To determine xerostomia-related frequency, factors, salivary flow rates and Oral Health-Related Quality of Life (OHRQoL) of patients attending the Universidad Andres Bello Dental School Clinic, in the city of Vina del Mar, Chile. The study involved 566 patients assessed with xerostomia, based on a single standardized questionnaire. The severity and impact of xerostomia on OHRQoL was assessed using a visual analogue scale (VAS) and the short version of the Oral Health Impact Profile Questionnaire (OHIP-14sp), respectively. Stimulated and non-stimulated salivary flow rates were obtained from a sample of patients. Xerostomia was reported in 61 patients (10.8%), comprising 50 women (83.3%) and 11 men (16.7%) (p < 0.013). The prevalence was 13% among the women and 6.1% among the men. Gender, age and medication were found to be independent risk factors for the development of xerostomia. Hyposalivation was found in 10 of the 35 patients with xerostomia (28.6%) and in 2 patients without it (p < 0.011). Patients with xerostomia had a reduced OHRQoL, compared with patients without xerostomia, as shown by the total OHIP-14sp score (p < 0.001). Xerostomia was a common, potentially debilitating condition with a major impact on the OHRQoL of a patient population attending a university-based dental clinic. Hyposalivation was present in almost 30% of the patients who complained of xerostomia. It is important that general dentists be aware of this condition, so that they can provide patients with a good diagnosis, treatment and follow-up.

/pdf/risk-factors-hyposalivation-and-impact-of-xerostomia-on-oral-48qxg5cgn2.pdf

Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life

Diminished Progression of Periapical Lesions with Zoledronic Acid in Ovariectomized Rats

Background & Objective: Menopause leads to physiological changes that take place due to decreased production of estrogen by ovary in women. The study was carried out to know the effect of menopause on saliva by evaluating the salivary flow rate and pH of stimulated saliva and to assess relation among oral diseases and the regularly menstruating women and post-menopausal women.
Method: The study was conducted on 40 healthy post-menopausal women and pre-menopausal women (controls) respectively, who attended private clinic. Data were collected through a questionnaire and oral examination. Samples of the saliva from control group were collected within the first 3 days of menstruation. A standard size paraffin wax was chewed by participants. The salivary secretion during the first one min was swallowed; and next five minute secretion was spat into graduated test tubes. Electrometrically, digital pH meter (Model me 962-P) and pH electrode was used to measure salivary pH and salivary flow rate was measured as ml/min.
Results: A notable decrease in the salivary pH and salivary flow rate, which could be credited to the high values of DMFT and OHI-S in both groups. Our study also shows significant difference in physiological changes and DMFT, OHI-S, PI and GI score in premenopausal women and postmenopausal women.
Interpretation & Conclusion: Our result reveals that there is a distinct decrease in the salivary pH and flow rate in postmenopausal women which gives route to poor oral hygiene and more susceptibility to oral physiological changes. Therefore, with aging in females, substance of preventive dentistry increases.

Keywords: Post menopause, Salivary flow rate, Salivary pH, Oral changes

https://www.ijohd.org/journal-article-file/1962

Evaluation of the effect of menopause on saliva and dental health

Oral health is vital for the general well-being, overall body health and the quality of life throughout our lifetime. Most of the oral diseases and conditions are largely related to the maintenance of oral hygiene, lacking that people suffer from diverse oral diseases at different times in their life. With greater life expectancy, the individuals have teeth involved with periodontal diseases that would not only require professional care but also home gum care for them to last a lifetime. Indian Society of Periodontology (ISP) has recognized the need for systematic documents to update everyday clinical practice of general dental practitioners and have provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral healthcare delivery across the country. The current set of clinical practice recommendations focused to “Gum Care for All”, is aimed at emphasizing and enhancing the awareness regarding oral health promotion, maintenance, and disease prevention. Twenty-five subject matter experts from across the nation, prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three distinct sections, namely pretherapeutic, therapeutic, and post therapeutic, to provide guidance during the respective phases of patient management and may serve as a quick and concise reference to the readers. The guidelines shall provide the distinct definitions, signs and symptoms, treatment required; recall visit specifications for plausible clinical case situations, home care advice regarding maintenance of oral hygiene including information on brushing technique, care and change of brush, use of interdental aids, and mouthwashes, etc. The document should advocate and guide the combined efforts of general dentists, and the population at large toward an empowered, evidence based, integrated, and comprehensive oral health care, which shall enhance the healthful functioning and longevity of the dentition and general health of the individual.

ISP good clinical practice recommendations for gum care

Background Decreased estrogen levels in postmenopausal women may cause an increase in oral symptoms including dry mouth, burning sensation of the mouth, and taste alterations. Management of salivary gland hypofunction by various modalities had been tried with variable results and associated side effects or discomfort. Aim To evaluate the effects of transcutaneous electric nerve stimulation (TENS) on whole salivary flow rate in postmenopausal females with and without oral dryness. Methods Fifty postmenopausal women, based on their response to Xerostomia Inventory, were divided into 2 groups of 25 each; group 1 were postmenopausal women with oral dryness (PMD + OD) and group 2 were postmenopausal women without oral dryness (PMD − OD). Unstimulated whole saliva collection was done by low forced spitting method. External salivary stimulation of parotid gland by electrodes of TENS unit was done and sialometry was repeated. The salivary flow rates were compared within both groups before and after stimulation and between the two groups. Results The mean salivary flow rates at baseline were statistically significantly lower in the PMD + OD group than the PMD − OD group. There was a mean increase of 0.33 ml and 0.46 ml with TENS stimulation in PMD + OD and PMD − OD groups, respectively. Conclusion Postmenopausal women with perception of oral dryness had lower salivary flow rates. 90% of the subjects, irrespective of oral dryness status, responded to TENS therapy. TENS stimulation resulted in a statistically significant increase in the quantity of whole saliva flow rate in postmenopausal women with or without oral dryness.

Effect of TENS on stimulation of saliva in postmenopausal women with or without oral dryness - An interventional study.

Objectives: To know the nature, incidence and severity of oral manifestations occurring in postmenopausal women. Study design: Oral changes were observed in 365 postmenopausal women and 365 age matched male individuals attending the department of Oral Medicine and Radiology. The patients were asked about complaints of dry mouth, taste and breath changes, mucosal and facial pain and were examined for oral changes such as ulceration, white and red lesions. The results obtained from the study were then correlated with various other similar studies. Results: The important oral findings in postmenopausal women were mucosal burning/pain (25.8%), dry mouth (27.1%), altered taste (3.6%), altered breath (6.3%) and facial pain (3.6%). Oral submucous fibrosis (OSMF) was significantly more common in males (5.5%) as compared to postmenopausal females (1.9%). Conclusion: Results from the present study reveal that oral symptoms are common problems in postmenopausal women. Postmenopausal patients showed significantly more oral changes than the control. These changes could be related to the hormone alterations. Therefore, dentists need to refer postmenopausal women with oral symptoms to a gynaecologist for more careful examinations and medical interventions if necessary.

/pdf/oral-findings-in-postmenopausal-women-attending-dental-e4crr7wzo6.pdf

Oral Findings in Postmenopausal Women Attending Dental Hospital in Western Part of India

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry “Dentin Hypersensitivity,” based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity

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Oral Findings in Postmenopausal Women Attending Dental Hospital in Western Part of India

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity