Objective To assess human unstimulated whole saliva components during pregnancy, to determine the relation, if any, between pregnancy and oral health, particularly total protein concentration, a-amylase activity, sialic acid content and calcium and phosphate concentrations were evaluated.Design Cross-sectional study. Participants Forty-five healthy primigravid women; 1 5 nonpregnant women acted as controls. Results 1. A higher total protein content at 10 and 21 weeks of gestation with respect to the controls and to pregnant women at 40 weeks; 2. a higher a-amylase activity at 10 and 21 weeks of gestation compared with the controls and to pregnant women at 40 weeks; 3. an increased sialic acid content at 21 and 40 weeks; 4. decreased calcium and phosphorus concentrations at 21 and 40 weeks of gestation.Conclusions Pregnancy modifies saliva composition. This could play a pivotal role in the incidence of pregnancy-induced dental caries. INTRODUCTIONFemale steroid sex hormones influence oral health through different mechanisms. Gingival tissue is affected by hormonal changes during puberty and pregnancy, as shown by more pronounced subclinical signs of gingivial inflammation during the ovulatory phase of the menstrual cycle and by the worsening of pre-existing gingivitis during human pregnancy. Pregnancy induces an increased response of the gingival tissues to local factors, such as plaque and tartar, through disturbance of tissue metabolism4.Besides the direct effect on tissue metabolism, pregnancy and the menstrual cycle alter the composition of human saliva, as a response to the changed steroid hormone levels. Many human studies have indicated that hormones influence the composition of female saliva, particularly at the time of ovulation. Correlation has been found between the ovulatory status of women and the phosphate level5. A cyclic variation has been also observed in sialic acid, glucose and some salivary electrolytesG8. Saliva plays a critical role in the maintenance of oral health, as it contains many innate and acquired factors with a protective role on oral tissue^^.^^. rate have been reported, and changes in salivary electrolyte levels and IgA concentration have been A decrease in salivary HC03 during pregnancy has been related to the effect of progesterone in lowering plasma bicarbonate con~entration'~.'~. D'Alessandro et al. l6 have suggested a relation between the protein changes in parotid saliva and the hormonal modifications during pregnancy. Secretory proteins are produced by many salivary cell types and salivary total protein content could reflect general exocrine capacity". Many salivary proteins have enzymatic functions, such as a-amylase, which represents the major component of the parotid secretion and is also present in the submandibular fluid, representing about 50% of total proteins.Laine et al. I4 did not find significant changes in salivary amylase, lysozyme or peroxidase activities during pregnancy. Furthermore, the whole saliva levels of thiocyanate, hypothiocyanite, lactoferrin, to...
Patients with problems related to central nervous system dysfunctions are often treated with psychotropic drugs. These include antipsychotics, antidepressants, mood stabilizers, anticonvulsants, and drugs blocking specific receptors in the brain such as anticholinergics or beta-blockers. However, these medications have serious side effects affecting the oral health. In addition, many dental patients make use of psychoactive drugs, such as amphetamine, ecstasy, and cocaine. This article aims to review data on the psychotropic drugs being used in the last 30 years, their pharmacological profile, with special attention to the side effects related to the oral health. Oral diseases such as bruxism, orofacial dystonia, oromandibular dyskinesia, and rabbit syndrome are related to extrapyramidal effects of antipsychotic drugs because of their antagonist activity on the dopaminergic receptors. Drugs with anticholinergic and/or antiadrenergic effects such as tricyclic antidepressants may cause dry mouth and related complications such as candidiasis and other oral infections. Among mood stabilizers, lithium treatment induces a wide range of side effects on oral system including dry mouth, sialorrhea, infections, and ulceration of the oral cavity. Psychostimulants may instead provoke xerotomia, gingival enlargements, bruxism, dental erosion, mucosal ulceration, and oral/nasal lesions. This literature review supports the idea that the higher prevalence of oral diseases among patients with mental disorders may be attributed to the side effects of their medications mediated by complex interactions between different targeted receptors. Thus, dentists must be aware of the possible risks of these medications in order to take appropriate precautions in treating these patients.
Oral diseases have been adversely associated with cardiovascular diseases (CVD), which are also the most frequent cause of death in older population. The aim of this study was to investigate the association among oral status indexes and CVD in patients aged more than 65 years attending in the Oral department of a public hospital Policlinico Umberto 1 of Rome. The study population consisted of 533 patients. Dental status was detected measuring the Decayed, Missing, and Filled Teeth (DMFT) and Community Periodontal Index (CPI) indexes. The chi-square test with a 95% confidence level was used to assess qualitative variables. Odds ratios (ORs) and stepwise logistic regression were used to calculate risk estimates; the independent variables: age, gender, DMFT, CPI index, Geriatric Oral Health Assessment Index (GOHAI) score, and tooth loss were included in the statistical model. P value <0.05 was considered a statistically significant cut-off. No differences were found between females and males for DMFT and CPI. GOHAI data were worst for females. Patients with CVD had less education and oral care (P < 0.05), and higher CPI index and number of missing teeth (P < 0.05). Data show that patients with more than 18 missing teeth have 2.5 times greater risk of CVD. CVDs are associated with type 2 diabetes mellitus, underweight, and obesity (P < 0.05). From the findings of this study, it can be confirmed a significant link between CVD and oral health. A cooperation among geriatrician, cardiologist, and dentist is suitable to counteract the development of CVD and to early identify patients at risk of CVD.
Liposomes are prepared from rat brain microsomal lipid and loaded with either Tb3+ or dipicolinic acid (DPA) to test fusion with the Tb-DPA assay. They are also loaded with octadecyl Rhodamine B chloride (R18) to test fusion with the R18 assay. The addition of either Ca2+ or Mg2+ to loaded liposomes develops fluorescence with both assays. The fluorescence elicited by Mg2+ is similar to that elicited by Ca2+ if assessed with R18, but much higher if determined by Tb-DPA. The Ca2(+)-dependent fluorescence of the Tb-DPA complex is not suppressed by the addition of EDTA, and therefore it is internal to vesicles. The contrary is true for the Mg2(+)-dependent fluorescence. Rat brain microsomes can be disrupted by adding octylgucoside and reconstituted by removing it by dialysis. We use this procedure to load microsomes with DPA. This allows the use of the Tb-DPA assay for testing the fusion of rat brain microsomes. Reconstituted microsomes fuse with liposomes. This fusion has characteristics similar to those of liposome-liposome fusion. However, no microsome-microsome fusion could be detected with either method. The two methods give different results, owing to the chemical properties of the assays. Indeed Tb-DPA implies the retention of vesicle content, whereas this is not required by the R18 assay.
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