritive food instead of toxic substances. Also visual information of a food product is essential in the choice and the acceptance of food products, whereas auditory information obtained during the chewing of crispy products will provide information on whether a product is fresh or stale. Food perception does not just depend on one individual sense, but appears to be the result from multisensory integration of unimodal signals. Large differences in oral physiology parameters exist among individuals, which may lead to differences in food perception. Knowledge of the interplay between mastication and sensory experience for groups of individuals is important for the food industry to control quality and acceptability of their products. Environment factors during eating, like TV watching or electronic media use, may also play a role in food perception and the amount of food ingested. Distraction during eating a meal may lead to disregard about satiety and fullness feelings and thus to an increased risk of obesity. Genetic and social/cultural aspects seem to play an important role in taste sensitivity and food preference. Males generally show larger bite size, larger chewing power and a faster chewing rhythm than females. The size of swallowed particles seems to be larger for obese individuals, although there is no evidence until now of an 'obese chewing style'. Elderly people tend to have fewer teeth and consequently a less good masticatory performance, which may lead to lower intakes of raw food and dietary fibre. The influence of impaired mastication on food selection is still controversial, but it is likely that it may at least cause adaptation in food choice. Systemic conditions, such as high blood pressure, diabetes and cancer, with or without medicine use, tend to be associated with taste and chewing alterations. However, definite conclusions seem hard to reach, as research protocols vary largely.
-
7.
World Workshop on Oral Medicine VI: clinical implications of medication-induced salivary gland dysfunction.
Aliko, A, Wolff, A, Dawes, C, Aframian, D, Proctor, G, Ekström, J, Narayana, N, Villa, A, Sia, YW, Joshi, RK, et al
Oral surgery, oral medicine, oral pathology and oral radiology. 2015;(2):185-206
Abstract
OBJECTIVE This study aimed to systematically review the available literature on the clinical implications of medication-induced salivary gland dysfunction (MISGD). STUDY DESIGN The systematic review was performed using PubMed, Embase, and Web of Science (through June 2013). Studies were assessed for degree of relevance and strength of evidence, based on whether clinical implications of MISGD were the primary study outcomes, as well as on the appropriateness of study design and sample size. RESULTS For most purported xerogenic medications, xerostomia was the most frequent adverse effect. In the majority of the 129 reviewed papers, it was not documented whether xerostomia was accompanied by decreased salivary flow. Incidence and prevalence of medication-induced xerostomia varied widely and was often associated with number and dose of medications. Xerostomia was most frequently reported to be mild-to-moderate in severity. Its onset occurred usually in the first weeks of treatment. There was selected evidence that medication-induced xerostomia occurs more frequently in women and older adults and that MISGD may be associated with other clinical implications, such as caries or oral mucosal alterations. CONCLUSIONS The systematic review showed that MISGD constitutes a significant burden in many patients and may be associated with important negative implications for oral health.
-
8.
Sialometry: aspects of clinical interest.
Falcão, DP, da Mota, LM, Pires, AL, Bezerra, AC
Revista brasileira de reumatologia. 2013;(6):525-31
Abstract
Whole saliva is a multiglandular secretion complex consisting of gingival fluid, desquamated epithelial cells, microorganisms, products of bacterial metabolism, food debris, leukocytes mucus from the nasal cavity and the pharynx. Saliva has many functions, including tissue repair, tamponage, protection, digestion, taste, antimicrobial action, maintaining tooth integrity and antioxidant defense system. A decrease in salivary flow (hyposalivation) is a common disorder and it is estimated that approximately 20% of the general population have this alteration. Hyposalivation may be due to diabetes mellitus, hypothyroidism, dehydration, impaired glandular parenchyma by infectious processes, granulomatous diseases or autoimmune and inflammatory conditions (such as Sjogren's syndrome and rheumatoid arthritis), radiotherapy of head and/or neck region, or it may be associated with mood disorders, adverse effects caused by the use of some medications or even be idiopathic. Conventional therapies for the treatment of reduced saliva flow with the use of chemical and gustatory secretagogues are still limited. However, new alternatives have shown great perspective in the treatment of this disorder. To diagnose a patient as having chronic hyposalivation is a challenge in clinical practice and methods of salivary flow assessment are little known by rheumatologists. The serial evaluation of salivary flow is important for the diagnosis and prognosis of certain oral and systemic conditions. This review addresses some aspects related to the role of saliva, the consequences of hyposalivation and methods of salivary flow rate measurement, useful concepts in the daily practice of rheumatology.
-
9.
The secretion, components, and properties of saliva.
Carpenter, GH
Annual review of food science and technology. 2013;:267-76
Abstract
Saliva has one of the most difficult roles to perform in the body. It must facilitate the taste and detection of foods nutritious to the body but also defend the mucosa from infection by the ever-present microbiota present in the mouth. It achieves these roles by having a complex composition and versatile physical properties. The protein and ion components make a solution that is 99% water into a viscoelastic solution capable of many roles, such as acting as a lubricant and an antimicrobial, preventing the dissolution of teeth, aiding digestion, and facilitating taste. This review describes the neural regulation of salivary secretion in terms of fluid, protein, and ion secretion. It then describes some of the components and physical properties of saliva and attempts to relate them to the functions that saliva must perform.
-
10.
The roles of salivary secretion, brain-gut peptides, and oral hygiene in obesity.
Ueda, H, Yagi, T, Amitani, H, Asakawa, A, Ikeda, S, Miyawaki, S, Inui, A
Obesity research & clinical practice. 2013;(5):e321-9
Abstract
Obesity has a prevalence of 15-30% among European and American populations. It is an incurable chronic disease associated with considerable mortality and co-morbidity. The co-morbidity risk can be reduced substantially by a moderate weight loss of 5-15%. Notably, additional weight gain exacerbates the morbidity of any concurrent disease. Obesity is also recognized as the basis for metabolic syndrome. Recent research has shown that adipocytes secrete various hormones and cytokines that contribute to obesity. Leptin is an adipostatic hormone that acts on receptors in the hypothalamus to suppress food intake and increase energy consumption. Reduced sensitivity to this molecule can trigger the onset of obesity. Neuropeptides such as leptin also affect salivary secretion. Various neuropeptides have been identified in saliva; the associated receptors are located in the salivary glands or in the nerves innervating the salivary glands. Obesity is associated with hyposalivation and thereby related to several aspects of oral health, such as caries and periodontitis. Hyposalivation is a severe morbidity that can lead to a precipitous decline in oral hygiene, which further leads to multifocal dental caries and periodontitis, or even cardiac disorders. In this article, we review the relationship between salivary secretion and neuropeptides known to play a role in obesity.