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PubMed1993

Validation of a 21-day, partial-mouth gingivitis model for evaluating chemotherapeutic dentifrices.

The experimental gingivitis model has long been used to evaluate chemotherapeutic agents in mouthrinses. Only recently however has the model been modified to test undiluted dentifrices by using a toothshield both to apply dentifrice and to protect selected teeth from toothbrushing. This also enables participants to brush the rest of the mouth and avoid the unpleasantness of 3 weeks without oral hygiene. Because of its well-documented efficacy, chlorhexidine was used in a toothpaste formulation to investigate the validity of the partial-mouth, experimental gingivitis model for evaluating therapeutic dentifrices. Optimal gingival health was established in 88 adults, who then were randomly assigned to two equal groups. A toothshield was constructed for each subject to fit the teeth of one mandibular quadrant. During the trial chlorhexidine or placebo dentifrice was applied undiluted to the test teeth via the toothshield, which also prevented plaque removal during brushing of the remaining dentition. After 21 days, plaque and gingivitis had developed in both groups. However, the chlorhexidine group had significantly less plaque and gingivitis than the placebo group. No adverse soft tissue effects were observed. This study demonstrated that the partial-mouth, experimental gingivitis model allowed unhindered development of plaque and gingivitis that was comparable to whole-mouth studies in which oral hygiene was suspended for 3 weeks. By corroborating with chlorhexidine, it is concluded that this short-term clinical model is valid for evaluating the chemotherapeutic effects of dentifrices.

Adolescent↗

PubMed2005

Issues in the epidemiological investigation of dry mouth.

Despite decades of research, much remains unanswered about the epidemiology of dry mouth. This review aims to provide an overview of the condition's epidemiology and the issues to consider when planning an epidemiological study of dry mouth. The latter can be broadly grouped into: study design; sampling and statistical power considerations; the measurement of dry mouth; and the selection, nature and measurement of relevant exposure measures, including medications and potential confounding variables. Each of these is discussed, in order to provide guidance for prospective researchers based on experience with past research. Finally, an agenda for further epidemiological research into dry mouth is proposed.

Aged↗

PubMed1984

Biochemical map of polypeptides specified by foot-and-mouth disease virus.

Pulse-chase labeling of foot-and-mouth disease virus-infected bovine kidney cells revealed stable and unstable viral-specific polypeptides. To identify precursor-product relationships among these polypeptides, antisera against a number of structural and nonstructural viral-specific polypeptides were used. Cell-free translations programmed with foot-and-mouth disease virion RNA or foot-and-mouth disease virus-infected bovine kidney cell lysates, which were shown to contain almost identical polypeptides, were immunoprecipitated with the various antisera. To further establish identity, some proteins were compared by partial protease digestion. Evidence for a membrane association of the polypeptides coded for by the middle genome region is also presented. A biochemical map of the foot-and-mouth disease virus genome was established from the above information.

Animals↗

PubMed1998

Randomised controlled trial of sucrose by mouth for the relief of infant crying after immunisation.

OBJECTIVES: To evaluate the effect of sucrose solution given by mouth on infant crying times and measures of distress in the immunisation clinic. DESIGN: Randomised, double blind, placebo controlled trial of sucrose solution 75% wt/vol v sterile water as a control. SETTING: The immunisation clinic of the Women's and Children's Hospital, Adelaide. PATIENTS: A total of 107 healthy infants attending for 2, 4, or 6 month immunisations with polio by mouth (Sabin), intramuscular diphtheria, tetanus, and pertussis (DTP), and intramuscular Haemophilus influenzae type b were randomised to receive 2 ml 75% sucrose solution or sterile water by mouth before the two injections. METHODS: The duration of infant crying was recorded during and immediately after two intramuscular immunisations and infant distress was assessed by a visual analogue scale (Oucher scores) independently by a nurse and a parent. RESULTS: The administration of 2 ml 75% sucrose solution by mouth reduced the infant crying time and Oucher distress scores after immunisation with DTP/H influenzae type b. CONCLUSIONS: Infant immunisation by intramuscular injection is a distressing procedure for infants and parents. Sucrose solution at a high concentration reduces infant distress and is safe and clinically useful in this setting.

Administration, Oral↗

PubMed1986

A field study of watery mouth: clinical, epidemiological, biochemical, haematological and bacteriological observations.

