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PubMed1993

An evaluation of the significance of mouth and hand contamination for lead absorption in lead-acid battery workers.

The present study was conducted to evaluate the role of ingestion through hand and mouth contamination in the absorption of lead in 25 lead-acid battery workers. Levels of personal exposure to airborne lead ranged from 0.004 to 2.58 mg/m3 [geometric mean 0.098, with 25% of samples exceeding threshold limit values (ACGIH) of 0.15 mg/m3]; the mean (SD) blood lead level was 48.9 (10.8) micrograms/dl. Mean hand lead contents increased 33-fold from preshift levels on Monday mornings (33.5 micrograms/500 ml) to midshift levels on Thursday afternoons (1121 micrograms/500 ml). Mouth lead contents increased 16-fold from 0.021 micrograms/50 ml on Mondays to 0.345 micrograms/50 ml on Thursdays. The typical Malay racial habit of feeding with bare hands and fingers without utensils (closely associated with mouth and hand lead levels on Mondays) explained the bulk of the variance in blood lead levels (40%), with mouth lead on Thursdays (closely associated with poor personal hygiene) explaining a further 10%. Air lead was not a significant explanatory variable. The implementation of a programme of reinforcing hand-washing and mouth-rinsing practices resulted in a reduction of the blood lead level by 11.5% 6 months later. These results indicate that parenteral intake from hand and mouth contamination is an important cause of lead absorption in lead-exposed workers.

Adolescent↗
PubMed1992

Cigarette smoking and nicotine delay postprandial mouth-cecum transit time.

The acute effects of both cigarette smoking and nicotine on postprandial mouth-cecum transit were studied in 20 habitual smokers, 10 males and 10 females. Mouth-cecum transit time was measured by the breath hydrogen technique, following ingestion of a standard mixed liquid meal. Each subject was studied on four separate occasions, either (1) sham or actively smoking two standard cigarettes, commencing 20 min after the meal, or (2) chewing two placebo or nicotine tablets over a 60-min period, commencing immediately after the meal. The time of administration of these stimuli was designed to minimize the effects on mouth-cecum transit time of alterations in gastric emptying. Mouth-cecum transit time was prolonged in response to both smoking [median and interquartile range: 120 (95, 150) min vs 100 (75, 140) min, P = 0.01] and nicotine [120 (80, 170) min vs 100 (70, 140) min, P = 0.002]. No difference was observed between sexes with respect to nicotine; the effect of smoking on mouth-cecum transit time, however, was less pronounced in females compared to males [difference active-placebo: 10 (10, 20) min vs 35 (20, 60) min, P = 0.01]. We conclude that acute cigarette smoking delays mouth-cecum transit time, an effect most likely due to nicotine.

Adult↗
PubMed1997

Arm and mouth coordination during the eating action in humans: a kinematic analysis.

The kinematic characteristics of the eating action in humans were assessed. Ten subjects were asked to bring to the mouth pieces of cheese of different sizes (0.7 cm and 2 cm). The pattern of mouth aperture with respect to the size of the food was similar to that found for grasping differently sized objects with the hand. Mouth aperture was appropriately scaled and the time of maximum aperture was reached earlier for the smaller than for the larger piece of cheese. The deceleration phase of the arm was prolonged when the small piece of cheese had to be brought to the mouth with respect to when the large piece of cheese had to be brought to the mouth. Temporal coupling between the time of maximum peak deceleration and the maximum mouth aperture was found in seven of the ten subjects. Taken together these preliminary results suggest that coordinated actions are subserved by the use of a common coordinating schema independently from the effectors involved.

Adult↗
PubMed2002

[Burning mouth].

BACKGROUND: The complaint of burning mouth is fairly common. Epidemiological studies suggest a prevalence of around 15% in postmenopausal women and between 0,7 and 7,9% for the general population. PURPOSE: The purpose of this article is to present a review of the literature on epidemiology, clinical symptoms, etiology, diagnosis, treatment and prognosis of burning mouth and burning mouth syndrome. RESULTS AND CONCLUSIONS: Potential causal factors have been extensively studied and reviewed, suggesting a multifactorial aetiology, that apparently includes local, systemic and psychogenic factors. However, reports of their relative importance are conflicting. Consequently this lack of evidence is reflected in inconsistent guidelines for diagnosis and treatment. Most of the authors emphasize the importance of history taking and clinical intraoral examination for diagnosis. The symptom of burning mouth associated with clinical mucosal abnormality has to be differentiated from burning mouth syndrome (BMS), a condition in which no mucosal abnormality is evident on examination. Whereas the symptom of burning mouth associated with clinical mucosal signs is described to be often manageable by eliminating possible causal factors, the background of most of the proposed treatments for BMS is empiric or even purely anecdotal. Only a few randomised controlled studies have been performed on treatment outcome. Their differing results are presented in a short overview.

