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Size Control Of Carbon Spherical Shells For Sensitive Detection Of Paracetamol In Sweat, Saliva, And Urine
The chronic sensation of a dry mouth is a disease condition called xerostomia and affects a large part of the population. Xerostomia is associated with decreased secretion, or more often, qualitative changes in saliva proteins and immunoglobulin concentrations that develop as a result of salivary gland dysfunction. Several reasons causing dry mouth were described, and usually, they include taking medications, diseases or radiotherapy. In some situations, when it is difficult to use salivary stimulants or salivary gland damage is irreversible, the only option might seem to be saliva substitutes. The paper presents the most important aspects considering saliva preparations. The rheological and lubricating properties and the reconstruction of the complex saliva structure has been the main purpose of research. The biological properties of saliva preparations were also widely discussed. As part of the work, the antimicrobial effect of three commercial saliva preparations was tested. Finally, inadequate antimicrobial properties against the strains isolated from the oral cavity were demonstrated. The development of salivary substitutes, in particular, the improvement of antimicrobial properties, can be achieved using nanotechnology, including drug delivery systems containing nanocarriers.
Most people who have been upset, anxious or under stress have experienced a dry mouth. This is a subjective feeling of reduced secretion of saliva in the mouth, associated not only with its amount but rather regarding quantitative and qualitative changes in saliva composition. The feeling of dry and cracked lips, sticky and viscous saliva, altered taste and smell, difficulty talking, problems with chewing, tooth caries and their increased erosion, heartburn and reflux exacerbation, oesophagitis, burning tongue, festering and irritating mucous membrane infections are the consequences of salivary gland dysfunction [1].
Living with reduced saliva secretion is not only difficult but also leads to serious health problems such as xerostomia. In such situations, therapeutic methods for stimulation of saliva secretion are used. However, in some cases, salivary gland damage requires continuous use of saliva substitutes [2, 3, 4]. The main purpose of this review was an analysis of the most important aspects concerning saliva preparations due to its microbial, rheological and lubrication properties.
Hyperglycemia And Xerostomia Are Key Determinants Of Tooth Decay In Type 1 Diabetic Mice
The chronic sensation of dry mouth leads to a disease entity called xerostomia. The number of undesirable factors affecting salivary glands, people suffering from stress, exposed to many diseases, and aging can make xerostomia a global problem. In prospective population studies [5] (n = 2942, adults aged 20–59), it was shown that regular xerostomia symptoms concern about 3.8%, while irregular, 12.2% of the population. In studies of older people [6] (n = 600, over 70 years of age) in Japan, the hyposalivation problem was observed in 37.3% of patients (27.8% in men and 47.3% in women). In other studies, Cardoso et al. [7] found that 45.5% of disease-free oropharyngeal cancer survivors (n = 906) reported problems with dry mouth. Rising interest in xerostomia and methods of its treatment, especially using artificial saliva, is currently observed. This is clearly visible in the bibliometric data (Figure 1), according to the Web of Science database. The term “xerostomia” in years 2000–2018 was found in 3671 publications, which were quoted more than 70, 000 times, while the term “artificial saliva” related to 2757 publications, which were cited about 37, 000 times.
Interestingly, patients complaining of dry mouth sometimes do not show any objective symptoms of hyposalivation. The diagnosis of xerostomia requires a detailed medical history, which includes a detailed description of the symptoms (patients most often complain of dry mouth, difficulty in swallowing and speaking, do not tolerate acute and acidic taste), diseases and the use of medicines. Nevertheless, the measurement of salivary flow is the basis for the diagnosis of xerostomia. However, it can be a problem to determine the amount of saliva that is indicative of the dysfunction of the salivary glands [8].
The term saliva, by default, refers to the terms "whole saliva" or "mixed saliva", which are used to describe the combined fluids present in the oral cavity. Measurement of its quantity is a good method to determine the degree of dryness of the mouth, while the measurement of salivary secretion from specific salivary gland allows determination of its individual efficiency [1].
Factors Contributing To Interindividual Variation In Retronasal Odor Perception From Aroma Glycosides: The Role Of Odorant Sensory Detection Threshold, Oral Microbiota, And Hydrolysis In Saliva
Saliva can be classified as resting (unstimulated) and stimulated. A main protective function of oral tissues is ascribed to resting saliva since it is present in the oral cavity for about 14 h a day. Stimulated saliva is secreted in the mouth for about 2 h a day, and its role is mainly related to alimentary functions. The average daily flow of whole saliva varies in health between 1 and 1.5 L. The unstimulated saliva flow rate is in the range of 0.3–0.7 mL per minute. Mechanical, chemical or psychoneurological stimulation increases the flow rate to 1.5–2 mL per minute [1]. Hyposalivation is observed when resting salivary flow rate decreases below 0.1 mL per minute and stimulated saliva below 0.5–0.7 mL per minute [1, 9, 10]. The salivary flow rate is usually measured 5 min after waking up or 2 h after the last meal. Unstimulated saliva flow is measured in a sitting position for 15 min, collecting saliva from the lower lip. Saliva can also be collected with cotton rolls, placed near the salivary glands (the differences in the weight of the rolls before and after the test should be taken into account). Another way is to use special, calibrated absorbent straps placed on the floor of the mouth. Stimulated saliva is collected after chewing gum or paraffin wax by the patient, or stimulation with 2% citric acid solution (placed on the sides of the tongue) [11]. The secretion of the parotid gland is usually collected by means of a suction device and a cup (Lashley or Carlson-Crittenden cup) placed over the Stensen duct [12]. In a similar way, the flow from the submandibular gland can be examined by isolating the Wharton’s duct [13]. There are also flow measurement systems from smaller salivary glands, including, for example, the use of micropipettes and filter papers [14].