More than 500 cases of watery mouth in newborn lambs were recorded in 11 flocks and a detailed examination was performed in more than 200 cases. The condition occurred predominantly in lambs aged 24 to 48 hours. The incidence in a flock varied from 1 per cent to 24 per cent and the mortality in affected lambs varied from 7 per cent to 83 per cent. A bacteraemia was found in 38 per cent of the affected lambs. There were no consistent abnormalities of clinical biochemistry or haematology. Watery mouth was more common in twins and especially in triplets than in single lambs. In twins the highest incidence of watery mouth was recorded in lambs born to ewes in poor body condition. Antibiotic given orally within 15 minutes of birth greatly reduced the incidence of watery mouth.

Age Factors↗

PubMed1987

Collagen and elastin fibers in human pulmonary alveolar mouths and ducts.

To provide a quantitative basis for the understanding of the mechanical properties of the lung tissue, the morphology of the pulmonary alveolar ducts was studied and the dimensions of the collagen and elastin fiber bundles in the alveolar mouths were measured. Statistical data are presented in this report. It was found that the probability frequency functions of the widths of both the collagen and elastin fibers are skewed to the right, but the fourth roots of the widths are normally distributed. Hence, knowing the mean and standard deviation of (width)1/4, the probability of finding fiber bundles of width D is known. On the other hand, we already know the analytic expressions of the strain energy per unit length of fibers of given width. With the probability distribution of width and an estimation of the length of alveolar mouths, the strain energy of the alveolar mouths can be computed. Then the contribution of the alveolar mouths to the stress in the lung parenchyma due to any strain can be obtained by a differentiation of the strain energy function with respect to that strain.

Autopsy↗

PubMed1992

Determination of volumes of fluid in the mouth by fluoride dilution.

A dilution technique, with fluoride as a marker, has been developed to measure the volume of saliva and other fluids in the mouth. Immediately after swallowing, a small amount of fluoride solution is placed in the mouth, mixed with the oral fluids, and expelled from the mouth. The fluoride concentration of the expelled oral fluid is measured and the volume of fluid in the mouth at the time of spitting calculated from the fluoride dilution. Mean values of 0.75 +/- (SD) 0.28 ml for males and 0.72 +/- (SD) 0.16 ml for females were recorded. The accuracy of the volume determination is about +/- 0.10 ml in vivo. This technique has provided a convenient and rapid means of determining saliva volumes. It could also be used to determine rates of secretion and may prove useful in the clinic for assessing a patient's salivary competence.

Adult↗

PubMed1997

Passive immunization against dental plaque formation in humans: effect of a mouth rinse containing egg yolk antibodies (IgY) specific to Streptococcus mutans.

Passive immunization involving the delivery of antibodies specific to pathogens of infectious diseases to the host has been an attractive approach to establish protective immunity against a variety of microbial pathogens, including Streptococcus mutans, which is the principal etiologic agent of dental caries in humans. The overall purpose of the present study was to determine the effectiveness of a mouth rinse containing antibodies to S. mutans in preventing the establishment of this bacterium in dental plaque of humans. The antibodies were derived from egg yolks obtained from hens immunized with whole cells of S. mutans grown in sucrose-containing medium. The immunoglobulin derived from the yolks (IgY) of immunized hens was characterized in vitro and in vivo in human volunteers. Cross-reactivity tests showed that immune IgY reacted with every serotype, except serotype b, which had lost its GTase activity, when the bacteria were cultured in sucrose-containing medium. Immune IgY inhibited S. mutans adherence to saliva-coated hydroxyapatite discs by 59.2%, while control IgY caused an inhibition of only 8.2%. In the short-term (4-hour) test using a mouth rinse containing 10% sucrose, immune IgY decreased the ratio of the percentage of S. mutans per total streptococci in saliva. In the long-term (7-day) test using a mouth rinse without sucrose, the ratio in saliva was not significantly reduced in the volunteers using the immune IgY due to the large standard deviation. However, comparing the ratios of the percentage of S. mutans per total streptococci in plaque of individual subjects, there was a tendency for a reduction of the ratios in the volunteers receiving the mouth rinse containing immune IgY. These results support the effectiveness of IgY with specificity to S. mutans grown in the presence of sucrose as an efficient method to control the colonization of mutans streptococci in the oral cavity of humans.

Antibodies, Bacterial↗

PubMed2005

Effectiveness of saliva substitute products in the treatment of dry mouth in the elderly: a pilot study.