Burning Mouth Syndrome↗
PubMed1987

Findings of mandibular movement and the position of the mandibular condyles during maximal mouth opening.

An investigation with respect to position of the mandibular condyles in relation to maximal vertical mouth opening was undertaken. For this purpose, 51 subjects of different nationalities were examined. None of the 51 persons had a TMJ disorder. The mobility of the mandible in different directions was clinically measured. With the use of two different reference lines (Methods A and B), the amount of the movement of the condyle from closed to maximal mouth opening position was measured in the sagittal plane on lateral tomograms. All of the measurements were recorded, and the means, SD, and range of variation were calculated. Statistical analysis was subsequently performed. The clinical results are comparable to those of other previous clinical studies. As seen in the lateral tomograms, the condyle in 41 out of 51 subjects moved beyond the articular eminence during maximal mouth opening. It was occasionally situated higher than the eminence. In only ten subjects, the condyle reached only the top of the articular eminence during maximal mouth opening. A moderate degree of dependency and correlation was found between maximal vertical movement of the mandible and the amount of movement of the right and left condyles from closed to maximal open position of the mouth, as seen in tomograms. None of our subjects had any sign of luxation despite the position of the condyle beyond the articular eminence with maximal mouth opening. Therefore, the diagnosis of condylar luxation cannot be established by radiologic investigation alone.

Adolescent↗
PubMed2004

Perivascular-submandibular lymph node metastasis in squamous cell carcinoma of the tongue and floor of mouth.

AIMS: The goal of this study was to investigate the incidence of occult metastasis in perivascular lymph node and nodal recurrence in these nodal pads in squamous cell carcinoma (SCC) of the tongue and floor of mouth. METHODS: We performed a prospective analysis of the incidence of an occult metastasis in the perivascular lymph nodes in 55 patients (41 with an oral tongue carcinoma and 14 with a mouth floor carcinoma) who underwent an elective supraomohyoid neck dissection (SOHND) for SCC of the tongue and floor of mouth, from 1997 to 2002. 99 SOHND procedures were performed as follows: 72 in tongue carcinomas and 27 in the mouth floor carcinomas. RESULT: Clinically occult, but pathologically positive perivascular lymph nodes occurred in four of 72 of the tongue carcinomas and two of 27 of the mouth floor carcinomas. The incidence of the regional recurrence at level I was three of 45. CONCLUSIONS: This preliminary report reveals a small incidence of perivascular lymph-node metastases and the infrequent nodal recurrence in this area after SOHND in early-staged tongue and floor of mouth SCC.

Adult↗
PubMed2004

Infant mouthing behavior: the immunocalibration hypothesis.

Avid mouthing, the propensity of infants to suck objects and put them in their mouths, is a pattern characteristic of the first 2-3 years of life, with its most intensive manifestation occurring during the first year. Although traditional accounts explain infant mouthing as a source of sensual gratification and/or environmental exploration, these proximate hypotheses are inconsistent with the high costs of mouthing, including choking, poisoning, and exposure to pathogens. We propose that mouthing serves to proactively expose the naive gastrointestinal tract to environmental antigens and commensal bacteria while under the sheltering umbrella of breastfeeding. Mouthing functions to accurately calibrate the developing immune system, including antibody production and mucosal immunity, to the local disease ecology. The critical exposure period is not open-ended, as failure to expose the gut to an adequate number of antigens early in life is associated with an increased risk of allergies, asthma, and atopy. Weaning initiates a number of immune changes that may program the neonatal immune system into certain life-long responses.

Child, Preschool↗
PubMed2005

[Normal mouth opening in the adult French population].

INTRODUCTION: Limitation of mouth opening is a frequent symptom in the pathologies of the temporomandibular joint. The aim of this study is to establish normative basis for this criterion in the French population. MATERIALS AND METHODS: Maximal mouth opening was measured by an electronic goniometric device. Measurements were taken in 228 people (110 men and 126 women) aged between 18 to 84 years, representative of the French population. RESULTS: The average mouth opening is 50.7 7 mm, but it was greater in the male population. It was also greater in tall patients and in younger patients (under 50 years). DISCUSSION: Our study is original because it is based on normal subjects and because our population sample age is the same as that of the French population. Men have a greater mouth opening than women, but this can be due to the fact that they are taller. Mouth opening is wider in young subjects, under 50, because they are younger and because they are taller. Mouth opening is wider in tall patients, whatever their sex or their age.