There are many factors that can cause xerostomia [15]. The main reason is taking medication, especially from the anticholinergic [16, 17, 18], sympathomimetic [19, 20, 21, 22] and antihypertensive [23] groups. Some opioids, benzodiazepines [24, 25] and anti-migraine agents [26] may also contribute to salivary disorders. The second main cause are diseases like Sjogren’s syndrome [27, 28], diabetes [29, 30, 31], depression [32, 33], anemia [34], bulimia [35] and genetic disorders (i.e., Down syndrome [36], Prader–Willi syndrome [37]). Problems with the dry mouth were also observed in alcoholics [38], cigarette smokers [39] and drug addicts [40, 41, 42, 43]. The third main cause is radiation therapy of patients that develop cancer in head and neck area [44, 45, 46, 47]. Irradiation causes degeneration of the salivary glands tissue causing reduction of saliva secretion. However, patient response to radiotherapy is individual and depends on the radiation dose and treatment area. In effect, the application of this therapy might provide to the short-term dryness or leads to a complete lack of saliva production.
Another factor associated with reduced salivation is aging. Research carried out in different age groups, clearly indicate the prevalence of problems with the secretion of saliva in elderly people [48, 49]. However, it correlates with the more frequent taking of medicines due to the occurrence of diseases. On the other hand, some authors [50, 51] indicate a lack of significant differences in salivary secretion between young and elderly (both healthy and non-medicated) people. On the other hand, it is known that the composition of saliva changes in the elderly age—especially the differences were observed with regards to the level of sodium and potassium ions, proline-rich proteins, IgA, lactoferrin, and lysozyme [52, 53]. In addition, some drugs such as anticholinergics cause more salivary problems in the elderly than in young people [50]. Similar observations are reported in the case of the influence of diseases on the secretion of saliva among people of all ages [51]. Considering all these factors, the problem with salivary secretion in
Meeting The Moment: Addressing Barriers And Facilitating Clinical Adoption Of Artificial Intelligence In Medical Diagnosis
Saliva can be classified as resting (unstimulated) and stimulated. A main protective function of oral tissues is ascribed to resting saliva since it is present in the oral cavity for about 14 h a day. Stimulated saliva is secreted in the mouth for about 2 h a day, and its role is mainly related to alimentary functions. The average daily flow of whole saliva varies in health between 1 and 1.5 L. The unstimulated saliva flow rate is in the range of 0.3–0.7 mL per minute. Mechanical, chemical or psychoneurological stimulation increases the flow rate to 1.5–2 mL per minute [1]. Hyposalivation is observed when resting salivary flow rate decreases below 0.1 mL per minute and stimulated saliva below 0.5–0.7 mL per minute [1, 9, 10]. The salivary flow rate is usually measured 5 min after waking up or 2 h after the last meal. Unstimulated saliva flow is measured in a sitting position for 15 min, collecting saliva from the lower lip. Saliva can also be collected with cotton rolls, placed near the salivary glands (the differences in the weight of the rolls before and after the test should be taken into account). Another way is to use special, calibrated absorbent straps placed on the floor of the mouth. Stimulated saliva is collected after chewing gum or paraffin wax by the patient, or stimulation with 2% citric acid solution (placed on the sides of the tongue) [11]. The secretion of the parotid gland is usually collected by means of a suction device and a cup (Lashley or Carlson-Crittenden cup) placed over the Stensen duct [12]. In a similar way, the flow from the submandibular gland can be examined by isolating the Wharton’s duct [13]. There are also flow measurement systems from smaller salivary glands, including, for example, the use of micropipettes and filter papers [14].
There are many factors that can cause xerostomia [15]. The main reason is taking medication, especially from the anticholinergic [16, 17, 18], sympathomimetic [19, 20, 21, 22] and antihypertensive [23] groups. Some opioids, benzodiazepines [24, 25] and anti-migraine agents [26] may also contribute to salivary disorders. The second main cause are diseases like Sjogren’s syndrome [27, 28], diabetes [29, 30, 31], depression [32, 33], anemia [34], bulimia [35] and genetic disorders (i.e., Down syndrome [36], Prader–Willi syndrome [37]). Problems with the dry mouth were also observed in alcoholics [38], cigarette smokers [39] and drug addicts [40, 41, 42, 43]. The third main cause is radiation therapy of patients that develop cancer in head and neck area [44, 45, 46, 47]. Irradiation causes degeneration of the salivary glands tissue causing reduction of saliva secretion. However, patient response to radiotherapy is individual and depends on the radiation dose and treatment area. In effect, the application of this therapy might provide to the short-term dryness or leads to a complete lack of saliva production.
Another factor associated with reduced salivation is aging. Research carried out in different age groups, clearly indicate the prevalence of problems with the secretion of saliva in elderly people [48, 49]. However, it correlates with the more frequent taking of medicines due to the occurrence of diseases. On the other hand, some authors [50, 51] indicate a lack of significant differences in salivary secretion between young and elderly (both healthy and non-medicated) people. On the other hand, it is known that the composition of saliva changes in the elderly age—especially the differences were observed with regards to the level of sodium and potassium ions, proline-rich proteins, IgA, lactoferrin, and lysozyme [52, 53]. In addition, some drugs such as anticholinergics cause more salivary problems in the elderly than in young people [50]. Similar observations are reported in the case of the influence of diseases on the secretion of saliva among people of all ages [51]. Considering all these factors, the problem with salivary secretion in