The aging population is susceptible to developing dry mouth (xerostomia). Elderly patients present all of the major risk factors to acquiring dry mouth which include systemic diseases and disorders, such as diabetes and depression, and the use of numerous medications, including anti-hypertensives and anti-depressants. The consequences of untreated dry mouth are severe limitations of masticatory function and speech, and increased risk of developing caries, periodontal diseases and fungal infections. Assessment of xerostomia, which includes a set of signs and symptoms that impact on the individual, can only be fully explored through a thorough medical history, intra-oral examination and recording the subjective views of patients. This study suggests a methodology for the assessment of xerostomia through a xerostomia questionnaire, which was used to evaluate the effectiveness and acceptability of a saliva substitute product (Biotène) in the treatment of xerostomia in 20 elderly patients exhibiting both severe and moderate symptoms. Wilcoxon signed-ranked tests revealed significant improvements in the number and severity of symptoms between the pre-test and the post-test groups. Biotène products were also found to be effective in the treatment of both severe and moderate symptoms of xerostomia. Biotène saliva substitutes are an acceptable and effective method of treatment for elderly people suffering from dry mouth.

Aged↗

PubMed2006

Full-mouth tooth extraction lowers systemic inflammatory and thrombotic markers of cardiovascular risk.

Prior studies of a link between periodontal and cardiovascular disease have been limited by being predominantly observational. We used a treatment intervention model to study the relationship between periodontitis and systemic inflammatory and thrombotic cardiovascular indicators of risk. We studied 67 adults with advanced periodontitis requiring full-mouth tooth extraction. Blood samples were obtained: (1) at initial presentation, immediately prior to treatment of presenting symptoms; (2) one to two weeks later, before all teeth were removed; and (3) 12 weeks after full-mouth tooth extraction. After full-mouth tooth extraction, there was a significant decrease in C-reactive protein, plasminogen activator inhibitor-1 and fibrinogen, and white cell and platelet counts. This study shows that elimination of advanced periodontitis by full-mouth tooth extraction reduces systemic inflammatory and thrombotic markers of cardiovascular risk. Analysis of the data supports the hypothesis that treatment of periodontal disease may lower cardiovascular risk, and provides a rationale for further randomized studies.

Adult↗

PubMed2004

Developing a strategy to improve ventilation in an unprotected airway with a modified mouth-to-bag resuscitator in apneic patients.

The strategies to ensure safety during ventilation of an unprotected airway are limiting airway pressure and/or inspiratory flow. In this prospective, randomized study we assessed the effect of face mask ventilation with small tidal volumes in the modified mouth-to-bag resuscitator (maximal volume, 500 mL) versus a pediatric self-inflatable bag versus automatic pressure-controlled ventilation in 40 adult apneic patients during induction of anesthesia. The mouth-to-bag resuscitator requires the rescuer to blow up a balloon inside the self-inflating bag that subsequently displaces air which then flows into the patient's airway. Respiratory variables were measured with a pulmonary monitor (CP-100). Mouth-to-bag resuscitator and pressure-controlled ventilation resulted in significantly lower (mean +/- sd) peak airway pressure (8 +/- 2 and 8 +/- 1 cm H(2)O), peak inspiratory flow rate (0.7 +/- 0.1 and 0.7 +/- 0.1 L/s), and larger inspiratory time fraction (33% +/- 5% and 47% +/- 2%) in comparison to pediatric self-inflating bag ventilation (12 +/- 3 cm H(2)O; 1 +/- 0.2 L/s; 27% +/- 4%; all P < 0.001). The tidal volumes were similar between groups. No stomach inflation occurred in either group. We conclude that using a modified mouth-to-bag resuscitator or automatic pressure-controlled ventilation with similar small tidal volumes during face mask ventilation resulted in an approximately 25% reduction in peak airway pressure when compared with a standard pediatric self-inflating bag.

Adult↗

PubMed1993

Dynamic control of cell-cell adhesion and membrane-associated actin during food-induced mouth opening in Beroë.