Adolescent↗
PubMed1998

Quantitative EEG patterns during nose versus mouth inhalation of filtered room air in young adults with and without self-reported chemical odor intolerances.

Individuals who report illness (e.g. nausea, headache) from common chemical odors tend to report CNS symptoms suggestive of olfactory-limbic system involvement. This study compared the resting quantitative electroencephalographic (qEEG) patterns of young adult college students reporting subjectively elevated chemical odor intolerance ratings (HICI) with those of controls reporting little or no odor intolerance (LOCI). Each group was subdivided into those with higher (HIDEP) vs. lower (LODEP) ratings of concomitant depression. Nineteen channels of EEG were recorded during a single session over four separate rest periods, respectively, following baseline, cognitive, chemical exposure and olfactory identification tests. Each recording involved two 30-s, eyes-closed, filtered room air breathing conditions: (1) nose inhalation followed by mouth exhalation and (2) mouth inhalation followed by mouth exhalation. HICI showed significantly less beta 1 (beta 1) over the temporal-central region during nose than during mouth inhalation. Over some temporal and central leads, task, DEP and CI interacted to influence beta 1 as well. For theta (theta), CI differences emerged during nose inhalation after the cognitive task at Cz, after chemical exposures at C3, Cz and C4 and after the olfactory ID task at C4. CI differences emerged during mouth breathing after the olfactory ID task at Cz, C4 and T4. The T5-T6 coronal array showed significant CI differences after chemical exposures during nose breathing and during mouth breathing after the cognitive and olfactory ID tasks. The theta findings in the HICI may be related to reports of disturbed attention in CI.

Adolescent↗
PubMed1998

Control of the contamination of pig carcasses by Escherichia coli from their mouths.

Swab samples from the mouths of 40 pig carcasses all yielded Escherichia coli, at estimated log mean numbers of 2.3 per sample. Single colonies of E. coli O157:H7 were isolated from two, and single colonies of other verotoxigenic strains of E. coli from a further two of those samples. E. coli from the mouth were deposited on the surfaces of carcasses during usual, commercial carcass dressing operations for cutting open the throat and the floor of the mouth, and freeing the tongue. After those operations had been performed, E. coli were recovered from a neck site on 45 of 50 carcasses which were sampled by swabbing that site. When 50 carcasses on which those operations had been performed were pasteurized, the log mean numbers of total aerobic counts recovered from the neck site on carcasses were reduced by two as compared with the unpasteurized carcasses, and only one E. coli was recovered from those carcasses. Pasteurization bleached the small areas of cut muscle exposed during the operations on the mouth and throat, but apparently had no other effect on the appearance of the carcasses. It is suggested that pasteurization of pig carcasses after operating on and regulatory inspection of the mouth and throat may be a commercially viable approach to reducing the contamination of pork with pathogens from the mouths of carcasses.

Animals↗
PubMed1998

An open-label, dose escalation pilot study of the effect of clonazepam in burning mouth syndrome.

OBJECTIVE: Current treatment for burning mouth syndrome is usually directed at correction of detected organic causes or is empiric, and it often involves the use of tricyclic antidepressants. Recently, there has been renewed interest in the use of benzodiazepines for burning mouth syndrome. The present study was designed to assess the effect of clonazepam in burning mouth syndrome. STUDY DESIGN: Thirty patients, each with a chief complaint of mouth burning without oral mucosal lesions, were entered into the study. All patients underwent routine blood screens. Identified abnormalities were corrected, when possible, before clonazepam was prescribed. The starting dose was 0.25 mg daily, with an increase in dose of 0.25 mg on a weekly basis if symptoms continued. RESULTS: The subject population consisted of 29 women and 1 man. All subjects had been symptomatic (average premorbid burning intensity, 7.0 +/- 1.9 on 10-point scale) for 1 month to 12 years (mean, 3.9 +/- 3.4 years; median, 2.75 years), and 16% had had burning for more than 2 years. Three groups of patients were identified: those who experienced partial to complete relief with clonazepam and who were using the medication at the last follow-up (group 1; 43%); those who found the clonazepam helpful but withdrew from the medication because of side effects--usually drowsiness (group 2; 27%); and those who did not benefit from clonazepam (group 3; 30%). Among the 3 groups, age was found to be significantly lower for group 1 than for group 2 but not significantly lower for group 1 than for group 3. Although the difference did not reach significance, the mean dose of clonazepam appeared lower for group 1 patients than for the other 2 patient groups. The number of patients with burning for less than 2 years was larger in group 1 than in the other groups. CONCLUSIONS: The results suggest that clonazepam may be helpful in burning mouth syndrome, inasmuch as 70% of patients (groups 1 and 2) experienced pain reduction with effects at low doses. These findings suggest that the mechanism of action of clonazepam may be specific and separate from the anxiolytic effect of the benzodiazepines and that clonazepam may represent a useful therapy in a subset of patients with burning mouth syndrome. Double-blind, placebo-controlled trials are warranted.

Aged↗
PubMed2003

Evaluation of tumour markers in patients with burning mouth syndrome.

Burning mouth syndrome (BMS) is an enigmatous condition both for the patient and the clinician, and is diagnosed on the basis of the patient's symptoms when they have on examination an apparently healthy looking oral mucosa. A variety of local and systemic factors are known to contribute to burning mouth syndrome. Some authors reported that underlying malignancy could be a possible cause for BMS. In 23 patients with burning mouth syndrome as well as in 20 age, sex, and race matched healthy controls levels of tumour markers-CEA, CA 19-9, AFP, and CYFRA 21-1-were determined from sera. Immunoradiometric assay (IRMA) for detection of ELSA-CEA, ELSA-CA 19-9, ELSA 2-AFP, ELSA-CYFRA 21-1 (CIS bio international, ORIS group, France) was used. Statistical analysis showed no significant differences in the level of tumour markers CEA, CA 19-9, AFP, CYFRA 21-1 in patients with burning mouth syndrome when compared to the healthy controls. We can conclude that evaluation of tumour markers in patients with burning mouth syndrome is not useful and in terms of cost-benefit this investigation should not be performed in patients with burning mouth syndrome.

Aged↗
PubMed2003

Respiratory muscle electromyogram and mouth pressure during isometric contraction.

When extra-diaphragmatic muscles are activated progressively under approximately isometric conditions, we expect a corresponding increase in respiratory muscle output. Therefore, we examined relative recruitment shown as the latency to onset of EMG activity, and the relationship between mouth pressure and electromyogram activity of the neck accessory and transversus abdominis (TRANS) muscles during respiratory maneuvers against occlusion. Fine wire electrodes were inserted into the scalene (SCLN), sternocleidomastoid (STERNO), trapezius (TRAPZ) and TRANS in six awake, healthy subjects. Mouth pressure, raw and moving average EMG signals were recorded during gradual production of expiratory or inspiratory mouth pressure to maximum (MPmax) at FRC in the standing posture. Group mean linear regression lines of EMG activity versus mouth pressure were strongly significant for SCLN and TRANS, less for STERNO, and least for TRAPZ. The SCLN and STERNO showed EMG activities with low, and TRAPZ showed EMG activity only with high, mouth pressure. At 90% MPmax, TRAPZ was much less active compared with TRANS, SCLN, or STERNO. These results suggest that over a wide range of respiratory effort there is a significant difference in the relationship between mouth pressure and EMG activity in the accessory muscles, with differential recruitment of individual respiratory muscles.

Adult↗
PubMed2005

Asymmetries in mouth opening during word generation in male stuttering and non-stuttering participants.

We examined lateral asymmetries in mouth opening in right-handed male stuttering (N = 11) and non-stuttering (N = 14) participants. Lateral asymmetries in mouth opening were video-recorded and analysed in participants while they generated words beginning with the bilabial phones /b, p, m/. Non-stuttering participants showed an expected preference for right mouth opening during the task, whereas a group of stuttering participants who were matched for sex and age produced a left or bilateral pattern of mouth opening. Analysis of variance revealed the difference between the groups to be significant (p < .001). However, there was more variability in the lateral mouth asymmetries in the stuttering participants. We interpret this finding as adding some support for the hypothesis that aberrant hemispheric control for speech is involved in stuttering. Asymmetric mouth openings appear to have no direct linguistic function, and we discuss the possible implications of the phenomenon for models of speech planning and programming.

Adult↗
PubMedDate not supplied

Evaluation of a vertical mouth stretching orthosis: two case reports.

Burns around the mouth frequently result in contractures or microstomia. Orthoses used in the past have usually been designed to stretch the mouth horizontally. Finding a comfortable effective way to stretch the mouth vertically proved to be a challenge. A jaw positioner was used for vertical mouth stretching in two case studies and was evaluated for effectiveness of preventing mouth contractures and for comfort, durability, ease of use, adaptability for children, and ease of measuring results. Vertical and horizontal passive range of motion increased with initial use and then was maintained in both patients. The jaw positioner was comfortable and easy to use. This orthosis could be adapted to fit in a child's mouth and was impossible to swallow. Progress was easy to monitor with the numeric scale on the orthosis. Though no single orthosis will be ideal for every oral burn, this jaw positioner is recommended for pediatric and adult patients with extensive circumoral burns who demonstrate fair to good compliance.