We used rhodamine-phalloidin and ultrastructural methods to follow dynamic changes in adhesive cell junctions and associated actin filaments during reversible epithelial adhesion in the mouth of the ctenophore Beroë. A cruising Beroë keeps its mouth closed by interdigitated actin-coated appositions between paired strips of cells lining the lips. The mouth opens rapidly (in 0.2-0.3 s) by muscular action to engulf prey (other ctenophores), then re-seals after ingestion. We found that the interlocking surface architecture of the adhesive cells, including the actin-coated junctions, rapidly disappears after food-induced opening of the mouth. In contrast, forcible separation of the lips in the absence of food rips the junctions, still intact, from the surfaces of the cells. The prey-stimulated loss of adhesive cell junctions and associated actin cytoskeleton is one of the most rapid changes in actin-based junctions yet observed. This system provides unique experimental advantages for investigating the dynamic control of reversible cell adhesions and membrane-associated actin filaments.

Actins↗

PubMed1994

Protective equipment as treatment for stereotypic hand mouthing: sensory extinction or punishment effects?

We examined the effects of noncontingent and contingent protective equipment as treatment for self-injurious hand mouthing exhibited by 2 individuals with profound mental retardation. Results of a functional analysis assessment revealed that neither subject's self-injury was maintained by social reinforcement: One subject's self-injury was cyclical in nature; the other's occurred during all assessment conditions but most frequently when left alone. In the noncontingent-equipment condition, oven mitts were placed on the individual's hands at the beginning of a session and remained on throughout. In the contingent-equipment condition, the mitts were briefly placed on the individual's hands following occurrences of hand mouthing. For 1 subject, noncontingent mitts produced a large decrease in the rate of hand mouthing and contingent mitts produced similar results following a return to baseline. Hand mouthing was also reduced in the 2nd subject, but this individual was exposed only to the contingent-equipment condition (i.e., there was no prior history with the noncontingent-equipment condition). These results suggest either a punishment or a time-out interpretation rather than an extinction interpretation to account for the behavior-reducing effects of contingent protective equipment on self-injury.

Adult↗

PubMed1998

Utilizing increased response effort to reduce chronic hand mouthing.

The effects of increased response effort on levels of hand mouthing, leisure engagement, and adaptive elbow flexion were investigated with 2 individuals who had been diagnosed with profound disabilities. Arm restraints designed to alter the amount of physical effort necessary to engage in hand mouthing were used. Results indicated that the treatment strategy reduced levels of hand mouthing but produced only small to moderate reductions in levels of leisure engagement and adaptive elbow flexion. At follow-up, the effects of increased response effort on hand mouthing and leisure engagement were maintained for both participants; however, the restraints were associated with substantial reductions in adaptive elbow flexion for 1 participant.

Adaptation, Psychological↗

PubMed1996

Full- versus partial-mouth disinfection in the treatment of periodontal infections. Long-term clinical observations of a pilot study.

A classical treatment for chronic adult periodontitis consists of four to six consecutive sessions of scaling and root planing at a 1- to 2-week interval. Such a so-called "quadrant or sextant therapy" might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of this study was to investigate, over an 8-month period, the clinical benefits of full-mouth disinfection within a 24-hour period in the control of chronic periodontitis. Ten adult patients with advanced chronic periodontitis were randomly assigned to a test and a control group. The control group received the standard scheme of initial periodontal therapy, consisting of scaling and root planing of the four quadrants was performed within 24 hours and immediately followed by a thorough supra- and subgingival chlorhexidine application to limit any transfer of bacteria. The latter involved tongue brushing with a 1% chlorhexidine gel for 60 seconds, mouthrinsing with a 0.2% chlorhexidine solution twice for 60 seconds, repeated subgingival irrigation of all pockets with a 1% chlorhexidine gel (3 times within 10 minutes), and mouthrinsing twice daily with a 0.2% chlorhexidine solution during 2 weeks. In addition, both groups received thorough oral hygiene instructions. The plaque index, gingival index, probing depth, gingival recession, and bleeding on probing were recorded prior to professional cleaning and at 1, 2, 4, and 8 months afterwards. Although the test group scored higher plaque indices than the control group, especially at months 2 and 4, the gingival index and bleeding tendency showed similar improvements with time. However, when the gingival/plaque ratio was considered, the latter was lower in the test group at all follow-up visits. For pockets > or = 7 mm, full-mouth disinfection showed a significantly (P = 0.01) higher reduction in probing depth at each follow-up visit with, at month 8, a reduction of 4 mm (from 8 mm to 4 mm), in comparison to 3 mm (from 8 mm to 5 mm) for the classical therapy. The increase in gingival recession in the full-mouth disinfection group remained below 0.7 mm, while in the control group it reached 1.9 mm after 8 months. This resulted in a gain of clinical attachment level of 3.7 mm for the test group versus 1.9 mm for the control group. A radiographical examination also indicated a superior improvement for the test group when compared to the control group. This pilot study suggests that a full-mouth disinfection in one day results in an improved clinical outcome in chronic periodontitis as compared to scalings per quadrant at 2-week intervals over several weeks.