Burns↗
PubMed2006

Benefit of "one-stage full-mouth disinfection" is explained by disinfection and root planing within 24 hours: a randomized controlled trial.

OBJECTIVES: The beneficial effects of the one-stage, full-mouth disinfection remain controversial in the scientific literature. This might be due to the fact that an entire mouth disinfection with the use of antiseptics has been confused with a full-mouth scaling and root planing. This parallel, single blind RCT study aimed to compare several full-mouth treatment strategies with each other. MATERIAL AND METHODS: Seventy-one patients with moderate periodontitis were randomly allocated to one of the following treatment strategies: scaling and root planing, quadrant by quadrant, at two-week intervals (negative control, NC), full-mouth scaling and root planing within 2 consecutive days (FRP), or three one-stage, full-mouth disinfection (FM) protocols within 2 consecutive days applying antiseptics to all intra-oral niches for periopathogens using as antiseptics: chlorhexidine (FMCHX) for 2 months, amine fluoride/stannous fluoride for 2 months (FMF), or chlorhexidine for 2 months followed by amine fluoride/stannous fluoride for another 6 months (FMCHX+F). At baseline and after 2, 4, and 8 a series of periodontal parameters were recorded. RESULTS: All treatment strategies resulted in significant (p<0.05) improvements of all clinical parameters over the entire duration of the study. Inter-treatment differences were often encountered. The NC group nearly always showed significant smaller improvements than the two CHX groups. The differences between the FRP or FM groups, and the two CHX groups only sporadically reached a statistical significance. CONCLUSION: These observations indicate that the benefits of the "OSFMD" protocol are partially due to the use of the antiseptics and partially to the completion of the therapy in a short time.

Adult↗
PubMed1993

Oral mucosal friction and subjective perception of dry mouth in relation to salivary secretion.

Assessment of oral mucosal friction and subjective perception of dry mouth was performed during treatment with thiazide diuretic bendroflumethiazide (2.5 mg o.d.) or placebo in a randomized, double-blind, cross-over study (2 x 2 wk) in 34 healthy volunteers. Treatment with bendroflumethiazide was associated with a 10% reduction in the stimulated whole saliva secretion rate and a 15% reduction in the salivary sodium concentration, as compared with placebo. Oral mucosal friction was concomitantly measured on the buccal mucosa and on the mucosa of the lower lip by means of a newly developed sliding friction device. In addition, a questionnaire was used to evaluate how the treatment was subjectively perceived with regard to symptoms of dry mouth. Mucosal friction of the lower lip increased significantly during treatment with bendroflumethiazide, as compared with placebo. When the test subjects, regardless of pharmacologic treatment, were divided into groups according to subjective perception of dry mouth, the dry mouth group showed significantly lower resting and stimulated flow rate and higher mucosal friction in comparison to the nondry group. When, in addition, pharmacologic treatment was also considered, the differences between the dry and the nondry group were restricted to resting whole saliva flow rate and mucosal friction during bendroflumethiazide treatment. It is concluded that resting whole saliva flow rate is the best predictive factor for evaluating subjectively perceived dry mouth. However, the sensitivity of the developed sliding friction device is capable of detecting minor changes in salivary secretion rate. In addition, measurements of oral mucosal friction may serve as an easily available method to complement sialometry when evaluating, for example, drug-induced dryness of the mouth.

Adolescent↗
PubMed2005

Do custom-made mouth guards have negative effects on aerobic performance capacity of athletes?

Mouth guards are considered an essential part of equipment for athletes participating in contact sports. The purpose of this study was to evaluate the effect of custom-made mouth guards on the ventilatory gas exchange effects of taekwondo athletes. The subjects were 22 elite athletes aged between 14 and 17 years. To determine the effect of mouth guard use during exercise, oxygen consumption (VO(2)) was measured with a portable gas analysis system while an exercise tolerance test with a shuttle run test protocol was performed. Values with and without mouth guard were compared. Wilcoxon ranks test was used for the statistical analysis. The results show that wearing mouth guards has no significant effect on maximal oxygen uptake (VO(2max)), minute ventilation (VE), tidal volume (VT) and respiratory exchange ratio (RER) while performing maximal exercise (P > 0.05). In conclusion, taekwondo athletes can use custom-made mouth guards without negative effects on their aerobic performance capacity.

Adolescent↗