Adult↗

PubMed1999

One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. I. Long-term clinical observations.

BACKGROUND: A standard treatment strategy for periodontal infections often consists of 4 consecutive sessions of scaling and root planing (per quadrant, at 1- to 2-week intervals), without proper disinfection of the remaining intra-oral niches for periodontopathogens. This could theoretically lead to a reinfection of previously disinfected pockets by bacteria from an untreated region/niche. This study aimed to investigate, over an 8-month period, the clinical benefits of a one stage full-mouth disinfection in the control of severe periodontitis. METHODS: Sixteen patients with early-onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups. The control group was scaled and root planed, per quadrant, at 2-week intervals and given standard oral hygiene instructions. A one stage full-mouth disinfection (test group) was sought by scaling and root planing the 4 quadrants within 24 hours in combination with the application of chlorhexidine to all intra-oral niches for periodontopathogens. Besides oral hygiene, the test group also rinsed twice daily with a 0.2% chlorhexidine solution and sprayed the tonsils with a 0.2% chlorhexidine spray, for 2 months. The plaque index, gingival index, probing depth, bleeding on probing, gingival recession, and clinical attachment level were recorded at baseline and at 1, 2, 4, and 8 months afterwards. RESULTS: The one stage full-mouth disinfection resulted, in comparison to the standard therapy, in a significant (P <0.001) additional probing depth reduction and gain in attachment up to 8 months. For initial pockets > or =7 mm, the "additional" probing depth reduction at the 8 month follow-up was 1.2 mm for single-rooted and 0.9 mm for multi-rooted teeth, with corresponding additional gains in attachment of 1.0 mm and 0.8 mm, respectively. The additional improvements were observed for all subgroups (adult periodontitis, generalized early-onset cases, smokers), with the largest differences in the non-smoking adult periodontitis patients. CONCLUSIONS: These findings suggest that a one stage full-mouth disinfection results in an improved clinical outcome for the treatment of chronic adult or early-onset periodontitis as compared to scaling and root planing per quadrant at 2-week intervals.

Adult↗

PubMed2007

Use of three-dimensional computed tomography for diagnosis and treatment planning for open-mouth jaw locking in a cat.

CASE DESCRIPTION: A 2.5-year-old spayed female Persian cat was evaluated for acute inability to close its mouth. CLINICAL FINDINGS: A wry-mouth malocclusion was evident, and the right side of the mandible was longer than the left side. The right mandibular tooth row appeared to be lowered. The lower jaw was persistently maintained in an open position. The presumptive diagnosis was open-mouth jaw locking. Diagnostic imaging with computed tomography and 3-dimensional reconstruction was performed for definitive diagnosis and to achieve a better understanding of the lesions. Imaging revealed locking of the right ramus of the mandible, which was displaced ventrolaterally, causing the coronoid process to impinge on the right zygomatic arch. TREATMENT AND OUTCOME: A bilateral partial ostectomy of the rostroventral margins of the zygomatic arches with an autogenous fat graft implantation was performed. The cat recovered without complications and by the following morning was bright, alert, and responsive and eating canned cat food comfortably. One year after surgery, the owner reported that the cat had continued to function well, was eating normally, and had not had any observed locking episodes since surgery. CLINICAL RELEVANCE: Unlike radiographic imaging, computed tomography may be used to create 3-dimensional reconstructions of structures in cases of suspected open-mouth jaw locking; improve evaluation of the lesions; and improve decision-making and client education for diagnosis, treatment options, and prognosis.

Animals↗

PubMed1994

A comparison of "closed" and "open" mouth techniques of inhalation of a salbutamol metered-dose inhaler.

To compare two techniques of inhalation of a salbutamol metered-dose inhaler--"closed" mouth (keeping the actuator between the lips) and "open" mouth (placing the actuator a few centimeters in front of the open mouth)--50 asthmatics were tested with both methods. Twenty-seven patients completed the study. The baseline FEV1 on the 2 test days was similar. Inhalation of salbutamol by both techniques resulted in a significant and similar degree of bronchodilatation. The majority of patients preferred the closed-mouth technique.

Administration, Inhalation↗